医患冲突的制度经济学分析

制度是造成医患冲突的重要因素。从制度经济学关于人的行为假设出发,论述了通过制度变迁缓解医患冲突的对策、建议。     

Informant Discrepancies in Assessing Child Dysfunction Relate to Dysfunction Within Mother-Child Interactions

We examined whether mother-child discrepancies in perceived child behavior problems relate to dysfunctional interactions between mother and child and stress in the mother. Participants included 239 children (6–16 years old; 58 girls, 181 boys) referred for oppositional, aggressive, and antisocial behavior, and their mothers. Mother-child discrepancies in perceived child behavior problems were related to mother-child conflict. Moreover, maternal stress mediated this relationship. The findings suggest that discrepancies among mother and child evaluations of child functioning are not merely reflections of different perspectives or artifacts of the assessment process, but can form components of conceptual models that can be developed and tested to examine the interrelations among critical domains of child, parent, and family functioning.     

Conflict Buffers and Marital Satisfaction: On the Effects of Different Forms of Social Support

This paper deals with the deterioration in the subjective quality of life of women as a result of marital conflict. Whereas primary and secondary prevention are generally targeted at maintaining or increasing the current level of marital happiness this paper focuses on the possibilities for buffering the negative impact of conflict on women’s quality of life. In particular, this paper is interested in the conflict buffering effects of various forms of social support such as home visiting by professional social workers or informal contacts with peers. In order to assess and compare the effectiveness of these forms of tertiary prevention, data from interviews with young mothers in the city of Zurich (Switzerland) will be reanalyzed. The data confirm the phenomenon of stress buffering from social support and reveal variation with regard to the effectiveness of different stress buffers. Female peer support e.g. seems to be at least as successful as home visiting by professional nurses and social workers.     

青少年亲子冲突处理策略问卷的编制及其应用

通过文献分析和实证研究,构建了亲子冲突处理策略的理论维度,并据此编制了青少年亲子冲突处理策略问卷。914名适龄被试接受测试,结果显示,该问卷具有良好的信度和效度,可以作为青少年亲子冲突处理策略的测量工具。研究发现,青少年亲子冲突处理策略有如下特点:①青少年处理亲子冲突的策略主要有主动解决问题策略、屈服让步策略、回避冲突策略、反抗攻击策略、他人调节策略。②青少年在亲子冲突处理策略的使用上具有显著的类型、性别、年龄差异,且冲突对象不同,策略的使用也有显著的差异性。     

小学儿童的道德行为及其与道德观念的相关——诚实原则和集体主义价值观冲突情境下的研究

研究探讨了585名7、9、11岁的小学儿童在诚实原则和集体主义价值观冲突的真实情境下的道德行为及其与道德观念的相关。结果表明,在诚实原则和集体主义价值观冲突情境下,小学儿童的道德行为主要受到诚实原则的支配,表现为:为集体说谎行为发生率都很低;随着年龄的增长,小学儿童的为集体说谎行为的发生率显著增高;小学儿童的为集体说谎行为不存在性别差异;7岁、9岁儿童的为集体说谎行为与集体观念无关,11岁儿童的为集体说谎行为与集体观念显著正相关。     

Dyadic predictors of outcome in a cognitive-behavioral program for patients with generalized anxiety disorder in committed relationships: a "spoonful of sugar" and a dose of non-hostile criticism may help

The present study tested whether pre-treatment levels of partner hostility and non-hostile criticism predicted outcome in an individual cognitive-behavioral therapy package for generalized anxiety disorder (GAD). Eighteen patients with a principal or co-principal diagnosis of GAD were randomly allocated to a treatment condition (n=8) or a delayed treatment condition (n=10). In addition, the patients and their partners were videotaped discussing the patients’ worries. These videotapes were later coded for levels of partner hostility and non-hostile criticism directed at the patients. Treatment resulted in statistically and clinically significant change at post-test. Finally, partner hostility predicted worse end-state functioning whereas partner non-hostile criticism predicted better end-state functioning.     

Using the Millon Behavioral Medicine Diagnostic to Delineate Treatment Outcomes in Rehabilitation

Patients undergoing rehabilitation have been evidenced to improve in different ways depending on their coping styles. Amplifiers, Repressors, and Social Copers are examples of patients who present differently in rehabilitation settings and tend to have differing levels of success in their response to treatment. The current study examined the differential treatment outcomes of three coping style groups undergoing multidisciplinary rehabilitation. A sample of 59 patients suffering from injuries associated with chronic pain were assessed using the Multidimensional Pain Inventory, Beck Depression Inventory, and Beck Anxiety Inventory before, during, and after multidisciplinary pain management treatment. Coping style groups derived from the Millon Behavioral Medicine Diagnostic consisting of Amplifiers, Repressors, and Social Copers were compared with regard to reductions in depression, anxiety, pain, functional impairment, and associated outcomes. Repeated measures ANOVA revealed that Amplifiers, Repressors, and Social Copers had varying levels of success in the treatment program. Hierarchical linear modeling analyses revealed the coping style groups to have significantly different change curves from pre to post-treatment in depression, anxiety, pain severity, functional impairment, affective distress, life control, social support, and soliciting help from others. These findings support prior research emphasizing the value of tailoring treatments in rehabilitation settings toward patients’ coping styles in order to maximize outcomes. A program (provided in either SAS or SPSS syntax) that will compute MBMD coping style group membership will be provided upon request. Request by e-mail to: dcipher@hsc.unt.edu or by fax to: +1-817-7352270.     

On helping lower status out-groups: The nature of the help and the stability of the intergroup status hierarchy

The current research expanded upon previous theoretical and empirical arguments regarding the nature of intergroup helping. In doing so, we considered the role of relative in-group status, the stability of this status, and the type of help provided. In a scenario study, we observed that members of a relatively high status group more strongly supported the provision of assistance to in-group members than members of a lower status out-group when the assistance was empowering in nature and when the high in-group status was unstable. When the intergroup status differences were stable, however, support for empowerment help to members of a lower status out-group was not significantly lower than support for such help to in-group members. We discuss these data with reference to realistic intergroup conflict theory and social identity theory.     

Better safe than sorry: Precautionary reasoning and implied dominance in risky decisions

In four studies, student and nonstudent participants evaluated the possible outcomes of binary decisions involving health, safety, and environmental risks (e.g., whether to issue a dam‐failure evacuation order). Many participants indicated that false positives (e.g., evacuation, but no dam failure) were better than true negatives (e.g., no evacuation and no dam failure), thereby implying that the more protective action dominated the less protective action. A common rationale for this response pattern was the precautionary maxim “better safe than sorry.” Participants apparently evaluated outcomes partly on the basis of the decisions that might lead to them, in conflict with consequentialist decision models. Consistent with this explanation, the prevalence of implied dominance decreased substantially when the emphasis on decisions was reduced. These results demonstrate that an initial preference for a decision alternative can alter the evaluation of possible consequences of both the preferred alternative and a competing alternative, suggesting positive feedback loops that reinforce the initial preference. The rationality of considering the decision itself as an attribute of possible outcomes is discussed. Copyright © 2009 John Wiley & Sons, Ltd.