Patient Adherence With Medical Treatment Regimens: An Interactive Approach

Inadequate patient adherence to treatment regimens is a ubiquitous problem in health care and carries a profound personal, societal, and economic cost. This article illustrates a general theoretical framework we believe to be useful for the interpretation, conception, and design of adherence research. The core tenet of this framework is that factors that influence adherence can be better understood by considering the interactive effects of patients' characteristics, type of adherence intervention, and characteristics of the illness and medical treatment context. This framework represents an extension and application of previous theory and research from personality, social, and clinical psychology concerning the value of an interactionalist perspective. We illustrate the framework using some of our past work involving treatment adherence among patients with chronic renal failure.     

Maintaining Life Satisfaction: The Role of Positive Cognitive Bias

Recent research into population standards of life satisfaction has revealed a remarkable level of uniformity, with the mean values for Western populations clustering at around three-quarters of the measurement scale maximum. While this seems to suggest the presence of a homeostatic mechanism for life satisfaction, the character of such a hypothetical device is uncertain. This paper proposes that well-being homeostasis is controlled by positive cognitive biases pertaining to the self. Most particular in this regard are the positive biases in relation to self-esteem, control and optimism. Past controversies in relation to this proposition are reviewed and resolved in favour of the proposed mechanism. The empirical data to support this hypothesis are discussed in the context of perceived well-being as an adaptive human attribute.     

Infantile stimulation and its effects on frustration- and fear-motivated behavior in rats

Infant rats that were either removed from the nest each day (handled) or left undisturbed (nonhandled) were, in adulthood, given 72 food-reinforced runway acquisition trials followed by 24 trials of extinction training with or without shock. Handled and nonhandled control animals were given runway training without food reinforcement. Reinforced rats ran faster than nonreinforced rats, and handled rats ran faster than nonhandled rats during the initial trials of runway acquisition irrespective of the reinforcement condition. Nonhadled rats stopped running sooner than handled rats when shock was introduced in the goalbox, but differences between handled and nonhandled rats given extinction training without shock were small. Results of a second experiment showed no differences between handled and non-handled rats in the magnitude of the depression effect after an incentive shift. It was concluded that infantile handling had little effect on frustration-motivated behavior, but did affect fear-motivated behavior.     

The Marriage Contract

This article is intended to serve as an introduction to the concept of the marriage contract, which has proved to be a useful clinical tool for clarification and treatment of troubled marriages. Transactional as well as intrapsychic factors are important aspects of marital dynamics. The contract concept employs both these behavioral parameters and facilitates therapeutic intervention at both levels.     

Children's interpretation of adult nonreaction: A trial-by-trial self-report assessment and evidence for contrast effects in an observational context

The study investigated children's interpretation of blank reaction (nonreaction) from one adult to another as a function of its pairing with positive or negative overt feedback. Each child watched through a one-way mirror as an evaluating adult provided feedback to a second adult who was performing on a two-choice discrimination task. After six initial blank reaction trials, children observed one of four types of feedback combinations over 60 experimental trials: (a) right feedback on some trials and blank reactions on others, (b) wrong feedback on some trials and blank reactions on others, (c) right, wrong, and nonreaction on different trials, or (d) nonreaction on all trials. There was little evidence that children consistently interpreted blank reaction as meaning right independent of feedback combination. In contrast, in the Right-Blank and Wrong-Blank feedback combinations, children interpreted blank as meaning the opposite of the overt feedback it was paired with on over two-thirds of the trials, with no sex differences or test anxiety effects.