Who shall be Allowed to Give? Living Organ Donors and the Concept of Autonomy

Free and informed consent is generally acknowledged as the legal andethical basis for living organ donation, but assessments of livingdonors are not always an easy matter. Sometimes it is necessary toinvolve psychosomatics or ethics consultation to evaluate a prospectivedonor to make certain that the requirements for a voluntary andautonomous decision are met. The paper focuses on the conceptualquestions underlying this evaluation process. In order to illustrate howdifferent views of autonomy influence the decision if a donor's offer isethically acceptable, three cases are presented – from Germany, theUnited States, and India. Each case features a person with questionabledecision-making capacity who offered to donate a kidney for a siblingwith severe renal insufficiency. Although the normative framework issimilar in the three countries, different or sometimes even contraryarguments for and against accepting the offer were brought forward. Thesubsequent analysis offers two explanations for the differences inargumentation and outcome in spite of the shared reference to autonomyas the guiding principle: (1) Decisions on the acceptability of a livingdonor cannot simply be deducted from the principle of autonomy but needto integrate contextual information; (2) understandings of the wayautonomy should be contextualized have an important influence on theevaluation of individual cases. Conclusion: Analyzing the conceptualassumptions about autonomy and its relationship to contextual factorscan help in working towards more transparent and better justifieddecisions in the assessment of living organ donors.     

Movie exposure to smoking cues and adolescent smoking onset: a test for mediation through peer affiliations.

OBJECTIVE: To determine whether the effect of movie exposure to smoking on adolescent smoking onset is mediated through increased affiliation with peers who smoke. DESIGN: A longitudinal study was conducted with a sample of 5th- 8th graders; persons who were nonsmokers at the baseline assessment (N = 2,614) were followed up 18 months later. Movie exposure to smoking cues was assessed at baseline with a rigorous coding procedure. MAIN OUTCOME MEASURE: A school-based survey and follow-up telephone interview determined whether the participant smoked cigarettes. RESULTS: Longitudinal structural modeling analysis indicated movie-smoking exposure was related to smoking onset both through an indirect effect involving increased affiliation with peer smokers and through a direct effect. The analysis controlled for demographics, parenting style, rebelliousness and sensation seeking, school performance, parental smoking, and sibling smoking; several of these variables also had mediated or direct effects to smoking onset. CONCLUSION: The effect of movie exposure on adolescent smoking onset is attributable in part to a social mechanism. Implications of media effects for prevention are discussed.     

Do High- and Low-Active Adolescents Have Different Prototypes of Physically Active Peers?

The Psychological Record - Previous studies have investigated social images in health-risk behaviors, suggesting that these images are important factors in adolescents’ health-related...     

Development of a Patient Adherence Scale for Exposure and Response Prevention Therapy

Exposure and response prevention (EX/RP) is an evidence-based treatment for obsessive-compulsive disorder (OCD). For EX/RP to be maximally effective, it is believed that patients must adhere outside of sessions to the procedures they learn in therapy. To date, there is no standard measure of patient EX/RP adherence, despite the importance of accurately assessing EX/RP adherence in both clinical research and practice. This paper describes the development of the Patient EX/RP Adherence Scale (PEAS), which assesses the patient's between-session adherence to the therapist's EX/RP instructions, and presents initial data on the scale's reliability and validity. The scale was designed to focus on the key procedures of EX/RP and to be brief enough to be used at each treatment session. The scale demonstrates excellent interrater reliability and good face and content validity. The usefulness of the scale is considered in the context of being an important tool to researchers trying to understand and improve outcomes of EX/RP for OCD as well as to EX/RP therapists in clinical practice. Future research will need to test the scale's reliability and validity in a larger sample of patients over the course of treatment.     

Use of geometry for spatial reorientation in children applies only to symmetric spaces

Proponents of the geometric module hypothesis argue that following disorientation, many species reorient by use of macro‐environment geometry. It is suggested that attention to the surface layout geometry of natural terrain features may have been selected for over evolutionary time due to the enduring and unambiguous location information it provides. Paradoxically, however, tests of the hypothesis have been exclusively conducted in symmetric (hence ‘unnatural’ and geometrically ambiguous) environments. The present series of studies examines reorientation by 18‐month–3‐year‐old children in a rectangular versus irregular quadrilateral enclosure (Study 1), a rectangular versus irregular quadrilateral array (Study 2) and an isosceles versus irregular triangular array (Study 3). Children were successful in symmetric but not asymmetric environments, casting doubt on the functional argument for an empirical basis of the geometric module hypothesis.