Clinical pragmatism: a method of moral problem solving

This paper presents a method of moral problem solving in clinical practice that is inspired by the philosophy of John Dewey. This method, called "clinical pragmatism," integrates clinical and ethical decision making. Clinical pragmatism focuses on the interpersonal processes of assessment and consensus formation as well as the ethical analysis of relevant moral considerations. The steps in this method are delineated and then illustrated through a detailed case study. The implications of clinical pragmatism for the use of principles in moral problem solving are discussed.     

Automation bias: decision making and performance in high-tech cockpits

Automated aids and decision support tools are rapidly becoming indispensable tools in high-technology cockpits and are assuming increasing control of"cognitive" flight tasks, such as calculating fuel-efficient routes, navigating, or detecting and diagnosing system malfunctions and abnormalities. This study was designed to investigate automation bias, a recently documented factor in the use of automated aids and decision support systems. The term refers to omission and commission errors resulting from the use of automated cues as a heuristic replacement for vigilant information seeking and processing. Glass-cockpit pilots flew flight scenarios involving automation events or opportunities for automation-related omission and commission errors. Although experimentally manipulated accountability demands did not significantly impact performance, post hoc analyses revealed that those pilots who reported an internalized perception of "accountability" for their performance and strategies of interaction with the automation were significantly more likely to double-check automated functioning against other cues and less likely to commit errors than those who did not share this perception. Pilots were also lilkely to erroneously "remember" the presence of expected cues when describing their decision-making processes.     

“Are False Memories Permanent?”: An Investigation of the Long-Term Effects of Source Misattributions

With growing concerns over children's suggestibility and how it may impact their reliability as witnesses, there is increasing interest in determining the long-term effects of induced memories. The goal of the present research was to learn whether source misattributions found by Ceci, Huffman, Smith, and Loftus (1994) caused permanent memory alterations in the subjects tested. When 22 children from the original study were reinterviewed 2 years later, they recalled 77% of all true events. However, they only consented to 13% of all false events, compared to the 22% false consent rate (among the same subset of children) found by Ceci et al. (1994). Additionally, while children remained accurate in their recall of true events (they maintained assents 78% of the time), they “recanted” their earlier false consents 77% of the time, after the 2-year delay. Implications of these findings for child witnesses and the legal system are discussed.     

Using a Person-Centered Approach in Community-Based Instruction for Adults with Developmental Disabilities

Instruction is a variable that has enhanced community access for adults with developmental disabilities. Community-based instruction emerged as an especially useful format to teach individuals daily living and work skills in the settings where skills would be used. As advocacy and self-advocacy for individuals with developmental disabilities increased, professionals recognized the importance of empowerment and self-determination in gaining community access. Adult education that incorporates the values of person-centered planning will evolve beyond what has traditionally been viewed as community-based instruction. This article describes the characteristics of community-based instruction designed to enhance not only community access, but also the participant's overall quality of life.     

Bain on Neural Networks

In his bookMind and body(1873), Bain set out an account in which he related the processes of associative memory to the distribution of activity in neural groupings—or neural networks as they are now termed. In the course of this account, Bain anticipated certain aspects of connectionist ideas that are normally attributed to 20th-century authors—most notably Hebb (1949). In this paper we reproduce Bain's arguments relating neural activity to the workings of associative memory which include an early version of the principles enshrined in Hebb's neurophysiological postulate. Nonetheless, despite their prescience, these specific contributions to the connectionist case have been almost entirely ignored. Eventually, Bain came to doubt the practicality of his own arguments and, in so doing, he seems to have ensured that his ideas concerning neural groupings exerted little or no influence on the subsequent course of theorizing in this area.     

Mood regulation expectancies, affect intensity, dispositional coping, and depressive symptoms: A conceptual analysis and empirical reanalysis

In a recent article, Flett, Blankstein and Obertinsky (1996, Personality and Individual Differences, 20, 221–228) examined cross-sectional relations between affect intensity, generalized expectancies for negative mood regulation (NMR expectancies), coping dispositions, and depression in a sample of 153 women. However, they did not report partial correlations of affect intensity and NMR expectancies, independent of each other, with coping and depression. Such information is needed for development of models of the coping process which integrate the roles of temperament variables, such as affect intensity, and cognitive-social learning person variables, such as NMR expectancies. Reanalysis of Flett etal.'s correlation matrix revealed that affect intensity and NMR expectancies were each independently associated with distinct coping dispositions, but that only NMR expectancies were independently associated with depressive symptoms.     

Reading performance and general cognitive ability in twins with reading difficulties and control pairs

The etiology of the observed relationship between general cognitive ability and reading performance was investigated by analyzing data from samples of twin pairs tested in the Colorado Learning Disabilities Research Center. Bivariate phenotypic and genetic structural equation models were fitted to data from 486 twin pairs selected for reading deficits (276 identical and 210 same-sex fraternal) and 314 control pairs (195 identical and 119 same-sex fraternal). Subtests of the Peabody Individual Achievement test (Reading Recognition, Reading Comprehension, and Spelling) were used as measures of reading performance, and verbal and performance IQ scores from the Wechsler Intelligence Scale for Children-Revised (WISC-R) or Wechsler Adult Intelligence Scale-Revised (WAIS-R) were used as indices of general cognitive ability. The results of these confirmatory factor analyses indicate that shared environmental influences do not contribute significantly to covariation between general cognitive ability and reading performance. In contrast, genetic influences contribute substantially to the relationship between the two latent factors. Moreover, the genetic and phenotypic variances of reading performance in the proband group are larger than those in controls, whereas both the genetic and phenotypic correlations between reading performance and general cognitive ability are lower in probands. These results are consistent with recent reports that reading disability may be caused by one or more genes with major effects.     

The specific action of different personality risk factors on cancer of the breast, cervix, corpus uteri and other types of cancer: A prospective investigation

We report the results of a prospective study of a random sample of 1353 elderly but healthy men and women who were followed up for a period of 10 yr, when mortality and cause of death were ascertained. Overall results have been reported elsewhere for mortality from cancer, coronary heart disease and other causes; here we are concerned with the personality factors predicting breast cancer, cervical cancer, cancer of the corpus uteri specifically, as well as other types of cancer in women. Ten specific hypotheses were tested, using specially constructed questionnaires for the purpose, and for most of these statistically significant support was obtained. The results justify belief that specific types of cancer may be related to specific stress/personality factors.     

Commitment,intimacy, and women's perceptions of premarital sex and contraceptive readiness

A person-perception study was conducted to examine the influence of intimacy and commitment on the acceptability of premarital sex and contraceptive preparedness. Ninety-six women rated a female target's personality and behavior after reading a diary entry describing a couple's initial sexual encounter. The nature of the couple's relationship and who provided the condom were manipulated between participants. Women inferred a committed relationship when intimacy was present. Women rated the target, and her behavior, as more acceptable when she had sex in a relationship with commitment. When she provided a condom, the target was perceived as less nice in the noncommitted than in the committed relationship. When her partner provided the condom, however, commitment level did not influence personality ratings.