Determining the status of non-transferred embryos in Ireland: a conspectus of case law and implications for clinical IVF practice

The development of in vitro fertilisation (IVF) as a treatment for human infertilty was among the most controversial medical achievements of the modern era. In Ireland, the fate and status of supranumary (non-transferred) embryos derived from IVF brings challenges both for clinical practice and public health policy because there is no judicial or legislative framework in place to address the medical, scientific, or ethical uncertainties. Complex legal issues exist regarding informed consent and ownership of embryos, particularly the use of non-transferred embryos if a couple separates or divorces. But since case law is only beginning to emerge from outside Ireland and because legislation on IVF and human embryo status is entirely absent here, this matter is poised to raise contractual, constitutional and property law issues at the highest level. Our analysis examines this medico-legal challenge in an Irish context, and summarises key decisions on this issue rendered from other jurisdictions. The contractual issues raised by the Roche case regarding informed consent and the implications the initial judgment may have for future disputes over embryos are also discussed. Our research also considers a putative Constitutional 'right to procreate' and the implications EU law may have for an Irish case concerning the fate of frozen embryos. Since current Medical Council guidelines are insufficient to ensure appropriate regulation of the advanced reproductive technologies in Ireland, the report of the Commission on Assisted Human Reproduction is most likely to influence embryo custody disputes. Public policy requires the establishment and implementation of a more comprehensive legislative framework within which assisted reproductive medical services are offered.     

The relationship between expressed social fears and assertiveness and its treatment implications

Behavior therapists have speculated about the relationship between social fears or social anxieties and lack of assertive behavior. Wolpe (1958) perhaps most clearly suggested such a relationship. “If he [the patient] has been ineffectual in such situations—unable, for instance, to return a faulty garment—I explain how unadaptive fears are at the bottom of this ineffectualness. … p. 116.” Wolpe further assumed that engaging in assertive behavior reciprocally inhibited fear in these same social situations and that assertive responses can be programmed for use in overcoming these fears.In later writings (Wolpe. 1969; Wolpe and Lazarus, 1966) Wolpe seems to have broadened his position concerning the cause of non-assertive behavior. Specifically, he now allows that an individual also may be non-assertive, “… not because of anxiety but because they have never had the opportunity of acquiring the necessary habits. p. 40” (Wolpe and Lazarus, 1966). For these individuals direct efforts in assertive training such as behavior rehearsal, operant conditioning or direct instruction are in order. For these individuals whose lack of assertiveness is due to a ‘phobic reaction’ or strong extrinsic fears, systematic desensitization is recommended in addition to assertive training.Despite this apparent change in position, the intuitively appealing notion that the more socially fearful an individual is the more non-assertive he is likely to be has not received the empirical attention it deserves. Rathus (1973) seems to have provided some indirect evidence pertaining to the relationship between social fears and assertiveness. In the context of evaluating the efficacy of an assertive training method he administered both the 100-item Temple Fear Survey Inventory (TFSI) (Braun and Reynolds, 1969) and the Rathus Assertiveness Schedule (RAS) (Rathus, 1973) to groups of female students receiving either assertive training, a placebo treatment or no treatment. He found that at post-test the assertive training group scored significantly higher than either the placebo or no treatment groups on the RAS and that there were no significant differences in post-test Full Scale TSFI Scores. Fear of Social Criticism Factor Scores or Fear of Social Incompetence Factor Scores although in each case the mean changes toward less fear were greater for the group receiving assertive training. This finding gives little support to the reciprocal relationship between social fears and assertiveness. What is needed is a direct determination of the degree to which social fears and assertiveness are related in a sizeable sample of subjects.     

Factor analysis of the 122 item fear survey schedule

The 122 item fear survey schedule was factor analyzed in an attempt to discover whether various stimuli cluster together in their capacity to evoke anxiety. The method of factor analysis involved a rotation to an oblique structure with the result that 5 conceptually pure factors emerged accounting for at least 90 per cent of the variance. The factors were named as follows: (1) fears related to small animals, (2) fears of the precipitators and manifestations of hostility, (3) moralistically related fears and sexual fears, (4) fears of isolation and loneliness, and (5) fears of anatomical destruction and physical pain. Using the items that correlated 0.35 or better with factors, a 40 item fear survey schedule emerged. Suggestions for clinical use of this fear survey schedule were made.     

Face-to-face and at a distance: The mediation of guidance and counselling through the new technologies

The hitherto widely-held assumption that the counselling interaction should be conducted face-to-face, while other activities within the overall guidance process could be supported by computer, is re-examined. Recent computer-mediated information and communications technologies are reviewed, and their implications for guidance and counselling as a whole are explored. While fears are still current that human relations will be mechanised through the use of the information and communications technologies, it is contended that human relations will be changed but not necessarily diminished. Comparisons are drawn with the ways in which open and distance learning have brought a re-examination of what is understood to be a 'real' teaching interaction. It is suggested that practitioners in the fields of guidance and counselling must similarly be prepared to manage radical change.     

普高生与中职生的个人未来目标和担忧

以1995名普高生和中职生为被试,采用未来取向问卷(中文版),考察了普高生和中职生的个人未来目标和担忧的内容与时间广度。研究发现:普高生与中职生较多地关注未来教育、职业、婚姻/家庭、家庭安康和自我,预期重要生活事件发生在二三十岁左右。普高生更多地提及教育目标和担忧以及与家庭安康有关的担忧,而中职生更多地提及职业目标和担忧,并预期职业目标和担忧发生的年龄较早;农村学生更多地提及与未来教育和家庭安康有关的目标,而相对较少提及职业目标,并预期教育和职业目标以及职业担忧发生的年龄早于城市学生;男生更多地提及职业和婚姻/家庭目标以及与自我有关的担忧,而女生更多地提及与家庭安康有关的目标和教育担忧,并预期教育和职业目标发生的年龄较早。     

CRISPR/Cas9 genome editing – new and old ethical issues arising from a revolutionary technology

Although germline editing has been the subject of debate ever since the 1980s, it tended to be based rather on speculative assumptions until April 2015, when CRISPR/Cas9 technology was used to modify human embryos for the first time. This article combines knowledge about the technical and scientific state of the art, economic considerations, the legal framework and aspects of clinical reality. A scenario will be elaborated as a means of identifying key ethical implications of CRISPR/Cas9 genome editing in humans and possible ways of dealing with them. Unlike most other discussions of CRISPR/Cas9 germline editing, which are generally based on deontological arguments, the focus in this case will be on a consequentialistic argument against certain applications of germline and somatic editing that takes not only the potential benefits and risks but also socioeconomic issues into consideration. The practical need for an indication catalogue, guidelines for clinical trials, and for funding of basic research will be pointed out. It will be argued that this need for regulatory action and discussion does not stem primarily from the fact that CRISPR/Cas9 germline editing is revolutionary in terms of its ethical implications and potential for human therapy, although this is the prevailing view in the current discussion. Understanding the value and interest dependency of arguments put forward by different stakeholders and learning from past debates related to similar technologies might prove a fruitful method of reaching judgments and decisions that come closer to a consensus upon which society as a whole can agree - which after all should be the true goal of an ethical debate and of bioethics.     

Hostility in the real world and online: the effect of internet addiction, depression, and online activity

Hostility online has not been evaluated by an empirical investigation. This study aims to evaluate (a) the difference between hostility in the real world and that online and (b) whether the difference is associated with Internet addiction, depression, or online activities. A total of 2,348 college students (1,124 males and 1,224 females) were recruited and completed the Chen Internet Addiction Scale, the Center for Epidemiological Studies' Depression Scale, and the questionnaire for online activity. Further, the Buss-Durkee Hostility Inventory-Chinese version-short form was utilized to evaluate hostility in both real and virtual worlds. The results demonstrated that the levels of all four dimensions of hostility were lower when getting online than those in the real world. Subjects with Internet addiction had higher hostility both in the real world and online as do subjects with depression. Further, college students with Internet addiction had increased expressive hostility behavior and those with depression had decreased hostility cognition, hostility affection, and suppressive hostility behavior when getting online. Lastly, the buffering effect of the Internet on hostility was attenuated among subjects paying the most online time in chatting, and those using the Internet mainly for online gaming had higher expressive hostility behavior not only in the real world but also online. These results suggest that attention should be paid to interventions concerning aggressive behavior among subjects with Internet addiction or online gaming and chatting. On the other hand, depressed college students would be less hostile after entering the Internet. It is suggested that the Internet would be one possible interactive media to provide intervention for depression.     

Motivation in Personal Construct Theory: A Conceptual Critique

Kelly's attempt to derive apparently motiwtional phenomena (hostility, guilt, etc.) solely from the confirmation or disconfirmation of personal constructs cannot adequately explain such phenomena. His account of hostility assumes that some beliefs are so resistant to change that the person seeks to compel confirmation of them; however, this resistance is incompatible with Kelly's own Choice Corollary. Anxiety is said to derive from the fact that disconfirmation would leave one's world in chaos, but “chaos” is shown to be an illogical concept. Humor, in turn, cannot be explained just by cognitive incongruity, since incongruity may as well lead to anxiety or hostility. Finally, guilt cannot be explained without reference to underlying fears of punishment and their rationalization in terms of supposedly objective moral concepts. Nevertheless, Kelly's Repertory Grid technique, supplemented by laddering, may be useful in indicating primary needs, moral convictions, and sources of anxiety.     

Beliefs and fears underlying type A behavior: correlates of time urgency and hostility

Price (1980, 1983) has proposed that Type A behavior allows individuals to cope with fears and anxieties engendered by beliefs about their environment they develop through socialization. The present investigation tested her cognitive social learning model of Type A behavior by developing measures of beliefs and fears and validating them against Type A measures. Data was provided by 137 male and female university students of administration who completed questionnaires. Three beliefs and four fears were assessed along with four aspects of Type A behavior. Measures of beliefs and fears were moderately correlated with measures of time urgency and hostility, particularly among women. Younger men and women reported stronger beliefs and fears.     

Basic anxieties affecting psychiatric staff and their attitudes to psychotic patients

SUMMARY

Institutions can be used by their individual members to strengthen mechanisms of defence, especially against early paranoid and depressive anxieties. This is not to imply that institutios become psychotic, but that we would expect to find in them manifestations of unreality, splitting, hostility, suspicion and other forms of maladaptive behaviour which are the equivalent of psychotic symptoms of an individual.

This paper describes some of the attitudes of those who care for psychotic patients in a hospital setting. These attitudes seem to be influenced by basic fears that are provoked by the relationship with the patients and by coming in contact with their needs and disturbance from a position of responsibility. Such fears are accompanied by phantasies and are related to specific defence mechanisms.     

Assessment of hostility in patients with coronary heart disease

One of the problems in efforts to more clearly conceptualize hostility is the amount of method variance, which ranges from self-report techniques to interview-based methods and mirrors the multidimensional nature of hostility and related constructs. In addition, rather few studies concerned with the assessment of hostility have specifically used samples of coronary heart disease (CHD) patients. The purpose of this study was, therefore, to examine the multidimensionality of the construct of hostility in a sample of male coronary patients with some frequently used instruments. Factor analysis was used to detect the relevant underlying constructs, which were assessed using a variety of hostility measures in a sample of cardiac patients undergoing baseline assessment in an ongoing health-education intervention study. Measurement included both questionnaires and interviews. Participants (N = 235) were divided into 3 diagnostic groups: patients who had recently undergone (a) a myocardial infarction, (b) coronary artery bypass grafting, or (c) percutaneous transluminal coronary angioplasty. A 4-factor solution appeared to provide the best fit, and the following factors were isolated: Anger-Out, Negative Affect, Coping, and Anger-In. All intercorrelations were less than .50. Medical diagnosis did not differ with regard to the 4 factors found. The total hostility construct as measured by the structured interview (SI) did not fit into the 4-factor model. This study was the first to show that dimensions of anger and hostility constitute valid and relevant aspects of the general construct of hostility for a representative group of CHD patients. The 4 aspects of hostility isolated using some well-known hostility questionnaires and the SI explained most of the observed variance. Although the SI appeared to tap more general state anger, the 4 aspects of hostility may be differentially related to health in those who are coronary prone. Future studies on the role of hostile or negative emotions in CHD patients should, therefore, pay greater attention to the multidimensional nature of hostility and may clearly benefit from the use of the 4-factor model described in this article.     

Between Fears,Contacts and Family Dynamics: the Anti-Immigrant Attitudes in Italy

Empirical research on sources of prejudice and anti-immigrant hostility has grown considerably over the years, and the literature on the topic has become substantial firstly in classical receiving countries and in recent years also in Europe. This work analyses the anti-immigrant attitudes in Italy. The main results of this study are three. The first is the importance of individual characteristics in explaining anti-immigrant hostility: much of the variability in anti-immigrant hostility is due to individual characteristics, and in particular to the educational level achieved. Second, contacts have opposite effect on hostility: real contacts (i.e., real interpersonal contacts) decrease anti-immigrant hostility, while abstract contacts (i.e., contacts mediated by mass media) increase hostility towards migrants. Third, anti-immigrant hostility is lower among issues concerning family immigration dynamics.     

Common fears: a comparison of adolescents' self-generated and fear survey schedule generated fears.

Investigations into normative fear in adolescence have indicated that the most common fears are consistently death-related and danger-related. Assessments have most commonly been made from self-reports on fear survey schedules. The aim of the present study, therefore, was to determine whether adolescents would provide responses comparable to those generated through the use of a fear survey schedule when asked to list their 3 greatest fears. A total of 439 adolescents aged 11 to 18 years (237 girls, 201 boys, 1 sex not reported) listed their greatest fears; then they completed the 78-item Fear Survey Schedule for Children-II (E. Gullone & N. J. King, 1992). Consistent with past research, the 10 most common fears generated via the fear schedule related to death and danger. However, on the whole, the self-generated fears deviated from the death and danger theme, also including fear of failure, fear of animals, and fear of the unknown. A tendency toward global responses in self-generated fears appeared to encompass the majority of specific death-related fears included in the fear schedule, thus allowing for other predominant fears to be listed among the 3 most common.     

Development and Evaluation of an Online Intervention for Reducing Hostile Interpretation Bias: A Randomized Controlled Trial

Hostility is a trait-level construct characterized by a generally suspicious and cynical view of other people that results in a tendency to interpret ambiguous social situations in hostile or threatening ways. Cognitive behavioral treatments for hostility have high dropout rates, which may be due to hostile beliefs interfering with treatment engagement. As such, there is a need for an alternative approach to prevent dropout and enhance engagement. The current study therefore developed and tested a 1-session, 40-minute online intervention targeting hostility. It was hypothesized that the hostility intervention would be rated as acceptable as indexed by self-report and completion rates. It was also hypothesized that the hostility intervention would be associated with greater reductions in hostility as compared to a control intervention. Finally, it was hypothesized there would be indirect effects of intervention condition on anger and aggression via changes in hostility.Undergraduates (N = 101) who reported elevated hostility and hazardous alcohol use were randomized to complete either the hostility intervention or a control condition targeting physical health habits. Results showed that individuals randomized to the hostility intervention found the intervention to be highly acceptable and all participants completed the intervention in its entirety. The hostility intervention was associated with significantly faster reductions in hostile interpretations than the control condition with medium to large effects. There were significant indirect effects of intervention condition on month one follow-up anger and aggression via changes in hostile cognitions. This proof-of-concept study provides initial evidence that a brief, single-session intervention may be a promising approach for reducing hostility and its correlates.     

The assessment of anger and hostility: a critical review

While the emotion of anger has become an increasingly important part of clinical assessment, the theoretical and psychometric adequacy of the instruments used to assess anger and hostility have long been questioned. In the present review, we first provide definitions of anger and hostility in order to provide a theoretical context from which to evaluate the scope of current measures of these constructs. Second, we review the major self-report scales used to assess anger and hostility in light of these definitions and provide a detailed evaluation of psychometric evidence concerning their reliability and validity. Finally, we offer specific recommendations concerning how anger and hostility assessment instruments can be improved and expanded. In particular, we note the need for (a) an expansion of anger assessment methods beyond traditional endorsement approaches, (b) scales to assess specific domains of anger experience, (c) scales that assess unique content domains of anger experience and expressions, such as spouse-specific or driving-related anger scales, and (d) scales that assess the clinical aspects of the anger construct.     

THE CRISPR APPLE ON THE TREE OF KNOWLEDGE CONFERENCE HIGHLIGHTS: CRISPR IN SCIENCE,ETHICS, AND RELIGION

The Institute on Religion in the Age of Science (IRAS) asked Ted Peters, an eminent theologian and bioethicist who was at the forefront of the cloning and stem cell debates in the past few decades, and myself, a molecular biologist, to invite scholars from various fields to brainstorm the religious and ethical implications of the CRISPR revolution. We invited keynote speakers, whose talks will be covered here, as well as other speakers and poster presentations. The conference also hosted question and answer sessions, chaplain sessions, and discussions throughout the week at the beautiful Star Island in the summer of 2019. The purpose of this paper is to highlight and sample the discussions and presentations from that conference. I will organize them into three broad topics: CRISPR in science, ethics, and religion. For readers unfamiliar with CRISPR technology, this overview can also serve as an introduction to the field, and a stepping stone for future ideas for CRISPR discussions.     

Common Fears: A Comparison of Adolescents' Self-Generated and Fear Survey Schedule Generated Fears

Investigations into normative fear in adolescence have indicated that the most common fears are consistently death-related and danger-related. Assessments have most commonly been made from self-reports on fear survey schedules. The aim of the present study, therefore, was to determine whether adolescents would provide responses comparable to those generated through the use of a fear survey schedule when asked to list their 3 greatest fears. A total of 439 adolescents aged 11 to 18 years (237 girls, 201 boys, 1 sex not reported) listed their greatest fears; then they completed the 78-item Fear Survey Schedule for Children-II (E. Gullone & N. J. King, 1992). Consistent with past research, the 10 most common fears generated via the fear schedule related to death and danger. However, on the whole, the self-generated fears deviated from the death and danger theme, also including fear of failure, fear of animals, and fear of the unknown. A tendency toward global responses in self-generated fears appeared to encompass the majority of specific death-related fears included in the fear schedule, thus allowing for other predominant fears to be listed among the 3 most common.     

Attitudes Toward Technologies for Conception: A 15-Year Follow-Up

The attitudes of students toward technologies related to conception were assessed in 1984 and again in 1999. It was expected that increased routinization of such technologies over time would result in higher approval ratings in the second survey. This hypothesis was not supported by the results; there were no changes in approval for most methods that were included in both surveys, and in some cases, approval decreased. It was also hypothesized that methods included in the 1984 survey would receive higher approval than would newer technologies added in 1999, and this was supported by the data. Differences in approval of specific items were found by the gender and religion of respondents. Results suggest that methods involving donors continue to be unacceptable to most students, that the "older" methods are not becoming more acceptable, and that newer methods (gestational surrogacy, egg donation, and cloning) are even more problematic.     

The fears of the counsellors: a qualitative study

The author begins this paper with the claim that fear is a relatively under-researched topic in counselling despite its prevalence. Ten counsellors were interviewed concerning their fears encountered in their therapeutic work. Participants were also asked what they had found to be helpful and unhelpful when attempting to deal with these fears. Fears reported are categorised into fears of losing control, fears of being separated from a group by way of disapproval or rejection, and fears of physical and/or sexual assault. Substantive quotations are provided from the interviews. The author concludes with the contention that a deeper consideration and enhanced understanding of counsellors' fears will assist counsellors and their supervisors to accord fear an appropriate and healthy respect without becoming unduly frightened in the process.     

Imagery-Enhanced Cognitive Restructuring of Hostile Beliefs: A Narrative Description

Cognitive restructuring (CR) is an efficacious intervention for reducing transdiagnostic hostility. However, evidence suggests that the efficacy of CR can be further improved. A promising candidate for improving the efficacy of CR is mental imagery. Previous work showed that enriching CR with mental imagery (I-CR) increased its efficacy in terms of reducing hostile beliefs and aggressive inclinations. In this article, we describe the rationale of the I-CR procedure, how to use it, and illustrate it with case examples. Our clinical experience underlines that imagery seems to capture both the hostile as well as helpful thoughts in a more effective way than verbal formulations. Future studies need to explore whether using this protocol is helpful for patients with clinical levels of hostility.