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PubMed2001

Eliciting children's thinking in families and family therapy.

In this article, I introduce a way of talking between a therapist and children, which aims to be more adaptive to the family therapy context than the modes of communication with children often reported by individual psychotherapists. Although the recent increase in articles concerned with the role of children in family therapy is welcomed, I suggest that the common recommendation of the use of "play" and nonverbal methods of communication with young children can at times introduce its own constraints on a child's thinking. A method of engagement in "dialectical" conversations with children is described, and illustrated with verbatim case examples. It is argued that this offers one route to a discourse commonly used between children, and one that acknowledges their capacity to think.

Adult↗

PubMed2003

Writing as thinking.

In this article I try to sketch preliminary answers to several questions. (1) What is the role of writing in science? (2) How can rhetorical analysis illuminate the nature of scientific writing? (3) What is the role of models and metaphors in scientific thinking and writing? Since this is a preliminary inquiry, my remarks are brief and suggestive, but I think they point to some profitable directions for further study.

Journal Article↗

PubMedDate not supplied

System thinking in a personal context to improve eating behaviors.

People can create positive environments so that their chances of relapse to poor habits are reduced and their likelihood of success is increased. Continuous quality improvement (CQI) suggests that this can be accomplished by making systemwide changes and deemphasizing personal effort. This article provides a 7-step approach to system thinking in a personal context. It offers a case study and other examples that show how to lose weight by making systemic changes in lifestyles. Learning about system thinking in a personal context also may help healthcare professionals understand the application of CQI within organizations.

Attitude to Health↗

PubMed1995

Evaluation of the Think First head and spinal cord injury prevention program.

OBJECTIVE: Evaluation of the impact of the Think First head and spinal cord injury prevention program on knowledge, attitudes, and behavior of 11-15 year old students toward injury risks and preventive strategies. SETTING: Three junior high and three senior high schools in rural and urban areas of Washington state. METHODS: Questionnaire survey before intervention, two weeks and three months after intervention to assess knowledge, attitude, and self reported behavior change. Observations of students as they left school property to determine bicycle helmet and seat belt use. RESULTS: Little impact on attitudes and no consistent change in knowledge or self reported behaviors. Too few students rode bicycles to accurately assess helmet use; no consistent change in seat belt use. CONCLUSION: The Think First program appears to have little impact on changes in knowledge, self reported behavior, or observed behavior. Other strategies to decrease injuries in adolescents may be more successful.

Accident Prevention↗

PubMed2000

Social cognition: thinking categorically about others.

In attempting to make sense of other people, perceivers regularly construct and use categorical representations to simplify and streamline the person perception process. Noting the importance of categorical thinking in everyday life, our emphasis in this chapter is on the cognitive dynamics of categorical social perception. In reviewing current research on this topic, three specific issues are addressed: (a) When are social categories activated by perceivers, (b) what are the typical consequences of category activation, and (c) can perceivers control the influence and expression of categorical thinking? Throughout the chapter, we consider how integrative models of cognitive functioning may inform our understanding of categorical social perception.

Cognition↗

PubMed1999

Morton neuroma: effect of MR imaging findings on diagnostic thinking and therapeutic decisions.

PURPOSE: To determine the effect of magnetic resonance (MR) imaging results on diagnostic thinking and therapeutic decisions by orthopedic surgeons in cases of a possible Morton neuroma. MATERIAL AND METHODS: Orthopedic surgeons completed a questionnaire before and after MR imaging for 54 feet in 49 patients thought to have Morton neuroma. Clinical diagnosis (Morton neuroma, differential diagnosis), location, diagnostic confidence, and therapeutic decisions were noted before and after MR imaging. The influence of the size of the neuroma on therapeutic decisions was analyzed. MR imaging diagnoses were compared with surgical results for 23 revised intermetatarsal spaces. RESULTS: After MR imaging, the clinical diagnosis of Morton neuroma was withdrawn in 15 of 54 (28%) feet. In 14 of 39 maintained diagnoses, the location or number of neuromas was changed after MR imaging. Confidence levels for Morton neuroma increased substantially after MR imaging. In 31 (57%) feet, a change in treatment plan resulted after MR imaging. Diameters of neuromas on MR images were significantly larger (P = .003) in surgically treated feet than in conservatively treated feet. MR imaging diagnoses were correct in all 23 revised intermetatarsal spaces. CONCLUSION: MR imaging has a major effect on diagnostic thinking and therapeutic decisions by orthopedic surgeons when Morton neuroma is suspected, especially because MR imaging helps in localization and size assessment of Morton neuromas.

Adult↗

PubMed2005

Meeting report: NCI think tanks in cancer biology.

Over the past year and a half, the Division of Cancer Biology of NCI has been assessing the state of cancer biology, with the goal of developing a research agenda for the near future that would accelerate progress in cancer research. Our goal was to identify emerging concepts and promising opportunities for investigation across nine scientific areas with unusual promise for rapid progress. A series of meetings called Think Tanks was convened, each involving a panel of 15-25 experts. In all, over 160 leaders in cancer research and related fields discussed the current state of science in their disciplines, projected its trajectory and recommended what NCI could or should do to facilitate progress. In addition to emphasizing the importance of continued support for investigator-initiated research, the Think Tanks permitted identification of a number of overarching themes. Critical among them was the need to support the development of integrative cancer biology and to encourage studies of the tumor microenvironment by establishing an infrastructure for interactive research. There was also consensus about the importance of comparative studies of normal and tumor states, and development of mechanisms for supporting collaborative, interdisciplinary research and training.

Animals↗

PubMed1979

Einstein's creative thinking and the general theory of relativity: a documented report.

A document written by Albert Einstein has recently come to light in which the eminent scientist described the actual sequence of his thoughts leading to the development of the general theory of relativity. The key creative thought was an instance of a type of creative cognition the author has previously designated "Janusian thinking," Janusian thinking consists of actively conceiving two or more opposite or antithetical concepts, ideas, or images simultaneously. This form of high-level secondary process cognition has been found to operate widely in art, science, and other fields.

Creativity↗

PubMed1983

Systems thinking in psychiatry: some theoretical and clinical implications.

The author discusses the theoretical and pragmatic value of systems thinking in psychiatry. An awareness of the pluralistic, multifactorial origins of psychopathology broadens the psychiatrist's understanding and increases his or her therapeutic potential. The psychiatrist who thinks in systems terms is a true generalist in medicine, and to practice that way is the most effective way of treating people.

Child Development↗

PubMedDate not supplied

Availability, wishful thinking, and physicians' diagnostic judgments for patients with suspected bacteremia.

A prospective cohort study was done to assess the effects of value bias and the inappropriate use of the availability heuristic on physicians' judgments of the probability of bacteremia. Subjects of the study were 227 medical inpatients in a university hospital who had blood cultures done. Estimates of the probabilities that individual patients would have positive blood cultures were collected from the house officers who ordered the cultures. Clinical data and culture results were also obtained. Based on the data the authors calculated "value variables," reflecting doctors' assessments of the risks that individual patients would die in the hospital if they were to have bacteremia. "Recalled experience variables" reflected the doctors' recollections of recent experiences with patients with bacteremia. The physicians significantly overestimated the likelihood of bacteremia for most of their patients. Their ROC curve for this diagnosis showed moderate discriminating ability (area = 0.687, SE = 0.073). Two recalled experience variables were significantly associated with the physicians' probability estimates. The value variables were significantly inversely associated with them. These relationships were independent of several clinical variables and measures of disease severity. The physicians' intuitive diagnostic judgments were thus influenced by the availability heuristic and by wishful thinking, a form of the value bias. The availability heuristic may mislead physicians by causing them to believe that random variations in the prevalence of a nonepidemic disease represent real trends. Wishful thinking may lead physicians to underestimate the likelihood of a disease for patients most at risk for its consequences. Teaching physicians to develop better judgmental strategies may improve the quality of their judgments and hence their patient care.

Anti-Bacterial Agents↗

PubMed2002

Who should receive subsidized psychotherapy?: Analysis of decision makers' think-aloud protocols.

Three groups of judges representing clinical, political, and laypersons' perspectives were given the task of prioritizing patients for subsidized psychotherapy within the Swedish health care system. The authors documented the judges' decision-making processes in think-aloud protocols and analyzed them qualitatively, focusing on the conflict between the urgency of a case and its suitability for treatment. In an earlier statistical analysis of the same material, clinicians had seemed to pay more attention to suitability criteria, whereas health care officials and laypersons prioritized based on urgency. The qualitative findings confirmed the centrality of this conflict and contributed to a deeper understanding of decision makers' ways of coping with it. Their conceptions of suitability and urgency were also elucidated by analysis of the think-aloud protocols.

Acute Disease↗

PubMed2005

Incremental validity of the psychological inventory of criminal thinking styles as a predictor of continuous and dichotomous measures of recidivism.

Postrelease recidivism data were collected on 137 male inmates released 1 to 72 months after completing the Psychological Inventory of Criminal Thinking Styles (PICTS) in follow-ups lasting 6 to 55 months. When a dichotomous measure of recidivism (0, 1+ arrests) was employed, Entitlement (En) was the only PICTS thinking-style scale to achieve significance after age, prior arrests, time at risk in the community, and the PICTS Superoptimism (So) scale were controlled in a binary logistic regression analysis. Both the Cutoff (Co) and En scales proved significant in predicting a continuous measure of recidivism (range = 0 to 6) after age, prior arrests, time at risk, and the So scale were controlled in a sequential linear regression analysis. Whereas the En scale displayed mixed incremental validity results relative to the Co scale, the Co scale failed to achieve incremental validity relative to the En scale.

Adult↗

PubMed2004

Views of health in the lay sector: a compilation and review of how individuals think about health.

The way lay people think about health and wellness influences their health and wellness-related behaviors. This article integrates and synthesizes the research conducted to understand lay health worldviews. We identify 18 themes that capture the findings about lay health worldviews. The themes fall into four categories: definitions of health, explanations for health, external and/or uncontrollable factors impinging on health, and the place health occupies in people's lives. The results lead to the observation that lay health worldviews--or health styles--are not understood in depth, particularly in US populations. Variation across the themes underscores the need for further descriptive research designed to understand consumers' ways of thinking about health and how the many changes in the professional and folk sectors affect lay worldviews. This has implications with respect to understanding consumers' health care behaviors and developing more effective communication strategies.

Attitude to Health↗

PubMed2003

A self-referent thinking model: how older adults may talk themselves out of being physically active.

The purpose of this qualitative study was to ground current theory on exercise behavior with authentic voices of older adults as they thought about physical activity. Aged 55 to 92, 41 adults of various activity levels provided interviews with regard to personal experiences, health issues, and motivation for active lifestyles. Key constructs from four contemporary health behaviour theories were integrated into a decisional balance template. Interpretive analysis organized positive and negative thinking on the template and thereby animated important theoretical constructs with the actual voices of older adults. Although generally supporting current theoretical models, the surprising finding was that active people expressed as much negative self-talk as did inactive people. However, they differed in their ability to balance each issue with strong positive thinking based on previous personal succesess and direct experience of benefits. This finding suggests that promoting health through lifestyle change is very difficult to do without positive past-mastery experiences.

Aged↗

PubMed2005

"Thinking Like a Marketer": training for a shift in the mindset of the public health workforce.

The marketing mindset focuses a practitioner on systematically thinking through key issues before undertaking a health promotion campaign. The Thinking Like a Marketer training, developed by the National Training Collaborative for Social Marketing is a challenging method for health educators and promoters to apply their skills in innovative ways. Focus groups were conducted with former trainees to assess the impact of the training. Additional data were collected from members of the Association of State and Territorial Promotion Directors of Health Promotion and Public Health Education organization through a 10-item elicitation survey. Findings suggest that although participants gained greater sensitivity and appreciation for the social marketing research process, the major barrier to application in the workplace surrounded upper management. On-site technical assistance, mentoring, and follow-up were important training needs identified through the survey and focus groups.

Education, Public Health Professional↗

PubMed1981

Rorschach movement and color responses and MMPI social extraversion and thinking introversion personality types.

Results of an analysis of MMPI profiles and Rorschach protocols scored by the Exner method for 100 psychiatric patients provided partial support for Rorschach's hypotheses that perceptions of color (FC, CF, and C) and movement (M) tap separate personality dimensions. First, the proportion of M responses on a protocol correlated significantly (p < .01) to thinking introversion as defined in terms of a subject's MMPI profile similarity to a prototypic MMPI profile with peak PtSc elevations. Second, the proportion of FC responses correlated negatively (p < .01) to social extraversion defined in terms of MMPI profile similarity to a prototypic MMPI profile with peak PdMa elevations. Hence, use of FC signified a socially reserved, controlled behavior. The findings regarding CF and C were inconclusive. Third, color and movement responses did not correlate significantly with somatization defined in terms of similarity to a prototypic MMPI profile with peak Hs, D, Hy elevations. Finally, the nonsignificant correlations of FC with M and with MMPI thinking introversion plus the nonsignificant correlation of M with color responses and MMPI social extroversion further supported the hypotheses that movement and color responses tap essentially unique personality dimensions.

Journal Article↗

PubMed1996

Ways of thinking about the long-term care of the baby-boom cohorts.

In examining various ways of thinking about the development of long-term care policy for the baby-boom cohorts, this article discusses the importance of basing long-term care policy discussions on a recognition of social and economic trends, as well as on the informal exchanges of care that occur over life and the diversity within the baby-boom cohorts. The implications of two ways of thinking about challenges posed by the aging of baby boomers--the generational equity/crisis perspective and the generational investment/gradual adjustment perspective are also discussed. It is suggested that the generational equity perspective is consonant with proposals to expand private savings for long-term care contingencies and private long-term insurance and, secondarily, with proposals to expand means-testing for benefits. The second perspective is more consistent with proposals to create new universal services through a traditional social insurance approach, or through a block grant such as the one discussed in the context of the Clinton health care reform plan.

Aged↗

PubMed2005

Poor knowledge and faulty thinking regarding hemolysis and potassium elevation.

A questionnaire to assess knowledge of the expected elevation in serum K measurement with different grades of hemolysis was administered to medical technologists working in biochemistry laboratories, hospital physicians and nurses. The questions involved different grades of hemolysis (mild, 1.0, moderate, 2.5 and severe, 5.0 g/L) and different final K measurements (2.9, 4.0, 5.2 and 8.2 mmol/L). Subjects estimated the K concentration in a non-hemolyzed sample for each scenario. Adjustment values (difference between final hemolyzed K concentration and subject's response) were calculated. For the 132 respondees, the mean correct score was 1.7/12. Mean adjustment values were: mild, 0.43 mmol/L (K 2.9), 0.55 (4.0), 0.88 (5.2) and 1.53 (8.2); moderate, 0.85 (2.9), 0.92 (4.0), 1.33 (5.2) and 2.50 (8.2); and severe, 0.93 (2.9), 1.48 (4.0), 1.96 (5.2), 2.96 (8.2). Correct adjustments were: mild, 0.28; moderate, 0.70; and severe, 1.40 mmol/L. Healthcare staff overestimated the effect of hemolysis on potassium measurement and used an incorrect proportional adjustment approach to the problem. Such poor knowledge and faulty thinking could lead to diagnostic delays or misdiagnoses. There is potential for such faulty thinking in all areas of laboratory medicine, and laboratories should review their educational responsibilities and reporting practices in light of this.

Blood Chemical Analysis↗