Ethical Care for Vulnerable Populations Receiving Psychotropic Treatment

The increasing use of pharmacotherapy raises specific ethical concerns for psychologists working with vulnerable populations. Due to a shortage of trained specialists, professionals without training in mental health, such as primary care providers, are increasingly prescribing and monitoring psychotropic medications. Vulnerable populations (e.g., older adults, people currently low in social status, immigrants, and racial/ethnic minorities) face additional barriers to mental health treatment and are at heightened risk when these factors intersect. Hence, these patients experience unique barriers to receiving optimal psychopharmacological care and are differentially vulnerable to deleterious outcomes associated with misdiagnosis and overmedication. Taken together, these factors fuel inequities in the access, quality, and utilization of mental health care. Psychologists working with these patients are ethically mandated to protect patients from harm and ensure equitable care across patient populations. Specifically, psychologists must respond to the dilemma of how to effectively treat patients within these vulnerable populations who have been misdiagnosed or poorly medicated while remaining within the bounds of their competence. This article recommends pathways to address these dilemmas through education, training, research, and advocacy.     

Neural evidence that vivid imagining can lead to false remembering

The imperfect nature of memory is highlighted by the regularity with which people fail to remember, or worse, remember something that never happened. We investigated the formation of a particular type of erroneous memory by monitoring brain activity using functional magnetic resonance imaging during the presentation of words and photos. Participants generated a visual image of a common object in response to each word. Subsequently, they sometimes claimed to have seen photos of specific objects they had imagined but not actually seen. In precuneus and inferior parietal regions of the cerebral cortex, activations in response to words were greater when participants subsequently claimed to have seen the corresponding object than when a false memory for that object was not subsequently produced. These findings indicate that brain activity reflecting the engagement of visual imagery can lead to falsely remembering something that was only imagined.     

Testing the tilt-constancy theory of visual illusions

Prinzmetal and Beck (2001) Journal of Experimental Psychology: Human Perception and Performance 27 206 - 217) argued that a subset of visual illusions is caused by the same mechanisms that are responsible for the perception of vertical and horizontal a theory they referred to as the tilt-constancy theory of visual illusions. They argued that these illusions should increase if the observer's head or head and body are tilted because extra reliance would then be placed on the illusion-inducing local visual context. Exactly that result had previously been reported in the case of the tilted-room and the rod-and-frame illusions. Prinzmetal and Beck reported similar increases in the tilt illusion (TI), as well as the Z?llner, Poggendorff, and Ponzo illusions. In two experiments, we re-examined the effect of head tilt on the TI. In experiment 1, we used more conventional TI stimuli, more standard experimental methods, and a more complete experimental design than Prinzmetal and Beck, and additionally extended the investigation to attraction as well as repulsion effects. Experiment 2 more closely replicated the Prinzmetal and Beck stimuli. Although we found that head tilt did increase TIs in both experiments, the increases were of the order of 1 degrees -2 degrees, more modest than the 7 degrees reported by Prinzmetal and Beck. Significantly, the TI increase was larger when inducing tilts and head tilts were in the same direction than when they were in opposite directions, suggesting that the tilt-constancy theory may be oversimplified. In addition, because previous evidence renders unlikely the claim that the Poggendorff illusion can be explained simply in terms of misperceived orientation of the transversals, the question arises whether there might be some other explanation for the increase in the Z?llner, Poggendorff, and Ponzo illusions with body tilt that Prinzmetal and Beck reported.     

Beliefs in moral luck: When and why blame hinges on luck

Belief in moral luck is represented in judgements that offenders should be held accountable for intent to cause harm as well as whether or not harm occurred. Scores on a measure of moral luck beliefs predicted judgements of offenders who varied in intent and the outcomes of their actions, although judgements overall were not consistent with abstract beliefs in moral luck. Prompting participants to consider alternative outcomes, particularly worse outcomes, reduced moral luck beliefs. Findings suggest that some people believe that offenders should be punished based on the outcome of their actions. Furthermore, prompting counterfactuals decreased judgements consistent with moral luck beliefs. The results have implications for theories of moral judgement as well as legal decision making.     

The Moral Metacognition Scale: Development and Validation

Scholars have advocated for the inclusion of metacognition (i.e., the extent to which one thinks about one’s thinking) in our understanding of the ethical decision making process and in support of moral learning. An instrument to measure metacognition as a domain-specific capacity related to ethical decision making (i.e. moral metacognition) is not found in the current literature. This research describes the development and validation of the 20-item Moral Metacognition Scale (MMS). Psychometric properties of the scale were assessed by exploration (Study 1) and confirmation (Study 2) of the factor structure, and the demonstration of convergent (Studies 3 and 4), discriminant (Studies 3 and 4), and predictive (Study 4) validity. Moral metacognition, as measured by the MMS, was significantly correlated with ethical awareness and ethical judgment. Limitations of our research, suggestions for future exploration, and practical implications are discussed.     

Are East Asians happy to work more or less? Associations between working hours,relative income and happiness in China,Japan, South Korea and Taiwan

As East Asians are, on average, less happy than those in economically developed Western nations, more insights regarding the associations between work, income and happiness are needed. This study analyzes data from the 2010 East Asian Social Survey to investigate these associations in China, Japan, South Korea and Taiwan, and is framed in a similar context as previous studies that utilize data from Western nations and through the lens of social comparison theory. Path analysis is used to model the associations between happiness and its predictors while taking correlations between the predictors into account. Results show that working hours are negatively associated with happiness in China, Japan and Taiwan, but such an association is not observed in South Korea. At the same time, relative income is significantly associated with happiness in all four East Asian nations, but it only mediates the association between working hours and happiness in China. These results suggest that careful consideration of economic and labour policies are critical to promote the happiness of East Asian workers. Findings from this study are useful for further inquiries with regard to specific explanatory factors of the associations between working hours, relative income and happiness in East Asia.     

Cognitive factors associated with depression and anxiety in adolescents: A two-year longitudinal study

Background/Objective: To examine the roles of anxiety sensitivity and attentional bias in the development of anxiety and depression symptoms among adolescents. Method: 214 grade 7 to grade 10 Hong Kong Chinese students completed a package of psychometric inventories to measure levels of anxiety sensitivity, selective attentional processing, and anxiety and depressive symptoms in 2016 and then again in 2017. Results: Girls, when compared with boys, exhibited more anxiety symptoms and anxiety sensitivity in 2016. They also reported a significant increase in mean depression level from 2016 to 2017. Regression analyses revealed that the physical-concerns dimension of anxiety sensitivity, positive attentional bias, and to a lesser extent negative attentional bias were related to the development of both anxiety and depression symptoms one year later. Fear of mental incapacity could predict depression one year later but not anxiety symptoms. Conclusions: Intervention through anxiety sensitivity training to reduce somatic concerns and attentional bias modification to increase habitual attention to positive stimuli and to disengage from negative stimuli can reduce anxiety and depression symptoms among high school students.     

Religion and Alcohol Use Among African-American and Hispanic Inner-City Emergency Care Patients

This study examines the impact of religious factors on alcohol consumption prior to seeking emergency care and on alcohol abuse in a random sample of inner-city Hispanic and African-American emergency care patients. A random sample of patients 18 years and older was drawn from a large inner-city hospital. Respondents who reported having consumed alcohol six hours prior to emergency admission were compared with other patients on a variety of demographic and religious indicators. Logistic regression models predicting consumption prior to admission and abstinence were estimated, along with Heckman's selection models of alcohol abuse. Religious participation has a significant negative impact on the odds of having alcohol six hours prior to seeking emergency care, and increases the odds of abstaining from alcohol. Religious coping styles, personal religiosity, and spirituality have no impact on indicators of alcohol consumption or abuse.