Informed consent revisited: Japan and the U.S

Informed consent, decision-making styles and the role of patient-physician relationships are imperative aspects of clinical medicine worldwide. We present the case of a 74-year-old woman afflicted with advanced liver cancer whose attending physician, per request of the family, did not inform her of her true diagnosis. In our analysis, we explore the differences in informed-consent styles between patients who hold an "independent" and "interdependent" construal of the self and then highlight the possible implications maintained by this position in the context of international clinical ethics. Finally, we discuss the need to reassess informed-consent styles suitable to the needs of each patient regardless of whether he or she resides in the United States or in Japan.     

Cognitive inhibition and interference in dissociative identity disorder: the effects of anxiety on specific executive functions

Using an experimentally based, computer-presented task, this study assessed cognitive inhibition and interference in individuals from the dissociative identity disorder (DID; n=12), generalized anxiety disorder (GAD; n=12) and non-clinical (n=12) populations. Participants were assessed in a neutral and emotionally negative (anxiety provoking) context, manipulated by experimental instructions and word stimuli. The DID sample displayed effective cognitive inhibition in the neutral but not the anxious context. The GAD sample displayed the opposite findings. However, the interaction between group and context failed to reach significance. There was no indication of an attentional bias to non-schema specific negative words in any sample. Results are discussed in terms of the potential benefit of weakened cognitive inhibition during anxious arousal in dissociative individuals.     

Responses to symptom induction exercises in panic disorder

Exposure to panic symptoms (interoceptive exposure) is often included as part of treatment for panic disorder (PD), although little is known about the relative effects of particular symptom induction exercises. This study describes responses of individuals with PD and nonclinical controls to 13 standard symptom induction exercises and 3 control exercises. Generally, individuals with PD responded more strongly to symptom induction exercises than did controls. The exercises producing the most fear included spinning, hyperventilation, breathing through a straw, and using a tongue depressor. This study also reports findings regarding specific symptoms triggered by each exercise, the percentage of participants reporting fear during each exercise, and predictors of fear.     

Understanding knowledge effects on attitude-behavior consistency: the role of relevance, complexity, and amount of knowledge

The role of properties of attitude-relevant knowledge in attitude- behavior consistency was explored in 3 experiments. In Experiment 1, attitudes based on behaviorally relevant knowledge predicted behavior better than attitudes based on low-relevance knowledge, especially when people had time to deliberate. Relevance, complexity, and amount of knowledge were investigated in Experiment 2. It was found that complexity increased attitude- behavior consistency when knowledge was of low-behavioral relevance. Under high-behavioral relevance, attitudes predicted behavior well regardless of complexity. Amount of knowledge had no effect on attitude- behavior consistency. In Experiment 3, the findings of Experiment 2 were replicated, and the complexity effect was extended to behaviors of ambiguous relevance. Together, these experiments support an attitude inference perspective, which holds that under high deliberation conditions, people consider the behavioral relevance and dimensional complexity of knowledge underlying their attitudes before deciding to act on them.     

Resisting persuasion by the skin of one's teeth: the hidden success of resisted persuasive messages

Recent research has suggested that when people resist persuasion they can perceive this resistance and, under specifiable conditions, become more certain of their initial attitudes (e.g., Z. L. Tormala & R. E. Petty, 2002). Within the same metacognitive framework, the present research provides evidence for the opposite phenomenon--that is, when people resist persuasion, they sometimes become less certain of their initial attitudes. Four experiments demonstrate that when people perceive that they have done a poor job resisting persuasion (e.g., they believe they generated weak arguments against a persuasive message), they lose attitude certainty, show reduced attitude-behavioral intention correspondence, and become more vulnerable to subsequent persuasive attacks. These findings suggest that resisted persuasive attacks can sometimes have a hidden yet important success by reducing the strength of the target attitude.     

Hedonic and sensory characteristics of odors conditioned by pairing with tastants in humans

Animals readily acquire positive odor-taste hedonic associations, but evidence for this in humans remains weak and was explored further. Retronasal pairing of odors with sucrose or salty stimuli (Experiment 1) increased the rated sweetness of sucrose-paired odors without altering liking, although changes in odor pleasantness correlated with sucrose liking. Experience of odors with sucrose or quinine by sweet likers (Experiment 2) found increased pleasantness and sweetness for sucrose-paired odors, whereas quinine-paired odors became less liked and more bitter. Odor-sucrose pairings in sweet likers and dislikers (Experiment 3) found increased sweetness in both groups but increased odor liking only in likers. These data suggest that evaluative and sensory learning are dissociable and that evaluative changes are sensitive to individual differences in sweet liking.     

Choice and ego-depletion: the moderating role of autonomy

The self-regulatory strength model maintains that all acts of self-regulation, self-control, and choice result in a state of fatigue called ego-depletion. Self-determination theory differentiates between autonomous regulation and controlled regulation. Because making decisions represents one instance of self-regulation, the authors also differentiate between autonomous choice and controlled choice. Three experiments support the hypothesis that whereas conditions representing controlled choice would be egodepleting, conditions that represented autonomous choice would not. In Experiment 3, the authors found significant mediation by perceived self-determination of the relation between the choice condition (autonomous vs. controlled) and ego-depletion as measured by performance.     

Some decks are better than others: the effect of reinforcer type and task instructions on learning in the Iowa Gambling Task

The Iowa Gambling Task (Bechara, Damasio, Damasio, & Anderson, 1994) has become widely used as a laboratory test of "real-life" decision-making. However, aspects of its administration that have been varied by researchers may differentially affect performance and the conclusions researchers can draw. Some researchers have used facsimile money reinforcers while others have used real money reinforcers. More importantly, the instructions participants receive have also been varied. While no differences have been reported in performance dependent on reinforcer type, no previous comparison of participants' instructions has been conducted. This is despite one set of instructions giving participants a clear hint about the nature of the task. Additionally, in previous research one set of instructions have not been used exclusively with one reinforcer type making any differential or cumulative effects of these factors difficult to interpret. The present study compared the effects of instruction and reinforcer type on IGT performance. When participants received instructions without a hint performance was affected by reinforcer type. This was not the case when the instructions included a hint. In a second IGT session performance was improved in participants who had received the hint instructions compared with those who had not.     

Consequences of lexical stress on learning an artificial lexicon

Four experiments examined effects of lexical stress on lexical access for recently learned words. Participants learned artificial lexicons (48 words) containing phonologically similar items and were tested on their knowledge in a 4-alternative forced-choice (4AFC) referent-selection task. Lexical stress differences did not reduce confusions between cohort items: KAdazu and kaDAzeI were confused with one another in a 4AFC task and in gaze fixations as often as BOsapeI and BOsapaI. However, lexical stress did affect the relative likelihood of stress-initial confusions when words were embedded in running nonsense speech. Words with medial stress, regardless of initial vowel quality, were more prone to confusions than words with initial stress. The authors concluded that non-initial stress, particularly when wor segmentation is difficult, may serve as "noise" that alters lexical learning and lexical access.     

Concreteness and item-to-list context associations in the free recall of items differing in context variability

Context variability can be defined as the number of preexperimental contexts in which a given concept appears. Following M. Steyvers and K. J. Malmberg's (2003) work, the authors have shown that concepts that are experienced in fewer preexperimental contexts generally are better remembered in episodic memory tasks than concepts that are experienced in a greater number of preexperimental contexts. The purpose of this article is to demonstrate that low context variability confers its memorial advantage because of stronger item-to-list context associations as compared with high context variability. Three experiments that use environmental context changes from study to test demonstrate that the low context variability advantage is eliminated when item-to-list context associations are not available because of environmental changes at test. In addition, the low context variability advantage is eliminated when inward processing at study prevents the formation of item-to-list context associations.