Preferences for involvement in medical decision making: comparing British and German views

Despite beneficial outcomes of patients' involvement in medical decision processes, it has been claimed that patients are generally not interested in medical decision making (MDM). Whereas current research focuses on actual MDM, this research explored the impact of nationality and perceptual processes of MDM. Preferences for involvement in decision making were examined in a sample of 204 German and 143 British university students. Hierarchical multiple regressions were employed to explore the link between socio-demographic information, individuals' perceived relationship with their GP, Health Locus of Control - Powerful Others, perceptions regarding the frequency and sufficiency of information provision and involvement in MDM, and individuals' preferred level of involvement and information. A significant amount of the variance in individuals preferences for involvement could be explained (Adjusted R2 = .59, p < .001). Independent t-test analyses showed that British and German perceptions of care differed significantly on a variety of different measures. Separate analyses for the German and British group highlighted cross-national differences in care and preferences for involvement. The study suggests that preferences to become involved might depend more on perceptual processes than actual involvement in decision making, and that communication and national health policy could play an important role.     

Predicting Acculturation Using Career,Family, and Demographic Variables in a Sample of Mexican American Students

The authors examined the relationship of a set of career variables, family cohesion, and demographic variables with the acculturation level of a sample of 176 Mexican American community college students. Multiple regression analyses using a blocked entry method revealed that only the demographic variables related significantly to acculturation. Based upon the zero order correlations, socioeconomic status would appear to account for most of the variance shared by acculturation and a linear combination of the demographic variables.     

Decision versus policy in crises intervention

The paper describes procedures for contrasting actions taken by crises intervention outreach workers and consumers with administrative policies. The data used to exemplify the procedures came from the outreach projects of six county MH/MR programs in Central Pennsylvania during the year following the flood caused by Hurricane Agnes, in 1972. The procedure identifies and counts the ways through which consumers entered the outreach process; the major outreach worker decision; and the immediate disposition of each consumer's case. The six county MH/MR program administrators were asked to consider program policies and show how they would ideally expect 1,000 hypothetical consumers to come into, to be processed through, and to be referred out of their respective outreach programs. Contrasts of the ideal and actual consumer data, along with consumer follow-up questionnaires, provided the basis for evaluating the six county MH/MR program outreach projects. These experiences provided the basis for a generalized model of evaluating crises intervention activities.     

Self-control of smoking—II effects of cue salience and source of delay imposition on the effectiveness of training under increasing delay

Imposed increasing delay of cigarette puffs has been shown to facilitate smoking inhibition. Hypothetical mechanisms involved (frustration extinction or rehearsal of coping responses) imply that increased temptation cue salience and decreased degree of external control in increasing delay training, should facilitate smoking inhibition. After three pre-test delay tolerance trials, all subjects were cued to pace their smoking in an increasing sequence of delay. During treatment the cigarette temptation cues were either visible or hidden. Delays were either self-imposed but cued by the experimenter or the delays were physically imposed by the experimenter. Post-test consisted of three delay tolerance trials. Pre-test to post-test improvement was significantly facilitated by cue salience and reduced external control. No significant interaction effects were obtained. Cue salience significantly reduced the self-reported aversiveness and GSRs during self-control trials. Implications for treatment were advanced.     

Self-report, situation-specific coping questionnaires: what are they measuring?

Self-report, situation-specific assessments of coping, such as the Ways of Coping Scale (WOC), have been used frequently in recent years. Several potential issues in the development and use of these questionnaires have been identified, including the applicability of coping items to different kinds of stressful events, the definition of the period for which Ss report coping efforts, and the meaning of the "extent" response key that is used for reporting coping items. In this study, 91 college students completed the WOC and were then interviewed about their responses; interview questions were focused on the 3 issues stated above. The hypothesized concerns about the WOC were supported. Many of the coping items were not applicable to certain kinds of stressful events. Also, how the coping report period was defined varied across Ss and the way in which the extent response key was interpreted differed across both Ss and WOC items.     

Examining the initial usability,acceptability and feasibility of a digital mental health intervention for college students in India

Generalised anxiety disorder (GAD) is prevalent among college students in India; however, barriers like stigma, treatment accessibility and cost prevent engagement in treatment. Web- and mobile-based, or digital, mental health interventions have been proposed as a potential solution to increasing treatment access. With the ultimate goal of developing an engaging digital mental health intervention for university students in India, the current study sought to understand students' reactions to a culturally and digitally adapted evidence-based cognitive behavioural therapy (CBT) for GAD intervention. Specifically, through theatre testing and focus groups with a non-clinical sample of 15 college students in India, the present study examined initial usability, acceptability and feasibility of the “Mana Maali Digital Anxiety Program.” Secondary objectives comprised identifying students' perceived barriers to using the program and eliciting recommendations. Results indicated high usability, with the average usability rating ranking in the top 10% of general usability scores. Participants offered actionable changes to improve usability and perceived acceptability among peers struggling with mental health issues. Findings highlight the benefits of offering digital resources that circumvent barriers associated with accessing traditional services. Results build on existing evidence that digital interventions can be a viable means of delivering mental healthcare to large, defined populations.     

Emotion among women with psychopathy during picture perception

Emotional reactions in women with psychopathy were examined in a mixed-picture paradigm using psychophysiological measures. Startle probes were presented at 2.0 or 4.5 s following onset of a 6-s picture presentation. At 2.0 s, nonpsychopaths exhibited the typical pattern of eyeblink reflex magnitude: unpleasant > neutral > pleasant. Psychopaths with high general levels of anxiety also exhibited this pattern. Psychopaths with lower anxiety exhibited attenuated reflex magnitudes during unpleasant pictures. Similarly, when focusing on psychopathy components, only individuals expressing high antisocial behavior and high emotional detachment exhibited smaller reflex magnitudes during unpleasant pictures. At 4.5 s, all groups exhibited normal, potentiated reflex magnitudes during unpleasant pictures. Group differences were not observed for other measures.     

Turning a deaf ear to fear: impaired recognition of vocal affect in psychopathic individuals

The processing of emotional expressions is fundamental for normal socialization and interaction. Reduced responsiveness to the expressions of sadness and fear has been implicated in the development of psychopathy (R. J. R. Blair, 1995). The current study investigates the ability of adult psychopathic individuals to process vocal affect. Psychopathic and nonpsychopathic adults, defined by the Hare Psychopathy Checklist-Revised (PCL-R; R. D. Hare, 1991), were presented with neutral words spoken with intonations conveying happiness, disgust, anger, sadness, and fear and were asked to identify the emotion of the speaker on the basis of prosody. The results indicated that psychopathic inmates were particularly impaired in the recognition of fearful vocal affect. These results are interpreted with reference to the low-fear and violence inhibition mechanism models of psychopathy.