Shaping Medical Students' Attitudes Toward Ethically Important Aspects of Clinical Research: Results of a Randomized,Controlled Educational Intervention

The effects of research ethics training on medical students' attitudes about clinical research are examined. A preliminary randomized controlled trial evaluated 2 didactic approaches to ethics training compared to a no-intervention control. The participant-oriented intervention emphasized subjective experiences of research participants (empathy focused). The criteria-oriented intervention emphasized specific ethical criteria for analyzing protocols (analytic focused). Compared to controls, those in the participant-oriented intervention group exhibited greater attunement to research participants' attitudes related to altruism, trust, quality of relationships with researchers, desire for information, hopes about participation and possible therapeutic misconception, importance of consent forms, and deciding quickly about participation. The participant-oriented group also agreed more strongly that seriously ill people are capable of making their own research participation decisions. The criteria-oriented intervention did not affect learners' attitudes about clinical research, ethical duties of investigators, or research participants' decision making. An empathy-focused approach affected medical students' attunement to research volunteer perspectives, preferences, and attributes, but an analytically oriented approach had no influence. These findings underscore the need to further examine the differential effects of empathy-versus analytic-focused approaches to the teaching of ethics.     

Tests of a Cognitive-Resource-Allocation Account of the Bizarreness Effect

The authors examined the role of cognitive-resource allocation in obtaining the often reported memory advantage for bizarre relative to common information by using the secondary-task method in 4 experiments. In Experiments 1 and 2, they investigated the relationship between differences in cognitive resource allocation during comprehension and in recall for common and bizarre information. In Experiments 3 and 4, they investigated the same relationship but measured cognitive-resource allocation during imaging rather than during comprehension. Although bizarre items required more time to comprehend and to image than did common items, the differences were not reliable predictors of the recall differences between item types. Furthermore, analyses of response latencies to a secondary task provided no compelling evidence in support of a cognitive-resource-allocation explanation of bizarreness effects. Implications for the development of a comprehensive model of the influence of bizarreness on memory are discussed.     

“They Say That You Are a Danger But You Are Not”: Representations and Construction of the Moral Self in Narratives of “Dangerous Individuals” 1

This article is based on an analysis of narratives of 26 offenders with mental health problems living in the United Kingdom. It explores the impact of an ascribed dangerous status and the construction of the self as moral and responsible in response to this label with reference to the literature on denial, deviance disavowal and other “techniques of neutralization” and Goffman's presentation of self. Two dominant strands are identified in relation to the construction of moral self-hood: “Not my fault” and “Good at heart” narratives. “Techniques of neutralization” are widely drawn on, particularly denial of responsibility in the “Not my fault” narratives that seek to explain anti-social behavior with reference to external forces such as a hostile environment inhibiting their ability to control their lives. In contrast, “Good at heart” narratives draw on the essentially good and moral nature of the inner-self. Both are used as evidence of sharing and adhering to moral norms in order to present an acceptable and credible self.     

Heart Rate and Affective Reactions to State Self-Objectification as a Function of Gender

The purpose of the present study was to examine heart rate (HR) and affective reactions to state self-objectification as a function of gender. We examined negative affect, positive affect, guilt, and HR at 6-second and 5-minute intervals across baseline, control, high objectification, low objectification, and cologne conditions in men (n = 53) and women (n = 57). Mixed factorial MANOVA results indicated a statistically significant Gender × Condition interaction. Both men and women showed a cardiac orienting response to high versus low objectification. Cardiac stress reactions to objectification were higher among women. Negative affective reactions to objectification were more pervasive across conditions among women.     

The role of attitudes towards the targets of behaviour in predicting and informing prenatal testing choices

Research considering the role of attitudes in prenatal testing choices has commonly focused on the relationship between the attitude towards undergoing testing and actual testing behaviour. In contrast, this study focused on the relationship between testing behaviour and attitudes towards the targets of the behaviour (in this case people with Down syndrome (DS) and having a baby with DS). A cross-sectional, prospective survey of 197 pregnant women measured attitudes towards the targets of prenatal testing along with intentions to use screening and diagnostic testing, and the termination of an affected pregnancy. Screening uptake was established via patient records. Although attitudes towards DS and having a baby with DS were significantly associated with screening uptake and testing and termination intentions, unfavourable attitudes were better than favourable ones at predicting these outcomes. For example, in the quartile of women with the ‘most favourable’ attitude towards people with DS 67% used screening although only 8% said they would terminate an affected pregnancy. Qualitative data suggested that not all women considered personal attitudes towards DS to be relevant to their screening decisions. This finding has implications for the way in which informed choice is currently understood and measured in the prenatal testing context.     

Noncompliance in hemodialysis patients as measured with the MBHI

Abstract

Fifteen patients beginning maintenance hemodialysis due to renal failure were administered the Millon Behavioral Health Inventory, the Family Environment Scale and Beck Depression Inventory at the outset of treatment. They were then followed regarding their compliance with fluid, diet and medication, using weight change and serum potassium and phosphorus levels. Statistically significant differences were found on independence/dependence conflicts and between patients showing at least moderate noncompliance with weight and/or phosphorus limitations. Significantly higher levels of depression were associated with consistently poorer compliance patterns.