Withdrawal Aversion and the Equivalence Test

If a doctor is trying to decide whether or not to provide a medical treatment, does it matter ethically whether that treatment has already been started? Health professionals sometimes find it harder to stop a treatment (withdraw) than to refrain from starting the treatment (withhold). But does that feeling correspond to an ethical difference? In this article, we defend equivalence—the view that withholding and withdrawal of treatment are ethically equivalent when all other factors are equal. We argue that preference for withholding over withdrawal could represent a form of cognitive bias—withdrawal aversion. Nevertheless, we consider whether there could be circumstances in which there is a moral difference. We identify four examples of conditional nonequivalence. Finally, we reflect on the moral significance of diverging intuitions and the implications for policy. We propose a set of practical strategies for helping to reduce bias in end-of-life decision making, including the equivalence test.     

Parenting and toddler self-regulation in low-income families: What does sleep have to do with it?

Toddlerhood is a sensitive period in the development of self-regulation, a set of adaptive skills that are fundamental to mental health and partly shaped by parenting. Healthy sleep is known to be critical for self-regulation; yet, the degree to which child sleep alters interactive child–parent processes remains understudied. This study examines associations between observed parenting and toddler self-regulation, with toddler sleep as a moderator of this association. Toddlers in low-income families (N = 171) and their mothers were videotaped during free play and a self-regulation challenge task; videos were coded for mothers’ behavior and affect (free play) and toddlers’ self-regulation (challenge task). Mothers reported their child's nighttime sleep duration via questionnaire. Results revealed significant Sleep × Maternal Negative Affect and Sleep × Maternal Negative Control interactions. Children who did not experience negative parenting had good self-regulation regardless of their nighttime sleep duration. For children who did experience negative parenting, self-regulation was intact among those who obtained more nighttime sleep, but significantly poorer among children who were getting less nighttime sleep. Thus, among children who were reported to obtain less nighttime sleep, there were more robust associations between negative parenting and poorer self-regulation than among toddlers who were reported to obtain more sleep.     

Integrating Treatment of Posttraumatic Stress Disorder and Substance Use Disorder

Historically, administrators and clinicians have been hesitant to address posttraumatic stress disorder (PTSD) in the treatment of substance use disorders (SUDs). However, research shows that SUD treatment recruitment and outcomes may be adversely affected if co‐occurring PTSD is left untreated. The authors provide guidelines for screening and assessment, treatment services, and workforce and organizational development that are designed to facilitate integrated PTSD–SUD treatment. Case examples illustrate the necessary precautions related to and the potential benefits of integrating treatment of PTSD and SUD.     

Muslim–Christian Relations in Tanzania with Particular Focus on the Relationship between Religious Instruction and Prejudice

The article evaluates religious education strategies in view of the need to cope adequately with prejudices between Muslims and Christians in Tanzania against the historical background of the two traditions and contemporary events. It shows that religious prejudice is the result of religious instruction provided within both communities, and is due either to negative stereotypes or ignorance of the tradition of the other. The challenge is to critically analyse the teaching contents, aims and methods of religious instruction of each tradition in order to unearth prejudicial elements, and to recommend ways and means of coping with them.     

Night-time thoughts in high and low worriers: reaction to caffeine-induced sleeplessness

There is ample evidence for the existence of an association between sleeplessness and worry. Not much is known, however, concerning the nature of this relationship. Therefore, a study was conducted investigating the causal relationship between sleeplessness and nocturnal worry. A 2 x 2 (Worry x Induced sleeplessness) analysis of covariance design was used. The first factor consisted of a subject variable defined by scoring either high or low on a trait measure of worry (the Penn State Worry Questionnaire) and the second factor consisted of 300 mg caffeine or placebo. A total of 96 female undergraduate students participated. The dependent variables comprised measures of nocturnal worry (the Night-Time Thoughts Questionnaire) and subjective and objective sleep parameters. Overall, caffeine caused an increase in nocturnal worry and sleeplessness. A significant interaction effect occurred between Worry and Induced sleeplessness on one of the objective sleep parameters, but no other interaction effects were significant. The results suggest that worry may occur as an epiphenomenon of sleeplessness.     

Emotional irritation before mental stress is associated with enhanced peripheral norepinephrine

Research suggests equivocal findings on associations of catecholamines and mood. Our study investigated the associations of emotional state, blood pressure and catecholamines in 55 healthy males undergoing mental stress. We especially checked the reported link between norepinephrine (NE) and emotional irritation. Blood pressure (SBP, DBP) and heart rate (HR) were continuously monitored. NE and epinephrine (EPI) were measured before, after, and 20 minutes after stress. Participants were divided into irritated versus non-irritated and anxious versus non-anxious subjects by median split on their baseline questionnaires. The task elicited significant cardiovascular, hormonal, and psychological stress responses. NE levels were significantly correlated with irritation before stress. Irritated subjects showed significantly higher DBP and NE than non-irritated subjects. The higher NE and DBP levels in the irritated participants suggest detrimental psycho-physiological interrelations promoting the development of stress-mediated cardiovascular diseases. Heightened emotional irritation before stress may be regarded as a psychological risk factor.     

A study of the perceived recognition affecting the adoption of innovation with respect to the online game in Taiwan.

The potential of online games to become a major global business and the existence of limited related references led to the current study. In this study, Rogers's diffusion of innovation (DOI) theory is applied to investigate the principles for the adoption of online games in Taiwan. The findings suggest that relative advantages and compatibility both have a significant effect on the adoption of online games for purposes of amusement, with the former being more important for early gamers and the latter being regarded as more critical for later gamers. In addition, complexity is found to impede online game diffusion and is regarded as the most important facilitator.     

The self and social cognition: the role of cortical midline structures and mirror neurons

Recent evidence suggests that there are at least two large-scale neural networks that represent the self and others. Whereas frontoparietal mirror-neuron areas provide the basis for bridging the gap between the physical self and others through motor-simulation mechanisms, cortical midline structures engage in processing information about the self and others in more abstract, evaluative terms. This framework provides a basis for reconciling findings from two separate but related lines of research: self-related processing and social cognition. The neural systems of midline structures and mirror neurons show that self and other are two sides of the same coin, whether their physical interactions or their most internal mental processes are examined.