Gender differences over time in medical school stressors,anxiety, and the sense of coherence

Gender differences in the perception of medical school stressors, trait anxiety, and the sense of coherence were investigated in a longitudinal study in an Israeli medical school. The overall stressor score increased for both sexes from orientation to the second year of studies. The increase in the stressor score among women was due primarily to their increasing concern about professional status issues; for men, the academic demands factor contributed most to their increased overall stressor score. Trait anxiety increased and the sense of coherence decreased over time for both sexes. The gender difference in anxiety was significant in the first two stages, but disappeared in the third stage, indicating that although men had lower scores at all stages, their scores increased relatively more than women's over time. The findings suggest that the stressors of medical education have a negative effect on two personality resources needed to deal with life's demands.     

Effects of performance expectancies created by peer comparison as related to social reinforcement,task difficulty,and age of child

Children in kindergarten-first grades and fourth-sixth grades (6 and 10 years of age, respectively) participated in one of two experiments and performed either a simple motor task or (for older children only) a two-choice simultaneous discrimination task at two difficulty levels. Children received either positive, negative, or no peer comparison statements (describing how other children their age had allegedly performed) and either praise, silence (in Experiment 2 only), or criticism on a fixed-interval 20-second schedule throughout the task. Young children were more responsive to adult evaluation of their performance than to peer comparison. Expectancies created by peer comparisons affected older children's motor performance most if they received reinforcement contrary to the expectancy. In situations requiring greater cognitive ability, older children, particularly boys, responded to the performance expectancies created by positive peer comparison. Older boys, compared with older girls, seemed to be more sensitive to peer comparison and social reinforcement.     

Reinforcement and the organization of behavior in golden hamsters: Punishment of three action patterns

Golden hamsters received free shock (Experiment 1) or they were partially (Experiments 2 and 3) or continuously (Experiments 4 and 5) punished with mild electric shock for face washing, open rearing, or scrabbling. Punishment immediately and enduringly reduced the time engaged in scrabbling and the number and length of its bouts. Face washing was also clearly associated with shock, since effects specific to the contingency between face washing and shock were retained when shock was discontinued, but under some conditions punishment increased the number of bouts of face washing. Open rearing was the most refractory of the three activities to suppression and showed least evidence of retaining the effects of punishment. This pattern of results differs from that found previously when food reinforcement was given for the same activities. It is discussed in terms of constraints on performance of learned associations by a variety of response-specific and reinforcer-specific motivational factors.     

Production of narrative discourse in aphasia

The study described the abilities of a group of 15 moderately impaired aphasics and 15 normals to produce narrative discourse. The experimental tasks included telling stories, summarizing stories, and giving morals to stories. The data were analyzed in terms of sentential grammar, discourse grammar, and subjective ratings of content and clarity of language. The results showed that aphasics produced well-structured discourse. The language of the aphasics' discourse was reduced in both complexity and amount, as compared to that produced by normals. The reduction of language reflected selective reduction of hierarchically organized information. The findings of the study confirm the results of previous research on mildly impaired aphasics, which also showed preservation of discourse structure with selective reduction of information.     

Relative rate of response and relative magnitude of reinforcement in multiple schedules

Pigeons were trained on a multiple schedule in which the duration of access to grain reinforcement was varied independently in the two components. The relative response rate in one component was an increasing function of the relative duration of reinforcement in that component. The similarity of this interaction to that found in multiple schedules of different reinforcement frequency is discussed. Extinction data were also similar to those obtained after training on multiple schedules of different reinforcement frequency.     

Does Adding the Dialectical Behavior Therapy Prolonged Exposure (DBT PE) Protocol for PTSD to DBT Improve Outcomes in Public Mental Health Settings? A Pilot Nonrandomized Effectiveness Trial With Benchmarking

The Dialectical Behavior Therapy Prolonged Exposure (DBT PE) protocol improves DBT’s effects on PTSD in research settings, but its effectiveness in community settings is largely unknown. This pilot nonrandomized controlled trial examined DBT with and without DBT PE in four public mental health agencies. Patients (N = 35, 12-56 years old, 80.0% female, 64.7% racial/ethnic minorities, 44.1% sexual minorities) had PTSD, were receiving DBT, and completed assessments every four months over one year. Sixteen patients (45.7%) initiated DBT PE, 19 (54.3%) did not, and dropout did not differ between groups (31.3% vs. 26.3%). The primary barrier to initiating DBT PE was clinician turnover (57.9% of non-initiators). After adjusting for confounds, DBT PE initiators (g = 1.1) and completers (g = 1.4) showed a greater reduction in PTSD than patients who received DBT only (g = 0.5; p’s < .05). Rates of reliable improvement in PTSD were 71.4% (DBT PE completers), 53.8% (DBT PE initiators), and 31.3% (DBT). Similar patterns were observed for posttraumatic cognitions, emotion dysregulation, general psychological distress, and limited activity days. There was no worsening of self-injurious behavior or crisis service use among patients who received DBT PE. Benchmarking analyses indicated comparable feasibility, acceptability, and safety, but a smaller magnitude of clinical change, than in efficacy studies. Results require replication in a randomized trial but suggest that DBT PE can be transported effectively to community settings.     

What is the Meaning of Proofs?

Journal of Philosophical Logic - The origins of proof-theoretic semantics lie in the question of what constitutes the meaning of the logical connectives and its response: the rules of inference...     

Challenges and Potential Solutions to Implementing Phone Coaching in Dialectical Behavior Therapy

Dialectical Behavioral Therapy (DBT) is an effective treatment for borderline personality disorder (BPD), yet many health care facilities struggle to implement one of the modes of DBT, phone coaching. The aims of this study were to present barriers and reported solutions regarding the implementation of DBT phone coaching. We conducted a sequential mixed methods national program evaluation that included a quantitative self-report survey completed by Department of Veterans Affairs (VA) facilities (N = 59) offering any of the four modes of DBT. Subsequent qualitative interviews using a semistructured interview guide informed by the Promoting Action on Research Implementation in Health Services (PARIHS) were completed with DBT providers and administrators from a subset (n = 16) of these VA sites. Four themes—the lack of tools and policies, compensation for phone coaching, clinician willingness to conduct phone coaching, and consistent program and leadership support—were identified and illustrated in a case study. This study also offered concrete recommendations for those health care organizations, managers, administrators, and clinicians who may be interested in implementing phone coaching at their health care facilities.