Exam 1: Behavioral Sciences

Passage The highly addictive nature of cigarettes can be partly explained by how nicotine, the primary addictive ingredient, is administered.  The fastest route of administration for most drugs is through inhalation; cigarette smoking results in the transmission of nicotine to the brain in about 15 seconds.  In the brain, nicotine activates the nicotinic acetylcholine receptors, which stimulate the brain's reward pathway and produce mild feelings of euphoria.  Those who quit smoking often relapse due to stress, weight gain, and withdrawal symptoms such as cravings and irritability.  Of those who attempt to quit without formal treatment, only 3%-5% remain abstinent after a year.Research suggests that mindfulness meditation-based programs can be an effective strategy to quit smoking.  Mindfulness is an aspect of meditation that involves cultivating a nonjudgmental awareness of the thoughts, emotions, and sensations arising in the present moment.For one study, researchers randomly assigned 88 smokers to either Mindfulness Training (MT) or the Freedom From Smoking (FFS) intervention developed by the American Lung Association.  Both groups participated in 90-minute group training sessions twice a week for four weeks.  The FFS intervention educated participants on the negative health consequences of smoking, coping strategies for cravings, and the development of healthy lifestyle habits.  The MT intervention taught mindfulness meditation techniques as a way of gaining awareness and acceptance of the cognitive, emotional, and physical components of cravings.  The number of cigarettes smoked per day and self-reported abstinence, as verified by exhaled carbon monoxide, were measured at the end of treatment and at a 17-week follow-up for participants in each group (Figure 1). Figure 1  Percentage of participants in each group abstinent at the end of treatment and at 17-week follow-up (* indicates p < 0.05) -Which of the following may be involved with physical drug dependence?Neurochemical changes in the brainWithdrawal symptoms with cessation of drug useTolerance to the drug used

Passage Trait theorists believe that all people have certain traits, or characteristic ways of thinking and behaving, that largely account for personality.  Psychobehavioral researchers conducted a pair of studies to determine whether individuals could intentionally alter one of their respective personality traits.In Study 1, participants were asked to select one personality trait they wished to increase from among the following: openness to experience, conscientiousness, extraversion, agreeableness, or emotional stability.  Participants first completed a short survey that measured baseline personality trait expression scores (pretest).  Participants in the experimental group (n = 125) then developed their own intervention plan intended to increase the selected personality trait whereas the control group (n = 125) did not implement any changes to daily activities.  At the end of the study, all participants completed the same self-report survey to reassess their personality trait expression scores (posttest).  Results were calculated by subtracting pretest from posttest scores for each person (change score), and then comparing the mean change scores for the experimental and control groups.  Results showed significantly greater change scores for experimental group participants who elected to increase their emotional stability, relative to control subjects who selected this trait.  The change scores did not differ significantly between the experimental and control groups that selected any of the other four traits (ie, openness to experience, conscientiousness, extraversion, or agreeableness).In Study 2, the same basic methodology was used on a new cohort with several adjustments to the Study 1 design.  Instead of asking participants in the experimental condition to formulate their own intervention plans, licensed therapists trained participants in practices to redirect thought processes, emotional responses, and behaviors associated with the selected personality trait.  The experimental group participants carried out these practices for the course of the study whereas the control group participants implemented no changes.  In contrast to the self-reports used in Study 1, personality trait expression scores (both pre and post) were determined by assessments made by researchers.  Results from Study 2 showed significantly greater increases in all five personality trait expression scores for experimental versus control participants. -A researcher interested in whether there is a correlation between the personality trait of neuroticism and somatic symptom disorder is most likely to assess if:

Passage Across the lifespan, mental and physical health depends on adequate sleep.  Extensive research suggests that sleep needs and characteristics change throughout an individual's life (Figure 1). Figure 1  Average hours of rapid eye movement (REM) and non-REM sleep for different age groups across the lifespanChronic sleep deprivation acts as a physiological stressor and can have a multitude of short- and long-term negative health consequences.  Studies show that over 30% of adults get less than the recommended minimum of 7 hours of sleep per night, putting them at greater risk for metabolic disorders (eg, obesity, diabetes), cardiovascular disease (eg, high blood pressure, stroke), and emotional disorders (eg, anxiety, depression).  Sleep deprivation is also associated with impaired cognitive functioning, decreased work performance, and an increased risk of accidents.However, the guideline that adults sleep at least 7 hours per night does not account for the considerable variation in individual sleep needs.  Research suggests that some individuals, known as "long sleepers," require an average daily sleep duration of more than 9 hours, while "short sleepers" require an average daily sleep duration of less than 6 hours.  One study found that biological night duration (established by one's circadian pacemaker or "master clock") appears to be a few hours shorter for short sleepers as compared to long sleepers.  Other studies suggest that short sleepers regularly sleep less than 7 hours without any apparent negative consequences due to one or more genetic mutations, such as a mutation on the DEC2 gene (also known as BHLHE41), which codes for a transcription factor involved in regulating circadian rhythms. -In which region of the brain would a lesion most likely disrupt the sleep/wake cycle?

Passage Until recently, deviance has generally been conceptualized as negative.  Positive deviance (PD) is used to describe the atypical behaviors exhibited by some individuals that result in superior outcomes when compared with others in the group.  Despite having similar access to limited resources, some people adopt novel strategies to problem-solve much better than their peers.  For example, rural Vietnamese villages in the 1990s had child malnutrition rates approaching 70%.  Despite this, certain villagers were able to nourish their children by developing innovative strategies that defied social norms.  These villagers fed their children plant parts not traditionally consumed (such as the leaves of the sweet potato plant) and fed them three or four times a day (instead of the customary two meals a day).  In other words, despite a lack of conventionally accepted means, these villagers engaged in alternative behaviors, or PD, to meet the societal goal of providing adequate nourishment to their children.Research into PD has focused on using these innovative individuals to catalyze change in their communities.  A pilot study attempting to spread the techniques of these initial PD villagers within their own community was successful:  Childhood malnutrition dropped by over 80% in two years.  However, the community-based approach to changing health behaviors appears to be crucial:  When an international aid organization attempted to implement a larger program based on these same practices, villagers resisted the imposed changes and it was unsuccessful.Another study assessed how PD can improve outcomes in health care settings.  Patients with difficult-to-manage chronic diseases often hold deeply entrenched beliefs about how to handle their illnesses and ignore alternative strategies.  PD patients, referred to as "bright spotters" in the study, are an exception.  They have successfully managed to control their complex illnesses using innovative approaches such as diet modifications and unique coping mechanisms.  Similar to the pilot study with Vietnamese villagers, preliminary results suggest that peer-led group activities may best allow bright spotters to teach fellow patients how to effectively manage their illnesses. -The pilot study of how PD can reduce malnutrition in Vietnamese villages is most applicable to which of the following?

Researchers conduct an experiment using dogs.  Each dog is placed in a cage with a short middle partition.  A light turns on five seconds before the dog receives a painful electric shock through the floor, which stops when the dog jumps over the partition.  If researchers count the number of trials each dog needs until it jumps over the partition before the shock is administered, they are most likely studying:

Passage The last several decades have seen a significant increase in immigration to the United States.  Today, more than 20% of American children age 17 and younger have at least one foreign-born parent, and about 30% of these children are themselves foreign-born.Immigrant youths in the United States tend to adapt extremely well to their new surroundings.  Researchers report that immigrant students often perform in school as well or better than their US-born classmates.  Studies assessing psychological adjustment reveal similar findings:  Foreign-born students are less likely to abuse alcohol or break the law, and they demonstrate relatively higher levels of self-esteem than their US-born peers.The following quotations are responses from overachieving immigrant middle school students when asked by interviewers to explain their success:Student 1, eighth-grade valedictorian:  "When my mother first came to the United States from China, she spent all her time working, trying to earn a living to support her three children.  I know how much she has sacrificed, and I am so grateful that I am willing to do just about anything for her."Student 2, a straight-A student:  "[In my neighborhood] everyone knows everyone.  They all know what I am up to, so I want to make a good impression and have them think highly of me.  I also want to represent my community well to others."Even though immigrant families are often more prosperous in the United States than they were in their home countries, they still often struggle financially, typically due to parental language barriers.  The impressive adaptations of immigrant students occur despite impoverished circumstances; their parents tend to emphasize the importance of education as a means to attaining prosperity, reminding their children that they immigrated to provide their children with access to better education than was available in their homeland.  Immigrant children tend to internalize their parents' attitude toward educational achievement.Members of ethnic minorities in the United States also stress loyalty to family and community over self, so children feel a strong sense of gratitude and allegiance to their parents.  Immigrant parents with successful children have usually formed close relationships with members of their ethnic community; members of ethnic enclaves tend to demonstrate consensus on values and exert an unusually high level of control over the children's behavior through regular monitoring. L. E. Berk. Child Development © 2006 Pearson -According to Kohlberg's theory of moral development, which of the following is most likely to motivate Student 2 to work hard in school?

Passage On the way home from a routine visit to the pediatrician, Sarah stops with her infant son at the local convenience store.  As she is waiting in line, a man squeezes in closely behind them and sneezes.  As Sarah walks home, she finds that her heart is racing, she feels nauseous, and she is terrified that her child will become severely ill.Soon after, she becomes obsessed with disease and contamination.  She begins to take extensive measures to "decontaminate" herself and her home, including washing her hands dozens of times daily.  These cleaning rituals have the immediate effect of lessening Sarah's anxiety, so she soon spends most of her day performing them.  She seeks treatment from a therapist, who instructs her to gradually expose herself to "contamination" but refrain from her cleaning rituals.  The therapist also teaches Sarah how to recognize and modify her maladaptive thoughts about illness prevention.  Within several weeks, Sarah finds that she can manage her thoughts about disease and contamination without resorting to ritualistic cleaning.A researcher hypothesized that individuals with obsessive-compulsive disorder (OCD), such as Sarah, would show a more generalized fear response to safe stimuli compared to controls.  Generalized conditioned fear responses occur when individuals react with fear to stimuli that resemble the original conditioned stimulus (eg, someone injured in an accident with a red truck fears all red vehicles).  The researcher conditioned 100 individuals (50 with OCD and 50 controls) to associate a shock with a visual stimulus.  In phase 1, participants viewed a computer screen that alternated between images of a small ring (1 cm) and a large ring (20 cm).  The small ring and large ring were displayed for 1 second each, with a blank screen in between for 5 seconds.  A mild electric shock was paired with the large ring, and no shock was paired with the small ring.  This was repeated for 10 trials.  In phase 2, shocks were discontinued, and three intermediate-sized rings were added to the series and presented in increasing size (ie, 1 cm, 5 cm, 10 cm, 15 cm, 20 cm) while the participants' startle response to each ring was measured.  This was repeated for 10 trials. ncbi.nlm.nih.gov/pmc/articles/PMC3932061/ -What are the conditioned and unconditioned stimuli in the study, respectively?

Passage Suicide is one of the leading causes of death in the United States.  Suicide risk is associated with a variety of factors.  Personal factors include childhood abuse, certain personality traits (eg, impulsiveness, aggression), and history of mental illness.  Over 90% of people who attempt suicide meet diagnostic criteria for at least one psychological disorder, and suicide risk increases as the number of co-occurring disorders increases.  Diagnosis severity also matters:  studies suggest that individuals are at greatest risk of attempting suicide while inpatient at or newly discharged from a psychiatric hospital.Social factors also play a role in suicide.  Sociologist Émile Durkheim argued that embeddedness in society is a key feature in determining the likelihood of an individual committing suicide.  Specifically, the more people that depend on an individual financially, emotionally, or physically, the less likely that individual is to commit suicide.  Studies suggest that suicide is also linked to religious affiliation and income level.  Religious groups that place more value on community events, church attendance, and collective solidarity tend to have lower rates of suicide among members, whereas more affluent individuals are more likely to commit suicide.Economic trends have also been linked to suicide.  One study retrospectively analyzed the relationship between the U.S. economy and suicide rates.  It found that the overall suicide rate tends to rise during economic recessions and drop during economic expansions (Figure 1). Figure 1  U.S. suicide rates compared to economic trendsFurther analysis of suicide data suggests that for every individual who successfully commits suicide, approximately 25 individuals are unsuccessful in such attempts, costing the United States billions of dollars annually in both lost wages and treatment expense.  Although white, middle-aged men are the most likely cohort to successfully commit suicide, women attempt suicide three times more often than men. -How would a proponent of Malthusian theory most likely interpret the data in Figure 1?

Passage Epidemiologists now consider obesity to be a global pandemic, occurring largely as a result of the spread of technology and culture worldwide.  Obesity has been linked to many serious health conditions, and as the obesity rate rises, the overall poorer health of the population impairs the functioning and stability of society.  Although experts disagree about whether obesity itself should be viewed as a disease to be treated with medical interventions, there is widespread consensus that obesity prevention is critical.  Research has shown that across one's life span, multiple biological, psychological, and social influences contribute to obesity; understanding the influence of these factors is essential to the development of effective obesity prevention programs.Study 1 was conducted using nearly 6,000 residents from a mid-sized city to investigate how obesity rates change over time in informal social groups.  During recruitment wave A, researchers asked an initial group of individuals to complete a two-minute health questionnaire; those who completed the questionnaire were then asked to participate in the research study.  During recruitment wave B, additional participants were recruited using a snowball sampling technique:  participants who enrolled during wave A provided contact information of friends and family members who were then asked to participate.  Researchers finalized the sample such that each participant had at least one family member, one close friend, and one acquaintance also in the study.  Every year for 20 years, researchers measured each participant's height and weight to calculate body mass index (BMI) and conducted an extensive interview with each participant to assess the type, strength, and geographic distance of their social ties with other participants.  Researchers found that the type and strength of social ties appeared to be more strongly linked to BMI than geographic closeness between social ties.Study 1 was criticized for not addressing larger contextual variables related to obesity, such as the availability of unhealthy food within a community.  Therefore, Study 2 randomly selected a subset of 500 cases from the Study 1 database and, using participants' addresses, researchers mapped and counted the number of retail food chains (ie, "fast food" restaurants selling low-quality, calorie-dense food) located within a 1-mile radius of participants' homes and compared this to BMI at the end of the 20-year study.  Results showed a significant relationship between higher BMI and more neighborhood retail food chains. J. A. Levine ©2011 American Diabetes Association; Christakis, N. A. and Fowler, J. H. ©2007 Massachusetts Medical Society -In Study 1, the initial recruitment approach (wave A) employed which of the following techniques?

Passage Psychotic disorders are characterized by a loss of contact with reality.  The most common psychotic disorder is schizophrenia, which has a typical onset of psychotic symptoms in early adulthood.  Schizophrenia displays considerable inter-individual variation throughout the course of the disorder; many factors appear to influence its progression.  Comorbid (co-occurring) conditions, common in schizophrenia, may lead to poorer prognoses.  For example, research suggests that fewer depressive symptoms are moderately associated with higher rates of medication compliance, whereas more depressive symptoms are associated with increased future relapses.  The early detection of psychosis also appears to have a significant impact on long-term outcomes in schizophrenia.  A first psychotic episode that goes untreated for a longer period is associated with more future hospitalizations and a diminished response to future therapeutic interventions.Researchers conducted a study to determine which was better at predicting the development of psychosis, a major component of schizophrenia, in high-risk young adults: the presence of certain speech pattern features or a standard clinical symptom inventory.  The participant sample was restricted to 50 younger adults (age 18-30) who either met criteria for prodromal syndrome (preclinical signs of psychosis) or had a first-degree relative with schizophrenia.Every three months for three years, participants were interviewed and given the Symptoms of Psychosis Inventory (SPI), a standardized clinical assessment designed to measure psychosis and related symptoms.  The SPI contains two subscales based on the major symptoms of schizophrenia: the Positive Symptom Scale (PSS) and the Negative Symptom Scale (NSS), which are summed to provide a total SPI score.  Transcribed interview data were analyzed with software designed to assess the following speech pattern features: semantic coherence (the relatedness of phrases to one another), the number of determiners (eg, "that," "which," "what") used in a phrase (determiner density), and phrase length.Experienced clinicians diagnosed 11 participants with active psychosis by the end of the study.  A computer program generated two models that predicted the development of active psychosis based on the data collected.  One model based the prediction solely on a combination of the three speech pattern features ("Speech Model") and the other model based the prediction solely on SPI symptoms data ("SPI Model") (Table 1).Table 1 Comparison of Predictive Models -Based on the symptoms of schizophrenia, which statement is accurate regarding the symptoms measured by the SPI?

Researchers hypothesized that student nurses make more errors when they train under the supervision of an instructor who has low expectations for their competency.  Which statement is accurate regarding research designed to test this hypothesis?

A survey of medical students found that most believe the surgical specialty has its own clearly defined "masculine" subculture, and that to succeed as surgeons, individuals need to "adopt masculine characteristics."  These beliefs best reflect which aspect of surgical medical education?

Passage Trait theorists believe that all people have certain traits, or characteristic ways of thinking and behaving, that largely account for personality.  Psychobehavioral researchers conducted a pair of studies to determine whether individuals could intentionally alter one of their respective personality traits.In Study 1, participants were asked to select one personality trait they wished to increase from among the following: openness to experience, conscientiousness, extraversion, agreeableness, or emotional stability.  Participants first completed a short survey that measured baseline personality trait expression scores (pretest).  Participants in the experimental group (n = 125) then developed their own intervention plan intended to increase the selected personality trait whereas the control group (n = 125) did not implement any changes to daily activities.  At the end of the study, all participants completed the same self-report survey to reassess their personality trait expression scores (posttest).  Results were calculated by subtracting pretest from posttest scores for each person (change score), and then comparing the mean change scores for the experimental and control groups.  Results showed significantly greater change scores for experimental group participants who elected to increase their emotional stability, relative to control subjects who selected this trait.  The change scores did not differ significantly between the experimental and control groups that selected any of the other four traits (ie, openness to experience, conscientiousness, extraversion, or agreeableness).In Study 2, the same basic methodology was used on a new cohort with several adjustments to the Study 1 design.  Instead of asking participants in the experimental condition to formulate their own intervention plans, licensed therapists trained participants in practices to redirect thought processes, emotional responses, and behaviors associated with the selected personality trait.  The experimental group participants carried out these practices for the course of the study whereas the control group participants implemented no changes.  In contrast to the self-reports used in Study 1, personality trait expression scores (both pre and post) were determined by assessments made by researchers.  Results from Study 2 showed significantly greater increases in all five personality trait expression scores for experimental versus control participants. -Psychoanalytic theory would most likely suggest that experimental group participants who are able to alter their personality traits have:

Passage Although the terms sex, sex category, and gender are commonly used interchangeably by most people, sociologists distinguish between them.  Sex refers to the biological distinction between bodies (eg, male, female).  Sex category (eg, male, female) is based on the visible secondary sex characteristics people use to attribute sex to others.  Gender (eg, masculine, feminine) specifically refers to the behaviors and behavioral expectations people attribute to others on the basis of the individual's perceived sex category.  Sex category and gender have recently been conceptualized as continua, with male and female as the extremes for sex category perception and masculine and feminine as the extremes for gender.  Despite this, sex category and gender are usually perceived by humans categorically instead of continuously.Researchers conducted a study to assess how sex category interpretation is related to implicit bias and cortical activity.  For the first phase, researchers tested sex category interpretation using 12 highly realistic computer-generated "facial morphs" varying along a continuum of apparent sex category from extremely male (1) to extremely female (12).  The sexually dimorphic content of the faces was manipulated, but all other aspects were unchanged.  For example, eyes and noses remained constant, but brow lines and eyebrows were thickened for male faces.  Participants viewed the 12 faces in random order, rating each face on a scale of 1 (extremely male) to 10 (extremely female).  Despite the uniform increments in the sexually dimorphic content of the facial morphs, responses demonstrated dichotomous sex category classification, as expected.For the second phase, which assessed the relationship between sex category interpretation and implicit bias, participants completed an implicit association test (IAT), in which they were shown the facial morphs with a pair of word attributes, one positive and one negative (eg, hard-working, lazy), and were asked to quickly pick the word they most associated with the face.  Participants demonstrated shorter response times for facial morphs at the end points of the sex category continuum.For the third phase, researchers assessed the relationship between face-sensitive regions in the occipitotemporal cortex, particularly the fusiform face area (FFA), and sex category interpretation.  Participants were injected with a glucose analog containing a radioactive tracer an hour before brain activity was measured while participants viewed the facial morphs.  Results suggest that FFA activity was strongest when the faces were at the end points of the sex category continuum, regardless of whether a face was perceived as male or female. -Which of the following displays the results of the first and second phases of the study, with the solid line representing participants' sex category ratings and the dashed line representing IAT response time?

Passage Of the biological factors impacting color perception in humans, one of the easiest to study is the number and type of color-sensitive photoreceptors.  The human retina typically contains three types of cone photoreceptors, which contain opsin proteins that are sensitive to short (blue), medium (green), and long (red) wavelengths of light (Figure 1A).The genes that encode for medium and long wavelength-sensitive opsin proteins are located on the X chromosome.  Mutations in these genes often produce a variant cone type that responds to wavelengths overlapping the response range of one of the normal cone types, so color perception is unaltered (Figure 1B).  However, in a small percentage of women, the variant cone type appears to be sensitive to a range of wavelengths that differs from that of normal cone types (Figure 1C).  It is hypothesized that these "tetrachromatic" women may be able to distinguish more colors than can the normal trichromatic population. Figure 1  Response curves for (A) three cone types (trichromat, normal color perception); (B) four cone types (likely normal color perception); and (C) four cone types (tetrachromat, hypothesized enhanced color perception)A researcher conducted a series of tasks to assess the extent to which color perception of tetrachromatic subjects differs from that of trichromatic controls.  Three women known to possess four retinal cone classes were recruited for the study.  One of the women had experienced a small lesion to her right primary visual cortex the year prior.  In addition, two women with normal trichromatic vision were recruited as controls (Table 1).Table 1  Characteristics of Subjects In Task 1, participants identified the colors of objects that were stationary (artificial condition) and in motion (natural condition).  Under both conditions, the researcher systematically varied where the objects were presented in the subjects' visual field.  Task 2 was a standardized, computer-administered color-discrimination task.  Task 3 was an extensive interview that assessed the subjects' subjective experience of color.Subject 1 was able to identify more colors than the controls under all experimental conditions, and Subject 2 and Subject 3 performed marginally better than controls in some of the experimental conditions.  Notably, only Subject 1 was able to verbalize her thoughts about her atypical color perception during Task 3, where she described seeing nuances in colors using words she had learned from her mother, who was also a tetrachromat and an artist.  The researcher concluded that language likely plays a significant role in color perception: Without a vocabulary for the full variety of colors tetrachromats can perceive, they are limited in their perception despite their biological trait. S. S. Deeb ©2005 John Wiley & Sons; K. A. Jameson, A. D. Winkler, and K. Goldfarb ©2016 IS&T International Symposium on Electronic Imaging. -Which hypothetical result from a study on tetrachromatic monozygotic (MZ) twins separated at birth and raised by different parents would provide the strongest evidence contradicting the conclusion in the final paragraph of the passage?  Tetrachromatic MZ twins' color discrimination abilities are more similar to each other than to:

Passage Studies suggest that health outcomes for preventable diseases are impacted by delayed treatment and lack of compliance.  People often postpone seeking medical care because they fear hearing bad news from their physician.  Paradoxically, when they finally do see a doctor, they may find out that their disease is indeed serious, but only because treatment was so delayed.Refusal to comply with a physician's instructions is another major issue.  Although there are many reasons for this, one possible explanation is that patients are responding with psychological reactance.  Reactance theory suggests that when an individual perceives that free choice is threatened or limited, he or she may respond by wanting to perform the threatened behavior even more, as if to preserve original freedoms.  For example, if a physician tells a patient to quit smoking, the smoker might respond by smoking even more in an effort to preserve the freedom to smoke.Researchers hypothesize that psychological reactance may be reduced or avoided when physicians communicate with their patients through a process known as deliberation.  In the following example, the physician has already explained to the patient that her weight could be having a negative impact on her diabetes.  The physician, using deliberation, then initiates a dialogue about how the patient would like to address the situation:Physician:  "You are already taking pretty strong medications, so your options are either to change your eating habits or increase your level of exercise.  It's your choice."Patient:  "I think I could exercise more by joining a gym.  I could stop eating dessert, but I would hate to give up chocolate."Physician:  "Okay.  Let's negotiate.  Why don't you try going to the gym and giving up sweets-except chocolate-for the next month.  Then come back to see me, and we'll see where we are." Adapted from S. Bigi ©2016 Frontiers. -How would incentive theory explain patients' motivation for continuing to smoke?

Passage Language is a skill acquired during early childhood that continues to develop for many years.  Communication using language involves multiple complex processes, including listening, speaking, comprehension, and cognition.  Receptive language ("language input") involves language comprehension, while expressive language ("language output") involves the ability to produce intelligible language.  In normally developing children, receptive language emerges first, followed by expressive language.To examine how age plays a role in the activation of the neurological networks involved in processing more complex language, researchers used functional magnetic resonance imaging (fMRI) to analyze how the use of receptive language generates metabolic activity in the brains of children.  A total of 672 participants were divided into three groups by age:  Age 4-6 (n = 219), age 7-9 (n = 224), and age 10-12 (n = 229).Participants in each group were asked to listen to pre-recorded stories while undergoing fMRI of the brain to determine if an age-related difference could be found in activated brain tissue volume during the listening task.  The recorded fMRI-monitored listening portion of the experiment lasted approximately 5 minutes.  Immediately following this listening exercise, fMRI monitoring was discontinued and the children were administered tests to determine comprehension of the material.  None of the children had been informed that they would be taking a comprehension test prior to its actual administration. Figure 1  fMRI listening task analyzed per age group: (A) comprehension test scores, and (B) brain volume activated  (Note: Solid lines represent the mean in each group.) M. M. Berl, E. S. Duke, J. Mayo, L. R. Rosenberger, E. N. Moore, J. VanMeter, N. Bernstein Ratner, C. J. Vaidya, and W. D. Gaillard ©2010 by Elsevier, Inc. -Does the concept of the critical period of language development help explain the differences between the age groups seen in this study?

Passage Both institutional and interpersonal factors contribute to persistent disparities in health outcomes for minorities in the U.S.  In Study 1, researchers sought to categorize the major factors contributing to the disparity by surveying 2,000 African American and 3,000 Hispanic residents in a major metropolitan city.  Of those surveyed, 64% met federal guidelines for living at or below the poverty threshold even though 90% of those surveyed were employed.  When asked, "What prevents you from going to the doctor?" the most common responses were financial considerations (92%), inability to get time off from work for appointments (85%), lack of transportation (52%), difficulty communicating with the health care provider (51%), and fear/distrust of the health care system (48%).Interpersonally, patients tend to fare better when their physician is of their same racial or ethnic background.  Study 2 observed all Hispanic patients (n = 110) who visited a clinic in an urban lower-income community over one week.  Patients met with either a Hispanic physician (n = 43) or a white, non-Hispanic physician (n = 67).  The Hispanic physician saw the patients who visited the clinic on Monday or Tuesday, and the white, non-Hispanic physician saw the patients who visited the clinic on Wednesday, Thursday, or Friday.  Both physicians were men who spoke Spanish fluently, had been working at the clinic for 8-10 years, and were unaware of the study's purpose beforehand.  This study collected data on the duration of the face-to-face appointment time with the physician, medication adherence one month after the appointment, and the number of symptoms disclosed to the physician by the patient.  Ninety-eight of the patients were already on medication or were prescribed new medication at the time of their appointment, and patients were contacted one month later for assessment of adherence.  The results of this study are shown in Figure 1. Figure 1  Average appointment time (minutes), medication adherence (percent), and number of symptoms disclosed according to patient-physician ethnic discordance vs. concordance Adapted from W. Yost, (C)2007 Academic Press. -Based on the description of Study 2, which of the following statements identifies a potential methodological error of the study's design?

Passage Until recently, deviance has generally been conceptualized as negative.  Positive deviance (PD) is used to describe the atypical behaviors exhibited by some individuals that result in superior outcomes when compared with others in the group.  Despite having similar access to limited resources, some people adopt novel strategies to problem-solve much better than their peers.  For example, rural Vietnamese villages in the 1990s had child malnutrition rates approaching 70%.  Despite this, certain villagers were able to nourish their children by developing innovative strategies that defied social norms.  These villagers fed their children plant parts not traditionally consumed (such as the leaves of the sweet potato plant) and fed them three or four times a day (instead of the customary two meals a day).  In other words, despite a lack of conventionally accepted means, these villagers engaged in alternative behaviors, or PD, to meet the societal goal of providing adequate nourishment to their children.Research into PD has focused on using these innovative individuals to catalyze change in their communities.  A pilot study attempting to spread the techniques of these initial PD villagers within their own community was successful:  Childhood malnutrition dropped by over 80% in two years.  However, the community-based approach to changing health behaviors appears to be crucial:  When an international aid organization attempted to implement a larger program based on these same practices, villagers resisted the imposed changes and it was unsuccessful.Another study assessed how PD can improve outcomes in health care settings.  Patients with difficult-to-manage chronic diseases often hold deeply entrenched beliefs about how to handle their illnesses and ignore alternative strategies.  PD patients, referred to as "bright spotters" in the study, are an exception.  They have successfully managed to control their complex illnesses using innovative approaches such as diet modifications and unique coping mechanisms.  Similar to the pilot study with Vietnamese villagers, preliminary results suggest that peer-led group activities may best allow bright spotters to teach fellow patients how to effectively manage their illnesses. -What two competing concepts help explain why the Vietnamese community-based approach was effective and external approaches were not?

Some studies have found an association between situational stress and intrafamily violence; when certain individuals experience a defeat, they react to this stress with violence toward a family member.  Which of the following provides the best explanation for these findings?