Conscientious objection and person-centered care

Person-centered care offers a promising way to manage clinicians’ conscientious objection to providing services they consider morally wrong. Health care centered on persons, rather than patients, recognizes clinicians and patients on the same stratum. The moral interests of clinicians, as persons, thus warrant as much consideration as those of other persons, including patients. Interconnected moral interests of clinicians, patients, and society construct the clinician as a socially embedded and integrated self, transcending the simplistic duality of private conscience versus public role expectations. In this milieu of blurred boundaries, person-centered care offers a constructive way to accommodate conscientious objection by clinicians. The constitutionally social nature of clinicians commits and enables them, through care mechanisms such as self-care, to optimize the quality of health care and protect the welfare of patients. To advance these conditions, it is recommended that the medical profession develop a person-centered culture of care, along with clinician virtues and skills for person-centered communication.     

Don't sit so close to me: unconsciously elicited affect automatically provokes social avoidance

Behavior may be automatically prompted by cues in our social environment. Previous research has focused on cognitive explanations for such effects. Here we hypothesize that affective processes are susceptible to similar automatic influences. We propose that exposure to groups stereotyped as dangerous or violent may provoke an anxiety response and, thus, a tendency to move away. In the present experiment, we subliminally exposed participants to images of such a group, and found that they displayed greater avoidance in a subsequent interaction. Critically, this effect was explained by their increased sensitivity to threat-related information. These findings demonstrate an affective mechanism responsible for nonconscious priming effects on interpersonal behavior.     

Simple arithmetic processing: Individual differences in automaticity

This study investigated individual differences in the ability to automatically access simple addition and multiplication facts from memory. It employed a target-naming task and a priming procedure similar to that utilised in the single word semantic-priming paradigm. In each trial, participants were first presented with a single digit arithmetic problem (e.g., 6+8) and were then presented with a target that was either congruent (e.g., 14) or incongruent (e.g., 17) with this prime. Response times for congruent and incongruent conditions were then compared to a neutral condition (e.g., X+Y, with target 14). For the high skilled group, significant facilitation in naming congruent multiplication and addition targets was found at SOAs of 300 and 1000?ms. In contrast, for the low skilled group, facilitation in naming congruent targets was only observed at 1000?ms. Significant inhibition in naming incongruent multiplication and addition targets at 300?ms, and addition targets at 1000?ms, was found for the high skilled group alone. This advantage in access to simple facts for the high skilled group was then further supported in a problem size analysis that revealed individual differences in access to small and large problems that varied by operation. These findings support the notion that individual differences in arithmetic skill stem from automaticity in solution retrieval and additionally, that they also derive from strategic access to multiplication solutions.     

Developmental changes in personal goal orientation from young to late adulthood: from striving for gains to maintenance and prevention of losses

Using a multimethod approach, the authors conducted 4 studies to test life span hypotheses about goal orientations across adulthood. Confirming expectations, in Studies 1 and 2 younger adults reported a primary growth orientation in their goals, whereas older adults reported a stronger orientation toward maintenance and loss prevention. Orientation toward prevention of loss correlated negatively with well-being in younger adults. In older adults, orientation toward maintenance was positively associated with well-being. Studies 3 and 4 extend findings of a self-reported shift in goal orientation to the level of behavioral choice involving cognitive and physical fitness goals. Studies 3 and 4 also examine the role of expected resource demands. The shift in goal orientation is discussed as an adaptive mechanism to manage changing opportunities and constraints across adulthood.     

Different parameters support generalization and discrimination learning in Drosophila at the flight simulator

We have used a genetically tractable model system, the fruit fly Drosophila melanogaster to study the interdependence between sensory processing and associative processing on learning performance. We investigated the influence of variations in the physical and predictive properties of color stimuli in several different operant-conditioning procedures on the subsequent learning performance. These procedures included context and stimulus generalization as well as color, compound, and conditional discrimination (colors and patterns). A surprisingly complex dependence of the learning performance on the colors' physical and predictive properties emerged, which was clarified by taking into account the fly-subjective perception of the color stimuli. Based on estimates of the stimuli's color and brightness values, we propose that the different tasks are supported by different parameters of the color stimuli; generalization occurs only if the chromaticity is sufficiently similar, whereas discrimination learning relies on brightness differences.     

Effects of antisocial personality, cocaine and opioid dependence, and gender on eye movement control

Substance-dependent patients have been reported to exhibit abnormal smooth pursuit and saccadic eye movements. However, contrasts of the effects of different substances and the effects of comorbid psychiatric symptoms such as antisocial personality have rarely been performed. Separate analyses examined the effects of cocaine dependence, opioid dependence, or antisocial personality disorder. In each analysis, sex was included as an additional grouping factor. The dependent measures were the gain of smooth pursuit eye movement and the delay and accuracy of saccadic eye movement. Analyses of covariance indicated that both cocaine dependence and antisocial personality, but not opiate dependence, were associated with a significant reduction in gain of smooth pursuit eye movement. Cocaine dependence and antisocial personality also slowed the onset of saccadic eye movements, but only in men. No group differences were found in the accuracy of saccadic eye movements. The results suggest that the neurophysiological effects of cocaine dependence and antisocial personality overshadow the effects of heroin. The significance of these findings for visual attention and reading skill has yet to be assessed.     

The role of dopamine in reinforcement: changes in reinforcement sensitivity induced by D1-type, D2-type, and nonselective dopamine receptor agonists

Dose-dependent changes in sensitivity to reinforcement were found when rats were treated with low, moderate, and high doses of the partial dopamine D1-type receptor agonist SKF38393 and with the nonselective dopamine agonist apomorphine, but did not change when rats were treated with similar doses of the selective dopamine D2-type receptor agonist quinpirole. Estimates of bias did not differ significantly across exposure to SKF38393 or quinpirole, but did change significantly at the high dose of apomorphine. Estimates of goodness of fit (r2) did not change significantly during quinpirole exposure. Poor goodness of fit was obtained for the high doses of SKF38393 and apomorphine. Decrements in absolute rates of responding were observed at the high dose of quinpirole and at the moderate and high doses of SKF38393 and apomorphine. Changes in r2 and absolute responding may be due to increases in stereotyped behavior during SKF38393 and apomorphine exposure that, in contrast to quinpirole, were distant from the response lever. The present data provide evidence that sensitivity to reward is affected more strongly by dopamine D1-like receptors rather than D2-like receptors, consistent with evidence from other studies investigating consummatory dopamine behavior and the tonic/phasic dopamine hypothesis.     

Suicidality in African American men: the roles of southern residence, religiosity, and social support

The rise in suicide by African Americans in the United States is directly attributable to the dramatic, nearly three-fold increase in suicide rates of African American males. Gibbs (1997) hypothesized high social support, religiosity, and southern residence are protective factors against suicidality for Black people. This hypothesis was tested among 5,125 participants from the National Comorbidity Survey; 299 were African American males. In this study we hypothesized that there would be significantly lower suicidality in the South, and social support and religiosity would mediate this relationship. Our results indicate that Southern region is indeed a significant predictor of suicidal symptoms in African American men, such that suicidal symptoms were lower in the South, but religiosity and social support did not account for this effect. Other potential mediators were also examined.     

A cross-sectional evaluation of the factorial invariance of anxiety sensitivity in adolescents and young adults

This study examined the cross-sectional factorial invariance of anxiety sensitivity in an ethnically diverse sample of adolescents (n = 173; mean age 15.5 years) and young adults (n = 291; mean age 20.1 years). Research in adult and youth samples suggests that anxiety sensitivity is best understood as a hierarchical construct with several lower-order factors. Factor models based on previous research using both adult and youth samples were compared and a hierarchical model with three lower-order factors provided the best fit to the data. Results supported the hypothesis that the factor structure of the Anxiety Sensitivity Index was invariant across age and gender. The factor scores also demonstrated differential correlations with symptoms of anxiety and depression. Results are discussed with regard to construct validation and understanding the structure of anxiety sensitivity in youth.