A biopsychosocial approach to liver transplant evaluation in two patients with Wilson's disease

Wilson's disease (WD) is characterized by hepatic, neurological, and/or psychiatric disturbances. In some cases, liver transplantation is indicated. Because psychologists and other health care workers play an increasing role in the evaluation of individuals presenting for transplant, an understanding of the heterogeneous phenotype of WD is important for mental health professionals working in medical settings. This article reviews two cases of patients with WD (one probable, one confirmed) presenting for liver transplantation and a biopsychosocial assessment approach is demonstrated. Patients are presented in terms of medical, psychiatric, and psychosocial history, neuropsychological examination results, and the subsequent indications for liver transplantation. Both patients exhibited neurocognitive and psychiatric symptoms. One patient was determined to be a marginally suitable candidate for transplantation, whereas the other was considered at high risk for negative outcome post-transplant. This article demonstrates the importance of considering phenotypic presentation, neurocognitive function, psychiatric status, and psychosocial circumstances in assessing transplant readiness in patients with WD. A comprehensive and integrative biopsychosocial assessment approach is appropriate for evaluating patients with WD presenting for liver transplantation.     

Birth,kind and naïve biology

Much recent debate concerning the acquisition of naïve theories of biology and of race has turned on the claim that even preschoolers understand biological inheritance. At issue is what is implied by the belief that offspring will have the characteristic features of their kind. The present paper argues that such an essentialist belief in innate potential need not indicate a domain‐specific understanding of the biological inheritance of human kinds (or race). In Study 1, preschoolers in a Switched‐at‐birth task were found to be as likely to judge an adopted girl to resemble her birth parents on the color of their shirts as on their race. In Study 2, a variant on the task, 4‐year‐olds were found to be more likely to judge the girl to resemble her adoptive parents, suggesting that the concept of birth origin was not central to their reasoning. Though the results are consistent with the claim that preschoolers reason about human kinds in an essentialist manner, they undermine the broader claim that such reasoning is anchored by a naïve theory of biology. The finding is of cultural as well as cognitive consequence.     

The Urge to Splurge: A Terror Management Account of Materialism and Consumer Behavior

This article presents terror management theory (TMT) as a way to understand how the human awareness of death affects materialism, conspicuous consumption, and consumer decisions. The pursuit of wealth and culturally desired commodities are hypothesized to reinforce those beliefs that function to protect people from existential anxieties. Following a brief overview of TMT and research, evidence is reviewed that explicates how intimations of mortality increase materialism as a way to enhance self‐esteem and affects consumer decisions that support one's cultural worldview. Adverse consequences of materialistic and consumeristic worldviews are described and the challenges for future research to discover ways to alleviate them are considered.     

Can empathy close the racial divide and gender gap in death penalty support?

Public opinion data indicate that the majority of US respondents support the death penalty. Research has consistently indicated, however, that Blacks and females are significantly less likely to support capital punishment than their White and male counterparts. Past research efforts attempting to account for these differences have, at best, only partially accounted for them: the racial divide and gender gap in death penalty support, while narrowed, remained evident. This study proposes that empathy, particularly ethnocultural empathy, may be a key explanatory correlate of death penalty support and that racial and gender differences in empathy may fully explain the observed racial and gender differences in death penalty support. This study uses three forms of empathy measures (cognitive, affective, and ethnocultural) to test this hypothesis using survey data from a sample of undergraduate students. Our results show that neither a variety of other “known correlates” of death penalty support nor cognitive or affective empathy scales were able to fully account for the observed racial difference in death penalty support. Ethnocultural empathy, however, was successful in reducing the effect of race on death penalty support to nonsignificance. To the best of our knowledge, this is the first study to have done so.     

RELATIONSHIP SATISFACTION, AFFECTIVITY, AND GAY-SPECIFIC STRESSORS IN SAME-SEX COUPLES JOINED IN CIVIL UNIONS

Relationship satisfaction, affect, and stress were examined in 313 same-sex couples who had had civil unions in Vermont during the first year of this legislation. Similarity between partners on age and on positive/negative affectivity was related to relationship satisfaction whereas there was no association with similarity in income, education, and outness. Lesbian couples ( n = 199), compared to gay male couples, reported experiencing more stress related to family reaction to their sexuality, whereas gay male couples ( n = 114) reported more stress surrounding the issues of HIV/AIDS and violence/harassment than did lesbian couples. This study is the first to examine within-couple factors among same-sex couples with legalized relationships.     

Values of fathers for themselves and their newborns

The paternal role has been neglected in parenting research. The present study focused on the values of fathers of newborns. Values of fathers of newborns drawn from the inner-city lower-class were compared with values of fathers of newborns drawn from the middle class. Highest goals of fathers from both groups for themselves were economic ('family security'); values for their children were morally focused ('honest'). Inner-city fathers placed a higher value on a clean and obedient child, whereas middle-class fathers placed a higher value on a loving and imaginative child. When values of these fathers were compared with values of a similar sample of mothers of newborns, socioeconomic status remained an important predictor of values. Sex of parent was significant in the inner-city sample as these fathers placed a higher valuation on goals associated with autonomy than did inner-city mothers.     

The role of target salience in crowding

We studied 'crowding' in the parafovea using orientation identification of a Gabor target as the task, and flanking Gabors on an isoeccentric circle as distractors. Orientation-discrimination thresholds were raised by nearby flanking distractors. This crowding effect was increased by the number of distractors and decreased by the spatial separation between target and distractors. Crowding was greatest when the target was in the centre of the distractor array and smallest when the target was on the edge of the array. A cue indicating the position of the target improved performance when the position was otherwise unknown and the spatial separation between target and distractors was large, but the cue had no significant effect when separation was small. Increasing the contrast of the target relative to the distractors reduced crowding, but targets of smaller contrast than that of the distractors are even harder to identify than those of the same contrast. Putting the target and distractors in different depth planes decreased crowding for some observers, but there were qualitative individual differences. A large (say, 45 degrees) difference in orientation between target and distractors caused the target to 'pop out' in a presence/absence task, despite the evidence from other studies that crowding is still found in these conditions. We conclude that salience has, at best, modest effects on crowding.     

Asian Families “Back Home”: An Unexplored Resource

Communities from which Asian migrants to the West originate are often seen by western professionals as a drain upon these new migrants’ resources, and are not included in formulations about problems or their solutions. In this article, a number of case examples are used to illustrate how the authors made use of the relationships of Bangladeshi migrants living in the east end of London to their families back home as a crucial resource in overcoming difficulties encountered in their new country. It is further argued that seeing such families as having transnational loyalties is a more helpful “frame” than seeing them as caught up in cultural conflict.     

Why do people need self-esteem? A theoretical and empirical review

Terror management theory (TMT; J. Greenberg, T. Pyszczynski, & S. Solomon, 1986) posits that people are motivated to pursue positive self-evaluations because self-esteem provides a buffer against the omnipresent potential for anxiety engendered by the uniquely human awareness of mortality. Empirical evidence relevant to the theory is reviewed showing that high levels of self-esteem reduce anxiety and anxiety-related defensive behavior, reminders of one's mortality increase self-esteem striving and defense of self-esteem against threats in a variety of domains, high levels of self-esteem eliminate the effect of reminders of mortality on both self-esteem striving and the accessibility of death-related thoughts, and convincing people of the existence of an afterlife eliminates the effect of mortality salience on self-esteem striving. TMT is compared with other explanations for why people need self-esteem, and a critique of the most prominent of these, sociometer theory, is provided.     

Perceptual simulation in property verification

If people represent concepts with perceptual simulations, two predictions follow in the property verification task (e.g., Isface a property of GORILLA?). First, perceptual variables such as property size should predict the performance of neutral subjects, because these variables determine the ease of processing properties in perceptual simulations (i.e., perceptual effort). Second, uninstructed neutral subjects should spontaneously construct simulations to verify properties and therefore perform similarly to imagery subjects asked explicitly to use images (i.e., instructional equivalence). As predicted, neutral subjects exhibited both perceptual effort and instructional equivalence, consistent with the assumption that they construct perceptual simulations spontaneously to verify properties. Notably, however, this pattern occurred only when highly associated false properties prevented the use of a word association strategy. In other conditions that used unassociated false properties, the associative strength between concept and property words became a diagnostic cue for true versus false responses, so that associative strength became a better predictor of verification than simulation. This pattern indicates that conceptual tasks engender mixtures of simulation and word association, and that researchers must deter word association strategies when the goal is to assess conceptual knowledge.