Simulating murder: the aversion to harmful action

Diverse lines of evidence point to a basic human aversion to physically harming others. First, we demonstrate that unwillingness to endorse harm in a moral dilemma is predicted by individual differences in aversive reactivity, as indexed by peripheral vasoconstriction. Next, we tested the specific factors that elicit the aversive response to harm. Participants performed actions such as discharging a fake gun into the face of the experimenter, fully informed that the actions were pretend and harmless. These simulated harmful actions increased peripheral vasoconstriction significantly more than did witnessing pretend harmful actions or to performing metabolically matched nonharmful actions. This suggests that the aversion to harmful actions extends beyond empathic concern for victim harm. Together, these studies demonstrate a link between the body and moral decision-making processes.

Faculty encounters with uncivil nursing students: an overview

The critical incident technique (CIT) was used to explore faculty experiences with uncivil nursing students. Twenty-one nursing faculty with various years of experience in teaching were interviewed to ascertain what they considered critical incidents of uncivil encounters with nursing students and what effect those encounters had on them. Thirty-six encounters were described by the faculty. Of the 36 encounters, 33 occurred with individual students and 3 occurred with groups of students. Twenty-three encounters occurred in the context of poor student performance requiring constructive criticism or resulting in course failure. A battlefield metaphor is used to describe the incidents, their antecedents, and their consequences. The encounters were precipitated by a period of escalating tensions and effort by the faculty to diffuse the situation. The faculty were surprised and caught off guard by the encounters, which ranged in severity from mild to highly aggressive. The faculty often perceived significant threats to well-being of self, loved ones, job security, and/or possessions. The aftermath of the encounters included physical and emotional tolls on faculty, decreased self-esteem and loss of confidence in teaching ability, significant time expenditures, and negative consequences to the educational process. Three of the faculty left teaching in part due to encounters with students.

Restraint and the Question of Validity

Restraint as an intervention in the management of acute mental distress has a long history that predates the existence of psychiatry. However, it remains a source of controversy with an ongoing debate as to its role. This article critically explores what to date has seemingly been only implicit in the debate surrounding the role of restraint: how should the concept of validity be interpreted when applied to restraint as an intervention? The practice of restraint in mental health is critically examined using two post-positivist constructions of validity, the pragmatic and the psychopolitical, by means of a critical examination of the literature. The current literature provides only weak support for the pragmatic validity of restraint as an intervention and no support to date for its psychopolitical validity. Judgements regarding the validity of any intervention that is coercive must include reference to the psychopolitical dimensions of both practice and policy.

Moral objections to suicide and suicidal ideation among mood disordered Whites, Blacks, and Hispanics

Understanding the beliefs that protect individuals against suicide can help to enhance suicide prevention strategies. One measure of suicide non-acceptability is the moral objections to suicide (MOS) sub-scale of the reasons for living inventory (RFLI). This study examined the MOS and suicidal ideation of White, Black, and Hispanic individuals with mood disorders. We expected minority individuals to have stronger objections to suicide.

METHOD

Eight hundred and four, White (588), Black (122) and Hispanic (94) participants with DSM-IV diagnoses of MDD or bipolar disorder were administered the scale for suicide ideation, the reasons for living inventory and several measures of clinical distress.

RESULTS

Higher suicidal ideation was modestly correlated with lower MOS scores overall (r=0.15, p=0.001). Among Blacks however the relationship was inverted: despite having higher suicidal ideation than Whites or Hispanics, Blacks reported the least accepting attitudes toward suicide.

CONCLUSION

These results suggest that attitudes regarding the acceptability of suicide may be independent of suicidal ideation.

Marcel Duchamp: on the fruitful use of narcissism and destructiveness in contemporary art

Considering Marcel Duchamp's work, this paper raises the question as to the nature of the subjective experience proposed by contemporary art to today's audience. Approaching art through the concept of sublimation, Freud maintains a fundamentally optimistic and positive view, putting forward its libidinal and sexual aspects, the pursuit of pleasure, beauty, and omnipotence. Following the path opened by Freud through the concept of the 'uncanny', most post-Freudian authors have proposed a 'blacker' image of artistic endeavour, allowing the expression of aggression. From a perspective which is neither that of an art historian nor a moralist, the author proposes the idea that certain propositions of contemporary art may allow the viewer to live narcissistic and destructive fantasies, via culturally sanctioned and socially acceptable means. The recognition of the fertile use of destruction as a condition of the emergence of the new, on the one hand, as well as the legitimacy of the expression through art of the most primitive fantasies and the right to non-communication, on the other, are postulated as constructs for a non-normative, non-judgemental psychoanalytic approach to the cultural world.

The 'uncanny', the sacred and the narcissism of culture: the development of the ego and the progress of civilization

The report by a member of the Brazilian parliament that the rejection of physical deformity is natural and instinctive, and the Muslim reaction to the publication in the Western press of cartoons considered to be offensive to their religion, serve as an introduction to the examination of conflicts in human relations. The two episodes may be classified as representing the sense of the 'uncanny', attributed by Freud to the narcissism that remained from primitive cultures, in which the shadow cast by the body and the mirrored reflection of the latter probably generated the idea of soul-which would be the narcissistic phenomenon causing the illusion of immortality. The presence of this illusion as a support for the beliefs of present-day civilized peoples makes clear the inopportune influence of primitive mental states in areas where more developed ones should prevail. The persistence of the omnipotent thinking derived from these states provides the possibility of drawing a parallel between the development of the ego-evolution from narcissism to object relation-and the progress of civilization. In this context, the majority of social conflicts can be attributed to the deficient object relation resulting from the strength of primary narcissism, which generates a tendency to reject that which is different and to facilitate the emergence of destructive aggressiveness. The progress of civilization would then occur by means of a development of the ego compatible with object relations that lead to a drastic reduction in destructiveness.

Mechanisms underlying an ability to behave ethically

Cognitive neuroscientists have anticipated the union of neural and behavioral science with ethics (Gazzaniga 2005). The identification of an ethical rule--the dictum that we should treat others in the manner in which we would like to be treated--apparently widespread among human societies suggests a dependence on fundamental human brain mechanisms. Now, studies of neural and molecular mechanisms that underlie the feeling of fear suggest how this form of ethical behavior is produced. Counterintuitively, a new theory presented here states that it is actually a loss of social information that leads to sharing others' fears with our own, thus allowing us to treat others as we would like to be treated. Adding to that hypothetical mechanism is the well-studied predilection toward affiliative behaviors. Thus, even as Chomsky hypothesizes that humans are predisposed to utter grammatical sentences, we propose that humans are 'wired for reciprocity'. However, these two neural forces supporting ethical behavior do not explain individual or collective violence. At any given moment, the ability to produce behavior that obeys this ethical rule is proposed to depend on a balance between mechanisms for prosocial and antisocial behaviors. That balance results not only from genetic influences on temperament but also from environmental effects particularly during critical neonatal and pubertal periods.

Learning to blast a way into crime, or just good clean fun? Examining aggressive play with toy weapons and its relation with crime

BACKGROUND

Researchers, such as Bandura, have proposed that children's mere exposure to the use of play weapons encourages deviant displays of aggression, but there is very little research to support this hypothesis of 20 years.

AIM

To examine the relationship between amount of weapon play and concurrent aggression as well as later violent juvenile crime, while controlling for other variables possibly influencing criminal pathways.

METHOD

Using longitudinal survey data collected from mothers and children (n = 2019) from age 5, with follow-up at age 15, correlations between children's play with toy weapons and juvenile criminality were examined. Multivariate regression analyses were employed to determine to what extent early childhood aggression, symptoms of attention deficit hyperactivity disorder, and symptoms of depression were antecedents of juvenile crime.

RESULTS

For bivariate analysis between toy weapon play and juvenile criminality, the effect size was small and not significant. The relationship remained not significant once control variables were introduced into the model.

CONCLUSIONS AND IMPLICATIONS

The act of pretending to be aggressive in childhood thus plays little role in predicting later criminality after other factors, such as gender, attention deficit hyperactivity disorder or depression, have been taken into account. Involvement in imaginative play with toy gun use in early childhood is unlikely to be useful as a risk marker for later criminal behaviour. Play fighting and war toy games may even be considered necessary components within the frame of normal development. Copyright © 2018 John Wiley & Sons, Ltd.

Evolutionary ethics, aggression, and violence: lessons from primate research

This paper is unusual for this journal because most readers do not deal professionally with animals. Information from primatology, however, is relevant to consideration of violence between people. I will focus mainly on aggression and peacemaking among nonhuman primates, but will address related topics as well. I do not use the term “aggression” to refer only to violent behavior, but to any overt conflict between individuals. Although I am a professor of psychology, I am a biologist by training. When I was a student many years ago, the major scholarly work on this topic was Konrad Lorenz’s On Aggression. It set into motion contemporary research on aggression from a biological perspective by making the controversial claim that aggression is an instinct not only in animals, but also in human beings. My own research and that of others suggests a slightly different view, namely, that aggression between individuals is a last resort when conflict resolution fails.

A research note on body mass, physical aggression, and the competitiveness of Asian-Pacific Islander adolescents in Guam

This study uses the evolutionary model to guide an exploration of the effects of body mass on aggressive and competitive behaviors among Asian-Pacific adolescents in Guam. Using a probability sample of Guam's high-school students, the results of logistic regressions suggest that adolescent females with greater body mass are more likely to engage in physical fights (aggression) and to participate in team sports (competitiveness). Ethnic differences indicate the possibility that individuals with lower body mass may be less likely to participate in physically aggressive acts and team sports. Alternate theoretical explanations for the results are also considered.

[Containment as a psychological process]

To move away from the clinical simplification of the term and restore its full complexity, it is possible to approach the notion of containment through the prism of psychological processuality. Beyond the theory, the caregiver's experience in their practice and in their contact with the patient can be considered on the basis of a series of standpoints which form the sphere of the "capacity of internal containment". However, containment is not the be all and end all of care. Containment has its limits and care must also be viewed as a constellation of complementary processes.

Why do acute healthcare staff behave unprofessionally towards each other and how can these behaviours be reduced? A realist review

Background

Unprofessional behaviour in healthcare systems can negatively impact staff well-being, patient safety and organisational costs. Unprofessional behaviour encompasses a range of behaviours, including incivility, microaggressions, harassment and bullying. Despite efforts to combat unprofessional behaviour in healthcare settings, it remains prevalent. Interventions to reduce unprofessional behaviour in health care have been conducted - but how and why they may work is unclear. Given the complexity of the issue, a realist review methodology is an ideal approach to examining unprofessional behaviour in healthcare systems.

Aim

To improve context-specific understanding of how, why and in what circumstances unprofessional behaviours between staff in acute healthcare settings occur and evidence of strategies implemented to mitigate, manage and prevent them.

Methods

Realist synthesis methodology consistent with realist and meta-narrative evidence syntheses: evolving standards reporting guidelines.

Data sources

Literature sources for building initial theories were identified from the original proposal and from informal searches of various websites. For theory refinement, we conducted systematic and purposive searches for peer-reviewed literature on databases such as EMBASE, Cumulative Index to Nursing and Allied Health Literature and MEDLINE databases as well as for grey literature. Searches were conducted iteratively from November 2021 to December 2022.

Results

Initial theory-building drew on 38 sources. Searches resulted in 2878 titles and abstracts. In total, 148 sources were included in the review. Terminology and definitions used for unprofessional behaviours were inconsistent. This may present issues for policy and practice when trying to identify and address unprofessional behaviour. Contributors of unprofessional behaviour can be categorised into four areas: (1) workplace disempowerment, (2) organisational uncertainty, confusion and stress, (3) (lack of) social cohesion and (4) enablement of harmful cultures that tolerate unprofessional behaviours. Those at most risk of experiencing unprofessional behaviour are staff from a minoritised background. We identified 42 interventions in the literature to address unprofessional behaviour. These spanned five types: (1) single session (i.e. one-off), (2) multiple sessions, (3) single or multiple sessions combined with other actions (e.g. training session plus a code of conduct), (4) professional accountability and reporting interventions and (5) structured culture-change interventions. We identified 42 reports of interventions, with none conducted in the United Kingdom. Of these, 29 interventions were evaluated, with the majority (n = 23) reporting some measure of effectiveness. Interventions drew on 13 types of behaviour-change strategy designed to, for example: change social norms, improve awareness of unprofessional behaviour, or redesign the workplace. Interventions were impacted by 12 key dynamics, including focusing on individuals, lack of trust in management and non-existent logic models.

Conclusions

Workplace disempowerment and organisational barriers are primary contributors to unprofessional behaviour. However, interventions predominantly focus on individual education or training without addressing systemic, organisational issues. Effectiveness of interventions to improve staff well-being or patient safety is uncertain. We provide 12 key dynamics and 15 implementation principles to guide organisations.

Future work

Interventions need to: (1) be tested in a United Kingdom context, (2) draw on behavioural science principles and (3) target systemic, organisational issues.

Limitations

This review focuses on interpersonal staff-to-staff unprofessional behaviour, in acute healthcare settings only and does not include non-intervention literature outside the United Kingdom or outside of health care.

Study registration

This study was prospectively registered on PROSPERO CRD42021255490. The record is available from: www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021255490.

Funding

This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR131606) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 25. See the NIHR Funding and Awards website for further award information.