Problem solving deteriorates following mood challenge in formerly depressed patients with a history of suicidal ideation

The authors divided 34 participants who had a history of depression into 2 groups, those having previous suicidal ideation or behavior (n=19) and those having no such symptoms (n=15), then compared the 2 groups with a group of participants who had no history of depression (n=22). Assessment of interpersonal problem-solving performance using the Means-Ends Problem-Solving (MEPS) task before and after a mood-induction procedure showed that only those formerly depressed people with a history of suicidal ideation shifted in MEPS performance, producing significantly less effective problem solutions following mood challenge, consistent with a differential activation account of vulnerability for recurrence of suicidal ideation and behavior. The deterioration in effectiveness following mood challenge was moderated by lack of specificity in autobiographical memory.     

Using brief experimental assessment of reading interventions for identification and treatment of a vocal habit

An 11-year-old boy presented in an outpatient clinic with a vocal habit that occurred during reading and conversation. A brief reading assessment was conducted to determine an effective intervention to decrease the habit. A modified version of the word error-correction procedure resulted in positive changes and was implemented by his mother during home reading practices. Significant decreases in the rate of vocal habit were observed during home reading probes, generalization probes, and follow-up.     

Online attentional-focus manipulations in a soccer-dribbling task: implications for the proceduralization of motor skills

A focus of attention on the step-by-step control of a skill has been shown to be detrimental to experts' performance but to have no significant effect on novices' performance (e.g., S. L. Beilock, T. H. Carr, C. MacMahon, & J. L. Starkes, 2002), contrary to the results of manipulations of the direction of attentional focus (e.g., G. Wulf, M. H?ss, & W. Prinz, 1998). In previous studies, researchers have not separated the focus of attention from the nature of the instruction provided or the skill level of the participants. In the present experiment, 10 skilled and 10 less skilled soccer players dribbled a ball after receiving instructions directing attention to an internal, skill-relevant feature (foot); an internal, skill-irrelevant feature (arm); or a skill-irrelevant task (word-monitoring). Performance was evaluated in relation to a no-attentional-focus control condition. For skilled performers, an internal focus on the arms and feet interfered with performance. For less skilled performers, an internal, yet skill-relevant, focus of attention (foot) did not degrade performance, whereas attention to the arms and word monitoring had a detrimental effect. No significant differences were observed across the three attentional manipulations when the skilled performers used the nondominant foot. The results generally supported the deautomization of skills hypothesis.     

A Lesson from My Father

Simple acts can heal. And God is present in those simple and humble acts. The following is a true story that illustrates these truths, told from the perspective of eyewitness, son, and physician.     

Concordant Spiritual Orientations as a Factor in Physician--Patient Spiritual Discussions: A Qualitative Study

Objectives: To understand the impact of physicians and patients religious/spiritual orientation on discussions of spiritual issues. Methods: We performed semi-structured interviews of 10 Missouri family physicians and 10 patients of these physicians, selecting subjects nonrandomly to represent a range of demographic factors, practice types, and chronic or terminal illness. We coded and evaluated transcribed interviews for themes. Results: Respondents expressed that similar belief systems facilitate patient–physician spiritual interactions and bring confidence to their relationships. Those holding dissimilar faiths noted limited ability to address spiritual questions directly. They cited significant barriers to spiritual interaction but considered that ecumenism, use of patient-centered care, and negotiation skills lessen these barriers. Conclusions: Our respondents view spirituality similarly to other aspects of the physician–patient relationship involving differing viewpoints. Where discordance exists, cross-cultural, patient-centered, diplomatic approaches facilitate spiritual discussions.     

Item response theory and the measurement of clinical change

An instrument's sensitivity to detect individual-level change is an important consideration for both psychometric and clinical researchers. In this article, we develop a cognitive problems measure and evaluate its sensitivity to detect change from an item response theory (IRT) perspective. After illustrating assumption checking and model fit assessment, we detail 4 features of IRT modeling: (a) the scale information curve and its relation to the bandwidth of measurement precision, (b) the scale response curve and how it is used to link the latent trait metric with the raw score metric, (c) content-based versus norm-based score referencing, and (d) the level of measurement of the latent trait scale. We conclude that IRT offers an informative, alternative framework for understanding an instrument's psychometric properties and recommend that IRT analyses be considered prior to investigations of change, growth, or the effectiveness of clinical interventions.     

Exploring the hand test with medically ill children and adolescents

Pediatric psychologists use the tools of assessment to evaluate the psychological functioning of youth with chronic and acute medical illnesses. This study is an exploration of the use of a performance-based measure, the Hand Test (HT; Wagner, 1983), with pediatric medical patients. A sample of medical inpatients (n = 27) and psychiatric outpatients (n = 24) were administered the HT, a self-report measure, and a parent-report behavior rating scale. Results indicate that the psychiatric group scored higher than the medical group on HT Aggression, Withdrawal, and Pathological scores. The Aggression (d = 0.90) and Pathological (d = 0.80) variables were particularly robust in differentiating between groups, but the Crippled variable did not differ between groups. Hierarchical logistic regression demonstrated the incremental validity of the HT over behavior ratings alone in the classification of clinical groups. Analyses indicated that the HT can add important information in the differentiation of medically ill children from those with psychological disturbance.     

A conceptual and psychometric framework for distinguishing categories and dimensions

An important, sometimes controversial feature of all psychological phenomena is whether they are categorical or dimensional. A conceptual and psychometric framework is described for distinguishing whether the latent structure behind manifest categories (e.g., psychiatric diagnoses, attitude groups, or stages of development) is category-like or dimension-like. Being dimension-like requires (a) within-category heterogeneity and (b) between-category quantitative differences. Being category-like requires (a) within-category homogeneity and (b) between-category qualitative differences. The relation between this classification and abrupt versus smooth differences is discussed. Hybrid structures are possible. Being category-like is itself a matter of degree; the authors offer a formalized framework to determine this degree. Empirical applications to personality disorders, attitudes toward capital punishment, and stages of cognitive development illustrate the approach.     

Validity and reliability of the audit and CAGE-AID in Northern Plains American Indians

According to the Indian Health Service, substance abuse and Type 2 diabetes are serious problems among Native Americans. To assess substance use in a medical setting, valid screening tests are needed so the Alcohol Use Disorders Identification Test (AUDIT), a simple brief screen for excessive drinking, and the CAGE-adapted to Include Drugs (CAGE-AID) for identifying primary care patients with alcohol and drug disorders were given 50 Northern Plains American Indians with diabetes. Both are short, easy to administer, have good sensitivity and specificity, and can be easily incorporated into a medical history protocol or intake procedure. Reliability coefficients were above .90 and appeared to have sufficient concurrent and divergent validity indicated by moderate correlations with the General Well-being Schedule (rs=-.39 and -.36), the Family-Adaptation, Partnership, Growth, Affection, & Resolve (r =-.47 and -.36), and the Beck Depression Inventory-IT (r = .36 and .29).     

Disentangling encoding versus retrieval explanations of the bizarreness effect: Implications for distinctiveness

Recall effects attributed to distinctiveness have been explained by both encoding and retrieval accounts. Resolution of this theoretical controversy has been clouded because the typical methodology confounds the encoding and retrieval contexts. Using bizarre and common sentences as materials, we introduce a paradigm that decouples the nature of the encoding context (mixed vs. unmixed lists of items) from the retrieval set (mixed vs. unmixed retrieval sets). Experiment 1 presented unmixed lists for study, and Experiment 2 presented mixed lists for study. In both experiments, significant bizarreness effects were obtained in free recall when the retrieval set intermixed items but not when the retrieval set consisted of only one item type. Also, Experiment 1, using a repeated testing procedure, did not reveal evidence for more extensive encoding of bizarre sentences than of common sentences. The results support the idea that retrieval dynamics primarily mediate the bizarreness effect, and perhaps more generally, distinctiveness effects.