Reconceptualizing feeding and feeding disorders in interpersonal context: The case for a relational disorder.

The feeding of young children is fundamentally a relational and multisystemic process. Successful treatment of clinically significant feeding problems involves careful assessment of the full range of influences on the feeding relationship and integrated treatment approaches. However, current diagnostic approaches to feeding disorders tend to be reductionistic, exclusively focused on the child as an individual, and overly concerned with exclusionary criteria. Criteria are proposed for "Feeding Disorder Between Parent and Child" that address these limitations and embrace the complexity of feeding problems. A multiaxial diagnosis that describes the child (including medical, developmental, and behavioral characteristics); the parent; the parent-child relationship; and the social and nutritional context of feeding will more accurately speak to treatment planning in this population. The proposed diagnostic criteria were developed and refined on the basis of the available literature and many years of treatment experience across the authors of this article. The proposed diagnosis will support the development and evaluation of treatment packages with components specifically targeted to issues of the child, parent, parent-child interaction, and the broader environment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reconceptualizing arousal: Psychobiological states in motor performance.

This review of research dealing with psychologically induced arousal and motor performance focuses on the hypothesized inverted-U function relating arousal to performance. The inverted-U hypothesis is supported only in a weak and psychologically trivial fashion. More useful research in human motor performance would investigate discrete psychobiological states, which include affect and cognition as well as physiology. Examination of profound individual differences in response to incentive and threat suggests that psychobiological states have their genesis in response expectancies and hypnotic-like self-inductions. The cognitive and affective components of these states are highly interactive and perhaps not profitably separated. Because performance anxiety is a central problem in the motor realm, it is carefully delineated and the test anxiety literature is scrutinized. Psychophysiological test batteries and other investigations in the area are described, and guidelines for future research are provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coping with sexual harassment: Reconceptualizing women's resistance.

This study explored the underlying structure of women's coping with sexual harassment from a rational-empirical approach. On the basis of multidimensional scaling, clustering, and confirmatory factor analysis across 8 data sets, 4 clusters of coping behaviors emerged, with little variance across the data sets. These clusters bear resemblance to Moos and colleagues' (C. J. Holahan, R. H. Moos, & J. A. Schaefer, 1996; R. Moos, 1992; R. H. Moos & J. A. Schaefer, 1993) distinction between coping strategies that differ in both method and foci. The four clusters that emerged are behavioral engagement, behavioral disengagement, cognitive engagement, and cognitive disengagement. This framework provides insight into the complex forms that women's coping with sexual harassment takes and has important legal implications. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Reconceptualizing advance care planning from the patient's perspective

BACKGROUND: Traditional academic assumptions about advance care planning (ACP) include the following: (1) the purpose of ACP is preparing for incapacity; (2) ACP is based on the ethical principle of autonomy and the exercise of control; (3) the focus of ACP is completing written advance directive forms; and (4) ACP occurs within the context of the physician-patient relationship. These assumptions about ACP have never been empirically validated. OBJECTIVE: To examine the traditional academic assumptions by exploring ACP from the perspective of patients actively participating in the planning process. METHODS: Forty-eight patients (30 men and 18 women with a mean age of 48.3 years) who were undergoing hemodialysis were interviewed 6 months after receiving an advance directive form. Their experience of ACP was noted in interviews that were audiotaped, transcribed, and analyzed. RESULTS: The participants said that their purpose in ACP was to prepare for death and dying, and their underlying goals included the exercise of control and an attempt to relieve burdens placed on loved ones. Advance care planning was viewed as a social process, and completing a written advance directive form was often regarded as unnecessary. Participants often involved close loved ones, but physicians infrequently. CONCLUSIONS: The traditional academic assumptions are not fully supported from the perspective of patients involved in ACP. The patients we interviewed stated that (1) the purpose of ACP is not only preparing for incapacity but also preparing for death; (2) ACP is not based solely on autonomy and the exercise of control, but also on personal relationships and relieving burdens placed on others; (3) the focus of ACP is not only on completing written advance directive forms but also on the social process; and (4) ACP does not occur solely within the context of the physician-patient relationship but also within relationships with close loved ones.     

Gender, victimization, and outcomes: Reconceptualizing risk.

Large-scale studies of gender differences in psychopathological reactions to victimization have focused on posttraumatic stress disorder, overlooking other trauma-related disorders. The present study expands this literature with a contextualized examination of interpersonal aggression exposure and sequelae. Using k-means cluster analysis on a sample of 16,000, the authors identified 8 distinct profiles of exposure to sexual violence, physical assault, stalking, and emotional abuse. Analyses of covariance then suggested links among victimization profile, gender, and mental and physical health. Results revealed no meaningful interactive effects of gender and interpersonal aggression on outcomes, once lifetime exposure to aggressive events was adequately taken into account. These findings argue against theories of female victims' greater vulnerability to pathological outcomes, instead linking risk to exposure history. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reconceptualizing social influence in counseling: The Elaboration Likelihood Model.

Previous investigations of attitude change in counseling based on S. R. Strong's (see PA, Vol 42:12025) social influence model have yielded mixed and inconclusive results. Such findings resemble the state of attitude change research that until recently existed in social psychology. In this article we introduce a model of attitude change from social psychology, the Elaboration Likelihood Model (ELM) of persuasion, which has served to unify some of the conflicting results in social psychology. The ELM may potentially account for the inconsistent findings within counseling psychology, providing a reconceptualization of the social influence process that builds upon Strong's (1968) theory and subsequent research. We also provide guidelines for the integration of recent social and counseling literatures in regard to the interpersonal influence process as represented by the ELM. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reconceptualizing Individual Differences in Self-Enhancement Bias: An Interpersonal Approach.

Self-enhancement bias has been studied from 2 perspectives: L. Festinger's (1954) social comparison theory (self-enhancers perceive themselves more positively than they perceive others) and G. W. Allport's (1937) self-insight theory (self-enhancers perceive themselves more positively than they are perceived by others). These 2 perspectives are theoretically and empirically distinct, and the failure to recognize their differences has led to a protracted debate. A new interpersonal approach to self-enhancement decomposes self-perception into 3 components: perceiver effect, target effect, and unique self-perception. Both theoretical derivations and an illustrative study suggest that this resulting measure of self-enhancement is less confounded by unwanted components of interpersonal perception than previous social comparison and self-insight measures. Findings help reconcile conflicting views about whether self-enhancement is adaptive or maladaptive. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reconceptualizing Health: A Response to Romanow and Marchildon (2003).

The Commission on the Future of Health Care in Canada (CFHCC) is to be congratulated for addressing the tension among various levels of government regarding health-care funding. The CFHCC also took the progressive step of creating the National Health Council, a body charged with ensuring greater accountability in health care. Psychologists have argued for decades that treatment decisions should be guided by a consideration of what works for whom and under what conditions. In our response to Romanow and Marchildon (see record 2003-09748-001), we argue that funding of health services in Canada has failed to heed this recommendation and the scientific evidence in support of the efficacy of psychological interventions for a wide range of health conditions. Despite remarkable advances in healthcare delivery, Canada's health-care system continues to be funded based on an outdated model of disease and illness. Romanow and Marchildon are to be applauded for their broad conceptualization of health and the role of various health professionals in advancing the health of Canadians. Unfortunately, this recognition did not make its way into the report of the CFHCC to the extent needed to make Canada's health system truly progressive. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reconceptualizing Team Identification: New Dimensions and Their Relationship to Intergroup Bias.

In 2 studies framed within social identity theory, the authors examined the relationships among cognitive, affective, and evaluative dimensions of team identification. They also sought to determine relationships between team identification and intergroup bias. Factor analyses in both investigations revealed similar findings. Items corresponding to cognitive identification and affective identification loaded on 1 factor. Items intended to measure evaluative identification loaded on 2 factors that depicted self-evaluations and evaluations perceived by others. Consistent with expectations, the cognitive-affective dimension of team identification was the strongest predictor of intergroup bias in both investigations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reconceptualizing psychological climate in a retail service environment: A multiple-stakeholder perspective.

Confirmatory factor analyses of a priori models of psychological climate were conducted with data collected from 18,457 sales personnel in 567 stores in 5 regions of a national retail organization. The results provide good support for viewing employee work-climate perceptions as composed of 2 higher order factors: concern for employees and concern for customers. These higher order factors are posited to reflect employees' cognitive appraisals of the behavior of agents toward (1) employees' well-being in the organization's internal environment and (2) the well-being of other organizational constituencies or stakeholders (e.g., customers) in the task environment, respectively. The implications of a multiple-stakeholder perspective for extending notions of psychological climate are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Arousal and the inverted-U hypothesis: A critique of Neiss's "Reconceptualizing arousal."

After reviewing the literature linking threat, incentive, and relaxation to motor performance, R. Neiss (see record 1989-14248-001) concluded that both the construct of arousal and the hypothesis of an inverted-U relationship between performance and arousal should be abandoned. These arguments were, however, based on research that does not permit clear evaluation of either the construct of arousal or the inverted-U hypothesis. Furthermore, some of Neiss's assumptions are questionable. This article reviews evidence that provides strong support for the inverted-U hypothesis. It is concluded that the concept of arousal is pragmatically useful in organizing a broad range of behavioral data. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reconceptualizing decisional balance in an adolescent sun protection intervention: Mediating effects and theoretical interpretations.

Objective: The Transtheoretical model (TTM) integrates principles of operant learning, such as stimulus control and reinforcement, and psychological factors, such as decisional balance. Understanding interrelationships between decisions, behavior, and consequences from multiple-theoretical perspectives can advance theory and inform development of more effective interventions. Method: This analysis examined the mediating effects of a special case of the decisional balance construct in which the pros of competing behaviors (i.e., sun protection vs. exposure) were measured rather than the pros and cons of the same behavior. Participants included 819 adolescents (10 to 16 years old, 53.5% girls, 58.4% White) randomized to a 24-month expert system intervention (SunSmart) or a physical activity and nutrition comparison group. Main Outcome Measures: Self-report measures included sun protection behaviors, pros for protection, and pros for exposure. Mediation analysis using latent growth curve models found both the treatment-to-mediator and mediator-to-behavior paths significant for decisional balance, producing an indirect effect of .323 (p Results: Multiple strategies for conceptualizing and measuring decisional balance appear to be valid. Results are interpreted from the TTM and operant perspectives. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cooperative outcome interdependence, task reflexivity, and team effectiveness: A motivated information processing perspective.

A motivated information processing perspective (C. K. W. De Dreu & P. J. D. Carnevale, 2003; see also V. B. Hinsz, R. S. Tindale, & D. A. Vollrath, 1997) was used to predict that perceived cooperative outcome interdependence interacts with team-level reflexivity to predict information sharing, learning, and team effectiveness. A cross-sectional field study involving management and cross-functional teams (N = 46) performing nonroutine, complex tasks corroborated predictions: The more team members perceived cooperative outcome interdependence, the better they shared information, the more they learned and the more effective they were, especially when task reflexivity was high. When task reflexivity was low, no significant relationship was found between cooperative outcome interdependence and team processes and performance. The author concludes that the motivated information processing perspective is valid outside the confines of the laboratory and can be extended toward teamwork in organizations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The case for case studies in nursing research: the problem of generalization

The development and progression of human breast neoplasia is characterized by the accumulation of numerous somatic genetic alterations. Although mutation of the p53 tumor suppressor gene is one of the most common alterations identified in invasive carcinomas, it is not clear whether mutations usually occur in noninvasive lesions before the development of invasion. To investigate the presence and heterogeneity of p53 mutations in breast neoplasia, we studied a morphological spectrum of paired lesions including invasive carcinomas and adjacent noninvasive epithelial lesions. Using 18 invasive ductal carcinomas with known p53 mutations, tissue samples were microdissected from formalin-fixed, paraffin-embedded tissue sections, and mutations in exons 4-8 of the p53 gene were identified by PCR amplification, single-strand conformational polymorphism, and direct sequencing. Multiple geographically distinct foci of invasive carcinoma were microdissected from six different invasive carcinomas, and all samples from each case had the same mutation. The absence of mutation heterogeneity provides evidence that p53 mutations occurred at the time of, or before, the clonal selection of the dominant component of the invasive carcinoma. To delineate the timing of p53 inactivation further in these cases, histological slides were reviewed to identify all noninvasive epithelial lesions. There were eight cases with associated ductal carcinoma in situ (DCIS), and in total, 27 distinct tissue samples representing a spectrum of histological subtypes and grades of DCIS were microdissected. In all 27 samples, the identical p53 mutation was identified in the DCIS as was present in the invasive carcinoma. In contrast, no p53 mutations were identified in any of the 21 microdissected foci of epithelial hyperplasia analyzed, including one sample with atypia. Together, these findings provide support that p53 mutations commonly occur early in breast neoplasia, usually at the stage of DCIS, but are not often identified in foci of hyperplasia. These findings support an important biological role for p53 mutation in progression from noninvasive precursors in breast neoplasia and provide further evidence that p53 mutation could have potential use as a molecular marker.