Task control and cognitive abilities of self and spouse in collaboration in middle-aged and older couples.

Collaborative problem solving may be used by older couples to optimize cognitive functioning, with some suggestion that older couples exhibit greater collaborative expertise. The study explored age differences in 2 aspects of collaborative expertise: spouses' knowledge of their own and their spouse's cognitive abilities and the ability to fit task control to these cognitive abilities. The participants were 300 middle-aged and older couples who completed a hypothetical errand task. The interactions were coded for control asserted by husbands and wives. Fluid intelligence was assessed, and spouses rated their own and their spouse's cognitive abilities. The results revealed no age differences in couple expertise, either in the ability to predict their own and their spouse's cognitive abilities or in the ability to fit task control to abilities. However, gender differences were found. Women fit task control to their own and their spouse's cognitive abilities; men only fit task control to their spouse's cognitive abilities. For women only, the fit between control and abilities was associated with better performance. The results indicate no age differences in couple expertise but point to gender as a factor in optimal collaboration.

Improving the effectiveness of the medical visit: a brief visit-structuring workshop changes patients' perceptions of primary care visits.

OBJECTIVE: To teach visit-structuring strategies to primary care clinicians with a 1.5-h experiential workshop and assess its effect on patient perceptions of their medical visits. METHODS: We developed and conducted a 90 min workshop for 75 clinicians from seven primary care clinics, and evaluated the effectiveness of the workshop by assessing changes in patients' ratings of visit qualities from 1 week prior (n=301) to 1 week after (n=322) the workshop. Patients rated their physicians' visit-structuring skills as well as satisfaction with their medical visits. RESULTS: Patients were highly satisfied with their visits both before and after the workshop. Post-workshop ratings of medical visits were more likely to indicate that all problems were addressed during the visit. CONCLUSIONS: A brief workshop had a positive measurable effect on patients' perception of their medical visits. Future research should address the utility of patient rated assessments of visit characteristics. PRACTICE IMPLICATIONS: Physicians' ability to establish and maintain a productive structure in primary care office visit is an important skill that can improve the quality of care, and some changes in physician visit-structuring behavior can be measured using patient perceptions.

Hostility, anger, aggressiveness, and coronary heart disease: an interpersonal perspective on personality, emotion, and health.

The related traits of hostility, anger, and aggressiveness have long been suggested as risk factors for coronary heart disease (CHD). Our prior review of this literature (Smith, 1992) found both considerable evidence in support of this hypothesis and important limitations that precluded firm conclusions. In the present review, we discuss recent research on the assessment of these traits, their association with CHD and longevity, and mechanisms possibly underlying the association. In doing so, we illustrate the value of the interpersonal tradition in personality psychology (Sullivan, 1953; Leary, 1957; Carson, 1969; Kiesler, 1996) for not only research on the health consequences of hostility, anger, and aggressiveness, but also for the general study of the effects of emotion, personality and other psychosocial characteristics on physical health.

Psychological predictors of adherence and outcomes among patients in cardiac rehabilitation.

PURPOSE: The purpose of this study was to evaluate the effects of optimism, depression, and neuroticism on adherence and outcomes among patients in cardiac rehabilitation (CR). METHODS: Participants included 46 patients (34 men) with coronary heart disease (CHD) who completed measures of psychological functioning (optimism, depression, neuroticism), physical functioning (exercise stress test, body mass index, symptom reports), and CHD knowledge during the first week (baseline) and last week of a 12-week CR program. RESULTS: Baseline depression scores accounted for 9.5% of the variance associated with change in aerobic capacity (maximum oxygen consumption), when controlling for relevant demographic variables and program attendance. However, optimism and neuroticism were not predictive of CR outcomes. Results also indicated that program dropouts were significantly younger and reported more psychological distress at baseline than did participants who completed the program. CONCLUSION: Depression appears to have a significant influence on adherence and improvement among patients in CR, but optimism and neuroticism were not significant predictors of change.