Beyond medical risk: investigating the psychological factors underlying women's perceptions of susceptibility to breast cancer, heart disease, and osteoporosis.

The relationships of epidemiological (objective) risk indices, perceived disease characteristics, and cognitive heuristics to women's perceived susceptibility to breast cancer, heart disease, and osteoporosis in a community sample of 312 women ages 40-86 were examined. Epidemiological indices accounted for a small to moderate proportion of the variance in perceived susceptibility. Psychological factors (perceived similarity to women who contract the target disease and perceived disease prevalence) predicted perceived susceptibility above and beyond medical risk factors. Opposite to actual risk, age correlated negatively with perceived susceptibility to all 3 diseases. Exploratory analyses suggested that perceived similarity, perceived prevalence, and absent/exempt beliefs might mediate this relationship. Confirmatory factor analyses verified that measures of absolute and direct comparative risk assess the same underlying construct of perceived susceptibility.     

Rational-emotive therapy applied to relationship therapy

RET is a comprehensive mode of relationship therapy that takes a double-barreled psychotherapeutic approach of helping all the partners in a relationship to accept responsibility for their own disturbances and failings and to work at correcting these-while, at the same time, helping them to understand and work actively at changing the marital or family system in which they are relating and the conditions in this system that are contributing to their practical and emotional problems. Rational-emotive relationship therapy is a form of cognitive behavior therapy that includes the following features: (1) It importantly stresses the cognitive or philosophic causes of emotional disturbance and of family disruption. (2) It teaches partners that they largely disturb themselves and that they can effectively refuse to continue to do so. (3) It almost always employs a number of cognitive, emotive, and behavioral techniques but employs them not merely to achieve symptomatic change but to help couples achieve a profound philosophic reconstruction that will, hopefully, lead to elegant and permanent change. It clearly acknowledges the biological as well as the sociological bases of disturbance, and therefore stresses vigorous and forceful, active-directive methods that will impinge upon and help alter the strongly held disturbances that partners frequently experience. (5) It holds to a rigorously scientific and yet highly humanistic outlook in both its theory and its practice. (6) It stresses a phenomenological, intraindividual, and depth-centered approach to understanding and tackling human disturbance, but at the same time uses practical problem-solving and skill-straining methods of changing family situations and interactions.     

Heart-rate deceleration and smiling in 3-month-old infants

The relation between heart-rate deceleration and the expression of positive affect in infancy is examined by testing the hypothesis that intensity of orienting (as indexed by heart-rate deceleration) is predictive of intensity of positive affect (smile size and duration). A social-stimulation procedure was utilized to elicit smiles in 41 3-month-old infants. The first smile elicited was coded for smile size and duration, and the preceding heart-rate deceleration was coded for magnitude, duration, and slope of deceleration. Slope and duration of heart-rate deceleration proved to be reliable predictors of smile size, but none of the heart-rate measures correlated with smile duration. Results suggest that the steeper and more rapid the deceleration, the larger the ensuing smile. Possible mechanisms for this finding are discussed.     

Amnesia and competency to stand trial: A review of legal and clinical issues

Recent case law is discussed regarding the role of amnesia in determining competency to stand trial. Clinical issues are examined for a range of amnestic conditions on a spectrum of organic and functional disorders. Clinical methods are explored for establishing the extent of amnesia and its relevance to competency.     

Family coercion and valid consent

Coercion is commonly said to invalidate consent, and that is always true if the source of the coercion is the physician. However, if it is a family member who coerces the patient to consent, the resultant consent may be quite valid and treatment should proceed.