The Ethics of Type 1 Diabetes Prediction and Prevention Research

There are approximately one million cases oftype 1 diabetes in the US, and the incidenceis increasing worldwide. Given that two-thirdsof cases present in childhood, it is criticalthat prediction and prevention research involvechildren. In this article, I examine whethercurrent research methodologies conform to theethical guidelines enumerated by the NationalCommission for the Protection of Human Subjectsof Biomedical and Behavioral Research, andadopted into the federal regulations thatprotect research subjects. I then offer twopolicy recommendations to help researchersdesign studies that conform to these ethicalrequirements.     

Learning from the law to address uncertainty in the precautionary principle

Environmentalists have advocated the Precautionary Principle (PP) to help guide public and private decisions about the environment. By contrast, industry and its spokesmen have opposed this. There is not one principle, but many that have been recommended for this purpose. Despite the attractiveness of a core idea in all versions of the principle—that decision-makers should take some precautionary steps to ensure that threats of serious and irreversible damage to the environment and public health do not materialize into harm—even one of the most widely endorsed principles needs considerable specification and refinement before it can be used. Moreover, the PP is an approach or guide to utilizing scientific evidence in social or legal decision-making contexts. In this it does not differ in kind from other approaches to using factual information such as in the law. The law provides some models for different strategies to guide decision-making under uncertainty when factual issues cannot be resolved with certainty. These in turn can help guide the formulation of different versions of PP and help clarify some presuppositions of the principle. Once some plausible versions of PP are articulated, I suggest some applications to existing environmental problems.     

Behavioral and pharmacological variables affecting risky choice in rats.

The effects of manipulations of response requirement, intertrial interval (ITI), and psychoactive drugs (ethanol, phencyclidine, and d-amphetamine) on lever choice under concurrent fixed-ratio schedules were investigated in rats. Responding on the "certain' lever produced three 45-mg pellets, whereas responding on the "risky" lever produced either 15 pellets (p = .33) or no pellets (p .67). Rats earned all food during the session, which ended after 12 forced trials and 93 choice trials or 90 min, whichever occurred first. When the response requirement was increased from 1 to 16 and the ITI was 20 s, percentage of risky choice was inversely related to fixed-ratio value. When only a single response was required but the ITI was manipulated between 20 and 120 s (with maximum session duration held constant), percentage of risky choice was directly related to length of the ITI. The effects of the drugs were investigated first at an ITI of 20 s, when risky choice was low for most rats, and then at an ITI of 80 s, when risky choice was higher for most rats. Ethanol usually decreased risky choice. Phencyclidine did not usually affect risky choice when the ITI was 20 s but decreased it in half the rats when the ITI was 80 s. For d-amphetamine, the effects appeared to he related to baseline probability of risky choice; that is, low probabilities were increased and high probabilities were decreased. Although increase in risky choice as a function of the ITI is at variance with previous ITI data, it is consistent with foraging data showing that risk aversion decreases as food availability decreases. The pharmacological manipulations showed that drug effects on risky choice may be influenced by the baseline probability of risky choice, just as drug effects can be a function of baseline response rate.     

Culture Is More than a Static Residual: Introduction to the Special Section on Culture and Foreign Policy

The literature on international relations frequently refers to culture in broad, macro-level ways to explain what cannot be explained by economic or military power. The assumptions that culture is simple, uniform and the opposite of power are, in the view of the authors, erroneous. Also, the authors note that there is a lack of scholarly interaction among psychologists interested in cross-cultural phenomena and international relations specialists interested in questions of identity and foreign policy. As an introduction to a special section on culture and foreign policy, this article calls for more communication among these scholarly communities; provides a set of observations about foreign policy and culture understood as a complex, dynamic concept; and calls for specific kinds of studies to better understand foreign policy in the context of cultural complexity and richness.     

Pathways to Risk Among Inner-City African-American Adolescent Females: The Influence of Gang Membership

Differential rates of participation in three categories of risk behaviors (i.e., sexual activity, substance use, violence) were explored, comparing gang members to nonmembers, within a sample of 1,143 inner-city African American adolescent females. The relationship between gang membership and risk behavior also was examined, by exploring the association between a variety of microsystemic influences (e.g., gang, family, school) and participation in risk behaviors. MANOVA analyses indicated that gang members, relative to nonmembers, reported higher rates of participation in each of the three categories of risk behaviors. Stepwise linear regression analyses indicated that gang membership was the variable with the most consistent predictive ability, across all categories of risk, as it entered early in all equations and remained in all three final models after controlling for other statistically significant contextual variables. Findings suggest that intervention efforts aimed at reducing adolescent females' participation in sexual activity, substance use, and violence should consider the influence of gang membership on the participation in these behaviors.     

Conduct Disorder in Girls: A Review of the Literature

The study of Conduct Disorder (CD) has primarily been limited to boys. The lack of research resulted from a premise that CD in girls was rare. However, CD in girls is a relatively common psychiatric diagnosis, and appears to be associated with several serious outcomes, such as Antisocial Personality Disorder and early pregnancy. Understanding gender differences in the course and severity of CD may lead to important information about etiology. Empirical studies on precursors, developmental course, risk factors and treatment for CD in girls are reviewed, while highlighting similarities and differences between girls and boys. Generally, CD symptoms in girls are stable. Precursors to CD in girls probably include Oppositional Defiant Disorder and temperamental factors, but also may include certain negative cognitions. What distinguishes CD in girls is the high risk they have to develop comorbid conditions, especially internalizing disorders. Risk factors for CD in girls partly overlap with those known for boys, but some factors appear to be highly salient for girls. Finally, there may be some significant effects of gender on treatment efficacy. Implications of these findings for future etiologic research are discussed.     

Faulty Judgment,Expert Opinion,and Decision-Making Capacity

An assessment of decision-making capacity is the accepted procedure for determining when a person is not competent. An inferential gap exists between the criteria for capacity specific abilities and the legal requirements to understand relevant information and appreciate the consequences of a decision. This gap extends to causal influences on a person'scapacity to decide. Using a published case of depression, we illustrate that assessors' uses of diagnostic information is frequently not up to the task of bridging this inferential gap in a justifiable way. We then describe cases of faulty judgement which challenge the understanding of diagnostic causal influences. These cases help to clarify the nature of the expertise required for capacity assessments. In practice, the requirements of decision-making capacity are often abandoned to other considerations due to a lack of requisite expertise. The legal policy supporting decision-making capacity as a means to protective intervention is justified only if the requisite expertise is developed. We propose the requisite expertise to be developed in the long term as a distinct multidisciplinary endeavour.     

The Burden of Dementia: A Medical and Research Perspective

Alzheimer's disease remains the most common form of dementia. Dementia symptoms vary depending on individual personality, life experience, and social and cultural influences. As dementia progresses, involvement of multi-disciplinary health care professionals is needed to manage the disease. Alzheimer research is progressing rapidly. While 5% of all Alzheimer's disease may be genetically determined, the majority is not. Susceptibility genes can reveal the risk of contracting Alzheimer's disease. Early life risk factors such as education, nutrition, and vascular disease may increase the likelihood of dementia in later life. In the United States, two acetylcholinesterase inhibitors have been approved as cognitive enhancers. Possible prevention and symptomatic treatment interventions have focused on estrogen replacement therapy, antioxidants, and anti-inflammatory medications. Research advances have improved the clinical management of dementia. Ethical implications to the patient, family, and society are multiple and remain challenging.     

Psychoanalysis and Diplomacy: Part III. Potentials for and Obstacles Against Collaboration

Given the pervasive influence of Realpolitik over government and the study of international relations, and some inherent difficulties within the field of psychoanalysis, it is not surprising that political science and psychoanalysis remain distant cousins. Part III in this series on diplomacy and psychoanalysis discusses obstacles against collaboration between these two disciplines, but also points to areas where collaboration is possible and can be useful.     

Effects of decision-making on reactions to an evaluational stressor

The present study tested the hypothesis that an opportunity to make decisions enhances perceived control. This hypothesis predicts that decision-making will reduce the adverse effects of stress. Subjects worked on an intellectual task and their stress reactions were assessed using subjective and behavioral measures. Decision-making improved the highly anxious subjects' persistence with the task. This finding supports the hypothesis. However, less anxious subjects persisted less after being allowed to make decisions. Several explanations positing possible cognitive and motivational processes of the less anxious subjects are offered.