Freedom, Fiction and Evidential Decision Theory

This paper argues against evidential decision-theory, by showing that the newest responses to its biggest current problem – the medical Newcomb problems – don’t work. The latest approach is described, and the arguments of two main proponents of it – Huw Price and CR Hitchcock – clearly distinguished and examined. It is argued that since neither new defence is successful, causation remains essential to understanding means-end agency.     

Gendered Career Paths: A Life Course Perspective on Returning to School

We applied a life course perspective to an examination of work-to-school transitions, and highlighted the individual and family-level factors that differentially shape the career pathways of men and women. We employed data from a sample of employed middle-class men and women in dual-earner couples (N?=?1,408 couples) to examine the relationship between returning to school and prior educational attainment, individual biographic pacing (age, timing of marriage), job history, current job conditions, psychological resources, and family demands. Results support several hypothesized gender differences in the return to school pathway. Women with the heaviest combination of work and family demands were the most likely to return, an unexpected finding that we discuss with reference to both personal and structural resources.     

Predictors of Cancer Worry in Unaffected Women from High Risk Breast Cancer Families: Risk Perception is not the Primary Issue

Some women at increased familial risk of breast cancer experience elevated levels of cancer-specific worry, which can possibly act as a barrier to screening, and may be a significant factor in decisions regarding risk-reducing surgery. The aim of this study was to comprehensively examine predictors of cancer-specific worry in high risk women and to test a model which proposes that perceived breast cancer risk mediates the impact of other factors on worry. 1,437 unaffected women from high risk breast cancer families completed questionnaires and interviews. Path analysis was used to test the model of potential predictors of cancer worry, including familial, personal and psychological variables, mediated via perceived cancer risk. Levels of cancer-specific worry were generally low despite an average perceived risk of 50.3%. The goodness-of-fit of the proposed model was poor, explaining only 9% of the variance for perceived risk and 10% of the variance for cancer specific worry. An alternative model of a direct relationship between all of the predictor variables and cancer worry, explained 24% of the variation in cancer worry. General anxiety, perceived risk, the stressful impact of recent cancer related events, a relative risk greater than 10, being closer in age to the youngest breast cancer diagnosis in family, and knowledge of personal mutation status, all independently contributed to cancer worry. Addressing general affective responses, experiences of recent cancer related events, in addition to education about personal risk, should be considered in counselling women with elevated cancer worry. Risk perception appears to act independently of other factors in its formulation and impact on cancer worry. Further research on the way in which women come to perceive their risk is indicated. The kConFab Psychosocial Group are (in alphabetical order of institution): Brain and Mind Institute, University of Sydney, Australia (I Hickie) Department of Haematology and Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia (K-A Phillips) Department of Medical Oncology, Prince of Wales Hospital, Randwick, Australia (B Bennett, B Meiser, K Tucker) Department of Oncology, St Vincent’s Hospital, Melbourne, Australia (S-A MaLachlan) Department of Psychological Medicine, Royal North Shore Hospital, St Leonards, Australia (C Tennant); Medical Psychology Research Unit, University of Sydney, Australia (P Butow, M Price).     

A five-year follow-up of patients with borderline pathology of childhood

Borderline pathology of childhood (BPC) may be a precursor of personality disorders. There is a lack of data concerning outcome in adolescence. A group of 59 adolescents, who had been treated as children in a Child Psychiatry Day Hospital five to seven years earlier, was evaluated. Using the child version of the Retrospective Diagnostic Interview for Borderlines, 28 participants had been diagnosed with BPC while the remaining 31 participants who did not have a history of BPC served as the comparison group. The youth and their parents were given a battery of measures assessing current psychopathology and functional status. The group with a history of BPC was more likely than the comparison group to exhibit a combination of internalizing and externalizing behavior problems. Adolescents with a history of BPC were more impaired than the comparison group on a global measure of functional status. Compared to children with no history of BPC, children diagnosed with BPC are more likely to display poorer functioning as adolescents and continue to be at risk for psychopathology during adolescence. Future directions for research are discussed.     

Cognitive-behavioral treatment groups for people with chronic physical illness in Hong Kong: reflections on a culturally attuned model

This study describes and evaluates a cognitive-behavioral treatment group for people with chronic physical illness in Hong Kong. We developed a group protocol based on the understanding that Chinese people generally prefer a structured group format, expect group leaders to be active and directive, and are not used to expressing opinions and emotions in groups. The experimental and waitlist control groups had 38 and 35 participants, respectively. A standardized questionnaire was administered to all participants before and after the group treatment. Results suggest that members of the experimental group showed improvements in mental health, negative automatic thoughts, and negative emotions when compared to those in the waitlist control groups, and at the end of group treatment. Implications for designing and running a culturally attuned CBT group for Chinese people are discussed.     

Reducing Psychological Distress in a Genetic Counseling Consultation for Breast Cancer

High levels of cancer specific distress have been found before and after genetic counseling for breast cancer. This study investigated the process of reducing distress during 111 genetic counseling consultations for familial breast cancer. Consultations were audiotaped, transcribed, and a detailed coding system developed to measure cues of emotional distress from the patient, and consultant (clinical geneticist or genetic counselor) behaviors before and after the cues. At least 1 emotional cue was given in 64 consultations, with a median of 1 cue per consultation. More emotional cues of distress occurred when the consultant responded empathetically to the first cue of distress. Satisfaction outcomes were largely positive regardless of the consultant's attentiveness to distress. Postconsultation depression scores were significantly reduced if more empathic responses were given, but anxiety remained the same. These results are discussed and recommendations are made for improving patient care.     

Twice Hurt: How Newspaper Coverage May Reduce Empathy and Engender Blame for Female Victims of Crime

In a content analysis of 148 newspaper articles we examined whether victims of violent crime (excluding sex crimes) are treated differently according to their gender. Articles taken from 4 newspapers showed that accounts of violent crime personalize male victims more than female victims: more personal information was included about male victims, and males were significantly more likely to be referred to by name rather than by a noun (“the victi”) or pronoun. In a second study we investigated whether such treatment could affect both empathy for the victim and victim blame. Participants read an account of a murder that manipulated victim gender, degree of personal information, and the manner in which the victim was described. Empathy for the victim was increased across victim gender by both inclusion of personal information and referring to the victim by name. Victim blame was also reduced by the inclusion of personal information. Implications of how the news media may subtly reduce empathy and engender blame for female victims are discussed.     

The Teacher's Career and Life

Abstract. Participants in a Wabash Center consultation on vocation discussed the variety of expectations, opportunities, and challenges that create contexts for teaching as they move through careers. These essays emerge from the experiences and reflections of four participants about different stages of careers in diverse contexts. Tom Massaro writes from the perspective of one who recently navigated the challenges leading up to the tenure review in a Jesuit theological school and notes common patterns amidst the diversity of challenges. Phyllis Airhart ponders vocational fidelity in the transitions to new roles and responsibilities at mid‐career in a Canadian university. Barbara Brown Zikmund deals with what she calls the ‘mature years’ and traces a major shift in her career from administration in an American school to teaching in Japan. Raymond Williams reflects on vocation during the process of preparing for retirement from teaching in a liberal arts college, attempting to respond faithfully to the inevitable question, ‘What are you going to do when you retire?’ Vocation is a thread that runs through each essay as reflection on the integrity and continuity of careers. The authors raise issues and make suggestions that may help others reflect on their vocation as teacher.