Discovering what it all means

This article deals with appropriate communication and interpersonal skills that nurses may use in order to support patients who are experiencing self-concept changes related to their health problems. Three areas of patient need related to self-concept are explored. The stages of adaptation to loss and the crucial task of grief work are reviewed, and nursing interventions designed to strengthen the self-concept and support patients as they adapt to loss are suggested. Sensitive communication, although a low-visibility nursing skill, is cited as critical in assisting the patient to achieve an optimum level of wellness.     

The interaction of stimulus and reinforcer control in complex temporal discrimination.

Six pigeons were trained in a discrete-trials signal-detection procedure to discriminate between a fixed-duration stimulus (5 s or 20 s) and a set of variable durations ranging from 2.5 s to 57.5 s in steps of 5 s. For each fixed-duration stimulus, the ratio of reinforcer frequencies contingent upon reporting the fixed versus the variable stimulus was systematically manipulated. Detection performance was well controlled by both the stimulus value and the reinforcer ratio. Both the discriminability between the fixed duration and the set of variable durations, and the discriminability between the fixed duration and each of the variable durations, were independent of the reinforcer-frequency ratio when discriminability was measured as log d. The sensitivity of response bias to reinforcement-ratio changes was independent of the value of the fixed duration, but was not independent of the discriminability of the variable durations from the fixed durations. Under current models, discriminability measures in complex temporal discrimination may be independent of biasing manipulations, but bias measures are not independent of stimulus values.     

Choice between reliable and unreliable outcomes: mixed percentage-reinforcement in concurrent chains.

Pigeons' choices between alternatives that provided different percentages of reinforcement in mixed schedules were studied using the concurrent-chains procedure. In Experiment 1, the alternatives were terminal-link schedules that were equal in delay and magnitude of reinforcement, but that provided different percentages of reinforcement, with one schedule providing, reinforcement twice as reliably as the other. All pigeons preferred the more reliable schedule, and their level of preference was not systematically affected by variation in the absolute percentage values, or in the magnitude of reinforcement. In Experiment 2, preference for a schedule providing 100% reinforcement over one providing 33% reinforcement increased systematically with increases in the duration of the terminal links. In contrast, preference decreased systematically with increases in the duration of the initial links. Experiment 3 examined choice with equal percentages of reinforcement but unequal delays to reinforcement. Preference for the shorter delay to reinforcement was not systematically affected by variation in the absolute percentage of reinforcement. The overall pattern of results supported predictions based on an extension of the delay-reduction hypothesis to choice procedures involving mixed schedules of percentage reinforcement.     

Physicians and clergy in dialogue

The goals and ends of contemporary medicine are often unclear. An explicit inquiry into the religious dimensions of healing offers an important perspective from which to evaluate the potential capabilities of the medical profession. This paper describes a course in which medical students joined divinity students to explore areas of mutual intellectual, professional, and personal interest. Students and faculty examined in depth three broad areas in which medicine and religion share common ground: concepts of health and illness from the religious perspective, approaches to the understanding of suffering and meaning, and the shared professional stresses of physician and clergy.This paper comes from the Department of Medicine, Beth Israel Hospital, and the Division on Aging and the Program for the Analysis of Clinical Strategies, Harvard Medical School, and the West Roxbury-Brockton Veterans Administration Geriatric Research, Education and Clinical Center, Boston.     

Testing the dimensionality of the self-consciousness scales

The self-consciousness scale of Fenigstein, Scheier, and Buss (1975) was subjected to internal and external consistency tests based on the classical test theory model. The scale was found to have five underlying dimensions: two for private self-consciousness (viz., self-reflectiveness and internal state awareness), two for public self-consciousness, and one for social anxiety. The confirmatory factor analysis procedures employed by Burnkrant and Page (1984) are shown to be fallible as indicators of unidimensionality. Theoretical implications of newly identified dimensions in the public self-consciousness subscale are discussed.     

Variable-interval schedules of timeout from avoidance

Rats were trained on concurrent schedules in which pressing one lever postponed shock and pressing the other occasionally produced a 2-min timeout during which the shock-postponement schedule was suspended and its correlated stimuli were removed. Throughout, the shock-postponement schedule maintained proficient levels of avoidance. Nevertheless, in Experiment 1 responding on the timeout lever was established rapidly, was maintained at stable levels on variable-interval schedules, was extinguished by withholding timeout, was reestablished when timeout was reintroduced, and was brought under discriminative control with a multiple variable-interval extinction schedule of timeout. These results are in contrast with Verhave's (1962) conclusion that timeout is an ineffective reinforcer when presented to rats on intermittent schedules. In Experiment 2 the consequence of responding on the timeout lever was altered so that the shock-postponement schedule remained in effect even though the stimulus conditions associated with timeout were produced for 2 min. Responding extinguished, indicating that suspension of the shock-postponement schedule, not stimulus change, was the source of reinforcement. By establishing the reinforcing efficacy of timeout with standard variable-interval schedules, these experiments illustrate a procedure for studying negative reinforcement in the same way as positive reinforcement.     

Relative allocation on concurrent schedules can depend on schedule parameters when behavioral parameters are constant

We develop a simple model of switching between the initial links of a concurrent-chain procedure. Behavior is determined by four parameters μ₁, μ₂, q₁, and q₂. The first two are the basic rates of switching from Schedule 1 and Schedule 2, respectively. The second two are the probabilities of leaving Schedule 1 and Schedule 2 after the corresponding terminal link has been completed. We show that for fixed values of these four parameters, the relative allocation on the initial links may change as a result of changes in initial-link schedules. The effect can be quite large if the switching rates are low. An implication is that relative allocation is not necessarily a good measure of behavior.     

Superstitious behavior in humans

Twenty undergraduate students were exposed to single response-independent schedules of reinforcer presentation, fixed-time or variable-time, each with values of 30 and 60 s. The reinforcer was a point on a counter accompanied by a red lamp and a brief buzzer. Three color signals were presented, without consistent relation to reinforcer or to the subjects' behavior. Three large levers were available, but the subjects were not asked to perform any particular behavior. Three of the 20 subjects developed persistent superstitious behavior. One engaged in a pattern of lever-pulling responses that consisted of long pulls after a few short pulls; the second touched many things in the experimental booth; the third showed biased responding called sensory superstition. However, most subjects did not show consistent superstitious behavior. Reinforcers can operate effectively on human behavior even in the absence of a response-reinforcer contingency and can, in some cases, shape stable superstitious patterns. However, superstitious behavior is not a consistent outcome of exposure of human subjects to response-independent reinforcer deliveries.     

Conditional relations by monkeys: Reflexivity, symmetry, and transitivity

Two cynomolgous macaques categorized six colors into two groups of three after conditional discrimination training (zero-delay symbolic match-to-sample). The procedures resulted in the establishment of relations among the elements of each set-relations that were not specifically trained and that can be characterized by the properties of reflexivity, symmetry, and transitivity. Each set of colors was related to a characteristic pattern of responding: One response pattern involved temporal duration (press and hold the response keys); the second response pattern entailed repeated pressing and releasing of the response keys (fixed ratio 8). Six combinations of two colors were trained, three combinations from each set. After discriminative performance stabilized for each monkey, they were tested with 10 additional color combinations, all of which differed from the training combinations. The conditional relations established between test combinations can be characterized as stimulus equivalence. The training procedures were analogous to the procedure of using category names, and have implications for understanding the function of language in the formation of equivalence classes.