I feel you feel what I feel: Perceived perspective‐taking promotes victims' conciliatory attitudes because of inferred emotions in the offender

In the context of bullying in a nursing workplace, we test the argument that an offender's perspective‐taking promotes victim conciliation, mediated by perceived perspective‐taking, that is, the extent to which the victim perceives the offender as taking their perspective. Perceived perspective‐taking facilitates the attribution of moral emotions (remorse, etc.) to the offender, thereby promoting conciliatory victim responses. However, perceived perspective‐taking would be qualified by the extent to which the severity of consequences expressed in the offender's perspective‐taking matches or surpasses the severity for the victim. In Studies 1 and 2 (Ns = 141 and 122, respectively), victims indicated greater trust and/or forgiveness when the offender had taken the victim's perspective. This was sequentially mediated by perceived perspective‐taking and victim's inference that the offender had felt moral emotions. As predicted, in Study 2 (but not Study 1), severity of consequences qualified victims' perceived perspective‐taking. Study 3 (N = 138) examined three potential mechanisms for the moderation by severity. Victims attributed greater perspective‐taking to the offender when the consequences were less severe than voiced by the offender, suggesting victims' appreciation of the offender's generous appraisal. Attributions of perspective‐taking and of moral emotions to the offender may play an important role in reconciliation processes. Key outcome: To the extent that victims perceive the offender as taking their perspective (perceived perspective‐taking), they infer that the offender feels more moral emotions, prompting victims to be more conciliatory. Perceived perspective‐taking benefits from the offender over‐stating the consequences to the victim.     

Development of clinical vignettes to assess healthcare decision-making capacity in elderly with mild cognitive impairment and Alzheimer's disease

IntroductionCognitive impairment can constrict healthcare decision-making capacity, as it affects the ability to understand, appreciate, and reason with information, as well as communication abilities. Therefore, decision-making capacity of elders with mild cognitive impairment or Alzheimer's disease should be carefully assessed when patients are asked to make decisions regarding their health. Vignettes are particularly relevant to assess healthcare decision capacity, since they can come close to real life situations and improve statistical reliability of capacity assessment instruments.ObjectiveThis paper describes the construction and development process of three hypothetical vignettes, to be included in a new Portuguese assessment tool of healthcare decision-making capacity (CAI-Health).MethodFor vignettes’ development, examples from other assessment tools were first reviewed to summarize their text length, language complexity and health information contained. Most prevalent causes of mortality and morbidity in Portuguese elders were then identified, in order to select the health issues to include in CAI-Health’ vignettes. Seven vignettes were developed, and three were selected to be included in CAI-Health. After vignette's selection, these were reviewed by three experienced medical experts, during a focus group.ConclusionVignettes final version include cases of increased complexity, presenting situations of mild cognitive impairment, lung tumor and knee arthrosis.     

Moral foundations tell us why guilt induces unfair allocation in multi‐party interactions

Previous studies have demonstrated that a sense of guilt promotes and maintains social fairness in two‐party interactions (Psychological Bulletin, 115, 1994 and 243). However, the situation is much more complex in three‐party or multi‐party interactions. De Hooge et al. (Journal of Personality and Social Psychology, 100, 2011 and 462) found that guilt could not only induce pro‐social behaviour towards the victim, but also have a disadvantageous impact on a third party. In the present study, we attempt to explain how guilt promotes unfair allocations from a moral foundations perspective. We conducted two experiments using a ‘three‐party dictator game’ paradigm. Firstly, it was repeatedly verified that guilt could induce unfair allocations in three‐party interactions. Secondly, five moral foundations (harm, fairness, ingroup, hierarchy and purity) were measured. Then the moderating and main effects of these five indices on how guilt affects the fair allocation of resources were explored using regression analysis. The results show that competition between harm and fairness in individual traits can explain the disadvantageous effect of guilt on fair allocations: the fairness foundation promoted equality in allocation, while the harm foundation promoted victim compensation.     

Integrated Primary Care: An Inclusive Three-World View Through Process Metrics and Empirical Discrimination

Integrating behavioral health services within the primary care setting drives higher levels of collaborative care, and is proving to be an essential part of the solution for our struggling American healthcare system. However, justification for implementing and sustaining integrated and collaborative care has shown to be a formidable task. In an attempt to move beyond conflicting terminology found in the literature, we delineate terms and suggest a standardized nomenclature. Further, we maintain that addressing the three principal worlds of healthcare (clinical, operational, financial) is requisite in making sense of the spectrum of available implementations and ultimately transitioning collaborative care into the mainstream. Using a model that deconstructs process metrics into factors/barriers and generalizes behavioral health provider roles into major categories provides a framework to empirically discriminate between implementations across specific settings. This approach offers practical guidelines for care sites implementing integrated and collaborative care and defines a research framework to produce the evidence required for the aforementioned clinical, operational and financial worlds of this important movement.     

TOWARD AN EPISTEMOLOGY OF CERTAIN SUBSTANTIVE A PRIORI TRUTHS

Abstract: This article explains and motivates an account of one way in which we might have substantive a priori knowledge in one important class of domains: domains in which the central concepts are response-dependent. The central example will be our knowledge of the connection between something's being harmful and the fact that it is irrational for us to fail to be averse to that thing. The idea is that although the relevant responses (basic aversion in the case of harm, and a kind of interpretive failure in the case of irrationality) are produced by independent psychological mechanisms, they have distal causes that turn out to be related in ways that—once language enters the picture—yield epistemically accessible necessary connections between the referents of their corresponding terms.     

Trauma Recovery in the Transgender and Gender Diverse Community: Extensions of the Minority Stress Model for Treatment Planning

Transgender and gender diverse (TGD) populations, including those that do not identify with gender binary constructs (man or woman) are increasingly presenting for treatment of posttrauma sequelae. Providers who offer services for trauma survivors including posttraumatic stress disorder (PTSD) treatment should be knowledgeable about evidence-based care and have some cultural familiarity with TGD experiences. Indeed, the Minority Stress Model suggests that the combination of distal and proximal minority stressors can combine to produce increased mental health symptoms as compared with cisgender peers, though this model has yet to be fully tested. Clients often present with a complicated picture of experiences, which include a variety of minority stressors, microaggressions, discrimination, and traumatic events that can all be related to their identity. However, conceptualizations of trauma treatment in the context of extensive minority stress are lacking. This paper summarizes the existing literature and offers guidance to mental health providers who are well positioned to address stigma, discrimination, violence, and related symptoms that arise from micro-, mezzo- and macro-level spheres of TGD individuals’ experience.     

Skin picking in patients with obesity: Associations with impulsiveness and self‐harm

Previous studies suggest elevated prevalence rates of skin picking and self‐harm in patients with obesity compared to individuals in the general population. Hence, further studies should investigate prevalence rates and correlates of skin picking in this population – especially its differentiation to self‐harm. Skin picking and obesity are both associated with specific facets of impulsiveness. This relation should be explored to shed light on potentially shared mechanisms in etiology. Therefore, the present study examined the occurrence of skin picking and its associations with impulsiveness and self‐harm in a sample of pre‐bariatric surgery patients with obesity class II/III. Within the routine preoperative psychiatric evaluation, a total of 139 bariatric surgery candidates (78% female, BMI range 35–69) completed a self‐report questionnaire assessing sociodemographic variables, anxiety, depression, self‐harm, impulsiveness, and skin picking severity (urges: frequency, intensity, controllability; behavior: frequency, intensity, controllability; resistance, emotional distress, impairment, and avoidance). Ten participants (7.2% of the sample) reported recurrent skin picking leading to skin damage, repeated attempts to decrease skin picking, and psychosocial impairment (emotional distress, impairment in functional areas, avoidance) due to skin picking. In line with previous findings, skin picking severity shows a medium correlation with attentional impulsiveness. The majority of self‐harm types were not associated with skin picking severity. The current study reveals a high occurrence of skin picking compared to the general population. The results indicate an association between skin picking severity and attentional impulsiveness. Further research is needed to investigate the differentiation of skin picking and self‐harm in more detail.     

Temperament, executive functions, and the allocation of attention to punishment feedback in passive avoidance learning

Several theories have been proposed to account for the apparent non-responsiveness to punishment cues or aversive events demonstrated by members of some disinhibited groups. Included among these theories are those that emphasize individual differences in temperament, temperament-related biases associated with the allocation of attentional resources, and impairments in executive functions. This study examined the relative contribution of each of these variables to the prediction of passive avoidance errors (PAEs, or failures to inhibit responding to punishment cues) during a computerized go/no-go task. Variations in temperament, attentional allocation to punishment feedback, and executive functions were found to independently and additively contribute to the prediction of PAEs in a mixed sample of men and women recruited at a university campus (n=145). Results from this study, therefore, support multiple theoretical perspectives on PAEs as assessed by the go/no-go experimental paradigm.     

Self‐Harm Focus Leads to Greater Collective Guilt: The Case of the U.S.‐Iraq Conflict

Collective guilt from harm one's group has caused an out‐group is often undermined because people minimize or legitimize the harm done (i.e., they generate exonerating cognitions). When a group action has harmed both the in‐group and an out‐group, focusing people on “self‐harm”—ways in which the in‐group has harmed itself—may elicit more collective guilt because self‐harm is less likely to be exonerated. In Study 1, American participants who focused on how the invasion of Iraq had harmed the United States expressed greater collective guilt over harm inflicted on the people of Iraq than those who focused on Iraqi suffering. Study 2 showed that this effect is due to reductions in exonerating cognitions among people focused on self‐harm. We consider the implications of these findings for intergroup reconciliation, particularly in situations where two groups have been involved in open conflict.     

Written on the body: Deliberate self-harm as communication

The inability to manage distress would be problematic at any time; but it is especially problematic when distress is accompanied by (or made up of) feelings of rage, cruelty and self-hatred. I will argue here that people who self-harm are communicating rage and hostility to themselves and others in ways that often leave them frustrated and hopeless; and leave professional carers aghast. I will conclude with some ideas about psychological therapies that may help such people; drawing very much upon the work of colleagues in the forensic psychotherapy field: especially Anne Aiyegbusi (2004 Aiyegbusi, A. 2004. “Forensic mental health nursing: Care with security in mind”. In A matter of security: The application of attachment theory to forensic psychiatry and psychotherapy, Edited by: Pfafflin, F. and Adshead, G. 167–192. London: Jessica Kingsley.  [Google Scholar]), Anna Motz (2008 Motz, A. 2008. The psychology of female violence: Crimes against the body, 2nd edn, Hove: Brunner Routledge.  [Google Scholar], 2009 Motz, A. 2009. Managing self harm: Psychological perspectives, London: Routledge.  [Google Scholar]) and Estela Welldon (1992).