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.     

Worms under cover: relationships between performance in learning tasks and personality in great tits (Parus major)

In animals, individual differences in learning ability are common and are in part explained by genetic differences, developmental conditions and by general experience. Yet, not all variations in learning are well understood. Individual differences in learning may be associated with elementary individual characteristics that are consistent across situations and over time, commonly referred to as personality or temperament. Here, we tested whether or not male great tits (Parus major) from two selection lines for fast or slow exploratory behaviour, an operational measure for avian personality, vary in their learning performance in two related consecutive tasks. In the first task, birds had to associate a colour with a reward whereas in the second task, they had to associate a new colour with a reward ignoring the previously rewarded colour. Slow explorers had shorter latencies to approach the experimental device compared with fast explorers in both tasks, but birds from the two selection lines did not differ in accomplishing the first task, that is, to associate a colour with a reward. However, in the second task, fast explorers had longer latencies to solve the trials than slow explorers. Moreover, relative to the number of trials needed to reach the learning criteria in the first task, birds from the slow selection line took more trials to associate a new colour with a reward while ignoring the previously learned association compared with birds from the fast selection line. Overall, the experiments suggest that personality in great tits is not strongly related to learning per se in such an association task, but that birds from different selection lines might express different learning strategies as birds from the different selection lines were differently affected by their previous learning performance.     

The bank of standardized stimuli (BOSS): comparison between French and English norms

Throughout the last decades, numerous picture data sets have been developed, such as the Snodgrass and Vanderwart (1980) set, and have been normalized for variables such as name and familiarity; however, due to cultural and linguistic differences, norms can vary from one country to another. The effect due specifically to culture has already been demonstrated by comparing samples from different countries where the same language is spoken. On the other hand, it is still not clear how differences between languages may affect norms. The present study explores this issue by collecting and comparing norms on names and many other features from French Canadian speakers and English Canadian speakers living in Montreal, who thus live in similar cultural environments. Norms were collected for the photos of objects from the Bank of Standardized Stimuli (BOSS) by asking participants to name the objects, to categorize them, and to rate their familiarity, visual complexity, object agreement, viewpoint agreement, and manipulability. Names and ratings from the French speakers are available in Appendix A, available in the supplemental materials. The results show that most of the norms are comparable across linguistic groups and also that the ratings given are correlated across linguistic groups. The only significant group differences were found in viewpoint agreement and visual complexity. Overall, there was good concordance between the norms collected from French and English native speakers living in the same cultural setting.     

The Development of Family Alliance From Pregnancy to Toddlerhood and Child Outcomes at 5 Years

This article presents a longitudinal study of the development of “family alliance” from pregnancy to toddlerhood in a community sample, as well as its links with the emotional and cognitive development of the child at age 5 years. Family alliance is defined as the quality of the interactive coordination between family members. We consider that the alliance constitutes a context for the child to learn emotion regulation and to develop an understanding of inner states. Family interactions (N = 38) were observed at the 5th month of pregnancy and at 3, 9, and 18 months after birth in a standardized situation of observation (Lausanne Trilogue Play). Marital satisfaction and child temperament were assessed through self‐reported questionnaires. Several outcomes of the child at age 5 years were measured: theory of mind performances, predominant emotional themes in pretend play, internalized and externalized symptoms. Results show that (a) three patterns of evolution of family alliance occur: “high stable” (n = 19), “high to low” (n = 10), and “low stable” (n = 9); (b) a high stable alliance is predictive of better outcomes in children at age 5 years, especially regarding theory of mind; (c) the temperament of the child is predictive of child outcomes; and (d) an interaction effect occurs between family alliance and temperament. These results highlight the importance of both family‐level and individual‐level variables for understanding individual differences in the social and cognitive development of children.     

A test of the circumvention-of-limits hypothesis in scientific problem solving: the case of geological bedrock mapping

Sources of individual differences in scientific problem solving were investigated. Participants representing a wide range of experience in geology completed tests of visuospatial ability and geological knowledge, and performed a geological bedrock mapping task, in which they attempted to infer the geological structure of an area in the Tobacco Root Mountains of Montana. A Visuospatial Ability × Geological Knowledge interaction was found, such that visuospatial ability positively predicted mapping performance at low, but not high, levels of geological knowledge. This finding suggests that high levels of domain knowledge may sometimes enable circumvention of performance limitations associated with cognitive abilities.     

Is Low Anxiety Part of the Psychopathy Construct?

Low anxiety has traditionally been considered a feature of psychopathy, but there has been mixed research support for this conceptualization. We investigated the PPI-R-SF Stress Immunity subscale (a measure of low anxiety) in relation to 2 widely used self-report psychopathy scales in a sample of 346 undergraduate students. Results indicated that PPI-R-SF Stress Immunity was nearly unrelated to other indicators of psychopathy, showing a near-zero loading on the common psychopathy factor defined jointly by the scales of the PPI-R-SF and SRP-III. Stress Immunity also showed a pattern of personality and temperament correlates much different from those of other psychopathy subscales. Finally, Stress Immunity had a slight negative correlation with self-reports of diverse antisocial acts. These results suggest that despite its historical importance in the conceptualization of psychopathy, low anxiety is likely not a core feature of psychopathy.     

The Relations among Maternal Depressive Disorder, Maternal Expressed Emotion, and Toddler Behavior Problems and Attachment

Direct and indirect relations among maternal depression, maternal Expressed Emotion (EE: Self- and Child-Criticism), child internalizing and externalizing symptoms, and child attachment were examined. Participants were mothers with depression (n?=?130) and comparison mothers (n?=?68) and their toddlers (M age?=?20 mo.; 53% male). Assessments included the Diagnostic Interview Schedule (maternal depression); the Five Minute Speech Sample (EE); the Child Behavior Checklist (toddler behavior problems); the Strange Situation (child attachment). Direct relations were significant linking: 1) maternal depression with both EE and child functioning; 2) Child-Criticism with child internalizing and externalizing symptoms; 3) Self-Criticism with child attachment. Significant indirect relations were found linking maternal depression with: 1) child externalizing behaviors via Child-Criticism; 2) child internalizing behaviors via Self- and Child-Criticism; and 3) child attachment via Self-Criticism. Findings are consistent with a conceptual model in which maternal EE mediates relations between maternal depression and toddler socio-emotional functioning.     

Nonword repetition and phoneme elision in adults who do and do not stutter

The purpose of the present study was to explore the phonological working memory of adults who stutter through the use of a non-word repetition and a phoneme elision task. Participants were 14 adults who stutter (M=28 years) and 14 age/gender matched adults who do not stutter (M=28 years). For the non-word repetition task, the participants had to repeat a set of 12 non-words across four syllable lengths (2-, 3-, 4-, and 7-syllables) (N=48 total non-words). For the phoneme elision task, the participants repeated the same set of non-words at each syllable length, but with a designated target phoneme eliminated. Adults who stutter were significantly less accurate than adults who do not stutter in their initial attempts to produce the longest non-words (i.e., 7-syllable). Adults who stutter also required a significantly higher mean number of attempts to accurately produce 7-syllable non-words than adults who do not stutter. For the phoneme elision task, both groups demonstrated a significant reduction in accuracy as the non-words increased in length; however, there was no significant interaction between group and syllable length. Thus, although there appear to be advancements in the phonological working memory for adults who stutter relative to children who stutter, preliminary data from the present study suggest that the advancements may not be comparable to those demonstrated by adults who do not stutter. EDUCATIONAL OBJECTIVES: At the end of this activity the reader will be able to (a) summarize the nonword repetition data that have been published thus far with children and adults who stutter; (b) describe the subvocal rehearsal system, an aspect of the phonological working memory that is critical to nonword repetition accuracy; (c) employ an alternative means to explore the phonological working memory in adults who stutter, the phoneme elision task; and (d) discuss both phonological and motoric implications of deficits in the phonological working memory.     

Compliance,opposition, and behavior problems in toddlers born preterm or low birthweight

Although children born preterm or low birth weight (PT LBW) are more likely to exhibit behavior problems compared to children born at term, developmental and family processes associated with these problems are unclear. We examined trajectories of maternal depressive symptoms in relation to toddler compliance and behavior problems in families with PT LBW infants. A total of 177 infants (93 boys, 84 girls) and their mothers enrolled in the study during the infant's NICU stay. Data were collected at five time points across 2 years. Assessments of maternal depressive symptoms were conducted at all time points, and toddler compliance and opposition to maternal requests and behavior problems were assessed at 2 years. Toddlers born earlier with more health problems to mothers whose depressive symptoms increased over time exhibited the most opposition to maternal requests during a cleanup task at 24 months, consistent with multiple risk models. Mothers with elevated depression symptoms reported more behavior problems in their toddlers. The study has implications for family‐based early intervention programs seeking to identify PT LBW infants at highest risk for problem behaviors.     

The attentional processes underlying impaired inhibition of threat in anxiety: the remote distractor effect

The current study explored the proposition that anxiety is associated with impaired inhibition of threat. Using a modified version of the remote distractor paradigm, we considered whether this impairment is related to attentional capture by threat, difficulties disengaging from threat presented within foveal vision, or difficulties orienting to task-relevant stimuli when threat is present in central, parafoveal and peripheral locations in the visual field. Participants were asked to direct their eyes towards and identify a target in the presence and absence of a distractor (an angry, happy or neutral face). Trait anxiety was associated with a delay in initiating eye movements to the target in the presence of central, parafoveal and peripheral threatening distractors. These findings suggest that elevated anxiety is linked to difficulties inhibiting task-irrelevant threat presented across a broad region of the visual field.