Interpreting cross-sectional data on stages of change

Abstract

The vast majority of studies investigating stage theories of health behaviour such as the transtheoretical model have used a cross-sectional research design. Participants are classified into stages and compared on theoretically relevant variables. This paper discusses the proper interpretation of cross-sectional data on stages of change. Linear patterns are not consistent with the stage model assumption that different causal factors are important at different stages but discontinuity patterns (patterns that do not show consistent increments or decrements across stages) can be diagnostic of a stage model. Researchers who use cross-sectional designs should specify predictions concerning the patterns to be expected under a stage model and under possible rival models, and interpret their data accordingly. Wherever possible, they should conduct prospective longitudinal and experimental studies which enable stronger inferences to be drawn.     

Counter-Closure

The focus of this paper is the prima facie plausible view, expressed by the principle of Counter-Closure, that knowledge-yielding competent deductive inference must issue from known premises. I construct a case that arguably falsifies this principle and consider five available lines of response that might help retain Counter-Closure. I argue that three are problematic. Of the two remaining lines of response, the first relies on non-universal intuitions and forces one to view the case I construct as exhibiting a justified, true belief to which none of the usual diagnoses of knowledge failure in Gettier cases apply. The second line involves claiming that Fake Barns and its ilk are misdiagnosed by epistemological orthodoxy as Gettier cases. We are thus confronted by a trilemma: either the case I discuss undermines the first-blush plausible principle of Counter-Closure; or the case I discuss instantiates a novel kind of Gettier case; or a popular conception of a key range of alleged Gettier cases must be rejected. No matter which horn we choose, the case points to a philosophically curious conclusion.     

What,and Where,Luck is: A Response to Jennifer Lackey

In ‘What Luck Is Not’, Lackey presents counterexamples to the two most prominent accounts of luck: the absence of control account and the modal account. I offer an account of luck that conjoins absence of control to a modal condition. I then show that Lackey's counterexamples mislocate the luck: the agents in her cases are lucky, but the luck precedes the event upon which Lackey focuses, and that event is itself only fortunate, not lucky. Finally I offer an account of fortune. Fortune is luck-involving, and therefore easily confused with luck, but it is not itself lucky.     

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.     

Internet Infidelity

SUMMARY

We used a multi-phase Delphi methodology to identify and explore critical issues, interventions, and gender differences in the treatment of Internet infidelity. We developed three representative vignettes related to Internet infidelity and asked twenty experts in extramarital affairs and/or sex addiction to respond to them, both through ratings and open-ended comments. We found little agreement among the experts. We discuss the unique features of Internet relationships, the areas of agreement and disagreement that we found among the experts, and the implications of our findings and the nature of Internet infidelity for both practice and training in marriage and family therapy.     

Metanoia

SUMMARY

The author draws on her experience working with individual men who are violent to their partners to think about the problem of international violence. A parallel is drawn between a man's feeling of “entitlement” to forcefully keep his partner “in line” and feelings of national entitlement to engage in violence to force one group's agenda on another. The differences between morals and taboos are discussed underscoring the community value of that which becomes socially and ethically “unthinkable.”     

Coping mediates between social support,neuroticism, and depression after earthquake and examination stress among adolescents

Abstract

The objective of this study was to investigate the mediating role of coping strategies in the relationships between neuroticism, social support, and depression in two groups of adolescents: earthquake group and examination group. Adolescents facing earthquake stress (earthquake group, N=219) completed measures of neuroticism, perceived social support, coping strategies, and self-rating depression. Similarly, adolescents facing examination stress (examination group, N=241) completed the same measures. Results indicated that the earthquake group reported more use of secondary control engagement coping, whereas the examination group reported more use of primary control engagement coping. In addition, neuroticism was more strongly associated with coping in earthquake group and coping strategies explained significantly larger part of the relationship between neuroticism and depression. In contrary, perceived social support was more strongly associated with coping in examination group, and coping strategies explained significantly larger part of the relationship between perceived social support and depression.     

Experimentally testing Taylor's stress,coping and adaptation framework

Abstract

Taylor (1995) constructed a comprehensive framework of stress and adaptation, which considers internal and external resources/impediments as moderators, based on previous studies and models. However, most past research used correlation designs and has not taken into account all of the framework's components within one study. This study tested the effects of the event (minor, major), primary appraisal (benign, severe), coping (problem-focused coping (PFC) versus emotion-focused coping), external resources (with/without social support), and internal impediments (hostility), on estimated distress (dependent variable) in written imagined stressful daily scenarios. All components except hostility were experimentally manipulated within subjects in the scenarios. The scenarios were rated by 281 Dutch students. The variables event, appraisal, and social support significantly and independently affected estimated distress. Event and appraisal synergistically interacted in relation to estimated distress. Finally, appraisal interacted with coping such that the distress-reducing effects of PFC occurred only in benign events, while coping did not affect estimated distress in severely appraised events. This study experimentally tested most components of Taylor's framework, and showed that events, appraisal, and social resources were independent determinants of estimated distress, and that appraisal interacts in a complex manner with the event and with coping.