A validation of a computerised task of risk-taking and moral decision-making and its association with sensation-seeking,impulsivity and sociomoral reasoning

The aim of this study was to investigate the reliability and validity of the computer based application of the Secret Agent (SA) task of risk-taking and moral decision-making. The participants were 100 male patients in a maximum security hospital (50 with severe mental illness and 50 with personality disorder) and 50 community based healthy controls. All participants completed the SA task, the Iowa Gambling Task (IGT), and measures of IQ, antisocial personality traits, sensation-seeking, impulsivity and sociomoral reasoning. The SA risk-taking and moral decision-making scales had satisfactory levels of reliability (Cronbach’s alpha). Risk-taking correlated significantly with sensation-seeking across all three participant groups. In contrast, risk-taking only correlated with impulsivity among the severe mental illness group. Moral decision-making correlated with sociomoral reasoning among the personality disorder group. No correlation was found between the SA scores and the IGT score and the IGT did not correlate with sensation-seeking or impulsivity. IQ and antisocial personality traits did not correlate with the SA or IGT scales. The study highlights the importance of context, the nature of the risk-taking task, and ‘problem framing’ of the instructions in their relationship with individual differences.     

Treating PTSD in active duty service members using cognitive processing therapy or prolonged exposure therapy: Examining everyday practice at a military outpatient clinic

The Institute of Medicine has stressed the need for evaluations of evidence-based treatments (EBTs) for posttraumatic stress disorder (PTSD) among active duty service members (AD) using a variety of evaluation approaches (Institute of Medicine, 2012). The current study examined the clinical files of 134 service members who completed treatment for PTSD using either prolonged exposure (PE) or cognitive processing therapy at an outpatient clinic. At the completion of each session, therapists made a clinical rating as to whether or not the session was protocol adherent. The total number of treatment sessions and the proportion of sessions rated as being protocol adherent were calculated. Multi-level models estimated the change in patient PTSD and other psychological symptoms over time as a function of clinician-rated protocol adherence and total number of sessions. Approximately 65% of clinic encounters were rated by therapists as being protocol adherent. Significant reductions in PTSD and psychological symptoms were associated with protocol adherence, and this was particularly true for patients who began treatment above clinical thresholds for both PTSD and other psychological symptoms. However, as the number of sessions increased, the impact of protocol adherence was attenuated. Patient characteristics, including gender, ethnicity, and co-morbidity for other psychiatric disorders were not related to symptom change trajectories over time. These findings suggest that protocol adherence and efficiency in delivery of EBTs for the treatment of PTSD with AD is critical.     

A theory of the normative force of pleas

A familiar feature of our moral responsibility practices are pleas: considerations, such as “That was an accident”, or “I didn’t know what else to do”, that attempt to get agents accused of wrongdoing off the hook. But why do these pleas have the normative force they do in fact have? Why does physical constraint excuse one from responsibility, while forgetfulness or laziness does not? I begin by laying out R. Jay Wallace’s (Responsibility and the moral sentiments, 1994) theory of the normative force of excuses and exemptions. For each category of plea, Wallace offers a single governing moral principle that explains their normative force. The principle he identifies as governing excuses is the Principle of No Blameworthiness without Fault: an agent is blameworthy only if he has done something wrong. The principle he identifies as governing exemptions is the Principle of Reasonableness: an agent is morally accountable only if he is normatively competent. I argue that Wallace’s theory of exemptions is sound, but that his account of the normative force of excuses is problematic, in that it fails to explain the full range of excuses we offer in our practices, especially the excuses of addiction and extreme stress. I then develop a novel account of the normative force of excuses, which employs what I call the “Principle of Reasonable Opportunity,” that can explain the full range of excuses we offer and that is deeply unified with Wallace’s theory of the normative force of exemptions. An important implication of the theory I develop is that moral responsibility requires free will.     

The Spontaneous Generation of the Human in the “Heng Xian”

This essay argues that the “Heng Xian” bridges between two distinct discourses that were both prevalent in the late fourth century. One discourse focused on the origination of the natural world through a spontaneous process of differentiation, a position familiar from the Daodejing and “Tai yi sheng shui.” The other focused on the specific ways in which different kinds of things live, a position known primarily from Ru discussions centering on the concept of xing 性, the nature or spontaneous reactions of a particular kind of thing. The “Heng Xian” attempts to account for the specificity of human life—including language and social organization—while remaining within a naturalistic view grounded in spontaneity. The essay concludes by reflecting on what the “Heng Xian” tells us about the status of human institutions.     

Treatment approaches for sleep difficulties in college students

College students face many challenges and live experiences that may lead to sleep difficulties, including: varied and changing schedules, repeated deadlines, increased freedom and self-responsibility, and group living arrangements, to name but a few. A high frequency of sleep difficulties is commonly reported among college student and others who encounter similar life experiences. The prevalence of sleep difficulties is explored and a rationale provided for treatment. It is suggested that interventionists need to consider the impact of sleep difficulties on their clients' immediate and long-term functioning. To help psychologists, counsellors, and therapists better ameliorate sleep problems a number of proven techniques are reviewed which are applicable to individuals in both clinical and non-clinical settings.     

A Test of Evolutionary and Sociocultural Explanations of Reactions to Sexual Harassment

Although the field of evolutionary psychology has been perceived to generate predictions that are untestable, one potentially falsifiable prediction of the evolutionary approach is that women should be less upset by unwanted sexual advances from high than from low status men. Three experiments tested this hypothesis within a workplace and an academic setting. Across the first two experiments, women and men were actually more upset by perceived sexual harassment from higher than lower status members of the other sex. Results of Study 3 suggested that women only showed this difference when there was a power relationship involved. These results conflict with the evolutionary prediction and support a sociocultural explanation of reactions to sexual harassment; that is, that they are influenced by power differentials.     

Clinical pragmatism: bridging theory and practice

This response to Lynn Jansen's critique of clinical pragmatism concentrates on two themes: (1) contrasting approaches to moral epistemology and (2) the connection between theory and practice in clinical ethics. Particular attention is paid to the status of principles and the role of consensus, with some closing speculations on how Dewey might view the current state of bioethics.