Clinicians' judgments of clinical utility: a comparison of the DSM-IV and five-factor models

Clinical utility, or the usefulness of a diagnostic system in clinical practice, has been identified as an important construct in proposed revisions to the diagnostic nomenclature and a significant limitation of dimensional models of personality disorder, such as the 5-factor model (FFM). Only 1 study to date has addressed explicitly the clinical utility of the FFM, and the findings suggested significant limitations. In the current study, 245 practicing psychologists described 3 historic cases using both the FFM and the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 2000) and then rated each model on 6 aspects of clinical utility. In contrast to prior research, the psychologists in this study considered the FFM to have greater clinical utility than the existing diagnostic categories.     

Producing biased diagnoses with unambiguous stimuli: The importance of feature instantiations

In this article, the authors demonstrate a laboratory analogue of medical diagnostic biasing (V. R. LeBlanc, G. R. Norman, & L. R. Brooks, 2001) in 2 experiments and explore the basis of this effect. Before categorizing novel exemplars, participants first evaluated the likelihood that the item was a member of the category suggested on that trial: either the correct category or a plausible alternative category. This was sufficient to produce a substantial bias toward the suggested category despite the use of unambiguous stimuli, explicit rules, and unhurried conditions--each of which would be likely to limit diagnostic bias. The authors argue that the production of this effect requires distinguishing between particular feature instantiations and more abstract representations of those features as well as allowing people to adopt a particular decision strategy mediating the use of instantiated features: a feature-recognition heuristic.     

The impact of secondary tasks on multi-tasking in a virtual environment

One experiment is described that examined the possible involvement of working memory in the Virtual Errands Test (McGeorge et al. (2001). Using virtual environments in the assessment of executive dysfunction. Presence, 10, 375-383), which requires participants to complete errands within a virtual environment, presented on a computer screen. Time was limited, therefore participants had to swap between tasks (multi-task) efficiently to complete the errands. Forty-two undergraduates participated, all attempting the test twice. On one of these occasions they were asked to perform a concurrent task throughout (order of single and dual-task conditions was counterbalanced). The type of secondary task was manipulated between groups. Twenty-one participants were asked to randomly generate months of the year aloud in the dual-task condition, while another 21 were asked to suppress articulation by repeating the word "December". An overall dual-task effect on the Virtual Errands Test was observed, although this was qualified by an interaction with the order of single and dual-task conditions. Analysis of the secondary task data showed a drop in performance (relative to baseline) under dual-task conditions, and that drop was greater for the random generation group than the articulatory suppression group. These data are interpreted as suggesting that the central executive and phonological loop components of working memory are implicated in this test of multi-tasking.     

Effects of instruction presentation mode in comparative judgments

In each of two experiments, the comparative instructions in a symbolic comparison task were either varied randomly from trial to trial (mixed blocks) or left constant (pure blocks) within blocks of trials. In the first experiment, every stimulus was compared with every other stimulus. The symbolic distance effect (DE) was enhanced, and the semantic congruity effect (SCE) was significantly larger, when the instructions were randomized than when they were blocked. In a second experiment, each stimulus was paired with only one other stimulus. The SCE was again larger when instructions were randomized than when they were blocked. The enhanced SCE and DE with randomized instructions follow naturally from evidence accrual views of comparative judgments.     

Place and summation coding for canonical and non-canonical finger numeral representations

Fingers can be used to express numerical magnitudes, and cultural habits about the fixed order in which fingers are raised determine which configurations become canonical and which non-canonical. Although both types of configuration carry magnitude information, it has been shown that the canonical ones are recognized faster and directly linked to number semantics. Here we tested whether this difference is a consequence of differences in the qualitative way of processing the two types of configurations. When participants named Arabic digits (Experiment 1) or verbal numerals (Experiment 2) primed by canonical and non-canonical finger configurations, qualitatively different priming patterns were observed for the two types of configurations. Canonical configurations activated a place coding representation, with priming spreading to close smaller and larger magnitudes as a function of the prime–target distance. Conversely, non-canonical configurations activated a summation coding representation priming smaller and equal magnitudes independently of the prime–target distance, and larger targets depending on this distance.     

Aversive racism and medical interactions with Black patients: A field study

Medical interactions between Black patients and nonBlack physicians are usually less positive and productive than same-race interactions. We investigated the role that physician explicit and implicit biases play in shaping physician and patient reactions in racially discordant medical interactions. We hypothesized that whereas physicians’ explicit bias would predict their own reactions, physicians’ implicit bias, in combination with physician explicit (self-reported) bias, would predict patients’ reactions. Specifically, we predicted that patients would react most negatively when their physician fit the profile of an aversive racist (i.e., low explicit-high implicit bias). The hypothesis about the effects of explicit bias on physicians’ reactions was partially supported. The aversive racism hypothesis received support. Black patients had less positive reactions to medical interactions with physicians relatively low in explicit but relatively high in implicit bias than to interactions with physicians who were either: (a) low in both explicit and implicit bias, or (b) high in both explicit and implicit bias.