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PubMed2006

Innovations: child & adolescent psychiatry: use of collaborative problem solving to reduce seclusion and restraint in child and adolescent inpatient units.

The authors describe "collaborative problem solving," a cognitive-behavioral approach for working with aggressive children and adolescents. The model conceptualizes aggressive behavior as the byproduct of lagging cognitive skills in the domains of flexibility, frustration tolerance, and problem solving. The goal is to train staff to assess specific cognitive skills that may be contributing to challenging behavior and to teach children new skills through collaborative problem solving. The authors present results from an inpatient unit that dramatically reduced rates of seclusion and restraint.

Adolescent↗
PubMed2002

The effects of cumulative practice on mathematics problem solving.

This study compared three different methods of teaching five basic algebra rules to college students. All methods used the same procedures to teach the rules and included four 50-question review sessions interspersed among the training of the individual rules. The differences among methods involved the kinds of practice provided during the four review sessions. Participants who received cumulative practice answered 50 questions covering a mix of the rules learned prior to each review session. Participants who received a simple review answered 50 questions on one previously trained rule. Participants who received extra practice answered 50 extra questions on the rule they had just learned. Tests administered after each review included new questions for applying each rule (application items) and problems that required novel combinations of the rules (problem-solving items). On the final test, the cumulative group outscored the other groups on application and problem-solving items. In addition, the cumulative group solved the problem-solving items significantly faster than the other groups. These results suggest that cumulative practice of component skills is an effective method of training problem solving.

Analysis of Variance↗
PubMed2006

Cognitive functions related to interpersonal problem-solving skills in schizophrenic patients compared with healthy subjects.

Subjects with schizophrenia have cognitive alterations. The functional consequences of these deficits need to be fully determined, in order to implement more effective rehabilitation programs for patients with schizophrenia. This research explores the relationships between cognitive functioning and social problem-solving skills in a group of 20 chronic schizophrenic patients compared with those found in a group of 20 healthy subjects. The following cognitive domains were evaluated: verbal memory (Rey Auditory-Verbal Test; RAVLT), visuo-spatial organization and visuo-spatial memory (Rey-Osterrieth complex figure test; RF), executive functioning (semantic verbal fluency test; VF, design fluency task; DF and Wisconsin Card Sorting Test; WCST), attention (d 2 cancellation test) and general intellectual ability (Standard Progressive Matrices of Raven; SPM). Social problem-solving skills were assessed with a video-based test; the Assessment of Interpersonal Problem-Solving Skills (AIPSS). As a group, patients performed significantly worse than control subjects on every cognitive variable and on AIPSS receiving, processing and sending constructs. Among schizophrenic patients, correlations between AIPSS constructs and neuropsychological tests were observed for VF, DF, d2 and SPM whilst these associations were not replicated in healthy subjects. However, in the whole sample, after adjusting for age, gender and education, SPM displayed significant associations with all three AIPSS constructs. Moreover, after taking SPM into account, neither diagnostic groups (patients versus control) nor cognitive variables, except d2, provided an additional contribution to AIPSS performance. Cognitive impaired performances, mainly frontal, have a deleterious effect on social problem-solving skills in the schizophrenic group. It is suggested that alterations in social problem-solving skills may reflect social anxiety and/or " theory of mind " impairment. These factors may explain the lack of association among healthy subjects. The results support the inclusion of cognitive remediation programs designed to enhance social skills for patients where a cognitive deficit is clearly ascertained.

Adult↗
PubMed1986

Training in social and interpersonal problem-solving skills for mildly and moderately mentally retarded adults.

The effectiveness of social-skills training, interpersonal problem-solving training, and a combination of the two in improving the social competence of 33 moderately and mildly mentally retarded adults was evaluated. Problem situations used in the training programs and in the key assessment measures were empirically derived. Results demonstrated that treated subjects improved on role-play tests of social skills and that moderately retarded treated subjects improved relative to moderately retarded controls on the problem-solving measure. Findings also indicated that subjects receiving the interpersonal problem-solving training component improved on ratings of personal-social responsibility. Results concerning generalization of treatment gains, however, indicated that future investigators should incorporate generalization strategies into their treatment programs.

Adolescent↗
PubMed1998

Evaluation of problem solving and communication skills of persons with schizophrenia.

Although much research has shown positive outcomes of teaching problem solving and communication skills to persons with schizophrenia, the amount of research on the assessment of these two sets of skills has been modest. The current study demonstrates an effective model for their assessment and includes a previously neglected procedure to determine if subjects attended to the skill prompts. It replicates and expands prior findings on problem solving and communication skills. Results indicated that persons with schizophrenia were generally deficit in problem solving skills. Persons without schizophrenia seemed to use more behavioral information when deciding if a problem existed and they were better able to differentiate between appropriate and inappropriate solutions to problems. Persons with schizophrenia were found to be deficit in communication skills that facilitate interaction and showed a style that subordinated their wants to those of others.

Adult↗
PubMed1988

Problem solving deficits after focal cerebral lesions.

Verbal comprehension and naming, identification of categories, as well as problem solving on reasoning and sorting tasks were examined in 57 patients with focal brain lesions and 20 control patients. The results confirmed the prediction that frontal lobe lesions cause a more pronounced deficit in problem solving than posterior lesions. However, patients with left frontal lobe lesions showed verbal inefficiency which possibly disturbed their sorting on the basis of feedback, but the inferiority of the frontal lobe damaged patients on category identification was not secondary to this verbal deficit. As the patients with left posterior lesions did not have marked verbal deficits, the present findings should be confined to patients lacking severe aphasia, which may also disturb problem solving in patients with posterior lesions.

Adult↗
PubMed2000

[Problem-solving in immunohematology: interpretation of ABO typing and its difficulties].

Practice in immunohematology is replete with complex problems that require practitioners' problem-solving performance. In immunohematology, the acquisition of the reasoning process and necessary skills for making clinical decisions is based on teaching problem-solving strategies which potentially reduce errors and improve patient outcome. We discuss the recognition and resolution of the common causes of discrepancies in ABO typing results using problem-solving strategies.

ABO Blood-Group System↗
PubMed1997

Clinical pragmatism: a method of moral problem solving.

This paper presents a method of moral problem solving in clinical practice that is inspired by the philosophy of John Dewey. This method, called "clinical pragmatism," integrates clinical and ethical decision making. Clinical pragmatism focuses on the interpersonal processes of assessment and consensus formation as well as the ethical analysis of relevant moral considerations. The steps in this method are delineated and then illustrated through a detailed case study. The implications of clinical pragmatism for the use of principles in moral problem solving are discussed.

Catholicism↗
PubMed1996

Role of autobiographical memory in social problem solving and depression.

Depressed patients frequently exhibit deficiencies in social problem solving (SPS). A possible cause of this deficit is an impairment in patients' ability to retrieve specific autobiographical memories. A clinically depressed group and a hospital control group performed the Means-End Problem-Solving (MEPS; J. J. Platt & G. Spivack, 1975a) task, during which they were required to attend to the memories retrieved during solution generation. Memories were categorized according to whether they were specific, categoric, or extended and whether the valence of the memories was positive or negative. Results support the general hypothesis that SPS skill is a function of autobiographical memory retrieval as measured by a cuing task and by the types of memories retrieved during the MEPS. However, the dysfunctional nature of categoric memories in SPS, rather than the importance of specific memories, was highlighted in the depressed group. Valence proved to be an unimportant variable in SPS ability. The cyclical links among autobiographical memory retrieval, SPS skills, and depression are discussed.

Adaptation, Psychological↗
PubMed1982

Sex differences in primary process thinking and flexibility in problem-solving in children.

The relationship between primary process thinking and flexibility in problem-solving was investigated. Specifically, it was hypothesized from psychodynamic theory that primary process integration on the Rorschach (Holt's scoring system) would be positively related to the capacity to shift problem-solving strategies on the Luchins' water-jar test. The Rorschach and water-jar test were individually administered to 47 third grade children. The hypothesis was confirmed for boys in that the Adaptive Regression score on the Rorschach was significantly related to performance on Luchins' water-jar test (r = .64, df = 16, p < .01). This relationship remained significant when IQ was partialed out (r = .59, df = 16, p < .01). There was no relationship between primary process integration and flexibility in problem solving for girls (r = .02, df = 26, NS). These results and sex differences were replicated with a second sample of children. Consistent sex differences also were found in the amount of primary process material expressed. Girls showed a significantly smaller percentage of primary process material than boys. Primary process integration was also related to Iowa test achievement scores, independent of IQ. This finding is consistent with previous studies.

Journal Article↗
PubMed2006

Evaluation of patient education in spinal cord injury rehabilitation: knowledge, problem-solving and perceived importance.

PURPOSE: Through inpatient education programmes the person with spinal cord injury (SCI) learns to understand and monitor his or her own physical, emotional and social well-being. The purpose of this study was to determine the patients' knowledge and problem-solving skills regarding SCI at admission, discharge and follow-up at 6 months after discharge; and to determine the perceived importance of each content topic included in the education programme. METHODS: A one-group repeated measures design was used to evaluate the outcomes. Knowledge was evaluated with a Multiple Choice Questionnaire (MCQ). Problem-solving ability based on participants' responses to Life Situation Scenarios relevant to each topic area was rated on a standardized four-point criterion reference scale. Perceived importance for each topic area was rated on a five-point Likert scale. RESULTS: Twenty-three participants completed all assessments. There was significant improvement in MCQ scores from admission to discharge (P = 0.04) and admission to follow-up (P = 0.02). For problem-solving ability, there was a trend toward improvement in all content topics with significant improvement from admission to follow-up for the topic of bowel care (P = 0.004). However, many participants continued to demonstrate poor problem-solving ability. Bowel, Bladder and Skin Care were consistently perceived as the most important education topics. CONCLUSIONS: Improvements in knowledge do not necessarily translate to improvements in problem-solving ability even for the topics perceived as important. This may indicate the need to incorporate more active learning strategies or contextually based strategies within patient education programmes to facilitate the transfer of knowledge within life situations.

Adolescent↗
PubMed1980

How one family perceives another: the relationship between social constructions and problem-solving competence.

This paper delineates a rarely studied but important family process: how a family perceives and understands the relationships in other families it knows. We hypothesize that these perceptions of other families are fundamental components of a family's shared construing of its social world. Families differ in how they perceive other families, specifically, and in their approach to construing or apprehending their social world, generally. We have hypothesized that these general differences also play a crucial role in shaping the style and competence of family problem-solving. A family's approach to any problem depends upon how it construes or interprets the social context of that problem. Using these general concepts of family life, we construct specific hypotheses linking family problem-solving and interfamily perception. We describe methods for measuring both family problem-solving and how a family perceives other families. Findings confirm our major hypothesis: A family that searches for underlying and subtle patterns in a problem-solving situation will develop a more differentiated and organized conception of other families.

Adolescent↗
PubMed1986

Situational social problem-solving skills and self-esteem of aggressive and nonaggressive boys.

This study was designed to assess specific social problem-solving, perceived competence, and self-esteem characteristics of 20 aggressive and 18 nonaggressive boys. Significant behavioral differences existed between the groups. The problem-solving measure provided for qualitative assessment of specific problem solutions that children consider, varying according to the interpersonal context of conflicts with peers, teachers, and parents and to the level of others' intent in conflicts (ambiguous frustration and hostile provocation). In univariate analyses, aggressive children had poorer self-esteem, generated fewer verbal assertion solutions in peer conflicts and during hostile frustration, and employed more direct action solutions with teachers and during hostile frustration. Discriminant analyses significantly differentiated the two groups. Findings indicated that future research should consider the relative distribution of specific kinds of problem situations that children produce, and that situational factors in social problem-solving skills should be addressed.

Black or African American↗
PubMed1995

A model for medical decision making and problem solving.

Clinicians confront the classical problem of decision making under uncertainty, but a universal procedure by which they deal with this situation, both in diagnosis and therapy, can be defined. This consists in the choice of a specific course of action from available alternatives so as to reduce uncertainty. Formal analysis evidences that the expected value of this process depends on the a priori probabilities confronted, the discriminatory power of the action chosen, and the values and costs associated with possible outcomes. Clinical problem-solving represents the construction of a systematic strategy from multiple decisional building blocks. Depending on the level of uncertainty the physicians attach to their working hypothesis, they can choose among at least four prototype strategies: pattern recognition, the hypothetico-deductive process, arborization, and exhaustion. However, the resolution of real-life problems can involve a combination of these game plans. Formal analysis of each strategy permits definition of its appropriate a priori probabilities, action characteristics, and cost implications.

Artificial Intelligence↗