Professional Autonomy in the Health Care System

Professional autonomy interferes at a structural level with the variousaspects of the health care system. The health care systems that can bedistinguished all feature a specific design of professional autonomy,but experience their own governance problems. Empirical health caresystems in the West are a nationally coloured blend of ideal type healthcare systems. From a normative perspective, the optimal health caresystem should consist of elements of all the ideal types. A workableoptimum taking national values into account could be attained bygovernance structures that also introduce elements from other ideal typesystems. Thus a normative approach to medical practice guaranteeing anessential degree of professional autonomy for a relationship of trustbetween the patient and the physician, could be combined with anefficient and equitable allocation of health care resources.     

Goal contagion: perceiving is for pursuing

Six studies examined the goal contagion hypothesis, which claims that individuals may automatically adopt and pursue a goal that is implied by another person's behavior. Participants were briefly exposed to behavioral information implying a specific goal and were then given the opportunity to act on the goal in a different way and context. Studies 1-3 established the goal contagion phenomenon by showing that the behavioral consequences of goal contagion possess features of goal directedness: (a) They are affected by goal strength, (b) they have the quality of goal appropriateness, and (c) they are characterized by persistence. Studies 4-6 show that people do not automatically adopt goals when the observed goal pursuit is conducted in an unacceptable manner, because the goal will then be perceived as unattractive. The results are discussed in the context of recent research on automatic goal pursuits.     

Temporal-spatial memory: retrieval of spatial information does not reduce recency

Factors influencing the shape of serial position curves in non-verbal serial short-term memory were examined, using a task testing memory for the position of dots. Similar recency slopes were found when both position and order were recalled (Experiment 1A) and when order only was required (Experiment 1B). This observation was confirmed and tested further in conditions requiring the same encoding but different amounts of spatial information at retrieval (Experiment 2). However, Experiment 2 also revealed an effect of spatial information retrieval on the overall level of memory for recency items. Overall, the results indicate that spatial items produce bow-shaped serial positions curves in tasks requiring the maintenance of order information and that recency is affected by the demand on spatial information retrieval in terms of the overall level of performance but not in terms of the recency slope. These findings are contrary to what is found in the literature on serial verbal recall when both item and order information are required.     

Editorial

Editorial Introduction

Editorial     

Does worry affect adjustment to bereavement? A longitudinal investigation

Background and objectives: Repetitive thought is a trans-diagnostic risk-factor for development of psychopathology. Research on repetitive thought in bereaved individuals has focused primarily on clarifying the role of rumination, repetitive thinking about past negative events and/or negative emotions. While detrimental effects of rumination have been demonstrated following bereavement, surprisingly few studies have aimed to clarify the role of worry, repetitive thinking about potential future negative events, in adjustment to loss. This study sought to fill this gap in knowledge. Methods/Design: One hundred eighty-three bereaved individuals (85.3% women) filled out questionnaires on sociodemographic and loss-related characteristics, worry, and symptom measures of depression, anxiety, and prolonged grief. After six months, 155 participants completed worry and symptom measures again. Using multiple regression analyses, concurrent and longitudinal associations between loss-related variables, worry, and symptoms of psychopathology were examined. Results: Main results were that worry was strongly positively associated with symptoms of anxiety, depression and prolonged grief concurrently and also predicted higher levels of anxiety, depression and prolonged grief longitudinally. Conclusions: Findings suggest that worry influences adjustment to bereavement negatively and may be a potential target in grief therapy, especially when aiming to reduce anxiety.     

A functional analysis of personal autonomy: How restricting ‘what’, ‘when’ and ‘how’ affects experienced agency and goal motivation

Personal autonomy is central to people's experiences of agency and abilities to actively take part in society. To address the challenges of supporting autonomy, we propose a functional model of autonomy, according to which the experience of agency is a function of the opportunity to determine what to do, when to act and how to act in goal-pursuit. We tested the model in three experiments where the three goal-pursuit components could be constrained by another person or an artificial intelligence (AI) agent. Results showed that removing any of the three components from one's own decisions reduced experienced agency (Study 1a and 1b) and lowered motivation to pursue goals in organisational contexts (Study 2). In comparison to the strong and robust main effects, interactions between the components and the effects of the source of restriction (human vs. AI) were negligible. Implications for personal autonomy, algorithmic decision-making and behaviour change interventions are discussed.