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.     

ETAT: Expository Text Analysis Tool

Qualitative methods that analyze the coherence of expository texts not only are time consuming, but also present challenges in collecting data on coding reliability. We describe software that analyzes expository texts more rapidly and produces a notable level of objectivity ETAT (Expository Text Analysis Tool) analyzes the coherence of expository texts. ETAT adopts a symbolic representational system, known asconceptual graph structures. ETAT follows three steps: segmentation of a text into nodes, classification of the unidentified nodes, and linking the nodes with relational arcs. ETAT automatically constructs a graph in the form of nodes and their interrelationships, along with various attendant statistics and information about noninterrelated, isolated nodes. ETAT was developed in Java, so it is compatible with virtually all computer systems.     

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.     

Within-individual variability in self-concepts and personality states: Applying density distribution and situation-behavior approaches across cultures

Within-individual variability in self-concepts and everyday personality states and affects was investigated in two experience sampling studies using density distribution and situation-behavior approaches. In all seven cultures sampled, within-individual variability was substantial and self-concept and personality state variability exhibited moderate convergence. Variability in personality and affect states was moderately predicted by perceived need satisfaction in the situations. The density distribution and situation-behavior approaches were moderately convergent in identifying the most variable individuals, but the pattern of cultural differences differed in the two methods. Contrary to cultural psychology perspectives, cultural differences in within-individual variability did not consistently correspond to cultural differences in individualism–collectivism, dialecticism, or tightness.     

Within- and between-language priming differ: evidence from repetition of pictures in Spanish-English bilinguals

In the current study, the authors used an immediate repetition paradigm with pictures to observe whether repetition enhances word production in bilinguals. In Experiment 1, participants were asked to name pictures that were named previously in the same language (Spanish-Spanish or English-English) or in the opposite language (Spanish-English or English-Spanish). Results revealed a repetition effect both within languages and between languages. Furthermore, there was an asymmetry within language, with repetition priming being larger in Spanish than in English. Experiments 2 and 3 revealed that lag interacted with language for both within- and between-language priming. However, lag resulted in a decrease in the asymmetry for within- but not between-language priming. The results are consistent with the view that within- and between-language repetition priming are mediated by different mechanisms.     

Profiles of Social Anxiety and Impulsivity Among College Students: A Close Examination of Profile Differences in Externalizing Behavior

Prior work indicates the presence of a subtype of Social Anxiety (SA) characterized by disinhibition or high externalizing behaviors such as substance use and Attention Deficit Hyperactivity Disorder (ADHD) symptoms. A sample of 375 undergraduates completed an online study including measures of SA, substance use, ADHD symptoms and impulsivity. Latent class analyses revealed three classes of individuals who evidenced: (a) low SA and low impulsivity, (b) high SA and low impulsivity, and (c) high SA and high impulsivity. Individuals high in both SA and impulsivity evidenced greater likelihoods of exhibiting externalizing behavior, relative to the two other classes. Post-hoc analyses revealed the largest and most significant differences between classes were seen with regard to ADHD. This finding extends previous work by replicating distinct profiles of SA and impulsivity, and highlighting that how these profiles relate to externalizing behaviors may depend on the externalizing domain.     

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.     

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.