Physicians' values and physician-value neutrality

For years articles have decried the lack of empathy in physicians' relationships with patients. In addition to being empathetic, physicians are called upon to assume the posture of value neutrality, i.e., not imposing one's values when dealing with patients. Empathy is clearly an expression of deeply held values; even the language used to define it is value-laden. Physicians are consistently called upon to exhibit traits which are expressions of their underlying values. However, if proponents of value-neutrality are to be taken literally one must not impose any of one's values on one's patients. But then one wonders how empathy could ever be expressed; further, it is hard to imagine what a truly value neutral physician would be like. It is time we recognize that any relationship between two persons requires the expression of values from both parties. These values help shape that relationship and define its further history. Physicians are not excluded from this process just because they consider themselves professionals. Divulging personal values to patients is both more honest and more in keeping with the concepts of justice, beneficence, non maleficence, and autonomy than to feign value-neutrality. A presentation of some type statement of values is timely and would give patients an idea of where a physician stands on a myriad of issues. Rather than being value-neutral, value non-neutrality seems a more right and reasonable posture for physicians to assume.     

An External Validation of Laboratory Evidence for Earned Dignity

Both theoretical arguments and laboratory evidence indicate that society awards earned dignity (worth) to persons perceived as voluntarily performing praiseworthy behaviors. Laboratory research, as well as common observation, indicates also that society accords an intrinsic dignity unconditionally to all people. On a questionnaire given in class, college students reported increased dignity earned by the Russians from their praiseworthy (i.e., embracing freedom) and voluntary rejection of the attempted coup in 1991. The questionnaire also revealed a general belief in intrinsic dignity. External evidence for earned dignity is shown by increased international support for the Russians after rejection of the coup. This convergence of laboratory and external data validates the laboratory techniques for studying social perception of human dignity.     

Are All Hostility Scales Alike? Factor Structure and Covariation Among Measures of Hostility1

Few studies have examined the correlational and structural relationships between measures of hostility that may predict coronary heart disease. Using data from a population-based study (N= 2,682), we examined the factor structure among the five subscales from Siegel's (1986) Multi-dimensional Anger Inventory, the three subscales from Spielberger et al.'s (1985) anger expression scales, a Cook-Medley (Cook & Madley, 1954) hostility subscale that measures cynicism, and items measuring hostility from four scales that assess Type A behavior. Eight separate factors were identified: hostile anger expression, perceived control over the expression of one's anger, frequency of anger, ease of anger provocation, brooding, hostile outlook, cynicism, and sullenness. These results suggest that the structure of hostility measures is more complex than previous factor analyses have suggested. Our findings point to the dangers in assuming that a factor structure can be generalized beyond the data on which it is based to provide theoretical statements about psychological structure. The new scales appear to be valid because they correlate with demographic variables and indicators of social support in the expected directions.     

Controlling the Ground Reaction Force During Lifting

The control of the ground reaction force vector relative to the center of gravity (CoG) was examined while subjects performed a back-lifting task. Six male subjects (aged 24.0 +/- 2.5 years) repeatedly lifted a barbell. A biomechanical analysis that used a linked segment model revealed that the summed rotations of body segments during lifting yielded a specific rate of change of the angular momentum of the entire body. This equaled the external moment provided by Fsubg; relative to CoG. This implies that multisegment movements involve control of the angular momentum of the entire body through an appropriately directed Fsubg;. Thus, in dynamic tasks Fsubg; is pointed away from rather than lined up with the CoG, as is the case in static tasks.     

Behavioral Intentions: Which Ones Predict Fertility Behavior in Married Couples?1

The published literature on the relationship between behavioral intentions and fertility behavior exhibits four major problems: inconsistent and confusing use of theoretical constructs, limited use of different types of intentions, use of nonbehavioral outcomes, and failure to explore adequately the couple aspects of the intentions/behavior relationship. The study reported here addresses these problems by using a theoretical framework that characterizes the psychological/behavioral sequence leading to a planned conception, three different types of fertility intentions, a behavioral outcome variable, and data from 196 married couples with no children and 185 married couples with one child. Data analysis results in a simultaneous equation, constrained regression model which indicates that child-timing intentions are the most important predictors of proceptive behavior over a 3-1/2 year period and that childbearing intentions are next in importance; that behavioral intentions are the final common pathway through which fertility motivations, attitudes, beliefs, and desires affect behavior; that the use of proceptive behavior as an outcome variable improves the explanatory power of our models; and that the interaction of couple intentions do not demonstrate greater husband or wife influence over couple proceptive behavior but do demonstrate that disagreement has a delaying effect on the onset of that behavior.     

Uncertainty in estimating distances from memory

Magnitude estimations involving spatial characteristics, such as distance, typically show a compressive function when estimates are made from memory. In particular, as the magnitude of a property grows larger and larger, estimates become more and more inaccurate, with increasing underestimates of the actual magnitude. Previous theories have attempted to explain this difference by supposing that magnitude estimation was accomplished through a reperceptual process, in which the errors of perception are magnified, or a transformation process, in which the memory trace undergoes a consistent alteration toward a more schematic form. The present experiments present evidence in support of an uncertainty hypothesis. When subjects are uncertain of the actual value of a distance, they are forced to guess on the basis of the mean distance they encountered, because they are unable to retrieve the information accurately. When they can retrieve the information, they are more certain and their estimates are more accurate. This hypothesis was also extended to integrative conditions in which the subjects were presented with the stimulus display in a piecemeal fashion. In these cases, distance estimates were derived by combining spatial representations. This method of presentation caused distance estimates to become less accurate.     

Participant roles and the processing of verbs during sentence comprehension

This paper explores the nature of thematic information made available when a verb is accessed during sentence comprehension. Following Shapiro, Zurif, and Grimshaw (1987), a cross-modal lexical decision (interference) task was employed to examine whether either the number of argument structures or the number of participant (thematic) roles inherent in a verb cause an increase in processing load upon access of the verb. It was determined that there was no evidence for such an increased processing load covarying with the number of argument structures of the verb, at least for those verb types examined in this study. However, there was an increase in processing load as a direct function of the number of participant roles carried by the verb. It is concluded that the participant roles (thematic roles associated with the central meaning of the verb) are stored with the representation of a verb and are made immediately, available upon access of the verb for further processing during comprehension.The first author gratefully acknowledges discussion and advice from Adele Goldberg and the support of grant T32 DC 00041 in pursuing this work. The second author acknowledges the support of NIH grant RO1 DC00494 for the work presented in this paper, and the helpful comments and criticisms of a reviewer.     

A Russian adaptation of the child behavior checklist: Psychometric properties and associations with child and maternal affective symptomatology and family functioning

The Child Behavior Checklist's (CBCL) applicability to a sample of 105 Russian 9- and 10-year-old children was evaluated by examining the internal consistency of Russian adaptations of parent and teacher report forms. In addition, child behavior scores were correlated with child reports of internalizing symptoms and maternal reports of their own internalizing symptoms and general family functioning. Finally, rates of child behavior problems and patterns of interrater agreement were compared with U.S. normative data. The psychometric properties of the adaptations demonstrate the adequacy of these instruments for use in Russia. Internal consistency and interrater agreement were generally comparable to estimates obtained in U.S. normative samples. Further, an exploration of the construct validity of the Russian versions of the CBCL and Teacher Report Form (TRF) lends additional support to the adequacy of these instruments.This work was supported in part by grants from the International Research Exchanges Board (IREX) (with funds provided by the Andrew Mellon Foundation, the National Endowment for the Humanities, and the U.S. Department of State) and the National Institute of Mental Health (MH-00508, an RSDA to D. Pauls). None of these organizations is responsible for the views expressed. In addition, the authors wish to thank Thomas Achenbach for his helpful comments and suggestions.     

A behavioral assessment scale for attention deficit disorder in brazilian children based on DSM-IIIR criteria

A teacher scale based on DSM-III-R diagnostic criteria for attention deficit hyperactivity disorder (ADHD) was developed for the behavioral assessment of children in Brazil. A total of 2, 082 children (782 males and 1,300 females) with a mean age of 11.2 years who were attending a public school in the greater Rio de Janeiro area were the subjects of this study. Two factors (Hyperactivity-Impulsivity and Inattention) were extracted from a principal-factor analysis conducted on the data, and the factor structure of the scale was found to be stable. Ratings of boys were higher than ratings of girls, and younger children had higher ratings than older children for both factors. Test-retest reliability for each item of the scale ranged from .56 to .70. The data are discussed in view of current controversies in the factor structure of teacher ratings of DSM-III-R ADHD symptoms.This research was supported by FINEP (42.88.0138.00) and FUNPENE. GNOB is the recipient of a CNPq Research Career Development Award (30.0197/82). RCAP was supported by a CNPq fellowship (82.2151/87). The authors are grateful to Rosely V. Magalhaes and Angela S. Guedes for assistance in data analysis with the SAS and SPSS packages. The authors wish to thank the school staff and teachers who participated in the study. This work was presented at the Fifteenth European Conference of the International Neuropsychological Society, Portugal, 1993.