"First Published in 1992, Routledge is an imprint of Taylor & Francis, an informa company.".

Adaptation and stress are two main concepts useful for better understanding the phases of illness and health-related human behavior. The two faces of adaptation, adaptation as a process and adaptation as a product, have raised the question of how long the adaptation process will take in cancer trajectories. The care setting transition from clinical-based into home-based cancer care has stressed the role of family caregivers (FCG) in cancer management. This study examines how types of demanded healthcare information affect the FCG’s (...) role in catalyzing the adaptation of female cancer patients. The mindsponge theory was used in conceptual development and results interpretation. Bayesian Mindsponge Framework (BMF) analytics was used for statistical analysis on a dataset of 48 spouses (husbands) and 12 other family members in five congested communities of Surabaya, Indonesia. Results showed that among the six types of demanded healthcare information, FCGs with a higher tendency to demand cancer-specific information are more likely to need support in catalyzing the adaptation of female cancer patients. Meanwhile, FCGs with a higher demand for information on alternative therapies are less likely to need support in catalyzing cancer adaptation. Other types of healthcare information have ambiguous effects on the need for support in cancer adaptation assistance. This study reveals that the demanded cancer-specific information, e.g., cancer’s prognosis or likely outcome, must be prioritized to assist FCG’s role in catalyzing adaptation among female cancer patients. Cancer prognosis and outcomes reflect the future of cancer care results. (shrink)

Cancer care has transitioned from clinical-based to home-based care to support longterm care in a more familiar and comfortable environment. This care transition has put family caregivers (FCGs) in a strategic position as care providers. Cancer care at home involves psychological and emotional treatment at some point, making FCGs deal with the stress of cancer patients frequently. Due to their limited care competencies, they need supportive care from healthcare professionals in cancer stress management. This study aims to examine how types (...) of demanded healthcare information affect the FCG’s role in reducing the stress of female cancer patients. The mindsponge theory was used in conceptual development and interpretation. Bayesian Mindsponge Framework (BMF) analytics were used for statistical analysis on a dataset of 48 spouses (husbands) and 12 other family members in five congested communities of Surabaya, Indonesia. Results showed that among the six types of healthcare information, FCGs with higher demand for cancer-specific information were more likely to need support in reducing the stress of female cancer patients. Meanwhile, FCGs with a higher demand for information about support services were less likely to need support to reduce cancer patients’ stress. Other types of healthcare information have ambiguous effects on the need for support in reducing cancer-induced stress. This study reveals that the demanded cancer-specific information, e.g., cancer prognosis or likely outcome, must be prioritized to assist FCG’s role in managing cancer stress. (shrink)

Background: While sustainability is a key concept in many different domains today, it has not yet been sufficiently emphasized in the healthcare sector. Earlier research shows that ethical values and evidence-based care models create sustainability in care practice. Objective: The aim of this study was to gain further understanding of the ethical values central to the realization of sustainability in care and to create an ethical practice model whereby these basic values can be made perceptible and active in care practice. (...) Research design: Part of the ongoing “Ethical Sustainable Caring Cultures” research project, a hermeneutical application research design was employed in this study. Participants: Dialogues were used, where scientific researchers and co-researchers were given the opportunity to reflect on ethical values in relation to sustainability in care. Findings: An ethical practice model with ethos as its core was created from the results of the dialogues. In the model, ethos is encircled by the ethical values central to sustainability: dignity, responsibility, respect, invitation, and vows. Discussion: The model can be used as a starting point for ethical conversations that support carers’ reflections on the ethical issues seen in day-to-day care work and the work community, allowing ethical values to become visible throughout the entire care culture. Conclusion: It is intended as a tool whereby carers can more deeply understand an organization’s common basic values and what they entail in regard to sustainability in care. (shrink)

The present study combines dehumanization research with the concept of organizational trust to examine how employees perceive various types of maltreatment embedded within the organizational practices that form the ethical climate of an organization. With the help of grounded theory methodology, we analyzed 188 employment exit interview transcripts from an ICT subcontracting company. By examining perceived trustworthiness and perceived humanness, we found that dehumanizing employees can deteriorate trust within organizations. The violations found in the empirical material were divided into animalistic (...) and mechanistic forms of dehumanization and linked to perceived integrity and benevolence, respectively. Based on the results, a model describing the link between dehumanization and trust is presented and discussed in relation to the ways in which perceptions of humanness become rooted in practices and affect the basic assumptions underlying ethical organizational behavior. (shrink)

BackgroundInstitutions of higher learning are persistently struggling with issues of academic dishonesty such as plagiarism, despite the availability of university policies and guidelines for upholding academic integrity.MethodologyThis was a descriptive qualitative study conducted on 37 students of a Healthcare Ethics course at an Australian tertiary institution from February 2016 to October 2018. The purpose of the study was to explore the reasons for plagiarism detected the TurnitinR plagiarism checking software and extensive review of manuscripts. The interviews were conducted in private (...) rooms and in strict confidence. Thematic analysis was manually done.ResultsFour major themes namely, lack of interest; pressure of time with competing priorities; lack of understanding of the policy on academic honesty, and “the determined students” were identified. Sub themes under lack of interest were lack of preparation and effort, low self-efficacy, poor studying techniques, and convenience of internet sources. Under pressure of time, the subthemes were, misplaced priorities, procrastination, high workloads, poor planning, competing interests, and the perception of availability of time at the start of the semester. Regarding lack of understanding of the policy on academic honesty, the subthemes identified were, lake of awareness of plagiarism, lack of awareness of acceptable similarity, conflicting messages from tutors and confusion with high school learning. The determined students were those that either made all effort to reduce plagiarism but still remained high, used the another language at home other than English, had poor paraphrasing techniques or lacked resources for English language editing.ConclusionThere are varied and diverse reasons for plagiarism. There is a need to systematically reinforce and educate students on issues pertaining to academic dishonesty and their associated implications. (shrink)

An onslaught of ethically questionable actions by top government, business, and religious leaders during the 1980s has brought the issue of ethics in decision making to the forefront of public consciousness. This study examines the ethical orientation of university students in four decision-making situations. The dependent variable — ethical orientation toward work-related decisions — is measured through student responses to questions following four work-related vignettes. Possible responses to each vignette are structured to permit categorization of respondents into two broad orientations: (...) egoistic and ethical. Independent variables are academic major, ethics in business orientation, gender, and religiosity. Generally, students tended to choose an ethical orientation over an egoistic orientation in each vignette. Business majors were generally no less likely to choose an ethical orientation toward work-related decisions than nonbusiness majors. Respondents characterized by moral unity (belief in the consistency between general ethical principles and work-related ethical standards) were more likely to have an ethical orientation toward work-related decisions than those subscribing to the amoral theory of business. Females showed a consistent tendency to be more ethically oriented toward work-related decisions than males. Finally, respondents high on religiosity tended to be more ethically oriented. (shrink)

Increased international migration of health professionals is weakening healthcare systems in low‐income countries, particularly those in sub‐Saharan Africa. The migration of nurses, physicians and other health professionals from countries in sub‐Saharan Africa poses a major threat to the achievement of health equity in this region. As nurses form the backbone of healthcare systems in many of the affected countries, it is the accelerating migration of nurses that will be most critical over the next few years. In this paper we present (...) a comprehensive analysis of the literature and argue that, from a human rights perspective, there are competing rights in the international migration of health professionals: the right to leave one's country to seek a better life; the right to health of populations in the source and destination countries; labour rights; the right to education; and the right to nondiscrimination and equality. Creative policy approaches are required to balance these rights and to ensure that the individual rights of health professionals do not compromise the societal right to health. (shrink)

Despite the growing interest in examining the role of religious beliefs as a guide towards environmental conscious actions, there is still a lack of research informed by an analysis of divine messages. This deficiency includes the extent to which ethics for environmental responsibility are promoted within textual divine messages; types of environmental themes promoted within the text of divine messages; and implications of such religious environmental ethics for business practice. The present study attempts to fill this gap by conducting a (...) thorough content analysis of environmental themes within the divine message of Muslims focusing on their related ethical aspects and business implications. The analysis has revealed 675 verses in 84 chapters throughout all 30 parts of the Qur’an, with environmental content relating to the core components of the natural world, i.e. human beings, water, air, land, plants, animals, and other natural resources. This environmental content and its related ethics are grounded on the belief that humans are vicegerents of God on the earth and their behaviours and actions are motivated by earthly and heavenly rewards. Implications of these findings for different sectors/businesses are also highlighted. (shrink)

Global climate change threatens the health, economic prospects, and basic food and water sources of people. A wide range of changes in household energy behaviour is needed to realise a sustainable energy transition. We propose a general framework to understand and encourage sustainable energy behaviours, comprising four key issues. First, we need to identify which behaviours need to be changed. A sustainable energy transition involves changes in a wide range of energy behaviours, including the adoption of sustainable energy sources and (...) energy-efficient technology, investments in energy efficiency measures in buildings, and changes in direct and indirect energy use behaviour. Second, we need to understand which factors underlie these different types of sustainable energy behaviours. We discuss three main factors that influence sustainable energy behaviours: knowledge, motivations, and contextual factors. Third, we need to test the effects of interventions aimed to promote sustainable energy behaviours. Interventions can be aimed at changing the actual costs and benefits of behaviour, or at changing people’s perceptions and evaluations of different costs and benefits of behavioural options. Fourth, it is important to understand which factors affect the acceptability of energy policies and energy systems changes. We discuss important findings from psychological studies on these four topics, and propose a research agenda to further explore these topics. We emphasise the need of an integrated approach in studying the human dimensions of a sustainable energy transition that increases our understanding of which general factors affect a wide range of energy behaviours as well as the acceptability of different energy policies and energy system changes. (shrink)

Visual information conveyed by iconic hand gestures and visible speech can enhance speech comprehension under adverse listening conditions for both native and non‐native listeners. However, how a listener allocates visual attention to these articulators during speech comprehension is unknown. We used eye‐tracking to investigate whether and how native and highly proficient non‐native listeners of Dutch allocated overt eye gaze to visible speech and gestures during clear and degraded speech comprehension. Participants watched video clips of an actress uttering a clear or (...) degraded (6‐band noise‐vocoded) action verb while performing a gesture or not, and were asked to indicate the word they heard in a cued‐recall task. Gestural enhancement was the largest (i.e., a relative reduction in reaction time cost) when speech was degraded for all listeners, but it was stronger for native listeners. Both native and non‐native listeners mostly gazed at the face during comprehension, but non‐native listeners gazed more often at gestures than native listeners. However, only native but not non‐native listeners' gaze allocation to gestures predicted gestural benefit during degraded speech comprehension. We conclude that non‐native listeners might gaze at gesture more as it might be more challenging for non‐native listeners to resolve the degraded auditory cues and couple those cues to phonological information that is conveyed by visible speech. This diminished phonological knowledge might hinder the use of semantic information that is conveyed by gestures for non‐native compared to native listeners. Our results demonstrate that the degree of language experience impacts overt visual attention to visual articulators, resulting in different visual benefits for native versus non‐native listeners. (shrink)

Australia's policy of mandatory indefinite detention of those seeking asylum and arriving without valid documents has led to terrible human rights abuses and cumulative deterioration in health for those incarcerated. We argue that there is an imperative to research and document the plight of those who have suffered at the hands of the Australian government and its agents. However, the normal tools available to those engaged in health research may further erode the rights and well being of this population, requiring (...) a rethink of existing research ethics paradigms to approaches that foster advocacy research and drawing on the voices of those directly affected, including those bestowed with duty of care for this population. (shrink)

Background In the US, many patients forgo recommended care due to cost. The ANA Code of Ethics requires nurses to give care based on need. Therefore, US nurses are compelled to practice in a context which breaches their professional ethical code. Research Objectives This study sought to determine if nurses do care for patients who forgo treatment due to cost (PFTDC) and if so, does this result in an experience of moral distress (MD). Research Design Semi-structured interviews were transcribed and (...) analyzed using a qualitative content analysis. Participants and Research Context A convenience sample of 20 nurses in practice for at least one year from a variety of health care setting participated. Ethical Considerations This project was approved by the Michigan State University Biomedical Institutional Review Board. Results There were 19 female and one male nurse-participants, averaging 47 years old with an average of 10 years in practice. 18 reported caring for PFTDC. These 17 nurse-participants experienced a moderate degree of MD as a result, averaging 5.4 of 10 on the Moral Distress Thermometer. In the interviews, the following themes were identified, strategies to help PFTDC, and the broken US health care system which had the subthemes of preference for business over patient-oriented benefit, PFTDC using the emergency department, and limited support for treatment/management of PFTDC. Conclusions The existence of this phenomenon places the profession of nursing in the US in a position of moral compromise and threatens to corrupt the institution of nursing in the US. (shrink)

This article summarizes the multitude of empirical studies that test ethical decision making in business and suggests additional research necessary to further theory in this area. The studies are categorized and related to current theoretical ethical decision making models. The studies are related to awareness, individual and organizational factors, intent, and the role of moral intensity in ethical decision making. Summary tables provide a quick reference for the sample, findings, and publication outlet. This review provides insights for understanding organizational ethical (...) decision constructs, where ethical decision making theory currently stands, and provides insights for future empirical work on organizational ethical decision making. (shrink)

This paper provides a revisionist account of the authority and power of the criminal mugshot. Dominant theories in the field have tended to focus on the ways in which mugshots have been used as a way of disciplining criminal bodies and rendering them docile. It is argued here that additional emphasis could usefully be placed on stories of resistance in which the monological production site of the prison or police station transforms into a dialogical site, in which the objects of (...) police photography can acquire agency. These issues are explored with particular reference to a set of photographs of English suffragettes acquired by the police for surveillance purposes. The suffragette’s refusal to comply with requests to have their photographs taken is used as a case study through which to examine the ways in which conventions about the form of the mugshot can be subverted, ideas about the types of people who were the object/subject of mugshots disrupted and the assumption of documentary neutrality undermined. (shrink)

This investigation examined how people’s beliefs about the functionality of emotion shape their emotional response and regulatory strategies when encountering distressing events. In Study 1, we present data supporting the reliability and validity of an 8-item instrument, the Help and Hinder Theories about Emotion Measure (HHTEM), designed to assess an individual’s beliefs about the functionality of emotion. Participants who more strongly endorsed a Help Theory reported greater wellbeing, emotional acceptance, and use of reappraisal to regulate emotion. Participants who more strongly (...) endorsed a Hinder Theory reported less wellbeing and more expressive suppression and substance use. In Study 2, we demonstrate that encouraging participants to view emotion as helpful affected their physiological and regulatory response to a distressing event. Participants in the Help Theory condition showed greater physiological reactivity (SCL) during a distressing film than control participants but were more accepting of their emotional response. Shortly after the film, SCL decreased for participants in the Help Theory condition. Compared to control participants, they engaged in less suppression and reported less lingering effect of the film on their mood. Together, these studies suggest that people’s theories about the functionality of emotion influence their reactivity, the strategies they adopt to regulate emotion, and their ability to rebound after distressing events. (shrink)

White identity is in ferment. White, European Americans living in the United States will soon share an unprecedented experience of slipping below 50% of the population. The impending demographic shifts are already felt in most urban centers and the effect is a national backlash of hyper-mobilized political, and sometimes violent, activism with a stated aim that is simultaneously vague and deadly clear: 'to take our country back.' Meanwhile the spectre of 'minority status' draws closer, and the material advantages of being (...) born white are eroding. This is the political and cultural reality tackled by Linda Martín Alcoff in The Future of Whiteness. She argues that whiteness is here to stay, at least for a while, but that half of whites have given up on ideas of white supremacy, and the shared public, material culture is more integrated than ever. More and more, whites are becoming aware of how they appear to non-whites, both at home and abroad, and this is having profound effects on white identity in North America. The young generation of whites today, as well as all those who follow, will have never known a country in which they could take white identity as the unchallenged default that dominates the political, economic and cultural leadership. Change is on the horizon, and the most important battleground is among white people themselves. The Future of Whiteness makes no predictions but astutely analyzes the present reaction and evaluates the current signs of turmoil. Beautifully written and cogently argued, the book looks set to spark debate in the field and to illuminate an important area of racial politics. (shrink)

How we experience space by listening: the concepts of aural architecture, with examples ranging from Gothic cathedrals to surround sound home theater. We experience spaces not only by seeing but also by listening. We can navigate a room in the dark, and "hear" the emptiness of a house without furniture. Our experience of music in a concert hall depends on whether we sit in the front row or under the balcony. The unique acoustics of religious spaces acquire symbolic meaning. Social (...) relationships are strongly influenced by the way that space changes sound. In Spaces Speak, Are You Listening?, Barry Blesser and Linda-Ruth Salter examine auditory spatial awareness: experiencing space by attentive listening. Every environment has an aural architecture.The audible attributes of physical space have always contributed to the fabric of human culture, as demonstrated by prehistoric multimedia cave paintings, classical Greek open-air theaters, Gothic cathedrals, acoustic geography of French villages, modern music reproduction, and virtual spaces in home theaters. Auditory spatial awareness is a prism that reveals a culture's attitudes toward hearing and space. Some listeners can learn to "see" objects with their ears, but even without training, we can all hear spatial geometry such as an open door or low ceiling. Integrating contributions from a wide range of disciplines—including architecture, music, acoustics, evolution, anthropology, cognitive psychology, audio engineering, and many others—Spaces Speak, Are You Listening? establishes the concepts and language of aural architecture. These concepts provide an interdisciplinary guide for anyone interested in gaining a better understanding of how space enhances our well-being. Aural architecture is not the exclusive domain of specialists. Accidentally or intentionally, we all function as aural architects. (shrink)

Differentiating self from other has been investigated at the neural level, and its incorporation into the model proposed Hurley is necessary for the model to be complete. With an emphasis on the feed-forward model in layer 2, we examine the role that self and other disruptions, including auditory verbal hallucinations (AVHs), may have in expanding the model proposed by Hurley.

To understand ethical consumer choice, it should be studied from a holistic, configurational perspective. We use fuzzy-set qualitative comparative analysis (fsQCA) ( N = 715) with a randomized experiment in the context of animal welfare to examine (a) the interdependencies of factors aiding or impeding ethical choice, and (b) whether ethical choices occur differently in a loss frame than in a gain frame. We identify several alternative pathways to ethical choice and non-choice, and within these pathways, we reveal substitution effects, (...) complementarities, and contingencies, reflecting the complexities of consumer choice. Furthermore, we demonstrate how ethical choice results more easily in a loss frame, and non-choice more easily in a gain frame, but how framing can also be irrelevant in certain situations. We contribute theoretically to ethical consumer choice in general and to food choice in particular by showing how it is the interplay of several factors in complex configurations that determines whether the situation favors ethical choice or non-choice. We outline important management and policy implications of our findings. (shrink)

This volume of the Thinker’s Guide Library uncovers current well-intentioned educational trends that inefficiently fragment energy and resources in our K-12 education systems. Critiquing the basic idea behind each of these fads illuminates their real motivations and provides for holistic use.

To guide treatment decisions for incompetent patients who have no advance directives, health care institutions should look to the preferences of their own communities of patients. That is the best way to ensure that incompetent patients' wishes will be followed.

Article published in Stance by Linda Martin Alcoff.

In this article, Ms. Krieger explores the controversy concerning pregnancy disability leave presented by the case of California Federal Savings v. Guerra in light of Thomas Kuhn's model of scientific paradigm change and Carol Gilligan's theory regarding sex differences in moral reasoning. She argues that the controversy reflects a period of paradigm crisis in equality jurisprudence, brought about in part by the recent inclusion of greater numbers of women into the jurisprudential community.

Although tissue plasminogen activator (tPA) is the only medication approved by the United States Food and Drug Administration (FDA) for acute ischemic stroke, there is no consensus about the need for informed consent for its use. As a result, hospitals throughout the U.S. have varying requirements regarding obtaining informed consent from patients for the use of tPA, ranging from no requirement for informed consent to a requirement for verbal or written informed consent. We conducted a study to (1) determine current (...) beliefs about obtaining patients’ informed consent for tPA among a large group of stroke clinicians and (2) identify the ethical, clinical, and organizational factors that influence tPA consent practices. Semi-structured interviews were conducted by trained and experienced investigators and research staff to identify key barriers to implementing acute stroke services. Part of the interview explored current beliefs and practices around informed consent for tPA.This was a multicenter study that included 38 Veterans Health Administration (VHA) hospital locations. Participants were 68 stroke team clinicians, serving primarily on the neurology (35 percent) or emergency medicine (41 percent) service. We conducted thematic analysis based on principles of grounded theory to identify codes about consent for tPA. We used interpretive convergence to ensure consistency among the individual investigators’ codes and to ensure that all of the investigators agreed on coding and themes.We found that 38 percent of the stroke clinicians did not believe any form of consent was necessary for tPA, 47 percent thought that some form of consent was necessary, and 15 percent were unsure. Clinicians who believed tPA required informed consent were divided on whether consent should be written (40 percent) or verbal (60 percent). We identified three factors describing clinicians’ attitudes about consent: (1) legal and policy factors, (2) ethical factors, and (3) medical factors.The lack of consensus regarding consent for tPA creates the potential for delays in treatment, uneasiness among clinicians, and legal liability. The identified factors provide a potential framework to guide discussions about developing a standard of care for acquiring the informed consent of patients for the administration of tPA. (shrink)

Can artifacts be agents in the same sense as humans? This paper endorses a pragmatic stance to that issue. The crucial question is whether artifacts can have free will in the same pragmatic sense as we consider humans to have a free will when holding them responsible for their actions. The origin of actions is important. Can an action originate inside an artifact, considering that it is, at least today, programmed by a human? In this paper it is argued that (...) autonomy with respect to norms is crucial for artificial agency. (shrink)

Sexual violence has become a topic of intense media scrutiny, thanks to the bravery of survivors coming forward to tell their stories. But, unfortunately, mainstream public spheres too often echo reports in a way that inhibits proper understanding of its causes, placing too much emphasis on individual responsibility or blaming minority cultures. -/- In this powerful and original book, Linda Martín Alcoff aims to correct the misleading language of public debate about rape and sexual violence by showing how complex (...) our experiences of sexual violation can be. Although it is survivors who have galvanized movements like #MeToo, when their words enter the public arena they can be manipulated or interpreted in a way that damages their effectiveness. Rather than assuming that all experiences of sexual violence are universal, we need to be more sensitive to the local and personal contexts – who is speaking and in what circumstances – that affect how activists’ and survivors’ protests will be received and understood. -/- Alcoff has written a book that will revolutionize the way we think about rape, finally putting the survivor center stage. (shrink)

In this paper I summarize two versions of a new form of ethical theory in which all basic moral terms are defined by direct reference to exemplars of goodness. I call the Christian form Divine Motivation Theory in a book by the same name (Cambridge University Press, 2004), and the more general form I call Exemplarist Virtue Theory (Gifford Lectures 2015) or Exemplarist Moral Theory (forthcoming 2017, Oxford University Press). In the Christian form the supreme exemplar is God. In exemplarist (...) virtue theory exemplars are superbly admirable persons or fictional characters, whose goodness is identified through the emotion of admiration rather than through the satisfaction of descriptive properties. In both versions of the theory the terms ‘good person’, ‘virtue’, ‘good life’, ‘admirable act’, and ‘right act’ are defined by the acts, motives, judgments, and attitudes of exemplary persons. (shrink)

Beginning in his PhD program, and over a period of years in the 1960s, Richard Paul thoughtfully examined and deliberately critiqued existing theories of logic and reasoning. He took what was a very narrow conception of reasoning and broadened it to more accurately represent human thinking when people reason. He captured the idea of universal intellectual standards by exploring standards typically used by skilled reasoners, and assembled these standards into a constellation of ideas that is easily understandable. Following the tradition (...) of Socrates, Paul continually emphasized the importance of developing conceptual understandings based in foundational ideas and principles of analysis, and tested through life experience. His work laid the groundwork for what may be termed first principles in critical thinking and for a legitimate field of critical thinking studies. (shrink)

Henry Richardson’s _Articulating the Moral Community_ develops an account of moral innovation, the process by which new moral norms come to be authoritatively binding and new ethical judgments come to be objectively true. In this essay, I argue Richardson’s proposed process of moral innovation is likely to be exceedingly rare, unnecessary for solving the problems posed by what he calls “objective moral gaps,” and not necessarily more desirable than moral innovation via local convention.

In his essay on paternalism and personal identity, Wilkinson draws on Derek Parfit’s Reasons and Persons (1984) to call for a reappraisal of the role of paternalism in healthcare decision-making in situations in which patients with capacity make decisions which are likely to have harmful consequences for themselves.1 The imperative to respect autonomy, coupled with JS Mill’s insistence that the state is justified in interfering with an individual’s liberty only in situations in which she harms or threatens to harm another (...) person, leaves clinicians with little room to constrain decisions in which a patient’s choice may seriously harm her. Parfit reduces personal identity to the continuity of psychological and physical traits across the lifecourse, and suggests that, since these sets of characteristics change significantly over time, it may make more sense to view a person at different time points as different ‘selves’, rather than as the same person. Parfit’s defence of paternalism involves arguing that, given this inevitable lack of continuity, causing harm to one’s future self is analogous to harming another person and that intervening to prevent this may be justifiable in accordance with the Harm Principle.2 The issue of personal identity has received considerable attention in the philosophical literature and it remains a vexed question. Parfit’s argument, along with the thought experiments on …. (shrink)

Hibbing et al. argue that the liberal–conservative continuum is (a) universal and (b) grounded in psychological differences in sensitivity to negative stimuli. Our commentary argues that both claims overlook the importance of context. We review evidence that the liberal–conservative continuum is far from universal and that ideological differences are contextually flexible rather than fixed.

Genetic and early environmental factors are interwoven in the etiology of Borderline Personality Disorder (BPD). Epigenetic mechanisms offer the molecular machinery to adapt to environmental conditions. There are gaps in the knowledge about how epigenetic mechanisms are involved in the effects of early affective environment, development of BPD, and psychotherapy response. We reviewed the available evidence of the effects of psychotherapy on changes in DNA methylation and conducted a pilot study in a sample of 11 female adolescents diagnosed with BPD, (...) exploring for changes in peripheral DNA methylation of FKBP5 gene, which encodes for a stress response protein, in relation to psychotherapy, on symptomatology and underlying psychological processes. For this purpose, measures of early trauma, borderline and depressive symptoms, psychotherapy outcome, mentalization, and emotional regulation were studied. A reduction in the average FKBP5 methylation levels was observed over time. Additionally, the decrease in FKBP5 methylation observed occurred only in those individuals who had early trauma and responded to psychotherapy. The results suggest an effect of psychotherapy on epigenetic mechanisms associated with the stress response. The finding that epigenetic changes were only observed in patients with early trauma suggests a specific molecular mechanism of recovery. The results should be taken with caution given the small sample size. Also, further research is needed to adjust for confounding factors and include endocrinological markers and therapeutic process variables. (shrink)