The Effects of Capitation on Outpatient Mental Health Episodes of Children

We analyzed the effects of the Colorado Medicaid Capitation Program on the duration and services of over 21,000 outpatient mental health episodes for young children. The study spanned a three year period before and after capitation was implemented, and compared episodes of outpatient care for children from 14 capitated Community Mental Health Centers (CMHCs) with those from three CMHCs that remained fee-for-service. Proportional hazards regressions revealed that capitation resulted in an increase in outpatient episode duration, over and above similar effects for the comparison fee-for-service episodes. The hypothesis that there were longer capitated episodes for children who were hospitalized was not supported. Children with behavioral and anxiety disorders had longer capitated episodes. Service intensity decreased over time in the managed care sites. Changes in case mix may have had an impact on changes in episode duration and service intensity. That outpatient episode duration increased over time while costs were lowered in the capitated agencies indicates some effects of capitation in changing patterns of care.     

Investigating sustained attention ability in the elderly by using two different approaches: Inhibiting ongoing behavior versus responding on rare occasions

Previous studies on sustained attention ability in the elderly produced inconsistent results. The aim of this study was to evaluate sustained attention performance in younger and older individuals by using, in a within-subjects design, two versions of the same task (the sustained attention to response task, SART) in which only in the response mode differed: in a traditionally formatted task (TFT), subjects had to respond to rare targets, and in a Go/No-Go task they had to withhold response to rare targets. Results showed that in the TFT SART only the older group exhibited a vigilance decrement. On the contrary, only young individuals showed a vigilance decrement in the Go/No-Go SART. These results showed that older individuals, who also reported less mind wandering and a higher level of motivation, exhibited preserved sustained attention ability in the Go/No-Go SART, which could be explained by increased engagement of cognitive control mechanisms in this population. The discrepancy in performance depending on the approach used also underlines the need for further studies on the nature of attention failures and their underlying mechanisms.     

Shared and distinct factors driving attention and temporal processing across modalities

In addition to the classic finding that “sounds are judged longer than lights,” the timing of auditory stimuli is often more precise and accurate than is the timing of visual stimuli. In cognitive models of temporal processing, these modality differences are explained by positing that auditory stimuli more automatically capture and hold attention, more efficiently closing an attentional switch that allows the accumulation of pulses marking the passage of time (Penney, Gibbon, & Meck, 2000). However, attention is a multifaceted construct, and there has been little attempt to determine which aspects of attention may be related to modality effects. We used visual and auditory versions of the Continuous Temporal Expectancy Task (CTET; O'Connell et al., 2009) a timing task previously linked to behavioral and electrophysiological measures of mind-wandering and attention lapses, and tested participants with or without the presence of a video distractor. Performance in the auditory condition was generally superior to that in the visual condition, replicating standard results in the timing literature. The auditory modality was also less affected by declines in sustained attention indexed by declines in performance over time. In contrast, distraction had an equivalent impact on performance in the two modalities. Analysis of individual differences in performance revealed further differences between the two modalities: Poor performance in the auditory condition was primarily related to boredom whereas poor performance in the visual condition was primarily related to distractibility. These results suggest that: 1) challenges to different aspects of attention reveal both modality-specific and nonspecific effects on temporal processing, and 2) different factors drive individual differences when testing across modalities.     

Super- (and not-so-super-) vision of counsellors-in-training: Supervisee perspectives on broadening and narrowing processes

This study investigated the experiences of broadening and narrowing in the supervisory process from the perspective of supervisees. Ten supervisees who had completed all requirements for a master's degree in counselling were interviewed using a semi-structured interview. Data were analyzed using a consensual qualitative research method. Results included categories of supervisor and supervisee actions that contributed to both broadening and narrowing experiences in supervision. The results are discussed in light of implications for the process of supervision.     

The Gender Wage Gap: An Explanation of Men’s Elevated Wage Entitlement

Perceptions of wage entitlement differ between women and men such that men are more likely to feel worthy of higher pay. Based on a combination of status-related theories and evidence from two studies of 120 undergraduate men, we examined men’s reactions to gendered threats to their task abilities. When told that women typically outperform men, men responded with elevated projections of their own competence without reducing their self-pay. These effects were not related to endorsements of masculinity ideology. Instead, exaggerated competence was related to individual men’s heightened legitimate entitlement, and resistant high self-pay was linked to narcissistic entitlement. These patterns demonstrate that what appears to be a gender-based phenomenon is explained more accurately by men’s internalized status beliefs.     

Perceptions of Sexual Orientation: A Hierarchically Restrictive Trait

Categorizing a person according to group membership (sexual orientation) attaches group stereotypes and behavioral expectations to that individual. For Study 1, students from New Mexico, United States (N?=?127) were asked to indicate the number of inconsistent behaviors it would take to change expectations about a categorized person. Study 1 revealed that sexual orientation is a hierarchically restrictive trait: for heterosexual targets, only a few inconsistent behaviors changed expectations, and for homosexual targets, many inconsistent behaviors did not change expectations. For Study 2, survey research (N?=?163) and path analyses revealed different patterns between male and female respondents for relationships between religiosity, attitudes toward homosexuals, attitudes toward sexuality, and the degree of hierarchical restrictiveness of sexual orientation.     

Serial list linking by macaque monkeys (Macaca mulatta): list property limitations

Four sophisticated macaque monkeys (Macaca mulatta) learned 6 different, 15-item ordinal lists (via conditional, 2-choice discriminations) as part of a study assessing some properties of serial list memory in monkeys. After assuring that the first 3 lists were well retained, the researchers attempted to link these by training only the 2 end-item pairs that ordered all 45 items into an inclusive series. A 20-day test of possible pairings among these 45 items was then conducted. Subsequently, the other 3 lists were trained and tested for retention, but no link training was provided. Then, a test like the one that had followed linking was administered. Unlike previous outcomes with three 5-item lists, linking did not yield immediate merger of three 15-item lists into a 45-item list, although 45-item lists were acquired after sufficient exposure to the testing/training regimen under both linking and nonlinking conditions. List length as a limiting factor in linking suggested processing restrictions analogous to those observed in human list memory. Results supported further investigation of list-linking characteristics.     

Peer Victimization in Youth with Tourette’s Syndrome and Chronic Tic Disorder: Relations with Tic Severity and Internalizing Symptoms

The present study analyzed rates of peer victimization in children with a chronic tic disorder as compared to children with type 1 diabetes and healthy controls. The associations among peer victimization, tic symptom severity, and psychological symptoms, as well as the potential mediating relationship between peer victimization, tic severity, and child internalizing symptoms, were also explored. Children with tics displayed higher rates of peer victimization than control groups, and peer victimization in children with tics was positively correlated with tic symptom severity, loneliness, anxiety symptoms, and parent report of child internalizing symptoms. Results also supported the hypothesis that peer victimization mediates the relationship between tic symptom severity and loneliness. Findings highlight the importance of the assessment and treatment of psychosocial variables in children with chronic tic disorders, including social functioning and peer relationships.