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Cognition in behavior therapy: agreements and differences.

The issue of cognition has often been divisive among behavior therapists. Typically the debate has centered around the causal status of cognition. Cognitive psychologists have argued for the causal efficacy of cognition, while behavior analysts have argued against it. These disputes are not entirely empirical matters. In part, they reflect irreconcilable differences at the level of theory and philosophy. Such differences may make theoretical integration impossible. However, in this paper we examine the potential for reconciliation of the cognitive and behavioral wings of behavior therapy when the issue of cognition is approached as a shared content area, rather than at the level of theory and philosophy. Behavior therapy has always been comprised of very diverse theoretical positions. Historically they found common ground around a set of shared values centered on an empirical science of clinical work. We will argue that this core of shared values still exists, and that even controversial topics can provide an arena for reconciliation when we focus on the core values that initially brought us together.

Behavior Therapy↗

Behavioral medicine. Broadening the interface between medicine and behavioral science.

The work of psychotherapists who have a cognitive-behavioral orientation and are trained in time-limited, focused psychotherapy has proved to be beneficial in the setting of a comprehensive medical and health maintenance organization. Group interventions that deal with relaxation, social skills, depression, agoraphobia, smoking cessation, problem drinking, weight modification, and Type A behavior, to mention a few, are conducted on an ongoing basis, allowing staff to treat large numbers of people in a time-efficient and cost-effective way. These groups also help the staff to provide a coordinated set of therapeutic and training experiences for patients through their participation in appropriate group treatment during the course of their individual treatment.

Behavior Therapy↗

Emerging paradigms of cognition in medical decision-making.

The limitations of the classical or traditional paradigm of decision research are increasingly apparent, even though there has been a substantial body of empirical research on medical decision-making over the past 40 years. As decision-support technology continues to proliferate in medical settings, it is imperative that "basic science" decision research develop a broader-based and more valid foundation for the study of medical decision-making as it occurs in the natural setting. This paper critically reviews both traditional and recent approaches to medical decision making, considering the integration of problem-solving and decision-making research paradigms, the role of conceptual knowledge in decision-making, and the emerging paradigm of naturalistic decision-making. We also provide an examination of technology-mediated decision-making. Expanding the scope of decision research will better enable us to understand optimal decision processes, suitable coping mechanisms under suboptimal conditions, the development of expertise in decision-making, and ways in which decision-support technology can successfully mediate decision processes.

Cognitive Science↗

Traditional Chinese medicine: some historical and epistemological reflections.

So-called Chinese medicine is practiced widely in the U.S.A. and Europe, and traditional Chinese medical concepts are presented, and advocated, through a vast body of secondary literature in European languages, as alternatives to current western interpretations of illness and disease. The present paper analyses some of the values determining the reception of traditional Chinese medicine in the west, and it demonstrates how the cognitive aesthetics of European culture and western science have influenced the selection of specific concepts from a heterogeneous pool of traditional Chinese conceptual systems of health care by western authors in recent years. A comparison of different approaches to health care in traditional Chinese as well as traditional European and modern western medicine suggests that the differences between Chinese and western medicine may not be as clear-cut as they have been portrayed in western secondary literature of the past years. One of the more fundamental dividing lines appears to be the handling of cognitive disagreements, and, possibly related to this, the ubiquitous phenomenon of patterned knowledge in Chinese medicine and culture.

China↗

The Institute of Medicine, National Academy of Sciences: formulating AIDS policy.

In 1985 the Institute of Medicine, National Academy of Sciences devoted its annual meeting to an exploration of acquired immunodeficiency syndrome (AIDS). The questions raised at the meeting propelled the IOM/NAS to initiate an assessment of the dimensions of the AIDS epidemic and to propose an appropriate national response. The Committee on a National Strategy for AIDS issued its report, "Confronting AIDS: Directions for Public Health, Health Care, and Research," in October 1986. The report detailed strategies for curbing the spread of infection, and for accelerating biomedical and social science research into the causes and possible cures for AIDS. In March 1987, the IOM/NAS established the AIDS Activities Oversight Committee to monitor and assess the nation's progress against AIDS and to coordinate the Academy's growing program of AIDS-related activities. Studies, conferences, and workshops are planned in the areas of drug and vaccine development, modeling the course of the epidemic, research in the behavioral and social sciences, equitable financing of care, pediatric AIDS, early cognitive impairment in HIV infection, IV drug abuse, and other topics.

Acquired Immunodeficiency Syndrome↗

Introduction to the special section on cognitive abilities: 100 years after Spearman's (1904) "'General intelligence,' objectively determined and measured".

The study of individual differences in cognitive abilities is one of the few branches of psychological science to amass a coherent body of empirical knowledge withstanding the test of time. There is wide consensus that cognitive abilities are organized hierarchically, and C. Spearman's (1904) general intelligence occupies the vertex of this hierarchy. In addition, specific abilities beyond general intelligence refine longitudinal forecasts of important social phenomena and paint a rich portrait of this important domain of psychological diversity. This opening article identifies and then reviews 5 major areas concerning the personological significance of cognitive abilities and the methods used to study them. In models of human behavior and important life outcomes, cognitive abilities are critical in more ways than social scientists realize.

Aptitude↗

New approaches to measurement and treatment research to improve cognition in schizophrenia.

An overview is provided of the set of articles included in this special issue of Schizophrenia Bulletin that were derived from the final meeting of the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) program. These essays summarize the presentations and discussions of the MATRICS New Approaches Conference that examined the future needs of the field for a coordinated research effort to improve the preclinical and clinical science required to optimize new cotreatments for the cognitive deficits in patients with schizophrenia. Specific priorities for a research agenda involving collaborations among academic, industrial, and governmental participants are addressed.

Cognition Disorders↗

A simple and unified approach to human voluntary movements.

In his provocative article, F. Mechsner (2004) advances the thesis that human voluntary movements are subject to "psychological" or "perceptual-cognitive" control and are thus organized "without regard to efferent patterns" (p. 355). Rather than considering in detail the experiments that he proffered by way of support, the present author discusses the degree to which that supposition has appeal on the grounds of simplicity and is defined in terms that are compatible with a unified science.

Brain↗

Science school and culture school: improving the efficiency of high school science teaching in a system of mass science education.

Educational expansion in western countries has been achieved mainly by adding years to full-time education; however, this process has probably reduced efficiency. Sooner or later, efficiency must improve, with a greater educational attainment per year. Future societies will probably wish more people to study science throughout high school (aged c. 11-19 years) and the first college degree. 'Science' may be defined as any abstract, systematic and research-based discipline: including mathematics, statistics and the natural sciences, economics, music theory, linguistics, and the conceptual or quantitative social sciences. Since formal teaching is usually necessary to learn science, science education should be regarded as the core function of high schools. One standard way to improve efficiency is the 'division of labour', with increased specialization of function. Modern schools are already specialized: teachers are specialized according to age-group taught, subject matter expertise, and administrative responsibilities. School students are stratified by age and academic aptitude. I propose a further institutional division of school function between science education, and cultural education (including education in arts, sports, ethics, social interaction and good citizenship). Existing schools might split into 'science school' and 'culture school', reflected in distinct buildings and zones, separate administrative structures, and the recruitment of differently-specialized teaching personnel. Science school would be distinguished by its focus on education in disciplines which promote abstract systematic cognition. All students would spend some part of each day (how much would depend on their aptitude and motivation) in the 'science school'; experiencing a traditional-style, didactic, disciplined and rigorous academic education. The remainder of the students' time at school would be spent in the cultural division, which would focus on broader aspects, and aim to generate a more rounded and social individual. For this to happen depends upon a recognition that science is relatively difficult to teach, requiring non-spontaneous and un-natural cognitive processes from students. Furthermore, it is much easier to learn science when young--if science is missed at school, it can be difficult or impossible to make up the ground later. Modern schools currently try to do too many things, and end-up doing none very well: the one big thing all schools should do for all students is to teach them science. For this to happen, schools need to specialize in their core function.

Adolescent↗

Computers in healthcare: overview and bibliography.

OBJECTIVE: The objective of this article is to provide an overview of computer technology and an associated bibliography, emphasizing institutional-based healthcare applications and pharmacoinformatics. DATA SOURCES: References were selected from the authors' files and from a computerized search over the last five years on computers in healthcare/medical informatics and in pharmacy. STUDY SELECTION: Articles selected for review and discussion were considered to be important contributions to the respective areas listed in the bibliography and representative of advancements in computer applications in healthcare and pharmacy. DATA SYNTHESIS: The computer has become an important support tool for healthcare professionals. Medical informatics and the discipline related to pharmacy, called pharmacoinformatics, have evolved from the cognitive underpinnings of medicine, pharmacy, and computer science. Recent developments in computer technology have resulted in computers that are fast, increasingly portable, and user friendly. Hospital information systems employ computers in various ways to deal with the vast amount of information used by various departments. Standards for electronic data exchange are being developed to increase the integration potential of these systems. Hospital pharmacists have used computers for drug distribution, financial analysis and inventory control, drug interaction detection, pharmacokinetic dosing, drug information, and drug therapy monitoring. Expert systems are being developed in several areas of drug therapy. Pharmacy educators have developed interactive courseware to help students learn problem-solving skills in the areas of calculations, therapeutics, and drug information. CONCLUSIONS: Pharmacists need to become more involved with applications of technology to pharmacy. Properly implemented, computers can provide more time for pharmacists to use their cognitive skills in the delivery of pharmaceutical care.

Clinical Pharmacy Information Systems↗

Methodologic support in habilitation and rehabilitation: communicative action between practice and science.

This study evaluated the early phase of development of a model for quality improvement of habilitation and rehabilitation project processes. The focus of the methodologic support in habilitation and rehabilitation model was on cooperation between practice contexts and science. Habermas' theory about communicative action was a theoretical frame of reference. Three project coordinators and ten project leaders were interviewed. The results revealed different attitudes towards methodologic support activities, demonstrating the importance of acknowledging cognitive and social functions, the process of legitimization, different approaches of practice versus science, and problems regarding information and communication. The model was shown to be important in bridging the gap between practice and science. To support reflective and emancipatory cognitive learning, more efforts to foster communicative action are called for, and more attention must be paid to the importance different missions and organizational structures have for the development of the dialog between practitioners and researchers.

Allied Health Personnel↗

The feasibility of students with a predominantly arts educational background coping with the physiology component of a university nursing degree programme.

In this paper the authors discuss their experiences in admitting students with an arts 'A' (advanced) level General Certificate of Education background to an undergraduate nursing degree course. Firstly, the implications of students' different cognitive styles, both professionally and in teaching, are examined. Secondly, there is a description of an introductory course that has been used to assist students in the arts-science transition. Finally, the performance of 'arts' students, in a physiology course over a 6-year period is described, analysed and discussed. The proposition emerges that arts students may be disadvantaged initially by having not only a lack of knowledge in physiology, but a different cognitive style to science specialists. The results of the students' examination performance over 6 years suggests that with the provision of only a limited amount of special help 'arts' students can perform as well as the 'science' students in physiology examinations. Other variables which may have contributed to this positive outcome are discussed.

Adaptation, Psychological↗

Sociology and the public understanding of science: from rationalization to rhetoric.

This paper contributes to the reappraisal of sociological theories of modernity inspired by the sociology of scientific knowledge (SSK). As much as these theories rely on received ideas about the nature of science that SSK has called into doubt, so do they rely on ideas about the public understanding of science. Public understanding of science has been assumed to conform to the monolithic logic and perception of science associated with rationalization, leading to an impoverished view of the cognitive outlook of the modern individual. Rationalization has become the basis for the construction of theoretical critique of science divorced from any clear reference to public understanding, with the result that theory has encountered considerable problems in accounting for public scepticism towards science. However, rather than question rationalization, the more typical strategy has been to propose radical changes in the modernization process, such as postmodernism and the risk society. Against this, an alternative view of public understanding is advanced drawn from SSK and rhetorical psychology. The existence of the sociological critique of science, and SSK in particular, suggests that the meaning of science in modernity is not monolithic but multiple, arising out of a central dilemma over the universal form of knowledge-claims and their necessarily particular, human and social grounding. This dilemma plays out not only in intellectual discourses about science, but also in the public's understanding of science. This argument is used to call for further sociological research into public understanding and to encourage sociologists to recognize the central importance of the topic to a proper understanding of modernity.

Humans↗

Information processing: a new model for understanding cognitive disturbances in psychiatric patients.

Information processing models are influenced by the information sciences and by computer technology, which progressed in the 1960s and 1970s. During the last decade these models have formed the theoretical basis for much of the experimental research on cognitive dysfunctions in psychiatric patients. An essential element in all of these models is that information is processed in several discrete stages. Different experimental paradigms have been developed in order to tap information about the processes taking place in each of these stages. Most of the research so far on pathological groups has been done on schizophrenic patients. Some deficits found in schizophrenics seem to be symptom-related. This is the case with performance deficits on the Continuous Performance Test with low processing load. Other dysfunctions might be vulnerability indicators, such as deficit performance on the forced choice Span of Apprehension task and the Continuous Performance Test with high momentary processing load, backward masking, serial recall for items that involve active rehearsal, and eye movement dysfunctions. However, information processing deficits do not seem to be specifically related to schizophrenia. Deficits can be found in other psychiatric syndromes too, especially in manic patients. Generally speaking, the dysfunctions emerge in a milder form in nonschizophrenic patients.

Attention↗

An admissions OSCE: the multiple mini-interview.

CONTEXT: Although health sciences programmes continue to value non-cognitive variables such as interpersonal skills and professionalism, it is not clear that current admissions tools like the personal interview are capable of assessing ability in these domains. Hypothesising that many of the problems with the personal interview might be explained, at least in part, by it being yet another measurement tool that is plagued by context specificity, we have attempted to develop a multiple sample approach to the personal interview. METHODS: A group of 117 applicants to the undergraduate MD programme at McMaster University participated in a multiple mini-interview (MMI), consisting of 10 short objective structured clinical examination (OSCE)-style stations, in which they were presented with scenarios that required them to discuss a health-related issue (e.g. the use of placebos) with an interviewer, interact with a standardised confederate while an examiner observed the interpersonal skills displayed, or answer traditional interview questions. RESULTS: The reliability of the MMI was observed to be 0.65. Furthermore, the hypothesis that context specificity might reduce the validity of traditional interviews was supported by the finding that the variance component attributable to candidate-station interaction was greater than that attributable to candidate. Both applicants and examiners were positive about the experience and the potential for this protocol. DISCUSSION: The principles used in developing this new admissions instrument, the flexibility inherent in the multiple mini-interview, and its feasibility and cost-effectiveness are discussed.

Adult↗

The failure of theories of personhood.

The belief persists in philosophy, religion, science, and popular culture that some special cognitive property of persons like self-consciousness confers a unique moral standing. However, no set of cognitive properties confers moral standing, and metaphysical personhood is not sufficient for either moral personhood or moral standing. Cognitive theories all fail to capture the depth of commitments embedded in using the language of "person." It is more assumed than demonstrated in these theories that nonhuman animals lack a relevant form of self-consciousness or its functional equivalent. Although nonhuman animals are not plausible candidates for moral personhood, humans too fail to qualify as moral persons if they lack one or more of the conditions of moral personhood. If moral personhood were the sole basis of moral rights, then these humans would lack rights -- and precisely for the reasons that nonhuman animals would.

Animal Rights↗

How to fit a response time distribution.

Among the most valuable tools in behavioral science is statistically fitting mathematical models of cognition to data--response time distributions, in particular. However, techniques for fitting distributions very widely, and little is known about the efficacy of different techniques. In this article, we assess several fitting techniques by simulating six widely cited models of response time and using the fitting procedures to recover model parameters. The techniques include the maximization of likelihood and least squares fits of the theoretical distributions to different empirical estimates of the simulated distributions. A running example is used to illustrate the different estimation and fitting procedures. The simulation studies reveal that empirical density estimates are biased even for very large sample sizes. Some fitting techniques yield more accurate and less variable parameter estimates than do others. Methods that involve least squares fits to density estimates generally yield very poor parameter estimates.

Chi-Square Distribution↗