Doctors,Patients, and Nudging in the Clinical Context—Four Views on Nudging and Informed Consent

In an analysis of recent work on nudging we distinguish three positions on the relationship between nudging founded in libertarian paternalism and the protection of personal autonomy through informed consent. We argue that all three positions fail to provide adequate protection of personal autonomy in the clinical context. Acknowledging that nudging may be beneficial, we suggest a fourth position according to which nudging and informed consent are valuable in different domains of interaction.     

The possible benefits of difficulty: how stress can increase and decrease subjective well-being

This study explores the effects of stress, trauma, coping and growth orientation on subjective well-being. Based on cognitive stress theory, it was hypothesized that adversity may contribute to increased or decreased well-being, depending on the subsequent meaning these experiences are given. Survey data from Norwegian UN/NATO veterans (N= 142) showed that stress and well-being were negatively associated (r=-0.20, p < 0.05) at the level of zero-order correlations. However, a full structural equation model revealed that the effect of stress on well-being was mediated positively through a problem-focused coping process combined with a growth component. Stress was negatively mediated through an avoidant-focused coping process and a distress component. The effect from stress was fully mediated in the model. The hypothesis that stress can produce both increased and decreased subjective well-being was confirmed.     

Episodic chasing in pathological gamblers using the Iowa gambling task

"Chasing ones losses" is a key symptom among pathological gamblers (PGs). This study focuses on quantitative differences in episodic chasing (i.e., sequences of disadvantageous decisions within a single gambling session) between PGs and non-pathological gamblers (NPGs). We compared 61 PGs and 39 NPGs on the Iowa Gambling Task (IGT) and the Zuckerman Sensation Seeking Scale (SSS). The PGs showed significantly more chasing and had significantly poorer decision-making strategies than NPGs, particularly among males (F = 4.52, p < 0.05). Random players were significantly less sensation seeking than advantageous and disadvantageous (i.e., chasing) players, but there was no interaction with group or gender. The results suggest that quantifiable within-session gambling behavior holds important implications for detecting underlying vulnerabilities to gambling pathology.     

Experimenting with phenomenology

We review the use of introspective and phenomenological methods in experimental settings. We distinguish different senses of introspection, and further distinguish phenomenological method from introspectionist approaches. Two ways of using phenomenology in experimental procedures are identified: first, the neurophenomenological method, proposed by Varela, involves the training of experimental subjects. This approach has been directly and productively incorporated into the protocol of experiments on perception. A second approach may have wider application and does not involve training experimental subjects in phenomenological method. It requires front-loading phenomenological insights into experimental design. A number of experiments employing this approach are reviewed. We conclude with a discussion of the implications for both the cognitive sciences and phenomenology.     

Narrative exposure therapy for posttraumatic stress disorder in tortured refugees: A preliminary uncontrolled trial

Halvorsen, J.Ø. & Stenmark, H. (2010). Narrative exposure therapy for posttraumatic stress disorder in tortured refugees: A preliminary uncontrolled trial. Scandinavian Journal of Psychology 51, 495–502. Torture has severe mental health effects, especially in terms of posttraumatic stress disorder (PTSD) and depression. However, there is still a lack of empirical treatment studies. The present paper presents data on 16 torture survivors receiving 10 sessions of narrative exposure therapy (NET). Symptoms of PTSD and depression, assessed by Clinician‐Administered PTSD Scale (CAPS) and Hamilton Rating Scale for Depression (HRSD), decreased significantly from pre‐treatment to 6‐month follow‐up, with Cohen’s d effect sizes of 1.16 and 0.84, respectively. Although treatment gains were moderate, further research on evidence‐based treatments for PTSD and depression in refugee torture survivors is warranted.     

Motivation for physical activity in young adults with physical disabilities during a rehabilitation stay: a longitudinal test of self‐determination theory

We tested a self‐determination theory (SDT) process model during a 3 week physical activity rehabilitation stay among young adults with a physical disability (N = 44, M_age = 24.7, SD = 5.1). As hypothesized, perceived autonomy support positively predicted needs satisfaction at the end of the stay (r = .38, p < .01). Further, needs satisfaction was positively linked to changes in autonomous motivation for physical activity (r = .47, p < .01). Both changes in autonomous motivation and self‐efficacy were associated with physical activity increases over the stay (r = .57, p < .01 and r = .47, p < .01, respectively). Bootstrapping results supported the SDT process model, indicating a support for a development toward more self‐determined motivation in rehabilitation.