"Show me" bioethics and politics

Missouri, the "Show Me State," has become the epicenter of several important national public policy debates, including abortion rights, the right to choose and refuse medical treatment, and, most recently, early stem cell research. In this environment, the Center for Practical Bioethics (formerly, Midwest Bioethics Center) emerged and grew. The Center's role in these "cultural wars" is not to advocate for a particular position but to provide well researched and objective information, perspective, and advocacy for the ethical justification of policy positions; and to serve as a neutral convener and provider of a public forum for discussion. In this article, the Center's work on early stem cell research is a case study through which to argue that not only the Center, but also the field of bioethics has a critical role in the politics of public health policy.     

Physiological arousal, dissonance, and attitude change: evidence for a dissonance-arousal link and a "don't remind me" effect

Two experiments replicated and extended research by Croyle and Cooper (1983) indicating that cognitive dissonance involves physiological arousal. In Experiment 1, subjects wrote counterattitudinal essays under conditions of high or low choice, and, to assess arousal effects owing to effort, with or without a list of arguments provided by the experimenter. In high-choice conditions only, and regardless of effort, subjects showed both arousal (heightened galvanic skin response) and attitude change. Arousal, however, did not decline following attitude change. The more effortful task (no arguments provided) produced increased arousal but not greater attitude change. In Experiment 2, the opportunity to change one's attitude following a freely chosen counterattitudinal essay was manipulated. As in Experiment 1, arousal increased following the essay but did not decline following a postessay attitude change opportunity. When subjects were not given an attitude change opportunity, however, arousal did decline. Thus, dissonance seems to create arousal, but attitude change sustains rather than reduces the arousal. It is suggested that if dissonance is a drive state, drive reduction typically may be accomplished through gradual cognitive change or forgetting.     

"He loves me, he loves me not . . . ": uncertainty can increase romantic attraction

This research qualifies a social psychological truism: that people like others who like them (the reciprocity principle). College women viewed the Facebook profiles of four male students who had previously seen their profiles. They were told that the men (a) liked them a lot, (b) liked them only an average amount, or (c) liked them either a lot or an average amount (uncertain condition). Comparison of the first two conditions yielded results consistent with the reciprocity principle. Participants were more attracted to men who liked them a lot than to men who liked them an average amount. Results for the uncertain condition, however, were consistent with research on the pleasures of uncertainty. Participants in the uncertain condition were most attracted to the men-even more attracted than were participants who were told that the men liked them a lot. Uncertain participants reported thinking about the men the most, and this increased their attraction toward the men.     

Stressful life events, bipolar disorder, and the "kindling model"

A common misconception is that bipolar disorder is an endogenous process. However, previous research suggests a role for life events in the onset of and recovery from bipolar episodes. Yet, there remains some question as to whether the relationship between life events and onset changes over the course of the disorder as a result of the number of episodes an individual has experienced. Using a rigorous interview measure of stressful life events, the current study tested the kindling model (R. M. Post, 1992), which theorizes that major life events play a diminishing role over the course of illness in bipolar patients. Analyses revealed that the number of episodes experienced does not appear to have a significant effect on bipolar 1 patients' reactivity to external stressors. In addition, the results suggest that a more complex relationship exists among age, stress, and onset of new episodes than can be adequately explained by the kindling model.     

"God made me a girl": sex-category constancy judgments and explanations revisited

To examine reasons for inconsistent findings in the development of sex-category constancy, children's constancy judgments and their accompanying explanations were studied over a 3-year period. Preschool, kindergarten, and 1st-grade children (N = 195) completed a sex-category constancy measure that elicited explanations and assessed constancy for the self and others across changes in gender-typed clothing, activities, and traits. Improvements in sex-category constancy performance were linked to explanations based on operational reasoning. Lower constancy scores were linked to explanations that emphasized gender role norms and external appearances. A separate analysis revealed that judgment-explanation relationships were stronger for questions about gender role changes in the self as opposed to others and for changes in gender-typed clothing as opposed to activities and traits. Findings suggest that the salience and personal relevance of gender role changes have important effects on children's sex-category constancy judgments and explanations.     

Antihypertensive treatment,compliance, and quality of life: Review of a little-understood relation

If patients notoriously violate treatment regimens known to effectively control hypertension, then there must be some subjective costs associated with adherence to these regimens. Generally speaking, there must be some reduction in quality of life associated with antihypertensive medication. Unfortunately the concept of quality of life, due to its lack of specificity, is of little help in further investigating the nature of these subjective costs. We developed a simple neuropsychophysiological model based on fundamental psychological and physiological processes: corticoinhibitory effects of phasic blood pressure elevation reduce the aversive or painful qualities of many stressors. This negative reinforcement increases the rate of the reinforced physiological behavior, i.e., phasic analgesic blood pressure increases. Such negatively reinforced operant behavior is known to be extremely resistant to extinction. Counter actions such as taking antihypertensive medication not only lead to reduced quality of life due to their cancellation of the analgesic effect of conditioned blood pressure increase, but also lead to some form of reluctance to comply with treatment. The model not only provides an innovative etiological path to the emergence of neurogenic essential hypertension, but also yields a highly specific and lean concept of quality of life. Furthermore, it supplies the health care community with a concise explanation for the well-known low compliance of patients with their antihypertensive regimens. In addition to its parsimony, the model fits well with various experimental findings and has been operationalized and tested empirically. Specific therapeutic implications can be derived.     

Race-related stress,quality of life indicators,and life satisfaction among elderly African Americans

This article examined the relationships among race-related stress, quality of life indicators, and life satisfaction among elderly African Americans. A sample of 127 elderly African Americans, consisting of 87 women and 26 men (and 14 missing values), were administered the Index of Race-Related Stress, the Satisfaction With Life Scale, and the 36-item Short-Form Health Survey. Results indicated that elderly African American men and women differed significantly with regard to institutional and collective racism-related stress. In addition, the authors found that institutional racism-related stress was a significant predictor of psychological health in this sample of elderly African Americans.     

Suicide, homicide, and the quality of life: an archival study

A study of the various United States as of 1940 showed that suicide rates were higher and homicide rates were lower in states where the quality of life was higher. These findings support a hypothesis derived from Henry and Short's theory of suicide and homicide.     

Life stress, the "kindling" hypothesis, and the recurrence of depression: considerations from a life stress perspective

Major depression is frequently characterized by recurrent episodes over the life course. First lifetime episodes of depression, however, are typically more strongly associated with major life stress than are successive recurrences. A key theoretical issue involves how the role of major life stress changes from an initial episode over subsequent recurrences. The primary conceptual framework for research on life stress and recurrence of depression is the "kindling" hypothesis (R. M. Post, 1992). Despite the strengths of the kindling hypothesis, a review of the research literature reveals inconsistencies and confusion about life stress and its implications for the recurrence of depression. Adopting a life stress perspective, the authors introduce 3 major themes that resolve the inconsistencies in the current literature. They integrate these themes and extrapolate the ideas with available data to develop a preliminary framework for evaluating competing explanatory models and to guide research on life stress and the recurrence of depression.     

You,me, and meaning: an integrative review of connections between relationships and meaning in life

Social relationships are seen to be vital to human functioning, both in terms of psychological functioning and physical health. Relationships are a cornerstone of well-being. For instance, having positive relationships has been linked to greater happiness, life satisfaction and physical health outcomes. Meaning in life, or the perception that one's life is significant and has a purpose, is another prominent cornerstone of well-being. As such, social relationships and meaning in life should have reciprocal associations. In this paper, cross-cultural theory and empirical research will be reviewed to explore the role of family, romantic and friendship relationships in supporting meaning in life. Further, we will discuss the implications of the current research and propose new directions for future research.     

"When it's just me at home, it hits me that I'm completely alone": an online survey of adolescents in self-care

The present study examined adolescents' experiences of loneliness and solitude in their responses to an online survey on self-care. Both quantitative (n = 272) and qualitative (n = 150) responses were coded for these feelings when home alone. Results indicate that adolescents experience the duality of aloneness, including both positive solitude and negative loneliness. Adolescents' responses range from embraced solitude and self-care to feelings of loneliness and rejection of time by themselves. Adolescents reporting loneliness were significantly less likely to enjoy being home alone during the day and at night (p < or = .001). Also, gender, age, and emotions such as fear, boredom, and separation anxiety are associated with loneliness among adolescents in self-care. Interventions to increase connectedness and combat loneliness during out-of-school hours are recommended.     

Predictive and treatment validity of life satisfaction and the quality of life inventory

The clinical and positive psychology usefulness of quality of life, well-being, and life satisfaction assessments depends on their ability to predict important outcomes and to detect intervention-related change. These issues were explored in the context of a program of instrument validation for the Quality of Life Inventory (QOLI) involving 3,927 clients from various clinical settings. Clinical norms were also generated that supplement existing nationwide norms. The predictive validity of the QOLI and life satisfaction in a university counseling center was supported in terms of its ability to predict academic retention both by itself and in conjunction with cumulative grade point average 1 to 3 years in advance. The QOLI was also found to be sensitive to treatment-related change in two naturalistic clinical settings and samples. The interpretation and intervention utility of measures of quality of life, well-being, and life satisfaction are discussed with respect to clinical and positive psychology research.     

Tamers,deniers, and me

Philosophical Studies - This paper critically examines a prominent and perennial strategy—found in thinkers as diverse as Kant and Shamik Dasgupta—of simultaneously embracing the...     

Activity, event transactions, and quality of life in older adults

A multidimensional assessment of activity and subjective well-being based on a cognitive model of event causation was tested in a sample of 60 older adults. Activity was conceptualized as involving the occurrence of an event, the presence or absence of a response to that event, and the hedonic tone of the outcome of that transaction. Events were categorized as to whether the environment or the individual initiated them: demands or desires, respectively. Well-being was conceptualized as having two independent components, positive and negative, assessed by positive and negative mood scales and general well-being and quality-of-life scales. Analyses showed that older adults who were responsive to events reported more positive well-being, but high responding was also associated with negative aspects of well-being. Demands interacted with desire responding and outcome; affective outcomes of desired actions were significantly influenced by the occurrence of demand events. Results are interpreted in an expanded model of activity theory.     

Euthanasia and the quality of life debate.

Orthodox Christian ethics is grounded in the sacredness of life principle. Yet, it can accept a quality of life approach where "quality" refers not to capacities or states, but to the relationship between the patient's condition and the quest for transcendent life goals (Walter and Shannon, 1990). The true quality of human life derives from the vocation to stewardship, which enjoins an attitude of humble acceptance toward beneficial or "redemptive" suffering. The proper response to suffering in terminal cases is not active euthanasia or physician-assisted suicide but appropriate pain management and personal care. In cases of PVS or deep coma, only the determination of higher brain death can warrant the withholding or withdrawing of food and hydration. Yet, artificial maintenance of biological existence is also immoral. Death is to be accepted and embraced as a transition to eternal life.