Self-reported reasons for moral decisions

Many investigations of moral decision-making employ hypothetical scenarios in which each participant has to choose between two options. One option is usually deemed “utilitarian” and the other either “non-utilitarian” or “deontological”. Very little has been done to establish the validity of such measures. It is unclear what they measure, let alone how well they do so. In this exploratory study, participants were asked about the reasons for their decisions in six hypothetical scenarios. Various concerns contributed to each decision. Action decisions occurred when utilitarian concerns dominated. Bystanding decisions resulted from different concerns or combinations of concerns dominating in different situations, with utilitarianism usually among participants’ concerns. None of the labels usually used for either decision therefore seems entirely appropriate. Five concerns were identified as necessary and sufficient to predict over 85% of participants’ decisions. This suggests great promise for future research, particularly in investigation of real-world moral decisions.     

Assessment as Intervention: A Pilot Study of Short-Term Dyadic Treatment

Assessment, as an intervention, is a hallmark of infant mental health that has not been evaluated for treatment effectiveness. A comprehensive assessment framework was standardized as a short-term intervention model and evaluated for treatment effects based on dynamic systems theory of change. The transdisciplinary interaction-based assessment model embeds nondidactic developmental guidance interpretations in the context of eliciting child functional capacities while engaging the caregiver in direct co-observation and reflection to challenge inflexibility in parents’ representations. The findings of this pilot project, with a community sample of Spanish- and English-speaking families, suggest this assessment as intervention model has the potential to promote an active process of change in parents’ representations toward a “disorderly,” or unstable state, possibly both in perceptions of self as caregiver and in representations of the child. Clinically, this disorderly state would be seen as an opportunity that could perpetuate the change process, recognizing disorderliness of representation as an opening, as emerging permeability of representations. Results indicate that this caregiver-clinician collaborative process is associated with caregiver reports of decreased distress, increased empathy for child’s difficulties, and changes in caregiver representations. A subset of families, caregivers who hold immutable views of their children, are less responsive to the developmental guidance approach and may require different or more long-term treatment.     

A simultaneous test of the relationship between identified psychosocial risk factors and recurrent events in coronary artery disease patients

Psychosocial factors are increasingly recognized as risk indicators for coronary artery disease (CAD) prognosis and they are likely interrelated. The objective of this study is to simultaneously test the relationship between key psychosocial constructs as independent factor scores and recurrent events in CAD patients. There were 1268 CAD outpatients of 97 cardiologists surveyed at two points. Recurrent events or hospitalization in the intervening nine months were reported. Factor analysis of items from the Hospital Anxiety and Depression Scale, Perceived Stress Scale, the ENRICHD Social Support Inventory, and Hostile Attitudes Scale was performed to generate orthogonal factor scores. With adjustment for prognostic variables, logistic regression analysis was performed to examine the relationship between these factor scores and recurrent events. Factor analysis resulted in a six-factor solution: hostility, stress, anxiety, depressive symptoms, support, and resilience. Logistic regression revealed that functional status and anxiety, with a trend for depressive symptoms, were related to experiencing a recurrent event. In this simultaneous test of psychosocial constructs hypothesized to relate to cardiac prognosis, anxiety may be a particularly hazardous psychosocial factor. While replication is warranted, efforts to investigate the potential benefits of screening and to investigate treatments are needed.     

Telling stories: The structure of adults' narratives

Abstract

Adults' narratives were analysed to study life-span changes in their structure. The narratives were collected from a group of adults in their 60s, 70s, and 80s. Four separate analyses were performed on the narratives' (1) hierarchical structure, (2) syntactic structure, (3) propositional content, and (4) cohesion. Age-group differences were obtained for the measures of hierarchical structure, syntactic structure, and cohesion. Further analyses revealed that the structural complexity of the narratives influenced their syntactic structure and cohesion. Interactions between the effects of age group and structural complexity suggest that elderly adults minimise the syntactic complexity of their narratives, reducing their cohesion, when producing structurally complex narratives. Finally, ratings of the quality of the narratives were strongly correlated with their structural complexity, suggesting that telling a “good” story involves constructing complex plots.     

MATERIALISM, SOCIOCULTURAL APPEARANCE MESSAGES, AND PATERNAL ATTITUDES PREDICT COLLEGE WOMEN'S ATTITUDES ABOUT COSMETIC SURGERY

Rates of cosmetic surgery procedures have increased dramatically over the past several decades, but only recently have studies of cosmetic surgery attitudes among the general population begun to appear in the literature. The vast majority of those who undergo cosmetic surgery are women. We examined cosmetic surgery attitudes among 218 undergraduate women, most of whom were White. Specifically, we examined their acceptance of cosmetic surgery and expressed desire to undergo cosmetic surgery procedures, and several potential predictors: appearance attitudes of mothers, fathers, and friends; awareness and internalization of sociocultural appearance messages; and materialism. Multiple regression analyses indicated that materialism and internalization of sociocultural messages consistently emerged as significant predictors of acceptance of cosmetic surgery and desire for cosmetic surgery procedures. Paternal attitudes positively predicted acceptance of cosmetic surgery for social reasons and desire for cosmetic surgery; nonmaterialism negatively predicted considering cosmetic surgery and the desire for cosmetic surgery procedures.     

Borderline personality as a self-other representational disturbance

A great deal has been written about the nature of borderline personality. We maintain that borderline psychopathology emanates from particular disturbances in mental representations-impairment in the ability to maintain and use benign and integrated internal images of self and others-and that these troubled ways of thinking drive the troubled interpersonal relations, affective instability, and impulsivity associated with borderline. Aspects of borderline self-other representational disturbances are present across a wide theoretical spectrum, and a number of research methodologies already exist to assess the phenomena. We conclude that borderline attributes exist on continua, and summarize important features as: (1) unstable mental images of self and others, often marked by self-loathing and attributions of malevolence to others; (2) interactions with others organized around a fundamental need for care that is felt to be necessary for basic functioning; (3) fear of others based on expectations of being mistreated and disappointed and/or terror of having one's identity subsumed by another person; (4) difficulty considering multiple and/or conflicting perspectives, with a tendency toward concrete, all-or-none, or black-and-white, thinking and distortion of reality; and (5) sadomasochistic interpersonal interactions in which a person alternatively inflicts suffering on others and suffers at the hands of others.     

Portrait of the therapist as a shaman

What follows will show that an understanding of the nature and purpose of shamanism contains a number of insights that bring to light some important, but often obfuscated, aspects of Western therapeutic practices. the point of departure of the argument is the theory of shamanism developed by the inventor of structural anthropology: Claude Lévi-Strauss. It will be argued, in particular, that his theory of shamanism provides a key to the therapeutic action of symbols upon the body as well as to the broader social function of therapy in general.     

Communicating BRCA1/2 genetic test results within the family: a qualitative analysis

Genetic testing for BRCA1/2 mutations associated with hereditary breast and ovarian cancer reveals significant risk information about one's chances of developing cancer. It is important to study communication processes in families where members are undergoing genetic testing because the information received is crucial not just to the individual concerned but also to other members of the biological family. This study investigates family communication of BRCA1/2 test results from both the informants' and recipients' perspectives. A total of 10 female patients and 22 of their relatives were interviewed. Patients' and their relatives described feelings of responsibility for sharing genetic information within the family to enable others to reduce their risks of developing cancer. However, there were limits to an individuals' responsibility once key family members had been informed, who then had to take responsibility for continuing dissemination of information. Whilst there was an implicit responsibility to inform the family of a mutation, information was edited or withheld in the best interest of relatives, dependent upon their perceived emotional readiness, resilience and current life stage and circumstances. The pre-existing family culture and the impact previous cancer diagnoses had upon the family also influenced the process of communication. Findings are discussed in relation to extant literature and implications for clinical practice are considered.