Evaluating pediatric psychology consultation services in a medical setting: An example

We examined the nature of referrals to a health center-based pediatric psychology service from 1990 to 1993 and assessed the satisfaction of health professionals with these services. Archival evaluation of 1467 records showed that over half of the consultation requests came from general pediatrics, pediatric neurology, and surgical services and that 70% of the psychological services were delivered on an outpatient basis. The most frequent referrals were for cognitive/neuropsychological evaluation and externalizing behavior problems. Pediatric psychology trainees were involved in 94% of the consultations. Survey of health professionals (n = 143) indicated very high overall satisfaction with the quality of services delivered. Presenting problems yielding the greatest likelihood for future consultation requests were behavior problems, child abuse, coping with illness, and depression/suicide. Results are discussed in the context of previous evaluations of pediatric psychology services and recommendations for future evaluation research.     

Analysis of long-term stress reactions in emergency room patients: An initial study

The psychological stress reactions of 44 family medicine patients who were treated in the emergency room were examined approximately a year after the event. Patients were assessed on several psychological measures, including one for posttraumatic stress disorder (PTSD), and on their perception of how stressful the event was initially and now. Results show continuing stress reactions related to the emergency room event. Three patients endorsed symptoms indicating full PTSD and 13 appeared to have at least partial PTSD. Age appeared to be a factor in the presence of stress symptoms and in degree of perceived communication with the physician.     

Health and behavior: The coming together of science and practice in psychology and medicine after a century of benign neglect

For thousands of years, physicians had available only a few drugs with which to minister to patients and the practice of psychology was an integral and therapeutically powerful component in the practice of medicine. Thus, good bedside medicine consisting of empathy, compassion, and a nurturant attitude toward the ill individual was a major component of the physician's armamentarium until relatively recently. However, the explosion in scientific knowledge in biology, physiology, chemistry, and microbiology which began a century ago and has continued through the twentieth century helped produce several generations of physician specialists and subspecialists with little knowledge of the powerful role psychological factors play in health and illness. As a result, practitioners of medicine and practitioners of psychology have had little or no contact during most of this century. However, as advances in microbiology, public health, and nutrition have eradicated many of the infectious diseases, infirmities associated with one's lifestyle have replaced the latter as the major causes of death today. One offshoot of this shift is that after a century of benign neglect, physicians and psychologists have rediscovered a common ground in the arena labeled health and behavior. Some factors responsible for these recent developments are highlighted.This article was an invited address delivered to a group of Japanese health psychologists as part of a Health Sciences Seminar in Tokyo on July 24, 1993. Concurrent with its publication here in English, it is being published in the Japanese language in the March 1994 issue of the journal,Japanese Health Psychology.     

Reflexive research and the grounding of analysis: Social psychology and the psy-complex

This paper is concerned with reflexivity in research, and the way research is grounded in the operations of the psy-complex in social psychology. A central argument is that qualitative research in general, and a focus on reflexivity in particular, requires theoretical grounding. Distinctions are drawn between ‘uncomplicated subjectivity’, ‘blank subjectivity’ and ‘complex subjectivity’; and the analytic device of the ‘discursive complex’ is described. It is argued that such theoretical grounding can usefully draw on developments in discourse analytic, deconstructionist, and psychoanalytic social research. The opposition between objectivity and subjectivity is deconstructed, and psychoanalytic conceptual reference points for an understanding of the discursive construction of complex subjectivity in the context of institutions are explored with particular reference to the location of the researcher in the psy-complex. The paper discusses the reflexive engagement of the researcher with data, and the construction of the identity of the researcher with reference to professional bodies. An analysis of a document produced by the British Psychological Society is presented to illustrate conceptual issues addressed in the first sections. This illustrative analysis is designed to show how the material is structured by a series of six discursive complexes, and that the institutional structure facilitates, and inhibits, certain forms of action and reflection.     

USING REINFORCEMENT-BASED METHODS TO ENHANCE MEMBERSHIP RECRUITMENT IN A VOLUNTEER ORGANIZATION

The present study employed reinforcement-based methods to induce existing members to recruit new members to join a chamber of commerce. Three interventions took place during June and July of 3 successive years. The investigators trained chamber leaders to use reinforcement methods (e.g., contingent tokens) to reinforce recruitment and dues collections. All three interventions produced substantial increases in their targets.     

TEACHING MULTIPLICATION FACTS TO STUDENTS WITH LEARNING DISABILITIES

Multiple baseline designs were used to examine the effects of an instructional package on accuracy of performance in solving multiplication facts by 3 students with learning disabilities. The instructional package included the following components: (a) a modified instructional sequence in which multiplication facts were grouped into the zeros, ones, doubles, fives, and nines categories, and those remaining; (b) identification of the category in which each fact belonged; (c) mnemonic strategies associated with solving facts in each category; and (d) steps to be completed for solving facts in each category. Results indicated that the instructional package produced substantial and immediate effects. After receiving instruction, a participant's accuracy was often 100%, and this was maintained throughout the evaluation even as other strategies were introduced. Comparable results occurred across students, demonstrating replication of the effects of the instructional package.     

欧洲大陆法律心理学述评

对欧洲大陆国家的法律心理学发展状况作了述评。全文包括３部分：对相关概念（犯罪心理学、审判心理学、法律心理学、司法心理学）的辨析;欧洲大陆国家法律心理学的现状;简要评价。     

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.     

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.