Ethical issues and the family doctor

Issues recognized as having ethical or moral components are becoming increasingly common, for society in general, the health care system and for general practitioner/family physicians in particular. Some of the peculiar problems for GP's relate to the provision of continuing, comprehensive, primary medical care to large numbers of individuals who provide extensive potential for conflict between all the involved elements: patients, physicians, families, consultants and societal attitudes. There is a need for more formal education programs.     

The use of a double-blind drug trial in family therapy to demedicalize a problem

A family therapy approach to a problem that had led previous clinicians to diagnose and treat a child as 'hyperkinetic', is described. The resistance to change that the preceding diagnosis had inculcated, is described. A method of overcoming this resistance by active involvement of the family in a double-blind trial of the drug treatment, was devised and used concurrently with a structural form of family therapy.     

Reliability, homogeneity and the construct validity of Cattell's 16PF

This paper reviews criticisms of the psychometric properties of Cattell's Sixteen Personality Factor Questionnaire and examines Cattell's claims that 16PF scale reliabilities and factor validities are seriously underestimated by conventional internal consistency approaches to reliability estimation.On large samples of British adults and undergraduates no evidence was found to support the claim that the 16PF is deliberately heterogeneous in item content. No presence of suppressor effects or balancing of specifics were found in the 16PF scales, most of which were reasonably homogenous by conventional standards. Conventional internal-consistency reliability estimates in fact give very similar results to alternate form reliability coefficients and Cattell's factorial validities. 16PF scales which were particularly poor in terms of scale consistency were L, M and N with C, O and Q4 emerging as measures of essentially the same trait of anxiety.     

Affect as a mediator of attributional egotism

A three-stage model of the relationships among achievement outcomes, outcome-related affect, attribution, and emotion is tested in two studies. It is suggested that success and failure elicit positive and negative affective states due to prior conditioning. These affective states then lead to an attribution process that serves to defend and enhance self-esteem. Next, emotional labels are chosen that are consistent with the affective states and the attributions. Two studies were designed to test the proposed relationships among achievement outcomes, affective states, and attributions. In the first study, subjects received information indicating that they were strongly or mildly aroused as a result of receiving outcome feedback on an achievement task. The results indicated that low arousal reduced egotistical attributions to internal factors. In the second study, subjects either succeeded or failed on an achievement task. Half of the subjects were provided with an opportunity to misattribute the arousal elicited by their outcomes to an irrelevant source. Subjects in the misattribution condition made less egotistical attributions to external factors than subjects who were given no opportunity to misattribute their arousal. The results of both studies suggest that outcome-related affect mediates the relationship between outcomes and attributions in achievement situations.     

Social Class and Reported Changes in Behavior After Job Loss

Reports were obtained from middle-class and working-class unemployed British men about change or lack of change since job loss in 37 different behaviors. The behaviors were grouped into Domestic Work, Domestic Pastimes, Other Pastimes, Book Reading, Recreations, Entertainment Through Money, and Social Contacts. Contrary to findings from 1930s research, significant increases in social contact and book reading were reported since job loss. Other significant increases were reported within all categories except Entertainment Through Money, where a significant decline was recorded. A number of social class differences were found. For instance, middleclass unemploycd men were significantly more likely than their working-class counterparts to report increased book reading for study and more visits to the public library. Working-class respondents were significantly more likely to report increased looking around shops without buying and reduced visits to the pub. Several significant associations between reported behavior changes and aspects of psychological and general health were observed.     

Some theory and results for metrics for bounded response scales

In an earlier note, a new metric for bounded response scales (MBR) was introduced which resembles the city-block metric but is bounded above. It was suggested the MBR may be more appropriate than minkowski metrics for data obtained with bounded response scales. In this article, some formal properties of the MBR are investigated and it is shown that it is indeed a metric. Empirical predictions are then derived from the MBR and contrasted with those of a “monotonicity hypothesis,” which holds that dissimilarity judgements tend to be biased towards overestimation of larger distances, and with the predictions of the minkowski metrics, which imply additivity of collinear segments. Some empirical results are presented which contradict the monotonicity hypothesis and the minkowski metrics, and favor the MBR. Finally, the logic used to motivate the MBR is invoked to define a subadditive concatenation for bounded norms in the one-dimensional case, which may be useful in psychophysical work where the upper bounds are often real, rather than due to the response scale. This concatenation predicts understimation for doubling and overestimation for halving and middling tasks.     

Behavioral,subjective, and electroencephalographic indices of sleep onset latency and sleep duration

Electrographic (EEG, EOG, EMG) indices have been used for some decades in the definition of the stages of sleep and more recently in the diagnosis of sleep-related disorders, e.g., insomnia, despite the lack of detailed information concerning the precise relationship between such electrographic indices and behavioral and subjective criteria of sleep. Evaluation of the relationship between EEG, behavioral, and self-report measures of sleep onset latency and sleep duration was conducted using 17 young normal sleepers. The behavioral measure was provided by an apparatus which records subjects' button-press responses to an auditory stimulus presented at various interstimulus intervals (2, 5, and random 1, 2, 5, 7, and 10 min). The behavioral and stage 2 EEG estimates of sleep onset latency (SOL) and sleep duration (SD) were almost identical. The stage 1 EEG provided the shortest estimate of SOL; the self-report measure, the longest. The SD measures were in reverse order. There were no significant differences among the three interstimulus interval conditions (2, 5, and random min). Average response rates to the 50-dB chime were 100% during wakefulness, 81% during EEG stage 1, and 8% during EEG stage 2. Almost all stage 2 responding occurred during the first 5 min of each stage 2 period. The validity of electrographic indices as sleep criteria and the implications of the findings for the formulation of an adequate definition of sleep and its clinical measurement are discussed.     

The relation between proximity and brightness similarity in dot patterns

The Gestalt studies demonstrated the tendency to visually organize dots on the basis of similarity, proximity, and global properties such as closure, good continuation, and symmetry. The particular organization imposed on a collection of dots is thus determined by many factors, some local, some global. We discuss computational reasons for expecting the initial stages of grouping to be achieved by processes with purely local support. In the case of dot patterns, the expectation is that neighboring dots are grouped as a function of proximity and similarity of contrast, by processes that are independent of the overall organization and the various global factors. We describe experiments that suggest a purely local relationship between proximity and brightness similarity in perceptual grouping.