Shaping Medical Students' Attitudes Toward Ethically Important Aspects of Clinical Research: Results of a Randomized,Controlled Educational Intervention

The effects of research ethics training on medical students' attitudes about clinical research are examined. A preliminary randomized controlled trial evaluated 2 didactic approaches to ethics training compared to a no-intervention control. The participant-oriented intervention emphasized subjective experiences of research participants (empathy focused). The criteria-oriented intervention emphasized specific ethical criteria for analyzing protocols (analytic focused). Compared to controls, those in the participant-oriented intervention group exhibited greater attunement to research participants' attitudes related to altruism, trust, quality of relationships with researchers, desire for information, hopes about participation and possible therapeutic misconception, importance of consent forms, and deciding quickly about participation. The participant-oriented group also agreed more strongly that seriously ill people are capable of making their own research participation decisions. The criteria-oriented intervention did not affect learners' attitudes about clinical research, ethical duties of investigators, or research participants' decision making. An empathy-focused approach affected medical students' attunement to research volunteer perspectives, preferences, and attributes, but an analytically oriented approach had no influence. These findings underscore the need to further examine the differential effects of empathy-versus analytic-focused approaches to the teaching of ethics.     

How Loving are You Willing to Be? Empathic Interpretations of Fallibility,Capability, and Luck in Psychotherapy

This article addresses possibilities for more empathic interpretations in the clinical situation. Using both clinical case material and mythical allegories, the author, a psychotherapist and philosopher, considers the interrelated themes of human capability, fallibility, luck, and compassion within the context of clinical circumstances, especially in relation to intractable compulsive disorders. While addressing the implications of deterministic and indeterministic assumptions regarding human nature, the author attempts to show how human capability is subject to fallibility and how both are dependent on the workings of luck. Clinical material is then used to elucidate and illustrate more empathic ways of relating both to patients in particular and our fellow human beings in general. A new interpretive framework is also introduced to facilitate and to suggest ways to more compassionately understand, interpret, and respond to patients' own struggles for well being.     

Protection and vulnerability processes relevant for early onset of substance use: a test among African American children.

This research tested predictions from a self-regulation model of factors relevant for early onset of tobacco and alcohol use with a community sample of 889 African American children (mean age = 10.5 years). Criterion variables were peer substance use, willingness to use substances, and resistance efficacy (intention to refuse substance offers). Structural modeling indicated effects of temperament dimensions were mediated through self-control and risk-taking constructs, which were related to school involvement, life events, and perceived vulnerability to harmful effects of substances. Peer use was predicted by life events, poor self-control, and parent-child conflict; willingness was predicted by life events, risk taking, and (inversely) parental support; and resistance efficacy was predicted by perceived vulnerability and (inversely) poor self-control. Findings are discussed with reference to theoretical models of early protection and vulnerability processes.     

Sexual activity is inversely related to women’s perceptions of the facial attractiveness of unknown men

A study was conducted to assess whether individual differences in sexual activity during the past 30 days, in particular penile–vaginal intercourse (PVI; which is associated with measures of relationship quality), are related to the perception of the facial attractiveness of unknown men. Forty-five women reported the frequency of a variety of sexual behaviors and rated the facial attractiveness and friendliness of 24 men. Women who reported more frequent orgasm from masturbation rated men as less friendly. This finding might be reflective of the more anti-social attitude associated with more frequent masturbation. The results also show that women who engaged more frequently in most kinds of sexual behavior, not only PVI, considered unknown men to be less facially attractive. That is, individuals who engage more frequently in a variety of sexual behaviors with their partner perceived unknown men as less attractive and thereby may be less susceptible to the lure of other (or if the only sexual behavior is masturbation, any) men.     

Clamped Corticosterone (B) Reveals the Effect of Endogenous B on Both Facilitated Responsivity to Acute Restraint and Metabolic Responses to Chronic Stress

To determine the effects of both corticosterone (B) and chronic stressors on acute ACTH responses to restraint, young male rats were exposed to streptozotocin-induced diabetes, cold (5-7 degreesC) or intracerebroventricular (icv) neuropeptide Y (NPY) for 5 d and then exposed to restraint within 2 h after lights on. Two groups of rats were studied: intact and adrenalectomized replaced with B pellets that maintained plasma B in the normal mean 24-h range of intact rats. In addition to ACTH and B responses to restraint on d 5, body weight, food intake, fat depots, glucose and other hormones were measured to determine the role of stress-induced elevations in B on energy balance. ACTH responses to restraint were normal in intact rats subjected to diabetes or cold. By contrast, there was no ACTH or B response to restraint in NPY-infused intact rats. All 3 groups of chronically stimulated adrenalectomized rats with clamped B had facilitated ACTH responses to restraint compared to their treatment controls. Overall food intake increased in all groups of stressed rats; however, augmented intake occurred only during the light in intact rats and equally in the light and dark in B-clamped rats. White adipose depot weights were decreased by both diabetes and cold and increased by NPY in intact rats; the decreases with cold and increases with NPY were both blunted and changes in fat stores were not significant in adrenalectomized, B-clamped rats. We conclude that: 1. diabetes- and cold-induced facilitation of restraint-induced afferent input to hypothalamic control of the hypothalamo-pituitary-adrenal (HPA) axis is opposed in intact rats by the elevated feedback signal of B secretion; 2. NPY does not induce facilitation of afferent stress pathways; 3. chronic stimulation of the HPA axis induces acute hyperresponsiveness of hypothalamic neurons to restraint provided that the afferent input of this acute stimulus is not prevented by B feedback; 4. stimulus-induced elevations in B secretion result in day-time feeding; 5. insensitivity of both caloric efficiency and white fat stores to chronic stress in adrenalectomized, B-clamped rats results from loss of normally variable B levels.     

Sex and age variations in the quality and intensity of children's emotional attributions to hypothetical situations

Sex and age differences in the quality and intensity of children's emotional attributions to affect-laden stories were explored. Seventy-two 7-, 9-, and 11-year-old children, with equal numbers of boys and girls of each age, were individually told 10 affect-laden stories. After each story, children were asked to indicate how they would feel as the story protagonist by pointing to angry, sad, happy, and scared faces, each of which had three degrees of intensity. The results revealed that boys attributed anger to themselves more frequently than did girls; girls attributed sadness and fear to themselves more frequently than did boys. Boys' first responses to the stories were more intensely angry and more intensely happy than were girls' first responses; and the intensity of both boys' and girls' emotional attributions decreased with age.This research was funded by a grant from the Graduate School of Boston University, #GRS-661-PS. The author expresses appreciation to the faculty and students of the Bartlett School, Lowell, Massachusetts, and to the Lowell-Lesley College Teacher Corps Project, especially to Allan Alson, John Cronin, and Edna Robinson. The author would also like to thank Shirley Brody, Emily Flynn, Benjamin Gozun, and Richard Simon for their help in various phases of this project.