Assessing mental capacity and susceptibility to undue influence

Clinicians are commonly asked to participate in the determination of an individual's mental capacity and susceptibility to undue influence. Vague statutory definitions and lack of operational criteria for both determinations have contributed to inconsistency in the quality and usefulness of expert input to these determinations. Questionnaire responses of 119 probate judges from the U.S. indicate that this input is quite influential despite the problems mentioned above. This paper presents and discusses the judges' views on selected procedural and conceptual aspects of expert evaluation and testimony.     

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.     

Extraversion: A “Hidden” Personality Factor in Coping?

Recent evidence suggests a larger role for personality determinants of the coping response than has been traditionally held. In the two studies presented here, we examined the influence of personality on the use of social support and other coping strategies in samples of undergraduate students. The first study surveyed a range of coping responses to naturally occurring stressors and found that Extraversion was related to social support seeking, optimism (identified as germane to coping in prior research) was related to problem solving, and both dispositions were negatively related to avoidance. The second study used an experimental approach and multiple personality measures to correct for possible methodological problems in the first. Extraversion again proved to be associated with help seeking; moreover, this relationship accounted for that of another disposition, self-esteem—a construct considered crucial in the literature. The utility of personality variables, particularly Extraversion, in predicting and explaining the choice of a coping strategy is discussed.     

A Paradigm for Studying the Accuracy of Self-Reports of Risk Behavior Relevant to AIDS: Empirical Perspectives on Stability, Recall Bias, and Transitory Influences

Despite the importance of the issue for AIDS-related research, there is a paucity of studies that have addressed the issue of the validity of self-reports of patterns of risk behavior over time. This article frames issues of measurement in the context of cognitive psychology and presents a research paradigm that investigators can use to explore issues of accuracy, bias, and stability in self-reports. The paradigm also permits the analysis of transitory influences on risk behavior, influences which have been minimized in current AIDS research. Preliminary data are presented that support the feasibility of the method and which are suggestive of important considerations in the development of valid measures in national surveys.     

Book reviews

Science as Salvation: a Modern Myth and its Meaning, Mary Midgley, 1994. London, Routledge x +256pp., Hb 04 15062713, £35; Pb 04 15107733, £8.99

Philosophical Naturalism, David Papineau, 1993 Oxford, Basil Blackwell xii +219pp., Hb 0631189025, £40; Pb 0631189033, £14.99

F. H. Bradley, Writings on Logic and Metaphysics, James W. Allard & Guy Stock (Eds), 1994. Oxford, Clarendon Press xv+357pp, Hb 0–198–24445–2, £40.00; Pb 0–198–24438‐X, £14.95

Invariance and Heuristics: Essays in Honour of Heinz Post, Steven French & Harmke Kamminga (Eds), 1993 Boston Studies in the Philosophy of Science, Vol. 148 Kluwer Academic Publishers, Dordrecht

Beyond Reason: Essays on the Philosophy of Paul Feyerabend, GONZALO MUNÉVAR (Ed.), 1991. Dordrecht, Kluwer Academic Publishers xxi + 535pp., hb, ISBN 0–7923–1272–4, £104.20

World Changes: Thomas Kuhn and the Nature of Science, Paul Horwich (Ed.), 1993. Cambridge, MA, Bradford Books/MIT Press vi + 356pp., pb, ISBN 0262581388, £14.95

Realism Rescued: How Scientific Progress is Possible, Jerold L. Aronson, Rom Harré & Eileen Cornell Way, 1994 London, Duckworth vii +213pp., Hb 0715624768, £30.00

Scientific Nihilism: On the Loss and Recovery of Physical Explanation, Daniel Athearn, 1994. State University of New York Press, Albany ix + 387pp., Hb ISBN 0–7914–1807–3, £52

Theism, Atheism, and Big Bang Cosmology, William Lane Craig & Quentin Smith, 1993. Oxford, Clarendon Press x +342pp., Hb 0198263481, £35; Pb 019826383X, £13.95     

The modification of auditory hallucinations

The ABAB withdrawal design was used to document the effectiveness of a behavioral treatment package in reducing the duration of auditory hallucinations of a chronically mentally ill inpatient. Results revealed clear functional control of the treatment package over the occurrence of the subject's auditory hallucinations during a 2-hr time period.     

Direct comparisons between residential and community students on school performance measures in a public school setting

The purpose of the current study was to evaluate the school performance of residential youth who attended a public school setting. Direct comparisons were made between the residential youth and students in the community on a number of school measures. Results from a multivariate analysis of covariance indicated that the residential students had significantly lower grades, participated in significantly fewer extracurricular activities, and exhibited more problematic behaviors such as tardies and absences. These findings were consistent with previous research which found that many residential youth have a number of behavioral, social, and academic difficulties that interfere with school functioning. A number of recommendations were made regarding educational placement for residential youth.