Rethinking Professional Ethics in the Cost-Sharing Era

Changes in healthcare financing increasingly rely upon patient cost-sharing to control escalating healthcare expenditures. These changes raise new challenges for physicians that are different from those that arose either under managed care or traditional indemnity insurance. Historically, there have been two distinct bases for arguing that physicians should not consider costs in their clinical decisions—an “aspirational ethic” that exhorts physicians to treat all patients the same regardless of their ability to pay, and an “agency ethic” that calls on physicians to be trustworthy advisors to their patients. In the setting of greater patient cost-sharing, physicians' aspiration and agency roles increasingly conflict. Satisfactorily navigating the new terrain of consumer-driven healthcare requires physicians to consider these two roles and how they can best be reconciled so as to maximize quality of care while respecting the heterogeneity of patients' financial resources and willingness to pay.     

The Effects of Social Anxiety and State Anxiety on Visual Attention: Testing the Vigilance–Avoidance Hypothesis

A growing theoretical and research literature suggests that trait and state social anxiety can predict attentional patterns in the presence of emotional stimuli. The current study adds to this literature by examining the effects of state anxiety on visual attention and testing the vigilance–avoidance hypothesis, using a method of continuous visual attentional assessment. Participants were 91 undergraduate college students with high or low trait fear of negative evaluation (FNE), a core aspect of social anxiety, who were randomly assigned to either a high or low state anxiety condition. Participants engaged in a free view task in which pairs of emotional facial stimuli were presented and eye movements were continuously monitored. Overall, participants with high FNE avoided angry stimuli and participants with high state anxiety attended to positive stimuli. Participants with high state anxiety and high FNE were avoidant of angry faces, whereas participants with low state and low FNE exhibited a bias toward angry faces. The study provided partial support for the vigilance–avoidance hypothesis. The findings add to the mixed results in the literature that suggest that both positive and negative emotional stimuli may be important in understanding the complex attention patterns associated with social anxiety. Clinical implications and suggestions for future research are discussed.     

Emotional expressions during early infant – father conversations

The present longitudinal and naturalistic study aimed to investigate fathers' and infants' facial expressions of emotions during paternal infant-directed speech. The microanalysis of infant and paternal facial expressions of emotion in the course of the naturalistic interactions of 11 infant – father dyads, from the 2nd to the 6th month, provided evidence that: (a) fathers and infants match their emotional states and attune their emotional intensity; (b) infants seem to match paternal facial emotional expressions more than vice versa; (c) the prevailing emotional states of each partner remain constant in the beginning and at the end of speech; and (d) the developmental trajectories of infant interest and paternal pleasure change significantly across the age range of 2 – 6 months and they seem to follow similar courses. These results are interpreted within the frame of the theory of innate intersubjectivity.     

Parent–child resemblance and kin investment: Physical resemblance or personality similarity?

Resemblance between parents and children has been suggested as an indicator of kinship. Because men, unlike women, cannot be certain about parenthood, resemblance may influence men more than women when making investment decisions. In the present paper we examine the relation of physical resemblance and personality similarity with parental investment for 90 Dutch parents and their school-age children. For mothers investment was linked to personality similarity, whereas for fathers investment was linked to physical resemblance, suggesting that fathers are influenced by physical cues when making investment decisions, whereas mothers are influenced by psychological cues.     

Don't throw the bathwater in with the baby

The Presidential Address of the European Association of Developmental Psychology, Goossens (2012, this issue), this year concerned how genes and environments interplay to shape loneliness and other developmental psychological relevant outcomes. This is a very welcome. However, when developmental psychology is now ready to integrate recent genetic and neuroscience knowledge and methods, I think it would be very wise not to go uncritically through the mistakes that have been made in other disciplines and instead to learn from their hard lessons. I discuss some problems (genes vs. environments, identifying genes for a phenotype, environmental causes of developmental outcomes, and gene×environment interaction and epigenetics) and some suggestions for solutions that can be used to avoid throwing the bathwater in with the baby.     

Measuring Schwartz's values in childhood: Multidimensional scaling across instruments and cultures

The Picture-Based Value Survey for Children (PBVS-C; Döring et al., 2010) assesses children's values through self-report and thereby depicts Schwartz's theory of universal human values at an early age. Despite evidence on the PBVS-C's structural validity, there remains an open question: Does the PBVS-C measure the same values as does Schwartz's Portrait Values Questionnaire (PVQ; Schwartz et al., 2001), an established assessment instrument for adult and adolescent respondents? To answer this question about the PBVS-C's validity, Polish (N = 167) and German (N = 119) children's values were measured with both instruments. The multitrait–multimethod correlation matrix (Campbell & Fiske, 1959) of value items from both instruments was analysed with multidimensional scaling (MDS), as proposed by Borg and Groenen (1997). Our structural expectations for the MDS output about the distinctiveness (1) of Schwartz's higher order value types (i.e., traits) and (2) of the two assessment methods (PBVS-C and PVQ) were confirmed in both samples.     

Developmental trajectory of intersubjectivity in the second and third year of life: Study of fixed-population and random-individual effects

Colwyn Trevarthen claimed that babies have an intrinsic motivation to communicate and engage with others that he called intersubjectivity. Around the ninth month of life, this motivation changes and passes from person-to-person dyadic (primary intersubjectivity) to triangulate a person–person–object relationship (secondary intersubjectivity). Despite the scientific consensus on this developmental leap, few empirical studies explore the trajectory of this more complex form of intersubjectivity between the second and third year of life. One hundred and fifteen free play sessions from 27 mother–child dyads (13 girls and 14 boys) between 9 and 37 months were filmed and were categorized based on the Level of Intersubjective Attunement Scale. The data were analysed using a linear mixed-effects model. Results show both a population trajectory of the levels of intersubjective attunement and random individual differences. We discuss these results in relation to the binomial typical developmental route and interindividual variability.     

家庭创新环境的特征及其与中学生日常创造性行为的关系：创造性人格的中介作用

以1117名中学生为被试,采用问卷法考察家庭创新环境的特点及其对日常创造性行为的影响机制。结果发现：（1）家庭创新环境体现在家庭情感氛围、父母创造性行为、父母教育理念和自主准予,可分为抑制型（17.3%）、一般型（41.9%）和创新型（40.8%）,创新型在日常创造性行为上得分显著高于抑制型;（2）家庭创新环境与创造性人格、日常创造性行为以及同伴提名得分相关显著;（3）创造性人格在家庭创新环境和同伴提名之间起完全中介作用,在家庭创新环境和日常创造性行为之间起部分中介作用。