On the relative contributions of positive reinforcement and escape extinction in the treatment of food refusal

We compared the effects of positive reinforcement alone, escape extinction alone, and positive reinforcement with escape extinction in the treatment of the food and fluid refusal of 4 children who had been diagnosed with a pediatric feeding disorder. Consumption did not increase when positive reinforcement was implemented alone. By contrast, consumption increased for all participants when escape extinction was implemented, independent of the presence or absence of positive reinforcement. However, the addition of positive reinforcement to escape extinction was associated with beneficial effects (e.g., greater decreases in negative vocalizations and inappropriate behavior) for some participants.     

Axis I and axis II disorders as predictors of prospective suicide attempts: findings from the collaborative longitudinal personality disorders study

This study examined diagnostic predictors of prospectively observed suicide attempts in a personality disorder (PD) sample. During 2 years of follow-up, 58 participants (9%) reported at least 1 definitive suicide attempt. Predictors that were examined include 4 PD diagnoses and selected Axis I diagnoses (baseline and course). Multivariate logistic regression analyses indicated that baseline borderline personality disorder (BPD) and drug use disorders significantly predicted prospective suicide attempts. Controlling for baseline BPD diagnosis, proportional hazards analyses showed that worsening in the course of major depressive disorder (MDD) and of substance use disorders in the month preceding the attempt were also significant predictors. Therefore, among individuals diagnosed with PDs. exacerbation of Axis I conditions, particularly MDD and substance use, heightens risk for a suicide attempt.     

The team halo effect: why teams are not blamed for their failures

In this study, the existence of the team halo effect, the phenomenon that teams tend not to be blamed for their failures, is documented. With 2 studies using both real teams and controlled scenarios, the authors found evidence that the nature of the causal attribution processes used to diagnose failure scenarios leads to individuals being more likely to be identified as the cause of team failure than the team as a collective. Team schema development, as indexed by team experience, influences this effect, with individuals who have more team experience being less likely to show the team halo effect     

Dispositional pessimism predicts illness-related disruption of social and recreational activities among breast cancer patients

The authors tested whether dispositional pessimism would predict withdrawal from social activities among women treated for breast cancer. In a cross-sectional sample 3-12 months postsurgery, disruption of social and recreational activities (measured by the Sickness Impact Profile) correlated with concurrently assessed pessimism. This association appeared mediated by emotional distress and fatigue. A longitudinal sample was studied shortly postsurgery and over the next year. Initial pessimism predicted disruption of social activities concurrently and prospectively (3, 6, and 12 months later) but predicted change in disruption from one time to the next only at final follow-up. These associations appeared partially mediated by distress. The authors conclude that pessimism places patients at risk for adverse outcomes in several respects rather than solely with regard to emotional distress.     

Rehabilitating equipoise

When may a physician legitimately offer enrollment in a randomized clinical trial (RCT) to her patient? Two answers to this question have had a profound impact on the research ethics literature. Equipoise, as originated by Charles Fried, which we term Fried's equipoise (FE), stipulates that a physician may offer trial enrollment to her patient only when the physician is genuinely uncertain as to the preferred treatment. Clinical equipoise (CE), originated by Benjamin Freedman, requires that there exist a state of honest, professional disagreement in the community of expert practitioners as to the preferred treatment. FE and CE are widely understood as competing concepts. We argue that FE and CE offer separable and, in themselves, incomplete justifications for the conduct of clinical trials. FE articulates conditions under which the fiduciary duties of physician to patient may be upheld in the conduct of research. CE sets out a standard for the social approval of research by institutional review boards. Viewed this way, FE and CE are not necessarily competing notions, but rather address complementary moral concerns.     

Will the real Charles Fried please stand up?

In response to the preceding commentary by Jerry Menikoff in this issue of the Journal, the authors argue that Fried's central concern is not that randomized clinical trials (RCTs) are conducted without consent, but rather that various aspects of the design and conduct of RCTs are in tension with physicians' duties of personal care to their patients. Although Fried does argue that the existence of equipoise cannot justify failure to obtain consent from research subjects, informed consent by itself does not supplant ill subjects' rights to personalized judgment and care embodied in Fried's equipoise.     

Measuring epistemic curiosity and its diversive and specific components

A questionnaire constructed to assess epistemic curiosity (EC) and perceptual curiosity (PC) curiosity was administered to 739 undergraduates (546 women, 193 men) ranging in age from 18 to 65. The study participants also responded to the trait anxiety, anger, depression, and curiosity scales of the State-Trait Personality Inventory (STPI; Spielberger et al., 1979) and selected subscales of the Sensation Seeking (SSS; Zuckerman, Kolin, Price, & Zoob, 1964) and Novelty Experiencing (NES; Pearson, 1970) scales. Factor analyses of the curiosity items with oblique rotation identified EC and PC factors with clear simple structure. Subsequent analyses of the EC items provided the basis for developing an EC scale, with Diversive and Specific Curiosity subscales. Moderately high correlations of the EC scale and subscales with other measures of curiosity provided strong evidence of convergent validity. Divergent validity was demonstrated by minimal correlations with trait anxiety and the sensation-seeking measures, and essentially zero correlations with the STPI trait anger and depression scales. Male participants had significantly higher scores on the EC scale and the NES External Cognition subscale (effect sizes of r =.16 and.21, respectively), indicating that they were more interested than female participants in solving problems and discovering how things work. Male participants also scored significantly higher than female participants on the SSS Thrill-and-Adventure and NES External Sensation subscales (r =.14 and.22, respectively), suggesting that they were more likely to engage in sensation-seeking activities.     

Correlated and coupled cognitive change in older adults with and without preclinical dementia

Common factor aging theories state that correlations among cognitive age effects signify a single underlying causal process. The logic underlying this proposition was evaluated by examining correlated cognitive change in a sample of 391 initially nondemented older adults who were tested annually for up to 16 years. Between-person correlations among rates of change (range = .56-.61) were partly attributable to model misspecification and the aggregation of heterogeneous groups of individuals. Correlated within-person cognitive change was much stronger in the cases (.45-.51) than in the noncases (.07-.18). These results demonstrate that correlated change may either signify causal commonality or the cumulative effects of multiple age-related conditions that can affect multiple cognitive systems.     

Auditory neuropathy/dys-synchrony: diagnosis and management

Auditory brainstem responses (ABRs) and otoacoustic emissions (OAEs) are objective measures of auditory function, but are not hearing tests. Normal OAEs reflect normal cochlear outer hair cell function, and an ABR indicates a synchronous neural response. It is quite possible for a patient to have normal OAEs but absent or grossly abnormal ABR and a behavioral audiogram that is inconsistent with either test. These patients, who may constitute as much as 10% of the diagnosed deaf population, have auditory neuropathy/dys-synchrony (AN/AD). To diagnose AN/AD accurately, ABRs are obtained in response to condensation and rarefaction clicks to distinguish cochlear microphonics (CM) from neural responses. Appropriate management is confounded by variation among patients and changes in auditory function in some patients over time. Recommendations for management include visual language exposure through methods such as American Sign Language (ASL), Cued Speech, or baby signs, and closely following patients.     

Psychological type and attitude toward Christianity: a replication

A sample of 149 university students completed the Francis Psychological Type Scales together with the Francis Scale of Attitude Toward Christianity. The data indicated that university students classified as Feeling Types hold a more positive attitude toward Christianity than those classified as Thinking Types. These findings replicate the 1999 report of Jones and Francis.