Impact of a preventive social problem solving intervention on children's coping with middle-school stressors

Children receiving 1 year or 1/2 year of a preventive social problem solving program in elementary school were compared with each other and with a no-treatment group upon entry into middle school. One year of training was significantly related to reductions in the severity of a variety of middle-school stressors. Most importantly, a clear mediating role for social problem solving (SPS) skills was found. Children lacking in SPS skills were more likely to experience intense stressors; however, possessing the skills was not necessarily predictive of adjustment to stressors. The results are discussed in terms of the implications of this asymmetry and the strong support given to the value of social problem solving as a preventive intervention for children.     

Behavioral effects of sucrose on preschool children

Despite speculation that sucrose consumption affects behavior, little empirical information is available. Accordingly, this study investigated the effect of sucrose consumption on the behavior of eight preschool children. Children were tested individually using a double-blind, crossover design. On separate mornings each child received 6 ounces of juice, sweetened on one morning with sucrose and on the other with an artificial sweetener. Children were observed for 90 minutes following the drinks, alternating between 15-minute sessions of work on structured tasks and 15-minute sessions of free play. Following the sucrose drink the children showed a decrement in performance in the structured testing situation, and they demonstrated more inappropriate behavior during free play. These differences in behavior were most pronounced approximately 45 to 60 minutes after the drinks. Thus, the study provides objective evidence in young children of a rather subtle, yet significant, time-dependent behavior effect of sucrose ingestion.This research was funded in part by grants from the General Research Grants Committee, University Hospital, Boston University Medical Center, and from the University of Connecticut Research Foundation. The project was conducted at the Clinical Research Center, Massachusetts Institute of Technology (National Institute of Health/General Clinical Research Center Grant 5M01-RR00088-20). We would like to express our appreciation to the many staff members of the Clinical Research Center for their extensive cooperation in helping us to plan and carry out this study, and to the director and staff of Technology Children's Center for their assistance in helping us to reach interested families. We also would like to thank the parents and children who participated in the study. Portions of this paper were presented at the annual meeting of the American Psychological Association, Toronto, August 1984.     

Quality-of-life measures: hospital interview versus home questionnaire

Measures adapted from social survey research were used to assess the quality of life of 33 end-stage renal disease (ESRD) patients in a 2-week test-retest design that varied both location and format of administration (hospital interview vs. home self-administered questionnaire). The measures were found to have substantial consistency over time, location, and format. These results indicate that quality of life is a stable construct and support the usefulness of questionnaire quality-of-life measures for evaluating medical interventions.     

Stress and coping in early adolescence: relationships to substance use in urban school samples

Measures of stress and coping were obtained from two cohorts of urban adolescents during the seventh- to eighth-grade period and were related to indices of cigarette smoking and alcohol use. Predictions were derived from a stress coping model of substance use. Stress was indexed by measures of subjective stress, recent events, and major life events; coping was assessed by behavior-based and intention-based methods. Concurrent and prospective analyses were consistent with predictions, indicating that stress was positively related to substance use, and four coping mechanisms (behavioral coping, cognitive coping, adult social support, and relaxation) were inversely related to substance use. Two types of predicted interactions, Stress X Coping and Positive X Negative Events, were found. Measures indexing peer support, distraction coping, and aggressive coping were positively related to substance use, independent of other predictors. Implications for substance use theory and prevention research are discussed.     

Health as a value: methodological and theoretical considerations

The concept of value placed on health is very important in several different theoretical approaches to the study of health behavior. In practice, however, health value is generally assumed to be universally high rather than being directly measured. If this assumption is incorrect, then theories that include health value have rarely been adequately tested. This paper presents a short 4-item Likert scale designed to measure the value placed on health. Norms from the utilization of this scale in five different samples are presented. Health value is found to increase with age among girls, but the increase apparently stops by late adolescence, before full adult levels of health value are achieved. Middle-aged women place a higher value on health than do middle-aged men, although no comparable sex difference appears in a sample of undergraduates. Consistent with theoretical predictions, both health locus of control beliefs and beliefs in the efficacy of certain preventive health behaviors correlate more highly with the performance of those same behaviors 5 to 9 months later among respondents who place a high value of health relative to those who do not value health so highly. However, this interaction is found only when it can be safely assumed that health is the primary value underlying the behavior. The importance of considering a variety of values in addition to health as possible motivators of preventive health behavior is stressed.     

Access to spoken language and the acquisition of orthographic structure: Evidence from deaf readers

Sensitivity to two types of orthographic structure was investigated: linguistically based orthographic regularity and summed single letter positional frequency. Deaf college students were found to make use of positional frequency information no less than hearing college students; however, the extent to which they made use of orthographic regularities in word recognition was related to their speech production skills. In one task, subjects were presented nonword letter strings for short durations, each followed by a masking stimulus and a target letter. They were asked to indicate whether or not the target had been present in the letter string. It was found that the accuracy of deaf subjects with good speech, like that of hearing subjects, was considerably greater for orthographically regular than irregular strings. In contrast, the accuracy of deaf subjects with poor speech was much less related to orthographic regularity. In a second task, in which subjects made judgements about how word-like various letter strings appeared, the judgements of the hearing subjects were more influenced by regularity than those of deaf subjects with poor speech. These results are discussed in terms of how expertise in speech relates to appreciation of orthographic regularity.     

A comparison of three predictors of an individual's memory performance: the individual's feeling of knowing versus the normative feeling of knowing versus base-rate item difficulty

Distinctions are drawn between different predictors of an individual's memory performance, with emphasis on the notion of privileged access to idiosyncratic knowledge. Research is reported in which undergraduates attempted to recall the answers to general-information questions, then made feeling-of-knowing judgments on nonrecalled items, and subsequently had a criterion test (relearning, perceptual identification, or one of two versions of recognition). For predicting an individual's criterion performance, the individual's own feeling-of-knowing predictions were intermediate between two kinds of normative predictions: The individual's feeling-of-knowing predictions were more accurate than predictions derived from normative feeling-of-knowing ratings but were less accurate than predictions derived from base-rate item difficulty (normative probabilities of correct recall). Subsidiary analyses showed that factors other than unreliability are responsible for the partial inaccuracy of the individual's feeling of knowing. Ramifications are discussed for possible ways to improve the accuracy of an individual's feeling-of-knowing predictions.     

Cognitive, motivational, social, and environmental influences on children's food choices

This study tested the applicability of a cognitive-motivational model of health behavior to children's food choices. A sample of 107 elementary schoolchildren provided ratings of 15 foods in terms of possible choice criteria (e.g., how tasty or healthful specific foods were) and social or environmental influences (e.g., whether foods were eaten by friends or were easy to get). Several measures of food consumption were taken, and cognitive-developmental level was assessed. Within-person correlations were calculated between food choices and each choice criterion and social/environmental factor. These "correlational indices" of influences on food choice subsequently were used to identify five distinct subgroups in the sample. Children at the operational level of cognitive development tended to be in one of three groups characterized by health orientation in food choice, taste orientation, or multiple-motive orientation. Dietary quality was poorest in the taste-oriented group. Children at the preoperational level tended to have one of two undifferentiated patterns of values across the correlational indices. Results provide evidence of: the viability of cognitive-motivational models to explain children's food choices, the promise of within-person research methodology, and the potential for enhanced health behavior-change programs by use of population segmentation and tailored interventions.     

Relationship of physicians' nonverbal communication skill to patient satisfaction, appointment noncompliance, and physician workload

A field study of 28 residents in family practice was conducted. Physicians' self-reports of empathy, self-monitoring ability, and affective communication skill as well as their objectively measured nonverbal communication skills were examined as predictors of patient satisfaction, appointment noncompliance, and physician workload (schedule density). Physicians completed the Hogan Empathy Scale, Snyder Self-Monitoring Scale, Affective Communication Test, short form of the Profile of Nonverbal Sensitivity, and a nonverbal encoding task. Patient satisfaction with communication, affective care, and technical care was assessed using a 25-item, visit-specific satisfaction scale. Appointment records were used to determine the number of patients seen by each physician and the compliance of patients with scheduled appointments. Results indicated that the three self-report measures were unrelated to the measures of patient noncompliance and patient satisfaction, but self-reported affective communication ability was significantly correlated with physician workload. Objectively measured physician sensitivity to audio communication predicted patient compliance: More sensitive physicians experienced fewer unrescheduled appointment cancellations. Nonverbal encoding skill was significantly related to patient satisfaction with affective care and to physician workload.