Fragile promise: The role of justification in promise-breaking

People who consider themselves moral sometimes use self-serving justifications to rationalize their selfish behaviours. Previous studies have tested the role of ambiguity in justifying wrongdoings, but it remains unclear whether ambiguity also plays a role in justifying promise-breaking behaviour and whether heterogeneity exists. To investigate justification in promise-breaking, we introduced a new experimental paradigm called the card-guessing task and used hierarchical cluster analysis to classify participants based on their promise-breaking decisions in unambiguous and ambiguous conditions. Experiment 1 revealed three clusters of solutions: Cluster 1 always kept their promises (i.e., keepers); Cluster 2 only exploited the vague promises and broke their promises in the ambiguous condition (i.e., intermediates); Cluster 3 tended to take advantage of vague promises and broke their promises irrespective of ambiguity (i.e., breakers). Experiment 2 confirmed that participants in the three clusters differed in their norm-abiding preferences and social value orientations. Keepers were more altruistic and had a stronger sense of norm compliance than intermediates and breakers. In conclusion, our study demonstrates that self-serving justifications were more likely to be employed by people who are moderately sensitive to deviation from social norms, which has implications for strategic interventions and policy formulation concerning unethical behaviour.     

Treating Young Adult Depression With Text-Delivered Cognitive Behavioral Therapy: A Pilot Randomized Clinical Trial

Young adults (ages 18 to 25) in the U.S. suffer from the highest rates of past-year major depressive episode and are the least likely to receive treatment compared to other age groups. As such, we examined the feasibility, acceptability, and efficacy of a text-message delivered cognitive behavioral therapy: CBT-txt with young adults. The study was a 2-month pilot RCT to test a 4-week intervention for depression that contained 197 text messages (average 12 texts every other day). The sample, recruited via Facebook and Instagram, was 102 U.S. young adults who presented with at least moderate depressive symptomatology. Assessments occurred at baseline prior to randomization and at 1 and 2 months post enrollment. The primary outcome, severity of depressive symptoms, was assessed using the Beck Depression Inventory II. Feasibility benchmarks were met and participants reported high levels of engagement with and acceptability of the intervention. Logistic regression indicated that treatment participants were three times as likely to have minimal or mild depression symptoms at 2 months compared to waitlist control participants. Latent change score modeling found that the strongest significant treatment effect appeared at the 1-month follow-up period, particularly for participants who began with severe depressive symptoms. Mediation analysis revealed significant indirect treatment effects of increases in behavioral activation on reducing depressive symptoms, suggesting a mechanism of change. Limitations were that the sample was relatively small and consisted of primarily women. These results provide initial evidence for the feasibility, acceptability, and efficacy of a text-delivered treatment for young adult depression.     

The elderly and high technology medicine: A case for individualized,autonomous allocation

The issues involved in decision making about the aggressiveness of future medical care for older persons are explored. They are related to population trends, the heterogeneity of older persons and a variety of factors involved in individual preferences. Case studies are presented to illustrate these points, as well as a review of pertinent literature. The argument is offered that, considering these many factors, a system of flexible, individualized care by informed patient preference, is more rational than the rationing of technological services by age.     

Family preservation using multisystemic treatment: Long-term follow-up to a clinical trial with serious juvenile offenders

In a randomized clinical trial, multisystemic family preservation was shown to significantly reduce rates of criminal activity and incarceration in a sample of 84 serious juvenile offenders and their multi-need families. In the current study, archival records were searched for re-arrest an average of 2.4 years post-referral. Survival analysis showed that youths who received multisystemic family preservation were less likely to be re-arrested than were youths who had received usual services. Such results represent the first controlled demonstration that family preservation, when delivered via a clearly specified treatment model, has lasting effects with serious juvenile offenders. Implications for family preservation and juvenile justice research are discussed.     

INCREASING CALORIE CONSUMPTION IN CHILDREN WITH CYSTIC FIBROSIS: REPLICATION WITH 2-YEAR FOLLOW-UP

Three mildly malnourished children with cystic fibrosis and their parents participated in a behavioral group-treatment program that focused on promoting and maintaining increased calorie consumption. Treatment included nutritional education, gradually increasing calorie goals, contingency management, and relaxation training, and was evaluated in a multiple baseline design across four meals. Children's calorie intake increased across meals, and total calorie intake was 32% to 60% above baseline at posttreatment. Increased calorie consumption was maintained at the 96-week follow-up (2 years posttreatment). The children's growth rates in weight and height were greater during the 2 years following treatment than the year prior to treatment. Increases in pace of eating and calories consumed per minute were also observed 1 year posttreatment. These findings replicated and extended earlier research supporting the efficacy of behavioral intervention in the treatment of malnutrition in children with cystic fibrosis.     

EFFECTS OF CHOSEN VERSUS ASSIGNED JOBS ON THE WORK PERFORMANCE OF PERSONS WITH SEVERE HANDICAPS

We evaluated the effects of several choice-related variables on the work performance of adults with severe handicaps. After assessing client work preferences, three choice-related situations were presented: (a) providing clients with the opportunity to choose a work task, (b) assigning a preferred task, and (c) assigning a nonpreferred task. Results indicated that clients attended to work tasks almost twice as much when they chose their tasks and when assigned to work on preferred tasks versus when assigned to work on nonpreferred tasks. Results are discussed regarding the need to assess systematically the effects of choice-related variables.     

The expected likelihood of transitivity of preference

May's model of pairwise preference determination is used to assess the expected likelihood that a subject's pairwise preference comparisons on three alternatives will be transitive. A closed form representation for this expected likelihood is obtained for each situation considered. When the subject is assumed to act precisely according to rankings on attributes with May's model, the computed expected likelihoods the relatively large. When the subject becomes a probabilistic chooser, as defined in a specific manner, expected likelihoods of transitivity decrease significantly from corresponding values with May's model. For a probabilistic Chooser, there is a significant likelihood that the subject might yield transitive pairwise preferences substantially different than the results suggested by May's model.This research was supported by a grant from the General University Research Program and through a fellowship from the Center for Advanced Study, both of the University of Delaware. Very helpful input from John H. Antil, Meryl P. Gardner, and James M. Munch is also acknowledged.     

Cognitive rehabilitation of chronic alcohol abusers

The current literature suggests that individuals who chronically abuse alcohol exhibit a wide variety of cognitive deficits resulting from cerebral dysfunction that is either directly or indirectly related to their alcohol consumption history. Cognitive deficits have been hypothesized as having implications for standard alcohol treatment efficacy as they may directly affect cognitively impaired individuals’ abilities to utilize various treatment modalities. Although evidence is accumulating that suggests this is actually the case, the majority of alcohol treatment programs neither directly consider the impact cognitive deficits have on treatment efficacy nor do they employ cognitive rehabilitation treatment strategies to remediate identified cognitive deficits. Few studies exist that investigate the remediability of neurobehavioral deficits or the efficacy of integrating cognitive rehabilitation strategies into more traditional treatment programs. Empirical investigations conducted to date indicate that some cognitive deficiencies secondary to alcoholism are amenable to cognitive rehabilitation and this remediation is generalizable. Rigorous well-controlled treatment outcome investigations are needed in order to determine the efficacy of cognitive rehabilitation techniques in naturalistic settings using ecological outcome measures. Also, emphasis should be placed on integrating cognitive rehabilitation techniques with proven efficacy into traditional alcoholism treatment programs.