Being skeptical about the medical humanities

In this paper the author challenges the prevailing view that contemporary writing in the medical humanities is serving the needs of the various health care disciplines. The current medical humanities literature assumes that physicians are the appropriate target group. This is most notably the case within health care ethics literature. There appears to be an unexamined assumption that physician-centric approaches to clinical ethical decision-making are the standard by which appropriate ethical practice is judged. The author challenges this assumption and addresses the problems that this approach engenders. The medical humanities literature appears to reinforce hierarchical, patriarchal arrangements which are themselves not morally neutral.     

Sex-role identity and “being-inrelation”: The implications for women counsellors

In order to assess whether women are predisposed to make better counsellors than men, a group of 53 women and men were tested for differences in sex-role identity, and relational/autonomous qualities as defined in the the theory of the Stone Center, Massachusetts. There was no significant difference between men and women in terms of sex-role identity. Individuals lacking any clear sex-role identity showed significantly lower levels of relational/autonomous qualities. While the research did not demonstrate that women are predisposed to make better counsellors than men it indicated the following possible trends: changing sex-role identity in both men and women; the prevalence of sex-role identity biological sex as a determinant of psychological characteristics; the importance of sex-role acquisition for psychological well-being.     

College Students' Perceptions of the Relationship Between Fee and Counseling

Fee as a variable that could have an impact on college students' perceptions of counseling was explored because of the authentic concerns about college counseling centers needing to charge direct fees for their services. Participants (N = 350) represented a cross-section of potential consumers of psychological services, not just individuals currently receiving services. On an overt level, fees seemed to be less influential in counseling considerations, but were taken into account on a more covert level. This study supports the psychological literature, which suggests that fee is not the most important factor in clients' decisions to seek counseling. Implications for counselors, administrators, researchers, and program planners are discussed.     

Psychological determinants of decision attitude

Decision attitude — an analog of risk attitude — is the propensity to make (or avoid making) a decision: in decision aversion, a person finds it more desirable to receive through fiat the better of two options than to have a choice between them; in decision seeking, the choice is more desirable, even though it can lead to nothing better than the best option. Both decision aversion and decision seeking were found in hypothetical scenarios. Experimental manipulations and subjects' justifications point to anticipated regret, fear of blame for poor outcomes, and desire for equitable distributions as sources of decision aversion. One source of decision seeking (for self) and decision aversion (when deciding for others) appears to be the desire for the self-determination of the affected parties. We consider the implications of our results for personal choice and public policy decisions.     

Reliability of self-reported service use: Test-retest consistency of children's responses to the Child and Adolescent Services Assessment (CASA)

This paper reports on the reliability of children's responses on the Child and Adolescent Services Assessment (CASA) — a self-report instrument for use with 8– to 18-year-olds that gathers information about services used to address mental health problems. Findings were based on interviews completed by 77 children at a one week test-retest interval. Results showed that reports of lifetime service use were as reliable as were reports of service use in the preceding three months. Children reported restrictive and intrusive services more reliably than services that were provided in their natural environment. Reliability appeared to be associated more strongly with characteristics of the type of service than with characteristics of the child. Children also could report reliably on some details about their encounters with service providers (e.g., length of stay, number of visits, and onset of service use).     

Children's Decisions About Substance Use: An Application and Extension of the Theory of Reasoned Action1

This research examines the applicability of Fishbein and Ajzen's (1975) theory of reasoned action (TRA) to intentions to use cigarettes and alcohol among 5th- and 6th-grade students. It also addresses the question of unidimensionality of outcome beliefs and referent norms. Results suggest that the TRA model describes children's decision making well, although the ability of income and race to add to prediction, net of the effects of attitude and perceived norm, are contrary to the theory's prediction. In addition, we find support for multidimensional components of both attitude and norm for both behaviors.     

Is Speech Arrest during Wada Testing a Valid Method for Determining Hemispheric Representation of Language?

Background and objective: The intracarotid amobarbital procedure, or Wada test, is the method of choice to determine hemispheric representation of language, and is routinely used in the presurgical evaluation for intractable epilepsy. Some investigators perform comprehensive language assessments, but others base language lateralization solely on speech arrest. This study sought to determine whether speech arrest alone during Wada testing provides valid data regarding language lateralization. Methods: The subjects (previously reported) were 21 patients evaluated for intractable epilepsy, who underwent language lateralization by Wada testing and functional MRI (FMRI). For each patient, language representation was determined by calculating: (1) a Wada laterality index based exclusively on speech arrest; (2) a Wada laterality index based on comprehensive language assessment; and (3) an FMRI laterality quotient. Correlation coefficients and categorical classifications were analyzed. Results: There was no significant correlation between the Wada laterality quotient derived from duration of speech arrest and either the comprehensive Wada language laterality score (r= .35,p= .12) or FMRI language laterality score (r= .32,p= .16). Categorical classification as left, right or bilateral language also showed marked discordance between speech arrest and the other two methods. Conclusion: Duration of speech arrest during Wada testing is not a valid measure of language dominance.