Developing the Good Physician: Spirituality affects the development of virtues and moral intuitions in medical students

The Project on the Good Physician is a national longitudinal study of moral and professional formation of American physicians over the course of medical training. The purpose of this paper is to examine the processes by which spirituality influences the development of three virtues (mindfulness, empathic compassion, and generosity) in medical students as mediated by the moral intuition to care/harm, as well as make predictions as to how this type of study could be generalizable to other populations. Study participants were 563 medical students recruited by the University of Chicago from 24 medical schools across the U.S. (54.7% male, 57% white) who completed measures assessing virtue formation 9 months apart. Path analysis of a cascade model showed that spirituality (but not religiousness) was directly and indirectly related to change in the virtue empathic compassion, and also indirectly related to change in the virtue generosity. Moreover, the moral intuition to care/harm partially mediated the association between spirituality and the virtues of empathic compassion and generosity (but not mindfulness).     

Age-related neural differences in affiliation and isolation

While previous aging studies have focused on particular components of social perception (e.g., theory of mind, self-referencing), little is known about age-related differences specifically for the neural basis of perception of affiliation and isolation. This study investigates age-related similarities and differences in the neural basis of affiliation and isolation. Participants viewed images of affiliation (groups engaged in social interaction) and isolation (lone individuals), as well as nonsocial stimuli (e.g., landscapes), while making pleasantness judgments and undergoing functional neuroimaging (BOLD fMRI). Results indicated age-related similarities in response to affiliation and isolation in recruitment of regions involved in theory of mind and self-referencing (e.g., temporal pole, medial prefrontal cortex). Yet age-related differences also emerged in response to affiliation and isolation in regions implicated in the theory of mind, as well as self-referencing. Specifically, in response to isolation versus affiliation images, older adults showed greater recruitment than did younger adults of the temporal pole, a region that is important for retrieval of personally relevant memories utilized to understand others' mental states. Furthermore, in response to images of affiliation versus isolation, older adults showed greater recruitment than did younger adults of the precuneus, a region implicated in self-referencing. We suggest that age-related divergence in neural activation patterns underlying judgments of scenes depicting isolation versus affiliation may indicate that older adults' theory of mind processes are driven by retrieval of isolation-relevant information. Moreover, older adults' greater recruitment of the precuneus for affiliation versus isolation suggests that the positivity bias for emotional information may extend to social information involving affiliation.     

Influence of perspective and goals on reference production in conversation

We examined the extent to which speakers take into consideration the addressee's perspective in language production. Previous research on this process had revealed clear deficits (Horton & Keysar, Cognition 59:91-117, 1996; Wardlow Lane & Ferreira, Journal of Experimental Psychology: Learning, Memory, and Cognition 34:1466-1481, 2008). Here, we evaluated a new hypothesis--that the relevance of the addressee's perspective depends on the speaker's goals. In two experiments, Korean speakers described a target object in situations in which the perspective status of a competitor object (e.g., a large plate when describing a smaller plate) was manipulated. In Experiment 1, we examined whether speakers would use scalar-modified expressions even when the competitor was hidden from the addressee. The results demonstrated that information from both the speaker's and the addressee's perspectives influenced production. In Experiment 2, we examined whether utterance goals modulate this process. The results indicated that when a speaker makes a request, the addressee's perspective has a stronger influence than it does when the speaker informs the addressee. These results suggest that privileged knowledge does shape language use, but crucially, that the degree to which the addressee's perspective is considered is shaped by the relevance of the addressee's perspective to the utterance goals.     

Stress reactivity in social anxiety disorder with and without comorbid depression

Previous research on neuroendocrine responding to a psychological stressor in individuals with Social Anxiety Disorder (SAD) has provided inconsistent results. A recent meta-analysis concluded that Major Depressive Disorder (MDD), which is frequently comorbid with SAD, is associated with blunted stress reactivity. It is, thus, possible that comorbidity status contributes to the inconsistent findings in the SAD literature. In this study, salivary cortisol responses to a psychological stressor were examined in three groups: healthy controls (CTL), SAD, and SAD with comorbid MDD (COM). The SAD group differed from the other two groups in their cortisol stress reactivity. It is important to note that analyses combining participants with SAD with and without comorbid MDD obscured findings of cortisol reactivity. In addition, the differences in cortisol reactivity cannot be accounted for by participants' affective responses to the stressor. The current findings indicate that individuals with SAD exhibit distinct stress-related cortisol responses depending on their comorbidity statuses.     

Relationships Among Spirituality, Religious Practices, Personality Factors, and Health for Five Different Faith Traditions

To determine: (1) differences in spirituality, religiosity, personality, and health for different faith traditions; and (2) the relative degree to which demographic, spiritual, religious, and personality variables simultaneously predict health outcomes for different faith traditions. Cross-sectional analysis of 160 individuals from five different faith traditions including Buddhists (40), Catholics (41), Jews (22), Muslims (26), and Protestants (31). Brief multidimensional measure of religiousness/spirituality (BMMRS; Fetzer in Multidimensional measurement of religiousness/spirituality for use in health research, Fetzer Institute, Kalamazoo, 1999); NEO-five factor inventory (NEO-FFI; in Revised NEO personality inventory (NEO PI-R) and the NEO-five factor inventory (NEO-FFI) professional manual, Psychological Assessment Resources, Odessa, Costa and McCrae 1992); Medical outcomes scale-short form (SF-36; in SF-36 physical and mental health summary scores: A user??s manual, The Health Institute, New England Medical Center, Boston, Ware et al. 1994). (1) ANOVAs indicated that there were no significant group differences in health status, but that there were group differences in spirituality and religiosity. (2) Pearson??s correlations for the entire sample indicated that better mental health is significantly related to increased spirituality, increased positive personality traits (i.e., extraversion) and decreased personality traits (i.e., neuroticism and conscientiousness). In addition, spirituality is positively correlated with positive personality traits (i.e., extraversion) and negatively with negative personality traits (i.e., neuroticism). (3) Hierarchical regressions indicated that personality predicted a greater proportion of unique variance in health outcomes than spiritual variables. Different faith traditions have similar health status, but differ in terms of spiritual, religious, and personality factors. For all faith traditions, the presence of positive and absence of negative personality traits are primary predictors of positive health (and primarily mental health). Spiritual variables, other than forgiveness, add little to the prediction of unique variance in physical or mental health after considering personality. Spirituality can be conceptualized as a characterological aspect of personality or a distinct construct, but spiritual interventions should continue to be used in clinical practice and investigated in health research.     

The effects of behavioral inhibition/approach system as predictors of Internet addiction in adolescents

This study aimed to determine how the Behavioral Inhibition System (BIS) and the Behavioral Approach System (BAS) affect Internet addiction in adolescents. Two hundred and eleven high school students participated in this study and completed the Young’s Internet Addiction Test (IAT), BIS/BAS scales, and several self-administered questionnaires about depression, anxiety, and impulsivity. Hierarchical regressions showed that BIS and BAS × BIS emerged as significant predictors of IAT; however, only BAS-fun seeking subscale predicted IAT among BAS related subscales. In further analyses, the BAS-fun seeking subscale was mediated by impulsivity and anxiety, and BIS was mediated by anxiety and depression. The current findings imply that BIS and BAS interdependently influence vulnerability to Internet addiction through both shared (anxiety) and different (depression and impulsivity, respectively) pathways.     

Attention and its coupling to action

We discuss two commentaries that we have received on our target article (Humphreys et al., 2010). We elaborate on the evidence for action effects on extinction and discuss whether these effects occur pre or post the selection of a response. In addition, we discuss the neural basis of the effects of action relations on extinction and on the generalization of results on action relations to real‐world examples.     

The stability of vocational interests from early adolescence to middle adulthood: a quantitative review of longitudinal studies

The present meta-analysis examined the stability of vocational interests from early adolescence (age 12) to middle adulthood (age 40). Stability was represented by rank-order and profile correlations. Interest stability remained unchanged during much of adolescence and increased dramatically during the college years (age 18-21.9), where it remained for the next 2 decades. Analyses of potential moderators showed that retest time interval was negatively related to interest stability and that rank-order stability was less stable than profile stability. Although cohort standings did not moderate stability, interests of the 1940s birth cohort were less stable than those of other cohorts. Furthermore, interests reflecting hands-on physical activities and self-expressive/artistic activities were more stable than scientific, social, enterprising, and clerical interests. Vocational interests showed substantial continuity over time, as evidenced by their higher longitudinal stability when compared with rank-order stability of personality traits. The findings are discussed in the context of psychosocial development.     

Using humor to increase COVID-19 vaccination intention for the unvaccinated: The moderating role of trust in government

Since COVID-19 was declared a global pandemic, scholars and practitioners have put much effort into testing effective advertising strategies for COVID-19 vaccinations. Guided by humor theories, this study aimed to examine (1) the effect of humor on persuading COVID-19 vaccination and (2) the moderating role of trust in government for the unvaccinated population. Across two studies (college students and general adult populations), for lower trust in government individuals, through greater public service advertisement (PSA) processing depth and believability, there was a higher vaccination intention after the humor (non-humor) advertisement. For higher trust in government individuals, there was evidence that the vaccination intention was lowered after the humor (vs. non-humor) message through lowered PSA processing depth and believability. This study expands humor theory into testing COVID-19 vaccination messages while considering an individual psychological factor, trust in the government, that has emerged as an essential determinant to COVID-19 messaging. The contributions to COVID-19 vaccination advertising strategy and advertising to the unvaccinated population, in general, are discussed.     

Rumination and Cognitive Distraction in Major Depressive Disorder: an Examination of Respiratory Sinus Arrhythmia

Difficulty regulating emotions following stressful events is a hallmark of Major Depressive Disorder (MDD). Although individuals’ ability to regulate their emotions is believed to have direct consequences for both emotional and physical wellbeing, few studies have examined the cardiovascular effects of different emotion regulation strategies in MDD. The current study is the first to examine the effects of two emotion regulation strategies, cognitive distraction and rumination, on both self-reported sadness and respiratory sinus arrhythmia (RSA) in individuals with MDD and healthy controls (CTLs). Following a forced-failure stressor, participants were randomly assigned to a rumination or cognitive distraction condition. As expected, rumination increased sadness and triggered RSA withdrawal for both MDDs and CTLs. Interestingly, although cognitive distraction reduced sadness, it also triggered RSA withdrawal. Moreover, cognitive distraction was associated with greater RSA withdrawal for MDDs than CTLs. Thus, although depressed individuals are able to use cognitive distraction to emotionally recover from stress, it may be associated with greater cognitive effort. Adding low-cost physiological measures such as RSA into assessments has the potential to offer new and important information about the effects of emotion regulation on mental and physiological health.