The influence of medical and legal authorities on deaths facilitated by physicians.

This study investigated whether two widely publicized cases of deaths facilitated by physicians were followed by significant peaks in mortality. In March, 1991, Timothy Quill, MD, published a controversial editorial describing the physician-assisted suicide (PAS) of his 45-year-old, female leukemia patient. In a landmark decision in December 1990, the Missouri Supreme Court allowed removal of life support for Nancy Cruzan, a comatose accident victim. Correcting for trends and seasonal fluctuations, the authors examined: (1) U.S. leukemia mortality in the period centered on Quill's editorial, and (2) mortality from accident/coma combinations in the period centered on the Missouri Supreme Court's decision on Cruzan. Female leukemia deaths rose 11.3% above the expected rate (p < .01) just after Quill's article was published. The more closely the decedent matched Quill's patient, the greater the peak, with the largest peak (33.9%) evident for female leukemia patients in their 40s, who were long-term residents of smaller communities (p < .05). Five possible explanations for the findings were assessed, leading to the conclusion that Quill's editorial elicited an increase in mortality. The involvement of physicians in this increase is supported by analysis of the Cruzan case. This showed a mortality peak of 57% for accident/coma patients following the court decision.     

Effects of biochemical validation of self-reported cigarette smoking on treatment success and on misreporting abstinence

Many investigators have reported that cigarette smokers who are trying to quit often falsely report being abstinent at the end of treatment. Unfortunately, much of the previous research designed to investigate this problem has been flawed, making the results difficult to interpret. We attempted to avoid these flaws and to investigate the measurement of alveolar carbon monoxide (CO) levels to validate self-reported smoking rates at the end of treatment. Participants in behavioral cessation clinics were randomly assigned to one of three conditions that varied in timing of exposure to information regarding CO measurement: at the beginning of treatment (demonstration of CO measurement, discussion of smoking effects on CO levels, and notification that individual CO levels would be measured at the conclusion of the clinic), at the end of treatment (demonstration, discussion, and notification of CO measurement prior to self-reports of smoking levels), or at the end of treatment (demonstration and discussion of CO measurement subsequent to self-reports of smoking levels). CO levels of all participants were measured at the end of treatment after they reported their current smoking levels. Only 16% of self-reports of abstinence were not verified by CO measurement. Smokers who observed the CO demonstration at the beginning of treatment were significantly more likely than the other two groups to achieve abstinence at the end of treatment and significantly less likely to misreport abstinence. Clinical and research implications of these results are discussed.     

The indirect effects of emotion regulation on the association between attachment style,depression, and meaning made among undergraduates who experienced stressful events

Undergraduates frequently report exposure to stressful life events which may negatively impact mental health. The current study examined associations among attachment style, depression, and meaning made, and tested both direct effects and indirect effects through emotion regulation difficulties. Undergraduates (N?=?336) who reported having experienced stressful and/or potentially traumatic events completed measures through an online survey. More than half of participants (64%) were female, with a mean age of 19.26 years. In both models, higher attachment anxiety and higher attachment avoidance were significantly associated with greater difficulties with accessing emotion regulation strategies, which in turn were related to higher depression symptom severity and lower meaning made. Lack of emotional awareness also partially explained the associations between attachment avoidance and outcomes in both models. Difficulties in engaging in goal-directed behavior partially explained the associations between attachment anxiety and meaning made, but not depression symptom severity. Our results suggest certain emotion regulation strategies may be key mechanisms through which individuals with high attachment anxiety or avoidance may reduce the potential negative mental health impact that stressful life events may have.     

Psychological and neurological predictors of abusive supervision

Although the negative effects of abusive supervision are well documented, less is known about the individual differences that drive supervisors to be abusive. We use a self‐control perspective to understand the unique roles of both psychological and neurological characteristics of supervisors in the prediction of abusive behavior. Specifically, we find a positive relationship between narcissism and abusive supervision, whereas political skill and intrinsic neurological connectivity in executive control regions of the brain negatively relate to abusive supervision. Our results further show that the relationship between narcissism and abusive supervision diminishes for those who are strong in terms of political skill. In addition, neurological executive control moderates the relationship between political skill and abusive behavior. When connectivity in executive control regions of the brain is lower, political skill becomes a more important factor in reducing the display of abusive behavior. Overall, we demonstrate how combinations of characteristics (both psychological and neurological) can provide a more in‐depth understanding of the emergence of abusive supervision.