Bioethicists Can and Should Contribute to Addressing Racism

The problems of racism and racially motivated violence in predominantly African American communities in the United States are complex, multifactorial, and historically rooted. While these problems are also deeply morally troubling, bioethicists have not contributed substantially to addressing them. Concern for justice has been one of the core commitments of bioethics. For this and other reasons, bioethicists should contribute to addressing these problems. We consider how bioethicists can offer meaningful contributions to the public discourse, research, teaching, training, policy development, and academic scholarship in response to the alarming and persistent patterns of racism and implicit biases associated with it. To make any useful contribution, bioethicists will require preparation and should expect to play a significant role through collaborative action with others.     

Profiles of Resilience and Psychosocial Outcomes among Young Black Gay and Bisexual Men

Young Black gay/bisexual men (YBGBM) are affected by contextual stressors—namely syndemic conditions and minority stress—that threaten their health and well‐being. Resilience is a process through which YBGBM achieve positive psychosocial outcomes in the face of adverse conditions. Self‐efficacy, hardiness and adaptive coping, and social support may be important resilience factors for YBGBM. This study explores different profiles of these resilience factors in 228 YBGBM in New York City and compares profiles on psychological distress, mental health, and other psychosocial factors. Four profiles of resilience were identified: (a) Low self‐efficacy and hardiness/adaptive coping (23.5%); (b) Low peer and parental support (21.2%); (c) High peer support, low father support (34.5%); and (d) High father and mother support, self‐efficacy, and hardiness/adaptive coping (20.8%). YBGBM in profile 1 scored markedly higher on distress (d = .74) and lower on mental health functioning (d = .93) compared to men in the other profiles. Results suggest that self‐efficacy and hardiness/adaptive coping may play a more important role in protecting YBGBM from risks compared to social support and should be targeted in interventions. The findings show that resilience is a multidimensional construct and support the notion that there are different patterns of resilience among YBGBM.     

Exploring the associations shared by mood,pain-related attention and pain outcomes related to sleep disturbance in a chronic pain sample

Objective: Sleep disturbance in chronic pain is common, occurring in two-thirds of patients. There is a complex relationship between chronic pain and sleep; pain can disrupt sleep and poor sleep can exaggerate pain intensity. This may have an impact on both depressive symptoms and attention to pain. This study aims to evaluate the relationship between chronic pain and sleep, and the role of mood and attention.

Methods: Chronic pain patients, recruited from a secondary care outpatient clinic, completed self-report measures of pain, sleep, depressive symptoms and attention to pain. Hierarchical regression and structural equation modelling were used to explore the relationships between these measures. Participants (n = 221) were aged between 20 and 84 (mean = 52) years.

Results: The majority of participants were found to be ‘poor sleepers’ (86%) with increased pain severity, depressive symptoms and attention to pain. Both analytical approaches indicated that sleep disturbance is indirectly associated with increased pain severity Instead the relationship shared by sleep disturbance and pain severity was further associated with depressive symptoms and attention to pain.

Conclusions: Our results indicate that sleep disturbance may contribute to clinical pain severity indirectly though changes in mood and attention. Prospective studies exploring lagged associations between these constructs could have critical information relevant to the treatment of chronic pain.     

Successful Black Men From Absent‐Father Homes and Their Resilient Single Mothers: A Phenomenological Study

The phenomenon of absent fathers is a common occurrence in today's homes that appears to be escalating, especially in Black households across the United States. The purpose of this study was to describe the lived experiences of successful Black men who were raised in absent‐father homes as well as the lived experiences of their resilient single mothers. The authors share themes that captured the participants' experiences and provide recommendations for community counselors, school counselors, and counselor educators. El fenómeno de padres ausentes es una situación común en los hogares actuales que parece estar en crecimiento, especialmente en hogares de familias negras en Estados Unidos. El propósito de este estudio era describir las experiencias vividas por hombres negros exitosos que fueron educados en hogares con padres ausentes, además de las experiencias vividas por sus resilientes madres solteras. Los autores comparten temas que capturaron las experiencias de los participantes y proporcionan recomendaciones para consejeros comunitarios, consejeros en escuelas y capacitadores de consejeros.     

Ambiguity,Competition, and Blending in Spoken Word Recognition

A critical property of the perception of spoken words is the transient ambiguity of the speech signal. In localist models of speech perception this ambiguity is captured by allowing the parallel activation of multiple lexical representations. This paper examines how a distributed model of speech perception can accommodate this property. Statistical analyses of vector spaces show that coactivation of multiple distributed representations is inherently noisy, and depends on parameters such as sparseness and dimensionality. Furthermore, the characteristics of coactivation vary considerably, depending on the organization of distributed representations within the mental lexicon. This view of lexical access is supported by analyses of phonological and semantic word representations, which provide an explanation of a recent set of experiments on coactivation in speech perception (Gaskell & Marslen–Wilson, 1999).     

Social identity and the perception of history: cultural representations of Aotearoa/New Zealand

The context of intergroup relations in Aotearoa/New Zealand was investigated using perceptions of history by Maori (Polynesian‐descended) and Pakeha (European‐descended) samples from university and the general public. There was strong consensus that the Treaty of Waitangi was the most important event in New Zealand's history, but only Maori, the subordinate ethnic group, showed in‐group favouritism in their judgments regarding the Treaty. Pakeha, the dominant group, showed outgroup favouritism, and distanced themselves from past injustices using linguistic strategies. Maori students showed interest in their ethnic origins (ontogeny), rating the distant past and Polynesian history higher, and free‐recalling more events prior to European arrival than other groups; Maori in the general population shared a more similar perception of history to Pakeha. Both in‐group favouritism and ontogeny were found in sentence‐completion choices. Historical perceptions were strongly related to positions on current political issues. Results are related to social identity theory, social representations theory, and social dominance theory. Copyright © 1999 John Wiley & Sons, Ltd.     

Patient-Informed Treatment Development of Behavioral Smoking Cessation for People With Schizophrenia

The objective of this study was to use qualitative methodology to tailor and refine an existing smoking cessation intervention for the population of people who use cigarettes and are diagnosed with schizophrenia, schizoaffective, or psychotic disorder. Successive cohort design methodology was used to iteratively modify the treatment in response to qualitative participant, therapist, and consultant feedback on the intervention. Qualitative methodology for participant feedback included analysis of semistructured interviews with participants, visualization of app utilization data, and stakeholder feedback from study therapists and consultants. Using the successive cohort design, a tailored multicomponent mobile health smoking cessation intervention was developed. The intervention included mobile contingency management (i.e., financial compensation for confirmed abstinence from smoking), pharmacotherapy for smoking cessation, cognitive-behavioral counseling sessions, and the Stay Quit app for relapse prevention. Two cohorts (N = 13) were completed in the study; after each cohort, the treatment protocol was revised. The intervention is described, as well as the qualitative findings from each cohort and subsequent changes made to the intervention based upon patient and provider feedback. Metrics of patient engagement included treatment adherence (40% in Cohort 1 and 63% in Cohort 2). Both participants and therapists reported that the intervention was helpful. Over one third of participants self-reported abstinence at posttreatment. Since qualitative methodology is often underutilized in mental health treatment development, this study demonstrates the utility of the successive cohort design for treatment development of behavior change interventions for at-risk, vulnerable populations.