Relative versus absolute standards for everyday risk in adolescent HIV prevention trials: expanding the debate

The concept of minimal risk has been used to regulate and limit participation by adolescents in clinical trials. It can be understood as setting an absolute standard of what risks are considered minimal or it can be interpreted as relative to the actual risks faced by members of the host community for the trial. While commentators have almost universally opposed a relative interpretation of the environmental risks faced by potential adolescent trial participants, we argue that the ethical concerns against the relative standard may not be as convincing as these commentators believe. Our aim is to present the case for a relative standard of environmental risk in order to open a debate on this subject. We conclude by discussing how a relative standard of environmental risk could be defended in the specific case of an HIV vaccine trial among adolescents in South Africa.     

Ethical and legal standards for research in prisons

Biobehavioral research, especially that which is conducted with prisoners, has become much more closely regulated in the last 30 years. State and federal law, as well as professional standards, regulate the conduct of many types of research; in the case of prisoners, this regulation is even more stringent. However, currently no mandatory, uniform, national regulatory or oversight process exists, and many privately funded research endeavors are operating in a regulatory void. In response to this, the National Bioethics Advisory Commission has argued for the creation of a single, national, independent regulatory body to oversee all human participant research, regardless of funding source. As ethicolegal research standards evolve alongside advances in science and technology, an appreciation of the history of prisoner research and an awareness of current standards is critical to conducting ethical prison research.     

Self-selection of standards by children: The relative effectiveness of pupil-selected and teacher-selected standards of performance

This study examines the effects of contingent reinforcement under conditions of pupil-selected and teacher-selected performance standards upon pupils' academic response rates. The academic response rate was measured by the number of correct responses emitted per session. Thirty pupils (15 second-graders and 15 third-graders) were randomly assigned to one of three experimental groups, based on matched triplets. One group worked under pupil-selected standards; the second group worked under standards selected by the experimenter with each pupil yoked to a member of the pupil-selected standards groups. Both groups participated in the calculation of their daily earnings. The third group served as a no-contingency control group. Baseline academic response rates on writing and math tasks were determined. During the experimental sessions reinforcement was provided in the form of points which were later traded for tangible rewards. The pupil-selected standards group showed a significantly greater number of correct responses in the writing and math tasks than the externally selected standards group.     

Social norms in adolescent risk engagement and recommendation

Social influence is an important determinant of adolescent risk-taking, but little is known about how social norms contribute to adolescents’ tendency to recommend and engage in risky behaviours. Using the Adolescent Risk-taking Questionnaire, we assessed subjects’ (n = 198, age = 10–26) propensity to engage in and recommend risk-taking as well as their perception of risk norms. Adolescents recommended risk-taking more often compared to children and young adults. Perceived social norms were the most important factor predicting engagement in risky behaviours, and adolescents perceived risk-taking to be more normative than children or adults. Our findings highlight two mechanisms that contribute to adolescent risk-taking, active recommendation and perceived social norms. On this basis, we discuss potential means to attenuate excessive adolescent risk-taking.     

Early adolescent health risk behaviors, conflict resolution strategies, and school climate

Drawing upon an ethnically and socio-economically diverse sample of 323 7th grade students from twelve urban schools within one school district, this mixed method study examined early adolescents' self-reported health risk behaviors as related to their conflict resolution strategies and their school's conflict resolution climate. Survey data suggested that early adolescents who reported using more cooperative and fewer aggressive conflict resolution strategies also reported to engage in fewer personal health risk behaviors. Reported engagement in fewer behavioral risks also was associated with attending schools with more supportive “conflict resolution climates.” Serial small group interviews in selected schools indicated that conflict resolution climate quality was associated with how well teachers were perceived to respond to students' conflicts and how they managed teacher–student conflicts. In addition, many students in less supportive climates exhibited cynical attitudes regarding the viability of the conflict resolution strategies promoted by schools and prevention programs.     

Homesickness in preadolescent and adolescent girls: risk factors, behavioral correlates, and sequelae.

Examined homesickness in 117 girls ages 8 to 16 during a 2-week stay at summer camp. (Homesickness is the distress or impairment caused by an actual or anticipated separation from home. It is characterized by acute longing and preoccupying thoughts of home and attachment objects.) Elevated preseparation levels of homesickness, high expectations of homesickness, negative separation attitudes, low decision control, and little previous separation experience predicted in-camp levels of homesickness. During the separation, homesickness was associated with insecure interpersonal attitudes, negative initial impressions of the novel environment, high perceived distance from home, and low perceived control. Female surrogate caregivers rated homesick girls as having lower social status and more somatic complaints, social problems, and externalizing behavior than less homesick girls. Although the prevalence, intensity, and longitudinal course of homesickness in girls did not differ from analogous samples of boys, girls' profile of risk factors, correlates, and sequelae is unique in its mixed behavioral presentation and small correlations with age and experience.     

Context and cognitions: environmental risk, social influence, and adolescent substance use

This study examined the cognitions thought to mediate the impact of context on adolescent substance use and also the extent to which context moderates the relations between these cognitions and use. Risk cognitions and behaviors were assessed in a panel of 746 African American adolescents (M age 10.5 at Wave 1, 12.2 at Wave 2). Results indicated that adolescents living in high-risk neighborhoods were more inclined toward substance use and more likely to be using at Wave 2. These context effects were mediated by the adolescents' risk cognitions: their risk images, willingness to use, and intentions to use. Also, context moderated the relation between willingness and use (the relation was stronger in high-risk neighborhoods) but it did not moderate the intentions to use relation.     

Uniqueness, Individuality, and Human Cloning

This paper challenges two main arguments often presented to show that cloning a human being would be morally wrong per se . These arguments are that human cloning would be intrinsically wrong 1) because it involves manufacturing a person rather than creating or reproducing one, and 2) because it violates some claim or right that individuals have to be biologically unique. I argue that while cloning may involve genetic selection, it need not always be a decision to select for a certain type of individual. Furthermore, I contend that the notion of biological uniqueness is inadequate to ground either the idea that biologically non-unique individuals are morally worse off than unique ones or that biological uniqueness itself constitutes a criterion of moral value or status.     

Selected risk factors in adolescent suicide attempts.

This study examined stress, depression, attempted suicide, and knowledge of common signs of potential suicide in Alabama adolescents. A modified version of the National Adolescent Student Health Survey (NASHS) was administered to 3,803 eighth- and tenth-grade public school students during the fall of 1988. The incidence of stress, depression, and attempted suicide was analyzed by gender, ethnicity, locale (urban vs. rural), and participation in sexual intercourse and use of alcohol. Chi-square tests were used to determine if there were significant differences between groups. Findings indicated that females were at greater risk than were males. Both males and females who engaged in sexual intercourse and alcohol consumption were at greater risk than were abstainers. When analyzed by ethnicity, white adolescents who engaged in these behaviors were at significantly greater risk than were those who abstained; differences were not as pronounced for black youth. Comparisons on the knowledge scale indicated that females scored better than males, whites scored better than blacks, and urban students scored better than rural students. The data suggest that many adolescents are having difficulty coping with stress and depression, and that those who are engaging in various types of risk-taking behavior are at greater risk for depression and suicide.     

Forgiveness results from integrating information about relationship value and exploitation risk

Exploitation is a fact of life for social organisms, and natural selection gives rise to revenge mechanisms that are designed to deter such exploitations. However, humans may also possess cognitive forgiveness mechanisms designed to promote the restoration of valuable social relationships following exploitation. In the current article, the authors test the hypothesis that decisions about forgiveness result from a computational system that combines information about relationship value and exploitation risk to produce decisions about whom to forgive following interpersonal offenses. The authors examined the independent and interactive effects of relationship value and exploitation risk across two studies. In Study 1, controlling for other constructs related to forgiveness, the authors assessed relationship value and exploitation risk. In Study 2, participants experienced experimental manipulations of relationship value and exploitation risk. Across studies, using hypothetical and actual offenses and varied forgiveness measures, the combination of low exploitation risk and high relationship value predicted the greatest forgiveness.     

Promoting adolescent sense of coherence: Testing models of risk,protection, and resiliency

Sense of coherence (SOC) is a dispositional trait that has been linked to well‐being in a broad range of populations and contexts. Little is known, however, about the factors associated with SOC development and maintenance across the lifespan. Conceptualized as a condition of resiliency, SOC in adolescents was explored via measures of risk and protection as reported on by 8th and 10th grade students (N = 1619). Employing cumulative indexes of protection and risk, analyses focused on testing four models of resiliency. Further, the relative and cumulative effects of protection and risk were explored across ecological domains. Analyses revealed support for the compensatory model of resiliency for males and females, while the challenge model also was supported for females. Analyses also revealed that protection and risk influencing SOC emerge at multiple domains for males and females. In addition, protective factors present at multiple domains were related to higher SOC while risk factors present at multiple domains were related to lower SOC regardless of gender. Results suggest a resiliency framework that considers multiple ecological domains is useful for understanding SOC in adolescents. Implications for additional research are presented. Copyright © 2008 John Wiley & Sons, Ltd.     

Through the community looking glass: reevaluating the ethical and policy implications of research on adolescent risk and sociopathology

Drawing on a conception of scientists and community members as partners in the construction of ethically responsible research practices, this article urges investigators to seek the perspectives of teenagers and parents in evaluating the personal and political costs and benefits of research on adolescent risk behaviors. Content analysis of focus group discussions involving over 100 parents and teenagers from diverse ethnic and socioeconomic backgrounds revealed community opinions regarding the scientific merit, social value, racial bias, and participant and group harms and benefits associated with surveys, informant reports, intervention studies, blood sampling, and genetic research on youth problems. Participants comments highlight new directions for socially responsible research.     

Ethical issues in research on adolescent depression and suicidal behaviour

The codes of ethical conduct of the Australian Psychological Society and the American Psychological Association imply that researchers of adolescent depression and suicidal behaviour must plan to intervene to assess risk where a participant in a study indicates an intention to commit suicide. Participants in research of this kind need to be advised of this possibility in advance. The obligation to intervene, and to advise of the possibility of intervention, pose practical and methodological problems for research in this area but do not, it is argued, absolve the researcher of the primary responsibility to contribute to the welfare of the research participant.