Fatigue and Quality of Life Following Radiotherapy for Breast Cancer: A Comparative Study

Clinical reports suggest that fatigue is a common and disruptive long-term side effect of radiotherapy; however, there has been little systematic attention given to this phenomenon. The primary aim of this study was to assess fatigue its impact on quality of life in women who had completed radiotherapy for breast cancer. A key feature of this study was the inclusion of a comparison group of women of similar age with no history of cancer. The results indicated that the fatigue experienced by women after radiotherapy for breast cancer was not significantly different in intensity, duration, or disruptiveness from fatigue experienced by healthy women. In addition, radiotherapy recipients reported a quality of life similar to that of the healthy women. For both groups of women greater fatigue was related to a poorer quality of life. These findings suggest that following radiotherapy for breast cancer, women can expect to experience fatigue which is not worse than what they might normally experience. This information may be a useful part of psychoeducational interventions designed for women scheduled to begin radiotherapy for breast cancer.     

Ought we to require emotional capacity as part of decisional competence?

The preceding commentary by Louis Charland suggests that traditional cognitive views of decision-making competence err in not taking into account patients' emotional capacities. Examined closely, however, Charland's argument fails to escape the cognitive bias that he condemns. However, there may be stronger arguments for broadening the focus of competence assessment to include emotional capacities, centering on the ways in which emotions aid humans in processing information. Before emotional capacities are added to the list of functions essential for decisional competence, though, the feasibility and utility of such a reorientation must be demonstrated.     

Chills and thrills: Does radio harm our children? The controversy over program violence during the age of radio

A review of the popular and scientific periodical for the 1930s and 1940s revealed that the controversy surrounding the radio “thriller” and its possible harmful effects on young listeners was one of radio's most highly publicized issues during its golden years of broadcasting. Many of the questions raised concerning this issue were similar to those asked later during the age of television. Relying heavily upon the psychoanalytic emphasis on emotion, catharsis, and intrapsychic dynamics, expert opinion voiced in various popular periodicals and newspapers of the day suggested that the violence and excitement portrayed in many of the crime and adventure programs was harmless, and perhaps beneficial, for most listeners. However, research in support of this conclusion was sparse, and psychologists evidenced little interest in the issue. Not until the advent of television, and the emergence of social learning theory in the early 1960s, did psychologists direct significant research effort towards evaluating the effects of media violence. © 1998 John Wiley &Sons, Inc.     

The Principle of Objectified Circumstances (POC): Clarifying the Proximate End

This paper seeks to clarify the proximate end. A distinction is made between the definition of an act and the identification of an act. The principle of objectified circumstances (POC) is postulated which, without expanding beyond the proximate end, gives due weight to both the perspective of the acting person and the context within which an act occurs. POC is used to help discern the object contained within the proximate end. It is applied to the issues of euthanasia, lying, mutilation, and the controversy between Martin Rhonheimer and Janet Smith concerning the use of condoms for HIV protection. The challenge of angelism is addressed. The paper argues that the object, located exclusively in the proximate end, can be understood in a way that is sensitive to both traditionalist and proportionalist schools of thought. POC opens up an avenue of thought for fresh dialogue concerning the identification of the moral object.     

Decisions,actions, and the appropriateness of confidence in knowledge

This research examines the appropriateness of confidence (i.e., subjective probability judgments) in knowledge associated with decisions and actions of social importance. One hundred and thirty seven participants completed a 50 item questionnaire assessing their knowledge of the two leading candidates in the 1988 presidential election in the U.S.A. Ninety one of the respondents completed the questionnaire one week prior to the election, whereas the other 46 completed the questionnaire on election day shortly after voting. After each item in the questionnaire, all respondents indicated whether or not the item content represented a reason why they voted (or intended to vote) for or against the candidate to whom the item referred. Within-person results indicated that, in comparison to items that were not cited as reasons for voting intentions or voting behavior, items endorsed as reasons were characterized by better accuracy and resolution, but worse overconfidence. Between groups, decision makers were significantly more accurate and better calibrated than those who had not made a decision between the candidates. Implications of inappropriate confidence on decision making effectiveness are discussed.     

Resistance as a Problem for Practice and Theory

Resistance is one of the most problematic and potentially counterproductive concepts in the entire field of psychotherapy. It is at the same time one of the most crucial, pointing toward perhaps the single most important factor—or, more accurately, set of factors—in determining the success or failure of the therapeutic enterprise. Drawing on the articles by Davis and Hollon, Prochaska and Prochaska, Reid, and Eagle in this issue, as well as on the author's own perspective, this paper explores this seeming contradiction in order to point toward an integrative resolution of the differing perspectives on resistance and related phenomena.     

Resilience and Protective Factors in Adolescence: An Autobiographical Perspective From Disadvantaged Youth

This article focuses on the development of adolescent resilience and protective factors within a sample of 86 inner-city high school students in Chicago. Resilience was considered present when (a) children living in conditions of risk (b) show better-than-predicted outcomes (c) presumably due to some intervening process. Conditions (a) and (b) were met using quantitative comparisons. Condition (c), the intervening process, was examined using autobiographical essays to begin to understand protective factors youth consider salient in overcoming adversity. Internal attributes such as perseverance, determination, and having the awareness to learn from the risk-attrition process surfaced in the content analyses. Motivational support from family members and teachers was also highly valued for promoting successful adjustment.