Case vignette: premature surrender

Three commentaries are offered on the following case: George, age 57, is a previously healthy man who recently underwent surgery for removal of a low-grade malignant thymoma. At the time of admission to the hospital, George stressed to the staff that he had long ago signed a "living will," which he renewed immediately after he learned of his cancer diagnosis. At the time of surgery, the tumor was found to extend into his mediastinum; although it was removable, this required revision of part of the sternum and grafting of the vessels feeding the heart chambers. Because of the resultant tissue damage and neuronal hyperactivity, George experienced postoperative episodes of cardiac arrhythmia and bronchospasm. Unanimous medical opinion was that this situation was a temporary problem that would resolve itself as the tissues healed. Until that time, however, it will be difficult to wean him from ventilatory support. When his stay in the intensive care unit became prolonged, George and his family began to insist that his status be changed to "do not resuscitate" and reminded the staff about his longstanding living will. All of this is happening despite the fact that the patient and family seemingly comprehend that although the short-term interventions are invasive, there is a high probability of a successful outcome. George's cancer prognosis is excellent, and, although he may well have an episode of life-threatening arrhythmia, he is likely to respond to resuscitation interventions. Once the immediate postoperative period is over, his potential for a long and productive life with full capacities is excellent. Consider the following questions: (a) Should George's expressed wishes be respected, or should the staff take additional steps to help him survive the postoperative period, even if that means violating his stated wishes? and (b) What steps might the staff follow in sorting through this problem?     

A formulation of Erikson's theory of ego identity formation

This paper provides a comprehensive formulation of Erik Erikson's theory of ego identity formation as it pertains to both the identity stage and to the remainder of the life cycle. The structure of the identity stage is discussed in terms of its more universal features and in terms of features more specific to North American society. The role played by “institutionalized moratoria” in influencing the outcome of the identity crisis and subsequent development is discussed in the context of two Eriksonian notions ignored in the literature: the value orientation stages and the struggle between the ego and superego for dominance of the personality. As part of the discussion, several constructive criticisms of Erikson's work are offered with the intent of making the theoretical formulation presented in this paper an appropriate basis for subsequent empirical investigations of his theory. One of the important implications of this paper is that it suggests that questions should be raised regarding the validity of the dominant research strategy currently in use.     

The Separation-Individuation Test of Adolescence

The procedures undergone to establish the validity of the Separation- Individuation Test of Adolescence (SITA) are described. The test consists of six scales designed to measure key dimensions of adolescent separation-individuation. Each scale was subjected to three stages of validation: theoretical-substantive, internal-structural, and external-criterion. The results of data with 305 adolescents are reported. Although particular modifications from the original form are planned, appreciative levels of validity were established for the SITA's various scales.     

An empirical investigation of self-esteem as a composite construct

Three measures of chronic self-esteem, plus four measures developed to assess situational components of self-esteem (task-specific self-esteem and social self-esteem), were administered to 238 undergraduates at a large, urban university and a community college in the southeastern United States. Evidence for a composite construct of self-esteem was found. Results also indicate task-specific self-esteem correlates as high as .42 (p < .01) with chronic self-esteem and as high as .76 (p < .01) with social self-esteem. Task-specific self-esteem was found to be a better predictor of grade point average than chronic or social self-esteem. Suggestions are made for further research on the situational components of self-esteem to extend current findings.     

Possible effects of forced report order on tachistoscopic recognition of bilaterally presented stimuli: A response to Young and Ellis

Comparing visual field asymmetries for bilaterally presented words and corresponding line drawings, we found an RVF advantage for words and no visual field asymmetry for line drawings. We suggested that the RVF advantage previously obtained by Young, Bion, and Ellis (Brain and Language, 11, 54–65, 1980) for bilaterally presented line drawings may have resulted from a forced order of report procedure, noting that the RVF advantage was greater on trials on which subjects were forced to report in the nonpreferred right-to-left order. Young and Ellis (Brain and Language, 20, 166–171, 1983) attempt to discredit this claim and maintain their hypothesis that the RVF advantage for line drawings is attributable to better temporary storage of these stimuli by the left than the right hemisphere. In the present article, we present in greater detail our arguments for the effects of forced order of report on the perception of bilaterally presented stimuli and refute Young and Ellis's ibid. criticisms of this proposal.     

Development of sex biases in children: 40 years later

Children in grades 2–10 (200 of each sex) assigned desirable and undesirable traits to girls or boys. Half the subjects had an additional option of both sexes. Children in all grades assigned more desirable traits to their own sex and more undesirable traits to the opposite sex, in line with Smith (1939). Both sexes became less positive toward their own sex and more positive toward the opposite sex with increasing age. This pattern also had characterized girls in Smith's study, whereas, boys had shown the opposite pattern. Beginning in the sixth grade, girls were more apt than boys to assign desirable traits to their own sex. Availability of the “both sexes” option decreased stereotyping, especially in girls.