The Future of Psychology in Medicaid's Health Delivery System for People with Disabilities

State Medicaid programs are rapidly converting fee-for-service health delivery systems to managed care for people with disabilities. In theory, managed care models of health delivery will substantially improve the quality of care for people with disabilities, but in reality, few successful models exist. This period of transition holds both opportunities and challenges for psychologists in medical settings. Because Medicaid reforms for people with disabilities may herald similar reforms for both the public and the private sectors, psychology's response will determine its role in the future of health care delivery for this population. Changes in training and increased attention to outcomes research, innovations in practice, and advocacy will be the keys to success.     

Inhibitory control over no-longer-relevant information: Adult age differences

Hartman and Hasher (1991) used a garden-path task in which younger and older adults generated the final word for each of a series of high-cloze sentences. Under instructions to remember the final word, the experiment included critical sentences for which the generated word was replaced by a new, to-be-remembered target. Using an implicit priming task, the first experiment replicated a basic finding: Younger adults showed priming only for the target words, whereas older adults showed priming for both the generated and target words. Two experiments explored boundary conditions. One showed that an additional sentence that interpreted the new target word enabled older adults to narrow access to only the target word. The provision of additional time following the introduction of the new target word did not. Specific information, not more time, is required for inefficient inhibitory mechanisms to clear the recent past from memory.     

The Development of the Toddler Behavior Screening Inventory

The purpose of the present study was to develop the Toddler Behavior Screening Inventory (TBSI) for rapidly assessing maternal reports of toddler behavior problems. The TBSI is a 40-item measure intended for use by pediatricians, psychologists, and other child-care professionals. A group of mothers (n = 312) rated the initial 93-item TBSI in terms of behavior frequency and parental perception of the behavior as problematic. Following item elimination, 40 items were retained due to being both frequent and problematic at all toddler age levels. Data were obtained with a new sample of mothers (n = 581) and showed the TBSI to possess good reliability and validity.     

Associations Between Clinic-Referred Boys and Their Fathers on Childhood Inattention-Overactivity and Aggression Dimensions

The question asked in this study of 70 clinically referred 6- to 12-year-old boys with behavior problems was whether or not childhood inattention-overactivity and aggression are transmitted specifically from biological fathers to sons. Fathers' self-reported childhood inattention-overactivity on a retrospectively valid measure was exclusively associated with parents' ratings of their sons' current attention problems on the Mothers' Operational Measure for Sub-grouping (MOMS), the Revised Child Behavior Checklist (RCBCL), and an approximated DSM-IV inattention dimension. Fathers' self-reported childhood aggression was not associated with ratings of their sons' aggression on the MOMS or DADS (a parallel instrument for fathers), nor on DSM-III oppositional or conduct disorder dimensions, but it was exclusively associated with RCBCL ratings of sons' aggressive and delinquent behavior. None of the nonspecific correlations (father inattention-overactivity with son aggression or father aggression with son inattention-overactivity) was significant.     

“Are False Memories Permanent?”: An Investigation of the Long-Term Effects of Source Misattributions

With growing concerns over children's suggestibility and how it may impact their reliability as witnesses, there is increasing interest in determining the long-term effects of induced memories. The goal of the present research was to learn whether source misattributions found by Ceci, Huffman, Smith, and Loftus (1994) caused permanent memory alterations in the subjects tested. When 22 children from the original study were reinterviewed 2 years later, they recalled 77% of all true events. However, they only consented to 13% of all false events, compared to the 22% false consent rate (among the same subset of children) found by Ceci et al. (1994). Additionally, while children remained accurate in their recall of true events (they maintained assents 78% of the time), they “recanted” their earlier false consents 77% of the time, after the 2-year delay. Implications of these findings for child witnesses and the legal system are discussed.     

Gender and Self-Reported Sexual Arousal in Response to Sexual Stimuli: A Meta-Analytic Review

Social constructionist theories and sociobiological perspectives have led to increased interest in gender differences in sexual behavior. This study involved a meta-analysis of gender differences in sexual arousal in response to sexual stimuli. Forty-six studies in which participants were presented with a sexual stimulus depicting males and females and in which participants responded using a self-report measure of arousal were compiled, and 62 independent effect sizes were aggregated. An overall effect size of d = .31 showed a small to moderate-sized gender difference in sexual arousal with men reporting more arousal than women across all studies. There was significant variation in the effect sizes, though, which was only partially explained by variables coded from the studies. It was found that the gender difference was slightly larger for studies using pornographic vs. erotic stimuli, was larger for studies where participants were tested in a private setting or small group compared to a large group, and was much larger for college age participants compared to those who were older than college age. Generally, the pattern of results provided more support for predictions from social influence theories compared to sociobiological theory.     

The creative potential of play and regression in analytical training: a personal reflection

The seminar group can serve as a framework in which to meet the fear generated during training. The group can become a maddening environment, but on occasions when it is experienced by the trainee as good enough, it can act like a playgroup which facilitates development. Experiences in the group can be viewed from the perspectives of group dynamics or of transference phenomena which embody regression. When this regression enables scope for play it can serve in the interests of ego development in the process of discovering the sort of analyst the trainee is becoming as the training unfolds. During play aspects of oneself can merge, then differentiate again. They can have different meanings at the same time. The rational and emotional, the adult and the childlike are all given a place in play.     

EFFECTS OF HIGH-PROBABILITY REQUESTS ON THE SOCIAL INTERACTIONS OF YOUNG CHILDREN WITH SEVERE DISABILITIES

High-probability requests were used to increase social interactions in 3 young boys with severe disabilities who had been identified as severely socially withdrawn. A multiple baseline design across participants was used to evaluate the effects of high-probability request intervention on (a) social initiations, (b) social responses, (c) continued interactions, and (d) performance of high- and low-probability requests. The students were observed in a second setting to examine generalization effects across peers who did not participate in the training sequence and settings. The results demonstrated that the high-probability requests increased the students' responsiveness to low-probability requests to initiate social behavior. Increases were also found in (a) unprompted initiations and extended interactions to the training peers, (b) unprompted initiations and extended interactions to peers who were not involved in the training procedure, and (c) generalized unprompted initiations and interactions in a second nontraining setting. The students maintained increased levels of initiations and interactions after all prompts were removed from both the training and nontraining settings.     

Ethnic and Gender Variations in the Sources of Information Used to Evaluate Performance in the Exercise Setting1

The purpose of this study was to identify ethnic and gender differences in the types of information Anglo and Hispanic exercisers use in self-evaluation. University students in exercise classes rated the importance of norm-referenced and self-referenced sources used in self-evaluation of performance. Results showed that males rated norm-referenced sources as more important to self-evaluation, while females rated self-referenced sources as most important. A gender by ethnicity interaction showed that Anglos, especially Anglo males, preferred norm-referenced sources, while Hispanics preferred self-referenced sources. Provided with this information, instructors could more effectively motivate exercise participants.