BEWILDERMENT AND THEREAFTER: Some Reflections in Response to Lee Yearley

The following reflections were originally an oral response to issues raised in Lee Yearley's presentation in May 2009 at Harvard Divinity School. As written here, they follow upon his oral and now written comments, highlighting key issues and points for development, drawing on this respondent's expertise in comparative and Hindu studies.     

Adult-child interaction during invasive medical procedures.

Adult-child interactions during stressful medical procedures were investigated in 43 pediatric patients videotaped during a venipuncture procedure in the course of cancer treatment. Relations among six adult behavior categories (explain, distract, command to engage in coping behavior, give control to the child, praise, and criticize/threat/bargain) and three child behavior categories (momentary distress, cry/scream, and cope) were examined using correlational and sequential analysis. Results indicated that adult distraction resulted in increased child coping and reduced momentary distress and crying. Adult explanations, although a likely response to child distress and crying, did not result in a reduction of these behaviors. Attempts to give the child control reduced child crying. Implications for clinical interventions during painful medical procedures are discussed.     

Cognitive slowing in decision tasks in early and advanced Parkinson's disease.

Ten untreated patients with recently diagnosed Parkinson's disease (PD), 9 treated patients with more advanced pathology, and 17 matched normal controls were investigated with three reaction tasks with increasing cognitive load but identical motor requirements: simple reaction, choice reaction with indicative stimuli, and choice reaction with ambiguous stimuli. Times required until a home key was released (= reaction time) and from then until a response key was pressed (= movement time) were recorded. Estimates of pure decision time (overall response time minus movement time in a simple reaction time task) revealed a difference between advanced and early PD patients. Advanced PD patients showed an overall slowing of decision time in the reaction time tasks, but the effect of the cognitive load of the tasks on the decision time was comparable to a control group. The untreated early PD patients performed quite normally in the more simple decision tasks but showed a disproportionate slowing of decision time in tasks with higher cognitive load.     

Aging and memory for expected and unexpected objects in real-world settings.

Adult age differences in the consistency effect were examined in 3 experiments. The consistency effect refers to items inconsistent with expectations being better remembered than items consistent with expectations. Younger and older adults walked into an office room and viewed objects that varied in their consistency with expectation. Immediate and delayed recognition tests on item information (i.e., distractors were defined by their semantic identity) revealed that both age groups recognized unexpected items better than expected items. However, when recognition of token information was requested (i.e., distractors were defined by their physical appearance), younger adults, in contrast to older adults, exhibited consistency effects. Also, under divided attention, young adults revealed the same pattern of data as did elderly adults under full attention. The results are discussed in terms of capacity-related differences in distinctive encoding.     

Assessing elements of women's decisions about mammography.

We investigated motivational and cognitive processes of behavior change with respect to mammography screening. One hundred forty-two women (ages 40 and older) recruited from three worksites answered a 41-item questionnaire consisting of statements based on constructs from the transtheoretical model of behavior change. Principal-components analysis identified two factors: a six-item component representing positive perceptions of mammography (Pros) and a six-item component representing avoidance of mammography (Cons). Analysis of variance showed that Pros, Cons, and a derived Decisional Balance measure (Pros minus Cons) were associated with stage of mammography adoption. Results are consistent with applications of the model to smoking cessation. The model is also discussed as it relates to other theories of behavior change and as a general strategy for analyzing perceptual data pertinent to health-related actions and intentions for behavioral change.     

Experiencing Range in an Electric Vehicle: Understanding Psychological Barriers

Range of electric vehicles (EVs) has long been considered a major barrier in acceptance of electric mobility. We examined the nature of how range is experienced in an EV and whether variables from other adaptation contexts, notably stress, have explanatory power for inter‐individual differences in what we term comfortable range. Forty EVs were leased to a sample of users for a 6‐month field study. Qualitative and quantitative analyses of range experiences were performed, including regression analyses to examine the role of stress‐buffering personality traits and coping skills in comfortable range. Users appraised range as a resource to which they could successfully adapt and that satisfied most of their daily mobility needs. However, indicators were found that suggested suboptimal range utilisation. Stress‐buffering personality traits (control beliefs, ambiguity tolerance) and coping skills (subjective range competence, daily range practice) were found to play a substantial role in comfortable range. Hence, it may be possible to overcome perceived range barriers with the assistance of psychological interventions such as information, training, and interface design. Providing drivers with a reliable usable range may be more important than enhancing maximal range in an electric mobility system.