Medical decision-making and minors: issues of consent and assent

The physician-patient relationship has been described as an egalitarian partnership in which patients and physicians work together to make healthcare decisions. Although adults receive considerable encouragement to become active participants in medical decision-making, children and adolescents often have little voice in such decisions and are granted limited access to confidential medical care. After a brief discussion of legal perspectives on informed consent, the present review examines the developmental literature on children and adolescents' capacities to make medical decisions that are informed, voluntary, and rational. The purposes and benefits of assent are identified. Remaining questions of how to evaluate capacity and balance parental and minor autonomy are explored.     

A controlled evaluation of cognitive behavioural therapy for posttraumatic stress in motor vehicle accident survivors

Seventy-eight motor vehicle accident survivors with chronic (greater than 6 months) PTSD, or severe sub-syndromal PTSD, completed a randomized controlled comparison of cognitive behavioral therapy (CBT), supportive psychotherapy (SUPPORT), or a Wait List control condition with two detailed assessments. Scores on the CAPS showed significantly greater improvement for those in CBT in comparison to the Wait List and to the SUPPORT conditions. The SUPPORT condition in turn was superior (p=0.012) to the Wait List. Categorical diagnostic data showed the same results. An analysis of CAPS scores including drop-outs (n=98) also showed CBT to be superior to Wait List and to SUPPORT with a trend for SUPPORT to be superior to Wait List. The CBT condition led to significantly greater reductions in co-morbid major depression and GAD than the other two conditions. Results held up well at a 3-month follow-up on the two active treatment conditions.     

Early adolescents' experiences with, and views of, Barbie

There has been a great deal of debate over the influence of Barbie dolls on girls' developing self-concept and body image. Two qualitative studies were conducted to gather information about early adolescents' experiences with, and perspectives on, the controversial toy. In Study 1, focus groups with twenty 6th-grade girls suggested that they have ambiguous feelings toward the doll and the feminine sexualized image it represents. Study 2 gathered essay responses from fifty 7th- and 8th-grade boys and girls regarding their experiences with, and opinions on, Barbie dolls. Participants reported both positive and negative feelings toward the doll and its influence on girls' development.     

Loneliness and Attitudes toward Aloneness in Belgian Adolescents: Measurement Invariance across Language,Age, and Gender Groups

In this study, the factor structure and psychometric properties of a French adaptation of the well-established Loneliness and Aloneness Scale for Children and Adolescents (LACA) was investigated in a French-speaking sample of Belgian adolescents (N?=?641; Mage?=?14.35, SD?=?2.03; 53.4% girls). In addition, measurement invariance analyses across the two main language groups in Belgium (i.e., Dutch-speaking and French-speaking) and across age and gender were conducted on a combined sample of French-speaking and Dutch-speaking Belgian adolescents (N?=?1282; Mage?=?14.36 years, SD?=?2.03; 53.6% female). Subsequently, group mean differences across language, age, and gender groups were investigated. Convincing support was found for the expected four-factor structure of the French adaptation of the LACA and the measure showed good reliability. Results further indicated that Belgian adolescents from the two principal language groups and from different age and gender groups interpreted the items of the LACA similarly. Therefore, analyses of group mean differences could be compared. Given the small effect sizes that accompanied the obtained effects, replication research is needed to further investigate these group mean differences.     

A Multi-Informant Approach to Assessing Safety Behaviors among Adolescents: Psychometric Properties of the Subtle Avoidance Frequency Examination

Safety behaviors are subtle avoidance strategies for minimizing distress within social situations (e.g., avoidance of eye contact). These behaviors factor prominently in the development and maintenance of social anxiety concerns, and when patients use these behaviors within psychosocial treatments for social anxiety, this may impede treatment response. Prior work supports the need to include measures of safety behaviors within evidence-based assessments of social anxiety. Along these lines, researchers developed the Subtle Avoidance Frequency Examination (SAFE) to assess safety behaviors among adults. However, we know relatively little about the SAFE’s psychometric properties when administered to adolescents. We tested the SAFE’s psychometric properties using adolescent self-reports and parallel parent reports in a mixed-clinical/community sample of 96 14 to 15 year-old adolescents and their parents (33 clinic-referred; 63 community control; 59.4% African American). Adolescent and parent SAFE reports displayed moderate correspondence with each other. Both adolescent and parent SAFE reports related positively to well-established measures of adolescent social anxiety and depressive symptoms. Both reports distinguished adolescents on referral status as well as cut scores on well-established measures of adolescent social anxiety. Further, both adolescent and parent SAFE reports displayed incremental validity in relation to survey reports of adolescent social anxiety, over-and-above survey reports of adolescent depressive symptoms, which commonly co-occur with social anxiety. However, adolescent (but not parent) SAFE reports predicted adolescents’ social anxiety and state arousal as displayed within social interactions with unfamiliar peer confederates. These findings have important implications for leveraging multi-informant approaches to assessing safety behaviors among adolescents.     

“The Destruction of a Legacy”: Agenda Setting and the Bill Cosby Sexual Assault Allegations

Utilizing agenda setting theory, this study investigates the Bill Cosby sexual assault allegation scandal and how the scandal is framed by the media. In order to examine if and how varied networks reported differently on the Cosby scandal, sixty articles from three, distinct networks (CNN, FOX News, E!) were analyzed and coded under seven different categories. Results demonstrate a significant difference among the analyzed networks and media frames most reported in the sample for this study. Although all networks address Cosby’s rise and fall of an American hero, agendas set and story frames presented varied. Specifically, CNN highlighted victims’/survivors’ powerful voice whereas E! and FOX News highlighted Cosby’s support from the black community, celebrities and co-stars. Additional results, discussion and future directions follow.     

Disgust predicts prejudice and discrimination toward individuals with obesity

This study examined the relevance of disgust to evaluations of an obese target person, and the connection between disgust and prejudice toward that person. Participants (n = 598) viewed an image of an obese or non‐obese woman, and then evaluated that woman on a number of dimensions (emotions, attitudes, stereotypes, desire for social distance). Compared with the non‐obese target, the obese target elicited more disgust, more negative attitudes and stereotypes, and a greater desire for social distance. Furthermore, disgust mediated the effect of the target's body size on all of the outcome variables (attitudes, stereotypes, social distance). Disgust plays an important role in prejudice and discrimination toward individuals with obesity, and might in part explain the pervasiveness of weight bias.     

Similar stimulus features control visual classification in orangutans and rhesus monkeys

Many species classify images according to visual attributes. In pigeons, local features may disproportionately control classification, whereas in primates global features may exert greater control. In the absence of explicitly comparative studies, in which different species are tested with the same stimuli under similar conditions, it is not possible to determine how much of the variation in the control of classification is due to species differences and how much is due to differences in the stimuli, training, or testing conditions. We tested rhesus monkeys (Macaca mulatta) and orangutans (Pongo pygmaeus and Pongo abelii) in identical tests in which images were modified to determine which stimulus features controlled classification. Monkeys and orangutans were trained to classify full color images of birds, fish, flowers, and people; they were later given generalization tests in which images were novel, black and white, black and white line drawings, or scrambled. Classification in these primate species was controlled by multiple stimulus attributes, both global and local, and the species behaved similarly.