Competency,and other constructs,in right to die cases

Subjects had to make a “remove” or “do not remove” life-sustaining measures decision in three right to die cases where the patients differed in competence; for half the subjects, a living will was present in all the cases, whereas, for the other half, it was not. Subjects also gave their determinative reasons for their decisions. Support for the right to die varied by case, but not by competency, or by the presence of a living will. The subjects' reasons were highly predictive of their decisions, and related to the way case-specific facts were construed, revealing a number of disparities between the way courts and citizens construe whether the patient's condition is “terminal,” “irreversible,” and “painful,” or not. Beyond construing facts differently, the results also revealed a disparity between evolving case law and the community's “common sense justice” over a fundamental belief: whether dying is seen as private matter, outside the bounds of State intervention, or not.     

The Effect of Action Valence and Race on 3- to 8-Year-Old Children's Social Cognitive Judgments

The present study investigated children's judgments of actions as a function of the valence of the action and the race of the actor. Three- to 8-year-old children were read an illustrated storybook in which 1 character did not share (a negatively valenced action) and the other character was helpful (a positively valenced action). The race of the characters was manipulated such that in the story, there was 1 Black character and 1 White character. Children were asked to make judgments about how mean/nice the characters were and what consequence (reward or punishment) they should receive for their actions. Despite the fact that children of this age show explicit and implicit pro-White biases (e.g., Baron & Banaji, 2006 Baron, A. S., & Banaji, M. R. (2006). The development of implicit attitudes: Evidence of race evaluations from ages 6 and 10 and adulthood. Psychological Science, 17, 53–58. doi:10.1111/j.1467-9280.2005.01664.x[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]), children's judgments were based solely on the valence of action and not on character race. The findings are discussed in light of moral development and the development of bias as it pertains to race.     

The development and validation of an implicit measure of competence need satisfaction

Research on self-determination theory has typically relied on explicit measures when examining the concept of competence need satisfaction. As a result, we know relatively little about competence need satisfaction that arises under conditions of automaticity. Across four studies, we developed and validated implicit measures of competence need satisfaction by drawing on two tasks: a relational variant of the implicit association test (IAT; Study 1, 3, and 4) and the implicit relational assessment procedure (IRAP; Study 2–3). Results across these studies revealed that both implicit measures were either unrelated or moderately related to their explicit counterpart. They were also unrelated to one another. Unlike the IRAP, the IAT was found to be reliable, to display discriminant validity, and to yield meaningful but modest relations with constructs in a nomological network. Together, these results provide modest support for the usefulness of the competence need satisfaction IAT but not of the competence need satisfaction IRAP as an implicit measure of the need for competence. Future research examining the unique predictive value of this IAT is needed, together with research on possible explanations for the low reliability of the IRAP.     

Asian and Pacific Island American students' acculturation and etiology beliefs about typical counseling presenting problems

Asian American Pacific Island college students (N = 93) completed measures of acculturation and mental health worldview, in the form of beliefs about the likely causes of 24 typical counseling presenting problems. A criterion sample of 27 staff from 2 university counseling centers reported their beliefs about the most likely cause of the same 24 problems for a typical client. A response similarity index was calculated, with higher scores reflecting greater similarity between student and counselor mental health worldviews. Results suggest that higher acculturation was associated with greater level of match between the students' etiology beliefs and those of counselors. The greatest differences were observed for serious personal problems, whereas there was more belief convergence about causes of academic problems.     

Response to Ranganathan

This essay responds to Bharat Ranganathan's “Comment” on my essay, “The Concept of Dignity in the Universal Declaration of Human Rights” (2011). Addressing key criticisms in this “Comment,” I make the following points. First, neither the idea of inherent dignity being “imparted” to humans, nor the Universal Declaration's implication—through its use of terms such as “inherent” and “inalienable”—that humans participate in transcendent reality, necessarily presuppose a Christian metaphysics. Second, a concept such as “inherent dignity” must be affirmed to be intrinsically heuristic unless we are to assume that its meaning can be completely known within the conditions of existence; but this affirmation does not render such concepts “indeterminate of sense.” Finally, Ranganathan's distinction between“weak” and “strong” senses of transcendence is untenable. If human truths beyond all contingencies are knowable (“weak” transcendence), then there must be a real dimension of meaning that transcends all contingencies (“strong” transcendence).     

Dilemmic Epistemology

Synthese - This article argues that there can be epistemic dilemmas: situations in which one faces conflicting epistemic requirements with the result that whatever one does, one is doomed to do...     

Time for change: using implementation intentions to promote physical activity in a randomised pilot trial

Objective: A common barrier to exercise is a perceived lack of time. The current pilot study examined the effects of an implementation intention intervention to enhance exercise self-efficacy, increase confidence to exercise when facing time constraints, and increase physical activity in middle-aged adults (n?=?63, aged 35–69). Design: Participants received a pedometer (Fitbit) to objectively measure activity and were randomly assigned to either a control or intervention condition. After a 1-week baseline, the intervention condition received instructions to plan how, where, and when they would add steps to their daily routine to meet their step goal, using personalised schedules and maps. Both groups were contacted nightly via email. Main Outcome Measures: Physical activity (steps and time spent in moderate-to-vigorous activity), goal achievement, exercise self-efficacy, time-relevant exercise self-efficacy and affect. Results: Compared to the control, the intervention condition significantly increased in steps, time spent in moderate-to-vigorous activity, and time-relevant exercise self-efficacy. Goal achievement was related to greater time-relevant exercise self-efficacy and more positive affect at the daily level. Conclusion: Findings suggest that the personalised planning intervention increased physical activity and confidence in achieving physical activity goals under time constraints. Avenues for future directions, especially for producing more sustained effects, are discussed.     

Statewide Implementation of Cognitive Behavioral Therapy for Psychosis Through a Learning Collaborative Model

Cognitive Behavioral Therapy for Psychosis (CBTp) is an evidence-based psychotherapeutic intervention (EBPI) for adults with schizophrenia spectrum disorders that remains under-implemented in the United States (U.S.). There has been little empirical attention on implementation and dissemination strategies for this EBPI. The Learning Collaborative (LC) model is a method of implementing evidence-based practices across agencies and geographic regions that may facilitate CBTp implementation and dissemination in the US.We applied the LC model in an attempt to enhance the accessibility of CBTp in community mental health settings statewide. Providers (N = 56) from 12 agencies voluntarily participated in an in-person, CBTp workshop followed by 6 months of biweekly phone-based consultation sessions (Phase 1). Twenty-one providers opted to participate in an additional 6-month CBTp LC immediately following completion of the initial CBTp LC (Phase 2). Adoption, penetration, provider-perceived skill development, fidelity, as well as provider-perceived implementation barriers were re-assessed during and 6 months after completion of Phase 2.One year after the completion of the Phase 2 LC, 21% of the original trainee group across 3 of the 12 participating agencies continued to offer CBTp to clients. CBTp trainees were treating between one and two clients each. Self-assessed CBTp skills improved modestly over the Phase 2 consultation period. On average, both clinicians and supervisors reached an acceptable fidelity score on the sessions reviewed. Participating providers identified multiple barriers to CBTp implementation, including features of the training and consultation, the agency, the intervention itself, and psychosocial and clinical challenges associated with the client population.Few CBTp implementation studies have applied a framework to CBTp implementation. The authors adapted the LC model in an attempt to promote adoption of CBTp in community mental health clinics across a large, populous state with poor access to mental health services. Identified challenges and recommendations should be considered in future implementation efforts.     

Internal health locus of control predicts willingness to track health behaviors online and with smartphone applications

Given rising technology use across all demographic groups, digital interventions offer a potential strategy for increasing access to health information and care. Research is lacking on identifying individual differences that impact willingness to use digital interventions, which may affect patient engagement. Health locus of control, the amount of control an individual believes they have over their own health, may predict willingness to use mobile health (mHealth) applications (‘apps’) and online trackers. A cross-sectional study (n = 276) was conducted to assess college students’ health locus of control beliefs and willingness to use health apps and online trackers. Internal and powerful other health locus of control beliefs predicted willingness to use health apps and online trackers while chance health locus of control beliefs did not. Individuals with internal and powerful other health locus of control beliefs are more willing than those with chance health locus of control beliefs to utilize a form of technology to monitor or change health behaviors. Health locus of control is an easy-to-assess patient characteristic providers can measure to identify which patients are more likely to utilize mHealth apps and online trackers.