Queer Patients and the Health Care Professional—Regulatory Arrangements Matter

This paper discusses a number of critical ethical problems that arise in interactions between queer patients and health care professionals attending them. Using real-world examples, we discuss the very practical problems queer patients often face in the clinic. Health care professionals face conflicts in societies that criminalise same sex relationships. We also analyse the question of what ought to be done to confront health care professionals who propagate falsehoods about homosexuality in the public domain. These health care professionals are more often than not motivated by strong religious convictions that conflict with mainstream medical opinion on homosexuality. We argue that they ought to be held accountable for their conduct by their professional statutory bodies, given that they abuse their professional standing to propagate sectarian views not representative of their profession. Lastly, we propose that medical schools have special responsibilities in training future health care professionals that will enable them to respond professionally to queer patients seeking health care.     

Feedback Sign Effect on Motivation: Is it Moderated by Regulatory Focus?

Quoi qu’en pense le sens commun qui incite à croire que le feedback (positif vs négatif) a des retombées décisives sur la motivation, l’enemble de la littérature n’apporte pas d’informations claires précisant quand et comment le feedback positif ou négatif accroît ou abaisse la motivation (voir par exemple Kluger & DeNisi, 1996 ). La variabilité dans l’impact du feedback peut être expliquée par la théorie de l’autorégulation ( Higgins, 1997, 1998 ). Plus précisément, des niveaux relativement élevés de motivation sont provoqués aussi bien par l’échec sous focalisation de prévention (manquer à ses obligations) que par le succès sous focalisation de promotion (réaliser un désir). Au cours de deux expériences, la focalisation régulatrice a été opérationnalisée par une manipulation des facteurs de situation (scénarios) et par trois mesures de différences individuelles (les valuers, les professions et les raisons de choisir tel emploi). Les résultats de ces travaux confirment les hypothéses avec les différentes opérationnalisations. D’autres expériences devraient explorer la probable interaction triple entre la focalisation régulatrice de situation, la focalisation régulatrice chronique et la feedback. Despite our common sense notion that indicates that feedback sign (positive vs. negative) has a decisive effect on motivation, the vast literature has no clear specifications regarding when and how positive (negative) feedback increases or decreases motivation (e.g. Kluger & DeNisi, 1996 ). The variability in feedback sign effects can be explained by self‐regulation theory ( Higgins, 1997, 1998 ). Specifically, relatively high levels of motivation are induced either by failure under prevention focus (failure to meet obligations) or by success under promotion focus (fulfilling a desire). In two experiments, regulatory focus was operationalised by a manipulation of situational factors (scenarios) and by three measures of individual differences (values, occupations, and the motives for choosing one's job). Results from these experiments corroborated the hypotheses with all the different operationalisations. Future experiments should investigate the possible three‐way interaction between situational regulatory focus, chronic regulatory focus, and feedback sign.     

Guilt,Shame, Disobedience: Social Regulatory Mechanisms and the “Inner Normative System”

The author, a criminologist, describes a metadisciplinary guilt conception that combines elements of psychoanalysis, psychology of moral judgment, and evolutionary psychology.     

Developmental Risk and Young Children’s Regulatory Strategies: Predicting Behavior Problems at Age Five

Children with early developmental delays are at heightened risk for behavior problems and comorbid psychopathology. This study examined the trajectories of regulatory capabilities and their potentially mediating role in the development of behavior problems for children with and without early developmental delays. A sample of 231 children comprised of 137 typically developing children and 94 children with developmental delays were examined during mildly frustrating laboratory tasks across the preschool period (ages 3–5). Results indicated that children with delays had greater use of maladaptive strategies (distraction, distress venting) and lower use of adaptive strategies (constructive coping) than typically developing children. For both groups, strategies had similar rates of growth across time; maladaptive strategies decreased and adaptive strategies increased. The intercept of strategy use, but not the slope, was found to mediate the relation between developmental risk and externalizing behaviors. Findings support that dysregulation, rather than the developmental risk, may be responsible for the high levels of comorbid psychopathology.     

Print Me an Organ? Ethical and Regulatory Issues Emerging from 3D Bioprinting in Medicine

Recent developments of three-dimensional printing of biomaterials (3D bioprinting) in medicine have been portrayed as demonstrating the potential to transform some medical treatments, including providing new responses to organ damage or organ failure. However, beyond the hype and before 3D bioprinted organs are ready to be transplanted into humans, several important ethical concerns and regulatory questions need to be addressed. This article starts by raising general ethical concerns associated with the use of bioprinting in medicine, then it focuses on more particular ethical issues related to experimental testing on humans, and the lack of current international regulatory directives to guide these experiments. Accordingly, this article (1) considers whether there is a limit as to what should be bioprinted in medicine; (2) examines key risks of significant harm associated with testing 3D bioprinting for humans; (3) investigates the clinical trial paradigm used to test 3D bioprinting; (4) analyses ethical questions of irreversibility, loss of treatment opportunity and replicability; (5) explores the current lack of a specific framework for the regulation and testing of 3D bioprinting treatments.     

What can Prudent Public Regulators Learn from the United Kingdom Government’s Nanotechnological Regulatory Activities?

This contribution discusses the United Kingdom (UK) government’s regulatory activities related to nanotechnological development. The central question is what other prudent public regulation can learn from the UK government’s regulatory strategy, its regulatory attitude and its large variety of regulatory measures. Other public regulators can learn from the interactive and integrative UK regulatory approach. They can also draw lessons from the critique on the UK government’s regulatory attitude and its problems to cope with specific nanotechnological challenges. These lessons are based on an evaluation of the UK government’s regulatory activities from the viewpoint of prudent regulation. The notion of responsive regulation, which provides basic ideas for the evaluation methodology, refers to a view on prudence that focuses on moral constitutional values. Interestingly, a similar view on prudence has been discussed in nanoethics.     

Aggression in Children With Reactive Attachment Disorder: A Sign of Deficits in Emotional Regulatory Processes?

Children diagnosed with reactive attachment disorder (RAD) have been reported to exhibit a multitude of symptoms and behaviors that are not captured by the Diagnostic and Statistical Manual of Mental Disorders criteria. One behavior in particular that has been the source of much argument and controversy is aggression. Although limited research on this topic does support an association between aggression and RAD behaviors, the exact nature of this link remains unclear. This study aims to fill this gap by reporting data from a study that examined the behavioral processes that occur in adopted children with RAD. Guided by the principles of grounded theory, this study employed a multi-stage semi-structured interview design. The sample consisted of 5 adoptive families, and included both adult and child participants, including the adopted children with RAD. The findings revealed 5 prominent themes: The adopted children are reported to engage in extreme and prolonged tantrums, known as rages; children were often inconsolable during these rages; these rages are perceived as uncontrollable by children with RAD; these rages are directed toward a discriminate caregiver; and the impetus for these rages appears to be associated with difficulties in adapting to environmental demands. An in-depth discussion that draws a theoretical connection between these rages and possible deficits in brain-based processes responsible for emotional regulation is presented.     

Regulatory focus and the family–work interface: The role of regulatory fit between cohabiting partners

The aim of the present study was to examine the impact of regulatory focus in goal pursuit and regulatory fit between marital partners on family conditions and the family–work interface. We hypothesized that when both partners are high on promotion focus (fit) they experience higher developmental possibilities at home and have an increased likelihood of family-to-work facilitation (FWF). In addition, we hypothesized that when both partners are prevention focused (fit) they experience less home demands and less family-to-work conflict (FWC). In total, 131 working couples participated in the study. Each partner provided information about his/her own regulatory focus, perceptions of home demands and home developmental possibilities, and experienced FWF and FWC. Results of moderated structural equation modelling analyses largely supported our hypotheses since the interaction between partners’ promotion focus predicted the levels of home developmental possibilities and FWF, whereas the interaction between partners’ prevention focus predicted home demands in the expected direction. In conclusion, the fit between partners’ self regulatory styles can influence family life and, consequently, the impact of family on work.     

Maternal Depression,Locus of Control,and Emotion Regulatory Strategy as Predictors of Preschoolers’ Internalizing Problems

Childhood internalizing problems may occur as early as preschool, tend to be stable over time, and undermine social and academic functioning. Parent emotion regulatory behaviors may contribute to child internalizing problems and may be especially important during the preschool years when parents model emotion coping and regulation for their children. Parents who feel out of control of their preschoolers’ behavior and emotional states may adopt avoidant emotion regulatory strategies. We proposed that parent depression, perceived locus of control, and experiential avoidance would be linked with internalizing symptoms in a high-risk sample of preschool-aged children. We also expected that locus of control would mediate the relationship between maternal depression, experiential avoidance, and child internalizing problems. Seventy-four urban, low-income, diverse mothers of Head Start preschool children completed rating scales measuring their own depression, locus of control, experiential avoidance, and their children’s internalizing behaviors. Correlational analyses revealed that mothers reporting higher levels of depression were more likely to report experiential avoidance, feeling out of control in their parenting role, and internalizing symptoms in their children. Hierarchical multiple regressions showed that locus of control explained additional unique variance in child internalizing problems over and above that explained by maternal depression. Locus of control mediated the relationship between maternal depression and child internalizing symptoms. The importance of considering parent locus of control and its relation to children’s internalizing symptoms is discussed as a potential target for early childhood prevention programs.     

Regulatory focus moderates the influence of age-related stereotypic expectancies on older adults’ test performance and threat-based concerns

This study examined how the influence of age-related stereotypic expectations on older adults’ test performance and threat-based concerns is moderated by self-regulatory processes. Before working on test items taken from materials used in drivers’ license examinations, 61 older adults were randomly assigned to a positive or negative stereotypic expectancy condition, and to a promotion or prevention focus condition, respectively. Participants exposed to negative stereotypic expectations performed worse and were more concerned than those exposed to positive stereotypic expectations under prevention but not promotion focus conditions. These findings suggest that the activation of prevention-focused self-regulation renders older adults particularly susceptible to detrimental effects of negative stereotypes.     

Examining the Regulatory and Reactive Temperamental Characteristics as Predictors of Low Income Preschool Children’s Executive Function

The current study is an examination of low income children’s reactive and regulatory temperamental characteristics as predictors of their executive function, with a particular focus on children’s regulatory temperament (i.e., inhibitory control and attentional focusing) as moderators of associations between reactive temperament (i.e., negative emotionality) and executive function. Participants were 291 children (159 boys) ages 37 to 70 months (M = 53.88 months, SD = 6.44 months) enrolled in 17 classrooms within 3 different preschools serving low income children in two Midwestern cities in the United States. Temperament was assessed via parent report during Fall 2014, and executive function were assessed via structured tasks implemented by independent researchers during Spring and Summer 2015. SAS PROC MIXED was used to test hierarchical regression models of children nested within classrooms. After controlling for child age, gender, ethnicity, and parent education, regulatory temperament moderated the association between reactive temperament and executive function. Children’s reactive temperament was inversely associated with their executive function. These findings suggest that understanding children’s regulatory and reactive temperamental characteristics may help to improve their executive functioning in early childhood.     

Validating Regulatory Sensory Processing Disorders Using the Sensory Profile and Child Behavior Checklist (CBCL 1?–5)

The objective was to validate Regulatory Sensory Processing Disorders’ criteria (DC:0-3R, 2005) using empirical data on the presence and severity of sensory modulation deficits and specific psychiatric symptoms in clinical samples. Sixty toddlers who attended a child mental health unit were diagnosed by a clinical team. The following two groups were created: toddlers with RSPD (N?=?14) and those with “other diagnoses in Axis I/II of the DC:0-3R″(OD3R) (N?=?46). Independently of the clinical process, parents completed the Infant Toddler Sensory Profile (as a checklist for sensory symptoms) and the Achenbach Behavior Checklist for ages 1?–5 (CBCL 1?–5). The scores from the two groups were compared. The results showed the following for the RSPD group: a higher number of affected sensory areas and patterns than in the OD3R group; a higher percentage of sensory deficits in specific sensory categories; and a higher severity of behavioral symptoms such as withdrawal, inattention, other externalizing problems and pervasive developmental problems in CBCL 1?–5. The results confirmed our hypotheses by indicating a higher severity of sensory symptoms and identifying specific behavioral problems in children with RSPD. The results revealed convergent validity between the instruments and the diagnostic criteria for RSPD and supported the validity of RSPD as a unique diagnosis. The findings also suggested the importance of identifying sensory modulation deficits in order to develop an early intervention to enhance the sensory capacities of children who do not fully satisfy the criteria for some DSM-IV-TR disorders.     

Parents’ Attachment Styles and Adolescents’ Regulatory Emotional Self-efficacy: The Mediating Role of Adolescents’ Attachment to Parents in China

Guided by attachment theory, this longitudinal study examined the mediating role of parent-adolescent attachment on the relation between parents’ attachment styles and adolescents’ regulatory emotional self-efficacy (RESE, including managing negative affect and expressing positive affect). Five hundred seventy-three Chinese junior high school students (46% male; aged 11–14 years, M = 12.76 years, SD = 0.74) completed measures of RESE at T1, parent-adolescent attachment at T2 (six months later), and RESE at T3 (another six months later), while 573 students’ parents (one student only has a parent, 241 fathers and 332 mothers) completed measures of adult attachment styles (anxiety and avoidance) at T1. Results from structural equation modeling indicated that father-adolescent attachment mediated the association between fathers’ attachment anxiety and adolescents’ self-efficacy beliefs in managing negative affect, while mother-adolescent attachment marginally mediated the relation between mothers’ attachment anxiety and adolescents’ self-efficacy beliefs in managing negative affect and expressing positive affect. These findings suggest that parents’ attachment anxiety could predict their children’s attachment to parents, in turn, impacting their children’s regulatory emotional self-efficacy.

     

The Shield of Defense or the Sword of Prosecution?How Self‐Regulatory Focus Relates to Responses to Crime

People can strive to attain goals in one of two ways: They can be tolerant of risk and focus on attaining successes, or they can be intolerant of risk and focus on avoiding pitfalls and failures. These differences, termed promotion focus and prevention focus, respectively, have been related to differences in how personal goals are understood, but not yet applied to policy issues. Two studies examine the implications of chronic (Study 1) and experimentally induced (Study 2) promotion vs. prevention goals for a law‐and‐order mind set. Participants high in promotion focus assigned more punishment to a criminal (Study 1). Compared to prevention‐focused participants, experimentally induced promotion focus increased the likelihood of arresting a suspect and justifying this choice (Study 2).     

IRB and Research Regulatory Delays Within the Military Health System: Do They Really Matter? And If So,Why and for Whom?

Institutional review board (IRB) delays may hinder the successful completion of federally funded research in the U.S. military. When this happens, time-sensitive, mission-relevant questions go unanswered. Research participants face unnecessary burdens and risks if delays squeeze recruitment timelines, resulting in inadequate sample sizes for definitive analyses. More broadly, military members are exposed to untested or undertested interventions, implemented by well-intentioned leaders who bypass the research process altogether. To illustrate, we offer two case examples. We posit that IRB delays often appear in the service of managing institutional risk, rather than protecting research participants. Regulators may see more risk associated with moving quickly than risk related to delay, choosing to err on the side of bureaucracy. The authors of this article, all of whom are military-funded researchers, government stakeholders, and/or human subject protection experts, offer feasible recommendations to improve the IRB system and, ultimately, research within military, veteran, and civilian populations.