Denial and Confirmatory Search: Paradoxical Consequences of Medical Diagnosis1

An experiment was conducted to examine the effects of medical diagnostic-test results on illness appraisal and the recall of symptoms and behavior. Subjects were tested for a fictitious enzyme deficiency and were told either that the test result was positive (deficiency present) or that it was negative (deficiency absent). In addition, some of the subjects were told the test was accurate 95% of the time and others were told it was accurate 75% of the time. As predicted, subjects judged the enzyme deficiency as less serious and more prevalent when presented with positive test results. Subjects with positive test results also recalled more behaviors that had been labeled as risk factors. Although positive test subjects tended to report more deficiency-related symptoms, diagnosis did not affect the free recall of general symptoms. In addition, information concerning the reliability of the diagnostic test had no effect on judgments or recall but did affect information seeking. Subjects with positive test results were less likely to request a definitive follow-up test when their results were unreliable. The results are interpreted as evidence for independent confirmatory search and denial processes following medical diagnosis.     

Neuroticism, extraversion, and related traits in adult twins reared apart and reared together

The relative importance of genetic and environmental factors for neuroticism, extraversion, impulsivity, and monotony avoidance were estimated in a sample of 99 monozygotic and 229 dizygotic pairs of twins reared apart (TRA) and a matched sample of 160 monozygotic and 212 dizygotic pairs of twins reared together (TRT). The average age was 58.6 (SD = 13.6); 72% of the twins were 50 or older. Model-fitting analyses verified the importance of genetic factors for all four measures; from 23% to 45% of the total variation was attributable to genetic sources. There was considerable evidence that these factors were operating in a nonadditive manner for extraversion and impulsivity. Shared environment accounted for less than 10% of the variance; some evidence for selective placement was found for neuroticism.     

The effects of contextual information and gender on the prediction of hypnotic susceptibility

Council, Kirsch, and Hafner (1986) obtained empirical support for the hypothesis that significant correlations between questionnaire measures of absorption and hypnotic susceptibility are an artifact of subjects' beliefs about their own hypnotizability. We tested this hypothesis in a two-session experiment. During Session 1, subjects completed questionnaire measures of absorption, mystical experience, daydreaming frequency, and paranormal beliefs. During Session 2, subjects were tested for hypnotic susceptibility. Subjects were also exposed to one of three information manipulations: They were told about hypnotic testing either before or after filling out the questionnaires or were not told about hypnotic testing. The information manipulation moderated the prediction of susceptibility by the questionnaire measures for women, but not for men. For women, scores on the absorption questionnaire predicted susceptibility only when subjects were informed about hypnotic testing. In the told-after condition, this effect generalized to all of the remaining questionnaire measures. For men, none of the questionnaires was a reliable predictor of susceptibility.     

Conceptions of states and traits: dimensional attributes with ideals as prototypes

Traits and states are concepts that people use to both describe and understand themselves and others. We show that people view these concepts as prototype-based categories that have a graded internal structure and fuzzy boundaries and identify a set of attributes that define the prototypical cores of two categories: traits and states. Prototypical traits are stable, long-lasting, and internally caused. Prototypical states are temporary, brief, and caused by external circumstances. These prototypes are not defined by averages, as the family-resemblance principle would suggest, but by ideal (or extreme) attribute values. Like other ideal-based categories, traits and states serve particular goals. Trait concepts permit people to predict the present from the past; state concepts identify those behaviors that can be controlled by manipulating the situation. These two complementary schemas are part of the extensive theory of psychological causality that is implicit in language. Abstract social concepts differ from object categories in their category standards, the nature of their attributes, and the interrelations among those attributes.     

Some observations on control by spoken words in children's conditional discrimination and matching by exclusion

This study examined matching-to-sample procedures that might result in the emergence of conditional behavior never explicitly taught. Subjects were preschool children. Two pictures were displayed as comparisons on every trial, and samples were spoken words. In baseline training preceding each of three experiments, children learned to select pictures of a dog, a table, and a banana in response to their spoken English names. Thereafter, probe trials displayed novel comparisons with baseline comparisons: one novel comparison was displayed with the dog and another with the table. The three experiments differed primarily in the nature of the samples presented on probe trials. In Experiment 1, probe samples were novel words, "JAIJAI" and "BREEL." On the probes, each of seven subjects reliably selected the novel comparisons, apparently "excluding" the familiar ones. In Experiment 2, probe samples were from the subjects' baseline. On one probe, for example, the sample was "TABLE," and the subject had to choose either the dog or the novel picture. Exclusion was logically possible because the dog had always before been incorrect in the presence of "TABLE." Under these conditions, however, only two of nine children excluded reliably. In Experiment 3, probe samples were words that had never been samples on any matching-to-sample trial, but that had controlled the children's behavior in other settings. On one probe, for example, the sample was "PENCIL," and the subject had to choose either the dog or a novel picture. Subjects virtually always excluded the former and selected the latter. Unreliable exclusion in Experiment 2, therefore, apparently resulted because the probe samples had previously served also as samples on baseline trials. Spontaneous verbalizations recorded during probing provided further data consistent with this interpretation. The study helps to define variables controlling exclusion performances by showing that such performances are more likely to occur if the sample has no prior experimental history.     

THE EFFECTIVENESS OF A CONSTANT TIME-DELAY PROCEDURE TO TEACH CHAINED RESPONSES TO ADOLESCENTS WITH MENTAL RETARDATION

The effectiveness of a 5-s constant time-delay procedure to teach three chained food preparation behaviors to four moderately retarded adolescent students was evaluated within a multiple probe design across behaviors. Results indicate that the procedure was effective in teaching all four students to make a sandwich, boil a boil-in-bag item, and bake canned biscuits. The skills maintained with at least 85% accuracy over a 3-month period. Training generalized from the school to the home setting for the 2 subjects that completed generalization probe sessions. The percentage of errors across all skills and students was less than 9%.     

Behavioral and sociocognitive correlates of ratings of prosocial behavior and sociometric status

Although peers' and teachers' evaluations of children's prosocial behavior and peers' sociometric ratings frequently have been used in studies of social development, the validity of young children's ratings of others has been questioned, as has that for teachers' ratings of prosocial behavior. In this study, preschoolers' ratings of peers' sociometric status and prosocial behavior, as well as teachers' ratings of children's prosocial dispositions, were obtained. These were correlated with children's naturally occurring prosocial or social behavior; ratings of prosocial behavior also were correlated with children's prosocial moral reasoning and prosocial self-attributions. Peers' sociometric ratings were positively related to children's sociability whereas prosocial ratings were related to helping (but not sharing) behavior. Teachers' ratings of prosocial behavior were not related to frequency of prosocial behaviors, but were positively related to developmentally mature moral judgments and self-reported motives.     

The impact of the therapeutic environment

This paper emphasizes the impact of the setting, space, and general physical properties of the clinic upon the difficult patient's profound neediness and absence of inner regulatory structure. Moreover, the clinic's administrative style and requirements often related to fiscal restraints, demands for accountability for both how funds are spent and treatment outcome, all impinge upon the patient. Humanizing clinics so they have the capacity for psychotherapeutic holding and provision of safety for difficult patients are discussed in detail in this contribution.