Healthcare Serial Killers as Confidence Men

Although there is adequate coverage of serial murder in the extant homicide literature, there is a lack of systematic examination of healthcare professionals who serially murder their patients. Using a sample of 58 healthcare serial killers located within North America, South America, and Europe between the years of 1970 and 2010, this study examines notable pre‐offense and post‐offense behaviours of healthcare serial killers. Patterns related to offender aetiology, victim cultivation, crime scene behaviour, and techniques of evasion were explored. The findings from this study suggest that the pre‐offense and post‐offense behaviours of healthcare serial killers can be conceptualised from the theoretical framework of confidence men or ‘con men’. The findings from this study also suggest that healthcare serial killings and offenders who perpetrate them continue to be elusive and warrant additional scholarly attention to reduce their likelihood of engaging in homicide undetected for extended time. Policy implications are also discussed. Copyright © 2013 John Wiley & Sons, Ltd.     

Deciding with the eye: How the visually manipulated accessibility of information in memory influences decision behavior

Decision situations are typically characterized by uncertainty: Individuals do not know the values of different options on a criterion dimension. For example, consumers do not know which is the healthiest of several products. To make a decision, individuals can use information about cues that are probabilistically related to the criterion dimension, such as sugar content or the concentration of natural vitamins. In two experiments, we investigated how the accessibility of cue information in memory affects which decision strategy individuals rely on. The accessibility of cue information was manipulated by means of a newly developed paradigm, the spatial-memory-cueing paradigm, which is based on a combination of the looking-at-nothing phenomenon and the spatial-cueing paradigm. The results indicated that people use different decision strategies, depending on the validity of easily accessible information. If the easily accessible information is valid, people stop information search and decide according to a simple take-the-best heuristic. If, however, information that comes to mind easily has a low predictive validity, people are more likely to integrate all available cue information in a compensatory manner.     

Feeling the ease: How the use of oral motor fluency changes in amnesia

The present study examined the evolution observed in amnesic patients’ use of motor fluency when making recognition memory decisions. In this experiment, 9 patients with amnesia and 18 matched controls were presented with two recognition memory tasks composed of 3 types of items: (1) natural words, (2) nonwords difficult to pronounce, and (3) nonwords easy to pronounce, the latter having been shown to be processed in a surprisingly fluent manner as long as participants can articulate them at a subvocal level (i.e., oral motor fluency). Our results provide evidence that the motor-movement manipulation was successful to induce a fluency effect. More specifically, data revealed that both amnesic patients and control participants showed a pattern of response consistent with the use of fluency as a cue to memory for studied items. However, only control participants relied on fluency to increase their rate of “yes” responses for unstudied items. These results suggest that patients with amnesia set a more conservative response criterion before relying on oral motor fluency, showing a pattern consistent with the idea that fluency is only used as a cue to memory when it exceeds a certain threshold. These findings are discussed in terms of adaptative metacognition strategies implemented by amnesic patients to reduce fluency-based memory errors as well as in terms of the variations that seem to occur in these strategies depending on the type of fluency that is experienced.     

Patient Perspectives on Co-Therapists’ Behaviors in Group CBT

Journal of Contemporary Psychotherapy - Therapist behaviour influences group cohesion and the outcome of group psychotherapy. The group members make first hand observations of the therapists in...     

Conducting a Pragmatic Trial in Integrated Primary Care: Key Decision Points and Considerations

Pragmatic trials testing the effectiveness of interventions under “real world” conditions help bridge the research-to-practice gap. Such trial designs are optimal for studying the impact of implementation efforts, such as the effectiveness of integrated behavioral health clinicians in primary care settings. Formal pragmatic trials conducted in integrated primary care settings are uncommon, making it difficult for researchers to anticipate the potential pitfalls associated with balancing scientific rigor with the demands of routine clinical practice. This paper is based on our experience conducting the first phase of a large, multisite, pragmatic clinical trial evaluating the implementation and effectiveness of behavioral health consultants treating patients with chronic pain using a manualized intervention, brief cognitive behavioral therapy for chronic pain (BCBT-CP). The paper highlights key choice points using the PRagmatic-Explanatory Continuum Indicator Summary (PRECIS-2) tool. We discuss the dilemmas of pragmatic research that we faced and offer recommendations for aspiring integrated primary care pragmatic trialists.

     

Parenting Adolescents with ADHD: Maternal and Adolescent Contributions and the Intervening Role of Stress

Journal of Child and Family Studies - Compared to parents of typically developing youth, parents of children and adolescents with ADHD tend to engage in fewer positive and more negative parenting...     

Maternal Experience with Online Information on Parenting and Infant Care: Qualitative Findings from Quebec,Canada

Journal of Child and Family Studies - Use of online health information is positively associated with citizen knowledge, empowerment, self-care, health outcomes, and quality of life. However, little...     

Adherence, body mass index, and depression in adults with type 2 diabetes: the mediational role of diabetes symptoms and self-efficacy.

OBJECTIVE: Evidence indicates that depression is linked to the development and worsening of diabetes, but the mechanisms underlying this link are not well understood. The authors examined the hypothesis that diabetes-related symptoms mediate the effect of both behavioral adherence and body mass index (BMI) on depression. In addition, they examined whether a prior finding that self-efficacy mediates the effect of behavioral adherence and BMI on depression would replicate with a larger sample size (W. P. Sacco, K. J. Wells, C. A. Vaughan, A. Friedman, S. Perez, & R. Morales, 2005). Also, the relative contributions of diabetes-related symptoms and self-efficacy to depression were evaluated. DESIGN AND PARTICIPANTS: Cross-sectional design involving adults diagnosed with Type 2 diabetes (N = 99). MAIN OUTCOME MEASURES: The primary outcome measure was depression (Patient Health Questionnaire: Nine Symptom Depression Checklist). Predictors of depression were diet and exercise adherence (Summary of Diabetes Self-Care Activities Questionnaire), diet and exercise self-efficacy (Multidimensional Diabetes Questionnaire), diabetes symptoms (Diabetes Symptom Checklist), and BMI (based on height and weight data from medical records). RESULTS: Path and mediation analyses indicated that adherence and BMI each contributed to depression indirectly, via their effects on self-efficacy and diabetes-related medical symptoms. CONCLUSION: Results provide evidence consistent with two independent pathways by which BMI and adherence could increase depression in people with Type 2 diabetes. The first pathway indicates that the effects of higher BMI and poor adherence on depression are mediated by lower self-efficacy perceptions. The second pathway indicates that the effect of higher BMI on depression is mediated by increased diabetes symptoms.     

Marital Interactions,Family Intervention,and Disagreements: A Daily Diary Study in a Low‐income Sample

Little research has examined associations between low‐income married couples’ daily interactions and severity of disagreements. Similarly, few researchers have considered how family‐strengthening interventions for low‐income couples may affect the quality of daily interactions and associations between interactions and conflict experiences. This study aims to fill these gaps in the literature by leveraging daily diary data from a random assignment study of a family‐strengthening intervention with low‐income husbands and wives 30 months postenrollment. Married couples randomly assigned to the intervention participated in 10 weeks of relationship education services. Control group couples received no services. Thirty months postrandom assignment, participants reported on the severity of daily marital disagreements over a 15‐day period, as well as their positive and negative emotions during inter‐spousal interactions. Multi‐level models demonstrated associations between reports of emotions in interactions and severity of disagreements. In addition, wives assigned to the family strengthening program reported fewer negative emotions during interactions at follow‐up than wives in the control condition. Finally, negative associations between positive emotions in interactions and severity of disagreements were stronger for wives assigned to the intervention, while positive associations between negative emotions in interactions and severity of disagreements were weaker for wives assigned to the intervention. Implications for future research and intervention development are discussed.     

Recent Decreases in Specific Interpretation Biases Predict Decreases in Neuroticism: Evidence From a Longitudinal Study With Young Adult Couples

Engaging in a romantic relationship represents one important life experience in young adulthood that has been shown to catalyze age‐related decrease in neuroticism (Neyer & Lehnart, 2007). The current research builds directly on this finding by investigating one process that underlies the partnership effect. We focused on the relationship‐specific interpretation bias (RIB; Finn, Mitte, & Neyer, 2013), which is the tendency to interpret ambiguous partner and relationship scenarios in a negative way. It was expected that the RIB decreases within relationships in young adulthood and that this decrease in turn predicts long‐term declines in neuroticism. A sample of 245 young adult romantic couples was assessed four times across 9 months. Actor and partner effects of changes in the RIB on changes in neuroticism were analyzed using a dyadic dual change model. Recent time‐to‐time decreases in the RIB predicted one's own (actor effect) decline in neuroticism across 9 months. Similarly, there was a trend for a partner effect. We conclude that changes in biased relationship‐specific interpretations reflect one unique process that contributes to the understanding of romantic relationship effects on personality development.