Remembering Numbers in Old Age: Mnemonic Training Versus Self-Generated Strategy Training

The effectiveness of two memory training programs designed to enhance four-digit number recall was examined in 90 healthy older adults. One group received instruction and training in the number-consonant mnemonic, whereas another group was instructed to adopt their own encoding and retrieval strategies to enhance number recall. Also, a control group receiving no training between testing occasions was included. The criterion task was administered according to the Buschke selective reminding procedure. Posttest performance was evaluated with and without cognitive support for remembering (i.e., verbal cues). Under unsupported conditions, the mnemonic group improved number recall following training and the self-generated strategy group showed a tendency in the same direction. When support was provided, group differences in favor of the two training groups increased. In addition, no training-related gains were observed in two verbal transfer tasks. The relatively similar patterns of gains in the two intervention groups were discussed in terms of advantages and disadvantages in the two training regimens balancing each other.     

The moral psychology of rationing among physicians: the role of harm and fairness intuitions in physician objections to cost-effectiveness and cost-containment

Introduction

Physicians vary in their moral judgments about health care costs. Social intuitionism posits that moral judgments arise from gut instincts, called “moral foundations.” The objective of this study was to determine if “harm” and “fairness” intuitions can explain physicians’ judgments about cost-containment in U.S. health care and using cost-effectiveness data in practice, as well as the relative importance of those intuitions compared to “purity”, “authority” and “ingroup” in cost-related judgments.

Methods

We mailed an 8-page survey to a random sample of 2000 practicing U.S. physicians. The survey included the MFQ30 and items assessing agreement/disagreement with cost-containment and degree of objection to using cost-effectiveness data to guide care. We used t-tests for pairwise subscale mean comparisons and logistic regression to assess associations with agreement with cost-containment and objection to using cost-effectiveness analysis to guide care.

Results

1032 of 1895 physicians (54%) responded. Most (67%) supported cost-containment, while 54% expressed a strong or moderate objection to the use of cost-effectiveness data in clinical decisions. Physicians who strongly objected to the use of cost-effectiveness data had similar scores in all five of the foundations (all p-values?>?0.05). Agreement with cost-containment was associated with higher mean “harm” (3.6) and “fairness” (3.5) intuitions compared to “in-group” (2.8), “authority” (3.0), and “purity” (2.4) (p?<?0.05). In multivariate models adjusted for age, sex, region, and specialty, both “harm” and “fairness” were significantly associated with judgments about cost-containment (OR?=?1.2 [1.0-1.5]; OR?=?1.7 [1.4-2.1], respectively) but were not associated with degree of objection to cost-effectiveness (OR?=?1.2 [1.0-1.4]; OR?=?0.9 [0.7-1.0]).

Conclusions

Moral intuitions shed light on variation in physician judgments about cost issues in health care.

     

Therapy for the Dead: Working Clinically with Jung's Black Books and The Red Book

With the 2020 publication of the facsimile edition of The Black Books, we have an opportunity to study the layers of C. G. Jung's creative writing process for the first time. In this paper, I explore Jung's practice of active imagination in relation to his fantasy dialogues with the dead during two specific episodes in 1914 and 1916. I discuss Jung's concept of the collective unconscious corresponding to the “mythic land of the dead” and I show how this idea develops in The Black Books and The Red Book, or Liber Novus, culminating in Septem Sermones ad Mortuos. I describe my work with a patient, who, in an early session, said she felt like the "living dead". I recount how the patient's experience of her own internal world began to change as we were able to wonder about the inner world of the patient's late mother and, together, to imagine her mother's lament. I consider the use of imagination when working with the concept of "therapy for the dead" (Hillman & Shamdasani, 2013, p. 164) in the context of intergenerational trauma.     

Executive dysfunction in autism

"Executive function" is an umbrella term for functions such as planning, working memory, impulse control, inhibition and mental flexibility, as well as for the initiation and monitoring of action. The primacy of executive dysfunction in autism is a topic of much debate, as are recent attempts to examine subtypes of executive function within autism and other neurodevelopmental disorders that are considered to implicate frontal lobe function. This article will review cognitive behavioural studies of planning, mental flexibility and inhibition in autism. It is concluded that more detailed research is needed to fractionate the executive system in autism by assessing a wide range of executive functions as well as their neuroanatomical correlates in the same individuals across the lifespan.     

Healing Rituals for Couples Recovering from Adultery

Recovery from the trauma of adultery is a process that is full of points where the couple can get stuck. We describe an experiential model that utilizes healing rituals. We start with a general exploration of the use of rituals in marriage and family therapy. The key elements of effective rituals are described. We describe stuck points in these relationships including: 1) knowing the details, 2) releasing the anger, 3) showing commitment, 4) rebuilding trust, and 5) rebuilding the relationship. Ritualized interventions are described for each of these stuck points.     

Distinguishing the cognitive and behavioral consequences of attitude importance and certainty: A new approach to testing the common-factor hypothesis

Some published factor analyses have suggested that attitude importance and certainty are distinct psychological constructs, but other factor analytic investigations have suggested they are largely redundant reflections of a more general underlying construct. This latter sort of finding has led investigators to average measures of importance and certainty together into a composite index and then explore its cognitive and behavioral consequences. In this paper, we report three studies gauging the underlying structure of these strength-related attitude attributes by assessing whether they in fact relate in the same ways to information processing and action tendencies. We found that importance and certainty both independently predicted the likelihood that a person attempted to persuade others to adopt his or her attitude. Importance (but not certainty) was associated with the tendency to seek out information that would enable people to use their attitudes in a subsequent judgment and only importance predicted whether or not they turned out to vote in an election to express their attitudes. Certainty (but not importance) was related to the tendency to find more than one political candidate acceptable. And importance and certainty interacted to predict the frequency with which people performed attitude-expressive behaviors. All this suggests that importance and certainty have distinct effects on thinking and behavior and supports the maintenance of conceptual and empirical distinctions between them in social psychological theory building.     

The Effect of Later Life Parental Divorce on Adult‐Child/Older‐Parent Solidarity: A Test of the Buffering Hypothesis1

The present study examined the effect of later life parental divorce on solidarity in the relationship between the adult child and older parent. This examination was achieved by testing the buffering hypothesis. A cross‐sectional quasiexperimental pre‐post treatment design was used (Cook & Campbell, 1979), with retrospective pretests and data from 100 adult‐child/older‐parent dyads. The ANOVA results show that the mother/adult‐child relationship with a higher degree of predivorce solidarity responded to later life parental divorce with less disruption of affectional solidarity and associational solidarity than those with a lower degree of predivorce solidarity. Thus, the current research provides modest evidence (for the mother/adult‐child relationship) to support the buffering hypothesis. We found no evidence of a buffering effect for the father‐child relationship.