A test of the validity of the motivational interviewing treatment integrity code

To evaluate the Swedish version of the Motivational Interviewing Treatment Code (MITI), MITI coding was applied to tape-recorded counseling sessions. Construct validity was assessed using factor analysis on 120 MITI-coded sessions. Discriminant validity was assessed by comparing MITI coding of motivational interviewing (MI) sessions with information- and advice-giving sessions as well as by comparing MI-trained practitioners with untrained practitioners. A principal-axis factoring analysis yielded some evidence for MITI construct validity. MITI differentiated between practitioners with different levels of MI training as well as between MI practitioners and advice-giving counselors, thus supporting discriminant validity. MITI may be used as a training tool together with supervision to confirm and enhance MI practice in clinical settings. MITI can also serve as a tool for evaluating MI integrity in clinical research.     

The Medical Humanities Today: Humane Health Care or Tool of Governance?

The medical humanities have been presented as a panacea for medical reductionism; a means for 'humanizing' medicine. However, there is a lack of consensus about the appropriate contributing disciplines and how curricula should be taught and assessed. This special issue critically examines the role of the medical humanities in medical education and their potential to serve, inadvertently or otherwise, as a tool of governance. The contributors, who include medical educators and medical practitioners, employ a range of perspectives for analysing the pertinent issues.     

Debating ethical expertise

This paper explores the relevance of the debate about ethical expertise for the practice of clinical ethics. We present definitions, explain three theories of ethical expertise, and identify arguments that have been brought up to either support the concept of ethical expertise or call it into question. Finally, we discuss four theses: the debate is relevant for the practice of clinical ethics in that it (1) improves and specifies clinical ethicists' perception of their expertise; (2) contributes to improving the perception of moral competence of non-ethicists; (3) gives insight into complementary styles of argumentation of ethicists and non-ethicists; and (4) contributes to the awareness of the problem of profession-building of (clinical) ethicists.     

The Autonomy of the Health Professional: An Introduction

Theoretical Medicine and Bioethics -     

Feedback in Couple and Family Therapy: A Randomized Clinical Trial

Routine Outcome Monitoring (ROM) is recommended as a psychotherapy procedure to serve as clinical feedback in order to improve client treatment outcomes. ROM can work as a warning signal to the therapist if the client shows signs of no change or deterioration. This study has investigated whether any difference in outcome could be detected between those clients in couple and family therapy who used the Systemic Therapy Inventory of Change (STIC) feedback system (ROM condition) versus those who were offered treatment without the use of STIC (“treatment as usual” or TAU condition). A sample of 328 adults seeking couple and family therapy in Norway was randomly assigned to ROM versus TAU conditions. Outcome measures were The Outcome Questionnaire–45 and The Revised Dyadic Adjustment Scale. The results demonstrated no significant differences in outcomes between the ROM and TAU. Possible explanations of this result related to design and implementation issues are discussed.     

Preference or ability: Exploring the relations between risk preference,personality, and cognitive abilities

Key issues in the behavioral sciences are if there exist stable risk preferences that generalize across domains and if these are best measured by revealed risk preference (RRP) in behavioral decision tasks or by surveys eliciting stated risk preference (SRP). We applied network analysis to data from a representative Swedish sample to investigate the relations between RRP, SRP, personality characteristics, and cognitive abilities, using in total over 70 measurements. The results showed that different measures of RRP were poorly intercorrelated and formed a community together with measures of numerical and cognitive abilities. Measures of SRP were weakly correlated with measures of RRP and identified in a distinctly separate community, along with personality characteristics and gender. The ensuing analyses provided support for a model suggesting that RRPs are contaminated by demands on numerical and cognitive abilities. RRPs may thus suffer from poor construct validity, whereas SRPs may better capture people's everyday risk preferences because they are related to more stable traits.     

Imagery-induced negative affect,social touch and frontal EEG power band activity

Social touch seems to modulate emotions, but its brain correlates are poorly understood. Here, we investigated if frontal power band activity in the electroencephalogram (EEG) during aversive mental imagery is modulated by social touch from one’s romantic partner and a stranger. We observed the highest theta and beta power when imaging alone, next so when being touched by a stranger, with lowest theta and beta activity during holding hands with the loved one. Delta power was higher when being alone than with a stranger or a partner, with no difference between the two. Gamma power was highest during the stranger condition and lower both when being alone and with the partner, while alpha power did not change as a function of social touch. Theta power displayed a positive correlation with electrodermal activity supporting its relation to emotional arousal. Attachment style modulated the effect of touch on the EEG as only secure but not insecure partner bonding was associated with theta power reductions. Because theta power was sensitive to the experimental perturbations, mapped onto peripheral physiological arousal and reflected partner attachment style we suggest that frontal theta power might serve as an EEG derived bio-marker for social touch in emotionally significant dyads.     

Hick’s law equivalent for reaction time to individual stimuli

Hick’s law, one of the few law-like relationships involving human performance, expresses choice reaction time as a linear function of the mutual information between the stimulus and response events. However, since this law was first proposed in 1952, its validity has been challenged by the fact that it only holds for the overall reaction time (RT) across all the stimuli, and does not hold for the reaction time (RT_i) for each individual stimulus. This paper introduces a new formulation in which RT_i is a linear function of (1) the mutual information between the event that stimulus i occurs and the set of all potential response events and (2) the overall mutual information for all stimuli and responses. Then Hick’s law for RT follows as the weighted mean of each side of the RT_i equation using the stimulus probabilities as the weights. The new RT_i equation incorporates the important speed–accuracy trade-off characteristic. When the performance is error-free, RT_i becomes a linear function of two entropies as measures of stimulus uncertainty or unexpectancy. Reanalysis of empirical data from a variety of sources provide support for the new law-like relationship.