Integrating Behavioral and Social Sciences in the Medical School Curriculum: Opportunities and Challenges for Psychology

The Institute of Medicine has reviewed and made recommendations concerning current teaching approaches, content, and barriers to the incorporation of behavioral/social sciences in medical school curricula (Cuff & Vanselow, 2004). This paper discusses those recommendations, the history of medical education reform, the barriers to and evolution of behavioral/social sciences’ inclusion, and the implications for psychology’s future role in academic medicine. Psychological concepts and technology permeate medical practice, but little progress has been made in integrating psychological and biological sciences. Looking to its basic science domains (e.g. cognition, learning, development, neuroscience), psychology can take scientific leadership in illuminating the mechanisms by which behavioral/social processes interact with biological functions in health, thereby providing the empirical basis for a truly integrated bio-behavioral curriculum. This article is based upon a symposium, “IOM Report on Enhancing Behavioral & Social Science in Medical Education: Impact and Opportunities for Psychology,” presented at the Annual meeting of the American Psychological Association, Washington, D.C., August 21, 2005. Suzanne Bennett Johnson, Chair; Elena Reyes, John E. Carr, and Anthony Errichetti, participants; Eugene K. Emory, Discussant.     

Scene recognition without identification

Recognition without identification (RWI) is old-new discrimination among recognition test items that go unidentified. Recently, the effect has been shown in situations that require pre-experimental connections between unidentified studied items and their test cues, such as when the test cues are general knowledge questions and the unidentified studied items are their answers, or when the test cues are pictures of celebrities and the unidentified studied items are their names. In these cases, RWI demonstrates a peculiar relationship with tip-of-the-tongue (TOT) experiences: Participants give higher recognition ratings when in a TOT state than when not, even though studying an item does not increase the probability of a TOT state for that item. The present study extends these findings to the recognition of scene information. We demonstrate a scene RWI effect with scenes when scene names cannot be retrieved, and replicate the previously reported relationship between TOT states and RWI. In addition, we show that the relationship between RWI and reported TOT states also occurs between RWI and reported déjà vu states with the test scenes.     

Understanding and Using Informants’ Reporting Discrepancies of Youth Victimization: A Conceptual Model and Recommendations for Research

Discrepancies often occur among informants’ reports of various domains of child and family functioning and are particularly common between parent and child reports of youth violence exposure. However, recent work suggests that discrepancies between parent and child reports predict subsequent poorer child outcomes. We propose a preliminary conceptual model (Discrepancies in Victimization Implicate Developmental Effects [DiVIDE]) that considers how and why discrepancies between parents’ and youths’ ratings of child victimization may be related to poor adjustment outcomes. The model addresses how dyadic processes, such as the parent–youth relationship and youths’ information management, might contribute to discrepancies. We also consider coping processes that explain why discrepancies may predict increases in youth maladjustment. Based on this preliminary conceptual framework, we offer suggestions and future directions for researchers who encounter conflicting reports of community violence exposure and discuss why the proposed model is relevant to interventions for victimized youths.     

Loób and Kapwa: An Introduction to a Filipino Virtue Ethics

This is an introduction to a Filipino virtue ethics which is a relationship-oriented virtue ethics. The concepts to be discussed are the result of the unique history of the Philippines, namely a Southeast Asian tribal and animist tradition mixed with a Spanish Catholic tradition for over 300 years. Filipino virtue ethics is based on two foundational concepts in Filipino culture. The first is loób, which can easily be misunderstood when literally translated into English as ‘inside’ but which is better translated as ‘relational will’, and the second is kapwa, which is literally translated as ‘other person’ but is better understood as ‘together with the person’. These serve as pillars for a special collection of virtues (kagandahang-loób, utang-na-loób, pakikiramdam, hiya, lakas-ng-loób/bahala na) which are not individualistic virtues in the same way as most of the cardinal virtues of the Western tradition (i.e. prudence, justice, temperance and fortitude) but are all directed towards the preservation and strengthening of human relationships. This introduction to a Filipino virtue ethics is articulated and organized through a dialogue with Aristotelian-Thomistic virtue ethics.     

Multi-Informant Assessments of Adolescent Social Anxiety: Adding Clarity by Leveraging Reports from Unfamiliar Peer Confederates

Adolescent social anxiety (SA) assessments often include adolescent and parent reports, and low reporting correspondence results in uncertainties in clinical decision-making. Adolescents display SA within non-home contexts such as peer interactions. Yet, current methods for collecting peer reports raise confidentiality concerns, though adolescent SA assessments nonetheless would benefit from context-specific reports relevant to adolescent SA (i.e., interactions with unfamiliar peers). In a sample of 89 adolescents (30 Evaluation-Seeking; 59 Community Control), we collected SA reports from adolescents and their parents, and SA reports from unfamiliar peer confederates who interacted with adolescents during 20-minute mock social interactions. Adolescents and parents completed reports on trait measures of adolescent SA and related concerns (e.g., depressive symptoms), and adolescents completed self-reports of state arousal within mock social interactions. Adolescents’ SA reports correlated with reports on parallel measures from parents in the .30s and with peer confederates in the .40s to .50s, whereas reports from parent-confederate dyads correlated in the .07 to .22 range. Adolescent, parent, and peer confederate SA reports related to reports on trait measures of adolescent SA and depressive symptoms, and distinguished Evaluation-Seeking from Community Control Adolescents. Confederates’ SA reports incrementally predicted adolescents’ self-reported SA over and above parent reports, and vice versa, with combined Rs ranging from .51 to .60. These combined Rs approximate typical correspondence levels between informants who observe adolescents in the same context (e.g., mother-father). Adolescent and peer confederate (but not parent) SA reports predicted adolescents’ state arousal in social interactions. These findings have implications for clarifying patterns of reporting correspondence in clinical assessments of adolescent SA.     

Parent–Child Informant Discrepancy is Associated with Poorer Treatment Outcome

In child clinical psychology, parent and child reports are typically used to make treatment decisions and determine the effectiveness of treatment. However, there are often moderate to large discrepancies between parent and child reports, and these discrepancies may reflect meaningful information about the parent, the child, and the parent–child relationship. Additionally, parent–child discrepancy may predict treatment outcome. This study examined parent–child discrepancy in a sample of 62 children (10.15±1.26 years old) with prominent social competence deficits and mixed diagnoses who were treated with a resilience-based, cognitive–behavioral group therapy program (the Resilience Builder Program) in a private clinical setting. Further analyses were conducted to investigate whether parent–child discrepancy related to treatment outcome. Consistent with the literature, prominent parent–child discrepancy was found across domains, with parents generally reporting more severe symptomatology. Treatment with the Resilience Builder Program resulted in significant improvement in parent report of multiple domains of functioning, including resilience, social skills, and emotion and behavior regulation. Importantly, larger parent–child discrepancy at the start of therapy was predictive of poorer overall treatment response. Given its impact on therapeutic effectiveness, these results suggest that parent–child disagreement regarding the child’s impairment at the onset of therapy is worthy of assessment prior to treatment, and may itself be a topic worthy of targeting in treatment.     

Context effects: the role of collectivism as a moderator

Social cognition experts have shown that participants' answers to research questions can be influenced by previous questions, something known as context effects. It has been suggested that participants from collectivist cultures pay more attention to the context, resulting in larger context effects. The present investigation examined context effects in an experiment that involved manipulating the order in which two questions, one about satisfaction with life as a whole and one about satisfaction with romantic life, were answered by a representative sample of participants from Mexico City. The results were consistent with other investigations that used samples from collectivistic cultures. Participants' responses to questions about satisfaction are influenced by a previous question, and country of origin affects the amount of attention given to the context. The implications of these results are discussed.     

Acculturation, personality, and psychological adjustment

Two studies investigated relationships between traditional indicators of acculturation, cultural distance, acculturation strategies, and basic dimensions of personality as they pertain to psychological adjustment among Hispanic students. Although personality characteristics have been shown to be important determinants of psychological well-being, acculturation research has put less emphasis on the role of personality in the well-being of immigrants. Hierarchical regression analysis showed that basic dimensions of personality such as extraversion and neuroticism were strongly related to psychological adjustment. Acculturation strategies did not mediate the effect of personality variables, but cultural resistance made a small, independent contribution to the explanation of some aspects of negative psychological adjustment. The implications of the results were discussed.     

Domestic dogs’ (Canis familiaris) choices in reference to information provided by human and artificial hands

Even young humans show sensitivity to the accuracy and reliability of informants’ reports. Children are selective in soliciting information and in accepting claims. Recent research has also investigated domestic dogs’ (Canis familiaris) sensitivity to agreement among human informants. Such research utilizing a common human pointing gesture to which dogs are sensitive in a food retrieval paradigm suggests that dogs might choose among informants according to the number of points exhibited, rather than the number of individuals indicating a particular location. Here, we further investigated dogs’ use of information from human informants using a stationary pointing gesture, as well as the conditions under which dogs would utilize a stationary point. First, we explored whether the number of points or the number of individuals more strongly influenced dogs’ choices. To this end, dogs encountered a choice situation in which the number of points exhibited toward a particular location and the number of individuals exhibiting those points conflicted. Results indicated that dogs chose in accordance with the number of points exhibited toward a particular location. In a second experiment, we explored the possibility that previously learned associations drove dogs’ responses to the stationary pointing gesture. In this experiment, dogs encountered a choice situation in which artificial hands exhibited a stationary pointing gesture toward or away from choice locations in the absence of humans. Dogs chose the location to which the artificial hand pointed. These results are consistent with the notion that dogs may respond to a human pointing gesture due to their past-learning history.