Research report: A preliminary analysis of medical futility decisionmaking: law and professional attitudes

Judicial decisions reviewed in this article indicate that courts have taken two disparate approaches to disputes over futility of treatment. To explore whether a consensus on medical futility is developing among hospitals, the authors conducted a nationwide survey of health care professionals at hospitals. Respondents assigned importance ratings to factors used in recent futility decisions made at their institutions. The resulting importance ratings showed significant variation by characteristics of the institution (comparing respondents from for-profit, not-for-profit, and government hospitals) and by profession of the respondent (comparing physicians and nurses). The respondents' judgments endorsed three distinct strategies for making futility decisions (i.e., emphasis on the patient's decision preferences, providing for the patient and family, and adhering to objective medical and social norms). © 1998 John Wiley & Sons, Ltd.     

From posts to protection: Ethical considerations regarding forensic psychiatrists and a duty to warn based on social media

Increasing use of social media in forensic mental health evaluations will lead to new challenges that must be resolved by forensic practitioners and the legal system. One such dilemma is the discovery of information that would typically trigger a legal duty and professional ethics obligation for mental health professionals to breach doctor-patient confidentiality to promote public safety and prevent harm to vulnerable third parties. Although the law and professional organizations offer clear guidance for practitioners in the treatment role, there is currently no clarity from the law or instruction from professional organizations on what mental health professionals should do if they discover such information during a confidential forensic evaluation. For example, a forensic evaluator may find evidence on social media of an evaluee’s threats to seriously harm others, abuse of children and the elderly, or severely impaired driving. There are no clear guidelines for how a forensic psychiatrist should respond in these complicated situations. We review the legal concepts and historical evolution of confidentiality, privilege, and mandated reporter duties that forensic practitioners should consider in these legally ambiguous situations. Finally, we discuss ethics frameworks practitioners can implement to determine their most ethical course of action when faced with such dilemmas.     

Climate action now: How to fuel a social movement

Our research develops a framework that explores how to fuel the climate movement by accelerating grassroots, community-based climate action. Drawing on insights from consumer psychology, our framework identifies the psychological mechanisms that encourage and motivate people, both individually and collectively, to take climate action, thereby contributing to our understanding of how to advance social action and propel a social movement. Our climate action framework builds on: (1) individuals we describe as climate upstanders who rise up to take climate action with like-minded others, and (2) communities of climate upstanders who engage in collective action aimed at addressing the climate crisis. Our framework expands the field of consumer psychology by redefining the role of consumers to include the practice of social action and broadening the study of consumers to include collective, community-based action. We call on consumer psychologists to research individual and collective consumer practices related to social action and contribute to making social good central to the study of consumer psychology.     

Making faces: Creating three-dimensional parameterized models of facial expression

Previous studies of the perceptual processing and dynamics of emotional expression in faces have been limited by the lack of realistic yet controlled stimuli. The present work offers researchers a method for creating such stimuli for exploring these phenomena. We describe the creation of the stimuli and a series of experiments testing the validity of these stimuli with respect to emotional expressions in humans. Participants evaluated synthesized facial images and standardized photographs of six basic emotional expressions for intensity and accuracy of perceived emotion. Comparisons of these measures were qualitatively similar for synthesized and photographed faces. A manipulation of the magnitude of the synthesized expressions yielded a significant effect on the perceived intensity of expression. In a subsequent multidimensional scaling study, no systematic differences were uncovered in the derived configurations of the synthesized expressions and the photographs. These results are discussed in the context of possible future research applications.     

Responses of seventh grade students to "do you have a partner with whom you would like to have a baby?"

This study investigated differences in demographic data, self-esteem, and coping skills for 225 students in Grade 7 who reported having a partner with whom they wanted to have a baby and 946 students who did not. Data were collected on the Rosenberg Self-esteem Scale, the Family Crisis-oriented Personal Evaluation Scale, and questions related to attitudes towards teen pregnancy and demographic data. The sample included 548 (46.8%) boys and 624 (53.2%) girls whose mean age was 13.2 yr. Students with a partner had significantly lower scores on the curriculum questions, self-esteem, and family coping skills, combined with higher scores in passivity. They indicated a desire to have a greater number of children, beginning by having their first child at a younger age and believed that having a baby improves a couple's relationship. Possible approaches may include effective teaching methods to overcome passivity through boosting self-confidence, goal-setting, and acquiring a purpose in life besides parenting a child.     

The effects of newcomer proactive behaviours on socialization outcomes: A meta-analysis

Organizational researchers and practitioners have shown increasing interest in how newcomer proactivity contributes to socialization. This meta-analysis synthesizes the existing empirical research that examines the relationships between frequently performed newcomer proactive behaviours (sensemaking, relationship building, positive framing and job change negotiation) and proximal and distal socialization outcomes. Proximal outcomes include role clarity, task mastery and social integration; distal outcomes include job performance, job satisfaction, organizational commitment and turnover intention. Based on 45 independent samples (N = 11,508), proactive behaviours were found to be generally beneficial for newcomer socialization. Relative weight analyses identified positive framing as the strongest predictor of five of the seven reviewed outcomes while relationship building accounted for the greatest part of the variance in social integration. Job change negotiation was the weakest predictor of socialization outcomes. The study also explored the impact of boundary conditions, including culture, study design and sample type, on the magnitude of these effects. The paper concludes by discussing the theoretical and practical implications of these findings, along with the study's limitations and suggestions for future research.     

Weighting information from outside sources: a biased process

How do people utilize information from outside sources in their decisions? Participants observed a signal‐plus‐noise or noise‐alone event and then made a yes–no decision about whether a signal had occurred. Participants were provided with two information sources to aid decision making. Each source consisted of four components that provided estimates of signal likelihood. In Experiment 1, the two sources had equal overall accuracy but differed in the expertise and internal correlation of their components. A regression analysis indicated that participants overweighed the high‐expertise‐high‐correlation source. This bias occurred on trials when the aggregate opinions of the sources disagreed. In Experiment 2, both the overall accuracy of the source and its components were manipulated. Participants overweighed information from the higher accuracy source. These biases reflect people's sensitivity to across‐trial and within‐trial differences in the accuracy and internal consistency of information sources. Experiment 3 provided additional evidence supporting these conclusions. Copyright © 2004 John Wiley & Sons, Ltd.     

National Threat and Political Culture: Authoritarianism, Antiauthoritarianism, and the September 11 Attacks

This paper uses published letters to the editor of major U.S. newspapers to investigate the cultural effects of a major national threat: the September 11, 2001, terrorist attacks. It is based on a hand-coded, stratified random sample of 1,100 letters to the editor published in 17 major papers in the United States (544 pre-September 11, 556 post-September 11). The letters are drawn from a population of 8,101 published letters. Degrees of both authoritarianism and antiauthoritarianism, as well as the general salience of questions of authoritarianism, rose significantly in the post-attack period. The paper suggests that, instead of a simple threat-authoritarianism causal link, authoritarianism and antiauthoritarianism are paired elements of political culture that are invoked together in the face of a national threat.     

Attentional focus affects how events are segmented and updated in narrative reading

Readers generate situation models representing described events, but the nature of these representations may differ depending on the reading goals. We assessed whether instructions to pay attention to different situational dimensions affect how individuals structure their situation models (Exp. 1) and how they update these models when situations change (Exp. 2). In Experiment 1, participants read and segmented narrative texts into events. Some readers were oriented to pay specific attention to characters or space. Sentences containing character or spatial-location changes were perceived as event boundaries—particularly if the reader was oriented to characters or space, respectively. In Experiment 2, participants read narratives and responded to recognition probes throughout the texts. Readers who were oriented to the spatial dimension were more likely to update their situation models at spatial changes; all readers tracked the character dimension. The results from both experiments indicated that attention to individual situational dimensions influences how readers segment and update their situation models. More broadly, the results provide evidence for a global situation model updating mechanism that serves to set up new models at important narrative changes.     

What motivates deviant behavior in the workplace? An examination of the mechanisms by which procedural injustice affects deviance

This research examines the motivational and social-cognitive processes underlying the procedural injustice and deviance relationship. Based on psychological need and self-determination theories, it was hypothesized that intrinsic motivation would mediate the relationship between procedural injustice and deviance. Based on the general aggression model and social-cognitive theory, it was hypothesized that this positive indirect effect would be moderated by dispositional aggression. Two studies were conducted, including multi-wave and multi-source data, to test these relationships through mediation and moderated mediation procedures. Results supported both hypotheses: intrinsic motivation mediated the procedural injustice and deviance relationship; and this positive indirect effect was moderated by dispositional aggression, such that higher levels of aggression increased the magnitude of the indirect effect. Results were consistent across multiple measures of intrinsic motivation, aggression, and deviance (self- and other-report). Theoretical and practical contributions include support for a process-based theory of deviant behavior in the workplace and organizational interventions aimed at enriching one’s job to develop greater feelings of intrinsic motivation.