The psychologist's role in assessing and facilitating patients' knowledge of advance directives in medical settings: A preliminary investigation

In a time of budgetary shortfalls in the medical industry, an aging population, and an increased emphasis on health care choices, psychologists are being called upon to administer advance medical directive programs to patients. This study reports preliminary findings from a program to assess and facilitate patients' knowledge of advance directives (ADs) by the Psychology Service at the Ann Arbor VA Medical Center. The participant pool included 243 male veteran patients admitted to medical and surgical wards at the hospital. The intervention included the use of a computer-generated prompt for consultation, which was sent to the psychology staff in response to a patient inquiry regarding ADs. It also involved an increased emphasis on the delivery of written material on ADs by the admissions clerks. The intervention appeared to result in a modest increase in patients' knowledge of advance directives. Suggestions are offered for areas that should be emphasized in future attempts to increase patients' knowledge and utilization of advance directives.     

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.     

Organizational factors and work involvement

The aim of this paper is to describe a study which investigated the influence of organizational factors on job involvement and specialization involvement. It was hypothesized that rank, self-expression, participation in decision making, and career factors affect job and specialization involvement. The independent variables were chosen by considering an extension of Schein's (1971, Journal of Applied Behavioral Science, 7, 401–426) “career cone” concept. The hypotheses were tested using a sample of Australian Army officers (N = 384) in a questionnaire survey. The results showed that job involvement is associated primarily with self-expression, although the latter is influenced in turn by participation in decision making, and that specialization involvement is associated with both self-expression and career factors. Rank does not affect either involvement variable. It was concluded that Schein's concept is a useful guide to theory and research on career attitudes. The results support the proposition that job and specialization involvement are distinct constructs. Implications for organizations are discussed.     

A signal detection framework for the evaluation of probabilistic forecasts

In this paper I formulate an approach for evaluating probabilistic forecasts in terms of signal detection theory. Signal detection theory provides a powerful perspective for this type of problem, and a rich empirical background including methodological tools as well as an extensive body of research in many domains. I propose procedures which emphasize the maximization of expected utility for the decision maker who uses the forecasts. Further, I suggest approaches to obtaining indices of calibration and resolution within this framework. I also present arguments that the proposed indices will exhibit the same basic properties as do decompositions of Brier's (1950, Monthly Weather Review, 78, 1–3) mean probability score. However, the properties may be reflected in different ways, and hence, the present methods may lead to different conclusions about forecasting ability. Finally, I argue that the use of an expected utility loss function makes this approach more appropriate for practical applications as well as for theoretical research than other procedures with more arbitrary loss functions.     

Further tests of a meta-model of youthful marijuana use

This paper tests a meta-model of youthful marijuana use on students in Grades 11, 12 and 13. Although the specific models for each grade varied in detail, all followed a meta-model making the following assumptions: (1) that use or nonuse of marijuana depends primarily on attitude towards use; (2) that attitude largely reflects the perceived functional and dysfunctional consequences of use; and (3) that what people perceive as functional or dysfunctional depends on relevant personality characteristics. All three models showed satisfactory goodness-of-fit in terms of nonsignificant overidentification tests (minimum P > 0.25) and small discrepancies between observed correlations and the corresponding theoretically implied correlations. A notable feature of the Grade 13 data in contrast to those for Grade 12 and previously reported findings was the seeming unimportance of the perceived value of marijuana use for gaining acceptance from peers. It was suggested that this might reflect the selective survival into Grade 13 in the sampled community of more independently-oriented students.     

父母低头行为对儿童青少年心理发展的影响

父母低头行为是指父母照顾或与孩子交流时,过分关注与使用手机而忽视孩子的行为。梳理相关研究发现,父母低头行为会对孩子产生多种不良影响,如,降低亲子关系交流质量、增加意外伤害风险、损伤人际交往能力、导致问题行为增多。现有研究采用取代假说、多任务操作理论以及依恋理论对影响过程进行解释。未来研究的关键在于邻近概念的区分、测量方式和研究方法的改进、探讨儿童对父母手机使用行为的看法以及移动设备对亲子互动可能的积极影响。     

When is an easy task difficult and vice versa? A reply to lane

Lane has argued that kantowitz and Knight incorrectly predicted an interaction between primary and secondary task difficulty for the variable-allocation model of attention. It is shown that such an interaction is indeed obtained if task-performance difficulty is defined in terms of capacity and only reasonable transformations of data are permitted. This interaction holds for any set of monotonic resource operating characteristics.     

The retention of nouns,adjectives, and verbs of sentences

This research compared the retention of nouns, adjectives and verbs of sentences. A model of the structure underlying the retention of sentences and in which deep structure constituent propositions are hierarchically related, was used to make predictions concerning the retention of these word classes. The model was not supported by the data and it was determined that latencies to recognize the words of a previously presented sentence were the same for all classes of words. This result indicated that for recognition (but not necessarily for other memory tasks), each word of a sentence is seperately or equally accessible (as long as inter-word imagery is the same). However, a further experiment showed that, although word class is not a variable, the image-arousing capacity of a word is. Latencies and error rates were much lower for high-imagery words than for low-imagery ones. The findings on error rates in recognizing words were interesting and pointed to a different model where the meaning representations and syntatic functions of words have an active role in sentence retention.