Anger Increases Susceptibility to Misinformation.

The effect of anger on acceptance of false details was examined using a three-phase misinformation paradigm. Participants viewed an event, were presented with schema-consistent and schema-irrelevant misinformation about it, and were given a surprise source monitoring test to examine the acceptance of the suggested material. Between each phase of the experiment, they performed a task that either induced anger or maintained a neutral mood. Participants showed greater susceptibility to schema-consistent than schema-irrelevant misinformation. Anger did not affect either recognition or source accuracy for true details about the initial event, but suggestibility for false details increased with anger. In spite of this increase in source errors (i.e., misinformation acceptance), both confidence in the accuracy of source attributions and decision speed for incorrect judgments also increased with anger. Implications are discussed with respect to both the general effects of anger and real-world applications such as eyewitness memory.

In-Group Versus Out-Group Source Memory.

A common finding in the source monitoring literature is that greater similarity impairs source discriminability. Experiments traditionally manipulate similarity overtly by describing or showing sources with explicitly differentiable features. However, people may also infer source characteristics themselves, which should also affect discriminability. Two studies examined inferred source characteristics by capitalizing on the out-group homogeneity effect, whereby in-group members are conceptualized as more diverse than out-group members. Participants learned about two sources who were described only as members of an in-group or an out-group and whose actions did not have higher a priori association with either group. Source memory was superior when participants believed the sources to be in-group members. This demonstrates that people spontaneously include inferred features with source representations and can capitalize on these features during source monitoring. Interestingly, information suggesting membership in one's in-group improved performance even for sources who had previously been considered out-group members (Experiment 2).

When anticipation beats accuracy: Threat alters memory for dynamic scenes.

Threat frequently leads to the prioritization of survival-relevant processes. Much of the work examining threat-related processing advantages has focused on the detection of static threats or long-term memory for details. In the present study, we examined immediate memory for dynamic threatening situations. We presented participants with visually neutral, dynamic stimuli using a representational momentum (RM) paradigm, and manipulated threat conceptually. Although the participants in both the threatening and nonthreatening conditions produced classic RM effects, RM was stronger for scenarios involving threat (Exps. 1 and 2). Experiments 2 and 3 showed that this effect does not generalize to the nonthreatening objects within a threatening scene, and that it does not extend to arousing happy situations. Although the increased RM effect for threatening objects by definition reflects reduced accuracy, we argue that this reduced accuracy may be offset by a superior ability to predict, and thereby evade, a moving threat.

The family empowerment program: an interdisciplinary approach to working with multi-stressed urban families.

The family empowerment program (FEP) is a multi-systemic family therapy program that partners multi-stressed families with an interdisciplinary resource team while remaining attached to a "traditional" mental health clinic. The rationale for this model is that far too often, families presenting at community mental health centers struggle with multiple psychosocial forces, for example problems with housing, domestic violence, child care, entitlements, racism, substance abuse, and foster care, as well as chronic medical and psychiatric illnesses, that exacerbate symptoms and impact traditional service delivery and access to effective treatment. Thus, families often experience fragmented care and are involved with multiple systems with contradictory and competing agendas. As a result, services frequently fail to harness the family's inherent strengths. The FEP partners the family with a unified team that includes representatives from Entitlements Services, Family Support and Parent Advocacy, and Clinical Staff from the agency's Outpatient Mental Health Clinic practicing from a strength-based family therapy perspective. The goal of the FEP is to support the family in achieving their goals. This is accomplished through co-construction of a service plan that addresses the family's needs in an efficient and coherent manner-emphasizing family strengths and competencies and supporting family self-sufficiency.

Improving severe sepsis outcomes: cost and time to first antibiotic dose.

This study was conducted to determine the effect of an empiric antimicrobial guide on clinical and economic outcomes related to severe sepsis. As all critical care nurses know, severe sepsis is often life-threatening. The study found that an empiric antimicrobial guide specific for severe sepsis was associated with a reduced length of stay, a significantly earlier time to first dose antibiotic, and significantly lower total and variable hospital costs.

Strengthening the educational value of undergraduate participation in research as part of a psychology department subject pool.

Participating in research must be an educational experience for students in order to ethically justify its inclusion as a requirement in college courses. Introductory Psychology students (N = 280) completed a written class assignment describing their research participation as a means to enhance this educational mission. Approximately half of students spontaneously mentioned something positive about the significance of the research or what they learned, with the remainder providing neutral, mixed, or negative comments. Students could articulate clearly and knowledgeably about the research in which they had participated. Such an assignment is an effective means to foster an understanding of the science of psychology.

Higher social intelligence can impair source memory.

Source monitoring is made difficult when the similarity between candidate sources increases. The current work examines how individual differences in social intelligence and perspective-taking abilities serve to increase source similarity and thus negatively impact source memory. Strangers first engaged in a cooperative storytelling task. On each trial, a single word was shown to both participants, but only 1 participant was designated to add a story sentence, using this assigned word. As predicted, social intelligence negatively predicted performance in a subsequent source-monitoring task. In a 2nd study, preventing participants from being able to anticipate their partner's next contribution to the story eliminated the effect.

Naughty nurse: Showtime's new medical drama.

Review and discussion of television program "Nurse Jackie."

Self-relevance and wishful thinking: facilitation and distortion in source monitoring.

When making source attributions, people tend to attribute desirable statements to reliable sources and undesirable statements to unreliable sources, a phenomenon known as the wishful thinking effect (Gordon, Franklin, & Beck, 2005). In the present study, we examined the influence of wishful thinking on source monitoring for self-relevant information. On one hand, wishful thinking is expected, because self-relevant desires are presumably strong. However, self-relevance is known to confer a memory advantage and may thus provide protection from desire-based biases. In Experiment 1, source memory for self-relevant information was contrasted against source memory for information relevant to others and for neutral information. Results indicated that self-relevant information was affected by wishful thinking and was remembered more accurately than was other information. Experiment 2 showed that the magnitude of the self-relevant wishful thinking effect did not increase with a delay.

Using prayer in psychotherapy: applying Sue's differential to enhance culturally competent care.

In this article, the authors discuss the application of Sue's cultural competence differential of hypothesis testing, dynamic sizing, and cultural specific expertise as a model for considering cultural factors in the treatment of an African American family. Three cultural dimensions are highlighted: spirituality, womanism, and community exposure to trauma. Given the centrality of spirituality for this African American family, prayer is used to facilitate the therapeutic process. Discussion from a womanist perspective highlights the spiritual, communal, and personal dimensions that the aunt faces as an African American woman. Consideration of the community context and potential exposure to trauma and loss allows for a fuller appreciation of the psychosocial context of the nephew. Sue's differential guides the case discussion.

Wishful thinking and source monitoring.

Memory distortions sometimes serve a purpose: It may be in our interest to misremember some details of an event or to forget others altogether. The present work examines whether a similar phenomenon occurs for source attribution. Given that the source of a memory provides information about the accuracy of its content, people may be biased toward source attributions that are consistent with desired accuracy. In Experiment 1, participants read desirable and undesirable predictions made by sources differing in their a priori reliability and showed a wishful thinking bias--that is, a bias to attribute desirable predictions to the reliable source and undesirable predictions to the unreliable source. Experiment 2 showed that this wishful thinking effect depends on retrieval processes. Experiment 3 showed that under some circumstances, wishes concerning one event can produce systematic source memory errors for others.

Diagnostic error in internal medicine.

BACKGROUND: The goal of this study was to determine the relative contribution of system-related and cognitive components to diagnostic error and to develop a comprehensive working taxonomy. METHODS: One hundred cases of diagnostic error involving internists were identified through autopsy discrepancies, quality assurance activities, and voluntary reports. Each case was evaluated to identify system-related and cognitive factors underlying error using record reviews and, if possible, provider interviews. RESULTS: Ninety cases involved injury, including 33 deaths. The underlying contributions to error fell into 3 natural categories: "no fault," system-related, and cognitive. Seven cases reflected no-fault errors alone. In the remaining 93 cases, we identified 548 different system-related or cognitive factors (5.9 per case). System-related factors contributed to the diagnostic error in 65% of the cases and cognitive factors in 74%. The most common system-related factors involved problems with policies and procedures, inefficient processes, teamwork, and communication. The most common cognitive problems involved faulty synthesis. Premature closure, ie, the failure to continue considering reasonable alternatives after an initial diagnosis was reached, was the single most common cause. Other common causes included faulty context generation, misjudging the salience of findings, faulty perception, and errors arising from the use of heuristics. Faulty or inadequate knowledge was uncommon. CONCLUSIONS: Diagnostic error is commonly multifactorial in origin, typically involving both system-related and cognitive factors. The results identify the dominant problems that should be targeted for additional research and early reduction; they also further the development of a comprehensive taxonomy for classifying diagnostic errors.

The influence of linguistic labels on source-monitoring decisions.

Three studies explored the extent to which people use various object features, including linguistic label, shape, and category membership, to make decisions about the source of their memories. To isolate the influence of each feature, we used items that were related in the following four ways: as synonyms, as similar in shape and category membership, as homographs, or as unrelated. Participants read sentences and either saw or imagined a picture of the critical word's referent. Experiment 1 showed that participants committed more source errors for synonyms (e.g., rabbit and bunny) than for objects that were conceptually and perceptually similar (e.g., doughnut and bagel), which produced more errors than unrelated items. However, there was no effect of label, as people did not have more errors for homographs (e.g., baseball bat and flying bat) than unrelated items. In Experiment 2, presenting the critical word at study was not sufficient to lead people to use an item's label to make source decisions. However, Experiment 3 showed more source errors for homographs than unrelated pairs when semantic context was minimised at study, suggesting that people can use linguistic labels to make source decisions when other information is unavailable.

Cognitive underpinnings of diagnostic error.

Unfortunately, general limits in cognitive performance extend to diagnostic situations. The authors remain optimistic about reducing cognition-based error, but not as optimistic as Croskerry (see his accompanying article), since the reality is that predictable patterns of error will persist.

Reducing diagnostic errors in medicine: what's the goal?

This review considers the feasibility of reducing or eliminating the three major categories of diagnostic errors in medicine: "No-fault errors" occur when the disease is silent, presents atypically, or mimics something more common. These errors will inevitably decline as medical science advances, new syndromes are identified, and diseases can be detected more accurately or at earlier stages. These errors can never be eradicated, unfortunately, because new diseases emerge, tests are never perfect, patients are sometimes noncompliant, and physicians will inevitably, at times, choose the most likely diagnosis over the correct one, illustrating the concept of necessary fallibility and the probabilistic nature of choosing a diagnosis. "System errors" play a role when diagnosis is delayed or missed because of latent imperfections in the health care system. These errors can be reduced by system improvements, but can never be eliminated because these improvements lag behind and degrade over time, and each new fix creates the opportunity for novel errors. Tradeoffs also guarantee system errors will persist, when resources are just shifted. "Cognitive errors" reflect misdiagnosis from faulty data collection or interpretation, flawed reasoning, or incomplete knowledge. The limitations of human processing and the inherent biases in using heuristics guarantee that these errors will persist. Opportunities exist, however, for improving the cognitive aspect of diagnosis by adopting system-level changes (e.g., second opinions, decision-support systems, enhanced access to specialists) and by training designed to improve cognition or cognitive awareness. Diagnostic error can be substantially reduced, but never eradicated.

Group therapy for black women: a therapeutic support model.

The development of a group therapy approach for black women is reported. The therapeutic and support functions of the group are discussed and the recurrent themes arising in group sessions are examined. Many group members achieved their goals of self-exploration, insight, and significant behavioral change.