Parallel lives: Community psychology in Latin America and the United States

Comparing the history of community psychology as it developed in the U.S. during the 1960s with the community psychology that developed 10 years later in Latin America, one is reminded of the title of Plutarch’s masterpice,Parallel Lives. Although there was very little contact or communication between the first community psychologists in these regions, very similar principles and orientations evolved. These similarities are particularly striking given the many ways in which the U.S. and Latin American contexts and histories differ. Since most readers are expected to be familiar with the history of community psychology as it developed in the U.S., this paper focuses primarily on the development of community psychology in Latin America in order to highlight areas of convergence as well as divergence from the U.S. experience. This paper is based on an address presented at the Fourth Biennial Conference, Society for Community Research and Action, Division 27 of the American Psychological Association, William and Mary College, Williamsburg, Virginia, 1993. The author acknowledges the valuable help received from J. R. Newbrough and from the referees in the revision of this paper.     

Competing interests: The need to control conflict of interests in biomedical research

Individual and institutional conflict of interests in biomedical research have becomes matters of increasing concern in recent years. In the United States, the growth in relationships — sponsored research agreements, consultancies, memberships on boards, licensing agreements, and equity ownership — between for-profit corporations and research universities and their scientists has made the problem of conflicts, particularly financial conflicts, more acute. Conflicts can interfere with or compromise important principles and obligations of researchers and their institutions, e.g., adherence to accepted research norms, duty of care to patients, and open exchange of information. Disclosure is a key component of a successful conflict policy. Commitments which conflict with a faculty member's primary obligations to teaching, research, administrative responsibilities, or patient care also need attention. Institutional conflict of interests present different problems, some of which are discussed in an analysis of an actual problem posed by two proposed clinical trials. This paper is adapted from a lecture presented to a Symposium on Scientific Integrity, Warsaw, Poland, 23 November 1995. Daniel Steiner was Vice-President and General Counsel of Harvard University (1972–92) and in that capacity became familiar with conflict of interest issues. He is currently Counsel to the Boston law firm. Ropes and Gray, and is Adjunct Lecturer in Public Policy at the John F. Kennedy School of Government. Harvard University.     

Social desirability,perceived stress,and PACT ratings in lung transplant candidates: A preliminary investigation

Some aspect of psychosocial criteria is commonly utilized by most transplant programs in assessing candidates' acceptability for transplantation. However, regardless of the assessment methodology, information obtained in pretransplant assessments may be limited given the evaluative nature of the assessment as well as the sensitive nature of the contents. Indeed, transplant candidates may present themselves in a favorable fashion, minimizing any negative traits or psychological dysfunction which they perceive might prevent transplantation. Unfortunately, there are limited data addressing the extent to which transplant candidates may present themselves in an overly positive light. This investigation surveys the prevalence of social desirability in lung transplant candidates as well as its association with self-reports of perceived stress. Further, the relationship between social desirability and interviewer ratings of transplant candidacy is examined. Subjects included 24 patients in end-stage organ failure being evaluated for lung transplant candidacy. Subjects completed the Perceived Stress Scale and a brief version of the Marlowe-Crowne Social Desirability Scale. Additionally, subjects were interviewer-rated on the Psychosocial Assessment of Candidates for Transplantation. Results indicate social desirability is a prevalent phenomenon in lung transplant candidates, with more than half of the sample scoring at or above the 84th percentile on the social desirability measure. Further, self-reports of perceived stress are moderately and inversely associated with social desirability (r=–.55,p .01). Social desirability was unrelated to interviewer-ratings of transplant candidates acceptability (r=.13,p .56). Future research might include larger samples of subjects, other organ transplant candidates, and more detailed assessments of symptom distress.     

Psychology and mind-body segregation: Are we part of the problem?

Despite advances in behavioral medicine and health psychology, the health care system and medical education continue to show resistance to a truly biopsychosocial model of medical practice. Psychologists in medical settings have generally been identified as challenging the concept of mind-body duality and the segregation of biologic and psychosocial sciences in medicine. However, examples are presented of how psychologists contribute to and perpetuate mind-body segregation via exclusive theoretical conceptualizations, arbitrary definitions of professional behavior, and dogmatic constraints on the limits of psychology's field of knowledge.     

Prevalence of traumatic brain injury in an inpatient psychiatric population

This study investigated the prevalence of traumatic brain injury (TBI) in an inpatient psychiatric population. We hypothesized increased prevalence of TBI relative to the general population due to a variety of risk factors observed in psychiatric patients. One hundred (mean age = 34) psychiatric inpatients completed the revised Head Injury Questionnaire. Chart review of 17 subjects reporting injuries established whether injuries were documented in medical records. Sixty-eight percent of this psychiatric population reported one or more injuries in which they were unconscious or dazed. This number is higher than the prevalence in the general population. Injuries were generally of mild to moderate severity; multiple injuries were common. Chart review of 17 subjects reporting TBI indicated that histories of TBI had not been noted in the medical record. Finally, 63% of TBI subjects reported that their injury predated the onset of their psychiatric symptoms. These results suggest a possible role of TBI in psychiatric symptomatology and have implications for psychiatric treatment in this population.     

Increasing senior citizen participation in a community-based nutritious meal program

Two experiments were conducted to compare the effects of several prompting and reinforcement procedures on the participation of elderly citizens in a nutritious meal program. Experiment I employed a variation of the multiple-baseline design across three groups of approximately 60 households each. Elderly persons not previously participating in the program were introduced to the following conditions: (1) public service radio announcements for four weeks to advertise the meal program and the availability of free transportation, (2) a home visit that served as a personal invitation and a second prompt for participation, (3) a followup telephone call, and (4) an incentive menu for participation, which was sent through the mail. Results indicated that the home visits and incentives were both effective as recruitment procedures and superior to other conditions; however, incentives proved to be the most cost-effective intervention. Experiment II used a variation of the multi-element design to compare the effects of scheduled activities and incentives in maintaining higher levels of participation by those persons who had attended the meal program at least once in the past, but whose current rate of participation was low. Results showed that activities improved attendance levels somewhat and that incentives substantially increased the number of meal program participants. Data from these experiments thus indicate that relatively inexpensive procedures may be used effectively to increase the extent to which elderly persons make use of potentially beneficial community-based services.     

Seat belt usage: A potential target for applied behavior analysis

Results of 1,579 observations of cars entering or exiting campus parking lots showed direct relationships between seat belt wearing and the intrusiveness of the engineering device designed to induce belt usage, and between device intrusiveness and system defeat. For example, all drivers with working interlocks or unlimited buzzer reminders were wearing a seat belt; but 62% of the systems with interlocks or unlimited buzzers had been defeated, and only 15.9% of the drivers in these cars were wearing a seat belt. The normative data indicated marked ineffectiveness of the negative reinforcement contingencies implied by current seat belt inducement systems; but suggested that unlimited buzzer systems would be the optimal system currently available if contingencies were developed to discourage the disconnection and circumvention of such systems. Positive reinforcement strategies are discussed that would be quite feasible for large-scale promotion of seat belt usage.     

A new measure for determining children's subjective organization of speech

A new technique for determining children's subjective organization of speech is described. The technique consists of teaching a child a sentence and then repeatedly (1) reading the sentence up to a selected point, (2) sounding a tone, and (3) having the child supply the next word. The time from the tone to the onset of the child's voice is the dependent variable. In the first study 6- and 8-year-old children memorized the following sentence: “John likes to feed the little puppies in the barn.” Their response times suggested that the dominant segmentation pattern consisted of four phrases: a subject phrase, a verb phrase, an object phrase and a modifier phrase. Within each phrase differences between reaction times were on the order of 30 msec. Across phrases they were on the order of 120 msec. The same trend emerged for subsamples of the children with various short-term memory sizes, and for adults. It also appeared for subsamples of the total scores (e.g., first six trials and last six trials). In order to provide further evidence of the technique's validity, different sentences of the same general type were presented to children with short-term memory spans of either 3, 4, or 5. As predicted, it was found that when children's spans corresponded to the number of hypothesized chunks (i.e., 4), they could repeat the sentences verbatim on the first exposure. They could not do so, however, when their spans were lower than that value or when the number of phrases was increased. It was concluded that the new technique is a promising one for assessing young children's patterns of speech segmentation.     

Effects of neutral and positive stimuli on stuttering: “Calling attention to stuttering” revisited

This study investigated the effects of presumably positive and neutral response-contingent stimuli on the occurence of stuttering. Eight adult stutterers spoke spontaneously during a 60-min experimental session, which was divided into three 20-min periods. During Condition I no stimuli were delivered. During Condition II a digital counter and a pair of yellow lights were activated each time the subject stuttered. During Condition III these same response-contingent stimuli were delivered, but with the additional factor that the subject would earn 5¢ each time the counter moved forward and the lights were illuminated. Conditions II and III were counterbalanced across subjects. The experimenter was unaware of which of the two contingencies were operative during Conditions II and III. Results showed no significant changes in occurence of stuttering due to either response-contingent stimulus. A discussion of theoretical and experimental implications is given.     

The use of averaged electroencephalic response techniques in the study of auditory processing related to speech and language

This paper reviews a number of studies done by the authors and others, who have utilized various averaged electroencephalic response (AER) techniques to study speech and language processing. Pertinent studies are described in detail. A relatively new AER technique, auditory brainstem responses (ABR), is described and its usefulness in studying auditory processing activity related to speech and language is outlined. In addition, a series of ABR studies, that have demonstrated significant male—female differences in ABR auditory processing abilities, is presented and the relevance of these data to already established differences in male—female language, hearing, and cognitive abilities is discussed.