Physician, monitor thyself: professionalism and accountability in the use of social media

The recent report of the AMA Council on Ethical and Judicial Affairs (CEJA), "Professionalism in the Use of Social Media," describes the types of social media medical professionals use, outlines ways in which existing AMA policies address issues of online professionalism, and makes a list of recommendations for physicians to maintain online professionalism. CEJA recommends directed efforts towards educating physicians about the benefits and pitfalls of social media and, in particular, underscores the difficulties of maintaining professional boundaries in the digital age. In this commentary, we highlight issues introduced by the report and suggest some specific ways that the recommendations of the committee can be implemented by medical schools, residency programs, and practicing physicians.     

Detecting conscious awareness from involuntary autonomic responses

Can conscious awareness be ascertained from physiological responses alone? We evaluate a novel learning-based procedure permitting detection of conscious awareness without reliance on language comprehension or behavioural responses. The method exploits a situation whereby only consciously detected violations of an expectation alter skin conductance responses (SCRs). Thirty participants listened to sequences of piano notes that, without their being told, predicted a pleasant fanfare or an aversive noise according to an abstract rule. Stimuli were presented without distraction (attended), or while distracted by a visual task to remove awareness of the rule (unattended). A test phase included occasional violations of the rule. Only participants attending the sounds reported awareness of violations and only they showed significantly greater SCR for noise occurring in violation, vs. accordance, with the rule. Our results establish theoretically significant dissociations between conscious and unconscious processing and furnish new opportunities for clinical assessment of residual consciousness in patient populations.     

Anterior thalamic lesions alter both hippocampal-dependent behavior and hippocampal acetylcholine release in the rat

The anterior thalamic nuclei (ATN) are important for learning and memory as damage to this region produces a persistent amnestic syndrome. Dense connections between the ATN and the hippocampus exist, and importantly, damage to the ATN can impair hippocampal functioning. Acetylcholine (ACh) is a key neurotransmitter in the hippocampus, and in vivo measures of ACh are correlated to learning and memory performance. In the present study, complete lesions of the ATN impaired performance on two measures of hippocampal-dependent learning and memory (spontaneous alternation and delayed alternation) and severely disrupted behaviorally evoked ACh efflux within the hippocampus of adult male rats. In contrast, incomplete ATN lesions did not impair spontaneous alternation performance but did impair delayed alternation performance while blunting hippocampal ACh efflux. Interestingly, ATN lesions of any size did not affect basal concentrations of ACh in the hippocampus. These results demonstrate that the ATN have the capacity to modulate behaviorally relevant neuronal transmission within the hippocampus.     

Being of two minds: Switching mindsets exhausts self-regulatory resources

The human psyche is equipped with the capacity to solve problems using different mental states or mindsets. Different mindsets can lead to different judgment and decision making styles, each associated with its own perspective and biases. To change perspective, people can, and often do, switch mindsets. We argue, however, that mindset switching can be costly for subsequent decisions. We propose that mindset switching is an executive function that relies on the same psychological resource that governs other acts of executive functioning, including self-regulation. This implies that there are psychic costs to switching mindsets that are borne out in depleted executive resources. One implication of this framework is that switching mindsets should render people more likely to fail at subsequent self-regulation than they would if maintaining a consistent mindset. The findings from experiments that manipulated mindset switching in five domains support this model.     

Perceptions of the cognitive compensation and interpersonal enjoyment functions of collaboration among middle-aged and older married couples

Perceptions of cognitive compensation and interpersonal enjoyment of collaboration were examined in three hundred middle-aged and older couples who completed measures of perceptions of collaboration, cognitive ability, marital satisfaction, an errand task and judged their spouse's affiliation. Older adults (especially men) endorsed cognitive compensation and interpersonal enjoyment and reported using collaboration more frequently than middle-aged adults. Greater need for cognitive compensation was related to lower cognitive ability only for older wives. Greater marital satisfaction was associated with greater interpersonal enjoyment. These two functions related to reports of more frequent use of collaboration and perceptions of spousal affiliation in a collaborative task.     

Changing exercise through targeting affective or cognitive attitudes

Two studies investigated the impact of affective and cognitive messages compared to a no-message control on self-reported exercise. Students (Study 1, N = 383 and Study 2, N = 197) were randomly allocated to one of the three conditions (control - no message, affective message or cognitive message). Participants completed questionnaire measures tapping components of the theory of planned behaviour in relation to exercise and reported their level of exercise (3 weeks later). In Study 2, measures of need for affect (NFA) and need for cognition (NFC) were also completed. Results showed that affective messages consistently produced greater increases in self-reported level of exercise than the other conditions. In both studies, this effect was partly mediated by affective attitude change. Study 2 indicated these effects to be significantly stronger among those high in NFA or low in NFC. These findings indicate the value of affective messages that target affective attitudes in changing exercise behaviour.     

Angry Thoughts and Response to Provocation: Validity of the Angry Cognitions Scale

Recently, Martin and Dahlen (J Ration Emot Cogn Behav Ther 25:155–173, 2007) developed the Angry Cognitions Scale (ACS), a theoretically derived instrument designed to measure the cognitive processes related to anger. This instrument has the potential to inform clinical and research perspectives of anger. Although preliminary evidence for the reliability and validity of the ACS was positive, further research is required regarding the ACS’s temporal stability and predictive validity. The current project sought to address this concern by assessing the six-week test–retest reliability of the ACS, exploring relationships between the ACS subscales and the experience and expression of anger, and assessing the ability of the ACS to predict cognitive and emotional responses to provocation. The ACS demonstrated adequate test–retest reliability and predicted hostile thoughts and state anger following provocation. Thus, results contribute to the literature on the ACS and support its use as a measure of cognitive processes associated with anger.     

Recovering from conflict in romantic relationships: a developmental perspective

This study adopted a developmental perspective on recovery from conflict in romantic relationships. Participants were 73 young adults (target participants), studied since birth, and their romantic partners. A novel observational coding scheme was used to evaluate each participant's degree of conflict recovery, operationalized as the extent to which the participant disengaged from conflict during a 4-min "cool-down" task immediately following a 10-min conflict discussion. Conflict recovery was systematically associated with developmental and dyadic processes. Targets who were rated as securely attached more times in infancy recovered from conflict better, as did their romantic partners. Concurrently, having a romantic partner who displayed better recovery predicted more positive relationship emotions and greater relationship satisfaction. Prospectively, target participants' early attachment security and their partners' degree of conflict recovery interacted to predict relationship stability 2 years later, such that having a partner who recovered from conflict better buffered targets with insecure histories.     

Predicting the job and life satisfaction of Italian teachers: Test of a social cognitive model

This study tested a social cognitive model of work and life satisfaction (Lent & Brown, 2006, 2008) in a sample of 235 Italian school teachers. The model offered good overall fit to the data, though not all individual path coefficients were significant. Three of five predictors (favorable work conditions, efficacy-relevant supports, and positive affectivity) produced significant, direct paths to job satisfaction. Job satisfaction, progress at personal work goals, and positive affectivity were predictive of teachers' life satisfaction. Task self-efficacy was related indirectly both to job satisfaction (via work conditions) and life satisfaction (via goal progress). Implications of the findings for future research and efforts to promote teachers' job satisfaction are discussed.     

The presence of a calling and academic satisfaction: Examining potential mediators

The present study examined the relation of calling and academic satisfaction with a diverse sample of 312 undergraduate students. The presence of a calling was moderately correlated with academic satisfaction, and a multiple mediation model was utilized to test three potential mediators to this relation: career decision self-efficacy, work hope, and meaning in life. Using bootstrapping techniques, significant indirect effects were found for two of the three mediators, career decision self-efficacy, and work hope. After including the mediators in the model, the relation of calling and academic satisfaction was non-significant. These results indicate that calling relates to greater satisfaction in the academic domain in part because of increased career decision self-efficacy and work hope. Directions for future research are discussed.