Functional measurement approach to self-estimation in multiattribute evaluation

Multiattribute analysis depends on measurement of values and weights. Unless these measures reflect the decision maker's true values and weights, the multiattribute formula may put a less-preferred alternative in first place. To avoid such disordinality requires stringent measurement conditions: First, the values and weights must be on linear (equal interval) or ratio (known zero) scales. Second, these scales must satisfy a condition of common unit across disparate attribute dimensions. Most methods of range adjustment beg both of these measurement questions. Functional measurement theory can solve both problems and so can be useful in multiattribute analysis. Past work has established the operation of a general cognitive algebra as an empirical reality. The averaging model, in particular, makes possible the definition and estimation of weights and values as distinct psychological parameters. It can also solve the problem of common unit. Cognitive algebra thus provides a grounded theoretical foundation on which to develop self-estimation methodology, in which decision makers provide direct estimates of their values and weights. The logic is straightforward. Functional measurement can analyze global judgments to obtain validated psychological scales. These scales may then be used as validational criteria for the self-estimates. Procedures to eliminate biases in the self-estimates can thus be tested and refined in well-learned multiattribute tasks, such as judgments of meals, in which global judgments are trustworthy. Once developed, such self-estimation procedures may be used with some confidence for general multiattribute analysis. A number of studies from 20-odd years of work on the theory of information integration are summarized to show good, although not unmixed promise for self-estimation.     

个人化设计在临床研究中的应用——从个体角度研究个体差异

本文从有关研究证据的基础上,介绍了个人化设计的理论基础和实验设计,并在此基础上讨论了个人化设计在临床研究领域中的应用价值,总结出一种适合临床病人使用的研究程序。个人化设计允许对个体的个人价值进行分析,并能同时研究不同刺激信息的作用,在个体水平上分析个体差异。通过简化了的实验程序,个人化设计为解决临床研究中的问题提供了一种新的思维方式。文中还对相关研究法的局限进行了讨论。     

The design and use of the Bioethics Consultation Form

The emergence of the ethics consultation as a means to resolve moral crises in clinical medicine has revealed the need for a worksheet that would facilitate intake and analysis. The author developed the Bioethics Consultation Form as an attempt to remedy this need. The form is arranged in an outline format and is a useful asset to ethics committee discussions and record keeping. The first section covers basic intake data concerning the patient's medical and personal information, advance directives, and values, as well as the values of the physician and family. After the intake section is completed with the above data, the ethics consultant then turns to the analysis section. This second section allows for (1) the discussion of conflicting values, (2) the identification of priorities, and (3) the elucidation of ethical norms relevant to the case.The Bioethics Consultation Form was adopted by the Patient Care Advisory committee of the Franklin Square Hospital Center in Baltimore, Maryland in 1986. The methodology in the use of the form will be discussed. Further, the potential spectrum of consultative cases that can be analyzed using the form will be highlighted.     

Making peace in gestational conflicts

Mary Anne Warren's claim that there is room for only one person with full and equal rights inside a single human skin ([1], p. 63) calls attention to the vast range of moral conflict engendered by assigning full basic moral rights to fetuses. Thereby, it serves as a goad to thinking about conflicts between pregnant women and their fetuses in a way that emphasizes relationships rather than rights. I sketch out what a care orientation might suggest about resolving gestational conflicts. I also argue that the care orientation, with its commitment to the significance of the partial and the particular, cannot be absorbed within standard, impartialist moral theory.     

A structural model for postpartum responses to the somatic and cognitive items on the Beck Depression Inventory

A distinction can be drawn between those items on the Beck Depression Inventory (BDI) that reflect mainly cognitive and emotional symptoms and those that reflect somatic symptoms. Responses to the BDI were obtained from women at 3, 6, 9, and 24 weeks postpartum. The covariances of cognitive and somatic symptom scores across the four time points were closely fit by a structural equations model referred to as the simplex. The modeling indicates that earlier cognitive scores directly predict later somatic scores but that early somatic scores do not directly predict later cognitive scores. Other data confirm the results.Much of this research was supported while the first author was an NIMH Fellow at the University of Iowa (MH15168).     

A review on equivalence-based procedures to teach food-portion estimation skills

This review involved a systematic analysis of equivalence-based instruction (EBI) that aimed to improve food-size interventions in diverse populations. Systematic searches identified seven studies published since 2010 that met inclusion criteria. These studies were analyzed according to their participants, design, setting, content taught, training structures, training protocol, testing format, treatment integrity, and outcomes. Results showed EBI procedures for teaching food estimation skills have been mostly implemented with adults. The type of content taught in the identified studies included carbohydrate ranges, portion size with food and non-food items, measuring cups and nutritional content of calories. Majority of included studies used one-to-many training structure and simultaneous protocols for teaching stimulus relations. Five studies completed a generalization probe and three studies reported treatment integrity data. Overall, all participants demonstrated skill acquisition of novel relations between food and portion measurement aides. Recommendations for future research and clinical applications of EBI in teaching food portion estimation are presented.     

Treating Young Adult Depression With Text-Delivered Cognitive Behavioral Therapy: A Pilot Randomized Clinical Trial

Young adults (ages 18 to 25) in the U.S. suffer from the highest rates of past-year major depressive episode and are the least likely to receive treatment compared to other age groups. As such, we examined the feasibility, acceptability, and efficacy of a text-message delivered cognitive behavioral therapy: CBT-txt with young adults. The study was a 2-month pilot RCT to test a 4-week intervention for depression that contained 197 text messages (average 12 texts every other day). The sample, recruited via Facebook and Instagram, was 102 U.S. young adults who presented with at least moderate depressive symptomatology. Assessments occurred at baseline prior to randomization and at 1 and 2 months post enrollment. The primary outcome, severity of depressive symptoms, was assessed using the Beck Depression Inventory II. Feasibility benchmarks were met and participants reported high levels of engagement with and acceptability of the intervention. Logistic regression indicated that treatment participants were three times as likely to have minimal or mild depression symptoms at 2 months compared to waitlist control participants. Latent change score modeling found that the strongest significant treatment effect appeared at the 1-month follow-up period, particularly for participants who began with severe depressive symptoms. Mediation analysis revealed significant indirect treatment effects of increases in behavioral activation on reducing depressive symptoms, suggesting a mechanism of change. Limitations were that the sample was relatively small and consisted of primarily women. These results provide initial evidence for the feasibility, acceptability, and efficacy of a text-delivered treatment for young adult depression.     

Psychometric properties and factor structure of the Fear Questionnaire phobia subscale items in two normative samples

Normative data for the Fear Questionnaire (Marks & Mathews, 1979), a popular self-report instrument measuring phobic concerns, were collected from both a community and a collegiate sample. The covariation and internal consistency of the blood-injury phobia (BI), social phobia (SO), and agoraphobia (AG) subscales were assessed in each sample, and the factor structure of the items from these three subscales was examined. Results indicated that, in general, community subjects reported more phobic concerns than did collegiate subjects, and females reported greater phobic concerns than did males. Results from confirmatory factor analyses suggest that the three factors of BI, SO, and AG did not emerge from either data set. Follow-up exploratory factor analyses did identify the general factors of blood-injury phobia and agoraphobia. Normative data from the present study are compared to those obtained previously, and directions for future research are provided.     

Clinical interpretation: The hermeneutics of medicine

I argue that clinical medicine can best be understood not as a purified science but as a hermeneutical enterprise: that is, as involved with the interpretation of texts. The literary critic reading a novel, the judge asked to apply a law, must arrive at a coherent reading of their respective texts. Similarly, the physician interprets the text of the ill person: clinical signs and symptoms are read to ferret out their meaning, the underlying disease. However, I suggest that the hermeneutics of medicine is rendered uniquely complex by its wide variety of textual forms. I discuss four in turn: the experiential text of illness as lived out by the patient; the narrative text constituted during history-taking; the physical text of the patient's body as objectively examined; the instrumental text constructed by diagnostic technologies. I further suggest that certain flaws in modern medicine arise from its refusal of a hermeneutic self-understanding. In seeking to escape all interpretive subjectivity, medicine has threatened to expunge its primary subject — the living, experiencing patient.