Recall by expert medical practitioners and novices as a record of processing attention

Using recall of clinical protocols as a measure of expertise in medicine has yielded disappointingly small effects. Experiments using recall of clinical laboratory data are presented to provide an explanation. In one experiment, subjects either deliberately memorized or first diagnosed and then were incidentally asked for memory. With incidental instructions, experts recalled over twice as much data as did students, but with memorization instructions, student performance approximated that of experts. Experts also showed a large advantage over students in incidental recall of data that were not relevant to the problem solution. These results suggest that expert processing in this "discrete, independent inputs" domain requires effortful analysis with minimal reliance on default values, rather than relatively effortless pattern perception reported in highly visual areas of expertise. For this area, intentional memory is a misleading measure of expertise. However, incidental memory is a valuable measure of processing during diagnosis.     

Chest pain without coronary artery disease: An exploratory comparison with panic disorder

Recent reports have indicated similarities between patients with persistent chest pain of nonorganic origin and patients with panic disorder. In order to explore this association further, we administered a structured interview and three self-report measures (State-Trait Inventory, Beck Depression Inventory, and SCL90-R) to three subject groups: (1) a sample with persistent chest pain (CP; n=14) who had been screened and found to have normal coronary arteries, (2) a sample of patients with panic disorder (PD; n=14), and (3) a sample of matched normals (n=14). CP patients were considered to be free of coronary artery disease (CAD) following normal cardiac catheterization and/or normal thallium stress tests and were not diagnosed initially with panic disorder. PD patients were diagnosed with a standardized psychiatric interview and were free of organic causes of panic. Using an exploratory data analytic approach, the results indicated that both CP and PD samples reported increased levels of state and trait anxiety (p <.0001), depression (p <.01), and somatization (p <.0001) compared with normals. CP patients differed from PD patients in their less frequent use of anxiolytic medication (p <.01) and lower levels of reported panic anxiety and phobic avoidance (p <.0001). These data suggest that persistent chest pain in the absence of CAD shares some features with panic disorder, yet differs from panic in key ways as well. The results are discussed in light of the role of anxiety in contributing to symptom labeling.This research was supported by Grant 86G-491 from the American Heart Association, Texas Affiliate, to J.G.B. H.T. is the recipient of USPHS Research Career Development Award K04-HL-0122246.     

Lesbian Partner Abuse: Implications for Therapists

Silence surrounds the issue of lesbian battering. Lesbian victims of partner abuse are even less likely than are their heterosexual counterparts to seek help in shelters or from counselors because of the overlay of homophobia that exists both in the battered women's movement and among mental health professionals. In addition, many lesbian and many lesbian-supportive therapists hold an idealized and unrealistic picture of the nature of lesbian relationships, leading them to deny the existence of buttering among lesbian couples. The nature, severity, and prevalence of abuse in lesbian relationships is addressed; current counseling and treatment models dealing with battering relationships are analyzed; and a counselor advocacy model for working with lesbian partner abuse, drawing from the experience of activists in the battered women's movement and our clinical experience, is suggested.     

Why Are Self-Disclosing Counselors Attractive?

Despite much evidence that counselor self-disclosure tends to be favorably received by clients, it is unclear which component is more influential: the act of revealing personal information or the information itself, especially when it implies client-counselor similarity. Based on the social influence model, we contrasted, in a quasicounseling analogue, (a) counselors who disclosed personal material that was similar to the client's problem, (b) counselors who disclosed problematic but irrelevant information, (c) counselors who disclosed nothing, and (d) counselors whose similarity to the client was revealed by someone else. Results show no differential effects on participants' perceptions of the counselor, but postresearch structured interviews indicated that both the disclosures and the similarity information had a considerable impact on participants' experience as clients during the counseling session.     

Self-Involving Versus Self-Disclosing Counselor Statements During an Initial Interview

This study examined the hypothesis that positive self-involving and self-disclosing counselor responses would be rated more favorably by subjects than negative self-involving and self-disclosing counselor responses (Andersen & Anderson, 1985). The differential effectiveness of the counselor responses during the initial interview was discussed, and some implications of the findings for counseling practice were considered.     

Twenty-four-hour sleep-wake patterns in a nursing home population

Sleep-activity patterns were objectively recorded over a 24-hr period in 19 elderly nursing home residents. On average, both sleep and wake times were observed during every hour of the 24 recorded hours; however, the sleep pattern of the residents was fragmented so that they rarely experienced even a single hour of consolidated time spent sleeping. It is hypothesized that several independent factors, including compensation for lost sleep, increased total time in bed, weakening of social constraints, and deterioration of the circadian sleep-wake rhythm, are interacting to produce this increase in sleep fragmentation.     

Age differences in memory performance and memory ratings as measured in a sample survey

Age differences in memory performance were studied in a probability sample of a cross-section of 1,491 adults living in the Detroit metropolitan area, with an oversample of those age 60 and older. Both a recall and a recognition measure were adapted to the survey context by querying respondents about the nature of the questions asked in an immediately preceding interview. Subjective memory assessment was also measured, using global memory ratings performed by the respondent, his or her spouse, and the interviewer. A clear, age-related decline in memory performance was found in this population sample. Subjective memory assessment also declined across age groups, but the relation was weaker. On the basis of multiple regression analyses of the recognition measure and the respondent's self-rated memory, which were judged to have the best measurement qualities, a substantial part of these age differences can be accounted for by differences in sociodemographic composition between age groups, by cognitive functioning and physical health.     

Age deficits in recall under optimal study conditions

Young and older adults studied lists of words under both standard and optimal study conditions for subsequent free recall. Under optimal conditions, the participants studied each word for as long as they wished, were allowed to take notes, and were encouraged to actively use whatever strategies they thought would maximize recall. Both age groups recalled more words under optimal study conditions than under standard conditions, but the improvement was greater for the young adults. This increase in the age-related recall deficit was not due to differences in study time. The results suggest that standard laboratory memory tasks do not overestimate the memory deficits of older adults because of a failure to provide either optimal learning conditions or sufficient study time.     

A perceived control intervention for at-risk older adults

Models of event causation and affective processes were used to design an experimental intervention for older adults. Ss were 2 at-risk populations, recently disabled and recently bereaved, each with matched nonrisk controls. Ss were randomly assigned to a placebo-contact group, a no-contact control group, or a 4-session, 10-week intervention focused on enhancing perceived control. Dependent variables assessed were personal mastery, psychological well-being and distress, positive and negative affect, and measures of daily events and activities. The intervention was nested within a 16-month longitudinal assessment of stress and adaptation processes in a large sample of community residents. The intervention had mixed effects on reports of personal mastery, but it significantly increased engagement in desirable activities and significantly decreased psychological distress and negative affect. Effects tended to be short-lived, however. Effects of the intervention tended to be particularly significant for the disabled group.     

Task-unrelated-thought frequency as a function of age: a laboratory study

Using retrospective reports, Giambra (1977-1978, 1979-1980) found an inverse relation between age and daydreaming/mind wandering. To deal with an alternate explanation of these results based on age-dependent memorial deficiencies and attitudes toward daydreaming/mind wandering and to provide independent convergent validity, five experiments were carried out. Task-unrelated thoughts (TUTs) were taken as the operational definition of daydreams/mind wanderings and their frequency recorded in vigilance tasks. All five experiments found an inverse relation between age (17-92 years, N = 471) and TUTs, confirming the reliability and validity of the earlier studies. The age-dependent reduction in TUTs was considered as evidence of reduced nonconscious information processing with increased age. The results of this study were incompatible with a recent theory that predicts for older individuals an increased input of irrelevant thoughts into working memory due to the older individual's reduced inhibitory control.