Re-visioning clinical research: gender and the ethics of experimental design

Since modern medicine is based substantially in clinical medical research, the flaws and ethical problems that arise in this research as it is conceived and practiced in the United States are likely to be reflected to some extent in current medicine and its practice. This paper explores some of the ways in which clinical research has suffered from an androcentric focus in its choice and definition of problems studied, approaches and methods used in design and interpretation of experiments, and theories and conclusions drawn from the research. Some examples of re-visioned research hint at solutions to the ethical dilemmas created by this biased focus; an increased number of feminists involved in clinical research may provide avenues for additional changes that would lead to improved health care for all.     

Risk Marker Analysis of Husband-to-Wife Violence: A Continuum of Aggression1

To evaluate whether a continuity of aggression assumption underlies husband-to-wife violence, an analysis of the 1985 National Family Violence Survey was performed to assess to degree to which highly recognized risk markers discriminate among various levels of husband-to-wife violence. Parallel analyses were conducted on men's reports of expressions of violence and women's reports of victimization. Individuals of both genders who reported more extreme forms of violence were more likely to report less extreme violence as well. In addition, several risk markers that discriminated individuals involved in husband-to-wife violence exhibited linear associations with the level of violence reported. These linear trends appeared consistent regardless of whether husbands' reports of inflicting violence or wives' reports of being victimized were examined. These results support the assumption that husband-to-wife violence lies upon a continuum of severity.     

University faculty gender roles perceptions

Gender role preferences for Ideal Woman and Ideal Man and perceptions of Most Women, Most Men and Self were surveyed in 400 faculty women and men, of which 83% were Caucasian, 9% Hispanic, 4% African-American, and 3% Asian. Both women and men faculty preferred an androgynous Ideal Woman, but a masculine Ideal Man. Similarly, faculty women described themselves as androgynous, while men described themselves as masculine. Both women and men perceive Most Women and Men as sex-typed. Women and men faculty preferences and perceptions were generally very similar.     

The ideal‐self inventory: A new measure of self‐esteem

This article reports on some research in progress developing a new measure of self‐esteem which we have called the Ideal‐Self Inventory (ISI). The inventory is based on a constructivist approach and simply asks participants to list ten characteristics to describe their ideal self together with the ten opposite characteristics to describe their not ideal self. The ISI has been tested on over 100 student volunteers and correlates significantly with the adult version of the Coopersmith Self‐Esteem Inventory. The applications of this new measure are discussed with particular reference to counselling and psychotherapy.     

Clinical,developmental and social aspects of infant crying and colic

Persistent unexplained infant crying in the first few months is a common source of distress for parents and is costly for the health services. The aim was to assess the merits of developmental and social conceptualizations of this phenomenon, compared to the clinical approach as represented by the concept of colic. From a community sample of 530 infants, 67 who met the ‘rule of threes’ definition of colic by fussing and crying for 3 or more hours per day at 4-5 weeks of age were chosen. To avoid confusion, these infants were called ‘persistent criers’. Groups of ‘evening criers’ (N = 38) and ‘moderate cries’ (N = 55) were also selected. These 160 infants were assessed by researcher measures of their consolability and by maternal diary measures of their amounts of fussing, crying and colic behaviour when 5-6 weeks old. The persistent and evening criers cried more than the moderate criers. However, irritable, ‘fussy’ behaviour was the predominant form of distress for all three groups of infants. Colic bouts–defined as ‘bouts of intense, unsoothable crying and other behaviour, perhaps due to stomach or bowel pain’–were rare even among the persistent criers and only 7% of these infants were found to be inconsolable. The results support growing evidence that normal infant developmental processes are central to this phenomenon. In addition, social interactions between infants and parents, and parental subjective variables, appear to be involved. Colic was distinguished as a rare and separate form of distress by the infants' mothers. Further evidence needs to determine whether colic is a distinct clinical phenomenon or an extreme degree of normal distress interpreted within a western cultural framework.     

Counselling problem drinkers: The realm of specialists. Alcoholics Anonymous or generic counsellors?

A study was carried out to investigate counsellors' attitudes and experiences in working with people with drinking problems and counsellors' understanding of Alcoholics Anonymous as a helping agent. Ninety-four counsellors responded to a questionnaire about their work with people with drinking problems and their knowledge of AA. Generic counsellors tended not to feel competent working with clients with alcohol problems. Feelings of competence increased with greater experience of the client group and, to a lesser extent, with more hours of specialist training. It was found that counsellors whose intake of alcohol amounted to more than eight units per week were less likely to take on clients with alcohol problems than were those who drank less. Counsellors usually had some knowledge of AA but had little understanding of the 12-step programme that forms the basis of recovery for alcoholics as described by AA. They were, however, in favour of clients attending AA as an adjunct to individual counselling     

Social processing errors among paranoid personalities

The present study tested clinical hypotheses about the social processing attributes of paranoid personalities (PP). Eighteen PPs and 18 normal controls (NC) viewed standardized role plays (Dodge, 1986) in which a provocation occurred but the protagonist's intention varied (i.e., ambiguous, accidental, hostile, or prosocial). Subjects identified the intention behind the action and then chose a response to that action (e.g., ignore what he did). The results indicated that PPs and NCs did not differ on intentioncue detection when the intention was clear, but PPs had a significantly higher rate of misreading ambiguous situations. Furthermore, when intentions were ambiguous, PPs were more likely than NCs to identify them as hostile intentions. Finally, PPs' reactions to the vignettes were different from normal controls' when the perceived intention was either prosocial or accidential. PPs were more likely to respond with anger and less likely to ignore the event, compared to NCs. These data provide initial support for clinical notions about the aberrant social processing of paranoid personalities.     

CHILDREN'S THINKING IN BOTSWANA: PIAGET TASKS EXAMINED*

This Piaget replication study was done in Botswana. Six tasks were completed by 554 primary school children from urban, rural, and traditional village environments. Conservation of number, length, mass and weight, seriation and classification exercises were carried out using materials commonly found in the culture. Previous studies by other investigators have compared schooled and unschooled subjects in other African countries, but often unschooled subjects were from rural areas, so the environmental effects could not be isolated. In this study comparisons were made between students in the three environments, between age groups, and between male and female subjects. Urban children completed tasks at an earlier age than those from other environments. In general, the results are similar to findings from other African countries.