Preparing Psychologists in Academic Health Centers for the Rapidly Changing Health Care Environment

The Association of Psychologists in Academic Health Centers (APAHC) convened its 5th National APAHC Conference in Boston March 3–5 2011. The conference and its theme, “Preparing Psychologists for a Rapidly Changing Health Care Environment,” brought psychologists from academic health centers together to examine how psychology can adapt to and help lead health care efforts in the face of health care reform. This paper reports on the conference and introduces the special issue of JCPMS that is dedicated to the conference. The conference theme is framed in the historical context of the four national conferences that preceded it. In examining the focus and topics of the preceding conferences, recurrent themes are identified and progress in certain areas is highlighted.     

The internal adaptation processes of professional boxers during the Showtime Super Six Boxing Classic: A qualitative thematic analysis

ObjectivesThe Super Six World Boxing Classic was conceived by Showtime Sports to feature the best six professional boxers in the super middleweight division (168 pounds) throughout a modified round robin tournament. The objective was to explore the adaptation and mal-adaptation processes of the tournament's original six tournament participants over time.DesignMedia data in the form of documentary episodes (n = 12 episodes, ～30 min each from the foregoing source were transcribed verbatim. Data included athletes' responses prior to their first bout and as each progressed or was eliminated. Boxers' post-bout explanations were also included.MethodThe original six contestants (mean age = 28.8 years at tournament start) from the tournament, with a record of 157 wins and 4 losses, were included within the project. Data were analyzed via thematic analysis (see Braun & Clarke, 2006).ResultsThe following themes were identified: (a) pre-conditions: moving into the tournament (subthemes: positive anticipation, uncertainty), (b) outcomes: moving through the tournament (subthemes: tournament progression, tournament regressions), and (c) consequences: moving out of the tournament (sub-themes: responses of the defeated, the king's adaptation).ConclusionsThis study highlights the adaptation processes of the six tournament contestants, demonstrating how one athlete adapted successfully and became champion through personal focus. The remaining athletes lost at least once, with pre-bout adaptation processes suggesting performance regression. These findings add to the adaptation literature, further contextualizing how adaptation meanings change and unfold over time.     

Provider Perspectives on Barriers and Strategies for Achieving Culturally Sensitive Mental Health Services for Immigrants: A Hamilton, Ontario Case Study

As research reveals that the healthy immigrant effect, whereby the health of immigrants at the time of arrival is high but subsequently declines and converges toward that of the native-born population, also extends to mental well-being, this paper aims to examine the barriers to mental health care for immigrants in Hamilton, Ontario. Through the use of face-to-face interviews with eight service providers, barriers to care were revealed to include cultural insensitivity, stigma and shame, and limited resources. Suggestions for improvements to mental health care are also discussed.     

Deconstructing the age-prevalence curve of alcohol dependence: why "maturing out" is only a small piece of the puzzle

Epidemiological studies have consistently demonstrated that heavy alcohol use and alcohol dependence (AD) tend to increase in adolescence and emerging adulthood and then show a large decline in the late 20s, a phenomenon called maturing out. This decline has been explained as an effect of "role incompatibility" in which involvement in new roles and activities interferes with a heavy drinking lifestyle. However, maturing out has been conceived mostly as a decrease in offset, with little attention paid to reductions in new onset or recurrence across decades of life. Moreover, although role incompatibility processes have been studied with young samples, little is known about the effect of life transitions (e.g., marriage, parenthood, changes in employment status) on AD later in life and whether similar effects are observed. Using longitudinal data from the National Epidemiologic Survey on Alcohol and Related Conditions, a nationally representative epidemiologic survey, we examined the patterns of stability and change in AD across the life span and the differential effect of life transitions on AD across different age strata. Results showed that persistence of AD tended to increase with age, although not dramatically, and that onset and recurrence tended to decrease with age. Moreover, the effects of life transitions on the course of AD varied across the life span and were different for men and women. These results indicate that life transitions differentially affect the patterns of stability and change in younger versus older people, have a different impact for men and women, and highlight the need to consider the unique aspects of each stage of adult development on the course of AD.     

Another fundamental social category? Spontaneous categorization of people who uphold or violate moral norms

Studies of social categorization have shown that humans robustly categorize others along dimensions of sex, age, kinship, and coalition. Drawing on a functional perspective, we predicted that humans should also categorize others along the dimension of morality (i.e., violating vs. upholding moral norms). In a study employing the memory confusion paradigm, university undergraduate participants (N = 39) were presented with same-sex targets randomly matched with sentences indicating violation or upholding of moral norms, and with sentences indicating competence or incompetence. Results showed that participants spontaneously categorized along morality but not along competence, suggesting that morality (beyond general valence) may be an important dimension of social categorization.     

The feature-positive effect in allocations of responsibility for collaborative tasks

People commonly believe they have contributed more to collaborative tasks than others give them credit for. We distinguish between two types of contributions – additions (such as adding words to a co-authored paper) and deletions (such as removing extraneous words) – and show that individuals are especially prone to receive less credit from others than they believe they deserve when their contributions consist of taking something away rather than adding something. Participants who shortened some writing believed they improved it just as much as did participants who lengthened some, but were seen by others as having contributed less. Although one can hardly fail to notice one's own deletions, these contributions – like any contributions that, by their very nature, leave little trace of themselves – are easy for others to overlook.     

The effectiveness of therapeutic assessment with an adult client: a single-case study using a time-series design

This article presents the therapeutic assessment (TA; Finn, 2007) of a traumatized young woman named Claire. Claire reported feeling debilitated by academic demands and the expectations of her parents, and was finding it nearly impossible to progress in her studies. She was also finding it difficult to develop and sustain intimate relationships. The emotional aspects of close relationships were extremely difficult for her and she routinely blamed herself for her struggles in this arena. The assessor utilized the TA model for adults, with the exception of not including an optional intervention session. The steps of TA, particularly the extended inquiry and the discussion of test findings along the way, cultivated a supportive and empathic atmosphere with Claire. By employing the single-case time-series experimental design used in previous TA studies (e.g., Smith, Handler, & Nash, 2010; Smith, Wolf, Handler, & Nash, 2009), the authors demonstrated that Claire experienced statistically significant improvement correlated with the onset of TA. Results indicated that participation in TA coincided with a positive shift in the trajectory of her reported symptoms and with recognizing the affection she held for others in her life. This case illustrates the successful application of case-based time-series methodology in the evaluation of an adult TA. The potential implications for future study are discussed.     

Exploring the construct validity of the social cognition and object relations scale in a clinical sample

The Social Cognition and Object Relations Scale-Global rating method (SCORS-G; Stein, Hilsenroth, Slavin-Mulford, & Pinsker, 2011; Westen, 1995) measures the quality of object relations in narrative material. This study employed a multimethod approach to explore the structure and construct validity of the SCORS-G. The Thematic Apperception Test (TAT; Murray, 1943) was administered to 59 patients referred for psychological assessment at a large Northeastern U.S. hospital. The resulting 301 TAT narratives were rated using the SCORS-G method. The 8 SCORS variables were found to have high interrater reliability and good internal consistency. Principal components analysis revealed a 3-component solution with components tapping emotions/affect regulation in relationships, self-image, and aspects of cognition. Next, the construct validity of the SCORS-G components was explored using measures of intellectual and executive functioning, psychopathology, and normal personality. The 3 SCORS-G components showed unique and theoretically meaningful relationships across these broad and diverse psychological measures. This study demonstrates the value of using a standardized scoring method, like the SCORS-G, to reveal the rich and complex nature of narrative material.     

A behavioral test of Horney’s linkage between authenticity and aggression: People living authentically are less-likely to respond aggressively in unfair situations

This study links Horney’s account of human growth and neurosis to authenticity by examining aggressive responses on the point subtraction aggressive paradigm, providing the first empirical test of whether authenticity can predict objective behavior. Data from undergraduate, postgraduate, and mature students demonstrate that when controlling for age, gender, trait-anger, agreeableness, and functional dimensions of coping, individuals who measure high on authentic-living respond less aggressively to attacks and counter-attacks in unfair situations. Authentic-living uniquely accounted for 14.2% of variance in aggressive-responses (r = −.37). The findings suggest that inauthenticity is a strong predictor of aggressive behavior, and therefore increasing levels of authenticity in counseling practice may reduce maladaptive levels of anger. We suggest future exploration between authenticity and models of emotional regulation will unearth the cause and effects of aggression within inauthentic individuals.     

Can survival processing enhance story memory? Testing the generalizability of the adaptive memory framework

Research from the adaptive memory framework shows that thinking about words in terms of their survival value in an incidental learning task enhances their free recall relative to other semantic encoding strategies and intentional learning (Nairne, Pandeirada, & Thompson, 2008). We found similar results. When participants used incidental survival encoding for a list of words (e.g., "Will this object enhance my survival if I were stranded in the grasslands of a foreign land?"), they produced better free recall on a surprise test than did participants who intentionally tried to remember those words (Experiment 1). We also found this survival processing advantage when the words were presented within the context of a survival or neutral story (Experiment 2). However, this advantage did not extent to memory for a story's factual content, regardless of whether the participants were tested by cued recall (Experiment 3) or free recall (Experiments 4-5). Listening to a story for understanding under intentional or incidental learning conditions was just as good as survival processing for remembering story content. The functionalist approach to thinking about memory as an evolutionary adaptation designed to solve reproductive fitness problems provides a different theoretical framework for research, but it is not yet clear if survival processing has general applicability or is effective only for processing discrete stimuli in terms of fitness-relevant scenarios from our past.