Physician Burnout and Patient Satisfaction with Consultation in Primary Health Care Settings: Evidence of Relationships from a one-with-many Design

Physician burnout, as a prolonged response to chronic emotional and interpersonal stressors on the job, has been associated with suboptimal patient care and deterioration in the patient?Cprovider relationship. Although prior studies have identified a range of factors associated with decreased patient satisfaction, most have been conducted in tertiary care settings, with staff burnout examined at the hospital unit-level. To examine the impact of physician burnout on patient satisfaction from consultation in the primary care setting, a cross-sectional survey was conducted in Western Greece. Using a one-with-many design, 30 physicians and 300 of their patients, randomly selected, responded to the survey. Results showed that patient satisfaction correlated significantly with physician emotional exhaustion (r = ?.636, p < .01) and physician depersonalization (r = ?.541, p < .01). Mixed-effects multilevel models indicated that 34.4% of total variation in patients?? satisfaction occurred at the physician level, after adjustment for patients?? characteristics. Moreover, physician emotional exhaustion and depersonalization remained significant factors associated with patient satisfaction with consultation, after controlling for patient and physician characteristics. Patients of physicians with high-exhaustion and high-depersonalization had significantly lower satisfaction scores, compared with patients of physicians with low-exhaustion and low-depersonalization, respectively. Future studies need to explore the mechanisms by which physician burnout affects patient satisfaction.     

University psychology clinics in Australia: Their place in professional training

Abstract: There is universal recognition of the need for developmentally appropriate supervised clinical experience in professional psychology training. University clinics were established to provide a bridging function for postgraduate clinical psychology students, assisting the integration of psychological theory and research into real‐world clinical applications and professional identity development. The aim of training in university clinics is to provide opportunities for clinical practice and high‐quality supervision to monitor and shape clinical skills. The experiences gained in external practicum settings complement this initial training but cannot replace it. The recent introduction of Medicare rebates for psychology services has threatened the survival of university clinics because low‐cost psychological treatment is now available from experienced practitioners. This paper provides data on Australian university clinics collected before the introduction of Medicare. Concerted efforts are needed to protect university clinics in order to maintain standards required for accreditation of clinical psychology training programs. The potential impact of the loss of university training clinics is discussed and strategies to ensure their survival are suggested.     

Age of acquisition and repetition priming effects on picture naming of children who do and do not stutter

The effects of age of acquisition and repetition priming on picture naming latencies and errors were studied in 22 children who stutter (CWS) and 22 children who do not stutter (CWNS) between the ages of 3;1 and 5;7. Children participated in a computerized picture naming task where they named pictures of both early and late acquired (AoA) words in two consecutive stages. Findings revealed that all children's picture naming latencies and errors were reduced following repetition priming and in response to early AoA words relative to late AoA words. AoA and repetition priming effects were similar for children in both talker groups, with one exception. Namely, CWS benefitted significantly more, in terms of error reduction, than CWNS from repetition priming for late AoA words. In addition, CWNS exhibited a significant, positive association between linguistic speed and measures of vocabulary, but CWS did not. These findings were taken to suggest that the (a) semantic-phonological connections of CWS may not be as strong as those of CWNS, and (b) existing lexical measures may not be sensitive enough to differentiate CWS from CWNS in lexically related aspects of language production. Educational objectives: After reading this article, the learner will be able to: (a) describe the effects of repetition priming and age of word acquisition in speech production; (b) summarize the performance similarities and differences of children who stutter and children who do not stutter on a computerized picture naming task; and (c) compare the results of the present study with previous work in this area.     

Psychophysiological and Neuropsychological Characteristics of Non-Incarcerated Adult Males with Higher Levels of Psychopathic Personality Traits

Although much research on psychopathic individuals has been conducted in incarcerated settings, there is increasing interest in studying adults with higher levels of psychopathic traits in the general population. The present study investigated differences in psychophysiological response and neuropsychological functioning between undergraduate males with higher levels of psychopathic traits (higher-p) and undergraduate males with lower levels of psychopathic traits (lower-p). Participants completed self-report measures and neuropsychological measures, and skin conductance response was measured during a risk-taking and affective-picture viewing task. Consistent with previous findings among samples of incarcerated psychopaths, higher-p adults exhibited diminished responses to aversive and positive affective stimuli and were more disinhibited on a motoric response inhibition task. Contrary to expectations, higher-p adults made marginally better decisions on a risky decision making task. Findings were discussed in relation to Gao and Raines’ (Behavioral Sciences & the Law 28(2) 194–210, 2010) model of the neurobiological underpinnings of adults with higher levels of psychopathic traits in non-incarcerated settings, and offer evidence that higher-p adults have both adaptive and non-adaptive traits.     

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.     

Cognitive reappraisal reduces perceived exertion during endurance exercise

Emotion regulation may influence psychological responses to exercise. We examined whether the emotion regulation strategies, cognitive reappraisal and distraction, influenced psychological state and prefrontal cortex oxygenation during endurance exercise. Twenty-four endurance runners ran for 90 min at 75–85% maximum heart rate in three separate sessions with no instruction or with instructions to use cognitive reappraisal or distraction. Participants rated their emotional arousal, emotional valence, and perceived exertion before, every 30 min during, and after exercise. Functional near-infrared spectroscopy quantified changes in prefrontal cortex oxygenation. Participants felt lower emotional arousal and physical exertion when instructed to utilize cognitive reappraisal than when given no emotion regulation instruction. Such responses to distraction did not differ from the other conditions. Emotion regulation strategies did not influence emotional valence or prefrontal cortex oxygenation. Participants’ analytical interpretation of the cognitive reappraisal instruction could contribute to small effect sizes and limited effects. Further research should determine contexts under which emotion regulation strategies most benefit endurance exercise experience.     

Self-report measures of child and adolescent psychopathy as predictors of offending in four samples of justice-involved youth

The authors examined the relation between self-report psychopathy measures and official records of offending in four samples of justice-involved youth (total N = 447). Psychopathy measures included the Antisocial Process Screening Device (APSD) and a modified version of the Childhood Psychopathy Scale (mCPS). Measures of offending included the total number of preadmission arrest charges for three samples (n = 392) and the total number of offenses in the year following release for two samples (n = 138). Neither measure was a strong correlate of preadmission offenses. Although mCPS scores were associated with postrelease offending in one sample, effects for the APSD were observed only when reoffending was conceptualized as a dichotomous variable, indicating a lack of robustness in this association. The findings suggest caution in the use of self-report measures of psychopathic features for decision making with respect to issues of delinquency risk among justice-involved youth.