Reply to Letter to the Editor

The current policy of the National Institute of Health designed to increase the participation of women and minorities is radically different from previous policies designed to protect minorities from abuses in research studies. The principal arguments to support this policy are twofold: 1) Increased representation of minorities and women in research would increase the generalizability of research data and allow for valid analyses of differences in subpopulations; and 2) being in a clinical research study is advantageous to participants regardless of the final research study results. It remains unclear whether minorities find these arguments compelling. Instead of telling minorities that participation in research is good for them, the research community should focus on understanding what minority communities want from clinical research and then tailoring the message to meet this need. Persuasive arguments to promote long-term increased representation of minorities in clinical research must come from within minority communities.     

Imaging or Imagining? A Neuroethics Challenge Informed by Genetics

From a twenty-first century partnership between bioethics and neuroscience, the modern field of neuroethics is emerging, and technologies enabling functional neuroimaging with unprecedented sensitivity have brought new ethical, social and legal issues to the forefront. Some issues, akin to those surrounding modern genetics, raise critical questions regarding prediction of disease, privacy and identity. However, with new and still-evolving insights into our neurobiology and previously unquantifiable features of profoundly personal behaviors such as social attitude, value and moral agency, the difficulty of carefully and properly interpreting the relationship between brain findings and our own self-concept is unprecedented. Therefore, while the ethics of genetics provides a legitimate starting point—even a backbone—for tackling ethical issues in neuroimaging, they do not suffice. Drawing on recent neuroimaging findings and their plausible real-world applications, we argue that interpretation of neuroimaging data is a key epistemological and ethical challenge. This challenge is two-fold. First, at the scientific level, the sheer complexity of neuroscience research poses challenges for integration of knowledge and meaningful interpretation of data. Second, at the social and cultural level, we find that interpretations of imaging studies are bound by cultural and anthropological frameworks. In particular, the introduction of concepts of self and personhood in neuroimaging illustrates the interaction of interpretation levels and is a major reason why ethical reflection on genetics will only partially help settle neuroethical issues. Indeed, ethical interpretation of such findings will necessitate not only traditional bioethical input but also a wider perspective on the construction of scientific knowledge.     

Speech and Language Disorders in Kenyan Children: Adapting Tools for Regions with Few Assessment Resources

This study sought to adapt a battery of Western speech and language assessment tools to a rural Kenyan setting. The tool was developed for children whose first language was KiGiryama, a Bantu language. A total of 539 Kenyan children (males=271, females=268, ethnicity=100% Kigiryama) were recruited. Data were initially collected from 52 children (pilot assessments), and then from a larger group of 487 children (152 cerebral malaria, 156 severe malaria and seizures, 179 unexposed). The language assessments were based upon the Content, Form and Use (C/F/U) model. The assessment was based upon the adapted versions of the Peabody Picture Vocabulary Test, Test for the Reception of Grammar, Renfrew Action Picture Test, Pragmatics Profile of Everyday Communication Skills in Children, Test of Word Finding and language specific tests of lexical semantics, higher level language. Preliminary measures of construct validity suggested that the theoretical assumptions behind the construction of the assessments were appropriate and re-test and inter-rater reliability scores were acceptable. These findings illustrate the potential to adapt Western speech and language assessments in other languages and settings, particularly those in which there is a paucity of standardised tools.     

Modality Effects and the Development of the Word Length Effect in Children

Two experiments investigated the development of the word length effect in children aged 4 to 10 years, comparing auditory and visual stimuli. The question addressed was whether word length effects emerged earlier with auditory presentation or visual presentation, or whether they emerged at the same age regardless of presentation modality. Results provided evidence that word length effects emerge earlier with visual than auditory presentation. The implication of our results is that with visual presentation, 4-year-olds engage in some form of verbalisation strategy that involves obtaining phonological representations of picture names and mapping them on to articulatory output plans. This strategy is clearly verbal in nature, but is not necessarily characterised as cumulative verbal rehearsal.     

Attributions for recovery and adherence to rehabilitation following anterior cruciate ligament reconstruction: A prospective analysis

Abstract

The relationship between causal attributions for recovery and adherence was examined in a sample of 80 individuals (25 females and 55 males) undergoing rehabilitation following anterior cruciate ligament reconstruction. Participants estimated their speed of recovery and then rated their open-ended attributions for recovery on the Revised Causal Dimension Scale (McAuley, Duncan and Russell, 1992). Adherence was assessed in terms of attendance at rehabilitation sessions and practitioner ratings for the remainder of the rehabilitation period. Participants who perceived themselves as recovering rapidly attributed their recovery to more stable and personally controllable factors than participants who perceived themselves as recovering slowly. Causal dimension ratings predicted attendance at rehabilitation sessions, but not practitioner ratings of adherence. The results, which further demonstrate the relevance of causal attributions to health behavior, are compared with previous cross-sectional findings.     

Stigma and Barriers to Mental Health Care in Deployed Canadian Forces Personnel

Mental disorders are prevalent on deployed operations, but only a small fraction of those with problems access care due to a range of barriers. A survey measuring need for care, perceived barriers, and care-seeking propensity was administered to Canadian Forces personnel during deployment in Afghanistan. Complex characteristics of barriers to care on deployment were found: stigma had no association with care-seeking propensity; perceived structural barriers were associated with greater care-seeking propensity; and perceived structural barriers were greater in more isolated locations. Only negative attitudes toward care had the expected negative association with care-seeking propensity. Research and practical considerations are discussed.     

Expectancies of infant-feeding methods among mothers in three ethnic groups

Abstract

The psychometric characteristics and construct validity of an inventory of expectancy statements about breast- and formula-feeding were assessed to refine a measure of the predictors of breastfeeding initiation and maintenance. Respondents were a tri-ethnic sample of mostly lower income mothers within two days after delivery. Ninety-six expectancy items reflecting eight hypothesized domains in expectancies of breastfeeding (BF) and formula-feeding(FF) were submitted to maximum likelihood factor analysis. Four factors were determined: “Benefits of BF,” “Relative Advantages of FF,” “Inconveniences of FF,” and “Relative Inconveniences of BF.” All factors were significantly related to actual BF of the new infant in the expected directions using unweighted factor scores in a multiple logistic regression analysis. Predicted BF closely matched actual BF for all ethnicities combined with a total error rate for misclassification of only 14%. This match was high for Anglo- and Black-American mothers. Each of the factors was determined to be reliably estimated by the ten most highly loaded items without an appreciable loss of internal consistency. Further research must assess expectancies prior to delivery in order to assess their predictiveness of behavior. and must further clarify the meaning of the expectancy factors to facilitate intervention.     

Ethical beliefs and behaviors in applied sport psychology: The AAASP ethics survey

Abstract

AAASP members (N = 508) were surveyed to obtain preliminary data on ethical beliefs and behaviors specific to the practice of applied sport psychology. Completed surveys were received from 165 individuals. On the structured response portion of the survey, there were few differences in ethical beliefs and behaviors as a function of gender, professional/student status, and academic discipline. Nevertheless, a large number of controversial behaviors (N = 24) and difficult judgments (N = 8) were identified. Results of the open-ended portion of the survey indicated that most of the questionable ethical practices cited by respondents corresponded to violations of American Psychological Association (APA) Ethical Standards. The findings lend initial support for AAASP to adopt the APA Ethical Standards and suggest the need for ethics training specific to applied sport psychology.     

Development and Evaluation of the Belief Acceptance Scale

The Belief Acceptance Scale (BAS) is a nine question scale that was developed to evaluate how open and accepting an individual is to other people’s beliefs across interdependent life domains. The purposes of this article are to demonstrate the internal consistency of the BAS and examine the instrument’s substructure and to correlate the BAS with validated measures of religiosity and demographic data gathered from a web-based Survey of Spiritual Experiences. The BAS focuses on cultural beliefs instead of religious motivations and was designed to be administered to religious and non-religious individuals. Three domains of belief acceptance were tested: the internal or subjective openness to other beliefs (Psychological Domain), willingness to participate in other ideologies and rituals (Reciprocal Domain), and the willingness to date or marry outside one’s belief system or cultural background (Social Domain). Responses from 350 individuals were correlated and analysed to estimate the scale’s internal consistency and subscale structure. Analyses support the validity of the BAS scores in that they demonstrate expected correlations with demographic data and standardised measures of religiosity. The results show that the BAS is an internally consistent scale with a coherent substructure that adequately measures openness to other beliefs, ideologies and belief systems.