Physicians' Silent Decisions: Because Patient Autonomy Does Not Always Come First

Physicians make some medical decisions without disclosure to their patients. Nondisclosure is possible because these are silent decisions to refrain from screening, diagnostic or therapeutic interventions. Nondisclosure is ethically permissible when the usual presumption that the patient should be involved in decisions is defeated by considerations of clinical utility or patient emotional and physical well-being. Some silent decisions—not all—are ethically justified by this standard. Justified silent decisions are typically dependent on the physician's professional judgment, experience and knowledge, and are not likely to be changed by patient preferences. We condemn the inappropriate exclusion of the patient from the decision-making process. However, if a test or treatment is unlikely to yield a net benefit, disclosure and discussion are at times unnecessary. Appropriate silent decisions are ethically justified by such considerations as patient benefit or economy of time.     

Visual crowding: a fundamental limit on conscious perception and object recognition

Crowding, the inability to recognize objects in clutter, sets a fundamental limit on conscious visual perception and object recognition throughout most of the visual field. Despite how widespread and essential it is to object recognition, reading and visually guided action, a solid operational definition of what crowding is has only recently become clear. The goal of this review is to provide a broad-based synthesis of the most recent findings in this area, to define what crowding is and is not, and to set the stage for future work that will extend our understanding of crowding well beyond low-level vision. Here we define six diagnostic criteria for what counts as crowding, and further describe factors that both escape and break crowding. All of these lead to the conclusion that crowding occurs at multiple stages in the visual hierarchy.     

Impulse processing: a dynamical systems model of incremental eye movements in the visual world paradigm

The Visual World Paradigm (VWP) presents listeners with a challenging problem: They must integrate two disparate signals, the spoken language and the visual context, in support of action (e.g., complex movements of the eyes across a scene). We present Impulse Processing, a dynamical systems approach to incremental eye movements in the visual world that suggests a framework for integrating language, vision, and action generally. Our approach assumes that impulses driven by the language and the visual context impinge minutely on a dynamical landscape of attractors corresponding to the potential eye-movement behaviors of the system. We test three unique predictions of our approach in an empirical study in the VWP, and describe an implementation in an artificial neural network. We discuss the Impulse Processing framework in relation to other models of the VWP.     

A five-factor measure of schizotypal personality traits

The current study provides convergent, discriminant, and incremental validity data for a new measure of schizotypy from the perspective of the five-factor model (FFM) of general personality structure. Nine schizotypy scales were constructed as maladaptive variants of respective facets of the FFM (e.g., Aberrant Ideas as a maladaptive variant of FFM Openness to Ideas). On the basis of data from 143 undergraduates, the convergent validity of these nine scales was tested with respect to seven established measures of schizotypy and the respective facets of the FFM. Discriminant validity was tested with respect to facets from other FFM domains and components of schizotypy. Incremental validity was tested with respect to the ability of the FFM schizotypy scales to account for variance in two established measures of schizotypy, after variance accounted for by respective FFM facets and other established measures of schizotypy were first removed. The findings support the validity of these new scales as measures of schizotypal traits and as maladaptive variants of the FFM.     

« Femmes au volant,danger au tournant » Les conductrices sont-elles victimes d’une menace de stéréotype ?

Owing to the sexuation of occupations associating technical attributes with men and relational skills with women, the latter are less numerous in professions where driving is involved. The negative stereotype associating women with poor driving skills is thus likely to have a cognitive and behavioral impact. According to the model of the stereotype threat, could activation of the threat inhibit the performance of women in a Highway Code test? After performing an association task that demonstrated a largely negative stereotype, 56 female students took a Highway Code test in two conditions: an experimental condition where the stereotype was activated by a comparison between men and women (N = 17); and a control condition without activation (N = 39). Subjects performed less well in the experimental condition, demonstrating the expected effects of the stereotype threat.     

Parallel distributed processing and neuropsychology: A neural network model of Wisconsin card sorting and verbal fluency

Neural networks can be used as a tool in the explanation of neuropsychological data. Using the Hebbian Learning Rule and other such principles as competition and modifiable interlevel feedback, researchers have successfully modeled a widely used neuropsychological test, the Wisconsin Card Sorting Test. One of these models is reviewed here and extended to a qualitative analysis of how verbal fluency might be modeled, which demonstrates the importance of accounting for the attentional components of both tests. Difficulties remain in programming sequential cognitive processes within a parallel distributed processing (PDP) framework and integrating exceedingly complex neuropsychological tests such as Proverbs. PDP neural network methodology offers neuropsychologists co-validation procedures within narrowly defined areas of reliability and validity.     

Self-Cutting and Suicidal Ideation among Adolescents: Gender Differences in the Causes and Correlates of Self-Injury

In recent years, non-suicidal self-injury (NSSI) among adolescents has been identified as alarmingly common place. Some studies have suggested that more than one in eight adolescents have engaged in self-cutting or other self-injuring behaviors. Even more of a concern is that self-injury often foreshadows suicide or suicide attempts. With self-cutting common in middle and high schools, understanding the antecedents and correlates of such behavior may help counselors and others public health officials identify troubled students and initiate preventative measures. This study utilizes data from 2,639 high school students from the Delaware Youth Risk Behavior Survey to investigate the gender differences in NSSI and suicidal ideation. Overall, 13% reported engaging in NSSI within the past year, with females reporting significantly higher rates (17%) of NSSI than males (9%). Results indicate that there are significant gender differences in NSSI and suicidal thoughts based upon previous victimization experiences, reported substance use, depression, health behaviors, and sexual orientation.     

Negative processing biases predict subsequent depressive symptoms

This study investigated the possible relationship between negative processing biases and subsequent depression. The Scrambled Sentences Test (SST), a measure of processing bias, was administered to a large sample of undergraduates. Participants also completed self-report measures of thought suppression tendencies, current level of depression, and lifetime worst-depression symptoms. High scores on the SST, reflecting a negative processing bias, predicted depression symptoms measured 4 to 6 weeks later, even after controlling for concurrent and past depression. The SST was administered both with and without cognitive load to all participants. The SST with load predicted subsequent depression for both men and women. The SST without load predicted depression for women only. The SST difference score, a measure of the change in scores between the no-load and load conditions, was a significant predictor of subsequent depression for men but not women. Among men, the combination of high thought suppression with either high SST-load scores or high SST difference scores proved to be a particularly strong indicator of vulnerability to subsequent depression.     

Implicit evaluation bias induced by approach and avoidance

We report a study in which faces with a neutral emotional expression were shown on a computer screen. By means of a joystick, participants pulled half of the faces closer (positive approach movement), and pushed the half away (negative avoidance movement). As a result, an operant evaluative conditioning effect occurred in a subsequent affective priming task: Participants responded more quickly to positive target words if they were preceded by a previously pulled face than a pushed face, and vice versa for negative target words. The effect became stronger the more often the faces had been trained to approach or to avoid. No effect was observed on explicit evaluations of the faces: Pushed faces were rated as sympathetic as pulled ones.