Physician,Divest Thyself

Responses to public health emergencies can entail difficult decisions about restricting individual liberties to prevent the spread of disease. The quintessential example is quarantine. While isolating sick patients tends not to provoke much concern, quarantine of healthy people who only might be infected often is controversial. In fact, as the experience with severe acute respiratory syndrome (SARS) shows, the vast majority of those placed under quarantine typically don't become ill. Efforts to enforce involuntary quarantine through military or police powers also can backfire, stoking both panic and disease spread. Yet quarantine is part of a limited arsenal of options when effective treatment or prophylaxis is not available, and some evidence suggests it can be effective, especially when it is voluntary, home-based and accompanied by extensive outreach, communication and education efforts. Even assuming that quarantine is medically effective, however, it still must be ethically justified because it creates harms for many of those affected. Moreover, ethical principles of reciprocity, transparency, non-discrimination and accountability should guide any implementation of quarantine.     

Compliance,coercion, and compassion: Moral dimensions of the return of tuberculosis

Since 1986, we have seen a rise in the occurrence of tuberculosis in the United States. Long considered defeated in this country, the disease is returning with distressing vigor. Outbreaks of MDR-TB, tuberculosis resistant to more than one medication, have been reported around the country. This article analyzes the Centers for Disease Control and Prevention's National Action Plan to Combat Multidrug-Resistant Tuberculosis, with particular focus on the moral dimensions of mandatory directly observed treatment (DOT) and involuntary quarantine. It is proposed that a moral response to the control of tuberculosis must be one which is sustainable and which can effectively curtail the spread of the disease at a minimal cost to individual rights.     

Working online due to the COVID-19 pandemic: a research and literature review

Given the contemporary situation of many analysts in the world now being forced to work online due to the effects of the COVID-19 pandemic, it is important to review the working online issue. Substantial debate over previous years has questioned whether a genuine analytic process can unfold through online work. This debate is reviewed with the conclusion that such a process is not necessarily precluded. Research outcomes are then reviewed to highlight those things that can facilitate positive outcomes when working online. These cover the ‘online disinhibition effect’, the therapeutic alliance, particular ways of using the screen, focussing on trauma, the importance of self-awareness, knowing the predictors of mental health, certain potential positives of isolation/quarantine and psychotherapy interventions that may be currently needed. Final recommendations and suggestions are then presented as in the diagnosis issue, professional development and guidelines to do with practical and ethical considerations.     

Criminal Quarantine and the Burden of Proof

In the recent literature a number of free will skeptics, skeptics who believe (as I do) that punishment is justified only if deserved, have argued for these two points: first, that the free will realist who would justify punishment has the burden of establishing to a high level of certainty - perhaps beyond a reasonable doubt, but certainly at least by clear and convincing evidence - that any person to be punished acted freely in breaking the law; and, second, that that level of evidence is simply not there. In this paper I make two parallel points against a quarantine theory of criminal justice. First, the free will skeptic who would justify universal criminal quarantine is also faced with a burden of proof, the burden to establish to a similarly high level that no human being ever acts freely. Second, there is not sufficient evidence for that conclusion either. I believe that the quandary that this creates for criminal justice can be resolved by distinguishing the methods associated with a particular approach from the approach itself: if our choice is between the methods of punishment and the methods of quarantine, the methods that constitute punishment are, I would argue, morally preferable to those that constitute quarantine.

     

Transmission and refutation of organisational rumours: Consumer identification and processing types

If consumers accept rumours without verifying them, considerable damage to individuals or organisations could result. By applying the appraisal theory of emotions, this article provides a framework for clarifying rumour communications by people who identify strongly or weakly with an organisation that is the object of a rumour. Study 1 reveals that when people identify strongly with the rumour object and hear an important rumour, they spread positive information more readily than negative information. They are also more likely to transmit information of high (vs. low) importance when the rumour is positive. Conversely, weak identifiers are equally likely to spread positive and negative information, regardless of importance. Study 2 incorporates a heuristic‐systematic model and demonstrates that strong identifiers process refutations systematically when those refutations refer to a positive, less important rumour. Conversely, they process refutation information heuristically if they confront positive, important rumours or if they receive a refutation of a negative rumour. Identification with the rumour object affects its spread, but rumour objects can develop refutation strategies to halt the spread of negative rumours or encourage the spread of positive rumours about the organisation. Rumour refutation efforts cannot be generalised but instead should be targeted according to consumers' strong or weak identification.     

“100% of anything looks good”: The appeal of one hundred percent

People overweight certainty, even when certainty is only an illusion. A vaccine that was described as 100% effective against 70% of disease targets was preferred to one described as 70% effective against 100% of disease targets (Studies 1 and 2). The appeal of 100% extends beyond the probability attribute. In Study 2, participants preferred both of the vaccines above to normatively equivalent vaccines that were less than 100% effective toward fewer than 100% of targets. In Study 3, participants preferred a 100% discount on a cup of coffee every 10 days to other more frequent, but lower amount, discounts. This preference evaporated, however, when savings were framed as points rather than as percentage discounts. We propose that people view 100% as a salient reference point and overweight it in those domains where it cannot be exceeded (e.g., probability, discount); the overweighting is weaker in domains where 100% can be exceeded (e.g., target range, points).     

It's not all about me: motivating hand hygiene among health care professionals by focusing on patients

Diseases often spread in hospitals because health care professionals fail to wash their hands. Research suggests that to increase health and safety behaviors, it is important to highlight the personal consequences for the actor. However, because people (and health care professionals in particular) tend to be overconfident about personal immunity, the most effective messages about hand hygiene may be those that highlight its consequences for other people. In two field experiments in a hospital, we compared the effectiveness of signs about hand hygiene that emphasized personal safety ("Hand hygiene prevents you from catching diseases") or patient safety ("Hand hygiene prevents patients from catching diseases"). We assessed hand hygiene by measuring the amount of soap and hand-sanitizing gel used from dispensers (Experiment 1) and conducting covert, independent observations of health care professionals' hand-hygiene behaviors (Experiment 2). Results showed that changing a single word in messages motivated meaningful changes in behavior: The hand hygiene of health care professionals increased significantly when they were reminded of the implications for patients but not when they were reminded of the implications for themselves.     

Reminders of an agentic ingroup buffer disease uncontrollability

Chronic illness has negative impacts beyond those on physical health. In particular, because it is often experienced as uncontrollable, chronic illness might reduce people's general sense of personal control and, subsequently, personal well-being. Drawing on recent theory and research, we proposed and tested in four experiments (N_total = 1323) a potential buffer to these negative effects: thinking about an agentic social ingroup in one's life. In Study 1, patients suffering from a chronic illness that was either high or low in medical disease controllability were asked either to think about an agentic ingroup or a personal issue. Low perceived disease-related control was associated with low perceived personal control only when participants' personal self, but not when their ingroup, was salient. In three follow-up vignette studies, we asked participants to take the perspective of a person who suffered from a health problem of low medical disease controllability and attended a self-help group that was described as either high or low in agency. The findings supported the predicted buffering effect: participants who reflected on a target suffering from a low control disease thought that the target would experience more personal control when the agentic (vs. the nonagentic) self-help group was salient. These findings suggest ingroups can serve as a source of personal control in the context of health-related threats to the extent that they are perceived as agentic. Thus, focusing on agentic properties of (health-related) ingroups might be a promising novel strategy when designing effective group-based interventions to cope with chronic illness.     

Glucose consumption decreases impulsive aggression in response to provocation in aggressive individuals

Impaired executive control is implicated in aggression. Research suggests that the acute administration of glucose can improve executive control. In two experiments undergraduates completed a measure of trait aggression and consumed a glucose or placebo beverage before being given the chance to administer a blast of white noise to a fictitious participant. In Experiment 1, all participants were provoked and mentally depleted or not. Glucose was most effective in reducing aggression for those high in trait aggression even when depleted. In Experiment 2, participants were provoked or not. When provoked, glucose reduced aggression among those high in trait aggression. However, when not provoked, glucose increased aggression among those high in trait aggression. These data suggest that the acute administration of glucose can be beneficial in reducing aggression in response to provocation among those high in trait aggression.     

How many pixels make a memory? Picture memory for small pictures

Torralba (Visual Neuroscience, 26, 123–131, 2009) showed that, if the resolution of images of scenes were reduced to the information present in very small “thumbnail images,” those scenes could still be recognized. The objects in those degraded scenes could be identified, even though it would be impossible to identify them if they were removed from the scene context. Can tiny and/or degraded scenes be remembered, or are they like brief presentations, identified but not remembered. We report that memory for tiny and degraded scenes parallels the recognizability of those scenes. You can remember a scene to approximately the degree to which you can classify it. Interestingly, there is a striking asymmetry in memory when scenes are not the same size on their initial appearance and subsequent test. Memory for a large, full-resolution stimulus can be tested with a small, degraded stimulus. However, memory for a small stimulus is not retrieved when it is tested with a large stimulus.     

Emotion regulation of fear and disgust: differential effects of reappraisal and suppression

Although excessive fear has been central to traditional conceptualisations of the anxiety disorders, recent research suggests that disgust may also play a role in the development of some anxiety disorders. While dysregulation of emotion may confer risk for the development of anxiety disorders, it remains unclear if there are differences in the extent to which fear and disgust can be effectively regulated. To fill this important gap in the literature, unselected participants (N?=?95) experienced fear or disgust via video exposure, and they were instructed to employ either reappraisal or suppression to regulate their emotional experience while viewing the videos. For those exposed to fear-relevant content, change in emotional distress did not significantly differ between those that suppressed and those that reappraised. However, significantly less emotional distress was observed for those that reappraised compared to those that suppressed when exposed to disgust-relevant content. Although physiological arousal varied over time as a function of the emotional content of the videos, it did not vary as a function of emotion regulation strategy employed. These findings suggest that reappraisal may be especially effective in regulating verbal distress when exposed to disgusting cues in the environment. The implications of these findings for the treatment of anxiety disorders that are characterised by excessive disgust reactions will be discussed.     

Regulation strategies during COVID-19 quarantine: The mediating effect of worry on the links between coping strategies and anxiety

IntroductionThe COVID-19 outbreak forced Italian citizens into a generalized quarantine from March to May 2020. The quarantine is a successful measure to reduce the virus's spread through physical and social distancing, but it can also have negative psychological consequences on the population. People experience high levels of worry and anxiety and have to cope with the consequences of the health emergency. The aim of this study was to preliminarily assess the causal relations among coping, worry and state anxiety at the time of COVID-19 first wave, and the mediation role of worry between coping and state anxiety.MethodsDuring March 2020, 1273 Italian citizens completed an ad hoc online survey composed of sociodemographic and preoccupation-related questions, and standardized self-report questionnaire (Brief COPE, Penn State Worry Questionnaire and State-Trait Anxiety Inventory-State form). Three separate mediation models were performed.ResultsThe relationship between coping strategies (i.e.: problem-focused coping, emotion-focused coping and dysfunctional coping) and state anxiety resulted to be mediated by worry. Dysfunctional and problem-focused coping had a negative effect on anxiety scores and this effect was amplified by high levels of worry. Emotion-focused coping reduced state anxiety scores through its effect on reducing the levels of worry, which in turn was related to a reduction in anxiety.ConclusionThe present study offers first evidence for the mediation role of worry in the relation between coping and anxiety during quarantine caused by COVID-19 pandemic. It supports the clinical importance of investigating people's coping strategies along with the levels of (cognitive) worry and their long-term effects on the psychological well-being during the outbreak, in order to deliver adequate personalized interventions. Psychological support should enhance emotion-focused coping strategies that have a protective effect on both worry and anxiety.     

A comparison of positive vicarious learning and verbal information for reducing vicariously learned fear

Research with children has demonstrated that both positive vicarious learning (modelling) and positive verbal information can reduce children's acquired fear responses for a particular stimulus. However, this fear reduction appears to be more effective when the intervention pathway matches the initial fear learning pathway. That is, positive verbal information is a more effective intervention than positive modelling when fear is originally acquired via negative verbal information. Research has yet to explore whether fear reduction pathways are also important for fears acquired via vicarious learning. To test this, an experiment compared the effectiveness of positive verbal information and positive vicarious learning interventions for reducing vicariously acquired fears in children (7–9 years). Both vicarious and informational fear reduction interventions were found to be equally effective at reducing vicariously acquired fears, suggesting that acquisition and intervention pathways do not need to match for successful fear reduction. This has significant implications for parents and those working with children because it suggests that providing children with positive information or positive vicarious learning immediately after a negative modelling event may prevent more serious fears developing.     

Positive Self-Statements: Power for Some, Peril for Others

ABSTRACT— Positive self-statements are widely believed to boost mood and self-esteem, yet their effectiveness has not been demonstrated. We examined the contrary prediction that positive self-statements can be ineffective or even harmful. A survey study confirmed that people often use positive self-statements and believe them to be effective. Two experiments showed that among participants with low self-esteem, those who repeated a positive self-statement ("I'm a lovable person") or who focused on how that statement was true felt worse than those who did not repeat the statement or who focused on how it was both true and not true. Among participants with high self-esteem, those who repeated the statement or focused on how it was true felt better than those who did not, but to a limited degree. Repeating positive self-statements may benefit certain people, but backfire for the very people who "need" them the most.     

Women and AIDS

While the origin of the AIDS virus remains controversial, it is indisputable that AIDS is spreading worldwide. By June 1987, the World Health Organization estimated that 50 million Africans were infected with HIV and that the disease was epidemic in many parts of the continent. However, African governments chose to deny the threat of the disease. The AIDS crisis has diverted resources from other vital areas of disease prevention, health promotion, and research. Whereas AIDS is spread in developed nations by sexual promiscuity, by drug addicts sharing unclean hypodermic needles, and by homosexual behavior, in Africa cultural factors contribute to the transmission of AIDS. Female genital mutilation leads to extensive laceration of the female genitals upon initiation of sexual intercourse and/or to substitution of anal sex during the weeks and months before vaginal penetration can be achieved. In addition, the reuse of the same knives during the mutilation can spread HIV infection. Other factors that contribute to the spread of HIV in Africa include the patriarchal practice of polygamy, the subordinate position of women that makes them unable to insist on protection during intercourse, and a failure to screen blood used in transfusions. With all of these risk factors at play, women at the grassroots level must be equipped with the health education that is the only available tool to fight AIDS. Women's organizations can provide information and education to people at risk of acquiring HIV, counsel infected persons, ensure the safety of the blood supply, and work to overcome harmful traditional practices.     

Biological markers of cognition in prodromal Huntington's disease: a review

Huntington’s disease (HD), an autosomal-dominant genetic disorder, has historically been viewed as a degenerative movement disorder but it also includes psychiatric symptoms and progressive cognitive decline. There has been a lack of consensus in the literature about whether or not cognitive signs can be detected in carriers before clinical (motor) onset of the disease, i.e., prodromal HD. However, recently validated mathematical formulas to estimate age of clinical onset, refined over the past 5–7 years, have allowed researchers to overcome the methodological limitation of treating all prodromal carriers as a homogenous high-risk group (i.e., whether they may be 2 or 15 years from diagnosis). Here we review 23 articles on the HD prodrome, all of which related cognition to a biological marker of disease burden (i.e., genetic load, neuroimaging). All studies found at least one cognitive domain was associated with disease burden in prodromal HD participants. There was greater variability in both the detection and cognitive domain affected in those farther from onset (or those with less pathology) while most studies reliably found declines in visuomotor performance and working memory in those closer to onset. These findings indicate that cognitive signs can be reliably detected in the HD prodrome when comparing cognition to additional disease markers, however, there continues to be significant variability on cognitive findings among large and methodologically rigorous studies. This may reflect true heterogeneity in the prodromal HD phenotype which must be further explored by analyzing intra-individual variance, determining demographic risk factors associated with decline/protection, and examining if particular HD families exhibit distinct cognitive profiles. These and additional future directions are discussed.     

Blameworthy Action and Character

A number of philosophers from Hume on have claimed that it does not make sense to blame people for acting badly unless their bad acts were rooted in their characters. In this paper, I distinguish a stronger and a weaker version of this claim. The claim is false, I argue, if it is taken to mean that agents can only be blamed for bad acts when those acts are manifestations of character paws . However, what is both true and important is the weaker claim that an act is not blameworthy unless it is rooted in some enduring aspect or aspects of the agent's character that may or may not be flaws, and that, if flaws, may or may not be bad in the same way that the act itself is.     

Event familiarity influences memory detection using the aIAT

The developers of the autobiographical Implicit Association Test (aIAT) describe it as a possible memory detection tool. This claim rests on the assumption the aIAT can reliably and automatically detect the accuracy of autobiographical events. However, the aIAT may be susceptible to factors that affect the assessment of truth vs. falseness, such as the relative familiarity of those events. We compared aIAT performance when participants reported recent vs. childhood autobiographical events, and when participants imagined vs. did not imagine a fabricated autobiographical event. The aIAT was less effective at distinguishing between real and fabricated events from childhood, compared to recent real and fabricated events. Imagining a fabricated event did not affect aIAT performance; however, there was a trend in the data suggesting imagination may have reduced the effect of event recency. Our results provide further evidence that reducing or enhancing source confusion—via familiarity—can influence the predictive value of the aIAT.     

Phases in Movement After-Effects and their relationship to the kinetic figural effect

Summary A Movement After-Effect (MAE) observed on a structured test figure contains generally two successive phases. The initial one is non-contingent upon the test figure and is assumed to result from an adaptation process. The second phase is shown to be contingent upon the features of the test figure and their similarity with those of the generating figure. A conditioning process is assumed to share in its appearance. In Experiment I, it is shown that the areal spread of MAE which may appear in the contingent phase is likely to result from a generalization process in which part of the test figure corresponding to an unstimulated area becomes transiently effective in generating a MAE. In Experiment II distributed practice of the MAE is shown to lead to an increase in the duration of the effect when the generating and test figures are similar. This last result suggests that the true conditioning stimulus is the generating figure as such.     

特征和位置信息在价值驱动注意捕获中的作用

本研究采用训练−测试范式考察颜色和位置信息在价值驱动注意捕获中的作用。实验1考察是否存在基于具体位置的价值驱动的注意捕获效应。在训练阶段, 被试对8个位置中两个位置出现的红色目标反应伴随着高奖励反馈, 而对另外两个位置出现的红色目标反应伴随着低奖励反馈, 其它4个位置为中性位置, 没有目标出现。在测试阶段, 一半试次中红色刺激作为分心物出现。结果发现, 只有当分心刺激出现在高奖励位置和两个高奖励位置之间的中性位置时才能够捕获注意; 实验2考察颜色和位置信息在价值驱动注意捕获中的交互作用。在训练阶段, 将颜色特征和位置信息联合起来进行学习。在测试阶段, 和高、低奖励相联结的颜色刺激各在1/3试次中作为分心物出现。结果发现, 只有当高奖励颜色出现在高奖励位置或出现在高奖励位置之间的中性位置时才能够捕获注意。研究结果表明：(1)位置联结的价值驱动的注意捕获效应能够泛化到特定邻近位置上; (2)个体在训练阶段将颜色和位置的联合特征与奖励建立联结, 训练阶段建立的联结不能泛化到部分特征上。价值驱动注意捕获效应的泛化具有选择性。