Diagnostic Work through Evidence-Based Guidelines: Avoiding Gaps Between Development and Implementation of a Guideline for Problem Behaviour in Elderly Care

Diagnostic work is the reflexive work of figuring out what issues are at stake and determining the scope for action. This work is not generally accommodated by evidence-based guidelines, which generally promote a uniform, predefined approach to solving healthcare problems that risk narrowing the opportunities for diagnostic work in healthcare practice. Consequently, guidelines are often criticised as too general to solve situated, individual healthcare problems and gaps between guidelines and their implementation are often reported. The Netherlands has developed a guideline for problem behaviour in elderly care, explicitly designed for diagnostic work, thus stimulating a situated approach. Relational problem behaviour is highly embedded in its context. The guideline stimulates diagnostic work, which helps to unravel problem behaviour and is opening alternatives in elderly care. Diagnostic work does not transfer guideline development problems to healthcare practice, but simply structures the decision-making process without giving a predefined answer. Diagnostic work is thus important to consider in order to avoid a gap between guideline development and implementation.     

On the Decision to Explore New Alternatives: The Coexistence of Under‐ and Over‐exploration

The decision whether to explore new alternatives or to choose from familiar ones is implicit in many of our daily activities. How is this decision made? When will deviation from optimal exploration be observed? The current paper examines exploration decisions in the context of a multi‐alternative “decisions from experience” task. In each trial, participants could choose a familiar option (the status quo) or a new alternative (risky exploration). The observed exploration rates were more sensitive to the frequent outcome from choosing new alternatives than to the average outcome. That is, the implicit decision whether to explore a new alternative reflects underweighting of rare events: Over‐exploration was documented in “Rare Disasters” environments, and insufficient exploration was evident in “Rare Treasures” environments. In addition, the results reveal a decrease in exploration of new alternatives over time even when it is always optimal and some exploration even when it is never reinforcing. These results can be captured with models that share a distinction between “data collection” and “outcome‐driven” decision modes. Under the data collection mode, the decision maker collects information about the environment, to be used in future choices. Under the outcome‐driven mode, the decision maker relies on small samples of previous experiences with familiar versus unfamiliar alternatives, before the selection of a specific alternative. The predictive value of a two‐parameter “explorative sampler” quantification of these assumptions is demonstrated. Copyright © 2013 John Wiley & Sons, Ltd.     

对恐怖情绪的调节:认知重评和表达抑制的差异——一项ERP研究

本研究采用事件相关电位(ERP)技术,通过测量由视觉诱发的脑电成分晚正波(LPP)来比较情绪调节策略在生理电特征上的差异,探讨认知重评和表达抑制的优劣。实验结果表明:(1)从波幅的角度来比较:在400—600ms时间窗口内,认知重评条件下恐怖图片诱发的LPP波幅显著小于在自由观看条件下的波幅,而表达抑制和自由观看组所诱发的LPP波幅差异较小。(2)从时间进程的角度来比较:认知重评与自由观看组的差异发生在400ms并持续到600ms;而表达抑制和自由观看之间的差异发生在450ms但是只持续到550ms。这表明认知重评相较于表达抑制,对负性情绪起调节作用开始较早,并且持续时间较长。这为认知重评优于表达抑制策略提供了神经生理学上的证据。     

问题解决中图式的建构:一项应用题分类研究

以小学三、四年级的60名儿童为被试,采用对基本算术应用题分类的方法测量图式,探讨了图式的作用以及影响图式获得的因素。结果表明,被试对问题的分类有前图式水平、图式水平、按解题程序分类三种情况,前两个水平又分成若干亚水平;图式的水平对问题解决成绩有预测作用;图式的水平和问题解决成绩均有显著的性别差异,女生优于男生。     

儿童侵犯性性别差异的社会认知技能视角

影响侵犯性性别差异的因素众多,本研究认为的社会认知技能的性别差异与侵犯性性别差异有密切关系,认知技能是风险因素和行为之间的调节者。女性相比于男性侵犯性行为少与女性神经机制的发展缺陷概率小,生理成熟早,最终发展形成较男性更好的社会认知技能有密切关系。     

Autism and the double empathy problem: Implications for development and mental health

This article proposes a link between autistic people being misperceived by the neurotypical majority and their being at risk of poor mental health and well-being. We present a transactional account of development in which the misperceptions (and consequent behaviour) of the neurotypical majority influences the perceptions and behaviour of autistic people such that they become increasingly separate and indeed isolated from mainstream society. This jeopardizes their mental health and prevents autistic people from developing to full potential. The situation is not only problematical for the development of autistic people but is also to the detriment of wider society, in so far as autistic people are effectively prevented from contributing fully. This account assumes that some (not necessarily all) autistic people yearn to be included, to be productive and to be useful. It thus directly opposes accounts that view autism as an extreme case of diminished social motivation.