Additional Evidence for the Relationship Between Type a Behavior and Social Support in Men

Abstract

This study examined social support as a mediator of susceptibility to coronary disease in Type A individuals. Sixty-four male subjects completed the Jenkins Activity Survey and the Sarason Social Support Questionnaire. The correlations between Type A scores, the speed and impatience and hard-driving competitiveness factors of the Jenkins survey, and Sarason's social support were found to be negative, which was contrary to earlier findings.¹ The authors hypothesize that these differing results may be a function of age and environment. Finally, and pertinent to the mechanism by which social support may be associated with coronary heart disease, systolic blood pressure was negatively correlated to satisfaction with social support.     

In pursuit of knowledge

This article is based on the proposition that to understand the nature of knowledge, and how best to acquire it, one must look first at how the brain abstracts knowledge from the information provided by sensory receptors. The nature of this biological process of knowledge acquisition is suggested by the necessary conditions for the occurrence of learning, and from consideration of these necessary conditions in terms of what is currently known about the properties and limitations of neural systems. This entails discussion of an important distinction that must be made between “perceptual” and “associative” learning and between the neural systems required to mediate these two kinds of learning. There is also discussion of the manner in which language can overcome the limitations of neurological systems to greatly extend the scope of associative learning. This leads on to discussion of the role of active efferent language systems and temporary memory in the mediation of thinking. Consideration of the main features of the biological process of knowledge acquisition confirms, and extends to perception, Hume's famous conclusion that knowledge derives from the similarity or temporal contiguity of recurring events. New insights are also obtained concerning the biological causes of bias in the knowledge acquisition process, concerning the intellectual process of theory generation, and concerning the role of theory in the conduct of empirical research. Finally, and most importantly, it can be concluded that all knowledge is theory and hence that the ultimate goal of science is the development of better theories.     

Tracheoesophageal and anal atresia in prenatal children exposed to a high dose of alcohol

A half-century ago Otto Ullrich became the first clinical geneticist to assume the Chairmanship of a clinical department in a medical school. Clinical genetics owes Ullrich the delineation and definition of several important genetic diseases and syndromes, most importantly the condition named after him and Henry Turner. This paper reports on Ullrich's teacher, his career, his personality, and “his” syndromes.     

Using CBT interpersonal team formulation on mental health inpatient wards

Objectives

Team formulation involves a multidisciplinary team coming together to understand the factors leading to the development and maintenance of a patient's problems and the implications of this for future care planning.

Method

This paper presents a case example describing this approach in an acute inpatient setting.

Results

“William” was a 59-year-old male with longstanding mental health difficulties. During his admission, he presented as verbally abusive, intrusive, and sexually inappropriate. He was also controlling and intimidating toward other patients. Staff were becoming frustrated and hopeless about managing William on the ward leading them to adopt inconsistent approaches in relating to him. A team formulation was developed to understand William's trauma history and how this impacted on his beliefs about himself and other people as well as his way of relating to others.

Conclusions

The team formulation helped staff to develop consistent care plans in relation to William's presentation on the ward and more empathy in relation to behaviors that they found challenging.     

Visual agnosia: Once more,with theory

The neuropsychology of cognitive functions has a long history. For well over a hundred years, clinicians have been studying the effects of brain lesions on language, memory, vision, and action. In contrast, “cognitive neuropsychology” is a very new field. The distinction is an important one to make here because Humphreys and Riddoch's new book on agnosia, “To see but not to see”, is a significant contribution to that subject in part just because it is the first book on the cognitive neuropsychology of agnosia.     

Hermann Stieve's clinical‐anatomical research on executed women during the “Third Reich”

Hermann Stieve (1886–1952) was Director of the Berlin Institute of Anatomy from 1935 to 1952. His research on the female reproductive system is controversial, as some of his scientific insights derived from histological investigations on the genital organs of executed women. These investigations were made possible by the sharp increase in executions during the “Third Reich.” Stieve's research was methodologically accurate and contributed significantly to contemporary scientific debates. Nevertheless, his use of the organs of execution victims, some of them resistance fighters, benefited from the Nazi justice system. He thus indirectly supported this system of injustice. The allegation, however, that Stieve “ordered” the death of prison inmates according to their menstrual cycle, appears to be incorrect. An appraisal of Stieve's research should avoid traditional black‐and‐white classifications of research during Nazi times. In our opinion, Stieve was neither a murderer nor a fervent Nazi. Nevertheless, his research results were flawed by their ethical and political context. Stieve will remain a somber footnote in the biographies of many execution victims. Clin. Anat. 22:163–171, 2009. © 2009 Wiley‐Liss, Inc.     

Behavior setting theory and community psychology: An analysis and critique

Although Barker's “behavior setting theory” (Barker, 1968; Price, 1976) is widely cited for its potential applications to community psychology, critical examination of this conception reveals significant limitations in its operational definition of “community” and in the extent to which predictions regarding direct influences on behavior have been validated in natural settings. From the perspective of community psychology there is also reason to question behavior setting theory's fundamental emphasis on the structural form of settings rather than on the functions they fulfill for their participants. Adopting new units of analysis and placing greater emphasis on the intended and unintended satisfactions that settings produce will make behavior setting theory more relevant to several problems in community psychology, including community assessment, person-environment interaction, and community change.     

Coping with stress: Naturalistic observations of the polish crisis

Naturalistic observations were made while the author was living and working in Poland as a visiting professor at the Institute of Psychology, Warsaw University, from October through December 1981. Social, political, economic, and interpersonal elements of the Polish “crisis” and reactions of the Polish people to these stressors are described. Individual patterns of coping with stress are categorized in terms of people's beliefs about the causes of stress and beliefs about personal control over the causes of stress. Three groups are identified: People who were certain that they could or could not modify the causes of stress and, therefore, coped by taking action (“fight” or “flight”); people who were uncertain about their capacity to modify the causes of stress, but believed that they could manage their daily lives; and people who believed that their only realm of influence was over intrapsychic events and coped via control over intake of information (repression or sensitization). The relative success of the different coping strategies is considered. Finally, the imposition of martial law and people's reactions to it are described.     

PERSON-SPECIFIC KNOWLEDGE AND KNOWLEDGE OF BIOLOGICAL CATEGORIES

We report new findings from a neurological case described by Hanley, Young, and Pearson (1989). In the original study, the patient, BD, had impaired biographical knowledge of people which appeared to extend to a general impairment of knowledge of “living things”. In more recent work, we present evidence which confirms Hanley et al.'s finding that BD has impaired person-specific knowledge, but we suggest that this is not associated with a more general impairment to do with knowledge of biological categories. We propose that an artefactual explanation of the original account is more likely based on differences in “age of acquisition” between items from “living” and “nonliving” categories. We conclude that biographical knowledge of people is represented separately from knowledge of biological categories in semantic memory.     

Officer friendly: Changing children's attitudes about the police

A police-community relations program in elementary schools, called the “Officer Friendly Program,” was evaluated. The program attempted to increase awareness of legitimate services performed by the police and to improve rapport with uniformed police officers. Males (second graders) who used a “Crime Resistance Activity Book” or had the book and officer visits in their classes were more likely than a control group to represent officers as helping someone in a situation where a crime had occurred. Females did not change their beliefs about a police officer's role as a result of degree of participation in the program. Also, white children (male and female) who had officer visits stood closer to an unfamiliar police officer during a conversation than those who did not have officer visits (i.e., control or book-alone conditions). These results were not found for black children. Previous writers have been either unduly optimistic or pessimistic about the possible impact of police-community relations programs in the schools. Results of this study show that beneficial effects of an Officer Friendly Program relate to child's sex and race as well as to the type of evaluation measure used.     

A prospective study of 1152 hospital autopsies: I. Inaccuracies in death certification

Comparison of certified clinical diagnoses with autopsy findings showed that, while the major cause of death was confirmed in 61 per cent. of cases, many diagnoses—both major and contributory—were wrong; many clinical diagnoses were either disproved or relegated to a less important role, and many autopsy findings had not apparently been anticipated. Accuracy was particularly poor in some clinical categories: notably cerebro-vascular disease and infections. In these, the diagnosis was more often wrong than right. Thus, death certificates are unreliable as a source of diagnostic data. The clinician's confidence in his major diagnosis bore a fairly close relationship to the frequency of its confirmation. Nevertheless, even when certified as “fairly certain”, the major diagnosis was wrong in about one-quarter of these cases. An attempt was made to assess the significance of incorrect diagnoses; one half of these might be clinically significant. Diagnostic accuracy did not improve with the time spent in hospital, and it bore an inverse relationship to the patient's age.     

Conflicting community commitments: A dialogical analysis of a British woman's World War II diaries

Recent developments of the concept of “sense of community” have highlighted the multiplicity of people's senses of community. In this article, the authors introduce the theory of the dialogical self as a means of theorizing the conflicts that can arise between a person's commitments to multiple communities. They ask the question, “When faced with conflicting community commitments, how does a person decide where his or her allegiances lie?” The contribution of the theory of the dialogical self is illustrated through an idiographic analysis of diaries kept by one British woman living through World War II. Conflicting commitments to her home community and to the national community's war effort provoke troubling dilemmas and efforts to resolve them through internal dialogues. Contributions to theory, research, and practice are discussed. © 2007 Wiley Periodicals, Inc.     

REFLECTIONS ON THE CREATION OF SETTINGS AND THE FUTURE SOCIETIES: THE ROSES AND THORNS

The presentation below was part of the 2011 Division 27 SCRA conference panel, “Seymour Sarason in Memorial: Prospects for Community and Social Change Innovative Session.”     

Comments on “Changing attitudes towards the care of children in hospital: a new assessment of the influence of the work of Bowlby and Robertson in the UK, 1940–1970” by Frank C.P. van der Horst and Rene van der Veer (Attachment & Human Development Vol 11, No 2, March 2009, 119–142)

The importance of James Robertson's work in changing the hospital conditions for young children is widely acknowledged but disputed by van der Horst and van der Veer (2009), although they presented evidence supporting his influence, they also presented considerable evidence showing that others were ignored, including writers in The Lancet and the British Medical Journal. van der Horst and van der Veer presented a muddled picture by failing to understand how the work of James Robertson influenced a wide range of people, opened up the debate and, through the Platt Report, gave parents the authority and confidence to challenge hospitals and stay with their young children. James Robertson's 1952 film “a Two-year-old Goes to Hospital” provided the ‘visual communication to pierce defences as the spoken word cannot do’. This film continues to be widely used today in teaching about young children.     

Insights into the origins of knowledge from the cognitive neuroscience of blindness

Children learn about the world through senses such as touch, smell, vision, and audition, but they conceive of the world in terms of objects, events, agents, and their mental states. A fundamental question in cognitive science is how nature and nurture contribute to the development of such conceptual categories. What innate mechanisms do children bring to the learning problem? How does experience contribute to development? In this article we discuss insights into these longstanding questions from cognitive neuroscience studies of blindness. Despite drastically different sensory experiences, behavioural and neuroscientific work suggests that blind children acquire typical concepts of objects, actions, and mental states. Blind people think and talk about these categories in ways that are similar to sighted people. Neuroimaging reveals that blind people make such judgements relying on the same neural mechanisms as sighted people. One way to interpret these findings is that neurocognitive development is largely hardwired, and so differences in experience have little consequence. Contrary to this interpretation, neuroimaging studies also show that blindness profoundly reorganizes the visual system. Most strikingly, developmental blindness enables “visual” circuits to participate in high-level cognitive functions, including language processing. Thus, blindness qualitatively changes sensory representations, but leaves conceptual representations largely unchanged. The effect of sensory experience on concepts is modest, despite the brain's potential for neuroplasticity.     

NURTURING HUMAN POTENTIAL IN THE CONTEXT OF SCHOOLING: THE LEGACY OF SEYMOUR B. SARASON

This paper is a slightly revised version of the presentation at the SCRA Biennial session, “Seymour Sarason in Memorial: Prospects for Community and Social Change,” Chicago, June 18, 2011.     

Patients’ perceived purpose of clinical informed consent: Mill’s individual autonomy model is preferred

Background

Although informed consent is an integral part of clinical practice, its current doctrine remains mostly a matter of law and mainstream ethics rather than empirical research. There are scarce empirical data on patients’ perceived purpose of informed consent, which may include administrative routine/courtesy gesture, simple honest permission, informed permission, patient-clinician shared decision-making, and enabling patient’s self decision-making. Different purposes require different processes.

Methods

We surveyed 488 adults who were planning to undergo or had recently undergone written informed consent-requiring procedures. Perceptions of informed consent purpose (from norm and current practice perspectives) were explored by asking respondents to rank (1?=?most reflective) 10 randomly-presented statements: “meaningless routine”, “courtesy gesture” “litigation protection”, “take away compensation rights”, “inform patient’, “make sure patient understand”, “document patient’s decision”, “discover patient’s preferences”, “have shared decision”, and “help patient decide”.

Results

Respondents’ mean (SD) age was 38.3 (12.5); 50.4% were males, 56.8% had?≥?college education, and 37.3% had undergone a procedure. From the norm perspective, the least reflective statement was “meaningless routine” (ranked 1–3 by 2.6% of respondents) and the most reflective statements were “help patient decide”, “make sure patient understand”, and “inform patient” (ranked 1–3 by 65%, 60%, and 48% of respondents with median [25%,75%] ranking scores of 2 [1,5], 3 [2,4], and 4 [2,5], respectively). Compared to their counterparts, males and pre-procedure respondents ranked “help patient decide” better, whereas females and post-procedure respondents ranked “inform patient” better (p?=?0.007 to p?<?0.001). Age was associated with better ranking of “help patient decide” and “make sure patient understand” statements (p?<?0.001 and p?=?0.002, respectively), which were ranked 1–3 by only 46% and 42% of respondents from the current practice perspective (median ranking score 4 [2,6], p?<?0.001 vs. norm perspective for both).

Conclusions

1) the informed consent process is important to patients, however, patients vary in their views of its purpose with the dominant view being enabling patients’ self decision-making, 2) males, pre-procedure, and older patients more favor a self decision-making purpose, whereas females and post-procedure patients more favor an information disclosure purpose, and 3) more self decision-making and more effective information disclosure than is currently practiced are desired. An informed consent process consistent with Mill’s individual autonomy model may be suitable for most patients.