Choosing Across Cultures: The Effect of Choice Complexity on Treatment Outcomes

Prior research has revealed that having choice over treatments can improve their efficacy. However, it is currently unknown if the benefits of treatment choice hold for complex decisions and different cultures. The effects of differing numbers of treatment options were explored across two cultural contexts: United States and Japan. Participants were exposed to an uncomfortable stimulus and provided with up to 15 placebo treatment options they believed would reduce discomfort. There was a significant interaction such that participants from Japan benefited most from fewer treatment options (2 and 5) compared with more treatment options (10 and 15). Participants from the United States, however, showed either no change in discomfort or less discomfort as the number of choices increased. Additionally, participants from Japan reported less satisfaction with the decision process when they had more treatment options to choose from whereas U.S. participants reported similar, if not slightly higher, satisfaction with more treatment options. Further, a second study indicated that a positive experience with the decision process mediated the relationship between choice complexity and treatment efficacy for Japanese participants. These data demonstrate the importance of culture and choice complexity when discussing treatment choice and resulting outcomes in the medical context. Copyright © 2015 John Wiley & Sons, Ltd.     

Eschewing Community: Black Metal

There is a great deal of literature that examines community orientations, in particular consumption‐based subcultures rooted in the appreciation of music scenes such as heavy metal and its subgenres. Much of this literature focuses on aspects of community maintenance, reaffirmation of shared identities and building of social bonds. In the present article, we report a study in which consumption of, and fandom in a specific scene in extreme metal, namely black metal, may lead to very unique consumer cultural orientations. Our analyses reveal that black metal fans' identities reside in a realm outside of a desired collective identification and tightly knit community, but rather one that uses signification, or representational means to convey meaning and belonging, as a way to signal repugnance with society and a reverence of individuality. The study engages a mixed qualitative approach utilizing interviews, observational research and content analysis to demonstrate how self‐identity related to the black metal music scene can thrive through an ideological and semiotic rejection of traditional community orientations seen in the majority of other extreme metal music scenes. This paper challenges traditional conceptualizations of group identity in music scenes by closely examining aspects of signification and fandom in black metal that represent a unique system of shared identities devoid of community building. Copyright © 2014 John Wiley & Sons, Ltd.     

Delivering Acceptance and Commitment Therapy for Weight Self-Stigma Through Guided Self-Help: Results From an Open Pilot Trial

Weight self-stigma is a promising target for innovative interventions seeking to improve outcomes among overweight/obese individuals. Preliminary research suggests acceptance and commitment therapy (ACT) may be an effective approach for reducing weight self-stigma, but a guided self-help version of this intervention may improve broad dissemination. This pilot open trial sought to evaluate the potential acceptability and efficacy of a guided self-help ACT intervention, included coaching and a self-help book, with a sample of 13 overweight/obese individuals high in weight self-stigma. Results indicated a high degree of program engagement (77% completed the intervention) and satisfaction. Participants improved on outcomes over time including weight self-stigma, emotional eating, weight management behaviors, health-related quality of life, and depression. Although not a directly targeted outcome, participants improved on objectively measured weight, with an average of 4.18 pounds lost over 7 weeks, but did not improve on self-reported weight at 3-month follow-up. Processes of change improved over time, including psychological inflexibility, valued action and reasons to lose weight. Coaching effects indicated greater retention and improvements over time with one coach vs. the other, suggesting characteristics of coaching can affect outcomes. Overall, these results provide preliminary support for the acceptability and efficacy of a guided self-help ACT program for weight self-stigma. Implications of these results and how to address clinical challenges with guided self-help are discussed.     

Activating Veterans Toward Sources of Reward: A Pilot Report on Development,Feasibility, and Clinical Outcomes of a 12-Week Behavioral Activation Group Treatment

This pilot study evaluates a 12-week group Behavioral Activation protocol adapted to meet the needs of a Veteran population seeking treatment in an outpatient mental health clinic at a Veteran Affairs Medical Center. In a detailed Method we describe the treatment structure. Acceptability and feasibility are addressed by providing data on referral sources, treatment retention, attendance, and patient satisfaction. Initial clinical outcomes are presented, focusing on symptom reduction, improved quality of life, and changes in the hypothesized mechanism of treatment: improving motivated behavior to pursue rewards (decisional anhedonia). Finally, feedback from individual exit interviews is presented. We conclude with implementation tips and challenges in the service of continuing to improve our evidence-based interventions in Veteran Affairs facilities.     

The Ugly Truth About Ourselves and Our Robot Creations: The Problem of Bias and Social Inequity

Recently, there has been an upsurge of attention focused on bias and its impact on specialized artificial intelligence (AI) applications. Allegations of racism and sexism have permeated the conversation as stories surface about search engines delivering job postings for well-paying technical jobs to men and not women, or providing arrest mugshots when keywords such as “black teenagers” are entered. Learning algorithms are evolving; they are often created from parsing through large datasets of online information while having truth labels bestowed on them by crowd-sourced masses. These specialized AI algorithms have been liberated from the minds of researchers and startups, and released onto the public. Yet intelligent though they may be, these algorithms maintain some of the same biases that permeate society. They find patterns within datasets that reflect implicit biases and, in so doing, emphasize and reinforce these biases as global truth. This paper describes specific examples of how bias has infused itself into current AI and robotic systems, and how it may affect the future design of such systems. More specifically, we draw attention to how bias may affect the functioning of (1) a robot peacekeeper, (2) a self-driving car, and (3) a medical robot. We conclude with an overview of measures that could be taken to mitigate or halt bias from permeating robotic technology.