Social Perceptions of Termination of Medical Treatment: Suicide or Rational Decision?

In two studies, college students read about a critically ill patient who died after CPR attempts failed, CPR was not attempted pursuant to a "Do-Not-Resuscitate" (DNR) order, he terminated all medical treatment, or he self-administered a lethal injection. Death resulting from treatment termination was perceived as significantly more unconventional than were death by CPR failure or DNR order. Ending treatment and lethal injection were perceived as equivalent acts of suicide, and resulted in the patient's being seen as less rational and less capable of making health care decisions. Timing of the patient's decisions regarding treatment, as indicated by the presence or absence of Living Will information, did not alter these perceptions. Results are discussed in light of opposing hypotheses regarding views of "naive" social perceivers toward actions with identical outcomes: that acts of commission are perceived as causal and rated more negatively than acts of omission (Spranca, Minsk, & Baron, 1991), and that acts seen as abnormal are attributed greater causal impact (Hilton & Slugoski, 1986).     

The Importance of Attitudes in the Prediction of College Students' Intentions to Drink

Fishbein's (1967, 1980) theory of reasoned action was used to test the relative importance of attitudes and subjective norms in predicting undergraduate students' intentions to perform 3 different types of social drinking actions: avoiding drinking, drinking enough to get a slight buzz, and drinking enough to get drunk. A multiple regression paradigm was used to determine the relative effectiveness of attitudes and subjective norms in predicting intentions to perform each of the 3 drinking behaviors. Although attitudes were consistently found to be better predictors of intentions than were subjective norms, the strength of the attitude-intention relation varied widely across the 3 actions. In particular, the attitude-intention correlation was strongest for "drinking enough to get drunk." Findings also suggest that subjective norms, previous behavior, and perceived behavioral control are not important variables for predicting this behavior.     

THE EFFECTS OF CONTINGENT AND NONCONTINGENT ATTENTION ON SELF-INJURY AND SELF-RESTRAINT

Self-restraint and self-injurious behavior (SIB) are two responses that can sometimes be members of the same functional response class (i.e., maintained by the same contingency). In such cases, a single treatment should be effective for both responses. In this investigation, we examined the effects of providing attention (the presumed reinforcer) both noncontingently and contingent upon either SIB or self-restraint. Results were consistent with our hypothesis that both responses were maintained by attention and suggested that noncontingent reinforcement was a potentially effective treatment.     

A PRELIMINARY PROCEDURE FOR PREDICTING THE POSITIVE AND NEGATIVE EFFECTS OF REINFORCEMENT-BASED PROCEDURES

In the current investigation, a modification was made to the preference assessment described by Pace, Ivancic, Edwards, Iwata, and Page (1985) to predict the effects of stimuli when used in a differential-reinforcement-of-other-behavior (DRO) schedule for 2 clients with severe self-injurious behavior (SIB) and profound mental retardation. Based on the results of the preference assessment, three types of stimuli were identified: (a) high-preference stimuli associated with high rates of SIB (HP/HS), (b) high-preference stimuli associated with relatively lower rates of SIB (HP/LS), and (c) low-preference stimuli associated with low rates of SIB (LP/LS). Consistent with the results of the preference assessment, the DRO schedule with HP/HS stimuli resulted in increased SIB, and the DRO schedule with LP/LS stimuli resulted in no changes in SIB. HP/LS stimuli were demonstrated reinforcers but did not result in a change in SIB when used in a DRO schedule. Thus, the stimulus preference assessment may be useful clinically in some situations for predicting both the beneficial and the negative side effects of stimuli in DRO procedures.     

CHOICE-MAKING TREATMENT OF YOUNG CHILDREN'S SEVERE BEHAVIOR PROBLEMS

The choice-making behavior of 5 young children with developmental disabilities who engaged in aberrant behavior was studied within a concurrent operants framework. Experimental analyses were conducted to identify reinforcers that maintained aberrant behavior, and functional communication training packages were implemented to teach the participants to gain reinforcement using mands. Next, a choice-making analysis, in which the participants chose one of two responses (either a mand or an alternative neutral response) to obtain different durations and qualities of reinforcement, was conducted. Finally, treatment packages involving choice making via manding were implemented to decrease inappropriate behavior and to increase mands. The results extended previous applications of choice making to severe behavior disorders and across behaviors maintained by positive and negative reinforcement.     

Parental Smoking and the “Epidemic” Spread of Cigarette Smoking1

“Epidemic” models of transitions between stages of cigarette smoking describe the spread of smoking behavior through face-to-face encounters. An epidemic model was successfully fitted that allowed epidemic parameters to be conditioned on the smoking status of adolescents' parents. Model comparisons supported the conclusion that the transition from nonsmoker to trier involved social contacts, whereas the transition from trier to regular smoker was best modeled as a constant rate (i.e., did not depend on the population prevalence of smokers). The transition rate from nonsmoker to trier was more rapid in children of smoking parents than in children of nonsmoking parents. Adolescents with and without smoking parents did not differ in the rate of transition from trier to regular smoking.     

Self-Optimization of Walking in Nondisabled Children and Children With Spastic Hemiplegic Cerebral Palsy

Children voluntarily adopt a frequency and movement pattern for walking. The force-driven harmonic oscillator (FDHO) model was used in this study for accurate prediction of the preferred walking frequency of nondisabled children and children with spastic hemiplegic cerebral palsy. Four potential optimality criteria with which the preferred walking pattern was forced to comply were examined: minimization of physiological costs, maximization of mechanical energy conservation, minimization of asymmetry in lower limb movements and minimization of variability of interlimb and intralimb coordination. Age and gender-matched nondisabled children (n = 6) and children with spastic hemiplegic cerebral palsy (n = 6) were tested under six frequency conditions of walking at a constant speed on a treadmill. For the nondisabled children, the results indicated that their preferred walking frequency could be accurately predicted by the FDHO model. They freely adopted a walking pattern that minimized physiological costs, asymmetry, and variability of inter- and intralimb coordination. For the children with spastic hemiplegic cerebral palsy, the prediction of preferred overground walking frequency required that the FDHO model be modified to account for muscle mass and leg length discrepancies between limbs and increased stiffness. Most of the children achieved the same optimality goals as the nondisabled when walking at the preferred frequency. However, the children were found to use different mechanisms to attain these goals: for example, a steeper increase observed in physiological cost at higher frequencies; a lowered center of gravity of the body, which allowed for angular symmetry; and greater variability of between-joint coordination in the nonaffected limb and less variability in the affected limb.     

Personality and Coping: Three Generations of Research

ABSTRACT This article introduces the Journal of Personality 's special issue on coping and personality. It first presents a historical overview of the psychological study of how people cope with stress and identifies three generations of theory and research: (a) the psychoanalysts and the ego development school, which tended to equate personality and coping strategies; (b) the transactional approach, which appeared in the 1960s and emphasized situational and cognitive influences on coping while downplaying the role of individual differences; and (c) the most recent, "third generation," whose work is represented in this special issue and focuses on the role of personality in coping while maintaining strong operational distinctions among coping, personality, appraisal, and adaptational outcomes. This introduction concludes with a discussion of unresolved conceptual and methodological issues and a brief orientation to the third-generation articles that follow in this special issue.     

Coping and Personality: Third Time's the Charm?

ABSTRACT In this special issue, a third generation of research is represented which recognizes and demonstrates that individual differences in personality play an important role in the coping process. Although progress is apparent, there are several unresolved issues, including the best way to measure coping and whether "type of coping" matters in naturalistic settings. Three potentially important parameters of coping—range, patterning, and competence—are described, but only the first has received systematic empirical attention. The study of coping might also be advanced by researchers giving more attention to the differences between problem situations in which traits are more easily expressed ("weak" situations) versus those where normative criteria and constraints are explicit ("strong" situations).