Assessment as Intervention: A Pilot Study of Short-Term Dyadic Treatment

Assessment, as an intervention, is a hallmark of infant mental health that has not been evaluated for treatment effectiveness. A comprehensive assessment framework was standardized as a short-term intervention model and evaluated for treatment effects based on dynamic systems theory of change. The transdisciplinary interaction-based assessment model embeds nondidactic developmental guidance interpretations in the context of eliciting child functional capacities while engaging the caregiver in direct co-observation and reflection to challenge inflexibility in parents’ representations. The findings of this pilot project, with a community sample of Spanish- and English-speaking families, suggest this assessment as intervention model has the potential to promote an active process of change in parents’ representations toward a “disorderly,” or unstable state, possibly both in perceptions of self as caregiver and in representations of the child. Clinically, this disorderly state would be seen as an opportunity that could perpetuate the change process, recognizing disorderliness of representation as an opening, as emerging permeability of representations. Results indicate that this caregiver-clinician collaborative process is associated with caregiver reports of decreased distress, increased empathy for child’s difficulties, and changes in caregiver representations. A subset of families, caregivers who hold immutable views of their children, are less responsive to the developmental guidance approach and may require different or more long-term treatment.     

Reconsidering the role of language in medicine

Background

Despite an expansive literature on communication in medicine, the role of language is dealt with mostly indirectly. Recently, narrative medicine has emerged as a strategy to improve doctor-patient communication and integrate patient perspectives. However, even in this field which is predicated on language use, scholars have not specifically reflected on how language functions in medicine.

Methods

In this theoretical paper, the authors consider how different models of language use, which have been proposed in the philosophical literature, might be applied to communication in medicine. In particular, the authors contrast the traditional, indexical thesis of language with new models that focus on interpretation instead of standardization.

Results

The authors demonstrate how paying close attention to the role of language in medicine provides a philosophical foundation for supporting recent changes in doctor-patient communication. In particular, interpretive models are at the foundation of new approaches such as narrative medicine, that emphasize listening to patient stories, rather than merely collecting information.

Conclusion

Ultimately, debates regarding the role of language which have largely resided in non-medical literatures, have important implications for describing communication in medicine. In particular, interpretive models of language use provide an important rationale for facilitating a more robust dialogue between doctors and patients.

     

Correspondence and disparity in the self- and other ratings of current and childhood ADHD symptoms and impairment in adults with ADHD

Experts recommend that clinicians evaluating adults for attention-deficit/hyperactivity disorder (ADHD) obtain information from others who know the patient well. The authors examined correspondence between the self- and other-ratings of ADHD symptoms and impairment using 3 groups of adults recruited on the basis of their severity of ADHD: ADHD diagnosis (n = 146), clinical controls self-referring for ADHD but not diagnosed (n = 97), and community controls (n = 109). The influences of diagnostic group, informant relationship, sex of participant, IQ, and comorbid anxiety and depression on self-informant disparities were also examined. Results indicated moderate to high agreement (.59-.80) between self and others on current functioning and slightly lower levels (.53-.75) between self- and parent ratings of childhood functioning. Examination of difference scores between self- and other ratings revealed small mean disparities (-0.1 to +5.0 points) but substantial variation (SDs = -2.4 to 8.9 points) for both current and childhood ratings. Clinic referrals not diagnosed with ADHD, particularly women, had higher disparities than was evident in the ADHD and community groups. Age, IQ, and education were not associated with disparities in most ratings. Higher anxiety, in contrast, was associated with greater disparities on all current and childhood measures of both ADHD and impairment.     

Pigeons' categorization may be exclusively nonanalytic

Recent theoretical and empirical developments in human category learning have differentiated an analytic, rule-based system of category learning from a nonanalytic system that integrates information across stimulus dimensions. In the present study, the researchers applied this theoretical distinction to pigeons' category learning. Pigeons learned to categorize stimuli varying in the tilt and width of their internal striping. The matched category problems had either a unidimensional (rule-based) or multidimensional (information-integration) solution. Whereas humans and nonhuman primates strongly dimensionalize these stimuli and learn rule-based tasks far more quickly than information-integration tasks, pigeons learned the two tasks equally quickly to the same accuracy level. Pigeons may represent a cognitive system in which the commitment to dimensional analysis and category rules was not strongly made. Their performance could suggest the character of the ancestral vertebrate categorization system from which that of primates emerged.     

Context fear learning specifically activates distinct populations of neurons in amygdala and hypothalamus

The identity and distribution of neurons that are involved in any learning or memory event is not known. In previous studies, we identified a discrete population of neurons in the lateral amygdala that show learning-specific activation of a c-fos-regulated transgene following context fear conditioning. Here, we have extended these studies to look throughout the amygdala for learning-specific activation. We identified two further neuronal populations, in the amygdalo-striatal transition area and medial amygdala, that show learning-specific activation. We also identified a population of hypothalamic neurons that show strong learning-specific activation. In addition, we asked whether these neurons are activated following recall of fear-conditioning memory. None of the populations of neurons we identified showed significant memory-recall-related activation. These findings suggest that a series of discrete populations of neurons are involved in fear learning in amygdala and hypothalamus. The lack of reactivation during memory recall suggests that these neurons either do not undergo substantial change following recall, or that c-fos is not involved in any such activation and change.     

Semantic priming occurs for word but not location pronunciation in the postcue task

Semantic priming refers to the finding that a word response is facilitated if it is preceded by a related word compared to when it is preceded by an unrelated word. Dallas and Merikle (Can J Psychol 30: 15–21 1976a; Bull Psychon Soc 8: 441–444 1976b) demonstrated that semantic priming occurred under conditions in which a pair of simultaneously displayed words was previewed for over a second prior to the onset of a cue indicating which of the words should be pronounced aloud (postcue task). In contrast, semantic interference effects have been reported for postcue picture-naming tasks (Dean et al. in J Exp Psychol Learn Mem Cogn 27: 733–743, 2001; Humphreys et al. in J Exp Psychol Learn Mem Cogn 21: 961–980, 1995). According to Dean et al., the semantic interference effects in postcue picture naming occur because the integration of the object and the cued attribute in memory is more difficult for categorically related pictures than for unrelated pictures. The aim of this experiment was to determine whether this idea was true for postcue word pronunciation tasks. Participants completed two postcue tasks, one requiring pronunciation of the target word indicated by a locational cue and another requiring pronunciation of the location of a centrally presented word. Results indicated a semantic priming effect only for the locational cue condition suggesting that the integration of the cue and identity information was unaffected by word context. These data suggest that priming in a postcue word pronunciation task may be due to feedback from residual activation within the semantic system facilitating access to the target word’s phonology.     

Leveraging Motivational Mindsets to Foster Positive Interracial Interactions

As the United States becomes increasingly diverse, interracial contact will become considerably less rare. Much research has suggested that interracial interactions are often stressful and uncomfortable for both Whites and racial minorities. Bringing together several bodies of research, the present article outlines a motivational perspective on the dynamics of intergroup contact. To this end, we consider the roles of three motivational mindsets that have the potential to shape interactions to be less cognitively depleting and more enjoyable for both interactants. In particular, we consider the effects of (i) approach and avoidance motivation (Handbook of Motivation and Cognition: Foundation of Social Behavior, 1990, New York: Guilford Press), (ii) promotion and prevention regulatory focus (American Psychologist, 52 , 1997, 1280), and (iii) learning and performance goals (Psychological Review, 95 , 1988, 256) in shaping the dynamics of interracial contact. We suggest that investigations into these motivational mindsets will offer further insight into how and why interracial interactions go awry and will assist in the development of strategies and interventions that facilitate more smooth and enjoyable contact experiences.     

A model of top-down gain control in the auditory system

To evaluate a model of top-down gain control in the auditory system, 6 participants were asked to identify 1-kHz pure tones differing only in intensity. There were three 20-session conditions: (1) four soft tones (25, 30, 35, and 40 dB SPL) in the set; (2) those four soft tones plus a 50-dB SPL tone; and (3) the four soft tones plus an 80-dB SPL tone. The results were well described by a top-down, nonlinear gain-control system in which the amplifier’s gain depended on the highest intensity in the stimulus set. Individual participants’ identification judgments were generally compatible with an equal-variance signal-detection model in which the mean locations of the distribution of effects along the decision axis were determined by the operation of this nonlinear amplification system.     

Reviews of current books

Pastoral Psychology -     

Criticisms of the satiety hypothesis as an explanation for within-session decreases in responding

The authors of four papers recently reported that satiation provides a better explanation than habituation for within-session decreases in conditioned responding. Several arguments question this conclusion. First, the contribution of habituation to within-session changes in responding seems clearly established. Information that is consistent with habituation, but that is difficult to reconcile with satiation, is not adequately addressed. Second, the limited evidence offered in support of satiation is ambiguous because the results are just as compatible with habituation as with other satiety variables. Finally, the term satiation is used in an intuitive way that is sometimes contradicted by research about the termination of ingestion. Use of the technical term satiation in a way that differs from its conventional usage will only isolate operant psychology from other areas of psychological research.