Research Report: How do GPs make referral and treatment decisions when patients present with mental health problems?

The purpose of this pilot study was to identify factors considered by GPs when making mental health referral decisions and to explore referral strategies and related individual differences between GPs. In structured interviews with nine GPs from two surgeries, brief case scenarios were presented. The GPs were asked what treatment or referral option they would recommend in each case, what the main reasons for their choices were and what outcomes they would expect. A short questionnaire was also used. The interviews were transcribed and a content analysis was carried out. Evidence for a variety of patient-related, service-related and doctor-related factors influencing referral decisions was found and compared with previous research findings. In line with results from earlier studies, individual differences between GPs in terms of referral rates, strategies used, confidence and interest in dealing with mental health problems were found. Implications of the findings and of previous research for referrers, service providers and for therapy were discussed. As the present study has obvious limitations, suggestions for future research were made.     

Inner speech sustains predictable task switching: direct evidence in adults

It has been proposed that inner speech supports task selection in task-switching studies, especially when the need for endogenous control is increased. This has been established through the suppression of inner speech in cognitive-flexibility tasks that leads to poorer performance. The aim of this study is to quantify the role of inner speech in a flexibility task by using surface laryngeal electromyography, which, contrary to previous studies, enables participants to freely verbalise the tasks. We manipulated endogenous and exogenous flexibility in a mathematical switching task paradigm. Experiment 1 shows that inner speech acts as a support for switching and is recruited more often when the tasks are of an endogenous type. The main result of Experiment 2 that language is recruited more for the mixing cost than for the switch cost (regardless of the endogenous factor) extends past findings obtained through articulatory suppression.     

Protective role of educational level on episodic memory aging: An event-related potential study

The aim of the present experiment was to investigate whether educational level could modulate the effect of aging on episodic memory and on the electrophysiological correlates of retrieval success. Participants were divided into four groups based on age (young vs. older) and educational level (high vs. low), with 14 participants in each group. Event-related potentials (ERP) were recorded while participants performed a word-stem cued-recall task. Age-related memory deficits were greater for the less educated individuals. Age differences in the ERP old/new effects were also modulated by the level of education. This study demonstrated that the effects of age on episodic memory and ERP correlates of retrieval success are smaller in participants with high educational levels than those with lower levels. These findings provide support for the reserve hypothesis and highlight the need to consider individual differences when studying cognitive and cerebral changes in aging.     

Evaluating the Character of People Who Insult the Nation: Implications for Immigrant Integration

We examine immigrant integration by analyzing how natives evaluate immigrants' character. Most literature examines how natives distinguish between immigrants with different levels of assimilation, which is best suited to identifying integration boundaries between different types of immigrants. We shift the analysis and examine the boundary between immigrants and natives, which measures integration by the extent to which immigrant status is relevant for character evaluations. We compare how natives respond to national insults that come from immigrants as opposed to natives. We focus on insulting the nation because it highlights the salience of national identity and clarifies the importance of group boundaries. We measure responses to national insults with vignette experiments from three original surveys in the United States. Our results are consistent with situationist theories of interpersonal interactions because they suggest that character evaluations are more dependent on the situational distinction between people who do and do not insult the nation than the demographic distinction between whether the insult comes from a native or immigrant. These findings have multiple implications for our understanding of national identity, immigrant integration, and immigrant‐native boundaries.     

Crash Algorithms for Autonomous Cars: How the Trolley Problem Can Move Us Beyond Harm Minimisation

The prospective introduction of autonomous cars into public traffic raises the question of how such systems should behave when an accident is inevitable. Due to concerns with self-interest and liberal legitimacy that have become paramount in the emerging debate, a contractarian framework seems to provide a particularly attractive means of approaching this problem. We examine one such attempt, which derives a harm minimisation rule from the assumptions of rational self-interest and ignorance of one’s position in a future accident. We contend, however, that both contractarian approaches and harm minimisation standards are flawed, due to a failure to account for the fundamental difference between those ‘involved’ and ‘uninvolved’ in an impending crash. Drawing from classical works on the trolley problem, we show how this notion can be substantiated by reference to either the distinction between negative and positive rights, or to differences in people’s claims. By supplementing harm minimisation with corresponding constraints, we can develop crash algorithms for autonomous cars which are both ethically adequate and promise to overcome certain significant practical barriers to implementation.     

Orientation priming of grasping decision for drawings of objects and blocks,and words

This study tested the influence of orientation priming on grasping decisions. Two groups of 20 healthy participants had to select a preferred grasping orientation (horizontal, vertical) based on drawings of everyday objects, geometric blocks or object names. Three priming conditions were used: congruent, incongruent and neutral. The facilitating effects of priming were observed in the grasping decision task for drawings of objects and blocks but not object names. The visual information about congruent orientation in the prime quickened participants’ responses but had no effect on response accuracy. The results are discussed in the context of the hypothesis that an object automatically potentiates grasping associated with it, and that the on-line visual information is necessary for grasping potentiation to occur. The possibility that the most frequent orientation of familiar objects might be included in object-action representation is also discussed.     

Validation of the 'How I Think Questionnaire' in a population of French-speaking adolescents with externalizing behaviors

'How I Think Questionnaire' (HIT) is used to measure self-serving cognitive distortions among delinquents. Previously validated on Americans, this instrument was translated, adapted and validated for French-speaking teens. To assess convergent and discriminant validity, 336 adolescents with externalizing behaviors in Québec (Canada) completed the HIT, the Self-Reported Delinquency Scale (SRD), and the Auto-aggression Questionnaire. There were 165 boys and 171 girls with M(age) = 16.4 years (SD = 0.5) who received services under the Youth Criminal Justice Act (n = 145) or the Youth Protection Act (n = 191). HIT and SRD total scores were correlated (0.51, p < 0.01). On the HIT, past suicidal attempting delinquents were not significantly different than non-suicide attempting delinquents; also delinquents living in closed detention facilities had more self-serving cognitive distortions than delinquents living in open facilities or under probation in the community. This French-language version of the HIT is a reliable and valid measure.     

La portée normative des avis d’expert dans l’élaboration de la décision administrative en matière de sécurité sanitaire

The development of scientific knowledge and the complexity of the issues of health safety have led to increase the use of expertise. The need for transparency following the “scandals” at the end of the last century has led the state to outsource its assessment procedures in health safety, by creating independent agencies. These agencies turn to outside experts because their own staff does not have all the necessary competence. So, the question is: what is the role of these experts in the elaboration of the standards made by the decisions of the agencies? The link between the decision and the expert advice may be almost considered as subordination: the administrative decision becomes stuck by the advice, due to the technical incompetence of the agency. But the circumstances of the administrative decision, especially the situation of scientific uncertainty, can impose a degree of autonomy. If the scope of expert advice seems considerable in certain aspects, it should not hide the full responsibility of policy makers.