The belief in malevolent spiritual beings is found in religions throughout the world. Islam is no... more The belief in malevolent spiritual beings is found in religions throughout the world. Islam is no exception, and this religion includes the belief in beings known as jinn. These beings often cause harm to humans, typically by possessing them. Jinn possession can be understood in several different ways in Islam and there are specific forms of exorcism depending on the type and strength of the jinn doing the possessing. Additionally, several customs related to the prevention of harm from jinn are prevalent in the Muslim world. Mass media, such as horror films or novels may play a role in perpetuating belief in jinn. While jinn possession is considered pathological some people experience secondary gain from being in a possessed state. These gains include getting attention, having their behavior excused as deviating from cultural norms, and experiencing a release of inhibitions. From a psychological point of view jinn possession is similar dissociative identity disorder. Delusional misidentification disorders may also have a relationship to jinn possession. Psychoanalysis suggests that jinn possession is a symbol of repressed unconscious instincts, and psychoanalytic treatment can be understood as a form of exorcism. Object relations psychology suggests that imaginary beings such as jinn are the projection of unwanted bad objects. Traditional healing techniques from Islam can be used in combination with psychodynamic techniques to help those suffering from jinn possession.
The belief in malevolent spiritual beings is found in religions throughout the world. Islam is no... more The belief in malevolent spiritual beings is found in religions throughout the world. Islam is no exception, and this religion includes the belief in beings known as jinn. These beings often cause harm to humans, typically by possessing them. Jinn possession can be understood in several different ways in Islam and there are specific forms of exorcism depending on the type and strength of the jinn doing the possessing. Additionally, several customs related to the prevention of harm from jinn are prevalent in the Muslim world. Mass media, such as horror films or novels may play a role in perpetuating belief in jinn. While jinn possession is considered pathological some people experience secondary gain from being in a possessed state. These gains include getting attention, having their behavior excused as deviating from cultural norms, and experiencing a release of inhibitions. From a psychological point of view jinn possession is similar dissociative identity disorder. Delusional misidentification disorders may also have a relationship to jinn possession. Psychoanalysis suggests that jinn possession is a symbol of repressed unconscious instincts, and psychoanalytic treatment can be understood as a form of exorcism. Object relations psychology suggests that imaginary beings such as jinn are the projection of unwanted bad objects. Traditional healing techniques from Islam can be used in combination with psychodynamic techniques to help those suffering from jinn possession.
The belief in malevolent spiritual beings is found in religions throughout the world. Islam is no... more The belief in malevolent spiritual beings is found in religions throughout the world. Islam is no exception, and this religion includes the belief in beings known as jinn. These beings often cause harm to humans, typically by possessing them. Jinn possession can be understood in several different ways in Islam and there are specific forms of exorcism depending on the type and strength of the jinn doing the possessing. Additionally, several customs related to the prevention of harm from jinn are prevalent in the Muslim world. Mass media, such as horror films or novels may play a role in perpetuating belief in jinn. While jinn possession is considered pathological some people experience secondary gain from being in a possessed state. These gains include getting attention, having their behavior excused as deviating from cultural norms, and experiencing a release of inhibitions. From a psychological point of view jinn possession is similar dissociative identity disorder. Delusional misidentification disorders may also have a relationship to jinn possession. Psychoanalysis suggests that jinn possession is a symbol of repressed unconscious instincts, and psychoanalytic treatment can be understood as a form of exorcism. Object relations psychology suggests that imaginary beings such as jinn are the projection of unwanted bad objects. Traditional healing techniques from Islam can be used in combination with psychodynamic techniques to help those suffering from jinn possession.
Schizophrenia is a severe mental illness that affects people all around the world. It presents in... more Schizophrenia is a severe mental illness that affects people all around the world. It presents in many different contexts, across geographic boundaries, and in different ways. Rates of schizophrenia seem generally to be the same regardless of geographical location, though there is some evidence that those in developed nations have a higher incidence of the disorder. Also, immigrants who relocate to areas where their culture has little, or no representation are at more risk for schizophrenia. While the prevalence of schizophrenia is similar around the world, the presentation of the disorder can vary widely, depending on the cultural, religious, and supernatural beliefs native to specific areas. Examples of varying types of presentation of schizophrenia, including culture-bound disorder variants, can give insight into the ways in which people from across the world make sense of this devastating disease, and ways in which they attempt to treat it.
Personality disorders are the most common serious mental illness. People suffering from these dis... more Personality disorders are the most common serious mental illness. People suffering from these disorders tend to exhibit emotional patterns and behaviors that seem troubling to the majority of people and are not necessarily explicable by immediate environmental stimuli. Nevertheless, many clinicians are unfamiliar with the most recent research on these disorders and the latest approaches to treatment. This study will review the current diagnostic conceptualization of personality disorders, their clinical treatment, and their relationship to cultural characteristics and culture-specific disorders. Introduction Diagnosis of Personality Disorders In the creation of the new DSM-V there was some debate about what to do with the diagnostic category for personality disorders. In the end the creators of the DSM-decided to holdover the different types of personality disorders from the DSM-IV but to remove these disorders from a separate axis. The DSM-V also keeps the same cluster structure as...
Schizophrenia is a severe mental illness that has devastating consequences for those who suffer f... more Schizophrenia is a severe mental illness that has devastating consequences for those who suffer from the disorder. The epidemiology of schizophrenia indicates that it occurs relatively often, in many different contexts, and in conjunction with other disorders, decreasing quality of life and causing premature death. There has been an enormous amount of research into the causes of schizophrenia and there is now have a much better understanding of the genetic, environmental, and psychological factors that contribute to the disease. While there are numerous ways to understand and conceptualize schizophrenia, a unified picture of the neurobiology, changes in brain structure, cognitive and social-cognitive impairments related to the disorder has yet to emerge. Convulsive therapies and psychosurgery were used unsuccessfully, indiscriminately and without scientific validation in the past to treat schizophrenia. Medical advances including advanced imaging technology have now provided the abi...
The idea that humans can be inhabited by supernatural entities is widespread among cultures and r... more The idea that humans can be inhabited by supernatural entities is widespread among cultures and religions around the world. Demonic possession is sometimes encountered by clinicians who choose to understand it as the actual presence of a demon possessing a human, or as a psychological phenomenon. Some forms of Christianity hold to the belief that demonic possession occurs in reality. Clinicians who share these beliefs may abandon a psychological understanding and treatment of the phenomenon in favor of religious explanations and rituals. Eastern religions like Buddhism understand demonic possession as relatively real but also see it as ultimately stemming from psychological issues. Psychoanalysis understands demonic possession as the result of interpsychic processes related to disturbances in the development of early internalized object relations. This has a number of implications for treatment of so-called demonically possessed individuals, which is exemplified in two clinical cases.
The Journal of Health and Medical Sciences is an Open Access publication. It may be read, copied,... more The Journal of Health and Medical Sciences is an Open Access publication. It may be read, copied, and distributed free of charge according to the conditions of the Creative Commons Attribution 4.0 International license.
German universities in the Nazi era experienced profound upheaval. Under turmoil and stress induc... more German universities in the Nazi era experienced profound upheaval. Under turmoil and stress induced by Nazi leadership these universities succumbed to pathologies related to large group processes. These group pathologies fell into predicable patterns based on dependency, ght or ight, or sexual pairing and are related to both narcissistic and paranoid group leadership. Such patterns of pathology led to organizational characteristics related to unbounded rationality and groupthink. These characteristics are reminiscent of problems found in modern universities. Psychological solutions will be proposed to offset these organizational symptoms of group pathology.
Little is known about using the Objective Structured Clinical Examination (OSCE) in physical diag... more Little is known about using the Objective Structured Clinical Examination (OSCE) in physical diagnosis courses. The purpose of this study was to describe student performance on an OSCE in a physical diagnosis course. Methods: Cross-sectional study at Harvard Medical School, 1997-1999, for 489 second-year students. Results: Average total OSCE score was 57% (range 39-75%). Among clinical skills, students scored highest on patient interaction (72%), followed by examination technique (65%), abnormality identification (62%), history-taking (60%), patient presentation (60%), physical examination knowledge (47%), and differential diagnosis (40%) (p < .0001). Among 16 OSCE stations, scores ranged from 70% for arthritis to 29% for calf pain (p < .0001). Teaching sites accounted for larger adjusted differences in station scores, up to 28%, than in skill scores (9%) (p < .0001). Conclusions: Students scored higher on interpersonal and technical skills than on interpretive or integrative skills. Station scores identified specific content that needs improved teaching.
To date published efforts to assess and improve medical student learning in urology have been lim... more To date published efforts to assess and improve medical student learning in urology have been limited due to the lack of an assessment tool with which to measure student learning. We report the development of a validated measure of medical student learning in urology. Four core topics in clinical urology were selected as the focus of the test development, namely prostate cancer, screening with prostate specific antigen, benign prostatic hyperplasia and erectile dysfunction. Detailed curricula and multiple choice questions were created for each topic. Content validity of the curriculum and 28 item examination was established by a panel of 2 urologists and 2 medical physicians. Instrument reliability was determined by administering the test on line to third-year surgery students. Test construct validity was established through its administration to 19 urology residents and attending physicians. Reliability of the 28-item test instrument was measured by Cronbach&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s alpha at 0.76 and its 1-week test-retest reliability was 0.72. All urology experts performed well on the test. Mean urological expert scores were significantly higher than mean student post-test scores (24.9 +/- 2.1 vs 17.8 +/- 3.8, 2-tailed t test p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). Urological experts with greater urological training had higher scores than those with less residency training. This study documents the development of a validated measure of medical student learning in urology. This validated instrument has the potential to improve educational quality control at medical schools and facilitate the development of effective, evidence based teaching methods.
After the development and implementation of a novel urology curriculum for medical students we ev... more After the development and implementation of a novel urology curriculum for medical students we evaluated urological learning by medical students using a validated measure of learning in the 4 clinical areas of benign prostatic hyperplasia, erectile dysfunction, prostate cancer and prostate specific antigen screening. Third year medical students completed an online validated pre-test and post-test immediately before and after the mandatory 1-week clinical rotation in urology. Online pre-surveys and post-surveys were also administered. Overall student participation was 90% (37 of 41) with 63% of students (26 of 41) completing all 4 tests and surveys. Student overall test scores improved significantly upon completion of the 1-week clinical rotation in urology (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). A trend toward increased learning by male students was identified (p = 0.07). Significant variation in exposure to outpatient clinics and in the performance of physical examination skills was observed among the different teaching sites. This study demonstrates significant learning by medical students during their 1-week clinical rotation in urology. Further data are needed to confirm the trend toward increased learning by males and elucidate its etiology. Scheduling changes have been implemented to address the inconsistencies across clinical sites.
A 15-session sex education program was delivered by teachers to 586 10th graders using techniques... more A 15-session sex education program was delivered by teachers to 586 10th graders using techniques based on social learning theory, including modeling, in-class and out-of-class practice of skills for abstaining from sexual intercourse, and for contraception. Knowledge about reproduction and birth control, intentions to use skills to avoid pregnancy, and communication with parents about pregnancy prevention were signifcantly greater at posttest and 6-month follow-up for the trained group than for the control group. Members of the trained group tended to use birth control more often, especially those who started to have sexual intercourse subsequent to the program. No differences in the frequency of sexual intercourse, pregnancy scares, or pregnancies were found Satisfaction with the program was high Although skill training by itself may not be sufficient to significantly prevent pregnancies, this program offers promise of being a useful component of combined school, home, and communi...
Rationale and Objectives. Traditional oral and written examinations can be limited in predicting ... more Rationale and Objectives. Traditional oral and written examinations can be limited in predicting future clinical performance. Therefore Objective Structured Clinical Examinations (OSCEs) have been introduced in other specialties. The authors assessed their value in radiology. The study includes 122 Harvard medical students who undertook 1-month compulsory clerkships at one of three hospitals (A, B, or C) in their 3rd and 4th year and a compulsory OSCE in their 4th year. The OSCE was constructed from five cases. Each had eight or nine standardized questions designed to test, within a set time, the perception of essential findings, their interpretation, and clinical judgment (maximum possible score, 100). Clerkship grades were high honors (score of 3), honors (score of 2), satisfactory (score of 1), and fail (score of 0). Predictors of OSCE scores-clerkship grade and affiliated hospital-were modeled as linear functions. Time elapsed between clerkship and OSCE was modeled as a nonlinear function. Although there was a positive relation between clerkship grade and OSCE grade, it accounted for an increase of only 5.7% in OSCE score per clerkship grade and did not predict performance of individual students. Students who trained in hospital B showed significantly higher OSCE grades. OSCE scores were highest when the examination was taken 8 months after the clerkship. The OSCE may be useful to uncover deficits in individuals and groups beyond the ones detected with traditional clerkship evaluations and provide guidance for remediation. The improved performance after additional clinical exposure suggests that the OSCE may be well suited to test the integration of radiologic and clinical knowledge.
OBJECTIVE: Training in Bright Futures and oral health concepts is critical for delivery of high-q... more OBJECTIVE: Training in Bright Futures and oral health concepts is critical for delivery of high-quality primary care and preventive health services by residents, our future pediatric workforce. The goal of this study was to evaluate the effectiveness of an online health promotion curriculum on pediatric residents' confidence, knowledge, and clinical performance in Bright Futures and oral health practice. METHODS: Residents from sites that had been stratified by size and randomized were assigned to the Bright Futures Oral Health curriculum (intervention group) or an active control group. Confidence and knowledge were measured by self-report and multiple-choice questions, respectively. Clinical performance was measured with structured clinical observations, performed by trained faculty, of Bright Futures and oral health performance before and after intervention. Mean scores between intervention and control groups were compared using a 2-tailed, repeated-measures F test. RESULTS: A total of 143 pediatric residents from 27 Continuity Research Network (CORNET) sites participated in the study. At a median of 3 months after intervention, the intervention group demonstrated significant improvement in general Bright Futures confidence (n ¼ 128, F ¼ 6.564, P ¼ .012) and knowledge (n ¼ 102, F ¼ 5.296, P ¼ .023), oral health confidence (n ¼ 123, F ¼ 15.220, P <.001), and clinical performance skills in oral health (n ¼ 96, F ¼ 11.315, P ¼ .001) compared with the control group. CONCLUSIONS: The Bright Futures Oral Health curriculum promoted an increase in confidence and knowledge in Bright Futures concepts and in confidence and clinical performance in oral health concepts among pediatric residents. This online curriculum demonstrated a positive impact on documented resident behavior, maintained for 3 months after intervention, and provides a replicable national training model to advance important elements of primary care pediatrics.
Problem Statement and Background: While the psychometric properties of Objective Structured Clini... more Problem Statement and Background: While the psychometric properties of Objective Structured Clinical Examinations (OSCEs) have been studied, their latent structures have not been well characterized. This study examines a factor analytic model of a comprehensive OSCE and addresses implications for measurement of clinical performance. Methods: An exploratory maximum likelihood factor analysis with a Promax rotation was used to derive latent structures for the OSCE. Results: A model with two correlated factors fit the data well. The first factor was related to Physical Examination and History-Taking was labeled as information gathering, while the second factor was related to Differential Diagnosis/Clinical Reasoning, and Patient Interaction and was labeled as reasoning and information dissemination. Case Management did not contribute to either factor. The factors accounted for a total 61.6% of the variance in the skills variables. Conclusions: Recognizing the psychometric components of OSCEs may support and enhance the use of OSCEs for measuring clinical competency of medical students.
Basic Measurement Concepts: Reliability & Validity Reliability Is greatly affected by the number ... more Basic Measurement Concepts: Reliability & Validity Reliability Is greatly affected by the number of items, number of participants, rating scale used, type of reliability coefficient sought, number of raters, time between ratings, type of items, and how well the test questions are written, etc. Can be affected (usually in a lesser degree) by inconsistencies in the testing location, test conditions, and the presentation of the test itself. Reliability is really a measure of how much error an assessment carries. 4/26/2005 9 Stringency/leniency-Questions or raters can be unnecessarily critical or charitable. Central tendency-undue avoidance of definitive ratings. Halo Effect-Basing all ratings on a general impression, or letting one trait overshadow the rest.
study examined four dimensions of health conception and their relationship to six dimensions of h... more study examined four dimensions of health conception and their relationship to six dimensions of health-promoting lifestyle in a population of older adults (n=364). A battery of instruments was administred to all subjects to measure health conception, health-promoting lifestyle, importance of health, perceived control of health, perceived health status, perceived benefits of exercise, perceived barriers to exercise; demographic information was also obtained. Using these data, an analysis of covariance was conducted to compare the goodness of fit of two alternate models of the relationship between health conception and health-promoting lifestyle derived from the literature. hIdel A hypothesized s'..rength of health conception as the single underlying dimension progressively related to the four health conception scales (eudaimonistic, adaptive, role performance, and clinical); Model B suggested that the adaptive and eudamonistic health conception variables weL-e strongly related to one another. Results of the analysis suggest that Model B was best fitted to the data. A discussion of these findings and their implications ensues, and recommendations for further research for are made. References are included and structural equation charts of the two models under investigation are appended. (TE)
Asian Journal of Humanities and Social Studies, 2013
The goal of Buddhism is to gain enlightenment through the realization of the psychological basis ... more The goal of Buddhism is to gain enlightenment through the realization of the psychological basis of human suffering. Like other religions Buddhists undertake this goal together in a community known as the Sangha, which, includes lay practitioners, clergy, and various symbolic figures. While, the ostensible goal of the Sangha is to help Buddhists reach a state of religious epiphany, it also functions in a psychological fashion to moderate the regressive effects of group membership. This moderation allows the Sangha to facilitate individuation for its members while they maintain their group membership. In this way the Sangha provides a practical method for applying spiritual principals to relationships with others in the group and later, to the world at large. This paper will review classical and object relations views of group psychology and then apply these perspectives to the understanding of the Sangha.
Structural equation modeling has become increasingly popular as a technique for the analysis of n... more Structural equation modeling has become increasingly popular as a technique for the analysis of non-experimental data in the social sciences. This increase can be traced in part to the development of computer programs that facilitate structural equation modeling. The Linear Structural Relations (LISREL) program is the most widely used tool for implementing structvral equation models. LISREL is applicable across a wide range of study, but is most useful in analyzing social science data. Some characteristics of the LISREL program are examined. The general LISREL model is explained along with methods for establishing the identification and goodness-of-fit of the overall model and its individual parameters. TC is concluded that the most important aspect of LISREL methodology is its flexibility; almost any type of problem involving regression or factor analytic procedures can be computed using LISREL. LISREL models should be theory driven, but should not be used to explore the grosser as...
The belief in malevolent spiritual beings is found in religions throughout the world. Islam is no... more The belief in malevolent spiritual beings is found in religions throughout the world. Islam is no exception, and this religion includes the belief in beings known as jinn. These beings often cause harm to humans, typically by possessing them. Jinn possession can be understood in several different ways in Islam and there are specific forms of exorcism depending on the type and strength of the jinn doing the possessing. Additionally, several customs related to the prevention of harm from jinn are prevalent in the Muslim world. Mass media, such as horror films or novels may play a role in perpetuating belief in jinn. While jinn possession is considered pathological some people experience secondary gain from being in a possessed state. These gains include getting attention, having their behavior excused as deviating from cultural norms, and experiencing a release of inhibitions. From a psychological point of view jinn possession is similar dissociative identity disorder. Delusional misidentification disorders may also have a relationship to jinn possession. Psychoanalysis suggests that jinn possession is a symbol of repressed unconscious instincts, and psychoanalytic treatment can be understood as a form of exorcism. Object relations psychology suggests that imaginary beings such as jinn are the projection of unwanted bad objects. Traditional healing techniques from Islam can be used in combination with psychodynamic techniques to help those suffering from jinn possession.
The belief in malevolent spiritual beings is found in religions throughout the world. Islam is no... more The belief in malevolent spiritual beings is found in religions throughout the world. Islam is no exception, and this religion includes the belief in beings known as jinn. These beings often cause harm to humans, typically by possessing them. Jinn possession can be understood in several different ways in Islam and there are specific forms of exorcism depending on the type and strength of the jinn doing the possessing. Additionally, several customs related to the prevention of harm from jinn are prevalent in the Muslim world. Mass media, such as horror films or novels may play a role in perpetuating belief in jinn. While jinn possession is considered pathological some people experience secondary gain from being in a possessed state. These gains include getting attention, having their behavior excused as deviating from cultural norms, and experiencing a release of inhibitions. From a psychological point of view jinn possession is similar dissociative identity disorder. Delusional misidentification disorders may also have a relationship to jinn possession. Psychoanalysis suggests that jinn possession is a symbol of repressed unconscious instincts, and psychoanalytic treatment can be understood as a form of exorcism. Object relations psychology suggests that imaginary beings such as jinn are the projection of unwanted bad objects. Traditional healing techniques from Islam can be used in combination with psychodynamic techniques to help those suffering from jinn possession.
The belief in malevolent spiritual beings is found in religions throughout the world. Islam is no... more The belief in malevolent spiritual beings is found in religions throughout the world. Islam is no exception, and this religion includes the belief in beings known as jinn. These beings often cause harm to humans, typically by possessing them. Jinn possession can be understood in several different ways in Islam and there are specific forms of exorcism depending on the type and strength of the jinn doing the possessing. Additionally, several customs related to the prevention of harm from jinn are prevalent in the Muslim world. Mass media, such as horror films or novels may play a role in perpetuating belief in jinn. While jinn possession is considered pathological some people experience secondary gain from being in a possessed state. These gains include getting attention, having their behavior excused as deviating from cultural norms, and experiencing a release of inhibitions. From a psychological point of view jinn possession is similar dissociative identity disorder. Delusional misidentification disorders may also have a relationship to jinn possession. Psychoanalysis suggests that jinn possession is a symbol of repressed unconscious instincts, and psychoanalytic treatment can be understood as a form of exorcism. Object relations psychology suggests that imaginary beings such as jinn are the projection of unwanted bad objects. Traditional healing techniques from Islam can be used in combination with psychodynamic techniques to help those suffering from jinn possession.
Schizophrenia is a severe mental illness that affects people all around the world. It presents in... more Schizophrenia is a severe mental illness that affects people all around the world. It presents in many different contexts, across geographic boundaries, and in different ways. Rates of schizophrenia seem generally to be the same regardless of geographical location, though there is some evidence that those in developed nations have a higher incidence of the disorder. Also, immigrants who relocate to areas where their culture has little, or no representation are at more risk for schizophrenia. While the prevalence of schizophrenia is similar around the world, the presentation of the disorder can vary widely, depending on the cultural, religious, and supernatural beliefs native to specific areas. Examples of varying types of presentation of schizophrenia, including culture-bound disorder variants, can give insight into the ways in which people from across the world make sense of this devastating disease, and ways in which they attempt to treat it.
Personality disorders are the most common serious mental illness. People suffering from these dis... more Personality disorders are the most common serious mental illness. People suffering from these disorders tend to exhibit emotional patterns and behaviors that seem troubling to the majority of people and are not necessarily explicable by immediate environmental stimuli. Nevertheless, many clinicians are unfamiliar with the most recent research on these disorders and the latest approaches to treatment. This study will review the current diagnostic conceptualization of personality disorders, their clinical treatment, and their relationship to cultural characteristics and culture-specific disorders. Introduction Diagnosis of Personality Disorders In the creation of the new DSM-V there was some debate about what to do with the diagnostic category for personality disorders. In the end the creators of the DSM-decided to holdover the different types of personality disorders from the DSM-IV but to remove these disorders from a separate axis. The DSM-V also keeps the same cluster structure as...
Schizophrenia is a severe mental illness that has devastating consequences for those who suffer f... more Schizophrenia is a severe mental illness that has devastating consequences for those who suffer from the disorder. The epidemiology of schizophrenia indicates that it occurs relatively often, in many different contexts, and in conjunction with other disorders, decreasing quality of life and causing premature death. There has been an enormous amount of research into the causes of schizophrenia and there is now have a much better understanding of the genetic, environmental, and psychological factors that contribute to the disease. While there are numerous ways to understand and conceptualize schizophrenia, a unified picture of the neurobiology, changes in brain structure, cognitive and social-cognitive impairments related to the disorder has yet to emerge. Convulsive therapies and psychosurgery were used unsuccessfully, indiscriminately and without scientific validation in the past to treat schizophrenia. Medical advances including advanced imaging technology have now provided the abi...
The idea that humans can be inhabited by supernatural entities is widespread among cultures and r... more The idea that humans can be inhabited by supernatural entities is widespread among cultures and religions around the world. Demonic possession is sometimes encountered by clinicians who choose to understand it as the actual presence of a demon possessing a human, or as a psychological phenomenon. Some forms of Christianity hold to the belief that demonic possession occurs in reality. Clinicians who share these beliefs may abandon a psychological understanding and treatment of the phenomenon in favor of religious explanations and rituals. Eastern religions like Buddhism understand demonic possession as relatively real but also see it as ultimately stemming from psychological issues. Psychoanalysis understands demonic possession as the result of interpsychic processes related to disturbances in the development of early internalized object relations. This has a number of implications for treatment of so-called demonically possessed individuals, which is exemplified in two clinical cases.
The Journal of Health and Medical Sciences is an Open Access publication. It may be read, copied,... more The Journal of Health and Medical Sciences is an Open Access publication. It may be read, copied, and distributed free of charge according to the conditions of the Creative Commons Attribution 4.0 International license.
German universities in the Nazi era experienced profound upheaval. Under turmoil and stress induc... more German universities in the Nazi era experienced profound upheaval. Under turmoil and stress induced by Nazi leadership these universities succumbed to pathologies related to large group processes. These group pathologies fell into predicable patterns based on dependency, ght or ight, or sexual pairing and are related to both narcissistic and paranoid group leadership. Such patterns of pathology led to organizational characteristics related to unbounded rationality and groupthink. These characteristics are reminiscent of problems found in modern universities. Psychological solutions will be proposed to offset these organizational symptoms of group pathology.
Little is known about using the Objective Structured Clinical Examination (OSCE) in physical diag... more Little is known about using the Objective Structured Clinical Examination (OSCE) in physical diagnosis courses. The purpose of this study was to describe student performance on an OSCE in a physical diagnosis course. Methods: Cross-sectional study at Harvard Medical School, 1997-1999, for 489 second-year students. Results: Average total OSCE score was 57% (range 39-75%). Among clinical skills, students scored highest on patient interaction (72%), followed by examination technique (65%), abnormality identification (62%), history-taking (60%), patient presentation (60%), physical examination knowledge (47%), and differential diagnosis (40%) (p < .0001). Among 16 OSCE stations, scores ranged from 70% for arthritis to 29% for calf pain (p < .0001). Teaching sites accounted for larger adjusted differences in station scores, up to 28%, than in skill scores (9%) (p < .0001). Conclusions: Students scored higher on interpersonal and technical skills than on interpretive or integrative skills. Station scores identified specific content that needs improved teaching.
To date published efforts to assess and improve medical student learning in urology have been lim... more To date published efforts to assess and improve medical student learning in urology have been limited due to the lack of an assessment tool with which to measure student learning. We report the development of a validated measure of medical student learning in urology. Four core topics in clinical urology were selected as the focus of the test development, namely prostate cancer, screening with prostate specific antigen, benign prostatic hyperplasia and erectile dysfunction. Detailed curricula and multiple choice questions were created for each topic. Content validity of the curriculum and 28 item examination was established by a panel of 2 urologists and 2 medical physicians. Instrument reliability was determined by administering the test on line to third-year surgery students. Test construct validity was established through its administration to 19 urology residents and attending physicians. Reliability of the 28-item test instrument was measured by Cronbach&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s alpha at 0.76 and its 1-week test-retest reliability was 0.72. All urology experts performed well on the test. Mean urological expert scores were significantly higher than mean student post-test scores (24.9 +/- 2.1 vs 17.8 +/- 3.8, 2-tailed t test p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). Urological experts with greater urological training had higher scores than those with less residency training. This study documents the development of a validated measure of medical student learning in urology. This validated instrument has the potential to improve educational quality control at medical schools and facilitate the development of effective, evidence based teaching methods.
After the development and implementation of a novel urology curriculum for medical students we ev... more After the development and implementation of a novel urology curriculum for medical students we evaluated urological learning by medical students using a validated measure of learning in the 4 clinical areas of benign prostatic hyperplasia, erectile dysfunction, prostate cancer and prostate specific antigen screening. Third year medical students completed an online validated pre-test and post-test immediately before and after the mandatory 1-week clinical rotation in urology. Online pre-surveys and post-surveys were also administered. Overall student participation was 90% (37 of 41) with 63% of students (26 of 41) completing all 4 tests and surveys. Student overall test scores improved significantly upon completion of the 1-week clinical rotation in urology (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). A trend toward increased learning by male students was identified (p = 0.07). Significant variation in exposure to outpatient clinics and in the performance of physical examination skills was observed among the different teaching sites. This study demonstrates significant learning by medical students during their 1-week clinical rotation in urology. Further data are needed to confirm the trend toward increased learning by males and elucidate its etiology. Scheduling changes have been implemented to address the inconsistencies across clinical sites.
A 15-session sex education program was delivered by teachers to 586 10th graders using techniques... more A 15-session sex education program was delivered by teachers to 586 10th graders using techniques based on social learning theory, including modeling, in-class and out-of-class practice of skills for abstaining from sexual intercourse, and for contraception. Knowledge about reproduction and birth control, intentions to use skills to avoid pregnancy, and communication with parents about pregnancy prevention were signifcantly greater at posttest and 6-month follow-up for the trained group than for the control group. Members of the trained group tended to use birth control more often, especially those who started to have sexual intercourse subsequent to the program. No differences in the frequency of sexual intercourse, pregnancy scares, or pregnancies were found Satisfaction with the program was high Although skill training by itself may not be sufficient to significantly prevent pregnancies, this program offers promise of being a useful component of combined school, home, and communi...
Rationale and Objectives. Traditional oral and written examinations can be limited in predicting ... more Rationale and Objectives. Traditional oral and written examinations can be limited in predicting future clinical performance. Therefore Objective Structured Clinical Examinations (OSCEs) have been introduced in other specialties. The authors assessed their value in radiology. The study includes 122 Harvard medical students who undertook 1-month compulsory clerkships at one of three hospitals (A, B, or C) in their 3rd and 4th year and a compulsory OSCE in their 4th year. The OSCE was constructed from five cases. Each had eight or nine standardized questions designed to test, within a set time, the perception of essential findings, their interpretation, and clinical judgment (maximum possible score, 100). Clerkship grades were high honors (score of 3), honors (score of 2), satisfactory (score of 1), and fail (score of 0). Predictors of OSCE scores-clerkship grade and affiliated hospital-were modeled as linear functions. Time elapsed between clerkship and OSCE was modeled as a nonlinear function. Although there was a positive relation between clerkship grade and OSCE grade, it accounted for an increase of only 5.7% in OSCE score per clerkship grade and did not predict performance of individual students. Students who trained in hospital B showed significantly higher OSCE grades. OSCE scores were highest when the examination was taken 8 months after the clerkship. The OSCE may be useful to uncover deficits in individuals and groups beyond the ones detected with traditional clerkship evaluations and provide guidance for remediation. The improved performance after additional clinical exposure suggests that the OSCE may be well suited to test the integration of radiologic and clinical knowledge.
OBJECTIVE: Training in Bright Futures and oral health concepts is critical for delivery of high-q... more OBJECTIVE: Training in Bright Futures and oral health concepts is critical for delivery of high-quality primary care and preventive health services by residents, our future pediatric workforce. The goal of this study was to evaluate the effectiveness of an online health promotion curriculum on pediatric residents' confidence, knowledge, and clinical performance in Bright Futures and oral health practice. METHODS: Residents from sites that had been stratified by size and randomized were assigned to the Bright Futures Oral Health curriculum (intervention group) or an active control group. Confidence and knowledge were measured by self-report and multiple-choice questions, respectively. Clinical performance was measured with structured clinical observations, performed by trained faculty, of Bright Futures and oral health performance before and after intervention. Mean scores between intervention and control groups were compared using a 2-tailed, repeated-measures F test. RESULTS: A total of 143 pediatric residents from 27 Continuity Research Network (CORNET) sites participated in the study. At a median of 3 months after intervention, the intervention group demonstrated significant improvement in general Bright Futures confidence (n ¼ 128, F ¼ 6.564, P ¼ .012) and knowledge (n ¼ 102, F ¼ 5.296, P ¼ .023), oral health confidence (n ¼ 123, F ¼ 15.220, P <.001), and clinical performance skills in oral health (n ¼ 96, F ¼ 11.315, P ¼ .001) compared with the control group. CONCLUSIONS: The Bright Futures Oral Health curriculum promoted an increase in confidence and knowledge in Bright Futures concepts and in confidence and clinical performance in oral health concepts among pediatric residents. This online curriculum demonstrated a positive impact on documented resident behavior, maintained for 3 months after intervention, and provides a replicable national training model to advance important elements of primary care pediatrics.
Problem Statement and Background: While the psychometric properties of Objective Structured Clini... more Problem Statement and Background: While the psychometric properties of Objective Structured Clinical Examinations (OSCEs) have been studied, their latent structures have not been well characterized. This study examines a factor analytic model of a comprehensive OSCE and addresses implications for measurement of clinical performance. Methods: An exploratory maximum likelihood factor analysis with a Promax rotation was used to derive latent structures for the OSCE. Results: A model with two correlated factors fit the data well. The first factor was related to Physical Examination and History-Taking was labeled as information gathering, while the second factor was related to Differential Diagnosis/Clinical Reasoning, and Patient Interaction and was labeled as reasoning and information dissemination. Case Management did not contribute to either factor. The factors accounted for a total 61.6% of the variance in the skills variables. Conclusions: Recognizing the psychometric components of OSCEs may support and enhance the use of OSCEs for measuring clinical competency of medical students.
Basic Measurement Concepts: Reliability & Validity Reliability Is greatly affected by the number ... more Basic Measurement Concepts: Reliability & Validity Reliability Is greatly affected by the number of items, number of participants, rating scale used, type of reliability coefficient sought, number of raters, time between ratings, type of items, and how well the test questions are written, etc. Can be affected (usually in a lesser degree) by inconsistencies in the testing location, test conditions, and the presentation of the test itself. Reliability is really a measure of how much error an assessment carries. 4/26/2005 9 Stringency/leniency-Questions or raters can be unnecessarily critical or charitable. Central tendency-undue avoidance of definitive ratings. Halo Effect-Basing all ratings on a general impression, or letting one trait overshadow the rest.
study examined four dimensions of health conception and their relationship to six dimensions of h... more study examined four dimensions of health conception and their relationship to six dimensions of health-promoting lifestyle in a population of older adults (n=364). A battery of instruments was administred to all subjects to measure health conception, health-promoting lifestyle, importance of health, perceived control of health, perceived health status, perceived benefits of exercise, perceived barriers to exercise; demographic information was also obtained. Using these data, an analysis of covariance was conducted to compare the goodness of fit of two alternate models of the relationship between health conception and health-promoting lifestyle derived from the literature. hIdel A hypothesized s'..rength of health conception as the single underlying dimension progressively related to the four health conception scales (eudaimonistic, adaptive, role performance, and clinical); Model B suggested that the adaptive and eudamonistic health conception variables weL-e strongly related to one another. Results of the analysis suggest that Model B was best fitted to the data. A discussion of these findings and their implications ensues, and recommendations for further research for are made. References are included and structural equation charts of the two models under investigation are appended. (TE)
Asian Journal of Humanities and Social Studies, 2013
The goal of Buddhism is to gain enlightenment through the realization of the psychological basis ... more The goal of Buddhism is to gain enlightenment through the realization of the psychological basis of human suffering. Like other religions Buddhists undertake this goal together in a community known as the Sangha, which, includes lay practitioners, clergy, and various symbolic figures. While, the ostensible goal of the Sangha is to help Buddhists reach a state of religious epiphany, it also functions in a psychological fashion to moderate the regressive effects of group membership. This moderation allows the Sangha to facilitate individuation for its members while they maintain their group membership. In this way the Sangha provides a practical method for applying spiritual principals to relationships with others in the group and later, to the world at large. This paper will review classical and object relations views of group psychology and then apply these perspectives to the understanding of the Sangha.
Structural equation modeling has become increasingly popular as a technique for the analysis of n... more Structural equation modeling has become increasingly popular as a technique for the analysis of non-experimental data in the social sciences. This increase can be traced in part to the development of computer programs that facilitate structural equation modeling. The Linear Structural Relations (LISREL) program is the most widely used tool for implementing structvral equation models. LISREL is applicable across a wide range of study, but is most useful in analyzing social science data. Some characteristics of the LISREL program are examined. The general LISREL model is explained along with methods for establishing the identification and goodness-of-fit of the overall model and its individual parameters. TC is concluded that the most important aspect of LISREL methodology is its flexibility; almost any type of problem involving regression or factor analytic procedures can be computed using LISREL. LISREL models should be theory driven, but should not be used to explore the grosser as...
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Hearing before the Senate Judiciary Committee: ... more Pg 93: Hearing before the Senate Judiciary Committee: September 15, 2010 Written Testimony of Kevin Volkan, Chair & Professor of Psychology, California State University Channel Islands, Camarillo, CA Neil Rocklin, Psychologist Private Practice
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Papers by Kevin Volkan
Hearing before the Senate Judiciary Committee:
September 15, 2010
Written Testimony of Kevin Volkan,
Chair & Professor of Psychology,
California State University Channel Islands, Camarillo, CA
Neil Rocklin, Psychologist Private Practice