PL3242: Health Psychology - Critique Paper

Critique of Position Paper D on Cancer

Critique by Tan Jia Xin Jacinth, Group 1

Question addressed:

The question addressed was “What would be the key features of a program for helping Singapore cancer patients deal with their diagnosis?”

Critique of paper:

The current paper examined has primarily explored a number of factors that affect how cancer patients cope with their disease, upon which the key features suggested for the cancer program was based. Factors that influence patients’ adjustment to cancer such as age, pre-surgical adjustment, having a choice of treatment and availability of social support were raised.

Apart from identifying these factors, a major strength of the paper would be that due consideration was given to the fact that individual differences among cancer patients exist and appropriate attempts were made by the author at developing a flexible program that could cater to different types of patients. Age and personality variation within patients were looked into in particular which brought about feasible coping methods such as distraction strategies for younger patients during treatment and having experts such as health psychologists to guide patients through their unique cancer experiences. Promoting active coping among cancer patients was also accurately highlighted as an essential element in the program, since substantial research findings has largely supported such coping as self efficacious which predicts better adaptation to the illness (Arraras et al, 2002).

The author has also demonstrated the understanding that cancer diagnosis has extended impact on the family members of patients as well, which can in turn affect the patients directly when they seek social support. Hence, a suggestion was made at extending the cancer coping program to the family members, which seems valid. On the whole, the paper illustrated an important and salient theme that psychosocial interventions, on top of physiological treatment, are indispensable in coping with cancer.

Nevertheless, while a multitude of ideas were presented as possible features that could be included in the cancer coping program, there were a number of points raised, which seem to be problematic and inadequate in addressing how exactly those methods aid in coping. Certain coping strategies that were recommended also appeared to be limited in bringing about the desired effect in the cancer patients.

Firstly, the author made a claim that a child with cancer will “definitely need more counseling and social support as compared to an older person since it is unexpected and evokes a sense of being robbed of life at an early stage.” While I would concur that the perception of a child and an adult regarding their cancer diagnosis would differ, it does not necessarily follow that a child would need more help and support than an adult. In comparing a child who is highly optimistic and adaptive to his condition to an adult with strong feelings of helplessness to his illness, it is more likely for the adult to require more support and guidance in coping since his lack of self efficacy is associated with poorer adjustment to cancer (Arraras et al, 2002).

In this sense, the issue at hand where age differences are concerned should be the nature of approach, rather than the quantity of help to be provided. For instance, a meta-analysis conducted by Aldridge & Roesch (2006) indicated that the use of avoidant and emotion focused coping strategy instead of problem focused ones were actually associated with better adjustment for children to their illness, which is contrary to the typical strategy that adults are recommended to use. This provides a case against varying the amount of help given as a means of dealing with age differences in cancer coping.

Secondly, the author highlighted the stage at which cancer is detected as an important feature that should be addressed in the program. Although it was rightly pointed out that different stages of detection would affect the perception and appraisal of their prognosis, the author appeared to be making use of this relationship as a justification for promoting early cancer detection per se, as opposed to how it aids coping with the illness. However, in my opinion, having knowledge of the stage of cancer should be applied to directing doctors, patients and caregivers to the appropriate measures associated with differences in needs arising from early or late detection, rather than to underscore risk communication. Therefore, the suggestion of establishing screening centers and having campaigns to bring about the public’s risk awareness to cancer seems irrelevant to the cancer coping program.

It was also mentioned in the paper that having informational support about the illness is crucial to helping cancer patients develop active coping with their condition. As such, the author indicated that patients should “actively ask many questions” to gain a better understanding of their illness which would guide subsequent decisions that they would have to make regarding treatment issues. Nevertheless, the author seemed to have made the implicit assumption that all patients are in that proper state of mind and have the capacity to “actively ask many questions”, which is ironic to the agreement that patients vary in how they perceive their illness according to their personality. It would be unlikely for a patient with Type C personality to want to know more about their condition and do something about it. Hence, the cancer coping program should include having health professionals to guide patients towards seeking informational support and highlight to them its importance instead of simply pointing out that they should actively seeking information.

The author proposed an interesting method known as the modeling technique which involves upward comparisons where patients learn from other cancer patients who are coping better than them, or downward comparison where patients come to know about patients who do not cope as well as them which could aid in building their self esteem. While developing self esteem could help patients become more self-efficacious in dealing with their condition, the sustainability of such self esteem by means of downward comparison is questionable. Upward comparison appears more sustainable in that when patients are inspired by those who are coping well with their illness, they could be motivated to learn from them and model their strategy. On the other hand, the self esteem built from downward comparison stems from the fact that others are worse off than them but does not equip them with any coping methods that they could employ on themselves. As such, although downward comparison may seem plausible, its effects may not be as sustainable as that of upward comparison.

Lastly, there was an emphasis on provision of social support in the program for coping with cancer as seen from the wealth of methods that were suggested, relating to increasing social support. They include the media and community support groups to promote their availability in providing social support to the cancer patients, as well as interacting with other cancer patients and family members. Indeed, social support has been found to predict longer survival and better adjustment to cancer (Maunsell et al, 1995; cited in Henderson & Baum, 2002). However, not all studies have demonstrated this similar relationship. Some studies have revealed that disease type and severity of the illness as possible moderators that may affect the relationship between social support and cancer adjustment (Henderson & Baum, 2002). For instance, for people diagnosed with a terminal stage of cancer, social support may not result in better adjustment for it may seem pointless to adjust well when they know they are going to die.

In addition, the effectiveness of social support also depends on the personality of the individual. People with high on traits of anger, cynicism and hostility could be more irritable, sensitive and as a result, often misinterpret the concern of family members as something negative. Therefore, while social support appears to be a good buffer of stress for cancer patients, the effectiveness is not always expressed.

In sum, the author has recognized and highlighted the importance of psychosocial interventions on top of the usual physiological treatments, instead of regarding them as dichotomous, in developing a program to help cancer patients cope with their conditions. Furthermore, numerous factors that influence cancer adjustment and appropriate coping strategies were proposed in an attempt to tailor to a flexible program that takes into account individual differences and needs. Nonetheless, the author should look into some of the suggestions made which were not clearly explained in terms of how it aids coping, as well as have in mind the limitations of some of the apparently effective features that can be included in the program.


References

Aldridge, A.A & Roesch, Scott C. (2006). Coping and adjustment in children with cancer: a meta-analytic study. Journal of Behavioural Medicine. 30(2): 115-129

Arraras, J.I., Wright, S.J., Jusue, G., Tejedor, M. & Calvo, J.I. (2002). Coping style, locus of control, psychological distress and pain-related behaviours in cancer and other diseases. Psychology, Health & Medicine. 7(2): 181-187

Henderson, B.N. & Baum A. (2002). Neoplasms. Handbook of clinical health psychology: Volume 1. Medical disorders and behavioral applications. (pp. 37-64).

PL3242: Health Psychology - Position Paper

Position Paper on Implications of Reseach on Illness Cognition for Dealing with Emerging Infectious Diseases

Tan Jia Xin Jacinth, Group 1

Question Addressed:

This position paper seeks to address the question: What are the implications of research on illness cognition for dealing with emerging infectious diseases such as SARS or bird flu?

Discussion Summary:

The group discussion comprised types of illness representation revealed through research, their effects on people’s understanding of SARS and bird flu, and applying this knowledge to developing possible coping responses to these infectious diseases.

In examining the various illness representations, there was general agreement that disease prototypes held by people were largely influential on how they react at respond to the disease. A particularly common disease prototype of SARS was presented by a member which stated fever as the initial characteristic symptom, close contact with SARS-infected people as the usual means of contagion, and death as a likely consequence, to name a few. Such a schema was the basis for how people react and respond to the disease.

For instance, one member pointed out that perception and interpretation of common symptoms such as fever differed on occasion. Since fever was a characteristic symptom for SARS, there was inevitably major concern towards fever. As such, people might pay greater attention to body temperature, which could be translated into perceived feelings of body warmth and duly interpreted as fever, a sign of SARS infection. This would lead to feelings of panic and immediate medical help would be sought.

With death frequently reported as a consequence, one member noted that it is no wonder that SARS was considered a disease of fear. Another member gave further elaboration by highlighting a research study which showed that psychological distress and anxiety can influence the way people make sense of their symptoms. Under such states, people are likely to misinterpret any symptoms, typically in the worst sense, which could result in wastage if time and resources were to be misdirected to them.

In view of these problems, a number of coping responses were suggested by members in dealing with infectious diseases. Members unanimously proposed the indispensable role that the media and government should play. Since knowledge of illness influences one's interpretation, detection and control of disease, the media and health authorities handling any disease crisis like SARS or bird flu must send out clear messages to the masses and provide accurate information and knowledge on the exact symptoms and the best course of action to be taken. It was also suggested that by educating the public on the exact nature of SARS or bird flu and how to react calmly towards possible symptoms, time and health care resources can then be appropriately focused on those who are really in need of them.

On the government’s part, most members pointed out the importance of government transparency in reporting the number of cases of infection during the crisis. One member quoted the example of China’s cover-up of number cases reported in both the SARS and bird flu pandemic which led to many undetected cases and its citizens unaware of the precise seriousness of the pandemic. Such ignorance can result in complacency of the public in taking social responsibility to contain the disease.

Other coping responses suggested include having medical personnel to take safety precautions, so as to prevent discrimination and misunderstanding of the health status of doctors and nurses, as well as developing measures directed towards breaking the chain of transmission of SARS and bird flu such as having quarantine, since they are largely transmitted via human contact.

Illness Cognition: Dealing with Emerging Infectious Diseases

The understanding of illness is often developed through cognitive schemas that people use to organize information about illness. More specifically referred to as disease prototypes, such representations of illness are known to “provide the basis for the person’s active attempts to understand and appropriately respond to potential health threats” (Bishop, 1991b).

Despite being a standard representation of illness, prototypes of the same disease can vary according to the kind of information obtained by individuals and interpretations of these prototypes can be subjective. Such varying understanding of disease would subsequently affect how people cope with them.

This issue is especially pertinent to emerging infectious diseases such as SARS and bird flu, which vast research and literature has been dedicated to both since their appearance in mainly Asian countries. In this paper, the types of perception and interpretation of infectious diseases, namely SARS and bird flu, revealed from research thus far will be addressed. The reasons and effects of holding such illness representations on people will be examined and following which, the major implications of these effects on coping responses to SARS and bird flu will be discussed.

Looking at SARS, a particularly common disease prototype indicated fever as the initial characteristic symptom, close contact with SARS-infected people as the typical means of contagion, and death as a likely consequence (Washer, 2004). These components apparently had an effect on how people reacted and responded to their own symptoms and the disease.

With fever, a common symptom, noted as a characteristic symptom for SARS, there was an inevitable major concern towards having it. As such, people might pay greater attention to body temperature, which could be translated into perceived feelings of body warmth and duly interpreted as fever, a sign of SARS infection. This would lead to feelings of panic, which perhaps would raise body temperature again since they are aroused. Not discounting the fact that some fever cases may be true symptoms of SARS, a good number of cases could be a result of such over reaction towards the disease.

Since death as a consequence is featured in disease prototypes due to frequent reports of death toll in affected areas, SARS evolved partially into a “disease of fear” and was thought to be “a ‘mystery’ disease, with the aura of being able to strike anyone, anywhere, anytime” (Smith, 2006). This would contribute to psychological distress and anxiety and which research has shown can influence the way people make sense of their symptoms (Cheng, Chong, Chang & Wong, 2006). Under such states, people are likely to misinterpret any symptoms, typically in the worst sense, which could result in wastage if time and resources were to be misdirected to them.

Learning that one of the major means of transmission of SARS as direct contact with those infected can result in over-cautious behaviour such as staying home as much as possible to prevent contact with anyone, as well as discrimination towards SARS patients, survivors and those at risk of SARS, particularly the health care professionals. While over-cautious behaviour is not all that bad apart from how the person’s daily life activities could be affected, discrimination has been shown to cause significant psychological distress for patients and survivors (Lee, Chan, Chau, Kwok & Kleinman, 2005), which in turn affects their “perceived impact” and “coping efficacy” on their stressful experience with SARS (Cheng, Chong, Chang & Wong, 2006).

Similarly, research has illustrated that individual’s understanding of bird flu affects their reactions and responses to the disease. However, as much as research has found that “age, avian influenza contagion worries, husbandry threat, avian influenza threat, and avian influenza anxiety predicted perceived sickness risk” (Fielding, Lam, Ho, Hedley & Leung, 2005), people’s actual perceived sickness risk towards bird flu is still very limited (Zwart, Velhuijzen, Elam, Aro, Abraham, Bishop, Richardus & Brug, 2007).

Research by Fielding et al. in 2005 offered three reasons for the general population’s high-risk behaviour which was a result of their low perceived risks of contracting bird flu. Firstly, some people are doubtful about certain dangers that were told to them and are thus, unlikely to change their behaviour. Secondly, some feel the helplessness in dealing with the disease and lastly, some of them have had frequent exposure to hazards and the fact that they survived meant unnecessary focus on risk. Such cognitions they have of the risk of contracting bird flu consequently led them to respond to the disease with little caution and complacency.

The low level of risk perception among people in bird flu infected areas has also been attributed to their “proximity to the current outbreak and the experience with the SARS epidemic”. Slightly different from the earlier reasons given, these experiences have created the belief that infectious diseases can be controlled and such optimism accounts for their reduced risk perception (Zwart et al., 2007).

So far, in examining the different cognitions people have of SARS and bird flu and how it affects their reactions and responses to these diseases, it seems that while their understanding of the disease have largely impacted their behaviour, these behaviour seem to be antagonistic to each other. Cognitions of SARS typically result in an over reactive and anxious response whereas cognitions of bird flu result in indifference and complacency towards their risk perception. Nevertheless, the understanding of these differences has important implications on developing appropriate coping responses to these infectious diseases.

Since information that people obtain about diseases would determine the prototypes they form of them, sources of information, particularly the media, must be able to send clear and accurate messages regarding the disease and the situation. This seems to be exceptionally challenging because many problems discussed earlier on were mainly the doings of the media.

SARS as a disease of fear was developed due to the media “manufacturing threats to public health by drawing upon past and present cultural myths of dangerous ‘others’, and in so doing contribute to unwarranted public fear, intolerance, and distrust” (Smith, 2006). A survey conducted regarding the quality of Canadian media in communicating information about SARS revealed that conflicting messages were often conveyed which brought about confusion to the public and their coverage was considered “excessive, sometimes inaccurate, and sensationalist” (Smith, 2006). Discrimination towards SARS infected patients and survivors were also attributed to “miscommunication by the media in rapidly amplifying stigma toward an unfamiliar illness” (Lee et al., 2005). Thus, before the media can be utilized as an accurate means of disseminating disease related information, it has to undo the harm it has caused initially.

Perhaps in face of any disease crisis in future, the media should gear towards working closely with the health organizations to understand the precise nature of the disease so as to ensure that the information they communicate to the public ultimately is credible. The media should also refrain from loading reports of the disease with any values and judgments and simply present the health warnings and information as they are. This would prevent any form of sensationalized news that could evoke unnecessary anxiety or emotions in the people.

The government is another important source of information who can obtain a large wealth of information given its authority and connections. However, as in the case of the media, governments have been found to withhold certain information from the public, such as the precise number of cases of the disease and the resulting death toll, which renders them unreliable. The classic examples would be the China government’s cover-up of disease cases and death toll in both the SARS and bird flu crisis.

Such cover-ups can have a profound negative impact on people’s understanding of the diseases as well as their associated response. In both cases of SARS and bird flu, the inaccurate report of case numbers would mask the seriousness of the spread of disease in that country, which would also affect the level of caution its people would exercise. The undermining of the situation of the crisis is even more dangerous for bird flu, in which research has shown that the level of perceived risks among people of affected areas is already low. Withholding the true case numbers would encourage these people to persist in their complacency and continue to engage in behaviours that would put them at greater risk of contracting the disease. Thus, it is extremely crucial that government must, at all costs, be transparent in releasing information to the public regarding the any crisis situation.

The government should also play an active role in educating the public regarding the contagiousness of the disease and as far as possible, address possible stigmas that could be attached to patients and survivors. They could also regulate the media in the type of information they present, especially in disallowing any direct or indirect perpetuation of disease related stigmas to be published. Most importantly, “clarity of responsibility, authority and accountability during outbreaks, from local to the global levels, is imperative for effective action” (Smith, 2006) and so it is the duty of the government to ensure this.

With the knowledge of people’s tremendous concern, fear and anxiety towards SARS, health authorities or any related organizations and departments should assume the responsibility of dealing with these problems. They could devise a management guide which addresses the concerns people might have and suggest ways of dealing with them. An excellent example of how this could be done would be the guide for management of SARS in the psychological aspect formulated by the Social Welfare Department in Hong Kong.

In this guide, the public’s concern and anxiety towards SARS were highlighted and acknowledged as natural and understandable. In helping them deal with such feelings, ways of coping responses were suggested, such as practicing relaxation and managing anxiety by limiting their exposure to news reports of SARS (Social Welfare Department, 2004). This method of helping the public cope with the crisis appears to be very useful and effective since their concerns are addressed directly and not dismissed, and as the welfare department demonstrates their understanding of the people’s possible thoughts and suggest ways to cope with them, these people can be calmed down and assured that they can be in control of the situation.

Lastly, as discussed earlier, people seem to be more apathetic towards the spread of bird flu because they are often unconvinced of certain indicated risks, have no perceived sense of control over the disease and have survived supposed risks which made them feel invulnerable. Therefore, it seems only appropriate that efforts in dealing with the disease should be directed at emphasizing risk communication, to greater impress upon them the importance of high risk perception, as well as developing ways to increase their sense of self-efficacy in dealing with the disease (Zwart et al., 2007).

For example, risk communication can be emphasized through heavy advertising by the media to bring up the various high-risk behaviours, such as buying live chickens, and underscore the consequences associated with such behaviour. Since these people appear to be more apathetic, fear appeals could possibly be used to induce some level of concern and anxiety in them. As for increasing their sense of self-efficacy with regard to the disease, a guide for coping responses similar to the one by the Hong Kong Social Welfare Department could be developed, for the same purpose of assuring people that they can be in control of the crisis and disease.

To recapitulate, understanding illness by means of disease prototypes can lead to subjective perception and interpretations of the disease, which then influences our reactions and response towards it. As such, once we are able to comprehend how and why people respond to diseases in a certain way, it can then form the basis on which problems associated with the instigator of their reactions and response can be identified and appropriate coping methods can be developed to help them better deal with any emerging infectious disease.

References

Bishop, G.D. (1994). Health Psychology: Integrating Mind and Body. Boston: Allyn bacon

Cheng, Sammy K.W., Chong, George H.C., Chang, Sonia S.Y., Wong, Chee Wing, Wong, Connie S.Y., Wong, Mike T.P. & Wong, Kit Ching. (2006). Adjustment to severe acute respiratory syndrome (SARS): Roles of appraisal and post-traumatic growth. Psychology and Health, 21, 301-317

Fielding, Richard, Lam, Wendy W.T., Ho, Ella Y.Y., Lam, Tai Hing, Hedley, Anthony J. & Leung, Gabriel M. (2005). Avian Influenza Risk Perception, Hong Kong. Emerging Infectious Diseases, 11, 667-682

Lee, Sing, Chan, Lydia Y.Y, Chau, Annie M.Y., Kwok, Kathleen P.S. & Kleinman Arther. (2005). The experience of SARS-related stigma at Amoy Gardens. Social Science & Medicine, 61, 2038-2046

Smith, Richard D. (2006). Responding to global infectious diseas outbreaks: Lessons from SARS on the role of risk perception, communication and management. Social Science & Medicine, 63, 3113-3123

Social Welfare Department (2005). Management of the Severe Acute Respiratory Syndrome (SARS)– Psychological Aspects. Hong Kong: Social Welfare Department. Retrieved on 22 February 2007 from http://www.swd.gov.hk/.

Washer, Peter. (2004). Representations of SARS in the British Newspapers. Social Science & Medicine, 59, 2561-2571

Zwart, Onno de, Veldhuijzen, Irene K., Elam, Gillian, Aro, Arja R., Abraham, Thomas, Bishop, George D., Richardus, Jan Hendrik & Brug, Johannes. (2007). Avian Influenza Risk Perception, Europe and Asia. Emerging Infectious Diseases, 13, 290-293

PL3234: Developmental Psychology - Term Paper

Review the kinds of play and their likely functions? To what extent is there evidence to support a claim that any of these forms of play actually benefit development?

The significance of play in development did not emerge until the late 20th century, largely due to the earlier collective view that play is “an activity peripheral to the mainstream of development” (Athey, 1984). Nevertheless, increased literature and research dedicated to play have suggested that this activity, in fact, serves important functions in aspects of cognition, language and social interaction, rendering it central to development from infancy onwards.

The purpose of this paper is to firstly, introduce the different types of play that developmental psychologists have classified and researched on, as well as examine their likely functions in developing cognitive, social and language skills. Following which, the extent to which these forms of play actually contribute to such development will be discussed. In this regard, a major point of contention would be that while play as a conceptual framework seem to suggest benefits to development, it does not adequately predict the outcome of development in general. Also, benefits to development can be observed in a particular context but not in another.

With the recognition of play having functional importance, developmental psychologists have classified the myriad of play activities in a cumulative order of play types. The first of which is functional play, where infants engage in “simple, repetitive motor movements with or without objects” (Rubin, Fein & Vandenberg, 1983; cited in Berk, 2006). Movements as such include running around a room, lifting a toy plane and moving it about in the air or tearing up of paper into pieces, to name a few. These repetition and sequence of movements allows for development and coordination of gross and fine muscles which aids in physical growth of the child. In addition, they learn about the spatial relations and properties of the objects which they are handling and acquire suitable physical responses to change and control these properties. Consequently, the child’s self-concept also begins to surface “as a physical object in space and time” (Athey, 1984).

Functional play is not isolated to infancy and early childhood period. In fact, it is associated with middle childhood and adolescence as well, when they begin to engage in more complex physical demands such as learning an instrument or playing sports where specialised physical coordination and skills have to be trained (Athey, 1984).

As motor coordination and skills are developed, children are then equipped with the ability to tackle constructive play, where they begin to construct things out of toys, paint or puzzles. In his paper, Singer (1994) discussed the special properties and functions of toys in providing various constructive plays which can expand children’s imagination and creativity to different degrees. He quoted a study by Pulaski, which revealed that minimally structured toys, such as drawing paper, paints and Play Doh, brought about richer fantasy and ideas than highly structured toys such as Barbie dolls or a dollhouse (Pulaski, 1973; cited in Singer, 1994). Such a finding implies that constructive play can actually cultivate and encourage imagination and creativity which are part of the cognitive development of individuals.

It seems that constructive play also contributes to the development language abilities in children. In a preschool setting where children play with toys together, the toys will elicit the use of language to communicate and maintain play with each other (Pellegrini & Jones, 1994). Even in the absence of playmates, children playing with toys under the guidance of a parent or caretaker will need to appeal to language in order to communicate any difficulties they have with the toys. Language is also used and hence developed to “serve an imaginative function” (Halliday, 1969; cited in Pellegrini & Jones, 1994) as children attempt to express and vocalize their ideas.

Along with the period where constructive play among children is possible, make-believe play is also prominent and important to development. In this activity, children engage in a kind of cooperative play with each other where they construct their own social world by acting out everyday and imaginary roles (Rubin, Fein & Vandenberg, 1983; cited in Berk, 2006), experiment with possible interactions and relationships among people and develop and learn various ways of dealing with social situations. In a sense, this is considered a form of social learning where children actively “develop concepts of different social roles and associate relevant behaviours with these roles” (Athey, 1984), allowing them to respond appropriately in the possible social interactions they may be faced with in real life. These behaviours include socially desirable ones such as cooperation and sharing.

Not only does make-believe play teach and enhance social development, once again, it promotes language use and hence development. Clearly, make-believe play requires communication among the characters that are being acted out and as such, it provides a good avenue for the children to enlarge their vocabulary, learn “a varied repertoire of linguistic strategies” (Halliday, 1969; cited in Pellegrini & Jones, 1994) as well as practice them. With improved language skills, children are also better able to express their own thoughts and emotions.

The last type of play is games with rules which involve the children’s understanding and adherence to the rules set in the games (Rubin, Fein & Vandenberg, 1983; cited in Berk, 2006). Instances of such games are board games, card games and hopscotch.

Given the nature of games with rules, understanding the game naturally becomes a function of language and comprehension skills while adherence to the rules of the game depends largely on the cooperativeness of the child, which is a social dimension which has to be developed beforehand. As Garvey (1977) pointed out, these emerging skills “rest on the reciprocal interaction of the child’s experiences with his physical, cognitive and emotional growth.” Therefore, it appears logical for games with rules to be undertaken only after the three plays that have been discussed so far because the skills involved in games stems from them. It would also follow that this type of play serves the function of applying and developing further the cognitive, language and social skills acquired earlier on by the child.

On the whole, discussion of the various kinds of play so far is largely supportive of the claim that these forms of play actually benefit development, since they appear to improve cognitive, language and social skills. However, while it works and fits well as a conceptual framework in enhancing development, its effectiveness may fail to be illustrated when it is extracted and placed in a different context.

Firstly, on the assumption of play being beneficial to development, there had been an increase in what Sutton-Smith referred to as the “domestication of childhood”. It refers to the “increasing control and supervision of play to get rid of its physical dangers and its emotional licenses” (Sutton-Smith, 1994). As play is being regulated and controlled by having schools’ playground being supervised or the abolition of playtime in the case of the United States, the range of play activities that children can participate in is reduced. This seem to suggest that only limited play activities are ultimately beneficial to development, rendering the general framework of play inadequate in predicting the final outcome of development.

In today’s society, there has been an increase in what Sutton-Smith called “the domestication of play” where children are no longer asked to go outside to play. Rather, parents attempt to make home the main area for play due to their fear of the unsafe streets as well as potential undesirable company that their children might run into (Sutton-Smith, 1994). In addition, with the development of computers in this recent century, more children are turning to computer or video games as a play activity. While computer games have rules which characterises them as one of the play activities that theoretically should benefit development, there is a “side-effect” of addiction to computers as children become overly interested and engrossed in the computer games. Consequently, addiction to computer games can lead to decreased focus on school work as well as social interaction with family and peers, this seems to demonstrate that play can actually hamper intellectual and social development.

In examining constructive play, where toys are a useful means of creation by children, it has become increasingly common practice in today’s context of growing numbers of dual-income families to use toys as simply a gift to replace the parental bonding that should come along with play. As a result, instead of developing the cognitive skill of expanded creativity, the children are actually left in solitude with their own toys (Sutton-Smith, 1994), which in turn creates a negative impact on the child’s social and emotional development from the lack of parental bonding.

As much as language seems to be a skill that can be well honed with play, it is assumed that the parent or caregiver who is teaching and guiding the play activity is competent in the language. However, this ideal case may not always hold. For instance, in Singapore where there are a substantial number of parents or caretakers who do not speak Standard English, it is likely that they will impart their non-standard English to the children they are playing and communicating with. As such, children will learn what they are exposed to, which fails to develop their language skills in any way.

When differences in cultural context are taken into consideration, play is not necessarily believed to be beneficial to development. A good example would be the Mayan parents, who generally do not promote play activities, but nevertheless, are able to bring up their children to be socially competent. This is particularly so because within the Mayan society, the children are required to undertake adult activities from young when they start to work. In this sense, there seem to be less distinct differences between the child and adult world within the Mayan society, as compared to the western societies for example (Berk, 2006). Thus, the Mayan children can still be socially adept even without the experience of pretend or make-believe play.

Additionally, there has been research and suggestion of play as a form of adjustment rather than preparation. In other words, as opposed to contributing to development, play is simply a behaviour that has been naturally selected to counter stress, for the lack of play does associate with mental illness, depression or social maladjustment (Sutton-Smith, 1994). This seems to point in the direction that the function of play was probably not geared towards benefiting development, although it is indirectly doing so.

In sum, from the available literature that has been gathered so far, the examination of various types of children’s play have been shown to support play as beneficial to development. Nonetheless, it is still limited as a general framework in predicting all development outcomes due to the continuous change in culture and values of society, as well as the existence of cultural variation among societies in viewing the usefulness of play.

References

Athey, I. (1984). Contributions of play to development. In Yawkey, T.D. & Pellegrini, A.D. (Ed.), Child’s Play: Developmental and Applied (pp. 9-27). New Jersey: Lawrence Erlbaum Associates, Inc.

Berk, L.E. (2006). Child Development, 7th Ed. United States of America: Pearson Education , Inc.

Garvey, C. (1977). Play, 3rd Ed. Cambridge, Massachusetts: Harvard University Press.

Pellegrini, A.D. & Jones, I. (1994). Plays, toys and language. In Goldstein, J.H. (Ed.), Toys, play, and child development (pp. 27-45). United States of America: Cambridge University Press.

Singer, J.L. (1994). Imaginative play and adaptive development. In Goldstein, J.H. (Ed.), Toys, play, and child development (pp. 6-26). United States of America: Cambridge University Press.

Sutton-Smith, B. (1994). Does play prepare for the future? In Goldstein, J.H. (Ed.), Toys, play, and child development (pp. 130-146). United States of America: Cambridge University Press.

PL2132: Research & Statistical Methods 2 - Lab Report

Running Head: PARALLEL AND SEQUENTIAL REPRESENTATIONS AND RECOGNITION

Effects of Parallel and Sequential Representations on Short-term Recognition

Chan Yi Tsun, Cheong Meiyi, Chua Siti Ayeshah Mohd Shafiq,

Tan Jia Xin Jacinth and Yong Yeng Hong

National University of Singapore

Abstract

This study, a 2x2 mixed factorial design, examined how parallel and sequential representation of information influenced the response time in a recognition task. Twenty-one undergraduates were randomly assigned either to the parallel representation or sequential representation condition. Participants decided whether the target house was a match or mismatch from the stimulus house presented earlier and the response time for correct answers was measured. Results supported the hypothesis that parallel processing produced a shorter response time than sequential processing. It partially supported the hypothesis that the number of features only influenced the response time for sequential processing. These findings indicate how future in-depth research could be directed at using audio description instead of written description for sequential representation.

Effects of Parallel and Sequential Representations on Short-term Recognition

The comparison between parallel and sequential representation of information has been commonly cited as an evidence for using images to perform cognitive tasks, specifically the short term recognition task. In a study by Nielsen and Smith (1973), students were shown either a schematic face picture or its verbal description with varying number and sizes of features and asked to memorize them. After a varied retention interval, they were made to match against stimuli presented and their response times were measured. Results from the study revealed that “matching was relatively fast and independent of the number of relevant features” only when the participants were shown the face picture, while the response time for matching based on the verbal description was slower and “increases as a function of the number of relevant features on the list (Nielsen & Smith, 1973; cited in Reed, 2006). These findings suggest parallel representation of information as an efficient and “useful strategy for recognizing described objects” (Finke, 1985).

A number of studies have also made similar findings which concluded reaction time as “an increasing function of stimulus information” for sequential but not parallel representation (Hick, 1952; cited in Lindsay & Lindsay, 1966). However, these studies have also pointed out a common underlying limitation of their findings in that participants could have made “multiple representations of a single form” (Posner, 1970; cited in Nielsen & Smith, 1970). Presenting the sequential representation in a written description, which was what these studies did, could result in the possibility of participants processing the verbal information in a visual form as well, which would render written description an invalid measure of sequential processing.

One of the main purposes of the present study was to control for this possibility by providing an audio description instead of a written description, while attempting to replicate the results of the current literature. The method of investigation was similar to that of Nielsen and Smith (1973), except that houses with different features were used in place of faces and the number of levels of features presented was reduced from three to two for simplification of the study.

In this regard, the present study sought to assess two hypotheses. First, it was posited that the time taken to match a perceived image to a memorized image is influenced by the type of representation – sequential or parallel. Participants in the parallel processing group were expected to produce a shorter response times than those in the sequential processing group. Second, with the number of features of the house to be processed varied at two levels – three and five, this factor should only affect the response time for sequential processing, with a longer response time for the five-features condition.

Method

Participants

Twenty-one male and female undergraduates from the Psychology statistics level-two course at the National University of Singapore participated in the study during lesson time.

Materials

A total of 34 pictures of houses were drawn out using the programme, “Paint”, out of which nine had three features (door, window and chimney) and the remaining 25 had five features (door, window, chimney, fence and path). Each of these features assumed one of two sizes: large or small (see Appendix 1).

For the parallel representation condition, 18 pictures of houses were used as stimuli and targets, with six used as both. Half of these 18 were three-featured houses and the rest were five-featured houses.

For the sequential representation condition, 12 pictures of houses were used as targets and12 pre-recorded audio descriptions of houses were used as the stimuli.

The programme, “E-Prime”, was used to present the targets and stimuli to the subjects, and to record their response time.

Procedure

The participants were randomly assigned into two conditions, with 10 participants in the parallel representation condition and 11 participants in the sequential representation condition. Each group then proceeded to carry out the experiments in two separate rooms.

For the parallel representation condition, each participant went through two practice trials followed by 10 test trials. Each trial followed the following sequence: (a) a picture of a stimulus house was projected onto a screen in front of the participant for four seconds; (b) an unfilled fixation slide appeared for four seconds; and (c) a picture of a target house whose onset started a clock appeared. The participants responded by pressing either a match button (‘1’ key) or a mismatch button (‘2’ key) as quickly and accurately as possible. The sequential representation condition followed similar procedures, except that an audio description of the stimulus house was read out to the participant in part (a) of the above sequence instead. The description always followed a fixed order of door, window, chimney, fence and path.

In both conditions, the number and sizes of house features to be remembered were randomly ordered in each trial. There were five matched and five mismatched responses in the test trials. These were also randomly-ordered. The response times for all the correct answers of every participant were recorded and analysed.

Results

Response time data were subjected to a 2 x 2 analysis of variance (ANOVA) with the type of representation as a between-subjects factor and the number of features presented as a within-subjects factor.

The mean response time of participants in the different conditions were as follows: parallel processing of three features was 2132.64ms (SD = 715.05), parallel processing of five features was 2424.58ms (SD = 751.49), sequential processing of three features was 3146.39ms (SD = 1233.53) and sequential processing of five features was 3216.55ms (SD = 954.32).

Results revealed a significant main effect for the type of representation: Response time was faster for parallel processing than sequential processing, F(1, 19) = 7.765, MSE = 1.10 x 106, p < .05. However, there was no significant main effect for the number of features: F(1, 19) = .498, MSE = 6.90 x 105, p > .05. In addition, no significant interaction effect was found: F(1, 19) = .187, MSE = 6.90 x 105, p > .05.

Discussion

The results of the present experiment supported the first hypothesis that the type of representation - sequential or parallel would influence the response time needed to determine whether a perceived image matched a memorized one. Participants who were in the parallel representation condition responded significantly faster than those in the sequential representation condition. These results were consistent with findings by Nielsen and Smith (1973).

The second hypothesis, nevertheless, was only partially supported. As predicted, the number of features in the image did not affect the response time for parallel representation. This implies that a person can maintain a visual pattern of the stimulus image in the short-term memory and all the features can be compared simultaneously with the target image.

However there was no significant result for the number of features on sequential processing in the present study. This was inconsistent with the findings reported by Nielsen and Smith (1973), which demonstrated that the response time for sequential processing was dependent on the number of features in the image. Similarly, reaction time increased as a linear function of the number of items in the memory set (Sternberg, 1967; cited in Reed, 2006). The most likely explanation for this inconsistency is that there was a lack of counterbalancing for the order of the mismatched feature in the mismatch trials of the sequential representation condition. Thus, in some trials, participants of the sequential representation condition did not have to compare all the features before making a response. This led to a lack of difference in response times between the three-feature condition and five-feature condition when the mismatched feature was the first, second or third feature to be compared. Hence, an improvement to this study would be to add more test trials, so as to vary and counterbalance the order of the mismatched feature presented.

Another limitation in the present study was that only two practice trials were provided before the actual trials. Practice trials were placed to allow participants to familiarize themselves with the matching task. In the original study by Nielsen and Smith (1973), participants went through 18 practice trials. However, this present study was not able to accommodate as many practice trials as that of the original study due to time constraints. In addition, the absence of feedback on correct or wrong responses during the practice trials could also have led participants to not fully understand the experiment and hence, made more mistakes in the practice and actual trials.

This study has managed to replicate the finding that parallel processing of information is faster than sequential processing even when audio description was used as a mode of sequential representation instead of the written description used in previous studies. Hence, future in-depth studies could adopt the use of audio description so as to minimize the possibility of participants representing written description in a visual form as well.

Similarly, a visual representation of the stimulus may not necessarily result in parallel processing of the information because it is possible for participants to memorize and recall the features individually instead of treating the whole house as a visual template to be encoded (Posner, 1970; cited in Nielsen & Smith, 1970). Hence, future studies could take this into consideration and develop with ways to ensure that parallel processing is used.

In conclusion, despite the limitations of the present study, it has managed to replicate the finding that parallel processing is a more efficient way of processing information for short-term recognition than sequential processing. It has also addressed the issue of using a more valid measure of sequential processing, which future studies be directed to use.

References

Finke, R.A. (1985). Theories relating mental imagery to perception. Psychological Bulletin, 98(2), 236-259.

Lindsay, R.K & Lindsay, J.M. (1966). Reaction time and serial versus parallel information processing. Journal of Experimental Psychology, 71(2), 294-303.

Nielsen, G.D & Smith, E.E. (1970). Representations and retrieval processes in short-term memory: recognition and recall of faces. Journal of Experimental Psychology, 85(3), 397-405.

Nielsen, G.D & Smith, E.E. (1973). Imaginal and verbal representations in short-term recognition of visual forms. Journal of Experimental Psychology, 101(2), 375-378.

Reed, S.K. (2006). Cognition: theory and applications. United States of America: Thomson Wadsworth.

PL3233: Cognitive Psychology - Term Paper

Researchers have used the concept of “emergent properties” to explain various aspects of cognition. Critically evaluate the use of this approach, focusing on one or more specific examples of cognitive phenomena, in explaining the nature of cognition.

The concept of “emergent properties” suggests that cognitive processes arise naturally “as a consequence of dynamic interactions that take place within the cognitive system” (Kintsch, 1999). By this approach, it implies that there is no unitary and distinct domain that is responsible for the cognitive phenomena.

Consider working memory from the emergent perspective. It is specifically a “controlled processing involving active maintenance and/or rapid learning, where controlled processing is an emergent property of the dynamic interactions of multiple brain systems” (O’ Reilly, Braver & Cohen, 1999). This implies a non-unitary nature of working memory where task performance requires for information to be coded or represented; attention to be controlled and directed to the relevant information and achieving and maintaining activation of the information when retrieval of it is made.

This interactive nature of working memory is exhibited by Engle’s model of working memory which involves the interaction of three components: First, the “Grouping skills, coding strategies and procedures for maintaining activation” ensures encoding and representation of information phonologically, visually, spatially, etc. which demands different levels of attention depending on the type of task and person involved. With successful encoding and representation, they become a part of the second component of “Short-term memory”, where they can either be further activated with attention focused on them or loss due to decay or interference. The “Central Executive” is the third component which helps to achieve activation of stored information through controlled retrieval. It is also directs controlled attention to encoding, representation and maintaining activation of STM in the other two components by blocking interference through inhibition of distractors (Engle, 1999).

What makes this “emergent property” approach plausible is because the explanation of working memory cannot be directly localised to an “independent mental level” (Bechtel & Richardson, 1992). As demonstrated by Engle’s model, working memory arises in the presence and interaction of different types of representation formats, controlled attention as well as the capacity to achieve and maintain activation of STM. Without any of which, working memory would be impossible. In addition, since working memory entails capacity limits and these limits can result from fundamentally different factors such as information-decay, limits in speed of processing or proactive interference (Miyake & Shah, 1999), it indicates that these limiting factors are affecting different aspects of working memory. Therefore, it seems evident that working memory is indeed, emergent from different interactive components.

Nevertheless, while the concept of “emergent properties” in working memory may seem more plausible than attributing it to a single determinant, problems still exist in characterizing the exact nature of subcomponents that interact for working memory to emerge (Kintsch, 1999). As opposed to Engle’s model, Baddeley (1999) postulates the visuospatial sketchpad, phonological loop, episodic buffer and the central executive as components of his working memory model. This difference is due to the limitations of methods used to investigate the nature of working memory, such as dual-task studies, that “cannot differentiate between models that define subsystems in terms of storage buffers, specialised processes, or pools of resources” (Kintsch, 1999). That is, while empirical evidence from dual-task studies can determine if a particular component is used by working memory, it cannot establish if the component was a storage buffer or otherwise, rendering the nature of subsystems from which working memory emerged, unclear.

Bibliography

1) Baddeley, Alan D. & Logie, Robert H. (1999). Models of Working Memory: Mechanisms of Active Maintenance and Executive Control. Miyake, Akira & Shah, Priti (Ed.), Working Memory: The Multiple-Component Model (pp. 28-61). United Kingdom: Cambridge University Press.

2) Engle, Randall W., Kane, Michael J. & Tuholski, Stephen W. (1999). Models of Working Memory: Mechanisms of Active Maintenance and Executive Control. Miyake, Akira & Shah, Priti (Ed.), Individual Differences in Working Memory Capacity and What They Tell Us About Controlled Attention, General Fluid Intelligence, and Functions of the Prefrontal Cortex. (pp. 102-134). United Kingdom: Cambridge University Press.

3) O’Reilly, Randall C., Braver, Todd S. & Cohen, Jonathan D. (1999). Models of Working Memory: Mechanisms of Active Maintenance and Executive Control. Miyake, Akira & Shah, Priti (Ed.), A Biologically Based Computational Model of Working Memory (pp. 375-411). United Kingdom: Cambridge University Press.

4) Kintsch, Walter, Healy, Alice F., Hegarty, Mary, Pennignton, Bruce F. & Salthouse, Timothy A. (1999). Models of Working Memory: Mechanisms of Active Maintenance and Executive Control. Miyake, Akira & Shah, Priti (Ed.), Models of Working Memory: Eight Questions and Some General Issues (pp. 412-441). United Kingdom: Cambridge University Press.

5) Miyake, Akira & Shah, Priti. (1999). Models of Working Memory: Mechanisms of Active Maintenance and Executive Control. Miyake, Akira & Shah, Priti (Ed.), Toward Unified Theories of Working Memory: Emerging General Consensus, Unresolved Theoretical Issues, and Future Research Directions (pp. 442-482). United Kingdom: Cambridge University Press.

6) Betchel, William & Richardson, Robert C. (1992). Emergence or Reduction? Beckermann, Ansgar, Flohr, Hans & Kim, Jaegwon (Ed.), Emergent Phenomena and Complex Systems (pp. 257-288). Germany: Walter de Gruyter & Co.

PL3232: Biological Psychology - Term Paper

Conventional Western medical techniques (i.e., using drugs to treat symptoms) are the only sensible way to treat disorders or medical problems. Critically discuss.


On the assumption that medical symptoms need to be treated, conventional western medicine has, more often than not, been used as the primary treatment for disorders or medical problems. Accompanied by scientific research and testing of pharmaceutical drugs, which are “based on the biological understanding of the organism” (MacIntosh, 1999), conventional medicine is typically deemed proven and accurate.

For instance, research has shown that low levels of serotonin in relation to other neurotransmitters in our body, such as norepinephrine and dopamine, contributes to depression. With further research, fluoxetine (Prozac) was found to “block the presynaptic reuptake of serotonin” (Durand & Barlow, 2006), which increased the serotonin levels eventually. Hence, fluoxetine is now a common drug used to treat depression. With such strong biological basis, conventional medicine appears to be a sensible means of treating disorders or medical problems.

However, as conventional medicine stands on its own, it is incomplete and thus, fallible. Firstly, despite scientific research backing, conventional medicine runs the risk of causing side effects in patients. In the treatment of ADHD in children, studies have shown that the use of stimulant medications, albeit effective in “reinforcing their brain’s ability to focus attention, resulted in unpleasant side effects of insomnia, drowsiness or irritability” (Durand & Barlow, 2006). In another instance, HIV-infected patients, who are usually prescribed antiretroviral drug treatment, often suffer side-effects of neuropathy, an abnormal functioning of damaged nerves (Chiaffarino, 2006). Such side effects only serve to pose additional physiological and even psychological problems to patients since they have effectively more symptoms to treat.

Secondly, conventional medicine assumes a sole need to treat biological symptoms and undermines the psychological effects that could arise due to the disorder, which can consequently confound treatment outcomes as well. In the case of cancer patients, not only do they have physiological effects of pain to deal with, the chronic nature of the disease may also cause them to be disheartened and lose hope in themselves. As such, they may need emotional assistance to be able to develop a positive and “‘fighting’ approach in managing their own disease” (Barnett, 2001) so as to benefit in their overall treatment. This psychological aspect of treatment is an issue that conventional medicine fails to tackle.

Since conventional medical techniques are limited in treating disorders and medical problems, it perpetuated the rise of alternative and complementary medicine. These non-conventional forms of medical techniques seek to address the inadequacies of conventional drug therapy.


Alternative medicine can be understood as a treatment which is “not the standard of care in conventional medicine” (MacIntosh, 1999). It can be seen as a substitute for conventional medicine. On the contrary, complementary medicine is a “non-standard treatment given in conjunction with conventional therapy, typically to enhance treatment outcome” (MacIntosh, 1999). Instances of alternative and complementary medicine include acupuncture, homeopathy, maintaining good dietary nutrition and psychospiritual therapy. They are often sought after by patients with chronic diseases, with many of them who “found relief for symptoms and efficacy for a particular health problem” (Faass, 2001).

Pain is a highly enduring symptom in cancer patients. Although analgesics are usually prescribed to them, there is a significant population who are “either very resistive to high doses of it or particularly prone to its accompanying side-effects” (Filshie & White, 2001). In these cases, patients can resort to acupuncture which “stimulates endogenous opioid release in the body” (Filshie & White, 2001), thus relieving pain. It also releases serotonin which has antidepressant activity that is crucial to curbing depression that is often comorbid with cancer patients (Filshie & White, 2001). Clearly, acupuncture proves to be an effective alternative to analgesics in dealing with physiological symptoms of pain. Even for those who are able to withstand the effects of analgesics, acupuncture can still be utilized as a complement to drug therapy in helping patients deal with emotional problems that arise from facing their illness.

Alternative and complementary medicine is also frequently used to treat children with ADHD since it is a chronic problem which “affects multiple domains of functioning, mainly academic, social and behavioral” (Sinha & Efron, 2005). Furthermore, stimulant medications administered to treat ADHD fails to eliminate all symptoms and causes side-effects. A complementary treatment that is practiced is biofeedback where exercises are repeated to “create or improve pathways of attention and impulse control” and allows the person to learn “appropriate mental state for a given situation, such as listening to instructions” (Healthwise, 2004). Herbal medicine such as Kava and St John’s wort are also carefully taken by patients to regulate their mood (Healthwise, 2004) when they experience side-effects of irritability from the stimulant medication.

As mentioned earlier, HIV patients are prone to side-effects of neuropathy as a result of their antiretroviral drug treatment. Once again, complementary medical techniques such as physiotherapy and massage can be used to treat the pain, numbness and muscle weakness in the body associated with neuropathy (Chiaffarino, 2006). Acupuncture and psychospiritual therapy can also be included in treatment to help patients relax and deal with any mood disorders.

Nevertheless, despite alternative and complementary medicine gaining a foothold in current medical settings, many lack the support of scientific research and testing, unlike conventional medicine. Therefore, their overall effectiveness still needs to be evaluated (Barnett, 2001). Perhaps the most sensible way to treat disorders and medical conditions is to integrate alternative and complementary medicine into the conventional model, such that the treatment methods are more holistic, since each approach on its own, is incomplete. As such, it is important for health practitioners to be informed of the use of alternative and complementary medicine by their patients so that they are aware and can ensure that alternative methods are appropriately integrated to optimize treatment outcomes (Faass, 2001).

To recapitulate, the mere use of drugs to treat biological symptoms is insufficient. Psychological problems that arise from dealing with the illness and additional physiological symptoms that evolve from the side effects of drug treatments can also influence patients’ conditions. Hence, only by means of an integrated medical technique can one sensibly and effectively treat disorders and medical problems.


References:

1) Durand, V. Mark, & Barlow, David H. (2006) Essentials of Abnormal Psychology. United States of America: Thomson Wadsworth.

2) Barnett, Mandy (2001). Integrated Cancer Care: Holistic, Complementary and Creative approaches. Barraclough, Jennifer (Ed.), Overview of Complementart therapies in Cancer Care (pp. 3-17). New York: Oxford University Press Inc.

3) Filshie, Jacqueline & White, Adrian (2001). Integrated Cancer Care: Holistic, Complementary and Creative approaches. Barraclough, Jennifer (Ed.), Acupuncture (pp. 69-82). New York: Oxford University Press Inc.

4) Faass, Nancy (2001). Integrating Complementary Medicine into Health Systems. Faass, Nancy (Ed.), Utilization Data on Complementary and Alternative Medicine (pp. 12-20). United States of America: Aspen Publishers, Inc.

5) Faass, Nancy & Gaudet, Tracy W. (2001). Integrating Complementary Medicine into Health Systems. Faass, Nancy (Ed.), Developing an Integrative Medicine Program: The Universty of Arizona Experience (pp. 35-40). United States of America: Aspen Publishers, Inc.

6) Kukuruzovic, RH. (2005). Complementary medicines and therapies, surging ahead in popularity: How is conventional medicine responding? J. Paediatr. Child Health, 41, 21–22

7) Sinha, D & Efron, D. (2005). Complementary and alternative medicine use in children with attention deficit hyperactivity disorder. J. Paediatr. Child Health, 41, 23-26

8) Chiaffarino, Francesca. (2006). Use of complementary and alternative medicine in HIV-infected subjects. Complementary Therapies in Medicine, 14, 193-199

9) Townsend Letterfor Doctors and Patients’ Archives. (1999). Understanding the Differences Between Conventional, Alternative, Complementary, Integrative and Natural Medicine. Retrieved September 2006 from http://www.tldp.com/medicine.htm

10) Healthwise: For Every Health Decision. (2004). Complementary and alternative medicine for attention deficit hyperactivity disorder (ADHD). Retrieved September 2006 from http://health.yahoo.com/topic/add/resources/article/healthwise/ue4897

PL2131: Research & Statistical Methods 1 - Lab Report

Running Head: GENDER AND SPATIAL ABILITY

Gender Differences in Spatial Ability

Tan Jia Xin Jacinth

National University of Singapore

Abstract

The aim of this study was to investigate whether there are significant gender differences in performance on a spatial ability task. One hundred and thirty-eight undergraduate students were administered the Vandenberg and Kuse (1978) Mental Rotations Test. The task consists of 20 problems, in which a picture of a three-dimensional primary object was presented with a set of four dissimilar objects in each problem. Only two out of the set of four are the same as the primary object and participants had to identify and select the correct two for as many problems as they can under a given time limit. At the end of the test, their scores were calculated and compiled. An independent samples T-test was performed on the data and the analysis suggested a significant difference between male and female participants in their Mental Rotations Test scores.

Gender Differences in Spatial Ability

Numerous literatures have reported disparity between males and females in their performance on various spatial ability tasks, with males at an edge over females in general (e.g., Collins & Kimura, 1997; Roberts & Bell, 2000). Some biological basis had been suggested to account for such differences, one of which being higher levels of testosterone in males which “influences abilities related to the encoding, comparison, initiation and/or decision processes” (Hooven, Chabris, Ellison & Kosslyn, 2004) that are involved in spatial ability tasks such as Mental Rotation. Another reason was that women in their midluteal phase have higher estrogen and progesterone levels as opposed to the menstrual phase, which reduces spatial ability (Hausmann, Slabbekoorn, Van Goozen & Kettenis, 2000). Nevertheless, some studies have found exceptions where women outperformed men in spatial ability tasks (Casey & Brabeck, 1990). They proposed an interaction of genetic and environmental factors where “right-handed women from non-right-handed families” who had been predisposed to “Masculine gender-typed activities such as carpentry, work with electrical circuits, or building model airplanes” tended to excel in spatial ability tasks (Casey & Brabeck, 1990). With the above findings in mind, the present study purports to test the hypothesis that significant gender differences on spatial ability task, specifically in mental rotation, exist.

Method

Participants

One hundred and four female and 34 male undergraduate students participated in the study. All participants performed the Mental Rotations Test during their respective classes in the computer laboratory of the Psychology department.

Materials

A six-page, revised version of the Vandenberg and Kuse (1978) Mental Rotations Test was used in the study.

Procedure

Participants were asked to perform the Mental Rotations Test. The paper-and-pencil task consists of 20 problems, where a picture of a three-dimensional primary object was presented together with a set of four dissimilar objects in each problem. Only two out of the set of four are the same as the primary object and participants had to identify and select the correct two by marking Xs in the boxes under them.

The test was divided into two parts, Part I and Part II, with 10 questions each. Participants were given three minutes to attempt each part and a one-minute break was allocated in between the two parts.

At the end of the test, participants had to check their answers against the answer key and determine the number of correct and incorrect objects identified by them. For every correct answer, one point was awarded, whereas for every incorrect answer, half a point was deducted, so as to correct for guessing. Finally, the individual and total scores for Parts I and II were calculated.

Results

The mean score for males was 20.8 with a standard deviation of 7.2 while the mean score for females was 14.98 with a standard deviation of 7.26. An independent samples T-test analysis indicated that the difference in performance on the Mental Rotations Test between both genders was significant, t(136) = 4.05, p<.05, d = 0.80.

Discussion

The results of the study supported the hypothesis that there are significant gender differences in performance on spatial ability task, specifically in mental rotation. The mean score of males was also substantially higher than that of females, indicating that males actually outperformed females in the task. As such, the results appear to be a replication of the extensive literatures which have suggested that males are more adept at spatial ability tasks.

It would then be appropriate to propose that underlying biological conditions, which are unique to males or females, could have caused the distinction in their spatial abilities. This proposition had been corroborated by findings of Hooven et al. (2004), which illustrated that higher testosterone levels in males was likely to have enhanced their spatial task performance. Findings of Hausmann et al. (2000) also attributed higher estrogen and progesterone levels in their midluteal phase to their poorer performance in spatial tasks. In addition, fundamental environment factors, such as “masculine gender-typed activities” could have also contributed to better spatial ability in males, as demonstrated in the results of Casey and Brabeck’s (1990) study.

Nevertheless, limitations to the present study could have undermined its results. While mental rotation is a possible measure of spatial ability in both genders, it is not absolute. There exist other components of spatial ability, namely spatial perception and spatial visualization (Rileaa, Roskos-Ewoldsenb & Bolesb, 2004), which could yield different results from that of mental rotation when performed and measured. Furthermore, as noted by Collins and Kimura (1997), it is uncertain whether the superior performance in the three-dimensional Mental Rotations Task by males is associated with the nature of that particular task or its higher level of difficulty relative to other rotation tasks in general. This threatens the construct validity of the study.

Perhaps considerations for future studies could include the measurement of spatial perception and spatial visualization, such as water level and paper folding, as utilized in the study by Rileaa et al. (2004), so as to obtain a more complete measure of spatial ability. Additionally, other types of mental rotation tasks, such as the two-dimensional picture rotation used by Collins and Kimura (1997), could also be included to ensure that the better performance by males is explainable in various mental rotations tasks, and not limited to the three-dimensional ones only.

References

Casey, M. Beth & Brabeck, Mary M. (1990). Women Who Excel on a Spatial Task: Proposed Genetic and Environmental Factors. Brain and Cognition, 12, 73-84.

Collins, David W., Kimura, Doreen. (1997). A Large Sex Difference on a Two-Dimensional Mental Rotation Task. Behavioral Neuroscience, 111, 845-849.

Hausmann, Markus, Sabbekoorn, Ditte, Van Goozen, Stephanie H. M. & Cohen-Kettenis, Peggy T. (2000). Sex Hormones Affect Spatial Abilities During the Menstrual Cycle. Behavioral Neuroscience, 114, 1245-1250.

Hooven, Carole K., Chabris, Christopher F, Ellison, Peter T. & Kosslyn, Stephen M. (2004). The Relationship of Male Testosterone to Components of Mental Rotation. Neuropsychologia, 42, 782-790.

Rilea, Stacy L., Roskos-Ewoldsenb, Beverly & Bolesb, David. (2004). Sex differences in spatial ability: A lateralization of function approach. Brain and Cognition, 56, 332-343.

Roberts, Jonathan E. & Bell, Martha Ann. (2000). Sex Differences on a Mental Rotation Task: Variations in Electroencephalogram Hemispheric Activation Between Children and College Students. Developmental Neuropsychology, 17, 199-223.

Vandenberg, S. & Kuse, A.R. (1978). Mental Rotations: A group test of three-dimensional spatial visualization. Perceptual and Motor Skills, 47, 599-604.

The Diagnostic & Statistical Manual of Mental Disorders - Nature, Developments & Issues.

The Diagnostic & Statistical Manual of Mental Disorders, otherwise known as the DSM, can be considered the bible of all mental health professionals. It documents the various kinds of mental disorders that have been dealt with and scientifically researched upon by a mental health professionals.

History & Developments.

The first DSM, DSM-I, was published in 1952. It was collated simply based on the consensus of a group of clinicians regarding what should/should not be included in the manual based on their own clinical experiences. Hence, data included were far less objective.

DSM-II was published in 1968 where treatment of mental illnesses experienced a shift from reactions to medical conditions. It also geared towards standardisation with WHO (World Health Organisation) and ICD (Inernational Classification of Diseases).

In 1980, DSM-III was formulated with major changes from DSM-II. In this edition, diagnostic criteria was introduced by means of the multi-axial approach. The description of disorders were far more expanded, with additional categories and backed by more objective research data. It was also made a-theoretical, i.e. more neutral towards theory, making it more widely acceptable. 7 years later, DSM-III-R (revised) replaced the DSM-III, with more disorders added.

The DSM-IV in 1994 expanded on classification categories with much more emphasis on empirical data. Then, the DSM-IV-TR (text revision) took place of DSM-IV in 2000, enhanced with current and up-to-date information, to ensure greater accuracy in diagnostic criteria. It also serves to bridge the gap between IV and V, which is the upcoming edition. Currently, the DSM-IV-TR is used by all mental health professionals.

What is the DSM?

The DSM is a multi-axial system for classifying and diagnosing mental disorders, published by the American Psychiatric Association (APA). The multi-axial system involves an assessment of several axes, each of which refers to a different domain of information that may help the clinician plan treatment and predict outcome.

There are 5 axes in the DSM-IV-TR classification:

Axis I -
Clinical Disorders: Grouped into 16 major diagnostic classes (e.g. Substance-related disorders, mood disorders, anxiety disorders).

Other conditions that may be a focus of clinical attention (e.g. Medication-induced movement disorder, malingering, acculturation problem).

Axis II -
Personality Disorders and/or Mental Retardation
These conditions are usually permanent, enduring and chronic than Axis I disorders. Not all chronic disorders are included nevertheless (e.g. Anorexia, Schizophrenia).

Axis III -
General Medical Conditions (e.g. Obesity, lung disease, heart attack, arthritis)
These conditions could help to rule out certain disorders.

Axis IV -
Psychosocial & Environmental Problems (e.g. Unemployment, lack of social support system, criminal record, legal difficulties, difficulty in accessing healthcare services, dysfunctional marriage)
With such knowledge, clinicians can then refer them to appropriate institutions and professionals to seek further help.

Axis V -
Global Assessment of Functioning
Assessed on a rating of 1-100 (0 being too little information)
1-30 indicates critical condition.

Axes III, IV and V are very important but often neglected. They set the context of illness and refer patients to appropriate agencies, as well as affect the kind of treatment method, goal and outcome.

The DSM-IV-TR also takes on a prototypical approach which is a system for categorizing disorders using essential, defining characteristics and a range of variation on other characteristics.

Issues of the DSM.

Benefits:

1) It is largely atheoretical and widely applicable in a variety of settings
- Atheoretical: neutral towards theory/etiology.
- Settings: inpatient, outpatient, consultation liaison, private practice, primary care etc.

2) Provides clear descriptions of diagnostic categories for clinical practice, facilitating the collection and communication of clinical information and aids in treatment planning.

3) Facilitates research and improves communication among clinicians and researchers.

4) Serves as an educational tool for teaching psychopathology.

Drawbacks:

1) It is a categorical classification system that divides mental disorders into types based on criteria sets with defining features and hance, does not fit well with the comorbid and heterogeneous nature of mental disorders.

- Greater blurring at the boundaries of categories and some symptoms apply to more than 1 disorder, making conclusion on course of disorder, treatment response and likelihood of associated problems confusing.

- E.g. Substance-related & mood/personality/anxiety disorder, Eating & mood disorder.

- Are personality disorders extreme versions of normal behaviour? variations? If so, a dimensional approach should be taken instead of a categorical one (like gender) since a categorical approach does not rate level of dependence (no in betweens, you have it or not).

- Hence a five-factor model was introduced as a supplement to describing personality: extraversion, agreeableness, conscientiousness, emotional stability, openness to experience.

2) Inadequate emphaiss on cultural factors that may contribute to mental health problems.

- Context of patient's cultural setting/reference group (as well as that of the clinician's).

-Cultural significance of certain disorders.

3) The DSM promotes an "orientation towards inadequacies" by attending to tragedies and failures rather than solution, resources and competence.

- Mental retardation diagnosis: mild, moderate, severe, profound. Highly stigmatising.

- AAMR categories: intermittent, limited, extensive, pervasive. Less stigmatising since it focuses on level of support and assistance required.

4) Persons are pathologised and stigmatised through psychiatric labelling.

- Individuals with the disorder may identify with the negative connotaions associated with the label which affects their self-esteem.

5) Emphasis on reliability at the expense of validity.

- "I am depressed" can be considered reliable. But most patients express that they are depressed when presenting their problems. Is "I am depressed" then, useful?

- If a clinician were to diagnose someone with a disorder using the DSM, different clinicians are likely to come up with the same diagnosis (highly reliable).

- However, the disorder might not manifest or present itself in the ways listed by the DSM (low validity).

- It traces back to research methods that had produced the categorization. The more controlled and "clean" the research method, the more reliable. Nevertheless, the world is not that "clean" hance results might not prove to be valid in actual fact.

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"The listing of Personality disorders and Mental Retardation on a separate axis (Axis II) ensures that consideration will be given to the possible presence of Personality disorders and Mental Retardation that might otherwise be overlooked when attention is directed to the usually more florid (elaborated) Axis I disorders." (The DSM-IV-TR)

Arbitrariness of the DSM?

Futher criticisms (Tomm, 1990, p.4):

1) DSM fails to include the diagnosis of the "DSM syndrome" - a spiritual psychosis characterized by a compulsive desire to objectify persons and to label them according to a predetermined psychiatric diagnosis.

2) These "victims" of modern psychiatric ideology give priority to knowledge about precise definitions - over knowledge about healing interactions - as manifest by obsessive preoccupation with preoccupation with pejorative adjectives, inclusion and exclusion criteria, etc.