Hope,Social Support,and Postpartum Depression: Disentangling the Mediating Effects of Negative Affectivity

We examined the potentially mediating effects of negative affectivity (NA) on the hope–depression relationship among a sample of postpartum women. We also assessed the social support reported by these women and examined the possible mediating effects of NA on the social support–postpartum depression relationship. Correlational analyses of data obtained from women (N = 98) who had given birth in the previous 6 months revealed that NA did not mediate either hope or social support in the prediction of postpartum depression. Hope accounted for a significant degree of variance in postpartum depression. These data suggest that hope has palliative effects among women following childbirth and these effects are not nullified or explained by emotional predispositions.     

The Role of Temperament in the Etiology of Child Psychopathology

A substantial proportion of children and adolescents come to suffer from psychological disorders. This article focuses on the temperament factors that are involved in the pathogenesis of child psychopathology. It is argued that besides the reactive temperament factor of emotionality/neuroticism, the regulative process of effortful control also plays an important role in the etiology and maintenance of internalizing and externalizing problems in youths. More specifically, vulnerability to child psychopathology is determined by a temperament that is characterized by high levels of emotionality/neuroticism and low levels of effortful control. Models are hypothesized in which reactive and regulative temperament factors either have interactive or additive effects on the development of psychological disorders in children, and conceptualized in terms of a developmental psychopathology perspective. Directions for future research and clinical implications of this temperamental view on psychopathology are discussed.     

The Duty to Eradicate Global Poverty: Positive or Negative?

In World Poverty and Human Rights, Thomas Pogge argues that the global rich have a duty to eradicate severe poverty in the world. The novelty of Pogges approach is to present this demand as stemming from basic commands which are negative rather than positive in nature: the global rich have an obligation to eradicate the radical poverty of the global poor not because of a norm of beneficence asking them to help those in need when they can at little cost to themselves, but because of their having violated a principle of justice not to unduly harm others by imposing on them a coercive global order that makes their access to the objects of their human right to subsistence insecure. In this paper, I claim that although Pogge is right in arguing that negative duties are crucial in an account of global justice, he is wrong in saying that they are the only ones that are crucial. Harming the global poor by causing their poverty provides a sufficient but not a necessary condition for the global rich to have a duty of justice to assist them. After engaging in a critical analysis of Pogges argument, I conclude by suggesting the need for a robust conception of cosmopolitan solidarity that includes positive duties of assistance which are not mere duties of charity, but enforceable ones of justice.     

Negative Affect in Victimized Children: The Roles of Social Withdrawal, Peer Rejection, and Attitudes Toward Bullying

This study evaluated the validity of mediating pathways in predicting self-assessed negative affect from shyness/social withdrawal, peer rejection, victimization by peers (overt and relational), and the attitude that aggression is legitimate and warranted. Participants were 296 3rd through 5th graders (156 girls, 140 boys) from 10 elementary schools. Self-report measures of victimization, attitudes, and negative affect, and a teacher-report measure of shyness/social withdrawal and peer rejection were completed during the spring semesters of 2 consecutive years. Hierarchical regression analyses supported the mediational model in predicting negative affect at Time 2. However, an increase in negative affect over the 12-month study period was best accounted for by direct effects of increased victimization and changes in attitudes/attributions regarding aggression. Implications for the planning of school interventions designed to interrupt these victimization-maladjustment pathways are discussed.     

Measuring Impulsivity in School-Aged Boys and Examining Its Relationship with ADHD and ODD Ratings

Seven different laboratory measures of impulsivity were administered to a group of 165 school-aged boys. Parents' and teachers' ratings of Attention Deficit and Hyperactivity Disorder and Oppositional/Defiant Disorder were also obtained. Factor analyses of impulsivity measures revealed the existence of a strong Inhibitory Control Factor including measures derived from Stop Task, the Continuous Performance Test, the Matching Familiar Figures Test, and the Circle Tracing Task. Other forms of impulsivity like resistance to interference, the Wisconsin Card Sorting Test and efficiency in the DRL Task loaded on a second independent factor. The Inhibitory Control factor was correlated with ADHD ratings, whereas the second factor was slightly related to the presence of ODD symptoms. Discussion is focused on the relevance of inhibitory control in impulsivity and ADHD research.     

The Double Life of Double Effect

The U.S. Supreme Court's majorityopinion in Vacco v. Quill assumes thatthe principle of double effect explains thepermissibility of hastening death in thecontext of ordinary palliative care and inextraordinary cases in which painkilling drugshave failed to relieve especially intractablesuffering and terminal sedation has beenadopted as a last resort. The traditionaldoctrine of double effect, understood asproviding a prohibition on instrumental harmingas opposed to incidental harming or harming asa side effect, must be distinguished from otherways in which the claim that a result is notintended might be offered as part of ajustification for it. Although double effectmight appropriately be invoked as a constrainton ordinary palliative care, it is not clearthat it can be coherently extended to justifysuch practices as terminal sedation. A betterapproach would reconsider double effect'straditional prohibition on hastening death as ameans to relieve suffering in the context ofacute palliative care.     

The placebo effect in popular culture

This paper gives an overview of the placebo effect in popular culture, especially as it pertains to the work of authors Patrick O’Brian and Sinclair Lewis. The beloved physician as placebo, and the clinician scientist as villain are themes that respectively inform the novels, The Hundred Days and Arrowsmith. Excerpts from the novels, and from film show how the placebo effect, and the randomized clinical trial, have emerged into popular culture, and evolved over time. An earlier version of this paper was presented at an international conference, “Placebo: Its Action and Place in Health Research Today,” held in Warsaw, Poland on 12–13 April, 2003.     

The concept of placebo

This paper attempts to define the concept of placebo as it is used in the clinical context The author claims that X is a placebo if and only if X has such a property d_p, that whenever in a therapeutic situation T a stimulus S appears, then in attending conditions A, it will cause a beneficial reaction R in the patient. Formally, the same structure may be used to define any pharmacologically active drug. The main difference between the drug and a placebo is in the range of possible substitutions for X and the property d. For the active drug there is only one possible substitution for X and property d and it can be scientifically explained why, and how the drug works. In the case of a placebo a set of possible substitutions for X and d is open, and so far it is impossible to offer any scientifically valid explanation of the action mechanism of placebo.     

The necessity and the value of placebo

The use of placebo in clinical trials has been repeatedly challenged as being unacceptable from an ethical point of view. The present paper responds to this criticism by taking up the issue in the light of the pertinent provisions of the Helsinki Declaration. Examples from different therapeutic areas are given that highlight the importance of placebo in situations in which its use is acceptable according to the Declaration. Particular emphasis is given to the question of active control trials, which, under conditions of low assay sensitivity, may become an ethically less acceptable approach than the use of a placebo control. An earlier version of this paper was presented at an international conference, “Placebo: Its Action and Place in Health Research Today,” held in Warsaw, Poland on 12–13 April, 2003.     

Adjustment to chronic low back pain--the relative influence of fear-avoidance beliefs, catastrophizing, and appraisals of control

The present study investigated the relative extent to which patients' adjustment to chronic low back pain (CLBP) was influenced by their fear-avoidance beliefs, their tendency to catastrophize, and their appraisals of control. Eighty-three CLBP patients completed a series of self-report measures before participating in a physical therapist-led intervention. Hierarchical multiple regression analyses revealed that patients' perceptions of their ability to decrease pain explained a small, but statistically significant, proportion of the variance in pain intensity. In addition, patients' levels of catastrophizing, as well as their fear-avoidance beliefs about both work and physical activity, were independently associated with levels of disability. Interestingly, however, when exploring the relative predictive utility of these three psychological factors, it became evident that fear-avoidance beliefs about physical activity (FABs-PA) were the only significant predictor of patients' disability. Specifically, those patients who exhibited higher levels of FABs-PA tended to report greater levels of disability, even after adjusting for age, sex and pain intensity.