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PubMedDate not supplied

Assessment of a computerized patient record system: a cognitive approach to evaluating medical technology.

Numerous research and development projects have been aimed at implementing computerized patient record (CPR) systems. Yet little emphasis has been placed on physicians' ability to learn and use these systems or on their effects on physicians' reasoning. This article describes an innovative approach to assessing these aspects of a CPR system. The method involves observing physicians' use of a CPR under various clinical conditions and analyzing the CPR system with a technique called the cognitive walkthrough. We will show how learning to use a CPR system can change a physician's performance, with accompanying effects on information gathering and reasoning.

Cognitive Science↗
PubMed1996

Reducing confirmation bias in clinical decision-making.

Schematic, category-based thinking is a common approach to reduce uncertainty. Once the stimulus in question is categorized under a scheme, there is a tendency to look for features that fit the scheme. We have a tendency toward "positive testing" that is, to test instances we think will fit our hypothesis, paying less attention to those that will not (confirmation bias). Schematic, category-based thinking interferes with the process of decision-making in general and in medicine and dentistry in particular. To reduce schematic thinking and to avoid confirmation bias, one must acknowledge their existence. It is the task of dental educators to open the existing schemes and encourage broad, even controversial thinking that will focus on more than one hypothesis.

Clinical Competence↗
PubMed1996

The relationship between victimization and cognitive schemata among episodically homeless, seriously mentally ill women.

This study explored the extent to which specific aspects of violent victimization are associated with cognitive schemata in the context of ongoing, often lifelong, trauma and negative life events. Specifically, we examined the relationships between cognitive schemata (safety, self- and other esteem, intimacy, and trust) and three dimensions of physical and sexual assault histories (recentness, frequency, and variety) among 91 predominantly African American, episodically homeless, seriously mentally ill women. Findings indicated that even in the context of pervasive violence, more frequent, recent, and varied abuse was associated with more negative cognitive schemata. We discuss these findings in the context of research and practice with disenfranchised populations at high risk for violent victimization.

Adult↗
PubMed1996

Eliciting facial affect, motivation, and expectancies in transference: significant-other representations in social relations.

Recent research has demonstrated transference in social perception, defined in terms of memory and schema-triggered evaluation in relation to a new person (S. M. Andersen & A. B. Baum, 1994; S. M. Andersen & S. W. Cole, 1990; S. M. Andersen, N. S. Glassman, S. Chen, & S. W. Cole, 1995). The authors examined schema-triggered facial affect in transference, along with motivations and expectancies. In a nomothetic experimental design, participants encountered stimulus descriptors of a new target person that were derived either from their own idiographic descriptions of a positively toned or a negatively toned significant other or from a yoked control participant's descriptors. Equal numbers of positive and negative target descriptors were presented, regardless of the overall tone of the representation. The results verified the memory effect and schema-triggered evaluation in transference, on the basis of significant-other resemblance in the target person. Of importance, participants' nonverbal expression of facial affect when learning about the target person (i.e., at encoding) reflected the overall tone of their significant-other representation under the condition of significant-other resemblance, providing strong support for schema-triggered affect in transference, through the use of this unobtrusive, nonverbal measure. Parallel effects on interpersonal closeness motivation and expectancies for acceptance/rejection in transference also emerged.

Affect↗
PubMed1997

The use of the psychological laboratory to study sensitive survey topics.

Maximizing the tendency of the survey respondent to answer truthfully when sensitive questions are presented is critical issue in survey methodology. A recent development devoted generally to the reduction of response error in survey data is the use of cognitive laboratory techniques during the survey development phase. The chapter categorizes and describes the various cognitive techniques that have been applied, by Federal agencies and other researchers, to the study of sensitive questions. Based on this analysis and review, a number of recommendations are made concerning specific aspects of survey design, when sensitive questions are administered.

Cognitive Science↗
PubMed1997

The message of psychosomatic diseases.

Kant, Schopenhauer and Helmholtz brought to Europe a tradition of critical psychology, which, as its starting point, questions the idea of faultless perception and focuses on how the image of the world is formed through illusion and misunderstanding. These men were accompanied by Sigmund Freud, whose interest centered primarily on psychopathology. This era was followed by a long period shaken by political, historical, and cultural crises that brought new, fashionable ideas that indefinitely stopped many developmental trends with fruitful beginnings. Central European cultural heritage was replaced by Anglo-Saxon cultural influences. The heritage of Kant and Helmholtz was forgotten, and Freud's thinking was pulled from its roots and given a strongly technological and practical emphasis. Simplified orthodoxy with stringent positivism ruled the scientific thinking of the 1950s and 1960s. Meanings, qualities, experiences, psychosomatics, and psychoanalysis were temporarily cast into the trashbin of science. Today cognitive theory holds a strong position in psychology, and the research interests of those who practice it vary a great deal. They extend in many directions and have brought research in the history of psychological ideas back to life. This research is rapidly altering many distorted and ossified views.

History, 19th Century↗
PubMed1997

Metaphor and the theory of libidinal development.

The author argues that ongoing work in cognitive linguistics affords a better understanding of how metaphor functions, both in psychic life and in the formulation of psychoanalytic theory. Lakoff and Johnson have shown that a great deal of our thought and perception depends on mainly unconscious metaphors, drawn in large part from basic bodily experience. Their findings can be most immediately related to psychoanalysis via the theory of libidinal development. There are two reasons for this. Firstly, the theory of libidinal development was itself generated in part by a metaphor--a misleading embryological one, which, historically, has tended to encourage reification. Secondly, the links that the theory points out between experience of cathected zones and later character traits are essentially metaphorical (or metonymic) in nature. The author considers that it should be possible to re-express the classical theory in language that both avoids reification and gives due importance to metaphor, and that such a re-expression would offer a number of advantages, including that of clarifying the relationship between possession of a penis and 'phallic' character traits.

Cognitive Science↗
PubMedDate not supplied

Using hypertext to facilitate nurse education.

The increased use of both multimedia and the World Wide Web for nurse education necessitates critical examination of the use of hypertext in nursing education. The use of hypertext and multimedia have the potential to revolutionize teaching and learning generally, and have a significant impact on nursing specifically. This article discusses hypertext use in nurse education and incorporates an examination of cognitive theories to identify specific hypertext design strategies customized for nursing user groups. Particular attention is directed to the application of cognitive flexibility theory to hypertext design for nurse education, highlighting the representation of both complex clinical situations and human physiology. The article concludes with a discussion of the potential uses of hypertext as a means of accessing information by nurses in clinical practice.

Cognitive Science↗
PubMed2005

Medical decision making: a selective review for child psychiatrists and psychologists.

Physicians, including child and adolescent psychiatrists, show variability and inaccuracies in diagnosis and treatment of their patients and do not routinely implement evidenced-based medical and psychiatric treatments in the community. We believe that it is necessary to characterize the decision-making processes of child and adolescent psychiatrists using theories and methods from cognitive and social sciences in order to design effective interventions to improve practice and education. This paper selectively reviews the decision-making literature, including recent studies on naturalistic decision making, novice-expert differences, and the role of technology on decision making and cognition. We also provide examples from other areas of medicine and discuss their implications for child psychiatry.

Adolescent↗
PubMed2001

The cognitive neuroscience paradigm: a unifying metatheoretical framework for the science and practice of clinical psychology.

The emerging discipline of cognitive neuroscience (CN) enjoins the efforts of cognitive psychologists, neuroscientists, computer scientists, clinical neurologists, neurophilosophers, and many others working collaboratively across traditional disciplinary boundaries to elucidate the manner in which the physical operations of the brain give rise to the vast panoply of human mental and behavioral events. The present article describes the foundational tenets of the CN metatheoretical framework and contends that the CN framework is capable of providing a coherent, unifying scientific paradigm for the discipline of clinical psychology. Clinical psychology's adoption of the CN paradigm would facilitate (a) its consilient linkage with the natural sciences, (b) resolution of long-standing internecine theoretical schisms, and (c) enhanced understanding and treatment of numerous forms of psychopathology. Nevertheless, psychology's historically influential radical behavioral (RB) perspective is not easily reconciled with the CN paradigm. However, unlike CN, RB (a) is not fully consilient with the natural sciences, (b) fails to articulate the proximal causal mechanisms that mediate environment-behavior relations, and (c) engages in "greedy reductionism" in its disavowal of informational levels of complexity in the patterning of neural activity. The article concludes with a discussion of the possibility of theoretical rapprochement between CN and RB.

Behaviorism↗
PubMed1985

Animal cognition as the praxist views it.

The distinction between psychology and praxics provides a clear answer to the question of animal cognition. As Griffin and others have noted, the kinds of behavioral phenomena that lead psychologists to speak of cognition in humans are also observed in nonhuman animals, and therefore those who are convinced of the legitimacy of psychology should not hesitate to speak of and to attempt to study animal cognition. The behavior of organisms is also a legitimate subject matter, and praxics, the study of behavior, has led to significant advances in our understanding of the kinds of behaviors that lead psychologists to speak of cognition. Praxics is a biological science; the attempt by students of behavior to appropriate psychology has been misguided. Generativity theory is an example of a formal theory of behavior that has proved useful both in the engineering of intelligent performances in nonhuman animals and in the prediction of intelligent performances in humans.

Animals↗
PubMed1996

At the centre of a science of psychopathology? Characteristics and limitations of cognitive research.

In this brief paper I will suggest that the cognitive approach has four characteristics which must place it at the centre of any complete science of psychopathology: (1) it leads to testable hypotheses about abnormal mental states; (2) it establishes a link between normal psychology and abnormal mental processes, and therefore obviates the need to dichotomise behaviour into the normal and the abnormal; (3) it has the potential to make apparently bizarre and irrational behaviour understandable; and (4) it is neutral with regard to the relative contributions that biology and the environment make to the aetiology of psychiatric disorders. I also identify three limitations of contemporary cognitive models of psychiatric disorders: (1) an over-reliance on conventional methods of psychiatric classification; (2) an underemphasis on social aspects of cognition; and (3) a failure to integrate findings obtained from different models. Once these limitations are overcome, cognitive research is likely to lead to a revolution in our understanding of abnormal behaviour.

Editorial↗
PubMed2006

Probabilistic models of cognition: conceptual foundations.

Remarkable progress in the mathematics and computer science of probability has led to a revolution in the scope of probabilistic models. In particular, 'sophisticated' probabilistic methods apply to structured relational systems such as graphs and grammars, of immediate relevance to the cognitive sciences. This Special Issue outlines progress in this rapidly developing field, which provides a potentially unifying perspective across a wide range of domains and levels of explanation. Here, we introduce the historical and conceptual foundations of the approach, explore how the approach relates to studies of explicit probabilistic reasoning, and give a brief overview of the field as it stands today.

Algorithms↗