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PubMed2002

Everyday problem solving in African Americans and European Americans with Alzheimer's disease: an exploratory study.

In this exploratory study, we compared the performance of 10 African American and 26 European American persons with early- to mid-stage Alzheimer's disease (AD) to 20 nondemented elderly (NE), using a shortened version of the Test of Problem Solving (TOPS). The TOPS measures verbal reasoning to solve everyday problems in five areas: explaining inferences, determining causes, answering negative why questions, determining solutions, and avoiding problems. Six linguistic measures were also examined: total utterances, abandoned utterances, length of utterances, maze words, questions, and total words. NE performed better than AD subjects on all but one measure of verbal reasoning ability. AD subjects also showed a trend to use more total utterances and abandoned utterances than NE. For the AD group, no ethnic differences were found for verbal reasoning or linguistic measures. The findings from this preliminary investigation suggest that, compared to European Americans, African American persons with AD demonstrate similar everyday problem solving and linguistic skills. Thus, assessments such as TOPS that examine everyday problem solving may be a useful nonbiased evaluation tool for persons with AD in these two ethnic groups.

Activities of Daily Living↗

PubMed1999

Deficient social problem-solving in boys with ODD/CD, with ADHD, and with both disorders.

OBJECTIVE: To study social problem-solving skills in psychiatrically defined aggressive boys, starting from Dodge's social information-processing model. METHOD: Videotaped stimuli of problematic social situations and questions were presented to elicit responses that indicate boys' social problem-solving skills (encoding and interpretation of social cues, generation of possible responses, evaluation of responses, self-efficacy evaluation, and response selection). Boys aged 7 to 12 years with oppositional defiant or conduct disorder (ODD/CD) (n = 48), attention-deficit hyperactivity disorder (ADHD) (n = 27), and both disorders (ODD/CD + ADHD) (n = 29) were involved as well as a normal control group (n = 37) and a psychiatric control group with internalizing disorders (n = 23). RESULTS: When compared with normal controls, boys with ADHD, with ODD/CD, and with ODD/CD + ADHD encoded fewer social cues and generated fewer responses. Boys with ODD/CD and with ODD/CD + ADHD moreover were more confident in their ability to enact an aggressive response than normal controls. When ODD/CD boys and ODD/CD + ADHD boys were given the opportunity to select a response from various types of responses shown, they selected an aggressive response more often than normal controls. Thus, in ADHD boys social problem-solving was affected only in encoding and in the generation of responses, whereas in ODD/CD and ODD/CD + ADHD boys social problem-solving was affected throughout the process. CONCLUSION: For the further study of social problem-solving in aggressive children, it is essential to differentiate between children with ADHD and children with ODD/CD and ODD/CD + ADHD.

Aggression↗

PubMedDate not supplied

Problem-solving in laparoscopic surgery.

The advent of the laparoscopic revolution and the wider applicability of laparoscopic procedures has caused surgeons to re-think the dynamics of intraoperative problem-solving. Problems of body habitus, previous surgery, exposure, bleeding, and anesthesia, as well as the problem cholangiogram, require new and innovative approaches, a practical approach to each of these common laparoscopic problems is presented.

Abdomen↗

PubMed1986

Problem-solving approach to clinical education.

A problem-solving method to provide appropriate clinical learning experiences was developed for physical therapy students enrolled in their first year of professional course work. Clinicians from selected facilities were asked to participate in a clinical rotation over a two-quarter period. Using a problem-solving format, each clinician was responsible for a two-hour presentation relating to a disease or disability. Each rotation was repeated weekly for seven different groups of 10 students. During the rotation, the clinician presented a patient with a particular disability or disease and worked with the students to identify patient problems, establish treatment goals, and discuss methods used to achieve the goals. The difficulties encountered with the clinical experiences and the positive aspects of the experiences are discussed.

Clinical Competence↗

PubMed1989

Social problem-solving therapy for unipolar depression: an initial dismantling investigation.

Tests the efficacy of social problem-solving therapy for unipolar depression and examines the relative contribution of training in the problem-orientation component of the overall model. This process involves various beliefs, assumptions, appraisals, and expectations concerning life's problems and one's problem-solving ability. It is conceptually distinct from the remaining four problem-solving components that are specific goal-directed tasks. A dismantling research design, involving 39 depressed Ss, provides findings that indicate problem-solving to be an effective cognitive-behavioral treatment approach for depression, thereby extending previous research. Moreover, the results underscore the importance of including problem-orientation training.

Adaptation, Psychological↗

PubMed2002

The disturbing effect of irrelevant information on arithmetic problem solving in inattentive children.

Two studies explored the influence of irrelevant information on the problem-solving ability of children rated as inattentive by their teachers, on the basis of symptoms of attention deficit hyperactivity disorder as defined by the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994). In the first study, 20 inattentive children, fourth and fifth graders, and 20 control children matched for IQ, gender, and schooling were administered 12-word arithmetic problems. Four problems included only essential information necessary for the problem's solution, whereas the other problems included irrelevant information, half at the beginning of the problem and half at the end. Although the inattentive children were equal to control children in their ability to solve problems with essential information, they performed more poorly in using appropriate problem-solving procedures when problems included irrelevant information, independent of its position. The second study compared the influence of numerical and verbal irrelevant information. Nineteen inattentive children and 18 control children, selected with similar criteria as Study 1, were presented with 12 problems, 6 with irrelevant numerical-arithmetic information and 6 with irrelevant verbal information. Both kinds of information produced a greater number of procedural errors in the inattentive group, but differences in calculation errors were less evident. Furthermore, inattentive children were more disturbed when the irrelevant information was verbal than when it was numerical, suggesting that inattentive children's difficulties in problem solving are partially due to an inability to inhibit irrelevant information, especially when it conveys a rich semantic knowledge.

Analysis of Variance↗

PubMed2002

Problem-solving skills training for mothers of children with newly diagnosed cancer: a randomized trial.

Mothers of children with serious illnesses have lower levels of well-being than mothers in the general population. Problem-solving therapy (PST), a cognitive-behavioral intervention, has been shown to be effective in treating negative affectivity (depression, anxiety) and other manifestations of reduced well-being. This report describes a problem-solving skills training (PSST) intervention, based on problem-solving therapy, for mothers of newly diagnosed pediatric cancer patients. Ninety-two mothers were randomly assigned to receive PSST or to receive standard psychosocial care (Control Group). After the 8-week intervention, mothers in the PSST Group had significantly enhanced problem-solving skills and significantly decreased negative affectivity compared with controls. Analysis revealed that changes in self-reports of problem-solving behaviors accounted for 40% of the difference in mood scores between the two groups. Interestingly, PSST had the greatest impact on improving constructive problem solving, whereas improvement in mood was most influenced by decreases in dysfunctional problem solving. The implications of these findings for refinement of the PSST intervention and for extension to other groups of children with serious illnesses are discussed.

Adaptation, Psychological↗

PubMed1996

An evaluation of the problem-solving ability of diplomates from a comprehensive nursing programme.

The aim of this South African study was to obtain a measurement of the problem-solving ability of diplomates from a basic nursing programme with this skill included in its programme objectives. The problem-solving skills of diplomates from this programme were compared with those of first years to determine if there is an improvement in the problem-solving skills. A comparison was also made with a different basic programmes not claiming to teach problem-solving. The research design selected for this study was the ex post facto design. Data were collected using the Triple Jump Method which is an interview technique. The findings suggested that the level of the problem-solving skills of the comprehensive nursing programme diplomate is not satisfactory. There was, however, some improvement in the problem-solving ability from the first to the fourth year. The level of performance of the fourth years was slightly higher than that of the third years of the three-year nursing programme, who were used as the control group. Recommendations on selection teaching and evaluation of students, as well as further research, were made.

Adult↗

PubMed1998

Critical thinking. A framework for problem solving in the occupational setting.

1. Critical thinking is essential in providing quality nursing care. Understanding the process of critical thinking increases the nurse's efficiency in the skill of problem solving. 2. To employ the critical thinking process, the nurse must analyze and criticize a problematic or change situation, reason, make inferences, and reach conclusions. 3. The result of critical thinking is attaining goals, solving problems, and making decisions. 4. Critical thinking is a process and not an outcome.

Clinical Competence↗

PubMed2001

The efficacy of problem-solving treatments after deliberate self-harm: meta-analysis of randomized controlled trials with respect to depression, hopelessness and improvement in problems.

BACKGROUND: Brief problem-solving therapy is regarded as a pragmatic treatment for deliberate self-harm (DSH) patients. A recent meta-analysis of randomized controlled trials (RCTs) evaluating this approach indicated a trend towards reduced repetition of DSH but the pooled odds ratio was not statistically significant. We have now examined other important outcomes using this procedure, namely depression, hopelessness and improvement in problems. METHOD: Six trials in which problem-solving therapy was compared with control treatment were identified from an extensive literature review of RCTs of treatments for DSH patients. Data concerning depression, hopelessness and improvement in problems were extracted. Where relevant statistical data (e.g. standard deviations) were missing these were imputed using various statistical methods. Results were pooled using meta-analytical procedures. RESULTS: At follow-up, patients who were offered problem-solving therapy had significantly greater improvement in scores for depression (standardized mean difference = -0.36; 95% CI -0.61 to -0.11) and hopelessness (weighted mean difference =-3.2; 95% CI -4.0 to -2.41), and significantly more reported improvement in their problems (odds ratio = 2.31; 95% CI 1.29 to 4.13), than patients who were in the control treatment groups. CONCLUSIONS: Problem-solving therapy for DSH patients appears to produce better results than control treatment with regard to improvement in depression, hopelessness and problems. It is desirable that this finding is confirmed in a large trial, which will also allow adequate testing of the impact of this treatment on repetition of DSH.

Cognitive Behavioral Therapy↗

PubMedDate not supplied

Collaborative problem-solving in telemedicine and evidence interpretation in a complex clinical case.

This study examined clinical problem-solving processes in the context of a telemedical consultation, in order to verify to what extent the technological environment preserves the characteristics of medical reasoning that are known to occur in more traditional clinical settings. This study also provided an opportunity for examining certain fundamental aspects of medical reasoning about complex cases. Within a case-study design, we used a theoretical framework and qualitative methods originating from cognitive science. Expert physicians used reasoning strategies commensurate with the complexity of the case. The technological context of the telemedical consultation did not overly contrive the interaction, allowing them to use real-time problem-solving processes characterizing medical reasoning in naturalistic settings. The results also suggest that high levels of expertise in the presence of very complex cases may elicit a particular configuration of problem-solving processes, associating certain reasoning patterns that are usually related to non-expert problem-solving with others that are typical of expertise. We believe that the evaluation of image transmission and diagnostic performance in telemedicine, as well as the determination of its indications and technological configurations, may benefit from taking into account, with the help of cognitive methodologies, the interacting problem-solving modalities that may be encountered in this context.

Adult↗

PubMed1998

Family rigidity, adolescent problem-solving deficits, and suicidal ideation: a mediational model.

Family rigidity and adolescent problem-solving deficits have each been linked to adolescent suicidal behaviors. The objective of the present study was to evaluate the hypothesis that family rigidity has primarily an indirect effect on adolescent suicidal ideation through its effect on adolescent problem-solving deficits. College students and their parents completed the Family Adaptability and Cohesion Evaluation Scale II. Students also completed the Problem-Solving Inventory and the Adult Suicidal ideation Questionnaire. Structural equation models confirmed that family rigidity has an indirect effect on adolescent suicidal ideation through its effect on adolescent problem-solving deficits. Directions for treatment efforts are discussed.

Adaptation, Psychological↗

PubMedDate not supplied

Adult age differences in monitoring of practical problem-solving performance.

A scale measuring practical problem-solving ability in adulthood was developed in a preliminary study and demonstrated to have satisfactory psychometric properties for research purposes: there was satisfactory internal consistency, discriminant validity, and there were significant relationships between performance and a measure of subjective experience. The purpose of the main investigation was to examine performance awareness on this measure of practical problem-solving ability. Younger (19-40 years) and older (59-84 years) subjects estimated performance either before and after taking the test (prediction/postdiction condition) or only after exposure to the materials (postdiction only). When the unsigned discrepancies between actual and expected performances were considered, there were no age differences in performance awareness of either time of estimation, but neither age group demonstrated improved accuracy from prediction to postdiction. When the directions of estimation errors were considered, older adults were significantly more likely to overestimate performance at both times of estimation compared to younger adults, who underestimated performance. Importantly, the same pattern of results was obtained with subjects who estimated only after taking the test and those who made predictions and postdictions.

Adult↗

PubMed1982

Training counseling and problem-solving skills with university students.

Often nonprofessionals lack specific instruction in relevant counseling and problem-solving skills. The effects of training procedures on counseling and problem-solving behaviors were examined experimentally with university students. The procedures involved the use of behavioral specifications, rationales, situational examples, study guides, and practice plus feedback on performance. Following training, the average percentage of occurrence of counseling and problem-solving behaviors increased to 89%. Generalization data in sessions with actual clients and expert ratings of the overall quality of counseling provided evidence of generalization to other settings and other evaluative dimensions of counseling and problem-solving performance.

Adult↗

PubMed1992

Problem solving to prevent work injuries in supported employment.

A problem-solving strategy was used to teach three groups of 3 individuals in supported employment how to prevent work-related injuries. The problem-solving strategy was taught in two training phases. The first training phase involved the use of cue cards, and the second involved the withdrawal of the cue cards. Interviews and staged generalization assessments in the participants' natural work environments were conducted before, during, and up to 12 weeks after training. In these assessments, situations were presented that were either similar or dissimilar to situations presented in training. Results of both the interviews and staged assessments indicated that the participants' newly acquired problem-solving skills generalized to similar and dissimilar situations.

Cues↗

PubMed1989

Perceived problem-solving skills and drinking patterns among college students.

The cognitive social-learning-theory literature on alcohol abuse points to failure to generate appropriate alternative behaviors to drinking as a major predictor of relapse to drinking. Viewing drinking as a continuous variable, ranging from abstinence to abuse, it should be possible to demonstrate a relationship between problem-solving abilities and drinking patterns. The hypothesis that individuals' perceived problem-solving skills are related to their pattern of alcohol use was examined. It was expected that poorer perceived problem-solving skills would be related to maladaptive use of alcohol in response to problem situations. 192 students in Introductory Psychology at a midsized southern university participated. Each subject completed questionnaires assessing frequency and quantity of alcohol use, and stimuli associated with the onset of drinking. The Problem-solving Inventory was used to measure perceived problem-solving skills. Drinking pattern variables were formed by factor analysis. Canonical correlation analysis of the data supported the hypotheses. Students with lower confidence in problem-solving capabilities reported greater use of alcohol to cope with negative emotions and to escape from responsibilities than students with high confidence in their abilities. Amount of alcohol consumed was not related to problem-solving skills.

Adaptation, Psychological↗

PubMed1979

The effects of EMG feedback training during problem solving: a case study.

The present case study investigated the effects of competing task demands on biofeedback training to reduce frontalis muscle tension. Baseline levels of frontalis muscle tension were recorded for relaxation and problem solving. The subject was trained to decrease muscle tension with biofeedback for the problem-solving task alone. The results indicated that EMG training during problem-solving was successfully accomplished. Frontalis muscle tension during relaxation baseline did not change as a result of reductions in muscle tension during problem-solving feedback training. This suggests that the decrease of muscle tension cannot be attributed to reductions in overall muscle tension levels. Instead, training was specific to the problem-solving feedback phases. Additionally, it was found that accuracy in problem-solving did not decline as a result of simultaneous feedback training. Thus EMG biofeedback training can be accomplished and exercised without disruption of ongoing mental activity.

Adult↗

PubMed2001

Social skills and problem-solving training for children with early-onset conduct problems: who benefits?

Families of 99 children with early-onset conduct problems, aged 4-8 years, were randomly assigned to a child training treatment group (CT) utilizing the Incredible Years Dinosaur Social Skills and Problem Solving Curriculum or a waiting-list control group (CON). Post-treatment CT children had significantly fewer externalizing problems at home, less aggression at school, more prosocial behavior with peers, and more positive conflict management strategies than CON children. Significantly more CT than CON children showed clinically significantly improvements on reports and independent observations of aggressive and noncompliant behavior. The differential treatment response was evaluated according to child comorbidity with attention deficit hyperactivity disorder (ADHD), parenting discipline practices. and family risk factors. The only risk factor related to failure to make improvements in child conduct problems after treatment was negative parenting (i.e., maternal critical statements and physical force). The long-term follow-up 1 year later indicated that most of the significant post-treatment changes were maintained.

Age of Onset↗