Leadership Perspectives on Integrating Psychologists into Specialty Care Clinics: An Evolving Paradigm

Integration of health psychologists into specialty care is a shift in the tertiary care construct that addresses all aspects of a patient’s presentation, including psychiatric/social history, psychological well-being, and behavioral contributions to the disease process, assuring both optimal health outcomes and cost-effectiveness in a financially challenging healthcare environment. In this paper, we discuss leadership perspectives (physician and psychologists) on the factors involved in integrating a health psychologist into a busy tertiary care environment. Ultimately, we hope that this information provides a primer on how to frame a proposal for an integrated health psychologist emphasizing the elements important to senior medical leadership and administration. First, we briefly discuss the current payer framework, providing support for integration emphasizing costs and other metrics. Second, we introduce organizational structure models and strategies for integration. Lastly, we will discuss the unique skillset psychologists possess, and additional skills necessary, to be effective in the changing landscape of healthcare. We think this information is important both for leaders attempting to integrate a health psychologist into specialty care and for the early career health psychologist embarking on his/her first senior staff position.     

“I Didn’t Expect to Learn as Much as I Did”: Rewards of Caregiving in Young Adulthood

While much attention is given to unpaid caregivers in midlife, there is a notable gap in the literature regarding young adults in family caregiving roles. Although two out of 5 family caregivers are between the ages of 18 and 40, we know relatively little about these younger relatives providing support to ill and disabled family members. Understanding the experiences of this under-researched population is critical to effective social service provision for this new wave of caregivers. In addition, the challenges associated with caregiving are well documented, yet examining the positive aspects of caregiving is necessary to provide a balanced picture of caregiving. The purpose of this qualitative study was to explore the gains experienced by family caregivers in young adulthood. In-depth telephone interviews were conducted with a diverse sample of 22 individuals who were (or had previously been) caregivers while in young adulthood. Analysis of the data resulted in identification of four themes concerning gains experienced by young adult caregivers: a strengthening of family relationships, character growth, personal satisfaction in the care provided, and material benefit. This study sheds some understanding on rewards experienced by a subgroup of family caregivers who has received little attention—young adult caregivers.     

Well-being and Substance Use in Emerging Adulthood: The Role of Individual and Family Factors in Childhood and Adolescence

The present study examined the long-term impact of individual and family factors during childhood and adolescence on outcomes associated with the transition to adulthood, specifically well-being and substance use. Data for this study were drawn from the Child Development Supplement (CDS) and Transition to Adulthood (TA) surveys (n?=?1362), both a part of The Panel Study of Income Dynamics (PSID). We first examined the influence of individual and family factors from childhood and adolescence on well-being and substance use during the transition to adulthood using Structural Equation Modeling (SEM). We then applied a mixture modeling approach to evaluate whether there were subgroups (latent classes) in these transitions to adulthood outcomes, and how these subgroups linked with the individual and family factors from younger years. We found that, in general, parental acceptance and psychological control in childhood and adolescence predicted all aspects of well-being during the transition to adulthood. Substance use during this transition was linked with being male, White, and heightened parental psychological control. Overall, observable differential associations between individual and family factors during childhood and adolescence and outcomes in later life highlighted a need to evaluate transitional aspects independently, rather than grouping young adults all together.     

Pick Your Poison: Choice of Activity Determines Mood Management Following a Stressful Task

People routinely seek out activities they believe will relieve stress. There has always been debate regarding the extent to which different activities, particularly those with aggressive content, successfully manage mood or worsen it. It is routinely believed that engaging in highly aggressive activities after becoming stressed worsens mood. However, unlike experiments, in real life people generally select activities that match their interests. In the present study, 105 university students were exposed to an acute stressor then randomized to either (a) a time filler control task; (b) to hit a bobo doll; or (c) given a choice of five different activities, some aggressive, some not. Results indicated that those who were given a choice of activities experienced the greatest reductions in stress and hostility. Furthermore, evidence did not suggest that more aggressive activities made participants more hostile, stressed, or aggressive.     

Telling young children they have a reputation for being smart promotes cheating

The present research examined the consequences of telling young children they have a reputation for being smart. Of interest was how this would affect their willingness to resist the temptation to cheat for personal gain as assessed by a temptation resistance task, in which children promised not to cheat in the game. Two studies with 3‐ and 5‐year‐old children (total N = 323) assessed this possibility. In Study 1, participants were assigned to one of three conditions: a smart reputation condition in which they were told they have a reputation for being smart, an irrelevant reputation control condition, or a no reputation control condition. Children in the smart reputation condition were significantly more likely to cheat than their counterparts in either control condition. Study 2 confirmed that reputational concerns are indeed a fundamental part of our smart reputation effect. These results suggest that children as young as 3 years of age are able to use reputational cues to guide their behavior, and that telling young children they have a positive reputation for being smart can have negative consequences.     

Older but not younger infants associate own‐race faces with happy music and other‐race faces with sad music

We used a novel intermodal association task to examine whether infants associate own‐ and other‐race faces with music of different emotional valences. Three‐ to 9‐month‐olds saw a series of neutral own‐ or other‐race faces paired with happy or sad musical excerpts. Three‐ to 6‐month‐olds did not show any specific association between face race and music. At 9 months, however, infants looked longer at own‐race faces paired with happy music than at own‐race faces paired with sad music. Nine‐month‐olds also looked longer at other‐race faces paired with sad music than at other‐race faces paired with happy music. These results indicate that infants with nearly exclusive own‐race face experience develop associations between face race and music emotional valence in the first year of life. The potential implications of such associations for developing racial biases in early childhood are discussed.     

Do storybooks with anthropomorphized animal characters promote prosocial behaviors in young children?

For millennia, adults have told children stories not only to entertain but also to impart important moral lessons to promote prosocial behaviors. Many such stories contain anthropomorphized animals because it is believed that children learn from anthropomorphic stories as effectively, if not better than, from stories with human characters, and thus are more inclined to act according to the moral lessons of the stories. Here we experimentally tested this belief by reading preschoolers a sharing story with either human characters or anthropomorphized animal characters. Reading the human story significantly increased preschoolers' altruistic giving but reading the anthropomorphic story or a control story decreased it. Thus, contrary to the common belief, realistic stories, not anthropomorphic ones, are better for promoting young children's prosocial behavior.     

Speaking a tone language enhances musical pitch perception in 3–5‐year‐olds

Young children learn multiple cognitive skills concurrently (e.g., language and music). Evidence is limited as to whether and how learning in one domain affects that in another during early development. Here we assessed whether exposure to a tone language benefits musical pitch processing among 3–5‐year‐old children. More specifically, we compared the pitch perception of Chinese children who spoke a tone language (i.e., Mandarin) with English‐speaking American children. We found that Mandarin‐speaking children were more advanced at pitch processing than English‐speaking children but both groups performed similarly on a control music task (timbre discrimination). The findings support the Pitch Generalization Hypothesis that tone languages drive attention to pitch in nonlinguistic contexts, and suggest that language learning benefits aspects of music perception in early development. A video abstract of this article can be viewed at: https://youtu.be/UY0kpGpPNA0     

Do relational and structural characteristics of negative school environments independently predict immigrant adolescents’ academic achievement?

A critical issue facing the majority of immigrant adolescents in U.S. public schools is persistent academic underperformance. Using data from the Children of Immigrants Longitudinal Study, this study investigates the extent to which negative social environments in U.S. public schools predict the academic achievement of immigrant adolescents. Importantly, we simultaneously examine the roles of both the relational (individual-level) and structural (school-level) characteristics of these negative social environments. Multilevel structural equation modeling revealed that immigrant students who are embedded in more negative relationships (e.g., having peers who discriminate against them) have lower levels of academic achievement. These predictive effects of individual-level negative social environments on academic achievement are mediated by both perceived school safety and educational expectations. Furthermore, we find double mediation effects (i.e., three-pathway mediations) via perceptions of school safety and educational expectations. The existence of these double mediation effects implies that relational characteristics strongly predict immigrant adolescents’ perceptions, attitudes, and school outcomes. Finally, we find that structural characteristics of negative social environments in U.S. public schools (i.e., total student enrollment and school-level dropout rate) also negatively predict immigrant adolescent achievement. We discuss the implications of these findings for improving immigrant adolescents’ achievements in U.S. public schools.     

Mindfulness Based Flourishing Program: A Cross-Cultural Study of Hong Kong Chinese and British Participants

The Mindfulness Based Flourishing Program (MBFP) is an online 8-week intervention developed for enhancing wellbeing with the use of mindfulness practices, through targeting a range of positive variables. The efficacy of the MBFP has been demonstrated in a randomized controlled trial, and in order to further establish it as an intervention with widespread application, cross-cultural validation is warranted. The current study was conducted with the primary aim of testing the validity of the MBFP with a Hong Kong Chinese population, as well as verifying its positive effects. A randomized wait-list controlled design was adopted with 115 participants (92 females, mean age = 31.50). Intervention outcomes were compared between Hong Kong Chinese and British participants. Five positive variables were examined (self-compassion, meaning in life, positive and negative emotions, gratitude, and mindfulness), and measures were taken pre- and post-intervention. Significant gains in wellbeing measures were observed in both the Hong Kong Chinese and the British experimental groups. Levels of wellbeing post-intervention were also higher for the two experimental groups as compared to their control counterparts. The current study provides preliminary evidence for the MBFP’s cross-cultural validity, and strengthens previous claims for its efficacy as a new, accessible alternative for enhancing wellbeing.