Social threat indirectly increases moral condemnation via thwarting fundamental social needs

Individuals who experience threats to their social needs may attempt to avert further harm by condemning wrongdoers more severely. Three pre-registered studies tested whether threatened social esteem is associated with increased moral condemnation. In Study 1 (N = 381) participants played a game in which they were socially included or excluded and then evaluated the actions of moral wrongdoers. We observed an indirect effect: Exclusion increased social needs-threat, which in turn increased moral condemnation. Study 2 (N = 428) was a direct replication, and also showed this indirect effect. Both studies demonstrated the effect across five moral foundations, and was most pronounced for harm violations. Study 3 (N = 102) examined dispositional concerns about social needs threat, namely social anxiety, and showed a positive correlation between this trait and moral judgments. Overall, results suggest threatened social standing is linked to moral condemnation, presumably because moral wrongdoers pose a further threat when one's ability to cope is already compromised.

Quantifying the cost of decision fatigue: suboptimal risk decisions in finance

Making decisions over extended periods of time is cognitively taxing and can lead to decision fatigue, which is linked to a preference for the 'default' option, namely whatever decision involves relatively little cognitive effort. Such effects have been demonstrated across a number of applied settings, including forensic and clinical contexts. Previous research, however, has not quantified the cost of such suboptimal decisions. We assessed the magnitude of the negative consequences of decision fatigue in the finance sector. Using 26 501 credit loan applications evaluated by credit officers of a major bank, we show that in this real-life financial risk-taking context credit loan approvals across the course of a day decreased during midday compared with early or later in the workday, reflecting a preference for the default option. To quantify the economic loss associated with such decision variability, we then modelled the bank's additional credit collection if all decisions had been made during early morning levels of approval. This would have resulted in $509 023 extra revenue for the bank, for one month. Thus, we provide further evidence that is consistent with a pattern of decision fatigue, and that it can have a substantial negative impact in the finance sector that warrants considerations to counteract it.

Disease and Disapproval: COVID-19 Concern is Related to Greater Moral Condemnation

Prior research has indicated that disease threat and disgust are associated with harsher moral condemnation. We investigated the role of a specific, highly salient health concern, namely the spread of the coronavirus, and associated COVID-19 disease, on moral disapproval. We hypothesized that individuals who report greater subjective worry about COVID-19 would be more sensitive to moral transgressions. Across three studies (N = 913), conducted March-May 2020 as the pandemic started to unfold in the United States, we found that individuals who were worried about contracting the infectious disease made harsher moral judgments than those who were relatively less worried. This effect was not restricted to transgressions involving purity, but extended to transgressions involving harm, fairness, authority, and loyalty, and remained when controlling for political orientation. Furthermore, for Studies 1 and 2 the effect also was robust when taking into account the contamination subscale of the Disgust Scale-Revised. These findings add to the growing literature that concrete threats to health can play a role in abstract moral considerations, supporting the notion that judgments of wrongdoing are not based on rational thought alone.

Using social and behavioural science to support COVID-19 pandemic response

The COVID-19 pandemic represents a massive global health crisis. Because the crisis requires large-scale behaviour change and places significant psychological burdens on individuals, insights from the social and behavioural sciences can be used to help align human behaviour with the recommendations of epidemiologists and public health experts. Here we discuss evidence from a selection of research topics relevant to pandemics, including work on navigating threats, social and cultural influences on behaviour, science communication, moral decision-making, leadership, and stress and coping. In each section, we note the nature and quality of prior research, including uncertainty and unsettled issues. We identify several insights for effective response to the COVID-19 pandemic and highlight important gaps researchers should move quickly to fill in the coming weeks and months.

The role of oxytocin in the facial mimicry of affiliative vs. non-affiliative emotions

The present paper builds upon a growing body of work documenting oxytocin's role in social functioning, to test whether this hormone facilitates spontaneous mimicry of others' emotional expressions. In a double-blind, randomized trial, adult Caucasian males (n = 145) received a nasal spray of either oxytocin or placebo before completing a facial mimicry task. Facial expressions were coded using automated face analysis. Oxytocin increased mimicry of facial features of sadness (lips and chin, but not areas around the eyes), an affiliative reaction that facilitates social bonding. Oxytocin also increased mimicry of happiness, but only for individuals who expressed low levels of happiness in response to neutral faces. Overall, participants did not reliably mimic expressions of fear and anger, echoing recent theoretical accounts of emotional mimicry as dependent on the social context. In sum, our findings suggest that oxytocin facilitates emotional mimicry in ways that are conducive to affiliation, pointing to a possible pathway through which oxytocin promotes social bonding.

Atoning Past Indulgences: Oral Consumption and Moral Compensation

Previous research has shown that moral failures increase compensatory behaviors, such as prosociality and even self-punishment, because they are strategies to re-establish one's positive moral self-image. Do similar compensatory behaviors result from violations in normative eating practices? Three experiments explored the moral consequences of recalling instances of perceived excessive food consumption. In Experiment 1 we showed that women recalling an overeating (vs. neutral) experience reported more guilt and a desire to engage in prosocial behavior in the form of so-called self-sacrificing. In Experimental 2 this logic was applied to actual spontaneous helping behaviors toward an experimenter, with participants who recalled an overeating (vs. neutral) experience exhibiting more such helping in the laboratory. Experimental 3 expanded the investigation to self-inflicted pain: overeating (vs. neutral) recall led to higher levels of self-punishment as indicted by longer time periods spent engaging in the cold pressor task. In sum, failures in normative food consumption can be viewed as moral transgressions that elicits both interpersonal and intrapersonal compensatory behaviors aimed at restoring a positive moral self-image.

Looking up to virtue: averting gaze facilitates moral construals via posteromedial activations

Witnessing exemplary actions triggers admiration, a positive emotion that can pertain to concrete skills, or move the onlooker beyond physical characteristics to appreciate the abstract, moral implications. Participants reacted to narratives depicting skilled or virtuous protagonists first during a videotaped interview then during functional magnetic resonance imaging (fMRI). We analyzed participants’ gaze aversion (an indicator of disengaging from the immediate environment) and cognitive construals (mentions of concrete characteristics vs abstract beliefs and values) during the interview, and relations to individuals’ subsequent neural activations. When participants averted their gaze, they were more likely to mention abstract construals, and both behaviors were more likely when reacting to virtue. Gaze aversion to virtue narratives predicted greater subsequent activation for those narratives in dorsal posterior cingulate cortex (dPCC), involved in visual attention control. The inferior-posterior posteromedial cortices (ipPMC), a default mode network hub involved in abstract thought, activated only to virtue, and activity level reflected individuals’ tendency to abstract construals. Critically, dPCC and ipPMC activity sequentially mediated the relationship between individuals’ gaze and abstract construal tendencies. No such relationships existed for reactions to skill, despite participants reporting equivalently strong positive emotion. In appreciating virtue, dPCC may support individuals in transcending the viewable context, facilitating ipPMC activity and moral construals.

The paradox of moral cleansing: When physical cleansing leads to increased contamination concerns

BACKGROUND AND OBJECTIVES

Moral threats, including threats to moral self-worth, have been associated with contamination concerns. Paradoxically, although self-cleansing provides temporary relief, it can worsen feelings of contamination. Self-affirmation might be an effective strategy, especially following obsessive type cognitions (e.g., responsibility beliefs) when moral threats are reactivated.

METHODS

In Experiment 1, participants recalled an immoral deed and then self-cleansed (using a hand-wipe), completed a control task, or self-affirmed. Contamination concerns were subsequently measured by a washing task. In Experiment 2, the same procedure was used but obsessive-type cognitions were activated by asking participants a series of questions about obsessive beliefs.

RESULTS

As expected, relative to the control condition, both self-affirmation and self-cleansing resulted in less subsequent repeated washing behaviour in Experiment 1. In Experiment 2, when the immoral recall was followed by activation of obsessive-type cognitions, self-cleansing led to more guilt and repeated washing than self-affirmation and control. Rather than alleviating feelings of contamination, physical self-cleansing led to more contamination concerns and guilt when in the context of activated obsessive-type cognitions, possibly because it paradoxically makes (moral) cleanliness goals salient.

LIMITATIONS

Future research needs to test clinical populations, for whom contamination concerns are all the more central.

CONCLUSIONS

This research provides further evidence of the influence of moral threat in contamination concerns, and the limits of moral cleansing. Self-affirmation resulted in less contamination concerns under both a neutral condition and activated obsessive type cognitions.

The Color Red Is Implicitly Associated With Social Status in the United Kingdom and China

Research and theorizing on human societies have shown that the color red plays a large role in human psychological functioning. The aim of the present study was to test the association between red and high-status symbols across cultural contexts. Using the Implicit Association Test (IAT) paradigm, across seven experiments (N = 357), we demonstrated that participants exhibited a faster association of red color and logos of high-status stimuli compared to red color and logos of low-status stimuli. The effect was shown among both males and females, with two different types of status symbols (car logos and university logos), and with four different contrast colors (white, gray, green, blue). Moreover, this association was observed in both United Kingdom and China. These findings provide compelling evidence for the implicit association between the color red and high social status across two different cultural contexts.

Close or far? Affect explains conflicting findings on motivated distance perception to rewards

Research on motivated perception has yielded conflicting findings: Whereas Balcetis and Dunning (2010) showed that people approaching (vs. avoiding) rewarding objects (e.g. food) see them as closer, Krpan and Schnall (2014a) found the opposite. Furthermore, whereas Balcetis (2016) suggested that people who perceive rewarding objects as closer (vs. farther) should subsequently consume more, Krpan and Schnall (2017) showed that they actually ate less. We introduce affect as the missing link to explain these conflicting findings. Two experiments showed that approach and avoidance can either involve, or lack, an affective experience, which in turn determines how they influence perception, and how perception is related to behavior. Consistent with Krpan and Schnall (2017), non-affective approach (vs. avoidance) motivation made candies look farther; seeing candies as farther in turn predicted increased consumption (Experiment 1). In contrast, consistent with Balcetis and Dunning (2010), affective approach (vs. avoidance) motivation made these stimuli look closer; seeing candies as closer was associated with more being eaten (Experiment 2). Our findings therefore reconcile previous inconsistencies on motivated perception, and suggest that people's view of their surroundings is more dynamic than previously assumed.

Social and Contextual Constraints on Embodied Perception

A number of papers have challenged research on physiological and psychological influences on perception by claiming to show that such findings can be explained by nonperceptual factors such as demand characteristics. Relatedly, calls for separating perception from judgment have been issued. However, such efforts fail to consider key processes known to shape judgment processes: people's inability to report accurately on their judgments, conversational dynamics of experimental research contexts, and misattribution and discounting processes. Indeed, the fact that initially observed effects of embodied influences disappear is predicted by an extensive amount of literature on judgments studied within social psychology. Thus, findings from such studies suggest that the initially presumed underlying processes are at work-namely, functional considerations that are informative in the context of preparing the body for action. In this article, I provide suggestions on how to conduct research on perception within the social constraints of experimental contexts.

Commentary and Rejoinder on

Johnson, Cheung, and Donnellan (2014a) reported a failure to replicate Schnall, Benton, and Harvey (2008) ’s effect of cleanliness on moral judgment. However, inspection of the replication data shows that participants provided high numbers of severe moral judgments – a ceiling effect. In the original data percentage of extreme responses per moral dilemma correlated negatively with the effect of the manipulation. In contrast, this correlation was absent in the replications, due to almost all items showing a high percentage of extreme responses. Therefore the parametric statistics reported by Johnson et al. (2014a) are inconclusive regarding the reproducibility of the original effect. Direct replications are prone to error when reviewers only judge similarity of methods, but not resulting data and conclusions. It is my conclusion that preventable problems can arise if publication decisions are made without independent post-data peer evaluation.

Overweight people have low levels of implicit weight bias, but overweight nations have high levels of implicit weight bias

Although a greater degree of personal obesity is associated with weaker negativity toward overweight people on both explicit (i.e., self-report) and implicit (i.e., indirect behavioral) measures, overweight people still prefer thin people on average. We investigated whether the national and cultural context – particularly the national prevalence of obesity – predicts attitudes toward overweight people independent of personal identity and weight status. Data were collected from a total sample of 338,121 citizens from 71 nations in 22 different languages on the Project Implicit website (https://implicit.harvard.edu/) between May 2006 and October 2010. We investigated the relationship of the explicit and implicit weight bias with the obesity both at the individual (i.e., across individuals) and national (i.e., across nations) level. Explicit weight bias was assessed with self-reported preference between overweight and thin people; implicit weight bias was measured with the Implicit Association Test (IAT). The national estimates of explicit and implicit weight bias were obtained by averaging the individual scores for each nation. Obesity at the individual level was defined as Body Mass Index (BMI) scores, whereas obesity at the national level was defined as three national weight indicators (national BMI, national percentage of overweight and underweight people) obtained from publicly available databases. Across individuals, greater degree of obesity was associated with weaker implicit negativity toward overweight people compared to thin people. Across nations, in contrast, a greater degree of national obesity was associated with stronger implicit negativity toward overweight people compared to thin people. This result indicates a different relationship between obesity and implicit weight bias at the individual and national levels.

Similar psychological distance reduces temporal discounting

People often prefer inferior options in the present even when options in the future are more lucrative. Five studies investigated whether decision making could be improved by manipulating construal level and psychological distance. In Studies 1a, 1b, and 2, temporal discounting was reduced when future rewards (trips to Paris) were construed at a relatively concrete level, thus inducing a similar level of construal to present rewards. By contrast, Studies 3 and 4 reduced temporal discounting by making present financial rewards more psychologically distant via a social proximity manipulation, and thus linked to a similar high level of construal as future rewards. These results suggest that people prefer the more lucrative option when comparing two intertemporal choices that are construed on a similar level instead of on a different level. Thus, changes in construal level and mental representations can be used to promote more desirable choices in economic decision making.

Embodiment in social psychology

Psychologists are increasingly interested in embodiment based on the assumption that thoughts, feelings, and behaviors are grounded in bodily interaction with the environment. We examine how embodiment is used in social psychology, and we explore the ways in which embodied approaches enrich traditional theories. Although research in this area is burgeoning, much of it has been more descriptive than explanatory. We provide a critical discussion of the trajectory of embodiment research in social psychology. We contend that future researchers should engage in a phenomenon-based approach, highlight the theoretical boundary conditions and mediators involved, explore novel action-relevant outcome measures, and address the role of individual differences broadly defined. Such research will likely provide a more explanatory account of the role of embodiment in general terms as well as how it expands the knowledge base in social psychology.

Elevation Puts Moral Values Into Action

Moral elevation has been shown to increase helping behavior. However, this might be due to a threatened moral self-image because people engage in a social comparison with a moral exemplar and conclude that their own moral integrity is inferior. Alternatively, feelings of elevation might provide a motivational impetus to act on one’s moral values. We provided participants with an opportunity to engage in self-affirmation, which was followed by an induction of moral elevation or a neutral control mood. Compared to the neutral mood, participants experiencing moral elevation showed higher levels of helping behavior following self-affirmation. This effect was especially pronounced in participants experiencing moral elevation who reminded themselves of previous prosocial behavior; they showed more helping than participants experiencing moral elevation who had not engaged in self-affirmation. Thus, rather than posing a threat to moral self-worth, feelings of elevation can provide the motivational trigger to act on affirmed moral values.

Clean, Proper and Tidy Are More Than the Absence of Dirty, Disgusting and Wrong

The desire to feel clean and pure might not merely be the absence of contamination and resulting feelings of disgust. Instead, it might have a social function because early in evolution social grooming not only involved improved personal hygiene and cleanliness, but also increased group cohesion. Thus, knowing that one’s body is clean, proper and tidy might have social implications that go beyond morality.

Transgressions and Expressions

Recent investigations into morality suggest that affective responses may precede moral judgments. The present study investigated, first, whether individuals show specific facial affect in response to moral behaviors and, second, whether the intensity of facial affect predicts subsequent moral judgments. Muscle activity relating to disgust (levator labii), anger (corrugator supercilii), and positive affect (zygomaticus major) was recorded while participants considered third-person statements describing good and bad behaviors across five foundations of morality (purity, fairness, harm, authority, and ingroup). Facial disgust was highest in response to purity violations, followed by fairness violations. In contrast, harm violations evoked anger expressions. Importantly, the extremity of subsequent moral judgments was predicted by facial affect, such that judgments about purity and fairness correlated with facial disgust, harm correlated with facial anger, and ingroup correlated with positive facial affect. These results demonstrate that individuals spontaneously exhibit domain-specific moral affect that allows inferences about their moral judgments.

Elevation leads to altruistic behavior

Feelings of elevation, elicited by witnessing another person perform a good deed, have been hypothesized to motivate a desire to help others. However, despite growing interest in the determinants of prosocial behavior, there is only limited evidence that elevation leads to increases in altruistic behavior. In two experiments, we tested the relationship between elevation and helping behavior. Prior to measuring helping behavior, we measured elevation among participants in an elevation-inducing condition and control conditions in order to determine whether witnessing altruistic behavior elicited elevation. In Experiment 1, participants experiencing elevation were more likely to volunteer for a subsequent unpaid study than were participants in a neutral state. In Experiment 2, participants experiencing elevation spent approximately twice as long helping the experimenter with a tedious task as participants experiencing mirth or a neutral emotional state. Further, feelings of elevation, but not feelings of amusement or happiness, predicted the amount of helping. Together, these results provide evidence that witnessing another person's altruistic behavior elicits elevation, a discrete emotion that, in turn, leads to tangible increases in altruism.

Direct evidence for the economy of action: glucose and the perception of geographical slant

When locomoting in a physically challenging environment, the body draws upon available energy reserves to accommodate increased metabolic demand. Ingested glucose supplements the body's energy resources, whereas non-caloric sweetener does not. Two experiments demonstrate that participants who had consumed a glucose-containing drink perceived the slant of a hill to be less steep than did participants who had consumed a drink containing non-caloric sweetener. The glucose manipulation influenced participants' explicit awareness of hill slant but, as predicted, it did not affect a visually guided action of orienting a tilting palmboard to be parallel to the hill. Measured individual differences in factors related to bioenergetic state, such as fatigue, sleep quality, fitness, mood, and stress, also affected perception: lower energetic states were associated with steeper perceptions of hill slant. This research shows that the perception of the spatial layout of the environment is influenced by the energetic resources available for locomotion within it. Our findings are consistent with the view that spatial perceptions are influenced by bioenergetic factors.

A hidden cost of happiness in children

Happiness is generally considered an emotion with only beneficial effects, particularly in childhood. However, there are some situations where the style of information processing triggered by happiness could be a liability. In particular, happiness seems to motivate a top-down processing style, which could impair performance when attention to detail is required. Indeed, in Experiment 1, 10- to 11-year-old children (N = 30) induced to feel a happy mood were slower to locate a simple shape embedded in a complex figure than those induced to feel a sad mood. In Experiment 2, 6- to 7-year-old children (N = 61) induced to feel a happy mood found fewer embedded shapes than those induced to feel a sad or neutral mood. Happiness may have unintended and possibly undesirable cognitive consequences, even in childhood.

With a clean conscience: cleanliness reduces the severity of moral judgments

Theories of moral judgment have long emphasized reasoning and conscious thought while downplaying the role of intuitive and contextual influences. However, recent research has demonstrated that incidental feelings of disgust can influence moral judgments and make them more severe. This study involved two experiments demonstrating that the reverse effect can occur when the notion of physical purity is made salient, thus making moral judgments less severe. After having the cognitive concept of cleanliness activated (Experiment 1) or after physically cleansing themselves after experiencing disgust (Experiment 2), participants found certain moral actions to be less wrong than did participants who had not been exposed to a cleanliness manipulation. The findings support the idea that moral judgment can be driven by intuitive processes, rather than deliberate reasoning. One of those intuitions appears to be physical purity, because it has a strong connection to moral purity.

With a Clean Conscience

Theories of moral judgment have long emphasized reasoning and conscious thought while downplaying the role of intuitive and contextual influences. However, recent research has demonstrated that incidental feelings of disgust can influence moral judgments and make them more severe. This study involved two experiments demonstrating that the reverse effect can occur when the notion of physical purity is made salient, thus making moral judgments less severe. After having the cognitive concept of cleanliness activated (Experiment 1) or after physically cleansing themselves after experiencing disgust (Experiment 2), participants found certain moral actions to be less wrong than did participants who had not been exposed to a cleanliness manipulation. The findings support the idea that moral judgment can be driven by intuitive processes, rather than deliberate reasoning. One of those intuitions appears to be physical purity, because it has a strong connection to moral purity.

Social Support and the Perception of Geographical Slant

The visual perception of geographical slant is influenced by physiological resources, such as physical fitness, age, and being physically refreshed. In two studies we tested whether a psychosocial resource, social support, can also affect the visual perception of slants. Participants accompanied by a friend estimated a hill to be less steep when compared to participants who were alone (Study 1). Similarly, participants who thought of a supportive friend during an imagery task saw a hill as less steep than participants who either thought of a neutral person or a disliked person (Study 2). In both studies, the effects of social relationships on visual perception appear to be mediated by relationship quality (i.e., relationship duration, interpersonal closeness, warmth). Artifacts such as mood, social desirability, and social facilitation did not account for these effects. This research demonstrates that an interpersonal phenomenon, social support, can influence visual perception.

Affective incoherence: when affective concepts and embodied reactions clash

In five studies, the authors examined the effects on cognitive performance of coherence and incoherence between conceptual and experiential sources of affective information. The studies crossed the priming of happy and sad concepts with affective experiences. In different experiments, these included approach or avoidance actions, happy or sad feelings, and happy or sad expressive behaviors. In all studies, coherence between affective concepts and affective experiences led to better recall of a story than did affective incoherence. The authors suggest that the experience of such experiential affective cues serves as evidence of the appropriateness of affective concepts that come to mind. The results suggest that affective coherence has epistemic benefits and that incoherence is costly in terms of cognitive performance.

Disgust as embodied moral judgment

How, and for whom, does disgust influence moral judgment? In four experiments participants made moral judgments while experiencing extraneous feelings of disgust. Disgust was induced in Experiment 1 by exposure to a bad smell, in Experiment 2 by working in a disgusting room, in Experiment 3 by recalling a physically disgusting experience, and in Experiment 4 through a video induction. In each case, the results showed that disgust can increase the severity of moral judgments relative to controls. Experiment 4 found that disgust had a different effect on moral judgment than did sadness. In addition, Experiments 2-4 showed that the role of disgust in severity of moral judgments depends on participants' sensitivity to their own bodily sensations. Taken together, these data indicate the importance-and specificity-of gut feelings in moral judgments.

FACING FEAR: EXPRESSION OF FEAR FACILITATES PROCESSING OF EMOTIONAL INFORMATION

Evidence shows that manipulating the expressive component of fear can influence the processing of emotional information. Participants unobtrusively produced the expressive behaviors typical of fear, anger or happiness. Participants producing the expression of fear were faster at classifying verbal material with emotional content than participants producing the expressions of happiness or anger. These effects were especially pronounced for participants who were generally sensitive to their own bodily cues, as indicated by their degree of field-dependence measured by the Rod-and-Frame Task (Witkin & Asch, 1948). The results suggest that one way of eliciting the cognitive consequences of fear is by inducing the embodied expressive behavior.

Mitomycin therapy in gastric cancer

Adenocarcinoma of the stomach remains a significant cause of mortality worldwide. The majority of patients present with stage III or IV disease, negating surgery as a curative option. Numerous drugs have been tested over the past 2 decades in single-agent and combination chemotherapy trials. Given by intravenous bolus, mitomycin has induced responses as high as 63% and as low as 24% in patients with various gastrointestinal malignancies. Mitomycin has also demonstrated efficacy when given in combination with doxorubicin and in the three-drug regimen FAM (5-fluorouracil/doxorubicin/mitomycin). FAM has been explored in multiple phase II and III trials and has become the standard with which many new combinations are compared. Compared with other doxorubicin-containing regimens, it has demonstrated the longest median survival (29.5 weeks) and the lowest incidence of severe toxicity. The addition of semustine or leucovorin to FAM has yielded responses comparable with those attained by FAM alone. In Japan, where treatment of gastric cancer has been more successful, possibly due to earlier diagnosis and more aggressive surgical approaches, mitomycin has been given intraperitoneally during surgery and postoperatively in combination with fluorinated pyrimidines or other agents. Mitomycin will undoubtedly play a role in the development of new approaches to the treatment of gastric cancer.

Aluminum induced anemia: pathogenesis and treatment in patients on chronic hemodialysis

The baseline hematologic status of 27 patients with modest degrees of aluminum overload was examined. In addition, hematologic data were evaluated in 19 of these patients during and after treatment with DFO. Although neither severe anemia nor microcytosis was observed pretreatment, there was a significant correlation between hemoglobin level and degree of aluminum burden as determined by bone surface aluminum staining (r = -0.58; P less than 0.007). Following treatment with DFO, hemoglobin concentration increased dramatically by 1.3 to 4.4 g/dl in eight patients but did not change in the remaining eleven. Responders and nonresponders were similar with regard to the degree of aluminum overload both before and after chelation therapy but differed with regard to baseline levels of erythropoietin (higher in responders) and degree of iron overload (greater in nonresponders). Pretherapy levels of red cell ALA dehydratase were depressed in all patients (32 +/- 4 vs. 56 +/- 5 U/g Hb in normals) but did not correlate with the degree of aluminum overload and did not change with chelation therapy. Pretherapy levels of red cell protoporphyrin were elevated in 15 of 24 patients (62%) and were higher in responders than in nonresponders. Following DFO therapy, levels fell by 25 to 50% in 7 of 8 patients with elevated pretherapy values, despite the tendency in several patients to develop iron deficiency with treatment.(ABSTRACT TRUNCATED AT 250 WORDS)