Perceptions of psychological content in the GP consultation - the role of practice, personal and prescribing attributes

Objective: The aim of the present study was to determine the relationship between the characteristics of general practices and the perceptions of the psychological content of consultations by GPs in those practices. Methods: A cross-sectional survey was conducted of all GPs (22 GPs based in nine practices) serving a discrete inner city community of 41 000 residents. GPs were asked to complete a log-diary over a period of five working days, rating their perception of the psychological content of each consultation on a 4-point Likert scale, ranging from 0 (no psychological content) to 3 (entirely psychological in content). The influence of GP and practice characteristics on psychological content scores was examined. Results: Data were available for every surgery-based consultation (n = 2206) conducted by all 22 participating GPs over the study period. The mean psychological content score was 0.58 (SD 0.33). Sixty-four percent of consultations were recorded as being without any psychological content; 6% were entirely psychological in content. Higher psychological content scores were significantly associated with younger GPs, training practices (n = 3), group practices (n = 4), the presence of on-site mental health workers (n = 5), higher antidepressant prescribing volumes and the achievement of vaccine and smear targets. Training status had the greatest predictive power, explaining 51% of the variation in psychological content. Neither practice consultation rates, GP list size, annual psychiatric referral rates nor volumes of benzodiazepine prescribing were related to psychological content scores. Conclusion: Increased awareness by GPs of the psychological dimension within a consultation may be a feature of the educational environment of training practices.

Children’s understanding of counterfactual alternatives

This study examines how children integrate information about counterfactual alternatives in making judgments. Previous research in adults had shown that they make judgments on the basis of comparisons between factual events and counterfactual alternatives. We suggest that children adopt a summative strategy instead, where they focus on the presented outcomes, both real and counterfactual, and base their judgments on the overall affective quality of these outcomes. Results from a single experiment comparing adults’ and children’s responses to a counterfactual judgment task show that children do tend to use a summative strategy as opposed to the comparative strategy adopted by adults. These results were further supported by participants’ justifications of their judgments, which were alternative focused for the adults, but outcome focused for the children. The results are discussed in relation to complexity-based theories of the development of human reasoning.

The impact of maternal control on children’s anxious cognitions, behaviours and affect: an experimental study

Controlling parenting is associated with child anxiety however the direction of effects remains unclear. The present study implemented a Latin-square experimental design to assess the impact of parental control on children’s anxious affect, cognitions and behaviour. A non-clinical sample of 24 mothers of children aged 4-5 years were trained to engage in (a) controlling and (b) autonomy-granting behaviours in interaction with their child during the preparation of a speech. When mothers engaged in controlling parenting behaviours, children made more negative predictions about their performance prior to delivering their speech and reported feeling less happy about the task, and this was moderated by child trait anxiety. In addition, children with higher trait anxiety displayed a significant increase in observed child anxiety in the controlling condition. The pattern of results was maintained when differences in mothers’ levels of negativity and habitual levels of control were accounted for. These findings are consistent with theories that suggest that controlling parenting is a risk factor in the development of childhood anxiety.

Water reuse for irrigation in Jordan: perceptions of water quality among farmers

The reuse of treated wastewater (reclaimed water) for irrigation is a valuable strategy to maximise available water resources, but the often marginal quality of the water can present agricultural challenges. Semi-structured interviews were held with Jordanian farmers to explore how they perceive the quality of reclaimed water. Of the 11 farmers interviewed who irrigate with reclaimed water directly near treatment plants, 10 described reclaimed water either positively or neutrally. In contrast, 27 of the 39 farmers who use reclaimed water indirectly, after it is blended with fresh water, viewed the resource negatively, although 23 of the indirect reuse farmers also recognised the nutrient benefits. Farmer perception of reclaimed water may be a function of its quality, but consideration should also be given to farmers’ capacity to manage the agricultural challenges associated with reclaimed water (salinity, irrigation system damage, marketing of produce), their actual and perceived capacity to control where and when reclaimed water is used, and their capacity to influence the quality of the water delivered to the farm.