Damage compounded: disparities, distrust, and disparate impact in end-of-life conflict resolution policies

For a little more than a decade, professional organizations and healthcare institutions have attempted to develop guidelines and policies to deal with seemingly intractable conflicts that arise between clinicians and patients (or their proxies) over appropriate use of aggressive life-sustaining therapies in the face of low expectations of medical benefit. This article suggests that, although such efforts at conflict resolution are commendable on many levels, inadequate attention has been given to their potential negative effects upon particular groups of patients/proxies. Based on the well-documented tendency among many African Americans to prefer more aggressive end-of-life medical interventions, it is proposed that the use of institutional policy to break decision making impasse in cases for which aggressive treatment is deemed "medically inappropriate" will fall disproportionately on that group. Finally, it is suggested that the development and application of institutional conflict-resolution policies should be evaluated in the context of historical and current experiences of marginalization and disempowerment, lest such policies exacerbate that experience.     

Perceived health: a test of incremental validity in relation to smoking outcome expectancies, motivation to smoke and desire to quit smoking

This study examined the role of perceived health in predicting theoretically-relevant aspects of smoking behavior among 161 young adult regular smokers (67 females; mean age = 21.9 years (SD = 7.2), cigarettes per day (M) = 12.2 (SD = 5.7)) recruited from the general community. Consistent with prediction, results indicated that relative to anxiety sensitivity, gender, number of cigarettes smoked per day and nicotine dependence, perceived physical health uniquely and significantly predicted expectancies for negative affect reduction and expectancies that smoking would lead to negative personal consequences. Additionally, perceived health incrementally predicted motivation to smoke to reduce negative affect. In contrast to expectation, perceived health was unrelated to motivation to quit smoking. Results are discussed in relation to the role of perceived health as a cognitive vulnerability factor for specific types of smoking patterns.     

Detection of feigned memory impairments using a Chinese word task

In this study the detection of feigned memory impairments was investigated using a forced-choice task with Chinese words as stimuli. Task difficulty on accuracy and response time and the faking strategies employed were examined for 85 participants, 42 men and 43 women, who were administered the experimental task. Following a simulation design, all participants performed under control and faking conditions. Their accuracy of performance and response times were measured. Analysis indicated significant differences on both outcome measures for the two conditions. Further, a significant difference in accuracy, but not in response time, among levels of task difficulty was observed. For classification accuracy, using the cut-off score criterion seemed more effective than using the below-chance criterion or response time. Implications for relying on chance criterion to identify deception are discussed.     

Causal ordering of academic self‐concept and achievement: Effects of type of achievement measure

Background. The relation between academic self‐concept and achievement has been examined in a large number of studies. The majority of these studies have found evidence for a reciprocal effects model. However, there is an ongoing debate on how students' achievement should be measured and whether the type of achievement indicator (grades, tests, teacher ratings) affects the causal pattern found in these studies. Aims. The study aims at clarifying how the types of achievement measures and the way they are modelled can affect the results of causal ordering studies. In that sense, the study will yield recommendations for researchers in this domain and also provide some direction for practitioners seeking ways to enhance their students' achievement and/or academic self‐concept. Sample. Repeated measures of academic self‐concept and achievement (standardized tests and teacher ratings) were examined in a sample of 1,753 students in Grades 7, 8, 10, and 12. Method. Structural equation modelling was used. Several models (with different types and numbers of achievement measures) were compared. Results. Only small differences were found between models using one or two indicators of achievement. All models generally supported the reciprocal effects model. However, the final model, wherein tests and teacher ratings were used as separate latent variables, showed different developmental patterns in the causal relation between academic self‐concept and achievement. Conclusions. Researchers should interpret the results of causal ordering studies discerningly because the type of measure chosen as an indicator of achievement might affect the causal pattern between academic self‐concept and achievement.     

The role of event relevance and congruence to social groups in flashbulb memory formation

ABSTRACT

Flashbulb memories are vivid, confidently held, long-lasting memories for the personal circumstances of learning about an important event. Importance is determined, in part, by social group membership. Events that are relevant to one’s social group, and furthermore, are congruent with the prior beliefs of that group, should be more likely to be retained as flashbulb memories. The Fukushima nuclear disaster was relevant to ongoing political conversations in both Germany and the Netherlands, but, while the disaster was congruent with German beliefs about the dangers of nuclear energy, it was incongruent with Dutch support for nuclear power. Danish participants would not have found the disaster to be particularly relevant. Partially consistent with this prediction, across two samples (N?=?265 and N?=?518), German participants were most likely to have flashbulb memories for the Fukushima disaster. Furthermore, event features thought to be related to flashbulb memory formation (e.g. ratings of importance and consequentiality) also differed as a function of nationality. Spontaneously generated flashbulb memories for events other than Fukushima also suggested that participants reported events that were relevant to national identity (e.g. the Munich attacks for Germans, the Utøya massacre for Danes, and Malaysian Airlines flight MH-17 for Dutch participants).     

Collaborative recall of details of an emotional film

Collaborative inhibition refers to the phenomenon that when several people work together to produce a single memory report, they typically produce fewer items than when the unique items in the individual reports of the same number of participants are combined (i.e., nominal recall). Yet, apart from this negative effect, collaboration may be beneficial in that group members remove errors from a collaborative report. Collaborative inhibition studies on memory for emotional stimuli are scarce. Therefore, the present study examined both collaborative inhibition and collaborative error reduction in the recall of the details of emotional material in a laboratory setting. Female undergraduates (n = 111) viewed a film clip of a fatal accident and subsequently engaged in either collaborative (n = 57) or individual recall (n = 54) in groups of three. The results show that, across several detail categories, collaborating groups recalled fewer details than nominal groups. However, overall, nominal recall produced more errors than collaborative recall. The present results extend earlier findings on both collaborative inhibition and error reduction to the recall of affectively laden material. These findings may have implications for the applied fields of forensic and clinical psychology.     

The Dialectics of Relational Psychoanalysis and Group Psychotherapy: Commentary on Paper by Robert Grossmark

In this commentary, I address the question of why so few psychoanalysts become group therapists as I respond to the thoughtful and impressive paper written by Robert Grossmark on his work with a psychotherapy group, now in its 10th year of meeting. Prior to discussing the clinical material, and to set the stage for a discussion of Grossmark's work, I comment on my sense of the prevailing attitudes on group affiliations and group therapy within our culture and field as they have progressed over time. I then discuss my reactions to Grossmark's handling of his group session. Many of his conceptualizations of group treatment are in accordance with my own beliefs. There are some differences, however, in how I view my role as a leader and some ideas I have about group treatment that Grossmark did not address.     

Perchance to Sleep: Minding the Unworded Body in Psychoanalysis

In contemporary relational psychoanalysis, influenced by developmental/attachment theories, infant research, and neurobiology, the effectiveness and transformational potential of “the talking cure” can be thought of as, at times, located in areas of nonverbal engagement. It has become increasingly evident that human experience is born in the body and structured in body-based memory that informs us of what we “know in our gut” and contributes to our relating as embodied beings—experiences that as psychoanalysts we cannot or need not necessarily translate directly into declarative discourse. A detailed case presentation from work with a patient suffering from a severe sleep disorder and other forms of bodily dysregulation will be offered to illustrate and explore the affectively meaningful engagement between patient and analyst of somatically encoded, presymbolic memory within the context of a symbolically rich, verbal treatment relationship.     

Barriers and Supports to Substance Abuse Service Use Among Homeless Adults

Although there is a great need for substance abuse services among the homeless, many homeless individuals do not use those services. This study examined barriers and supports related to service use. Participants recognized a need for treatment and significant barriers to accessing care.