Applying implementation science theories to support practice change in the assessment of cognition by occupational therapists.

Background Understanding cognitive impairments is essential for effective rehabilitation and discharge planning for adults with neurological conditions. The aim of this study was to identify barriers to completing standardised cognitive assessments and evaluate the implementation of an intervention to support practice change. Methods A mixed-methods approach was applied to translate cognitive assessment recommendations into clinical practice using the Theoretical Domains Framework (TDF) and the Capability, Opportunity, and Motivation Behaviour model (COM-B) theories. Occupational therapists at one metropolitan health service in Australia were invited to participate. Pre- and post-implementation file audits and surveys were conducted, along with focus groups that collected qualitative data analysed using the TDF and COM-B. Results Survey 1 (n =40) and focus group data (n =24) identified barriers in the TDF domains of knowledge (selection of assessments), environment and resources (equipment and time constraints), and social influences (pressure from other disciplines). To address barriers to implementing a cognitive assessment framework, scripts, cue cards, video-recorded training, and posters were developed as guided by the Behaviour Change Wheel (BCW). Survey 2 showed increased capability to physically administer cognitive assessments (53-74%) and improved clinician understanding of relevant clinical practice guideline (CPG) recommendations (22-50%). File audit data indicated a 30% increase in the number of standardised assessments completed. Conclusions The application of two implementation theories led to the development of an intervention that increased occupational therapists' confidence and their adherence to CPG recommendations. This study serves as a potential model for using the TDF and COM-B to create implementation interventions in various clinical practice areas.

Evidence in court: witness preparation and cross-examination style effects on adult witness accuracy.

Witnesses play a clear and pivotal role in the criminal justice system and there is an obvious public interest in identifying procedures that both undermine and maximize the quality of evidence received by the criminal courts. This paper reports an investigation into the effects of witness familiarization and cross-examination type on adult witness accuracy that situates outcomes in both legal and psychological context. 60 mock witnesses observed a crime event and each witness was then cross-examined by a practising barrister in a moot courtroom according to two conditions - either via a scripted complex version of cross-examination or by a simpler but equivalent scripted examination. Mock witnesses were also allocated to two further conditions - half the participants received a guidance booklet on cross-examination and the other half received no familiarization to the process. Study outcomes showed that familiarization of witnesses to cross-examination processes increased accurate responses and reduced errors. The guidance seemingly allowed accessibility to cognitive information that enabled witnesses to process information more effectively. On this basis, advance written information about the nature of the cross-examination and potentially misleading tactics used by advocates could help to immunize against negative lawyerly influence.

Impact of Evidence Type and Judicial Warning on Juror Perceptions of Global and Specific Witness Evidence.

The Court of Appeal in England and Wales held (R. v. Sardar, 2012) there had been no exceptional circumstances that justified a jury retiring with a transcript of the complainant's interview. This paper reports an investigation into the impact multiple evidence forms and use of a judicial warning has on juror evaluations of a witness. The warning focuses juror attention on placing disproportionate weight on the evidence as opposed to their general impression of it. Sixty jury-eligible participants were presented with witness evidence in transcript, video, or transcript plus video format. Half the participants in each condition received the warning. All mock jurors completed a questionnaire which assessed perceptions of witness and task. Outcomes showed that transcript plus video evidence, when accompanied by a warning, did impact on mock jurors' global assessments of the witness. The warning made the task less clear for jurors and, in the video condition, led to higher ratings of how satisfactory and reliable the witness was. Findings support the provision of a judicial warning to jurors and show some initial support for judiciary opposition to the provision of an additional transcript only when jurors are asked to make the more usual global witness assessments.

Subjective cues to deception/honesty in a high stakes situation: an exploratory approach.

The low ecological validity of much of the research on deception detection is a limitation recognized by researchers in the field. Consequently, the present studies investigated subjective cues to deception using the real life, high stakes situation of people making public appeals for help with missing or murdered relatives. It was expected that cues related to affect would be particularly salient in this context. Study 1 was a qualitative investigation identifying cues to deception reportedly used by people accurate at detecting deception. Studies 2 and 3 were then empirical investigations that mainly employed the cues reported in Study 1. A number of subjective cues were found to discriminate between honest and deceptive appeals, including some previously unidentified cues, and cues likely to be context-specific. Most could be categorized under the themes of authenticity of emotion, and negative and positive affective reactions to the appealer. It is concluded that some cues to deception may emerge only in real life, high stakes situations; however, it is argued that some of these may be influenced by observers' perceptions of the characteristics of offenders, rather than acts of deception per se.

Facilitating memory with hypnosis, focused meditation, and eye closure.

Three experiments examined some features of hypnotic induction that might be useful in the development of brief memory-facilitation procedures. The first involved a hypnosis procedure designed to facilitate face identification; the second employed a brief, focused-meditation (FM) procedure, with and without eye closure, designed to facilitate memory for an emotional event. The third experiment was a check for simple motivation and expectancy effects. Limited facilitation effects were found for hypnosis, but these were accompanied by increased confidence in incorrect responses. However, eye closure and FM were effective in facilitating free recall of an event without an increase in errors. FM reduced phonemic fluency, suggesting that the effectiveness of FM was not due to simple changes in expectancy or motivation.

The impact of cyberstalking: the lived experience - a thematic analysis.

Cyberstalking (CS) can have major psychosocial impacts on individuals. Victims report a number of serious consequences of victimization such as increased suicidal ideation, fear, anger, depression, and post traumatic stress disorder (PTSD) symptomology. Research is largely limited to quantitative outcome research. This study examines the diversity of experiences reported by people who define themselves as having been cyberstalked. Thematic analysis was used to explore 100 CS victim narratives, gathered by means of an online survey questionnaire designed to capture structured text responses. Five emergent themes were evident in the data: control and intimidation; determined offender; development of harassment; negative consequences; and lack of support. Findings identify similarities and differences to traditional stalking, along with the necessity of support for victims and illustration of the negative impacts this form of harassment produces.

Are high hypnotizables especially vulnerable to false memory effects? A sociocognitive perspective.

This article examines issues raised by a recent UK legal case in which the defense argued that the accusations made by the highly hypnotizable plaintiff were likely based on false memories. The authors argue that the evidence related to hypnotizability and false memory production is inconsistent but may be illuminated by a sociocognitive perspective. They present 2 preliminary studies that indicate that when the instructions imply that accurate reporting is a feature of hypnosis, higher hypnotizables may actually be more resistant than low or medium hypnotizables to false memories arising from misleading information given during hypnosis. They conclude that, when memory accuracy is emphasized rather than productivity, there is little evidence to link high hypnotizability with a propensity to produce false memories.

Enhancing witness memory with techniques derived from hypnotic investigative interviewing: focused meditation, eye-closure, and context reinstatement.

Due to several well-documented problems, hypnosis as a forensic interviewing tool has been largely replaced by the cognitive interview; however, the latter is problematic in time and complexity. This article builds on previous research showing that some procedures used in traditional hypnotic forensic interviewing might still be useful in developing alternative procedures for use in investigative interviewing. Two experiments are described that include a focused meditation with eye-closure technique with similarities to conventional hypnotic induction but without the label of hypnosis. In the first, focused meditation was comparable to a context reinstatement, or revivification, technique in facilitating memory in children aged 6 to 7 without increasing errors or inflating confidence. In the second, when used in combination with context reinstatement, focused meditation was resistant to the effects of misleading information in adults. Implications are discussed.