Medical Students’ Efforts to Integrate and/or Reclaim Authentic Identity: Insights from a Mask-Making Exercise

Medical students’ mask-making can provide valuable insights into personal and professional identity formation and wellness. A subset of first- and second-year medical students attending a medical school wellness retreat participated in a mask-making workshop. Faculty-student teams examined student masks and explanatory narratives using visual and textual analysis techniques. A quantitative survey assessed student perceptions of the experience. We identified an overarching theme: “Reconciliation/reclamation of authentic identity.” The combination of nonverbal mask-making and narrative offers rich insights into medical students’ experience and thinking. This activity promoted reflection and self-care, while providing insight regarding personal and professional development.     

Worry and rumination: do they prolong physiological and affective recovery from stress?

Background: Anxiety and depression have been linked to repetitive negative self-regulation styles in the form of worry and rumination respectively. Following predictions of the metacognitive model [Wells, A., & Matthews, G. (1994). Attention and emotion: A clinical perspective. Hove: Erlbaum], the current study compared the effect on recovery from stress of three strategies: worry, rumination, and distraction using a stress exposure paradigm. It was predicted that worry and/or rumination would be associated with delayed recovery on physiological and/or self-report indices when compared to distraction.

Method: Fifty-four participants were randomly assigned to one of the self-regulation conditions and then completed a modified version of the Trier Social Stress Test [TSST; Kirschbaum, C., Pirke, K. M., & Hellhammer, D. H. (1993). The “TSST” – A tool for investigating psychobiological stress responses in a laboratory setting. Neuropsychobiology, 28, 76–81. doi:10.1159/000119004]. Skin conductance and negative affect (NA) measurements were obtained at six different time points.

Results: Skin conductance indicated a prolonged recovery in the rumination condition when compared with the distraction condition. Individuals in the worry condition reported an immediate-delayed recovery from stress marked by higher NA scores in comparison to the distraction condition.

Conclusions: These findings may provide important insights into the effects of different forms of repetitive negative thinking on physiological and psychological recovery from stress. The different response patterns observed are discussed within the context of the metacognitive model.     

Change in Maternal Stress for Families in Treatment for their Children with Oppositional Defiant Disorder

Our objective was to predict change in maternal stress over the course of a randomized clinical trial comparing the efficacy of two interventions for Oppositional Defiant Disorder (ODD): Parent Management Training and Collaborative & Proactive Solutions. In a secondary analysis of data collected from this randomized clinical trial, we examined whether children’s self-reported positive relations with their parents impacted responsiveness to treatment, which in turn impacted maternal stress. One hundred thirty-four children and their parents (38.1% female, ages 7–14, M age?=?9.51, SD?=?1.77) were tracked across three time points: pre-treatment; one-week post-treatment; and six-month post-treatment. Hierarchical linear models tested change in children’s reports of positive relations with parents, clinician reports of ODD severity, and maternal reports of parenting stress. Models then tested multilevel mediation from positive relations with parents, through ODD severity, onto maternal stress. Hypothesized indirect effects were supported such that children’s reports of positive views toward parents uniquely predicted reductions in ODD severity over time, which in turn uniquely predicted reductions in maternal stress. Results highlight the promise of potential secondary benefits for parents following interventions for children with oppositional problems. Furthermore, results underscore the importance of the parent–child relationship as both a protective factor and as an additional target to complement interventions for child disruptive behaviors.     

The Development,Psychometric Analyses and Correlates of a Self-Report Measure on Disorganization and Role Reversal

A limited number of measures assess young adults’ perceptions of childhood disorganized and controlling attachment, and although they are empirically strong, the use of these measures can be time consuming and financially straining. The current study aimed to add to the attachment literature by developing a self-report measure, the Childhood Disorganization and Role Reversal Scale (CDRR), to assess for the complexity of those attachment constructs in young adults. This study aimed to assess the psychometric properties of the CDRR using two separate samples of 750 and 656 undergraduate students (601 females; M_age?=?18.68, 66.4% Caucasian; 531 females; M_age?=?18.68 years, 63.6% Caucasian; respectively), and a community sample of 96 participants (81 females, M_age?=?19.27, 65.6% Caucasian). The results of the Principal Component Analysis (PCA) revealed a four-factor structure for both CDRR parent versions. The CDRR mother version includes the Disorganization/Punitive, Mutual Hostility, Affective Caregiving, and Appropriate Boundaries scales, while the CDRR father version includes the Disorganization, Affective Caregiving, Appropriate Boundaries, and Punitive scales. Overall, support was provided for the psychometric properties of the CDRR. For instance, the CDRR scales demonstrated adequate structural stability (confirmatory factor analyses), internal consistency (Cronbach’s coefficient alphas ranged from .78–.95 for mother scale, and .75–.96 or father scale), temporal reliability (intraclass correlation coefficient ranged from .68–.89 for mother scale, and .69–.87 for father scale), criterion-related validity, convergent validity, and discriminant validity. The CDRR will assist researchers in broadening the understanding of psychological outcomes of disorganized and controlling attachment representations in young adulthood.     

On the limits of statistical learning: Intertrial contextual cueing is confined to temporally close contingencies

Since the seminal study by Chun and Jiang (Cognitive Psychology, 36, 28–71, 1998), a large body of research based on the contextual-cueing paradigm has shown that the cognitive system is capable of extracting statistical contingencies from visual environments. Most of these studies have focused on how individuals learn regularities found within an intratrial temporal window: A context predicts the target position within a given trial. However, Ono, Jiang, and Kawahara (Journal of Experimental Psychology, 31, 703–712, 2005) provided evidence of an intertrial implicit-learning effect when a distractor configuration in preceding trials N ? 1 predicted the target location in trials N. The aim of the present study was to gain further insight into this effect by examining whether it occurs when predictive relationships are impeded by interfering task-relevant noise (Experiments 2 and 3) or by a long delay (Experiments 1, 4, and 5). Our results replicated the intertrial contextual-cueing effect, which occurred in the condition of temporally close contingencies. However, there was no evidence of integration across long-range spatiotemporal contingencies, suggesting a temporal limitation of statistical learning.     

Frequency of finger looking during finger counting is related to children's working memory capacities

Finger counting can be useful in solving arithmetic problems, noticeably because it reduces the working memory demand of mental calculations. However, proprioceptive information might not be sufficient to keep track of the number of fingers raised during problem solving, and visual input may play an important role in this process. The present study was designed to address this question and shows that 8-year-old children look at their fingers in 60% of the trials during finger counting when solving additive problems. Moreover, our results reveal that the frequency of finger looking is negatively correlated with working memory capacities and is higher for more difficult problems. These findings suggest that finger looking is recruited in managing the cognitive demand of the arithmetic task, probably by providing additional external cues to monitor the number of steps that have to be incremented during finger counting.     

Dual-task automatization: The key role of sensory–motor modality compatibility

How do people automatize their dual-task performance through bottleneck bypassing (i.e., accomplish parallel processing of the central stages of two tasks)? In the present work we addressed this question, evaluating the impact of sensory–motor modality compatibility—the similarity in modality between the stimulus and the consequences of the response. We hypothesized that incompatible sensory–motor modalities (e.g., visual–vocal) create conflicts within modality-specific working memory subsystems, and therefore predicted that tasks producing such conflicts would be performed less automatically after practice. To probe for automaticity, we used a transfer psychological refractory period (PRP) procedure: Participants were first trained on a visual task (Exp. 1) or an auditory task (Exp. 2) by itself, which was later presented as Task 2, along with an unpracticed Task 1. The Task 1–Task 2 sensory–motor modality pairings were either compatible (visual–manual and auditory–vocal) or incompatible (visual–vocal and auditory–manual). In both experiments we found converging indicators of bottleneck bypassing (small dual-task interference and a high rate of response reversals) for compatible sensory–motor modalities, but indicators of bottlenecking (large dual-task interference and few response reversals) for incompatible sensory–motor modalities. Relatedly, the proportion of individuals able to bypass the bottleneck was high for compatible modalities but very low for incompatible modalities. We propose that dual-task automatization is within reach when the tasks rely on codes that do not compete within a working memory subsystem.

     

Predictive Relationship Between Parental Beliefs and Accommodation of Pediatric Anxiety

Behavior performed by parents to assist a youth in avoiding or alleviating anxiety, known as accommodation, is ubiquitous among pediatric anxiety disorders and strongly related to poor treatment outcome. According to cognitive-behavioral theory, the beliefs parents hold regarding accommodation should predict parental accommodating behavior. Unfortunately, little is known about the beliefs parents hold regarding accommodation, as there exists no validated measure of this construct. First, the psychometric properties were examined for the Parental Accommodation Scale (PAS), a novel measure of parental accommodating behavior frequency (PAS-Behavior scale) and parental beliefs about accommodation (PAS-Belief scale). Second, the relationship between parental beliefs about accommodation and accommodation frequency was examined. Results provide preliminary evidence of the internal consistency and convergent validity of the PAS. Stronger positive beliefs about accommodation significantly predicted accommodation frequency, even after controlling for youth anxiety severity. Specifically, beliefs that accommodation prevents youth from losing behavioral and emotional control significantly predicted accommodation frequency. Therefore, efforts to decrease accommodation in clinical settings should involve correcting maladaptive parental beliefs about accommodation, with a particular emphasis on beliefs regarding the necessity of accommodation in preventing a youth from losing behavioral and emotional control.