Enhancing social diffusion theory as a basis for prevention intervention: A conceptual and strategic framework

Social diffusion theory has recently been recognized as a promising approach for large-scale disease prevention and health promotion efforts. This paper describes how principles and tactics from social cognitive theory, operant psychology, social psychology, social marketing, and the overarching stages of change model can be used to further develop the conceptual and strategic (technological) bases of social diffusion theory. Within an integrative framework, we discuss in detail more effective ways to train peer mediators of behavior change as one example of how social diffusion theory can benefit from this conceptual and strategic reformulation. We then further illustrate the use of peer mediators of change in human immunodeficiency virus (HIV) and cancer prevention intervention studies with both interventions training peer mediators to diffuse information, norms, and risk reduction strategies. Although the results of these studies showed reductions in high-risk behaviors across population segments, more closely following the framework discussed in this article should further increase the behavior change potential of future interventions based on social diffusion theory.     

Psychoanalytic patients in the U.S., CANADA,and Australia: I. DSM-III-R disorders,indications, previous treatment,medications, and length of treatment

To determine the demographics, DSM-III-R disorders diagnosed, indications used in recommending psychoanalysis, previous treatment histories, use of medication, and length of treatment in patients in psychoanalysis in the U.S., Canada, and Australia, a mail survey of practice was sent to every other active member of the American Psychoanalytic Association and every member of the Australian Psychoanalytical Society. This supplemented an earlier survey sent to all Ontario psychoanalysts. The response rates were 40.1 % (n = 342) for the U.S., 67.2% (n = 117) for Canada, and 73.9% (n = 51) for Australia. Respondents supplied data on 1,718 patients. The employment rate for patients increases as analysis progresses (p < .0001). The mean number of concurrent categories of disorders (Axis I, Axis II, and Disorders First Evident in Childhood) per patient at the start of treatment is 5.01 (SD = 3.66; median = 4; mode = 3). There are no statistically significant differences across countries. Mood, anxiety, sexual dysfunction, and personality disorders are most common. American Psychiatric Association / American Psychoanalytic Association peer review criteria for indicating psychoanalysis are followed for 86.5% of patients. Over 80% of patients in all three countries had undergone previous treatments prior to analysis. In the U.S., 18.2% of analysands are on concurrent psychoactive medication; in Australia, 9.6%. The mean length of analyses conducted in the U.S. is 5.7 years, in Australia 6.6, and in Canada 4.8. Psychoanalytic patients in all three countries have similar rates of DSM-III-R psychopathology, and many indications of chronicity.     

Differential effects of list strength on recollection and familiarity

Numerous studies have found a null list strength effect (LSE) for recognition sensitivity: Strengthening memory traces associated with some studied items does not impair recognition of nonstrengthened studied items. In Experiment 1, the author found a LSE using receiver operating characteristic-based measures of recognition sensitivity. To account for the discrepancy between this and prior research, the author (a) argues that a LSE occurs for recollection but not for discrimination based on familiarity, and (b) presents self-report data consistent with this hypothesis. Experiment 2 tested the dual-process hypothesis more directly, using switched-plurality (SP) lures to isolate the contribution of recollection. There was a significant LSE for comparisons involving SP lures; the LSE for discrimination of studied items and nominally unrelated lures (which can be supported by familiarity) was not significant.     

A basis for bias in geographical judgments

To determine why North Americans tend to locate European cities south of North American cities at similar latitudes (Tversky, 1981), we had observers provide bearing estimates between cities in the U.S. and Europe. Earlier research using latitude estimates of these cities has indicated that each continent has several subjective regions (Friedman & Brown, 2000a). Participants judged cities from two subjectively northern regions (Milwaukee-Munich), two subjectively southern regions (Memphis-Lisbon), and the two "crossed" regions (Albuquerque-Geneva; Minneapolis-Rome). Estimates were biased only when cities from the subjectively northern regions of North America were paired with cities from the subjectively southern region of Europe. In contrast to the view that biases are derived from distorted or aligned map-like representations, the data provide evidence that the subjective representation of global geography is principally categorical. Biases in numerical location estimates of individual cities and in bearing estimates between city pairs are derived from plausible reasoning processes operating on the same categorical representations.     

The perception of length on curved and flat surfaces

In three experiments, observers judged the apparent extents of spatial intervals along the surface of a curved cylinder or a flat plane that was binocularly viewed in a natural, indoor environment. The observers' judgments of surface lengths were precise and reliable but were also inaccurate and subject to relatively large constant errors. These distortions differed among the observers, but they tended to perceive lengths oriented along the curved dimension of the cylinder as being longer than physically equivalent lengths in the noncurved dimension. This phenomenon did not occur when the observers judged curved and noncurved paths on the flat surface. In addition, some observers' judgments of length were affected by changes in the distance to the cylinder, whereas others were affected by the cylinder's orientation in space. These results demonstrate that the perception of length on surfaces is highly dependent on the particular context in which the length occurs.     

The effects of age upon the perception of depth and 3-D shape from differential motion and binocular disparity

The ability of younger and older adults to perceive the 3-D shape, depth, and curvature of smooth surfaces defined by differential motion and binocular disparity was evaluated in six experiments. The number of points defining the surfaces and their spatial and temporal correspondences were manipulated. For stereoscopic sinusoidal surfaces, the spatial frequency of the corrugations was also varied. For surfaces defined by motion, the lifetimes of the individual points in the patterns were varied, and comparisons were made between the perception of surfaces defined by points and that of more ecologically valid textured surfaces. In all experiments, the older observers were less sensitive to the depths and curvatures of the surfaces, although the deficits were much larger for motion-defined surfaces. The results demonstrate that older adults can extract depth and shape from optical patterns containing only differential motion or binocular disparity, but these abilities are often manifested at reduced levels of performance.     

Diagnosing agoraphobia in the context of panic disorder: examining the effect of DSM-IV criteria on diagnostic decision-making

A diagnostic and statistical manual (DSM)-IV diagnosis of agoraphobia in the context of panic disorder (PD) is based on three nosologically sufficient criteria: (1) avoidance, (2) use of companions, and (3) endurance of situations despite distress. Therefore, an agoraphobia diagnosis can be made across an extremely broad range of cases including when there are no avoidance behaviors (e.g., the patient endures the situation). It was hypothesized that clinicians do not weight these criteria equally and that the DSMs individual, sufficient criteria lead to poor inter-rater reliability. Clinicians (N=48) rated hypothetical patients with symptom profiles emphasizing each of these three criteria. Consistent with expectation, clinicians differentially weighted these criteria. Avoidance was relatively more apt to produce a diagnosis when only one criterion was emphasized in clinical vignettes. Inter-rater reliability was poor in instances when only one sufficient criterion was highlighted. Knowledge concerning DSM criteria resulted in a greater rate of agoraphobia endorsement, but knowledge did not account for the overall pattern of findings.