The psychologist's role in assessing and facilitating patients' knowledge of advance directives in medical settings: A preliminary investigation

In a time of budgetary shortfalls in the medical industry, an aging population, and an increased emphasis on health care choices, psychologists are being called upon to administer advance medical directive programs to patients. This study reports preliminary findings from a program to assess and facilitate patients' knowledge of advance directives (ADs) by the Psychology Service at the Ann Arbor VA Medical Center. The participant pool included 243 male veteran patients admitted to medical and surgical wards at the hospital. The intervention included the use of a computer-generated prompt for consultation, which was sent to the psychology staff in response to a patient inquiry regarding ADs. It also involved an increased emphasis on the delivery of written material on ADs by the admissions clerks. The intervention appeared to result in a modest increase in patients' knowledge of advance directives. Suggestions are offered for areas that should be emphasized in future attempts to increase patients' knowledge and utilization of advance directives.     

Varieties of positive and negative priming

Numerous recent investigations have focused on a particular relation between the roles a stimulus plays in successive displays: when a stimulus ignored by a subject on one occasion is to be attended on a succeeding occasion, reaction time to that stimulus is slowed relative to a control condition. But this is but one possible case ofnegative priming. There are other ways in which negative priming might occur, and there are several varieties of positive priming as well. All these possibilities were explored in the present experiment.     

On the time course of negative priming: Another look

In two experiments, the pattern of persistence of negative priming effects across delay intervals of 500 and 2,500 msec was assessed using a within-subjects, random sequencing of delays. Neill and Valdes (1992; Neill, Valdes, Terry, & Gorfein, 1992) have argued that a within-subject experimental design is required for decay of negative priming to be seen, in contrast to results reported elsewhere (e.g., Tipper, Weaver, Cameron, Brehaut, & Bastedo, 1991) showing stable negative priming effects across delays. In neither experiment was substantial evidence of decay detected, raising questions for the notion that suppression necessarily declines across brief temporal intervals and for the assertion that episodic retrieval is the sole source of negative priming.     

Factor analysis of the social performance survey schedule

There are several studies suggesting that the Social Performance Survey Schedule (SPSS) is a reliable and valid measure of social skill. However, the factorial structure of the SPSS has never been examined. In the present study, SPSSs taken by 652 college students were factor analyzed by the method of principal components and the resulting factors were rotated according to the varimax criterion. Separate factor analyses were conducted for men and women. Seven factors, which accounted for a little over a third of the total variance, were retained for each sex. A large general factor labeled Prosocial Competence emerged for both sexes. Beyond this, the factorial solutions for the two sexes tended to diverge, with males showing a large negative factor (Social Offensiveness) and three smaller negative factors and females showing five relatively small negative factors. Suggestions were made concerning additional factor analytic studies of the SPSS and the ways in which derived factors might be used in research and clinical work.This research was supported by funds from the Rutgers University Research Council. Thanks are due to Leona Aiken for her statistical consultation.     

The pain behavior scale: Modification and validation for outpatient use

The present study investigated the validity of an inpatient pain behavior rating scale modified for outpatient use. A series of 43 consecutive outpatients referred for evaluation of chronic pain was examined using the Pain Behavior Scale (PBS) and other psychometric instruments. Analyses revealed significantly higher Pain Behavior Scale scores for low back and multiple pain-site groups. The results also indicated a high degree of internal consistency of the scale. A multiple regression analysis, predicting observed pain behavior from reported pain behavior, indicated that decreased activity accounted for 32% of the variance in the PBS score. A similar regression for pain experience found that the pain level and the sensory scale score on the McGill Pain Questionnaire accounted for 39% of the PBS variance. Psychological characteristics including disease conviction, self-control, depression, and anxiety explained 45% of the variability in the PBS score. Thus, the scale is related to pain intensity, interference with activities, and a variety of psychological characteristics. The scale provides a measure of observable pain behavior that is also relatively independent of these clinical data sources. The Pain Behavior Scale as modified for outpatient use provides a brief index of pain behavior with potential use in the comprehensive evaluation of the pain patient.     

Sensation-seeking and selection of entertainment

The relationship between entertainment activity preference and sensation-seeking was investigated by survey and actual movie selection and viewing. Cardiac rate and rate change was monitored during movie selection and viewing. High sensation-seeking (HSS) females reported preferences for activities centered about alcohol, sexually-explicit materials and ‘rock’ music. HSS males reported preferences for sexually-explicit materials and news/documentary reports. Low sensation-seeking (LSS) males and females reported preferences for the musical stage, theatrical drama and comedy, and romantic/dramatic novels. HSS males and HSS females allotted high proportions of viewing time to an ‘action’ movie, and changed channels more frequently than LSS. The indices of cardiac response utilized in this study were unrelated to movie viewing activities, a result which does not support the ‘optimal level of arousal’ view of sensation-seeking proposed by Zuckerman (1979).