Theoretical Medicine and Bioethics Index to Volume 20

Volume Contents

heoretical Medicine and Bioethics Index to Volume 20     

Social influences on smoking in middle-aged and older women

The purpose of this study was to examine the role of 2 types of social influence--general social support and living with a smoker--on smoking behavior among middle-aged and older women in the Women's Health Initiative (WHI) Observational Study. Participants were postmenopausal women who reported smoking at some time in their lives (N=37,027), who were an average age of 63.3 years at baseline. Analyses used multiple logistic regression and controlled for age, educational level, and ethnicity. In cross-sectional analyses, social support was associated with a lower likelihood and living with a smoker was associated with a higher likelihood of being a current smoker and, among smokers, of being a heavier smoker. Moreover, in prospective analyses among baseline smokers, social support predicted a higher likelihood and living with a smoker predicted a lower likelihood of smoking cessation 1-year later. Further, in prospective analyses among former smokers who were not smoking at baseline, social support predicted a lower likelihood and living with a smoker predicted a higher likelihood of smoking relapse 1-year later. Overall, the present results indicate that social influences are important correlates of smoking status, smoking level, smoking cessation, and smoking relapse among middle-aged and older women.     

Helping parents to motivate adolescents in mathematics and science: an experimental test of a utility-value intervention

The pipeline toward careers in science, technology, engineering, and mathematics (STEM) begins to leak in high school, when some students choose not to take advanced mathematics and science courses. We conducted a field experiment testing whether a theory-based intervention that was designed to help parents convey the importance of mathematics and science courses to their high school-aged children would lead them to take more mathematics and science courses in high school. The three-part intervention consisted of two brochures mailed to parents and a Web site, all highlighting the usefulness of STEM courses. This relatively simple intervention led students whose parents were in the experimental group to take, on average, nearly one semester more of science and mathematics in the last 2 years of high school, compared with the control group. Parents are an untapped resource for increasing STEM motivation in adolescents, and the results demonstrate that motivational theory can be applied to this important pipeline problem.     

Error monitoring dysfunction across the illness course of schizophrenia

Response monitoring abnormalities have been reported in chronic schizophrenia patients, but it is unknown whether they predate the onset of psychosis, are present in early stages of illness, or are late-developing abnormalities associated with illness progression. Response-synchronized event-related potentials (ERP) recorded during a picture-word matching task yielded error-related negativity (ERN), correct-response negativity (CRN), and error positivity (Pe) from 84 schizophrenia patients (SZ), 48 clinical high risk patients (CHR), and their age-matched healthy controls (HC; n = 110 and 88, respectively). A sub-sample of 35 early illness schizophrenia patients (ESZ) was compared to 93 age-matched HC and the CHR patients (after statistically removing the effects of normal aging). Relative to HC, 1) SZ, ESZ, and CHR had smaller ERNs, and 2) SZ and ESZ had larger CRNs and smaller Pes. Within the SZ, longer illness duration was associated with larger CRNs but was unrelated to ERN or Pe. CHR and ESZ did not differ on ERN or CRN, although Pe was smaller in ESZ than CHR. These results indicate that while ERN, CRN, and Pe abnormalities are present early in the illness, only the ERN abnormality is evident prior to psychosis onset, and only the CRN abnormality appears to worsen progressively over the illness course. Brain regions subserving response monitoring may be compromised early in the illness and possibly during its clinical prodrome.     

Bearing the unbearable: ancestral transmission through dreams and moving metaphors in the analtyic field

Abstract: This paper explores how untold and unresolved intergenerational trauma may be transmitted through unconscious channels of communication, manifesting in the dreams of descendants. Unwitting carriers for that which was too horrific for their ancestors to bear, descendants may enter analysis through an unconscious need to uncover past secrets, piece together ancestral histories before the keys to comprehending their terrible inheritance die with their forebears. They seek the relational containment of the analytic relationship to provide psychological conditions to bear the unbearable, know the unknowable, speak the unspeakable and redeem the unredeemable. In the case of ‘Rachael’, initial dreams gave rise to what Hobson (1984) called ‘moving metaphors of self’ in the analytic field. Dream imagery, projective and introjective processes in the transference‐countertransference dynamics gradually revealed an unknown ancestral history. I clarify the back and forth process from dream to waking dream thoughts to moving metaphors and differentiate the moving metaphor from a living symbol. I argue that the containment of the analytic relationship nested within the security of the analytic space is a necessary precondition for such healing processes to occur.     

Even simple forms of social learning rely on intention attribution in marmoset monkeys (Callithrix jacchus)

Intention attribution guides the cognitively most demanding forms of social learning, such as imitation, thereby scaffolding cumulative cultural evolution. However, it is not thought to be necessary for more basic forms of social learning. Here we present evidence that in marmoset monkeys (Callithrix jacchus) even most basic forms of social learning such as enhancement depend on intention attribution. Marmosets perceived the behavior of a conspecific and a conspecific-like robot, but not that of a moving black box, as goal directed. Their subsequent choice behavior was shaped by social facilitation and stimulus enhancement, that is, by very simple forms of social learning, but only when exposed to the conspecific and robot, which they previously had perceived as intentional agents. We discuss the implications of this finding for contemporary debates about social learning, including emulation learning and ghost control studies, the necessity of goal-directed copying for cumulative cultural evolution, and the limits of current classification systems of social learning for the evolution of social and asocial learning.     

Strategic development in exact calculation: group and individual differences in four achievement subtypes

This longitudinal study sought to identify developmental changes in strategy use between 5 and 7 years of age when solving exact calculation problems. Four mathematics and reading achievement subtypes were examined at four time points. Five strategies were considered: finger counting, verbal counting, delayed retrieval, automatic retrieval, and derived fact retrieval. Results provided unique insights into children's strategic development in exact calculation at this early stage. Group analysis revealed relationships between mathematical and/or reading difficulties and strategy choice, shift, and adaptiveness. Use of derived fact retrieval by 7 years of age distinguished children with mathematical difficulties from other achievement subtypes. Analysis of individual differences revealed marked heterogeneity within all subtypes, suggesting (inter alia) no marked qualitative distinction between our two mathematical difficulty subtypes.