Order effects in belief updating with consistent and inconsistent evidence

The current study tests for the presence of differential order effects in evaluation tasks with consistent and inconsistent evidence as predicted by the Hogarth and Einhorn (1992) belief-adjustment model. The results, based on both between-subjects and within-subjects experiments, demonstrate that there were significant recency effects with inconsistent evidence as predicted, larger recency effects when the inconsistent evidence was farther apart in subjective value as predicted, and significant recency effects even when subjects were given training designed to both help them understand the task as completely as possible and to be better able to assess the pieces of evidence. By including a within-subjects design, we were able to demonstrate that the difference in subjective value between two pieces of evidence is the primary factor influencing the magnitude of the recency effect, regardless of whether the evidence is consistent or inconsistent. This latter finding is unique and contrary to previous research and theory.     

An evaluation of the reliability of probability judgments across response modes and over time

Despite the importance of probability assessment methods in behavioral decision theory and decision analysis, little attention has been directed at evaluating their reliability and validity. In fact, no comprehensive study of reliability has been undertaken. Since reliability is a necessary condition for validity, this oversight is significant. The present study was motivated by that oversight. We investigated the reliability of probability measures derived from three response modes: numerical probabilities, pie diagrams, and odds. Unlike previous studies, the experiment was designed to distinguish systematic deviations in probability judgments, such as those due to experience or practice, from random deviations. It was found that subjects assessed probabilities reliably for all three assessment methods regardless of the reliability measures employed. However, a small but statistically significant decrease over time in the magnitudes of assessed probabilities was observed. This effect was linked to a decrease in subjects overconfidence during the course of the experiment.     

Double agency and the ethics of rationing health care: a response to Marcia Angell

The arguments against doctors as "double agents" that are presented by Marcia Angell in the preceding article do not defeat the core justification for rationing some relatively high-expense, low-benefit care, and they do not enable us to conclude that clinicians should be barred from any active, substantive role in decisions to limit that care. They do, however, reveal several important conditions that need to govern cost-conscious medial practice in order to preserve an ethic of fidelity to patients: insurers' profits and providers' incomes must be fair, providers must inform patients of any economic reasons that lead to the foregoing of care, and "direct incentive" arrangements must not be used to contain costs.     

Child and adolescent services research at the national institute of mental health: Research opportunities in an emerging field

This article describes an important new area of research on services for children and adolescents with mental disorders at the National Institute of Mental Health, the parameters of mental health services research for youth, and the opportunities that are available for grant-funded investigations in this area.     

Nonsuicidal physically self-damaging acts in adolescents

To determine the frequency and correlates of nonsuicidal physically self-damaging acts in 12–14 year olds, a two stage epidemiologic survey with a self-administered questionnaire (N=3283) followed by a psychiatric interview of a subsample of the adolescents and their parents (N=444) was used. Prevalence estimates of interview validated nonsuicidal physically self-damaging acts were 2.46% in males and 2.79% in females. Significant relationships were found between nonsuicidal physically self-damaging acts and suicidal ideation, major depression and undesirable life events. Data suggest that physically self-damaging acts occur at substantial rates during early adolescence. The strong correlation between nonsuicidal self-destructive acts and both suicidal ideation and major depression clarifies prior conflicting reports in the literature and suggests that a history of self-damaging acts should be taken into consideration when evaluating for possible depression and suicide risk.     

The aggression-coercion cycle: Use of seclusion and restraint in a child psychiatric hospital

The widespread use of seclusion and restraint in child psychiatric hospitals to manage aggression and noncompliance is based on the assumption that coercive consequences reduce the frequency of undesirable behaviors exhibited by the patients. We report a study of the use of seclusion and restraint in a public child psychiatric hospital during a 3-year period. Twenty-eight percent of the patients had been secluded or restrained a total of 1670 times. About 25% of these patients had been secluded more than five times during their hospitalization, and 32% had been placed in restraints more than once. Behaviors that typically resulted in repeated seclusion included physical aggression toward staff, verbal aggression toward peers, non-compliant or oppositional behavior, and self-harm. Variables that predicted patients most at risk for repeated seclusion included age, gender, and psychiatric diagnosis. The predictor variables for those most at risk for repeated restraint included age, property destruction, and self-harm. The high rates of use of seclusion and restraint suggest that these methods for controlling the behavior of children and adolescents in this child psychiatric hospital may not have been therapeutic. We suggest that staff in such hospitals engage in a pattern of behavior characterized by an aggression-coercion cycle, in which increasingly aggressive and coercive behaviors are exhibited by both patients and staff.     

Development of knowledge bases and the reliability of a decision support system for behavioral treatment consultation for persons with mental retardation: The Mental Retardation-Expert

The development of expert and decision support systems requires the collection, organization, codification, and storage of a body of specialized knowledge. The development, using reconstructive methods, of two such knowledge bases, the first containing the current scientific literature and the second containing an expert’s knowledge, is described for an automated decision support system, the Mental Retardation-Expert. This system provides practitioners with assistance in the treatment of aggressive, self-injurious, and destructive behaviors displayed by individuals with mental retardation or developmental disabilities. The average interobserver reliability of the expert knowledge base ranged from 92.5% to 95.0% when calculated across four clinicians’ assessments of 31 abstracted cases.     

The effects of exposure to different sources of sexual information on sexual behavior: Comparing a “sex-expert system” to other educational material

Sexpert, an expert computer program designed to counsel couples on their sexual relationships, was evaluated. Eighty-one heterosexual couples were assigned to one of three experimental manipulations (Sexpert, video, and self-help book) or a control condition. Daily sexual behavior monitoring forms and structured retrospective reports served as measures of baseline and post-manipulation behavior. Daily monitoring of sexual behavior failed to show significant changes occurring after the manipulations. However, retrospective data concerning the postmanipulation period show that compared with the control, the Sexpert, video, and book manipulations had a significant positive impact on couples’ sexual behavior, communication, and learning about sexuality. Sexpert, video, and book were similarly evaluated, except that Sexpert was evaluated as more engaging. In addition, subjects retrospectively reported positive changes in communication, relationship satisfaction, and sexual behavior during the baseline period. This suggests that daily behavioral monitoring is intrusive and may confound the variables measured by it.     

Mental Arithmetic: A Componential Analysis of Speed-of-Processing Across Monolingual,Weak Bilingual,and Strong Bilingual Adults

Two experiments compared rates of solving simple and complex addition and multiplication problems in groups of speakers of French or English in Experiment 1 (n = 35) and Spanish or English in Experiment 2 (n = 84). Subjects were divided into groups of English unilinguals, weak bilinguals, and strong bilinguals according to their performance on a naming task. In both experiments, simple problems consisted of two single-digit numbers. At least three single-digit numbers were used for complex problems in Experiment 1 and double-digit numbers in Experiment 2. Mean solution times, particularly for complex problems, were lowest for the monolingual group, followed in turn by the weak bilingual and strong bilingual groups, but these differences were not statistically reliable in either experiment. In Experiment 2, however, componential analyses of solution times indicated that strong bilingual subjects were slower at executing the carry operation when solving complex problems, relative to the two remaining groups. Results were interpreted in terms of the relationship between bilingualism and the representation and processing of numerical information.     

Disordered Communication and Grieving in Deaf Member Families

When a deaf child is born to hearing parents, a grieving process is initiated in the parents. Unresolved grieving over their child's deafness often makes it difficult for hearing parents to accept the importance of signing, thus increasing the child's problems — further source of grief for these parents. Clinical illustrations are provided of (1) the reciprocal relationship between disruption of the mourning process and disturbance of communication between family members, and (2) the transmission of the dysfunctional relationship between hearing parents and deaf children to the subsequent relationship between the deaf children, when they reach adulthood, and their hearing children.