Beliefs about surgery: Development and validation of an instrument to assess cognitive representations about surgery,in the context of a chronic illness

Objectives: Within a trial of medical and surgical treatments for gastro-esophageal reflux disease (GORD), involving randomised arms and preference arms, we tested the applicability of the Beliefs about Medicines Questionnaire (BMQ) and developed and tested the validity of a new Beliefs about Surgery Questionnaire (BSQ). Methods: Patients with GORD (N = 43) were interviewed to elicit their beliefs about medical and surgical treatments. These contributed to the development of BSQ items. The BMQ and BSQ were completed by trial participants at baseline (randomised trial: N = 325; preference trial: N = 414). Factor analysis and discriminant function analysis were used to assess validity. Results: Principal components analysis (PCA) largely replicated the four-factor BMQ structure. PCA of the combined BMQ/BSQ yielded six factors explaining 54.5% variance. BSQ items loaded onto distinct factors, demonstrating divergence from BMQ. As predicted, BMQ/BSQ scores enabled correct classification of 78.5% of participants to medication and surgery groups in the preference trial (χ²(6) = 205.9, p < 0.001) but only 54.5% (no better than chance) in the randomised trial (χ²(6) = 9.4, p = 0.154). Conclusions: The BSQ is a valid measure of perceptions about surgical treatments for GORD. With the BMQ, it provides information that may guide patients’ choices about treatment. This measure may be applicable to other conditions.     

Constructs to describe individual knowledge / Constructos para describir el conocimiento individual

Abstract

The basic unit of any cognitive model that attempts to describe individual knowledge and its manifestations must be chosen carefully, as the resulting position on learning, teaching and, in general, of the psychological research subject depends largely on this choice. The objective is to assess and contrast two constructs of enormous significance in cognitive psychology that have been used as cognitive units under different theoretical contexts: the concept in its classical sense, and the scheme in its organismic version. Arguments are presented to show that the latter is more consistent with constructivist assumptions and is more respectful of psychological data such as the Gestalt and prototype effects or the existence of procedural and implicit knowledge.     

Patrón de Conducta Tipo A y antecedentes familiares de hipertensión: un estudio psicofisiológico

Resumen

En este estudio se evaluaron los efectos del Patrón de Conducta Tipo A y los antecedentes familiares de hipertensión en diversos parámetros cardiovasculares, conductuales y subjetivos de la respuesta de estrés.

Con este fin, 100 sujetos (50 varones y 50 mujeres) participaron en tareas de esfuerzo mental con control vs. no control. Las diferencias entre sujetos A y B se manifestaron en una mayor amplitud del pulso en los primeros. La mayor reactividad en Tasa Cardiaca se observó entre los sujetos con antecedentes familiares de hipertensión, mientras que la presión sanguínea sistólica se vio condicionada por la interacción de dichos antecedentes con el Patrón de Conducta Tipo A. Finalmente, los componentes cardiovasculares, subjetivos y conductuales de la respuesta de estrés confirmaron la motivación por el control de dichos sujetos descrita en la literatura.     

COMPREHENSION MONITORING IN GOOD AND POOR READERS: EVIDENCE FROM VERBAL AND PERFORMANCE MEASURES

The present study examined the ability of second grade good and poor readers to monitor their comprehension of inconsistent texts. Comprehension monitoring was assessed by both a performance measure (underlining inconsistencies) as well as verbal measures (ratings of passage comprehensibility and liking). Because poor readers equate adequate comprehension with accurate decoding, while good reader equate adequate comprehension with accurately deriving the meaning of a text, it was expected that performance and verbal measures of comprehension monitoring would be related for good but not for poor readers. As predicted, self‐reports of comprehension and liking were highly related to the performance measure of error detection for good readers but not for poor readers. The implications of these results for assessing comprehension monitoring ability are discussed.     

The Gender Pay Gap: Challenging the Rationalizations. Perceived Equity, Discrimination, and the Limits of Human Capital Models

A gender gap in earnings has proven both persistent and universal. This paper relies mainly on U.S. data, but a gap between women’s and men’s earnings exists in every country. There is a continuing debate as to the extent to which the gap reflects merely the inevitable and reasonably fair result of differing work patterns and behaviors by women and men or the impact of employment discrimination against women. The human capital approach, in which various explanatory variables are used to shrink the perceived size of the gap, is often used to argue that much of the gap is due, not to discrimination, but to differing investments in employment by women and men. However, neither “investments” nor “outcomes” can be assessed in gender-neutral ways and the model’s underlying notion of rational choices made against the backdrop of a gender-neutral playing field is flawed. Discrimination appears to be entwined with gendered work patterns and behaviors; many of the human capital “explanatory” variables themselves require explanation. Understanding the gap requires recognition of the limitations of human capital models, and a willingness both to take a more sophisticated approach to such models, and to think beyond this approach.     

The Waiting Room: Ontological Homelessness, Sexual Synecdoche, and Queer Becoming

An autobiographical reflection on the experience of being diagnosed as intersex, this essay considers the waiting room an apt metaphor for lives shaped by medical understandings of queer corporealities. Drawing upon the work of Gayle Salamon, Malatino develops the concept of sexual synecdoche as a useful analytic tool for considering the operations of medical pathologization in the realm of non-normative gender. She concludes with a discussion of queer becoming as an alternative ontology of gendered being that offers a resistant, coalitional way beyond contemporary, problematic institutionalized understandings of intersex subjectivities.     

In the Name of Psychoanalysis: Persistent Controversies and Evolution in Psychoanalysis: A Review of Impossible Training: A Relational View of Psychoanalytic Education by Emanuel Berman

In his book Impossible Training, Emanuel Berman stresses the historical roots of current standards of psychoanalytic training and demonstrates the persistence of controversies that have been present in psychoanalysis and psychoanalytic training from their inception. This perspective, of psychoanalysis and psychoanalytic education as evolving, encourages candidates and practitioners to be participants and creative voices in an evolving field rather than rote followers learning a trade. The author proposes ways that the transference of educators to the younger generation of psychoanalysts can facilitate or interfere with the training of candidates. Berman is applauded for shedding light on current controversies in psychoanalytic education by showing their roots in historical controversies. However, the author points out Berman's tendency to overvalue his side of the controversy rather than embrace controversy itself as in the best interest of the evolution and development of the field.     

The Role of Mental Rigidity and Alcohol Consumption Interaction on Intimate Partner Violence: A Spanish Study

Intimate partner violence (IPV) has often been linked to alcohol consumption. Alcohol abuse affects cognitive processing through its effects on the prefrontal cortex, generating influence in mental rigidity (MR). This study analyzes the influence of MR as a predisposing factor to violence. The sample consisted of 136 men with a history of IPV. Participants with high MR had lower empathy and perception of the severity of IPV, and higher alcohol consumption and hostile sexism than participants with lower MR. These results should be considered in the development of prevention and intervention programs with the goal of increasing their effectiveness.     

How central are judgment and agency to epistemology?

Ernest Sosa’s Judgment and Agency marks an important change from his earlier work in epistemology. While belief was at the center of his earlier approach to epistemological issues, a far more sophisticated mental state, judgment, plays the central role here. This paper examines the significance of this change in focus, and argues that there is reason to favor the earlier belief-centered approach over this new judgment-centered account.     

Effects of outcome and trial frequency on the inverse base-rate effect

The inverse base-rate effect is a bias in contingency learning in which participants tend to predict a rare outcome for a conflicting set of perfectly predictive cues. Although the effect is often explained by attention biases during learning, inferential strategies at test may also contribute substantially to the effect. In three experiments, we manipulated the frequencies of outcomes and trial types to determine the critical conditions for the effect, thereby providing novel tests of the reasoning processes that could contribute to it. The rare bias was substantially reduced when the outcomes were experienced at equal rates in the presence of predictive-cue frequency differences (Exp. 2), and when the predictive cues were experienced at equal rates in the presence of outcome frequency differences (Exp. 3). We also found a consistent common-outcome bias for novel cue compounds. The results indicate the importance of both cue and outcome frequencies to the inverse base-rate effect, and reveal a combination of necessary conditions that are not well captured by appealing to inferential strategies at test. Although both attention-based and inferential theories explain some aspects of these data, no existing theory fully accounts for these effects of relative novelty.