Recall by expert medical practitioners and novices as a record of processing attention

Using recall of clinical protocols as a measure of expertise in medicine has yielded disappointingly small effects. Experiments using recall of clinical laboratory data are presented to provide an explanation. In one experiment, subjects either deliberately memorized or first diagnosed and then were incidentally asked for memory. With incidental instructions, experts recalled over twice as much data as did students, but with memorization instructions, student performance approximated that of experts. Experts also showed a large advantage over students in incidental recall of data that were not relevant to the problem solution. These results suggest that expert processing in this "discrete, independent inputs" domain requires effortful analysis with minimal reliance on default values, rather than relatively effortless pattern perception reported in highly visual areas of expertise. For this area, intentional memory is a misleading measure of expertise. However, incidental memory is a valuable measure of processing during diagnosis.     

Age differences in the acculturation process

Age differences were assessed in a conceptual model that seeks to explain how acculturation affects psychological well-being among Mexican Americans. The data were from a national probability sample of 859 persons of Mexican decent. It was hypothesized that low acculturation creates financial stress. Moreover, low acculturation and financial stress were in turn predicted to erode feelings of personal control and self-esteem. Finally, diminished feelings of control and low self-esteem were hypothesized to exert a negative impact on psychological well-being. When data from respondents of all ages was assessed, empirical support was found for all of the hypotheses except the linkage between acculturation and financial stress. However, few age differences emerged in the model. The authors conclude that older Mexican Americans may not be more vulnerable to the stressors associated with acculturation.     

Frontal lobe dysfunction and memory impairment in patients with chronic progressive multiple sclerosis

Deficits in semantic encoding have been described in patients with frontal lobe disease who also show memory impairments. As a group, patients with multiple sclerosis (MS) exhibit memory impairment, fail to make effective use of semantic encoding to aid memory, and perform poorly on verbal fluency and concept formation tests which are sensitive to frontal lobe damage. In the present study the semantic encoding capacity of MS patients was measured using a modification of Wicken's release from proactive interference (PI) paradigm. Individual patients varied considerably in the severity of their impairments on verbal fluency, verbal recognition memory and on Wisconsin Card Sorting Task, but even patients who evidenced both memory impairment and signs of frontal lobe dysfunction showed normal release from PI after a categorical shift. Memory disturbances in MS are unlikely to result from an incapacity for semantic encoding, which seems preserved in MS, but may arise instead from deficits in processing information rapidly.     

Perioral somatosensory determinants of nursing behavior in Norway rats (Rattus norvegicus)

Prior to assuming the upright crouching posture over their pups during nursing bouts, lactating rats typically engage in several oral behaviors, including nuzzling, licking and rearranging pups. By acutely depriving dams of various aspects of perioral stimulation from pups (with anesthesia of the mystacial pads or of the tongue, with mouth suturing, or with muzzling), we found the following: (1) Distal stimulation from pups maintains proximity-seeking behavior, but is insufficient to stimulate nursing behavior. (2) Lack of tongue feedback decreases pup licking and hastens the onset of crouching. (3) Snout, but not tongue, contact with pups is required for hovering over them. (4) The position of the dam while hovering over her litter enables the pups to gain access to her ventrum, thereby provoking her upright, crouching posture. (5) Older pups are capable of bypassing the dam's perioral attentions and stimulating crouching directly by burrowing under the dam's ventrum.     

The written summary in group psychotherapy revisited

This paper addresses the use of the weekly written summary with patients in group psychotherapy. In an effort to stimulate group process and effect cotherapist communication, the authors instituted this group recording in an ongoing psychodynamically oriented mixed adult group. While the utilization of this device did, in fact, stimulate the group process and became an important part of the group's life, the therapists additionally saw significant effects upon their working alliance. These included increased focused dialogue upon group dynamics, more purposeful planning for group interventions, and heightened awareness of the significance of interventions in the group.Ms. Bosman-Clark is formerly Clinical Instructor, Department of Psychiatry, Baylor College of Medicine.     

The physiology of the tunnel

Several theories to account for the origin of tunnel hallucinations and tunnel experiences near death are considered: (1) the idea of a real tunnel; (2) representations of transition; (3) reliving birth memories; (4) imagination; and (5) physiological origins. Three different physiological theories are considered that related the tunnel form to the structure of the visual cortex. All can account for much of the phenomenology of the tunnel experience, and all lead to testable predictions. It is argued that the tunnel experience involves a change in the mental model of the self in the world. Because of this, an experience of purely physiological origin, with no implications for other worlds or for survival, can nevertheless produce lasting changes in the sense of self and reduce the fear of death.