Social influence, marriage, and the heart: cardiovascular consequences of interpersonal control in husbands and wives.

Human and experimental animal research suggests that social stress in general--and chronic, effortful attempts to exert social control in particular--may contribute to cardiovascular disease. We examined the effects of exerting social influence or control on cardiovascular responses in married couples. Compared to husbands discussing a problem with their wives, husbands attempting to influence or persuade their wives displayed larger increases in systolic blood pressure (SBP) before and during the discussion. Furthermore, these physiological effects were accompanied by increases in anger and a more hostile and coldly assertive interpersonal style. Although wives who engaged in social influence attempts displayed generally similar behavior, they did not show the elevated SBP response or anger. We discuss the results in terms of the social context of cardiovascular reactivity and potential marital factors in cardiovascular health.     

Randomized controlled trial of an intervention to prevent adherence failure among HIV-infected patients initiating antiretroviral therapy.

OBJECTIVE: Compare the efficacy of a multicomponent social support intervention to standard-of-care counseling on medication adherence among HIV-infected patients initiating antiretroviral therapy. DESIGN: Randomized controlled trial. Generalized estimating equations tested for differences in the percentage of participants achieving 90% adherence. MAIN OUTCOME MEASURES: Pill-taking, electronically monitored over 6 consecutive months; plasma viral load (VL), assessed at 3 and 6 months following initiation of therapy. RESULTS: Of 226 participants who were randomized and began the trial, 87 (38%) were lost to the study by 6 months. The proportion of adherent participants declined steadily over time, with no time by group interaction. Sustained adherence was associated with increased odds of achieving an undetectable VL (OR=1.78; 95% CI=1.01, 3.13). In intention-to-treat analyses, a larger proportion of the intervention group than the control group was adherent (40.15% vs. 27.59%, p=.02) and achieved an undetectable VL p=.04). However, the majority of participants who remained on study experienced some reduction in VL (>or=1-log drop or undetectable), regardless of experimental condition. CONCLUSION: The multicomponent social support intervention significantly improved medication adherence over standard-of-care counseling; evidence for improved virologic outcomes was inconsistent. Early discontinuation of care and treatment may be a greater threat to the health of HIV patients than imperfect medication-taking.     

When the happy victimizer says sorry: Children's understanding of apology and emotion

Previous research suggests that children gradually understand the mitigating effects of apology on damage to a transgressor's reputation. However, little is known about young children's insights into the central emotional implications of apology. In two studies, children ages 4–9 heard stories about moral transgressions in which the wrongdoers either did or did not apologize. In Study 1, children in the no‐apology condition showed the classic pattern of ‘happy victimizer’ attributions by expecting the wrongdoer to feel good about gains won via transgression. By contrast, in the apology condition, children attributed negative feelings to the transgressor and improved feelings to the victim. In Study 2, these effects were found even when the explicit emotion marker ‘sorry’ was removed from the apology exchange. Thus, young children understand some important emotional functions of apology.     

Attitudes,Tracing, and Control

There is an apparent tension in our everyday moral responsibility practices. On the one hand, it is commonly assumed that moral responsibility requires voluntary control: an agent can be morally responsible only for those things that fall within the scope of her voluntary control. On the other hand, we regularly praise and blame individuals for mental states and conditions that appear to fall outside the scope of their voluntary control, such as desires, emotions, beliefs, and other attitudes. In order to resolve this apparent tension, many philosophers appeal to a tracing principle to argue that agents are morally responsible (only) for those attitudes whose existence can be traced back, causally, to a voluntary action or omission in the past. My aim in this article is to critically evaluate this tracing strategy and to argue that it gives us a misguided picture of when and why we are morally responsible for our attitudes. I argue that we should accept a ‘judgment sensitivity’ condition of moral responsibility rather than a ‘voluntary control’ condition, and defend this account against various objections.     

The Rate and Characteristics of Suicide Attempters in the Native Hawaiian Adolescent Population

Native Hawaiian high school students, N = 1779, were surveyed for symptoms of psycho-pathology and suicide attempts in the previous 6 months. Seventy-seven (4.3%) of the students reported making a suicide attempt. There were no significant differences in prevalence rates for males and females. Depression, anxiety, aggression, substance abuse symptoms, and low family support, but not peer support, were significantly correlated with suicide attempts. On logistic regression, depression, substance abuse, and family support independently predicted attempts. The lack of gender difference may indicate a cultural characteristic of the Hawaiian population that differentiates it from mainstream American populations but likens it to the Native American population.