Compelled authorizations for disclosure of health records: magnitude and implications

Each year individuals are required to execute millions of authorizations for the release of their health records as a condition of employment, applying for various types of insurance, and submitting claims for benefits. Generally, there are no restrictions on the scope of information released pursuant to these compelled authorizations, and the development of a nationwide system of interoperable electronic health records will increase the amount of health information released. After quantifying the extent of these disclosures, this article discusses why it is important to limit disclosures of health information for nonmedical purposes as well as how it may be possible to do so.     

Childhood tomboyism and adult androgyny

Female university and community college students (N =194) completed the Bem Sex-Role Inventory and a 12-item tomboyism index. Subjects were predominantly Euro-American (71%). A multiple regression analysis was used to test the prediction that androgyny and masculinity would significantly predict tomboyism scores. The proportion of variance in tomboyism accounted for by masculinity was significant, but once masculinity was entered, no additional predictive value was added by the entry of androgyny or femininity. Tomboyism was not related to the development of expressive qualities such as compassion and sensitivity to the needs of others. However, tomboyism was positively related to some desirable instrumental qualities such as assertiveness and self-reliance. Tomboyism was common and generally declined at puberty due to social pressure. To whom correspondence and reprint requests should be addressed at Department of Psychology & Human Development, California Polytechnic State University, San Luis Obispo, CA 93407.The second and third authors were senior undergraduates at Cal Poly San Luis Obispo when this research was conducted.     

Beyond Consent: Building Trusting Relationships With Diverse Populations in Precision Medicine Research

With the growth of precision medicine research on health data and biospecimens, research institutions will need to build and maintain long-term, trusting relationships with patient-participants. While trust is important for all research relationships, the longitudinal nature of precision medicine research raises particular challenges for facilitating trust when the specifics of future studies are unknown. Based on focus groups with racially and ethnically diverse patients, we describe several factors that influence patient trust and potential institutional approaches to building trustworthiness. Drawing on these findings, we suggest several considerations for research institutions seeking to cultivate long-term, trusting relationships with patients: (1) Address the role of history and experience on trust, (2) engage concerns about potential group harm, (3) address cultural values and communication barriers, and (4) integrate patient values and expectations into oversight and governance structures.     

A Retrospective Survey of Childhood Experiences

The present study introduces a balanced survey of a range of behavioral and emotional experiences to assess impressions of a person’s childhood. Ninety-one undergraduates and 70 of their parents rated exposure to positive and negative social and solitary experiences. The survey demonstrated acceptable internal consistency and 4-week test–retest reliability, and scores correlated with Zimbardo’s Time Perspective Inventory of temporally based beliefs and values, Batcho’s inventory of personal nostalgia, and Holbrook’s measure of historical nostalgia. Correlations with time perspective and nostalgia inventories suggest that favorable impressions of childhood are associated with benefits such as social connectedness, personal continuity, and health-promoting behaviors and adverse impressions with less adaptive impacts such as unsatisfactory relationships, discontinuity, and distress. Ratings of social experiences were correlated more closely with childhood happiness than were solitary experiences. The Childhood Survey shows promise as a tool to expand the exploration of childhood experiences beyond adverse events to encompass components that comprise a happy childhood.     

Mixing measures: testing an assumption of the attention network test

The human attention system has been subdivided into three networks that appear to be functionally and anatomically independent: alerting, orienting, and executive control. The Attention Network Test (ANT) is a quick and easy tool that measures the efficiency of these three networks by averaging reaction time and accuracy scores across several different cue and flanker conditions. Using ANOVAs and correlation procedures, we found that (a) intranetwork correlations were surprisingly low, and (b) Cue X Flanker interactions were found within alerting, orienting, and executive control measures. Taken together, these findings highlight the interaction between the three networks and the potential difficulty in accurately measuring them with this task.     

The effect of personal relevance and approach-related action expectation on relative left frontal cortical activity

Past research using a variety of methods has suggested that the frontal cortex is asymmetrically involved in the experience and expression of positive (or approach motivational) and negative (or withdrawal motivational) affects, with the left frontal region being involved in positive affects (or approach) and the right frontal region being involved in negative affects (or withdrawal). However, some studies have failed to replicate these effects, leaving many scientists questioning the meaning of the past supportive findings. To examine these inconsistencies in results, we tested the hypothesis that increasing the personal relevance of the stimuli and approach motivational intensity would increase relative left frontal activation. Results supported the predictions. Moreover, by showing the predicted effects with anger-inducing stimuli, the results demonstrated that motivational direction, rather than affective valence, accounts for asymmetrical frontal cortical activity.     

Cholinergic modulation of trace conditioning trained in serial compound: A developmental analysis

In four experiments the effects of serial compound conditioning on responding to a trace-conditioned CS were evaluated using a fear conditioning paradigm. The subjects were 18- and 25-day-old Sprague-Dawley rats, previously shown to exhibit little or no trace fear conditioning. Here, animals as young as 18 days of age were shown to be capable of trace conditioning between a visual CS1 and a shock US, provided the trace interval was filled with a non-target CS2 during serial conditioning trials (CS1-->CS2-->US). To explore cholinergic mechanisms involved in trace and serial conditioning, additional experiments assessed conditioned responding following pre-training administration of the muscarinic receptor antagonist scopolamine. Scopolamine produced a dose-dependent reduction in responding to the trace CS1, regardless of whether subjects were trained with standard trace (CS1-->trace interval-->US) or serial (CS1-->CS2-->US) trials. Responding to CS2 was unaffected by scopolamine. These data suggest that central cholinergic systems are functional in the young animals, but are not normally sufficiently activated by standard trace conditioning procedures. The results suggest that serial compound conditioning can promote trace conditioning in young rats, as it does in adults, perhaps by enhancing cholinergic activity during training. Implications for the late ontogenetic emergence of trace conditioning as it relates to maturation of neural pathways and their role in the potentiating effects of a gap filler are discussed.     

Hemispheric asymmetries for global and local processing as a function of stimulus exposure duration

The experiments assess the relationship between stimulus exposure duration and hemispheric asymmetries for global and local processing. Six durations (27, 40, 53, 67, 80, and 147 ms) were tested in a selective attention task in which hierarchical letterforms were presented unilaterally to the left or right visual field. The results indicated that left hemisphere-local asymmetries were demonstrated more often than right hemisphere-global asymmetries and that asymmetries were most commonly found in the middle range of durations tested. The pattern of results emphasizes the importance of further study into those conditions under which the predicted asymmetries can be reliably demonstrated in healthy individuals.     

The influence of instructive feedback presentation schedule: A replication with children with autism spectrum disorder

Instructive feedback (IF) is a modification to discrete trial instruction that may increase instructional efficiency for individuals with autism spectrum disorder. Several variations of IF have recently been evaluated in the literature; however, few studies have assessed the effectiveness and efficiency of presenting secondary targets on continuous versus intermittent presentation schedules. The current study evaluated the effectiveness and efficiency of various presentation schedules of secondary targets during discrete trial instruction. Specifically, we replicated and extended Griffen et al. (1998) by comparing a condition in which secondary targets were presented during each trial of a session, a condition in which secondary targets were presented every other trial, and a condition in which secondary targets were presented about every 4 trials. Within-subject replications were included for both participants. One of the intermittent presentation schedules was associated with the most optimal outcomes in all 4 comparisons.