New directions for the education of clinical psychologists: The primary care setting,the VA's PRIME program,and the in-depth generalist model

As part of this special issue on psychology in primary care settings, we describe the Department of Veterans Affairs' (VA's) new approach to education for practice in the primary care setting and we concurrently address some general issues related to the education of clinical psychologists for practice in this setting. In this article we argue that the primary care psychologist, in parallel with the generalist in medicine, must have a strong generic background in clinical psychology in order to gain the broad range of clinical skills necessary to function effectively as an in-depth generalist (IDG) who is capable of addressing the variety of psychological issues that emerge in the primary care setting. The IDG model of professional practice, which we believe is best suited for primary care/managed care settings, requires extensive training in generic clinical skills and increased time devoted to its implementation at both the predoctoral and the postdoctoral levels.     

The detection and management of mental health disorders in pediatric primary care

We reviewed the literature on the detection and management of mental health disorders within the context of pediatric primary care. Pediatricians have displayed a low sensitivity and high specificity in research investigating the detection of mental health impairment in children. Active management efforts characterize approaches to identified cases with more recently trained primary care pediatricians displaying a wider range of skills in managing mental health disorders. Few efforts have been made by pediatric psychologists to develop strategies for enhancing detection rates and management or to empirically evaluate the integration of pediatric psychology services into the primary care context. A conceptual model of factors influencing detection rates and ongoing management of mental health disorders within pediatric primary care is presented. Recommendations are made for more direct involvement of pediatric psychologists within the primary care context.     

短时动作记忆的容量和精确度与动作学习的关系

该研究采用实验室实验法,被试自我报告分析及调查访问法,以三个年龄（１０岁、１４岁、１８岁）组学生及专项运动员为实验对象,揭示短时动作记忆的容量和精确度及其与动作学习指数的关系。结果表明：（１）被试的短时动作记忆容量为“５±２”,短时动作记忆的容量与动作学习的练习次数相联系;短时动作记忆的精确度与第一次动作练习的准确度相联系。（２）短时动作记忆的容量有随年龄增长而递增的趋势。（３）运动员与非运动员被试对于同类动作学习的练习次数存在显著性差异。     

Evaluating children's mental health service systems: An analysis of critical behaviors and events

A lack of studies which evaluate system change by tracking client outcomes is noted in the children's mental health area. This deficit may be a result of the inability of researchers to define outcomes and to draw conclusions about which measures reflect the efficacy of services and service delivery systems. This paper reviews five social validation surveys which examined children's mental health outcome measures. Based on the results of the five surveys, a model of critical behaviors and events is presented. This model will assist evaluators and researchers in understanding which critical events and behaviors should be measured to assess the impact of community-based mental health services for children.     

The effects of maternal employment and non-maternal infant care on development at two and four years

Differences in maternal employment during children's first year of life and children's entry into non-maternal care before the age of 1 year failed to predict differences in cognitive and socioemotional development at 2 and 4 years of age, after family background variables were controlled. Two samples were studied: a population sample of 1100 Bermudian children and a smaller subsample of children most of whom were determined to be at risk for developmental problems. To assess the effects of maternal employment, we compared infants with mothers who worked 20 or more hours a week to infants with mothers who worked less than 20 hours a week. To assess the effects of entry into non-maternal care before the age of one, we compared infants who were placed in regular non-maternal care before the age of one versus infants who did not experience regular non-maternal care before the age of one. The results revealed that family background variables frequently predicted many child outcome measures in both the total sample and the smaller research sample. After controlling for family characteristics, no differences were found between children whose mothers worked 20 or more hours a week when they were infants and children with mothers who worked less than 20 hours a week in either sample. In addition, age of entry into non. maternal care before the age of one did not significantly predict any child outcome measures.     

Developing the matrix representation grid (MRG): A method for observing group processes. Findings from time-limited group psychotherapy for alcohol-dependent patients

The MRG was published 1988 in order to support developments in group psychotherapy methods as one of the all too few process observation research methods for studying group-as-a-whole. After 9 years of what pilot studies have labeled successful clinical trials, this study aims at validating the MRG against the established SAVI: Structural Analysis of Verbal Interaction (Agazarian & Simon 1989). Videotaped group sessions from short-term groups for alcohol dependent patients conducted along two therapy methods, one behaviorally oriented and the other group analytic, are used as material. The MRG is validated in the study, confirmed to be clinically valuable, and some interesting comparisons between the two treatment modalities are also made.     

Family-centered intensive case management: A step toward understanding individualized care

New York State's initial attempt at individualizing services occurred within the context of an experiment. We randomly assigned children 5–12 years old who were referred for out-of-home placement in treatment foster care to either treatment foster care, Family-Based Treatment (n=15), or to Family-Centered Intensive Case Management (FCICM) (n=27). FCICM used teams of case managers and parent advocates to provide in-home services. Flexible service dollars, respite care, and behavior management skills training were available to assist teams in individualizing care. Preliminary outcomes indicate that children in FCICM are doing as well or better than children assigned to FBT in their functioning and symptom reduction. Parents of children in FCICM have made gains, although not at a statistically significant level, in behavior management skills and family strengths that allow them to provide care for their children at home.     

Matching adolescents with foster mothers and fathers: An evaluation of the role of temperament

We tested the notion that better foster care adjustment would be observed when the temperaments of mothers and fathers were matched with those of adolescent foster children. We hypothesized that families in which foster parents and foster children had high (easy) scores on subscales of the Revised Dimensions of Temperament Scale (DOTS-R) would also report higher family functioning and higher foster care adjustment than parents and children from families in which one or both family members had low (difficult) scores on these scales. The hypotheses were supported when the mothers and fathers family assessments were used but rejected when the observations of the case managers and adolescents were tested. Methodological and substantive explanations for the findings are discussed and recommendation for foster care practice and continuing research are provided.     

A biopsychosocial therapeutic approach in a private outpatient clinic in Portugal

Patients with chronic stress and ambiguous symptoms are likely to be more frequent in primary care. Somatizers represent 75.8% of the patients in this study and executives 56% of the sample. Job stressors were present in 78.3% of executive men. This scenario suggests that the primary care physician has to be academically better prepared to fully understand and deal with stress problems in daily clinical practice. The physician must have skills to deal with stress at a curative and preventive level, extending those skills to the workplace.     

Stimulus control of delayed matching in pigeons: Directed forgetting

Pigeons were trained in delayed matching-to-sample with two postsample stimuli. A postsample R-cue signaled that a matching choice phase would follow. A postsample F-cue signaled that a matching choice phase would not follow. Previous research found reduced matching accuracy on F-cued probe trials when comparison stimuli were presented in the choice phase. The present four experiments systematically varied the events following an F-cue to determine the conditions under which the F-cue reduces delayed-matching accuracy. When F-cues and R-cues controlled different behavior, matching on probe trials was poor. When both cues controlled the same behavior, matching on probe trials was good. This result is best explained by the theory that comparison stimuli retrieve the sample representation, but only in the behavioral context established by the R-cue. The present research supports the view that response-produced stimuli serve a contextual role in animal short-term memory.