Environmental Factors Contributing to Wrongdoing in Medicine: A Criterion-Based Review of Studies and Cases

In this article we describe our approach to understanding wrongdoing in medical research and practice, which involves the statistical analysis of coded data from a large set of published cases. We focus on understanding the environmental factors that predict the kind and the severity of wrongdoing in medicine. Through review of empirical and theoretical literature, consultation with experts, the application of criminological theory, and ongoing analysis of our first 60 cases, we hypothesize that 10 contextual features of the medical environment (including financial rewards, oversight failures, and patients belonging to vulnerable groups) may contribute to professional wrongdoing. We define each variable, examine data supporting our hypothesis, and present a brief case synopsis from our study that illustrates the potential influence of the variable. Finally, we discuss limitations of the resulting framework and directions for future research.     

Is better beautiful or is beautiful better? Exploring the relationship between beauty and category structure

We evaluate two competing accounts of the relationship between beauty and category structure. According to the similarity-based view, beauty arises from category structure such that central items are favored due to their increased fluency. In contrast, the theory-based view holds that people’s theories of beauty shape their perceptions of categories. In the present study, subjects learned to categorize abstract paintings into meaningfully labeled categories and rated the paintings’ beauty, value, and typicality. Inconsistent with the similarity-based view, beauty ratings were highly correlated across conditions despite differences in fluency and assigned category structure. Consistent with the theory-based view, beautiful paintings were treated as central members for categories expected to contain beautiful paintings (e.g., art museum pieces), but not in others (e.g., student show pieces). These results suggest that the beauty of complex, real-world stimuli is not determined by fluency within category structure but, instead, interacts with people’s prior knowledge to structure categories.     

Evaluation of the Latin American version of the Life Orientation Test-Revised

The Life Orientation Test (LOT-R) is the most intensively used instrument for the assessment of optimism, but empirical evidence of its psychometric quality in Latin America is lacking. The aim of this study was to test psychometric properties of this questionnaire based on a representative sample of the general population of Colombia (N = 1,500). Confirmatory factor analyses confirmed the bi-dimensionality of the questionnaire with two factors, namely Optimism and Pessimism. The sum scores of the optimism and pessimism subscale correlated with r = ?.12. Convergent validity aspects were studied by correlating LOT-R values with anxiety, depression, quality of life, fatigue, mental health, hopelessness, and self-efficacy. Optimism was more strongly correlated with these variables than pessimism. Normative data and mean values for both genders and different age groups are given. Generally, there were only small age and gender effects. Compared to the German norm data, the Colombian participants scored on average one scale point higher in the dimension of optimism. In summary, the LOT-R in its Spanish version is an appropriate and practical tool for screening purposes in individual diagnostics and epidemiological research in Latin American samples.     

Inhibitory Control and Moral Emotions: Relations to Reparation in Early and Middle Childhood

ABSTRACT. This study examined links between inhibitory control, moral emotions (sympathy and guilt), and reparative behavior in an ethnically diverse sample of 4- and 8-year-olds (N = 162). Caregivers reported their children's reparative behavior, inhibitory control, and moral emotions through a questionnaire, and children reported their guilt feelings in response to a series of vignettes depicting moral transgressions. A hypothesized meditation model was tested with inhibitory control relating to reparative behavior through sympathy and guilt. In support of this model, results revealed that high levels of inhibitory control were associated with high levels of reparative behavior through high levels of sympathy and guilt. However, the mediation of inhibitory control to reparation through guilt was significant for 4-year-olds only. Results are discussed in relation to the temperamental, regulatory, and affective-moral precursors of reparative behavior in early and middle childhood.     

A Study of the Performance on English and Spanish Editions of the Stanford-Binet Intelligence Test by Spanish-American Children

Twenty male Ss between the ages of three and nine years were shown individually, 12 video scenes of interpersonal situations depicting either peer-peer, peer-adult, or adult-adult in one of two contexts: either cooperative or uncooperative. After each video presentation the S was questioned about the actions and emotions expressed in the scene.

The older Ss were more literal and gave greater detail in their recounting of the scenes. Since the experiment was not methodically complex enough to provide substantial information about the roles of egocentricity and decentering in the child's comprehension of social interaction, alternative paradigms were suggested.     

An Evaluation of Weighting Methods Based on Propensity Scores to Reduce Selection Bias in Multilevel Observational Studies

Observational studies of multilevel data to estimate treatment effects must consider both the nonrandom treatment assignment mechanism and the clustered structure of the data. We present an approach for implementation of four propensity score (PS) methods with multilevel data involving creation of weights and three types of weight scaling (normalized, cluster-normalized and effective), followed by estimation of multilevel models with the multilevel pseudo-maximum likelihood estimation method. Using a Monte Carlo simulation study, we found that the multilevel model provided unbiased estimates of the Average Treatment Effect on the Treated (ATT) and its standard error across manipulated conditions and combinations of PS model, PS method, and type of weight scaling. Estimates of between-cluster variances of the ATT were biased, but improved as cluster sizes increased. We provide a step-by-step demonstration of how to combine PS methods and multilevel modeling to estimate treatment effects using multilevel data from the Early Childhood Longitudinal Study–Kindergarten Cohort (ECLS-K).     

Some examples of multivariate analysis in educational and psychological research

This paper provides the formulas necessary for testing the significance of the differences between mean values of different multivariate normal populations by Hotelling's generalization of Student's ratio. It also indicates the methods, proposed by Mahalanobis, and by Rao, of classifying different multivariate populations and individuals. The methods are illustrated by means of personality test data obtained from students preparing for the General Elementary and the General Secondary Teaching Credentials.     

Prospective memory: Effects of divided attention on spontaneous retrieval

We examined the effects of divided attention on the spontaneous retrieval of a prospective memory intention. Participants performed an ongoing lexical decision task with an embedded prospective memory demand, and also performed a divided-attention task during some segments of lexical decision trials. In all experiments, monitoring was highly discouraged, and we observed no evidence that participants engaged monitoring processes. In Experiment 1, performing a moderately demanding divided-attention task (a digit detection task) did not affect prospective memory performance. In Experiment 2, performing a more challenging divided-attention task (random number generation) impaired prospective memory. Experiment 3 showed that this impairment was eliminated when the prospective memory cue was perceptually salient. Taken together, the results indicate that spontaneous retrieval is not automatic and that challenging divided-attention tasks interfere with spontaneous retrieval and not with the execution of a retrieved intention.