Chronic illness: not-so-passive injustice?

Why is our system, which is so biased toward the provision of acute care, underserving the chronically ill?...I think the main reason...has to do with the difficulty of providing for the needs of the chronically ill through a system of largely employment-based private insurance. People who are chronically ill are likely to drop out of employment: they are not a group that employment-based insurance is intended to serve or that employers have an interest in serving....I do not believe we can shift the focus of organization of services for the chronically ill to home or family, as Douard suggests, without reforming the insurance system....     

Predicting attendance at health screening: Organizational factors and patients' health beliefs

The present study firstly considers the effectiveness of two invite methods. Three hundred and twenty-five patients aged between 30 and 50 were invited to attend a general health check either by letter or opportunistically during a routine consultation After six months the two invite methods had similar attendance rates, although the opportunistic method produced fewer patients at screening and was biased in favour of females. The study also examined the health beliefs of attenders (n = 98) and non-attenders (n = 33) who had been sent questionnaires based on the health belief model prior to the commencement of the screening programme. Discriminant analysis revealed attenders to be more likely to report cutting back on everyday activities when ill and to believe in the seriousness of high blood pressure and weight problems. Non-attenders were found to be more worried about the screening appointment. These findings have important implications for those who plan screening services.     

The visual perception of smoothly curved surfaces from minimal apparent motion sequences

A series of four experiments was designed to investigate the minimal amounts of information required to perceive the structure of a smoothly curved surface from its pattern of projected motion. In Experiments 1 and 2, observers estimated the amplitudes of sinusoidally corrugated surfaces relative to their periods. Observers’ judgments varied linearly with the depicted surface amplitudes, but the amount of perceived relative depth was systematically overestimated by approximately 30%. The observers’ amplitude judgments were also influenced to a lesser extent by the amount of rotary displacement of a surface at each frame transition, and by increasing the length of the apparent motion sequences from two to eight frames. The latter effect of sequence length was quite small, however, accounting for less than 3% of the variance in the observers’ judgments. Experiments 3 and 4 examined observers’ discrimination thresholds for sinusoidally corrugated surfaces of variable amplitude and for ellipsoid surfaces of variable eccentricity. The results revealed that observers could reliably detect differences of surface structure as small as 5%. The length of the apparent motion sequences had no detectable effect on these tasks, although there were significant effects of angular displacement and surface orientation. These results are considered with respect to the analysis of affine structure from motion proposed by Todd and Bressan (1990).     

Role of specific similarity in a medical diagnostic task.

Three experiments are reported showing that diagnosis of skin disorders by medical residents and general practitioners was facilitated by similar cases previously seen in the same context. Diagnosis of similar cases was facilitated more than that of dissimilar cases in the same diagnostic category, demonstrating that facilitation was not solely due to activation of the diagnostic category as a whole. Because diagnosis was posed in a multiple-choice format that always included the correct diagnosis, the relative disadvantage of dissimilar items was not due to the unavailability of the category name. The similarity effect also occurred with 2-week delay between the initial case and the test cases. Variations in diagnostic procedure, ranging from giving a quick first impression to arguing for given alternative diagnoses before selection, did not interact with the effect of similarity. This result suggests that the similarity effect is not strongly dependent on a particular diagnostic strategy.     

Negative results on a reported facial expression of contempt

Ekman and Friesen (1986) claimed to have discovered a facial expression, a unilateral lip curl, universally recognized as conveying contempt. Their conclusion was based on a series of labeling studies, all of which relied on one response measure—subjects choosing one label from a small, preselected list. This article reports two studies on the question of whether their result can be replicated with other response measures. In one study, subjects were allowed to respond with any emotion label they wanted; in the second, subjects were asked to make quantitative ratings on six emotion scales. Neither method suggested contempt as subjects' interpretation of the unilateral lip curl.This study was funded by a grant from the Social Sciences and Humanities Research Council of Canada. I thank Dee-Ann Matsugu, Lara Weick, and Lisa Wong for their careful work on this study.     

Cognitive complexity and the similarity-attraction paradigm

The study investigated the role of cognitive complexity as a moderator of the similarity-attraction relationship described by Byrne (1971). Subjects conducted face-to-face interviews with confederates who played roles as job applicants. Similarity-dissimilarity was manipulated by the confederate roles, as well as by the information given the subjects in accordance with the procedures described by Byrne (1971). The situation was viewed as one in which judgments were made about a complex, multidimensional stimulus. Information received about another person in an interview setting was viewed as consisting of different dimensions to be assessed by the perceiver. The hypothesis was tested and confirmed that cognitively complex judges were more likely than simple judges to perceive and evaluate similarity/dissimilarity in others. Thus, complex judges evaluated similar applicants more positively than dissimilar applicants, while no differences were found for simple judges. Cognitive complexity thus appears to moderate the “Law of Attraction” described by Byrne (1971).     

THE AVERSIVE CONTROL OF EXCESSIVE ALCOHOL CONSUMPTION BY CHRONIC ALCOHOLICS IN THE LABORATORY SETTING1

The efficacy of several methods of aversive control of excessive alcoholic drinking was investigated in a semi-naturalistic setting that permitted objective measurement of the drinking behavior of chronic alcoholics. Studies 1A and 1B compared an escape-conditioning procedure with a control procedure in which aversive electrical shocks were administered before drinking. Neither procedure effectively decreased subjects' pretreatment, baseline alcoholic drinking behavior. In Study 2, aversive response-contingent shocks effectively suppressed alcoholic drinking, but drinking subsequently returned to its former levels after withdrawal of punishment. Self-administered shock appeared to be as effective as experimenter-administered punishment for controlling drinking, even when the punishment contingency was faded out over time. Study 3 replicated the suppressant effect of punishment, and demonstrated that contingent shock was significantly more effective than yoked, noncontingent shock. A direct comparison of self- versus experimenter-administered punishment suggested a possible slight advantage for the latter.     

Strens,traumas, and trauma resolution

With both primary and early secondary prevention in mind, this investigation sought to answer several basic questions regarding the resolution of traumas and their conversion into strens - growth-potentiating experiences. College volunteers (N = 40) described in detail their significant positive and negative experiences. The results indicate that many people did experience a trauma that was converted into a stren, and the resolution appeared to be primarily a cognitive process, usually done by the subject himself, and it most frequently occurred between 2 weeks and 4 months after the precipitating event.     

Sequential variables and the Kamin effect

The results of two experiments demonstrated that retention deficits occurred in a within-subjects design only when the intermediate interval test was either the first or second test of the retention of prior aversive conditioning experience; when two relearning tests preceded a 1-hr test, no performance deficits were observed. It was suggested that internal cues may serve as memory attributes of avoidance behavior during early stages of avoidance learning, while other stimuli may facilitate the retrieval of the memory of prior avoidance training with repeated testing.