The self-fulfilling prophecy in intensive care

Predictions of poor prognosis for critically ill patients may become self-fulfilling if life-sustaining treatment or resuscitation is subsequently withheld on the basis of that prediction. This paper outlines the epistemic and normative problems raised by self-fulfilling prophecies (SFPs) in intensive care. Where predictions affect outcome, it can be extremely difficult to ascertain the mortality rate for patients if all treatment were provided. SFPs may lead to an increase in mortality for cohorts of patients predicted to have poor prognosis, they may lead doctors to feel causally responsible for the deaths of their patients, and they may compromise honest communication with patients and families about prognosis. However, I argue that the self-fulfilling prophecy is inevitable when life-sustaining treatment is withheld or withdrawn in the face of uncertainty. SFPs do not necessarily make treatment limitation decisions problematic. To minimize the effects of SFPs, it is essential to carefully collect and appraise evidence about prognosis. Doctors need to be honest with themselves and with patients and their families about uncertainty and the limits of knowledge.     

Evaluating the two-component inspection model in a simplified luggage search task

Visual inspection of X-ray images of luggage is a time-pressured task that typically shows large initial training effects, but there exists a paucity of models capable of evaluating performance and speed concurrently. In the present study, visual inspection ability during learning was modeled using Drury’s two-component inspection model (TCM; Drury, 1975) in a laboratory experiment involving 12 younger (mean age = 20.8 years) and 12 older (mean age = 60.0 years) naive participants undertaking a simplified luggage search task. Model fits and assumptions were found to be reliable and accurately reflected improvement with training for decision time, although neither search nor decision components of the model individually showed a significant effect of age. The decision component of the model showed larger improvement with training than did the search component, and stopping-time policy accurately reflected the improvements found between ages and within training levels. The TCM is a useful supplement to detection theory when speed of performance is a factor.     

What do eye movements reveal about the role of memory in visual search?

Horowitz and Wolfe (1998, 2003) have challenged the view that serial visual search involves memory processes that keep track of already inspected locations. The present study used a search paradigm similar to Horowitz and Wolfe's (1998), comparing a standard static search condition with a dynamic condition in which display elements changed locations randomly every 111 ms. In addition to measuring search reaction times, observers' eye movements were recorded. For target-present trials, the search rates were near-identical in the two search conditions, replicating Horowitz and Wolfe's findings. However, the number of fixations and saccade amplitude were larger in the static than in the dynamic condition, whereas fixation duration and the latency of the first saccade were longer in the dynamic condition. These results indicate that an active, memory-guided search strategy was adopted in the static condition, and a passive “sit-and-wait” strategy in the dynamic condition.     

Parents' estimations of their own intelligence and that of their children: a comparison between English and Icelandic parents

In this study, 158 parents (79 fathers and 79 mothers) with a mean age of 38.3 yrs (SD = 8.2), estimated their own, and their children's, overall intelligence as well as their children's score on the 12 intelligence scales from the Wechsler's Intelligence Scale for Children (WISC-III). The sample included English (n = 122) and Icelandic parents (n = 36), and a comparison between them showed few differences except that Icelandic parents' estimates were lower than English parents' estimates. The results showed fathers estimated their own overall intelligence higher than mothers estimated theirs and sons were estimated higher than daughters on overall intelligence. Two factors (verbal, performance) of intelligence were identified through factor analysis of the ratings of the 12 WISC subscale score estimates. A hierarchical regression showed that these two factors explained most of the variance in the estimation of the child's overall intelligence; however, gender of child and parents' self-estimated own overall intelligence added incremental variance.     

Reduced right hemisphere activation in severely abused violent offenders during a working memory task: An fMRI study

This study uses functional magnetic resonance imaging (fMRI) to address two important gaps in our knowledge of brain functioning and violence: (1) What are the brain correlates of adults in the community who have suffered severe physical abuse early in life and who go on to perpetrate serious violence in adulthood? (2) What characterizes those who experience severe physical abuse but who refrain from serious violence? Four groups of participants recruited from the community (controls, severe physical child abuse only, serious violence only, and severely abused, seriously violent offenders) underwent fMRI while performing a visual/verbal working memory task. Violent offenders who had suffered severe child abuse show reduced right hemisphere functioning, particularly in the right temporal cortex. Abused individuals who refrain from serious violence showed relatively lower left, but higher right, activation of the superior temporal gyrus. Abused individuals, irrespective of violence status, showed reduced cortical activation during the working memory task, especially in the left hemisphere. Brain deficits were independent of IQ, history of head injury, task performance, cognitive strategy, and mental activity during the control task. Findings constitute the first fMRI study of brain dysfunction in violent offenders, and indicate that initial right hemisphere dysfunction, when combined with the effects of severe early physical abuse, predisposes to serious violence but that relatively good right hemisphere functioning protects against violence in physically abused children. Aggr. Behav. 27:111–129, 2001. © 2001 Wiley‐Liss, Inc.     

The Beliefs in the Inheritance of Risk Factors for Suicide Scale (BIRFSS): Cross‐Cultural Validation in Estonia,Malaysia, Romania,the United Kingdom,and the United States

The genetics of suicide is increasingly recognized and relevant for mental health literacy, but actual beliefs may lag behind current knowledge. We examined such beliefs in student samples (total N = 686) from Estonia, Malaysia, Romania, the United Kingdom, and the United States with the Beliefs in the Inheritance of Risk Factors for Suicide Scale. Cultural effects were small, those of key demographics nil. Several facets of construct validity were demonstrated. Marked differences in perceived plausibility of evidence about the genetics of suicide according to research design, observed in all samples, may be of general interest for investigating lay theories of abnormal behavior and communicating behavioral and psychiatric genetic research findings.