Consultation in adolescence: Hurried,terminable, interminable1

The physiological ambivalence displayed by adolescents towards dependence on adults is an obstacle, at least initially, to a course of psychotherapy. A consultation is often the only thing that can be offered to start with, and constitutes an essential stage even for those teenagers who go on to prove themselves able to benefi t from therapy or analysis. The way this fi rst meeting is handled is therefore crucial. The author investigates the diffi culties and paradoxes of this consultation, the particular nature of the ‘time’ of the consultation compared to that of therapy, and the different internal attitude this requires of the analyst. She thus identifi es two separate confi gurations‐a hurried consultation and an interminable consultation‐which can result when the consultation fails in its primary objectives. Both are connected with possible collusive elements in the professional linked to specifi c adolescent angst. The very detailed account of a consultation shows the ‘journey’ made by a 14 year‐old starting from her urgent request to be freed from a symptom experienced as an incomprehensible obstacle, to her gradual development of curiosity towards herself and towards her own mental and emotional make‐up, resulting in her acceptance of therapeutic treatment, which would initially have been impossible.     

Development of specialization scales for the MSPI: A comparison of empirical and inductive strategies

An empirical measurement model for interest inventory construction uses internal criteria whereas an inductive measurement model uses external criteria. The empirical and inductive measurement models are compared and contrasted and then two models are assessed through tests of the effectiveness and economy of scales for the Medical Specialty Preference Inventory (Zimney, 1979). The empirical results clearly demonstrate the advantages of using an empirical model for occupational interest inventory construction, whether alone or in conjunction with an inductive model. Furthermore, the results indicated that the empirical model may be used to resolve the long-standing problems in constructing predictive inventories for specialty choice within an occupation.     

Goal-setting in diabetes self-management: A systematic review and meta-analysis examining content and effectiveness of goal-setting interventions

Background: Goal-setting is recommended and widely used within diabetes self-management programmes. However, empirical evidence around its effectiveness lacks clarity. This review aims to evaluate the effectiveness of goal-setting interventions on diabetes outcomes and to determine which behaviour change techniques (BCTs) are frequently used within these interventions.

Methods: A systematic search identified 14 studies, describing 12 interventions targeting diabetic-control which incorporated goal-setting as the main intervention strategy. Study characteristics, outcome measures and effect sizes of the included studies were extracted and checked by two authors. The BCT taxonomy v1 was used to identify intervention content. Meta-analyses were conducted to assess intervention effects on the primary outcome of average blood glucose levels (HbA1c) and on body-weight. Psycho-social and behavioural outcomes were summarised in narrative syntheses.

Results: Significant post-intervention improvements in HbA1C were found (?.22, 95% CI, ?.40, ?.04) across studies. No other main effects were identified. The BCT ‘goal-setting (behaviour)’ was most frequently implemented and was identified in 84% of the interventions.

Conclusions: Goal-setting interventions appear to be associated with reduced HbA1C levels. However, the low numbers of studies identified and the risk biases across studies suggest more research is needed to further explore goal-setting BCTs in diabetes self-management.     

Working adults’ well‐being: An online self‐help goal‐based intervention

An online self‐help goal‐setting and planning (GAP) intervention to improve working adults’ well‐being was tested using a longitudinal, randomized crossover design. The study sought to (1) test the effectiveness of the intervention relative to wait‐list controls; and (2) test the stability of effects over a 3‐month follow‐up period. Participants were recruited from the UK Civil Service and were randomized to either a GAP intervention or a wait‐list control condition. Wait‐list participants then crossed‐over to receive GAP. Relative to wait‐list controls (N = 149), GAP participants (N = 158) reported significantly higher levels of positive affect (PA) and flourishing, but similar levels of negative affect (NA) and life satisfaction immediately after the intervention. Longitudinal data were analysed for the whole sample (N = 307). Compared to the start of the intervention, participants reported an increase in PA and flourishing directly after the intervention and 3 months later. NA and life satisfaction showed no change by the end of the intervention, but had improved by 3‐month follow‐up. Completing more modules predicted post‐intervention improvements in well‐being, accounting for pre‐intervention well‐being levels. The online self‐help format allowed the intervention to be offered with minimal therapeutic support, enabling convenient access by a large group of employees. The study provides an example of a successful adaptation of a clinically proven well‐being intervention to make it accessible to working adults.

Practitioner points

• Well‐being interventions proven in clinical settings can be effectively adapted for use in workplace settings with only minor alterations.
• Brief, online self‐help interventions can improve working adults’ well‐being.
• Goal‐based interventions can improve working adults’ well‐being when focused towards goals that are aligned with personal values and have been chosen by the individual.

     

任务设置影响负相容效应的机制——自上而下认知控制对阈下启动信息加工的影响

结合掩蔽启动范式和Go-Nogo范式,考察了任务设置影响负相容效应的机制。实验中以指向左或右的双箭头为掩蔽启动项,在两个Block中的Go试次中分别以箭头和汉字为目标项,要求被试对箭头或汉字做辨别反应,Nogo试次中不呈现目标项,被试无需反应。结果发现:Go试次中,只有在箭头任务设置下才出现负相容效应,脑电结果表现为一致条件下P3潜伏期显著长于不一致条件;Nogo试次中,箭头任务设置下的P3波幅显著大于汉字任务设置下的P3波幅。说明负相容效应受到任务设置这种自上而下认知控制过程的影响,且这种影响发生在阈下启动信息加工阶段。支持注意敏化模型,提示可以在更普遍的角度上理解负相容效应。     

行为决策中诱饵效应的认知加工机制

在原选项集中加入一个诱饵选项能够使人们的选择发生改变, 这就是诱饵效应。研究者发现可以通过设置相似诱饵、妥协诱饵、吸引诱饵以及幽灵诱饵等达到诱导决策者选择目标选项的目的。当前, 很多研究探索了诱饵效应的认知加工机制, 有研究者基于启发式加工和分析式加工的视角开展研究, 也有研究者从维度加工和选项加工的视角对此进行探索。诱饵效应的认知加工过程受到年龄、后悔情绪、决策形式以及时间压力等因素的影响。未来的研究需要构建适用于各类诱饵效应的统一的认知加工机制模型, 探索知觉在诱饵效应形成过程中的基础性作用, 探索个体的决策风格对不同类型诱饵效应的影响, 并通过合理利用诱饵效应助推社会发展。     

Independent use of activity materials by the elderly in a residential setting

A lottery was implemented to encourage the elderly clients of a residential home to use activity materials any time they wished, independently of staff intervention and the institutional routine of the home. During baseline, there were minimal levels of independent use of activity materials by residents. Various conditions were implemented but only the introduction of a £20 lottery prize brought about a significant increase in the frequency of independent use of activity materials. A follow‐up suggested that the reinforcing properties of the activity materials themselves eventually maintained the target behavior.     

TEACHING FUNCTIONAL COMMUNITY SKILLS TO AUTISTIC CHILDREN USING NONHANDICAPPED PEER TUTORS

In this study, two autistic children were paired with normal peers who, after pretraining sessions, taught community skills to the autistic children. Data were collected during three conditions: baseline, modeling, and peer tutoring. Results demonstrated that no identified skills were acquired during the baseline and modeling conditions. However, direct instruction of each child by a peer tutor resulted in the learning and maintenance of functional community skills.     

Medicine as a career: Choices and consequences

Medicine has traditionally been regarded as a rewarding career both financially and socially. How true, however, is that tradition in today's world of rising costs and decreasing revenues? The educational debt of the physician-in-training is steadily increasing, and currently does not affect specialty choice. As the cost of medical education continues to rise, the applicant pool begins to shrink, thereby possibly affecting the quality of future physicians. Once the physician has completed training however, the majority enjoy a positive return on investment. Their incomes generally fail to remain ahead of inflation, and therefore, have remained within a narrow band of $40,000 in 1970 dollars. Finally, the demand for physician services cannot be attributed solely to either the consumer (patient) or to the supplier (physician). Rather, the demand for medical services appears to be a unique combination of the two. In conclusion, medicine still is an attractive career path, but the choices and consequences are becoming much more demanding.