Therapeutic Misconceptions: When the Voices of Caring and Research Are Misconstrued as the Voice of Curing

Research on doctor-patient communication has characterized such interactions as being asymmetrical. The present article tries to shift emphasis away from the different orientations individuals bring to the communicative setting and attempts to highlight the different orientations ("voices") within a given individual. We draw on an in-depth analysis of discourse between a 2 l-year-old man who can be ascribed the roles of both patient and potential research subject and an interviewer who acts in both the role of medical staff and researcher. Focusing our analysis on a limited number of linguistic forms (pronouns and demonstratives), it is argued that the use of the same form for different referents signals a conflation of two voices—the voice of health care ("caring") and the voice of "research." Furthermore, we argue that the voice of research is most likely to be interpreted by the patient/research subject within the framework of curing. As such, the present article promotes a shift in emphasis from different institutional—and as such often assumed to be preexisting—orientations between the communicating parties to differing orientations within the individual that cannot help but be misconstrued in terms of the curing voice. Our conclusion focuses on the ethical and discourse analytic implications of analyzing voices in a discussion.     

Therapeutic misconceptions: when the voices of caring and research are misconstrued as the voice of curing

Research on doctor-patient communication has characterized such interactions as being asymmetrical. The present article tries to shift emphasis away from the different orientations individuals bring to the communicative setting and attempts to highlight the different orientations ("voices") within a given individual. We draw on an in-depth analysis of discourse between a 21-year-old man who can be ascribed the roles of both patient and potential research subject and an interviewer who acts in both the role of medical staff and researcher. Focusing our analysis on a limited number of linguistic forms (pronouns and demonstratives), it is argued that the use of the same form for different referents signals a conflation of two voices -- the voice of health care ("caring") and the voice of "research." Furthermore, we argue that the voice of research is most likely to be interpreted by the patient/research subject within the framework of curing. As such, the present article promotes a shift in emphasis from different institutional -- and as such often assumed to be preexisting -- orientations between the communicating parties to differing orientations within the individual that cannot help but be misconstrued in terms of the curing voice. Our conclusion focuses on the ethical and discourse analytic implications of analyzing voices in a discussion.     

Communicating the Risk of Violent and Offending Behavior: Review and Introduction to this Special Issue

How to communicate risk of recidivism in correctional and forensic contexts has been a subject of scholarly discussion for two decades. This emerging literature, however, is sparse compared with studies on the assessment of risk for violent and offending behavior. In this special issue of Behavioral Sciences and the Law, we have gathered together empirical and review papers exemplifying promising directions and methodologies. We begin with a review of the state of the field, and lessons that can be drawn from research into medical risk assessment and risk communication, finding that many of the same principles apply to the forensic context. How risks are framed, and how numerate assessors are, affects how risk information is understood and applied. We discuss the existing research bearing on these issues, as well as the conceptual, practical, empirical, and legal implications of communicating risk using numerical or categorical risk terms. Along with the seven articles in this volume, we suggest directions for future research on measuring and communicating change, understanding and managing the statistical literacy of those who use and communicate risk assessments, and developing a theoretical framework for forensic risk communication research. We hope this volume will help integrate and invigorate research into forensic risk communication. Copyright © 2015 John Wiley & Sons, Ltd.     

On the Margin: Power and Women's HIV Risk Reduction Strategies

HIV risk and prevention research has failed to investigate adequately the effects of gender-related factors such as relationship power, sexual communication, abuse, and gender roles on women's abilities to engage in protective actions. We propose that women's HIV risk from heterosexual transmission is embedded in the context of gender, race/ethnicity, and class oppression. This context has central implications for interpersonal relationship factors relevant to women's HIV risk. We suggest a framework for understanding women's HIV risk within the context of oppression and the role of power in intimate sexual relationships. Three common dynamics of oppression are considered: (1) Silencing, (2) Violence and Fear of Violence, and (3) Internalized Oppression. These dynamics are based on characteristics of oppression discussed in the work of Jean Baker Miller on gender, Hussain Bulhan on race, and Paulo Freire on class. These dynamics are discussed in the context of findings reported in this journal issue and those of other authors. Finally, the discussion identifies common patterns across studies, as well as areas of disagreement and directions for future research and public health prevention efforts.     

Social Considerations Related to Adolescent Girls’ Sexual Empowerment: A Response to Lamb and Peterson

We expand on Lamb and Peterson’s (2011) discussion of the influence of social forces on the development of girls’ sexual empowerment. A predominant message from a variety of media in the U.S. is that women are sexual objects controlled by men’s sexual desires. Media messages are bolstered by the sexist treatment of girls and women in everyday society, and by gendered social roles derived from the patriarchal structure of society. We present empirical evidence that societal representations of sexuality in the United States are gendered and promote male control over female sexuality. We review research linking exposure to these sexist messages with the development of self-objectification and attitudes and behaviors supportive of gender stereotyped sexual roles. While many studies are conducted with women rather than girls, researchers are beginning to study these issues in older girls, and some longitudinal data are available. We make suggestions for further research within an ecological framework that would allow the examination of messages from multiple sources within a developmental framework.     

Collective intentionality and socially extended minds

There are many ways to advance our understanding of the human mind by studying different kinds of sociality. Our aim in this introduction is to situate claims about extended cognition within a broader framework of research on human sociality. We briefly discuss the existing landscape, focusing on ways of defending socially extended cognition. We then draw on resources from the recent literature on the socially extended mind, as well as the literature on collective intentionality, to provide a framework for thinking about the social dimension of individual minds. We then turn to a brief overview of the individualistic approaches advanced by Ludwig and Spaulding in this volume. And we close with a discussion of the transformative role of the social mind in individual life presented by Kern and Moll, as well as the distributed approach to interacting systems defended by Goldstone and Theiner.     

Explanation and Causality in Counselling: Consequences and Alternatives

Despite calls for counselling to take greater cognizance of the social context in which we live, it remains primarily monadic in its approach, focusing on individual pathology rather than on contextual links. This is explored in a discussion of behavioural, cognitive, and humanistic approaches to counselling which — despite their differences — exhibit remarkably similar features when viewed from a perspective outlining patterns of causality. A systemic approach is presented which attempts to provide a framework for describing human behaviour that acknowledges the interaction between intrapsychic dynamics and patterns of communication. The likely consequences of the traditional and systemic approaches are then discussed within a framework of 'self-fulfilling prophecies' .     

Culture,self, and collectivist communication: linking culture to individual behavior

This study develops and demonstrates a theoretical framework and corresponding methodology to link variables at the culture level to the individual level and, then, to specific outcome variables. The authors argue that in order to advance theory about culture's influence on communication, researchers must begin to examine how culture affects individual level (psychological) processes and, subsequently, how these processes affect communication. The image of self, referred to as self-construal, is an ideal candidate to perform the role of linking culture to behavior. The self is shaped by cultural forces and affects many, if not all, communication behaviors. The proposed strategy is applied in the test of a path-analytic model linking cultural collectivism with interdependent self-construals and, ultimately, high-context communication. The discussion includes implications for theory development and possible applications to further research.     

Private events: Do they belong in a science of human behavior?

The role of thinking, feeling, and other private events has received a great deal of attention in mainstream psychology but has been virtually ignored in behavior analysis until recently. This paper introduces a series of papers from a symposium that explored the roles of private events in a science of human behavior. We briefly explore the role private events are assigned in several behavioral orientations. Next, we discuss several positions on how private events might be conceptualized within a behavior-analytic framework. We conclude by noting that the dearth of research and conceptualizations about private events unnecessarily limits the theoretical or conceptual understanding on which applied behavior analysts base their work. With this paper and the papers that follow, we hope to spark research, discussion, and yes, thinking, about the roles of thinking and feeling.     

Reinforcement learning in the brain

A wealth of research focuses on the decision-making processes that animals and humans employ when selecting actions in the face of reward and punishment. Initially such work stemmed from psychological investigations of conditioned behavior, and explanations of these in terms of computational models. Increasingly, analysis at the computational level has drawn on ideas from reinforcement learning, which provide a normative framework within which decision-making can be analyzed. More recently, the fruits of these extensive lines of research have made contact with investigations into the neural basis of decision making. Converging evidence now links reinforcement learning to specific neural substrates, assigning them precise computational roles. Specifically, electrophysiological recordings in behaving animals and functional imaging of human decision-making have revealed in the brain the existence of a key reinforcement learning signal, the temporal difference reward prediction error. Here, we first introduce the formal reinforcement learning framework. We then review the multiple lines of evidence linking reinforcement learning to the function of dopaminergic neurons in the mammalian midbrain and to more recent data from human imaging experiments. We further extend the discussion to aspects of learning not associated with phasic dopamine signals, such as learning of goal-directed responding that may not be dopamine-dependent, and learning about the vigor (or rate) with which actions should be performed that has been linked to tonic aspects of dopaminergic signaling. We end with a brief discussion of some of the limitations of the reinforcement learning framework, highlighting questions for future research.     

The Influence of the Internet on the Psychosocial Predictors of Collective Action

The Internet has emerged as an important communication platform for the support of collective action, but little is known about how it influences the psychosocial motives for participation. Two quantitative studies were conducted within two different mobilizing contexts, in which offline collective actions were launched through computer‐mediated communication. We examined whether and how the frequency with which people participated in online political discussions moderated the effects of the psychosocial predictors of collective action, specifically politicized identity, anger, collective efficacy, and morality. Results showed that collective action intention was predicted by politicized identity only when participants reported a higher versus lower frequency of online discussion. However, anger did not predict collective action when people had the chance to express this emotion through a higher versus lower frequency of online discussion. Moreover, collective efficacy and morality supported collective action intention in participants who reported a higher versus lower frequency of online discussion. We theorize on how computer‐mediated communication, and its specific features, can be studied as a mobilizing context that influences the psychosocial motives to participate in collective action. Copyright © 2012 John Wiley & Sons, Ltd.     

A developmental-contextual perspective on youth covictimization by community violence

Witnessing violence within the community-covictimization-has been recognized as a threat to the optimal development of youth. Following a discussion of methodological issues that plague covictimization research, the literature on covictimization is reviewed, beginning with findings on its prevalence. Correlates of covictimization are then examined within the Shakoor and Chalmers framework, comprising emotional, cognitive, and behavioral domains. Recent lines of research investigating interactions among these three domains are also explored. Further, a developmental-contextual approach toward studying covictimization is outlined and, from this perspective, the relationship of covictimization to social cognition, health-related behaviors, parenting, and social support is discussed. Finally, recommendations for further research are presented.     

Malevolent Creativity in Terrorist Organizations

Terrorist organizations are both imitative and innovative in character. While the drivers of imitation have been extensively modeled using concepts such as contagion and diffusion, creativity and innovation remain relatively underdeveloped ideas in the context of terrorist behavior. This article seeks to redress this deficiency by presenting a conceptual framework with which we can understand the complex nature and multiple drivers of creativity and innovation within terrorist organizations. The overriding questions we address are: what factors spark creativity and innovation within terrorist organizations, and are there particular organizational traits that increase an organization's propensity to be creative and innovative? Using insights from industrial and organizational psychology and aided by illustrative examples and case studies from the history of terrorism, we aim to show that the multiple drivers of creativity and innovation are identifiable. By providing a conceptual framework that explores these key issues, we suggest that a much clearer research agenda for these issues may emerge. We conclude with a discussion concerning how our framework can help inform counter‐terrorism practices.     

DO YOU KNOW WHAT YOUR NEIGHBOURS ARE DOING ? A STUDY OF SCIENTIFIC COMMUNICATION IN EUROPE1

After this year's research on scientific communication in Europe, where almost 100 interviews were conducted in 8 European countries, one finding is clear: there is better communication between Europe and America than among European countries. Since space is limited, the analysis of this finding will be made in terms of the communication behavior of the members of the cross-national organization, the European Association of Experimental Social Psychologists. Their behavior indicates communication within a specialty, and in part, a representative case for the overall findings of the research. The Association is a limited membership organization with members in 14 countries. Since its initiation in 1963, the group has increased not only in size but in its cross-national representation. The questionnaire-interview data obtained at the Association's most recent meeting, supplemented by the findings from the general interview sample, provides the basis for the following discussion.     

The evolution of mutualistic interspecific communication: assessment and management across species

This article investigates the evolution of interspecific communication within a mutualistic setting, using the assessment-management approach to communication as a theoretical framework. The author introduces sequential stages in the evolution of mutualistic interspecific communication from unilateral assessment, to bilateral assessment, to asymmetric communication, and finally to highly complex, coevolved bilateral assessment and management and presents animal examples of each evolutionary stage. From these examples, the author forms predictions regarding when and how interspecific communication is most likely to develop, along with suggestions for further research.     

Correlates of parent–child communication about specific sexual topics: A study of rural parents with school-aged children

Using data from 600 parents of children aged 5 to 18, and a context-oriented, developmental socialization conceptual framework, the interrelationships between parents' perceptions of themselves, their child, and their family relationships and the amount of parent–child discussion of 16 sexuality topics were explored. Canonical correlation analysis was used to demonstrate how circumstances and contexts influence the complexity of parent–child conversations for mother–daughter, mother–son, father–son, and father–daughter dyads. Results lend support to the conceptual framework used, as well as to previous studies of this topic area. The implications of these findings for parent–child relationships and for future research on parent–child communication about sexuality are discussed.     

Integrating Social Information Processing and Attachment Style Research with Cognitive-behavioral Couple Therapy

The majority of the empirically validated interventions for relational distress focus primarily upon improving behavioral functioning, particularly couples’ communication patterns in conflict situations. However, although communication is highly predictive of relationship distress and later divorce, research on the effectiveness of premarital and marital interventions based on communication training has shown limited results. Therefore, although the skills-based approaches can be effective in treating relational discord and instability, they also often neglect another potentially powerful mechanism in the development of relational distress: the social cognitions and/or schemata regarding relationships that individuals carry into their marriages that stem from negative attachment experiences. Thus, this article describes how blending information gleaned from attachment style research with the body of literature addressing social information processing can enhance current methods for the treatment of relational discord. The existing research on adult romantic attachment styles is placed within a social-cognitive information processing framework and a case study demonstrating the utility of this approach with difficult couples is described.     

Operationalizing the Reciprocal Engagement Model of Genetic Counseling Practice: a Framework for the Scalable Delivery of Genomic Counseling and Testing

With the advent of widespread genomic testing for diagnostic indications and disease risk assessment, there is increased need to optimize genetic counseling services to support the scalable delivery of precision medicine. Here, we describe how we operationalized the reciprocal engagement model of genetic counseling practice to develop a framework of counseling components and strategies for the delivery of genomic results. This framework was constructed based upon qualitative research with patients receiving genomic counseling following online receipt of potentially actionable complex disease and pharmacogenomics reports. Consultation with a transdisciplinary group of investigators, including practicing genetic counselors, was sought to ensure broad scope and applicability of these strategies for use with any large-scale genomic testing effort. We preserve the provision of pre-test education and informed consent as established in Mendelian/single-gene disease genetic counseling practice. Following receipt of genomic results, patients are afforded the opportunity to tailor the counseling agenda by selecting the specific test results they wish to discuss, specifying questions for discussion, and indicating their preference for counseling modality. The genetic counselor uses these patient preferences to set the genomic counseling session and to personalize result communication and risk reduction recommendations. Tailored visual aids and result summary reports divide areas of risk (genetic variant, family history, lifestyle) for each disease to facilitate discussion of multiple disease risks. Post-counseling, session summary reports are actively routed to both the patient and their physician team to encourage review and follow-up. Given the breadth of genomic information potentially resulting from genomic testing, this framework is put forth as a starting point to meet the need for scalable genetic counseling services in the delivery of precision medicine.     

Creating shared reality in interpersonal and intergroup communication: the role of epistemic processes and their interplay

We describe research on the creation of shared reality in communication, emphasizing the epistemic processes that allow communicators to achieve confident judgements and evaluations about a communication topic. We distinguish three epistemic inputs: (1) the communicator’s own judgement about the topic (judgement of communicator); (2) the communicator’s perception of the audience’s judgement about the topic (judgement of audience); and (3) the communicator’s message to the audience about the topic (message of communicator). We argue that the influence of each input increases with the communicator’s confidence in the validity of that input. We review a variety of empirical studies in terms of this framework. We also address barriers to shared-reality creation in intergroup communication and describe interventions that work by increasing the validity strength of judgement of an outgroup audience. We discuss the relation between the present research and other approaches to social influence and social sharing.     

Risk-factor research and prevention programs for anxiety disorders: a translational research framework

The aim of the present essay is to discuss the interconnection between risk-factor research and prevention program development for panic-spectrum psychopathology. We argue that prevention of panic-spectrum psychopathology specifically, and anxiety disorders more generally, is likely to be best advanced through active, systematic translation of basic, risk-factor research. After operationalizing key terminology, we present some exemplar risk-factor candidates for panic-spectrum psychopathology, summarize research related to their role as risk-factors for panic problems, and link this discussion to risk-factor nomenclature. We then present a translational framework for extrapolating extant knowledge on these and other potential risk-factors for panic-spectrum psychopathology with respect to the development of preventative interventions. The proposed translational framework is intended to describe a forward-feeding process by which risk-factor research could be used by clinical researchers to inform prevention programs; and reciprocally, how such prevention knowledge could be most effectively utilized to drive new, clinically focused risk-factor research.