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.     

Toward a Comprehensive Strategy for Effective Practitioner–Scientist Partnerships and Larger-Scale Community Health and Well-Being

This article articulates joint priorities for the fields of prevention science and community psychology. These priorities are intended to address issues raised by the frequent observation of natural tensions between community practitioners and scientists. The first priority is to expand the knowledge base on practitioner–scientist partnerships, particularly on factors associated with positive outcomes within communities. To further articulate this priority, the paper first discusses the rapid growth in community-based partnerships and the emergent research on them. Next described is an illustrative research project on a partnership model that links state university extension and public school delivery systems. The article then turns to the second, related priority of future capacity-building for diffusion of effective partnership-based interventions to achieve larger-scale health and well-being across communities. It outlines two salient tasks: clarification of a conceptual framework and the formulation of a comprehensive capacity-building strategy for diffusion. The comprehensive strategy would require careful attention to the expansion of networks of effective partnerships, partnership-based research agendas, and requisite policy-making.     

Delayed attentional engagement in the attentional blink

Observers often miss the 2nd of 2 visual targets (first target [T1] and second target [T2]) when these targets are presented closely in time; the attentional blink (AB). The authors hypothesized that the AB occurs because the attentional response to T2 is delayed by T1 processing, causing T2 to lose a competition for attention to the item that follows it. The authors investigated this hypothesis by determining whether the AB is attenuated when T2 is precued. The results from 4 experiments showed that the duration and magnitude of the AB were substantially reduced when T2 was precued. The observed improvement in T2 report did not occur at the expense of T1 report, suggesting that processing of T1 was already completed or was at least protected when the cue was presented. The authors conclude that, during the AB, there is a delay between detection and the selection of target candidates for consolidation in short-term memory.     

Multiple-object tracking is based on scene, not retinal, coordinates

This study tested whether multiple-object tracking-the ability to visually index objects on the basis of their spatiotemporal history-is scene based or image based. Initial experiments showed equivalent tracking accuracy for objects in 2-D and 3-D motion. Subsequent experiments manipulated the speeds of objects independent of the speed of the scene as a whole. Results showed that tracking accuracy was influenced by object speed but not by scene speed. This held true whether the scene underwent translation, zoom, rotation, or even combinations of all 3 motions. A final series of experiments interfered with observers' ability to see a coherent scene by moving objects at different speeds from one another and by distorting the perception of 3-D space. These reductions in scene coherence led to reduced tracking accuracy, confirming that tracking is accomplished using a scene-based, or allocentric, frame of reference.