New uses for the on-line computer medium in mental health care

A number of research projects related to new uses for computers in mental health service delivery are presented. These projects include work on software psychology, new computer applications in mental health care, and studies relating to the successful implementation of technology in mental health settings. Emphasis is placed on developing a better understanding of appropriate uses of technology rather than merely describing new applications.     

Sickness in spoon river: Village health at the turn of the century

Edgar Lee Masters published numerous poems, plays, and novels between 1900 and 1942; most go unread, with the exception ofSpoon River Anthology, which is among the most popular works of American poetry of the twentieth century. This collection of poems tells of the lives of the inhabitants of a fictional American town—Spoon River, Illinois. Many of the poems consider sickness and health in the community, and the insight they offer into human responses to illness continues to be relevant today, contributing not only to the lasting popularity ofSpoon River Anthology, but also the literary value of the work.     

A BRIEF EXPERIMENTAL ANALYSIS FOR IDENTIFYING INSTRUCTIONAL COMPONENTS NEEDED TO IMPROVE ORAL READING FLUENCY

Brief experimental analyses of oral reading fluency were conducted with 4 participants who had been referred by teachers and parents for reading problems. The procedures involved the sequential application of reading interventions to improve students' oral reading fluency. Following a baseline condition, instructional treatments were combined with prior conditions until there was improvement in oral reading fluency in the instructional passages and passages with high content overlap. Differentiated response patterns, assessed via a multielement design, were obtained for all participants. Results are discussed in terms of the potential benefits and limitations of conducting brief experimental analyses for selecting reading interventions.     

Gender moderates the relation between implicit and explicit self-esteem

Relative to men, women are more strongly socialized to trust their feelings and intuitions. We thus expected that the association between implicit and explicit self-esteem would be stronger for women than for men. That is, if implicit self-esteem contains a large intuitive, experiential or affective component, then people who are in touch with their feelings and intuitions should be more likely to report explicit self-esteem scores that are congruent with their implicit self-esteem scores. Six studies supported this idea by showing that the association between implicit and explicit self-esteem is indeed stronger for women than for men. This finding held in three different cultures and for two different measures of implicit self-esteem. We discuss the implications of this finding for debates regarding the nature and validity of implicit self-esteem.     

Clinical events in coronary patients who report low distress: adverse effect of repressive coping

OBJECTIVE: Coronary artery disease (CAD) patients who report low distress are considered to be at low psychological risk for clinical events. However, patients with a repressive coping style may fail to detect and report signals of emotional distress. The authors hypothesized that repressive CAD patients are at risk for clinical events, despite low self-rated distress. DESIGN: This was a prospective 5- to 10-year follow-up study, with a mean follow-up of 6.6 years. At baseline, 731 CAD patients filled out Trait-Anxiety (distress), Marlowe-Crowne (defensiveness), and Type D scales; 159 patients were classified as "repressive," 360 as "nonrepressive," and 212 as "Type D." MAIN OUTCOME MEASURES: The primary endpoint was a composite of total mortality or myocardial infarction (MI); the secondary endpoint was cardiac mortality/MI. RESULTS: No patients were lost to follow-up; 91 patients had a clinical event (including 35 cardiac death and 32 MI). Repressive patients reported low levels of anxiety, anger and depression at baseline, but were at increased risk for death/MI (21/159 = 13%) compared with nonrepressive patients (22/360 = 6%), p = .009. Poor systolic function, poor exercise tolerance, 3-vessel disease, index MI and Type-D personality--but not depression, anxiety or anger--also independently predicted clinical events. After controlling for these variables, repressive patients still had a twofold increased risk of death/MI, OR = 2.17, 95% CI = 1.10-4.08, p = .025). These findings were replicated for cardiac mortality/MI. CONCLUSION: CAD patients who use a repressive coping style are at increased risk for clinical events, despite their claims of low emotional distress. This phenomenon may cause an underestimation of the effect of stress on the heart. (PsycINFO Database Record (c) 2008 APA, all rights reserved).     

How does bilingualism improve executive control? A comparison of active and reactive inhibition mechanisms

It has been claimed that bilingualism enhances inhibitory control, but the available evidence is equivocal. The authors evaluated several possible versions of the inhibition hypothesis by comparing monolinguals and bilinguals with regard to stop signal performance, inhibition of return, and the attentional blink. These three phenomena, it can be argued, tap into different aspects of inhibition. Monolinguals and bilinguals did not differ in stop signal reaction time and thus were comparable in terms of active-inhibitory efficiency. However, bilinguals showed no facilitation from spatial cues, showed a strong inhibition of return effect, and exhibited a more pronounced attentional blink. These results suggest that bilinguals do not differ from monolinguals in terms of active inhibition but have acquired a better ability to maintain action goals and to use them to bias goal-related information. Under some circumstances, this ability may indirectly lead to more pronounced reactive inhibition of irrelevant information.     

Beyond fear: rapid spatial orienting toward positive emotional stimuli

There is much empirical evidence for modulation of attention by negative -- particularly fear-relevant -- emotional stimuli. This modulation is often explained in terms of a fear module. Appraisal theories of emotion posit a more general mechanism, predicting attention capture by stimuli that are relevant for the needs and goals of the organism, regardless of valence. To examine the brain-activation patterns underlying attentional modulation, we recorded event-related potentials from 20 subjects performing a dot-probe task in which the cues were fear-inducing and nurturance-inducing stimuli (i.e., anger faces and baby faces). Highly similar validity modulation was found for the P1 time-locked to target onset, indicating early attentional capture by both positive and negative emotional stimuli. Topographic segmentation analysis and source localization indicate that the same amplification process is involved whether attention orienting is triggered by negative, fear-relevant stimuli or positive, nurturance-relevant stimuli. These results confirm that biological relevance, and not exclusively fear, produces an automatic spatial orienting toward the location of a stimulus.     

Self-esteem and autonomic physiology: parallels between self-esteem and cardiac vagal tone as buffers of threat

In this article a potential physiological connection to self-esteem is suggested: cardiac vagal tone, the degree of influence on the heart by the vagus, a primary nerve of the parasympathetic nervous system. This hypothesis emerges from parallels between the two literatures that suggest both self-esteem and cardiac vagal tone function to provide protection from threat responding. This article reviews these literatures and evidence and preliminary findings that suggest in some contexts self-esteem and cardiac vagal tone may exert an influence on each other. Last, the article discusses theoretical and applied health implications of this potential physiological connection to self-esteem.