Pennsylvania health system agrees to $65 million settlement after hackers leaked nude photos of cancer patients

Sean Lyngass

CNN.com

Originally posted 23 Sept 24

A Pennsylvania health care system this month agreed to pay $65 million to victims of a February 2023 ransomware attack after hackers posted nude photos of cancer patients online, according to the victims’ lawyers.

It’s the largest settlement of its kind in terms of per-patient compensation for victims of a cyberattack, according to Saltz Mongeluzzi Bendesky, a law firm that for the plaintiffs.

The settlement, which is subject to approval by a judge, is a warning to other big US health care providers that the most sensitive patient records they hold are of enormous value to both hackers and the patients themselves, health care cyber experts told CNN. Eighty percent of the $65-million settlement is set aside for victims whose nude photos were published online.

The settlement “shifts the legal, insurance and adversarial ecosystem,” said Carter Groome, chief executive of cybersecurity firm First Health Advisory. “If you’re protecting health data as a crown jewel — as you should be — images or photos are going to need another level of compartmentalized protection.”

It’s a potentially continuous cycle where hackers increasingly seek out the most sensitive patient data to steal, and health care providers move to settle claims out of courts to avoid “ongoing reputational harm,” Groome told CNN.

According to the lawsuit, a cybercriminal gang stole nude photos of cancer patients last year from Lehigh Valley Health Network, which comprises 15 hospitals and health centers in eastern Pennsylvania. The hackers demanded a ransom payment and when Lehigh refused to pay, they leaked the photos online.

The lawsuit, filed on behalf of a Pennsylvania woman and others whose nude photos were posted online, said that Lehigh Valley Health Network needed to be held accountable “for the embarrassment and humiliation” it had caused plaintiffs.

“Patient, physician, and staff privacy is among our top priorities, and we continue to enhance our defenses to prevent incidents in the future,” Lehigh Valley Health Network said in a statement to CNN on Monday.

The info is here.

Here are some thoughts:

The ransomware attack on Lehigh Valley Health Network raises significant ethical and healthcare concerns. The exposure of nude photos of cancer patients is a profound breach of trust and privacy, causing significant emotional distress and psychological harm. Healthcare providers have a duty of care to protect patient data and must be held accountable for their failure to do so. The decision to pay a ransom is ethically complex, as it can incentivize further attacks and potentially jeopardize patient safety. The frequency and severity of ransomware attacks highlight the urgent need for stronger cybersecurity measures in the healthcare sector. By addressing these ethical and practical considerations, healthcare organizations can better safeguard patient information and ensure the delivery of high-quality care.

Real-Time Exposure to Negative News Media and Suicidal Ideation Intensity Among LGBTQ+ Young Adults

Clark, K. A., Kellerman, J. K., et al. (2024).

JAMA Pediatrics.

https://doi.org/10.1001/jamapediatrics.2024.3133

Abstract

Importance  With a recent surge in anti–lesbian, gay, bisexual, transgender, or queer (LGBTQ+) policies and associated news and media coverage, there is a need to study the association of LGBTQ+ focused news or media exposure and short-term changes in suicidal ideation (SI) among LGBTQ+ youth.

Objective  To examine within-person direct and indirect associations between exposure to general and LGBTQ+ negative news or media and SI intensity through expectations of rejection.

Conclusions and Relevance  This intensive longitudinal cohort study found that SI intensity modestly increased in the hours immediately following exposure to LGBTQ+ negative news or media among LGBTQ+ young adults. These findings have timely implications for research and intervention, particularly within sociopolitical and geographic contexts where news or media coverage about LGBTQ+ topics is intensified.

Key Points

Question  Is real-time exposure to negative news or media (eg, a news headline) associated with short-term changes in suicidal ideation (SI) intensity among lesbian, gay, bisexual, transgender, or queer (LGBTQ+) young adults?

Findings  In this intensive longitudinal cohort study of 31 LGBTQ+ young adults aged 18 to 24 years, participants completed 3 assessments per day for 28 consecutive days, resulting in 2189 total assessments. Real-time exposure to LGBTQ+ negative news or media, but not general negative news or media, was significantly associated with heightened intensity of active SI, passive SI, and self-harm ideation.

Meaning  These findings suggest that SI intensity may modestly increase in the hours immediately following identity-specific, but not general, negative news or media exposure among LGBTQ+ young adults.

The article is paywalled.

Here are some thoughts:

This intensive longitudinal cohort study conducted in Tennessee examined the impact of negative LGBTQ+ news and media exposure on suicidal ideation (SI) among LGBTQ+ young adults. The findings revealed that participants reported exposure to negative LGBTQ+ news and media in 11.8% of total assessments over the 28-day study period. Notably, recent exposure to LGBTQ+ negative news and media was associated with a small but statistically significant increase in the intensity of active SI, passive SI, and self-harm ideation. Importantly, no significant associations were observed with exposure to general negative news and media, underscoring the unique impact of identity-specific negative media. Furthermore, a moderate proportion of the association between LGBTQ+ negative media exposure and SI intensity was mediated by expectations of rejection. The study also found stronger associations among participants who reported some active SI during the study period, indicating heightened vulnerability.

The context of this study is particularly relevant given the sociopolitical climate in Tennessee during the data collection period, which coincided with the introduction of numerous bills targeting LGBTQ+ residents. These findings suggest that interventions targeting media organizations could promote responsible reporting practices and increase awareness of the potential suicidogenic impact of negative LGBTQ+ news coverage. Additionally, the study contributes to the growing body of evidence documenting the mental health harms associated with policies that restrict LGBTQ+ visibility and rights, while also highlighting that inclusive and affirming policies are linked to mental health benefits.

From a clinical perspective, the results indicate that routinely assessing the impact of negative media exposure among LGBTQ+ young adults receiving clinical services may be warranted, especially during periods of heightened negative public discourse. Implementing LGBTQ+ affirmative cognitive behavioral therapy could help these individuals cope with minority stress experiences, particularly in high-stigma contexts.

However, the study does have several limitations. It did not assess the type or content of negative media exposure, which could influence SI intensity. The generalizability of the findings may be constrained due to a relatively small sample size from one Southern state, and the focus was solely on SI intensity rather than suicidal behavior. Additionally, the study did not evaluate positive news and media exposure, which could also play a role in mental health outcomes. Lastly, due to sample size constraints, it was not possible to explore potential heterogeneity of effects across different social identities. Overall, this study provides rigorous evidence of the impact of negative LGBTQ+ news and media on mental health among LGBTQ+ young adults, emphasizing the need for responsible media practices and supportive policies and interventions.

Is It Better to Be Happy or Right? Examining the Relative Role of the Pragmatic and Epistemic Imperatives in Momentary Affective Evaluations

Raz, I., Reggev, N., & Gilead, M. (2024).

Emotion, 24(6), 1343–1357.

https://doi.org/10.1037/emo0001349

Abstract

According to research highlighting the importance of predictions, the confirmation of expectations may be a positively-laden experience. A strong test of this principle is the case of the “doomsayer’s delight”: the possibility that belief confirmation can be rewarding even when negative expectations are realized. In order to investigate this idea, we conducted two high-powered experiments examining people’s immediate affective reactions following exposure to expected or unexpected positive and negative stimuli. The results show that people feel significantly worse when their pessimistic expectations are confirmed than when their optimistic expectations are violated. This finding was not moderated by several theoretically relevant individual difference measures or temporal dynamics. Findings from this study contribute to our understanding of the interplay between epistemic and pragmatic motivations in guiding emotional responses.

Here are some thoughts:

This research has importance to psychotherapy. The study's findings challenge traditional theories about emotional responses to expectation confirmation, particularly in the context of negative outcomes. This is crucial for clinical psychologists as it provides new insights into how individuals process and react to negative events, which is fundamental in treating various mental health conditions. The research suggests that confirming pessimistic expectations actually leads to worse feelings than unexpected negative events, contradicting the notion of "doomsayer's delight." This understanding can help clinicians develop more effective therapeutic approaches for patients with anxiety, depression, or other disorders characterized by negative thought patterns.

The study's emphasis on the interplay between epistemic (knowledge-driven) and pragmatic (practical) motivations in shaping emotional responses offers a more nuanced framework for understanding human emotions. This perspective can inform cognitive-behavioral therapies, helping psychologists address both the cognitive and practical aspects of their patients' emotional experiences. Additionally, the research's exploration of immediate emotional reactions provides valuable information about the initial stages of emotional processing, which can be particularly relevant in treating acute stress reactions or developing early intervention strategies.

Furthermore, the study's findings on individual differences and the complexity of emotional experiences underscore the importance of personalized treatment approaches. Clinical psychologists can use this information to tailor their interventions to each patient's unique emotional response patterns, potentially improving treatment outcomes. The research also highlights the role of cognitive processing time in emotional responses, which could have implications for techniques like mindfulness or cognitive restructuring used in therapy.

Lastly, the study's methodology and findings contribute to the broader understanding of human emotional processes, which is fundamental to clinical psychology practice. By challenging existing theories and providing new perspectives on how people respond to negative events, this research encourages clinicians to continually update their knowledge and adapt their therapeutic approaches based on the latest empirical evidence.

National politics ignites more talk of morality and power than local politics

Dillion, D., et al. (2024).

PNAS Nexus, 3(9).

https://doi.org/10.1093/pnasnexus/pgae345

Abstract

Politics and the media in the United States are increasingly nationalized, and this changes how we talk about politics. Instead of reading the local news and discussing local events, people are more often consuming national media and discussing national issues. Unlike local politics, which can rely on shared concrete knowledge about the region, national politics must coordinate large groups of people with little in common. To provide this coordination, we find that national-level political discussions rely upon different themes than local-level discussions, using more abstract, moralized, and power-centric language. The higher prevalence of abstract, moralized, and power-centric language in national vs. local politics was found in political speeches, politician Tweets, and Reddit discussions. These national-level linguistic features lead to broader engagement with political messages, but they also foster more anger and negativity. These findings suggest that the nationalization of politics and the media may contribute to rising partisan animosity.

Here are some thoughts:

In recent years, American politics has undergone a significant transformation, becoming increasingly divisive and focused on national issues at the expense of local concerns. Researchers have identified a key factor contributing to this shift: the reliance on moral, power-centric, and abstract language in national politics. This linguistic style serves as a unifying framework, capturing attention and coordinating opinions across broad and diverse audiences.

Studies have revealed striking differences in language styles between national and local politics. Across various mediums, including politician speeches, Twitter, and Reddit, national politics consistently employs more moral, power-centric, and abstract language. Furthermore, this language style fosters widespread engagement, but also cultivates anger and negativity. Notably, politicians and individuals adapt their language depending on the context, using more moralized language in national settings than local ones.

These findings have significant implications for our understanding of the nationalization of politics and its consequences. The shift towards national politics may contribute to increased polarization and division, highlighting the need for further research into the effectiveness of abstract, moralized, and power-centric language in different contexts. Additionally, exploring how these dynamics play out in more homogeneous societies could provide valuable insights.

Ultimately, recognizing the benefits and drawbacks of national politics' reliance on moral, power-centric language is crucial. While it unites people and encourages participation, it also diverts attention from important local issues and fosters animosity. By understanding these complexities, we can work towards more effective coordination and communication in diverse groups, minimizing conflict and promoting constructive engagement.

Discrimination in Medical Settings across Populations: Evidence from the All of Us Research Program.

Wang, V. H., Cuevas, A. G., et al. (2024).

American Journal of Preventive Medicine.

https://doi.org/10.1016/j.amepre.2024.05.018

Abstract

Introduction

Discrimination in medical settings (DMS) contributes to healthcare disparities in the United States, but few studies have determined the extent of DMS in a large national sample and across different populations. This study estimated the national prevalence of DMS and described demographic and health-related characteristics associated with experiencing DMS in seven different situations.

Methods

Survey data from 41,875 adults participating in the All of Us Research Program collected in 2021–2022 and logistic regression were used to examine the association between sociodemographic and health-related characteristics and self-reported DMS among adults engaged with a healthcare provider within the past 12 months. Statistical analysis was performed in 2023–2024.

Results

About 36.89% of adults reported having experienced at least one DMS situation. Adults with relative social and medical disadvantages had higher prevalence of experiencing DMS. Compared to their counterparts, respondents with higher odds of experiencing DMS in at least one situation identified as female, non-Hispanic Black, having at least some college, living in the South, renter, having other living arrangement, being publicly insured, not having a usual source of care, having multiple chronic conditions, having any disability, and reporting fair or poor health, p<0.05.

Conclusions

The findings indicate a high prevalence of DMS, particularly among some population groups. Characterizing DMS may be a valuable tool for identifying populations at risk within the healthcare system and optimizing the overall patient care experience. Implementing relevant policies remains an essential strategy for mitigating the prevalence of DMS and reducing healthcare disparities.

The article is paywalled here.

Here are some thoughts:

A recent national study revealed alarming rates of discrimination in healthcare settings, affecting approximately 37% of U.S. adults. Disproportionately impacted groups include women, Black and Hispanic individuals, those with limited English proficiency, renters, publicly insured or uninsured individuals, and those with chronic conditions or disabilities. These populations face higher odds of experiencing discrimination in healthcare settings, perpetuating existing health disparities.

The study highlights the intersectionality of race/ethnicity and socioeconomic status as a critical factor in exposure to discrimination. Furthermore, specific situations drive experiences of discrimination for certain populations, such as lack of respect or poor communication from healthcare providers.

To address these disparities, healthcare institutions are developing implicit bias training, though research suggests modest effectiveness. Coupling bias training with reflective exercises or perspective-taking may enhance efficacy. Additionally, promoting diversity within the healthcare workforce and policy interventions, such as the Hospital Consumer Assessment of Healthcare Providers and Systems survey, can help monitor and improve patient-provider relationships.

However, the current survey lacks components measuring discrimination. Incorporating these measures can inform national trends, identify vulnerable populations, and guide targeted interventions. Study limitations include data collection during the COVID-19 pandemic and potential underestimation of discrimination due to measurement constraints.

Key Takeaways:

• 37% of U.S. adults experience discrimination in healthcare settings
• Disproportionate impact on vulnerable populations
• Intersectionality of race/ethnicity and socioeconomic status exacerbates disparities
• Targeted interventions and policy changes are necessary to address discrimination
• Measuring discrimination in healthcare settings is crucial for improvement

Recommendations:

• Develop effective bias training programs
• Promote diversity within the healthcare workforce
• Incorporate discrimination measures into national surveys
• Tailor interventions to address specific experiences of discrimination
• Foster patient-centered care to reduce healthcare disparities

Liberal-conservative asymmetries in anti-democratic tendencies are partly explained by psychological differences in a nationally representative U.S. sample

De Oliveira Santos, D., & Jost, J. T. (2024).

Communications Psychology, 2(1).

https://doi.org/10.1038/s44271-024-00096-3

Abstract

Based on theory and research in political psychology, we hypothesized that liberal-conservative differences in right-wing authoritarianism, social dominance orientation, and political system justification would contribute to asymmetries in anti-democratic tendencies. These hypotheses were tested in a nationally representative survey of U.S. adults (N = 1557). Results revealed that conservatives were less supportive of political equality and legal rights and guarantees and more willing to defect from democratic “rules of the game” and vote for anti-democratic candidates, even after adjusting for political extremism. Mediational analyses suggested that conservatives’ anti-democratic tendencies were partially attributable to higher levels of right-wing authoritarianism and social dominance orientation. Conservatives also scored higher in political system justification, which was associated with support for free speech and mitigated anti-democratic tendencies. Democrats and Republicans who approved January 6, 2021, insurrectionists were more conservative and higher in right-wing authoritarianism than those who did not. Implications for social psychology and society are discussed.

The research is here.

Here are some thoughts:

This research study investigated ideological asymmetries in pro- and anti-democratic sentiments among a nationally representative sample of U.S. adults. The findings revealed that conservatives were less supportive of political equality and legal rights, and more willing to deviate from democratic norms and vote for anti-democratic candidates, even after accounting for political extremism.

These anti-democratic tendencies were partially attributed to higher levels of right-wing authoritarianism (RWA) and social dominance orientation (SDO) among conservatives. Interestingly, conservatives also scored higher in political system justification (PSJ), which was associated with support for free speech and mitigated anti-democratic tendencies.

The study examined seven different indicators of pro- and anti-democratic sentiment, providing a comprehensive view of how political orientation affects various aspects of democratic support. Mediational analyses showed that RWA and SDO significantly mediated the negative effects of political conservatism on democratic principles, while PSJ played a role in maintaining support for democratic norms.

The research also explored attitudes towards the January 6, 2021 insurrectionists, finding that both Democrats and Republicans who approved of them were more conservative and higher in RWA than those who disapproved.

Overall, this study provides evidence of an ideological asymmetry in adherence to democratic norms and principles in the United States, contributing to our understanding of the relationship between political ideology and support for democracy.

Traveling To Die: The Latest Form of Medical Tourism

Debby Waldman

KFF News

Originally posted 20 Aug 24

In the 18 months after Francine Milano was diagnosed with a recurrence of the ovarian cancer she thought she’d beaten 20 years ago, she traveled twice from her home in Pennsylvania to Vermont. She went not to ski, hike, or leaf-peep, but to arrange to die.

“I really wanted to take control over how I left this world,” said the 61-year-old who lives in Lancaster. “I decided that this was an option for me.”

Dying with medical assistance wasn’t an option when Milano learned in early 2023 that her disease was incurable. At that point, she would have had to travel to Switzerland — or live in the District of Columbia or one of the 10 states where medical aid in dying was legal.

But Vermont lifted its residency requirement in May 2023, followed by Oregon two months later. (Montana effectively allows aid in dying through a 2009 court decision, but that ruling doesn’t spell out rules around residency. And though New York and California recently considered legislation that would allow out-of-staters to secure aid in dying, neither provision passed.)

Despite the limited options and the challenges — such as finding doctors in a new state, figuring out where to die, and traveling when too sick to walk to the next room, let alone climb into a car — dozens have made the trek to the two states that have opened their doors to terminally ill nonresidents seeking aid in dying.

The info is here.

Here are some thoughts:

This article delves into the complex ethical and psychological dimensions of medical aid in dying, highlighting several key issues. At its core, the story of Francine Milano underscores the importance of personal autonomy in end-of-life decisions, with many terminally ill patients finding empowerment and dignity in having control over their final moments.

The legal requirement of a six-month prognosis reflects the ongoing ethical debate surrounding quality versus quantity of life. However, the logistical challenges and travel burdens placed on patients seeking this option raise questions about equitable access and the ethics of imposing additional stress on those already suffering.

The article also touches on the impact on family dynamics, with out-of-state patients often having fewer loved ones present during their final moments. Safeguards such as mental capacity assessments and waiting periods attempt to balance patient autonomy with societal protections, addressing concerns about vulnerable individuals being coerced.

The article acknowledges moral and religious objections, illustrating the ongoing ethical debate in society. Interestingly, the observation that a third of approved patients don't follow through suggests that for some, the mere option provides psychological comfort.

The geographic inequity in access to aid in dying based on state laws raises further ethical concerns.

Lastly, the gradual expansion of these laws points to evolving societal attitudes towards death and dying, which has profound implications for how we approach end-of-life care psychologically and ethically. These multifaceted issues highlight the intricate interplay between individual rights, societal values, and the psychological needs of terminally ill patients and their families in the context of assisted dying.

Tubal Sterilization Rates by State Abortion Laws After the Dobbs Decision

Xu, X., Chen, L.,  et al. (2024).

JAMA.

https://doi.org/10.1001/jama.2024.16862

Abstract

The June 2022 US Supreme Court decision Dobbs v Jackson Women’s Health Organization overturned the federal constitutional right to abortion. Consequently, legality of abortion is now regulated by individual states, and multiple states have banned or restricted abortion. Because women may turn to sterilization if abortion is more difficult to obtain, we examined whether the use of sterilization procedures changed after the Dobbs ruling by restrictiveness of state abortion laws.

Here are some thoughts:

The study revealed a significant increase in tubal sterilization rates among women in the United States following the Dobbs v. Jackson Women's Health Organization ruling. This decision overturned Roe v Wade, leading to stricter abortion laws in many states. The researchers found that the increase in tubal sterilizations was particularly pronounced in states with strict abortion bans, suggesting a direct correlation between limited abortion access and women seeking permanent contraception. The study emphasizes the importance of considering the permanent nature of tubal sterilization when making decisions about contraception, highlighting the potential unintended consequences of abortion restrictions on reproductive health and access to healthcare.

This AI chatbot got conspiracy theorists to question their convictions

Helena Kudiabor

Nature.com

Originally posted 12 Sept 24

Researchers have shown that artificial intelligence (AI) could be a valuable tool in the fight against conspiracy theories, by designing a chatbot that can debunk false information and get people to question their thinking.

In a study published in Science on 12 September1, participants spent a few minutes interacting with the chatbot, which provided detailed responses and arguments, and experienced a shift in thinking that lasted for months. This result suggests that facts and evidence really can change people’s minds.

“This paper really challenged a lot of existing literature about us living in a post-truth society,” says Katherine FitzGerald, who researches conspiracy theories and misinformation at Queensland University of Technology in Brisbane, Australia.

Previous analyses have suggested that people are attracted to conspiracy theories because of a desire for safety and certainty in a turbulent world. But “what we found in this paper goes against that traditional explanation”, says study co-author Thomas Costello, a psychology researcher at American University in Washington DC. “One of the potentially cool applications of this research is you could use AI to debunk conspiracy theories in real life.”

The info is here.

Here are some thoughts:

Researchers have developed an AI chatbot capable of effectively debunking conspiracy theories and influencing believers to reconsider their views. The study challenges prevailing notions about the intractability of conspiracy beliefs and suggests that well-presented facts and evidence can indeed change minds.

The custom-designed chatbot, based on OpenAI's GPT-4 Turbo, was trained to argue convincingly against various conspiracy theories. In conversations averaging 8 minutes, the chatbot provided detailed, tailored responses to participants' beliefs. The results were remarkable: participants' confidence in their chosen conspiracy theory decreased by an average of 21%, with 25% moving from confidence to uncertainty. These effects persisted in follow-up surveys conducted two months later.

This research has important implications for combating the spread of harmful conspiracy theories, which can have serious societal impacts. The study's success opens up potential applications for AI in real-world interventions against misinformation. However, the researchers acknowledge limitations, such as the use of paid survey respondents, and emphasize the need for further studies to refine the approach and ensure its effectiveness across different contexts and populations.

Negative news headlines are more attractive: negativity bias in online news reading and sharing

Zhang, M., Wu, H., et al. (2024).

Current Psychology.

https://doi.org/10.1007/s12144-024-06646-6

Abstract

Clickbait—online content designed to attract attention and clicks through misleading or exaggerated headlines—has become a prevalent phenomenon in online news. Previous research has sparked debate over the effectiveness of clickbait strategies and whether a bias toward negativity or positivity drives online news engagement. To clarify these issues, we conducted two studies. Study 1 examined participants’ preferences for news headlines, revealing a higher selection rate for negative headlines. This finding indicates a negativity bias in the news reading process and underscores the effectiveness of negative information in clickbait strategies. Study 2 simulated the process of news sharing and examined how participants generalize and report negative news. The findings show that participants amplified the negativity of the original news by using more negative terms or introducing new negative language, demonstrating an even stronger negativity bias during news sharing. These findings affirm the presence of a negativity bias in online engagement, in reading and sharing news. This study offers psychological insights into the clickbait phenomenon and provides theoretical support and practical implications for future research on negativity bias in online news.

The research is cited above.

Do moral values change with the seasons?

Hohm, I., O’Shea, B. A., & Schaller, M. (2024).

PNAS, 121(33).

https://doi.org/10.1073/pnas.2313428121

Abstract

Moral values guide consequential attitudes and actions. Here, we report evidence of seasonal variation in Americans’ endorsement of some—but not all—moral values. Studies 1 and 2 examined a decade of data from the United States (total N = 232,975) and produced consistent evidence of a biannual seasonal cycle in values pertaining to loyalty, authority, and purity (“binding” moral values)—with strongest endorsement in spring and autumn and weakest endorsement in summer and winter—but not in values pertaining to care and fairness (“individualizing” moral values). Study 2 also provided some evidence that the summer decrease, but not the winter decrease, in binding moral value endorsement was stronger in regions with greater seasonal extremity. Analyses on an additional year of US data (study 3; n = 24,199) provided further replication and showed that this biannual seasonal cycle cannot be easily dismissed as a sampling artifact. Study 4 provided a partial explanation for the biannual seasonal cycle in Americans’ endorsement of binding moral values by showing that it was predicted by an analogous seasonal cycle in Americans’ experience of anxiety. Study 5 tested the generalizability of the primary findings and found similar seasonal cycles in endorsement of binding moral values in Canada and Australia (but not in the United Kingdom). Collectively, results from these five studies provide evidence that moral values change with the seasons, with intriguing implications for additional outcomes that can be affected by those values (e.g., intergroup prejudices, political attitudes, legal judgments).

Significance

We report evidence that people’s moral values change with the seasons. Analyses of a decade of data (232,975 questionnaire responses from 2011 to 2020) revealed a consistent seasonal cycle in Americans’ endorsement of moral values pertaining to loyalty, authority, and purity (with stronger endorsement in spring and autumn and weaker endorsement in summer and winter). This seasonal cycle was partially explained by an analogous seasonal cycle in Americans’ experience of anxiety. Similar seasonal cycles were observed in data from Canada and Australia (but not the United Kingdom). These findings have implications for attitudes and actions that can be affected by moral values, including intergroup prejudices, political ideologies, and legal judgments.

The article is linked above. It is paywalled.

Here are some thoughts: 

Recent research reveals that seasons may influence moral decision-making at a population level. The study found that binding values, which include loyalty, authority, and purity, exhibit biannual patterns, peaking in spring and fall while dipping in winter and summer. In contrast, individualizing values, such as care and fairness, remain relatively stable across seasons. This seasonal pattern was consistent over multiple years in the United States, Canada, and Australia, although it was not observed in the United Kingdom. Additionally, the researchers discovered that population-level anxiety patterns correlate with fluctuations in binding values, with anxiety peaking in spring and fall. These increases in anxiety may be linked to seasonal transitions in school and work, which can contribute to feelings of threat and a desire for group cohesion.

The implications of this research suggest that morality may be less rational and objective than commonly believed. While dramatic moral shifts do not occur at the individual level, collective small shifts in individual moral thinking could influence broader societal trends, such as discrimination, legal systems, and public compliance with government advice. Understanding these subtle influences can provide valuable insights into population-level behavioral trends and help us better anticipate seasonal shifts in social and political dynamics.

Human embryo models are getting more realistic — raising ethical questions

Smriti Mallapaty

nature.com

Originally posted 11 Sept 24

Here is an excerpt:

Science accelerates

Meanwhile, the science keeps moving at such a pace that regulators have a lot to keep up with. In June 2024, the ISSCR announced that it had set up a working group to assess the state of the science and review earlier guidelines, in light of the models published since 2021.

In 2023, around half a dozen teams described models that recapitulate the development of embryos just after implantation. Two models in particular were widely covered by the media — one by Magdalena Zernicka-Goetz, a developmental biologist at the California Institute for Technology in Pasadena, and one by Jacob Hanna, a stem-cell biologist at the Weizmann Institute of Science in Rehovot, Israel. They were described as complete post-implantation models, but that title has been hotly debated.

“These are not complete models,” says Rivron. The one by Zernicka-Goetz’s group7 doesn’t have cells that behave like trophoblasts, which provide nutrition for the embryo — and although Hanna’s8 does contain a trophoblast-like layer, it isn’t as organized as the real thing, say researchers.

“It’s almost like a beauty contest — whose ‘model’ looked better,” says Jianping Fu, a bioengineer at the University of Michigan in Ann Arbor. “There’s a lot of excitement, but at the same time, there’s some hype in the field right now.”

Some researchers question the value of chasing a complete model. It’s a “pretty exquisite balancing act”, says Hyun. Researchers want models to resemble an embryo closely enough that they provide real insight into human development but not so closely that they can’t tell the difference between the two, and so risk restrictions to their work. “You want to skate as close to the edge as possible, without falling over,” he says.

Some researchers try to avoid this ethical dilemma by intentionally introducing changes to their embryo models that would make it impossible for the model to result in an organism. For example, Hanna has started working on models in which genes involved in brain and heart development have been inactivated. He has inferred from discussions with Christian and Jewish leaders in his community that an embryo model lacking brain or heart tissue would not be considered a form of person.

The info is here.

Here are some thoughts:

Scientists have made significant strides in developing sophisticated "embryo models" using stem cells that closely mimic aspects of early human development. These models present exciting opportunities to explore critical areas such as embryo development, infertility, and disease prevention, while also raising important ethical questions. Key advancements include the creation of "blastoids," which resemble early embryos at the blastocyst stage, as well as models that capture post-implantation development and gastrulation. Additionally, researchers have developed organ-specific models, such as those representing the neural tube and somites, which are crucial for understanding organogenesis.

The potential applications of these models are vast, including studying the causes of early pregnancy loss, improving the success rates of in vitro fertilization (IVF), testing drug safety, and producing blood stem cells for transplants. However, the rapid advancement of this field has led to ongoing challenges related to ethical and regulatory considerations, such as defining the distinction between embryos and embryo models, establishing limits on culturing duration, and imposing restrictions on implantation into animals or humans. As the field continues to progress, there is a pressing need for ongoing ethical guidance and oversight, as well as public engagement and transparency to address societal concerns.

Burnout, racial trauma, and protective experiences of Black psychologists and counselors

Brown, E. M., et al. (2024).

Psychological trauma : theory, research, practice

and policy, 10.1037/tra0001726.

Advance online publication.

https://doi.org/10.1037/tra0001726

Abstract

Objective: The present study explored rates of burnout and racial trauma among 182 Black mental health professionals (BMHPs) and utilized racial-cultural theory to explore potential protective factors against burnout and racial trauma.

Method: We collected data from 182 Black psychologists and counselors who were active mental health professionals during 2020. Descriptive statistics, multivariate analyses of variance, follow-up univariate analyses of variance, bivariate correlations, and multiple regression analyses were used.

Results: Both burnout and racial trauma were considerably higher among BMHPs than has been reported across general samples of helping professionals and across a sample of Black participants across the United States. Differences among rates of burnout and racial trauma existed across genders and specialties (i.e., counseling and psychology). Higher levels of social support and an external locus of control significantly predicted lower levels of burnout and racial trauma. In addition, higher levels of resilient coping predicted lower levels of burnout. Last, more frequent meetings with a mentor significantly predicted lower levels of racial trauma.

Conclusions: Results from this study suggest that BMHPs may be more susceptible to burnout and race-based traumatic stress as a result of their work.

Clinical Impact Statement

The purpose of this study was to examine the rates of burnout and racial trauma of Black mental health

professionals in the wake of COVID and the racial unrest of 2020. It was found that Black mental health

professionals had significantly high rates of burnout and racial trauma. Previous studies have shown that

high levels of burnout and race-based traumatic stress can be detrimental to one’s mental and physical

health. Therefore, results show that greater attention needs to be given to the well-being of Black mental

health professionals to support them in their work.

The article is paywalled.

Here are some thoughts:

Black mental health professionals (BMHPs) face significant challenges, including high rates of burnout and racial trauma, particularly in the wake of recent racial and political unrest. This study found that BMHPs, especially those with master's degrees, experience higher levels of burnout and racial trauma compared to other helping professionals. However, social support, mentoring, and a strong sense of calling to the Black community can serve as protective factors against these negative impacts. The study underscores the importance of providing greater support to BMHPs, particularly during times of heightened racial tension, to help them cope with the immense stress and trauma they encounter in their work.

Moral Disagreement across Politics is Explained by Different Assumptions about who is Most Vulnerable to Harm

Womick, J., et al. (2024). 

PsyArXiv Preprints

https://doi.org/10.31234/osf.io/qsg7j

Abstract

Liberals and conservatives disagree about morality, but explaining this disagreement does not require different moral foundations. All people share a common harm-based mind, making moral judgments based on what seems to cause harm—but people make different assumptions of who or what is especially vulnerable to harm. Liberals and conservatives emphasize different victims. Across eight studies, we validate a brief face-valid assessment of assumptions of vulnerability (AoVs) across methodologies and samples, linking AoVs to scenario judgments, implicit attitudes, and charity behaviors. AoVs, especially about the Environment, the Othered, the Powerful, the Divine, help explain political disagreement about hot-button issues surrounding abortion, immigration, sacrilege, gay rights, polluting, race, and policing. Liberals seem to amplify differences in vulnerability, splitting the world into the very vulnerable versus the very invulnerable, while conservatives dampen differences, seeing all people as similarly vulnerable to harm. AoVs reveal common cognition—and potential common ground—among moral disagreement.

The pdf is here.

Here are some thoughts: 

The study explores the origins of moral disagreement between liberals and conservatives. It argues that both groups share a common harm-based moral framework, but differ in their assumptions about who or what is particularly vulnerable to harm. Liberals emphasize the vulnerability of the marginalized, while conservatives focus on the vulnerability of traditional power structures. These differing perspectives shape their moral judgments and political disagreements on various issues. The study concludes that by understanding these differing assumptions of vulnerability, we can gain a better understanding of moral disagreement and potentially find common ground.

The rise of checkbox AI ethics: a review

Kijewski, S., Ronchi, E., & Vayena, E. (2024).

AI And Ethics.

https://doi.org/10.1007/s43681-024-00563-x

Abstract

The rapid advancement of artificial intelligence (AI) sparked the development of principles and guidelines for ethical AI by a broad set of actors. Given the high-level nature of these principles, stakeholders seek practical guidance for their implementation in the development, deployment and use of AI, fueling the growth of practical approaches for ethical AI. This paper reviews, synthesizes and assesses current practical approaches for AI in health, examining their scope and potential to aid organizations in adopting ethical standards. We performed a scoping review of existing reviews in accordance with the PRISMA extension for scoping reviews (PRISMA-ScR), systematically searching databases and the web between February and May 2023. A total of 4284 documents were identified, of which 17 were included in the final analysis. Content analysis was performed on the final sample. We identified a highly heterogeneous ecosystem of approaches and a diverse use of terminology, a higher prevalence of approaches for certain stages of the AI lifecycle, reflecting the dominance of specific stakeholder groups in their development, and several barriers to the adoption of approaches. These findings underscore the necessity of a nuanced understanding of the implementation context for these approaches and that no one-size-fits-all approach exists for ethical AI. While common terminology is needed, this should not come at the cost of pluralism in available approaches. As governments signal interest in and develop practical approaches, significant effort remains to guarantee their validity, reliability, and efficacy as tools for governance across the AI lifecycle.

The article is here.

Here are some thoughts:

The scoping review reveals a complex and varied landscape of practical approaches to ethical AI, marked by inconsistent terminology and a lack of consensus on defining characteristics such as purpose and target audience. Currently, there is no unified understanding of terms like "tools," "toolkits," and "frameworks" related to ethical AI, which complicates their implementation in governance. A clear categorization of these approaches is essential for policymakers, as the diversity in terminology and ethical principles suggests that no single method can effectively promote AI ethics. Implementing these approaches necessitates a comprehensive understanding of the operational context of AI and the ethical concerns involved.

While there is a pressing need to standardize terminology, this should not come at the expense of diversity, as different contexts may require distinct approaches. The review indicates significant variation in how these approaches apply across the AI lifecycle, with many focusing on early stages like design and development, while guidance for later stages is notably lacking. This gap may be influenced by the private sector's dominant role in AI system design and the associated governance mechanisms, which often prioritize reputational risk management over comprehensive ethical oversight.

The review raises three critical questions: First, whether the rise of practical approaches to AI ethics represents a business opportunity, potentially leading to a proliferation of options but lacking rigorous evaluation. Second, it questions the robustness of these approaches for monitoring AI systems, highlighting a shortage of practical methods for auditing and impact assessment. Third, it suggests that effective AI governance may require context-specific approaches, advocating for standards like "ethical disclosure by default" to enhance transparency and accountability.

Significant barriers to the adoption of these approaches have been identified, including the high levels of expertise and resources required, a general lack of awareness, and the absence of effective measurement methods for successful implementation. The review emphasizes the need for practical validation metrics to assess compliance with ethical principles, as measuring the impact of AI ethics remains challenging.

Culture shapes moral reasoning about close others

Baldwin, C. R., et al. (2024).

Journal of Experimental Psychology:

General, 153(9), 2345–2358.

https://doi.org/10.1037/xge0001626

Abstract

Moral norms balance the needs of the group versus individuals, and societies across the globe vary in terms of the norms they prioritize. Extant research indicates that people from Western cultures consistently choose to protect (vs. punish) close others who commit crimes. Might this differ in cultural contexts that prioritize the self less? Prior research presents two compelling alternatives. On the one hand, collectivists may feel more intertwined with and tied to those close to them, thus protecting close others more. On the other hand, they may prioritize society over individuals and thus protect close others less. Four studies (N = 2,688) performed in the United States and Japan provide self-report, narrative, and experimental evidence supporting the latter hypothesis. These findings highlight how personal relationships and culture dynamically interact to shape how we think about important moral decisions.

Impact Statement

Public Significance Statement—Modern civilization is built on rules about how to behave. Yet, in Western cultures, when these rules are violated by people we know and love, people consistently dismiss them. Here, we demonstrate that this propensity to protect close others is powerfully influenced by culture. In four studies, we provide evidence (N = 2,688) that people from Japan—a culture in which individual interests are prioritized less than in the United States—are less likely to protect close others who transgress out of concern for the impact on society. We also demonstrate that this cultural difference disappears when people from Japan are themselves the victims, a scenario in which societal interests are muted and personal interests are focal. This work highlights how personal relationships and culture dynamically interact to shape how we think about important moral decisions.

The article is paywalled.

Here are some thoughts:

Cultural differences in moral decision-making regarding close others who commit crimes have been observed between Western and Eastern societies. Four studies conducted in the United States and Japan (N = 2,688) reveal that Japanese participants are less inclined to protect close others who transgress compared to Americans. This difference stems from Japanese prioritizing societal concerns over individual relationships. The research employed various methods, including self-report, narrative, and experimental designs, consistently demonstrating this cultural divergence. Importantly, the influence of close relationships on moral reasoning was evident across all samples, but its strength was attenuated among Japanese participants and Americans primed with social norms emphasizing society over individuals. When the societal implications of a crime were minimized, the cultural difference disappeared, highlighting the mechanism driving this effect. These findings illustrate how culture modulates the impact of close relationships on moral reasoning through superordinate goals (e.g., protecting the self vs. society). The results challenge the common assumption that collectivistic societies prioritize close social relationships more than individualistic ones. Instead, they suggest that Japanese interdependence is defined more in terms of societal obligations rather than specific relationships. This research contributes to a more nuanced understanding of how culture and personal relationships dynamically interact to shape important moral decisions, and it emphasizes the need for studying moral decision-making in diverse cultural contexts

Prediction of Future Parkinson Disease Using Plasma Proteins Combined With Clinical-Demographic Measures

You, J., et al. (2024).

Neurology, 103(3).

https://doi.org/10.1212/wnl.0000000000209531

Abstract

Background and Objectives

Identification of individuals at high risk of developing Parkinson disease (PD) several years before diagnosis is crucial for developing treatments to prevent or delay neurodegeneration. This study aimed to develop predictive models for PD risk that combine plasma proteins and easily accessible clinical-demographic variables.

Results

A total of 52,503 participants without PD (median age 58, 54% female) were included. Over a median follow-up duration of 14.0 years, 751 individuals were diagnosed with PD (median age 65, 37% female). Using a forward selection approach, we selected a panel of 22 plasma proteins for optimal prediction. Using an ensemble tree-based Light Gradient Boosting Machine (LightGBM) algorithm, the model achieved an area under the receiver operating characteristic curve (AUC) of 0.800 (95% CI 0.785–0.815). The LightGBM prediction model integrating both plasma proteins and clinical-demographic variables demonstrated enhanced predictive accuracy, with an AUC of 0.832 (95% CI 0.815–0.849). Key predictors identified included age, years of education, history of traumatic brain injury, and serum creatinine. The incorporation of 11 plasma proteins (neurofilament light, integrin subunit alpha V, hematopoietic PGD synthase, histamine N-methyltransferase, tubulin polymerization promoting protein family member 3, ectodysplasin A2 receptor, Latexin, interleukin-13 receptor subunit alpha-1, BAG family molecular chaperone regulator 3, tryptophanyl-TRNA synthetase, and secretogranin-2) augmented the model's predictive accuracy. External validation in the PPMI cohort confirmed the model's reliability, producing an AUC of 0.810 (95% CI 0.740–0.873). Notably, alterations in these predictors were detectable several years before the diagnosis of PD.

Discussion

Our findings support the potential utility of a machine learning-based model integrating clinical-demographic variables with plasma proteins to identify individuals at high risk for PD within the general population. Although these predictors have been validated by PPMI, additional validation in a more diverse population reflective of the general community is essential.

The article is cited above, but paywalled.

Here are some thoughts:

A recent study published in Neurology demonstrates the potential for early detection of Parkinson's disease (PD) using machine learning techniques. Researchers developed a predictive model that analyzes blood proteins in conjunction with clinical data, allowing for the identification of individuals at high risk of developing PD up to 15 years before symptoms appear. The study involved over 50,000 participants from the UK Biobank, focusing on 1,463 different blood plasma proteins. By employing machine learning to identify patterns in protein levels alongside clinical information—such as age, history of brain injuries, and blood creatinine levels—the researchers were able to achieve significant accuracy in predicting Parkinson's risk.

The findings revealed 22 specific proteins that are significantly associated with the risk of developing PD, including neurofilament light (NfL), which is linked to brain cell damage, as well as various proteins involved in inflammation and muscle function. This model not only offers a non-invasive and cost-effective screening method but also presents opportunities for early intervention and improved disease management, potentially enabling the development and assessment of neuroprotective treatments.

However, the study does have limitations that warrant consideration. The participant population was predominantly of European descent, which may limit the generalizability of the findings to more diverse groups. Additionally, the reliance on medical records for PD diagnosis raises concerns about potential misdiagnoses. Future research will need to validate the model in diverse populations and utilize more precise measurement techniques for protein levels. Longitudinal studies that incorporate repeated measurements could further enhance the predictive power of the model.

Overall, this groundbreaking research offers new hope for the early detection and intervention of Parkinson's disease, potentially revolutionizing the approach to managing this neurodegenerative disorder.

ABA amicus brief asserts ban on gender-affirming care denies equal protection

American Bar Association

Press Release

Originally released 3 September 24

The American Bar Association filed an amicus brief today with the U.S. Supreme Court, arguing that a Tennessee law that prohibits gender-affirming medical care for minors violates the equal protection clause of the Fourteenth Amendment.

The ABA brief, filed in support of the federal government’s challenge to the law, contends that the Tennessee law, known as Senate Bill (SB1), impermissibly denies the fundamental right to medical autonomy for certain groups while allowing it for others.

“Equal protection forbids differential treatment in the exercise of important constitutional rights absent the strongest justification, and Tennessee’s SB1 cannot withstand scrutiny under that standard,” the ABA brief says. It adds: “The ABA has recognized in its past policy statements, state policy denying any individual access to needed medical care for reasons wholly unrelated to any medical justification — as SB1 does — is inimical to equality and equal dignity before the law.”

Gender-affirming care typically encompasses a range of social, psychological, behavioral and medical interventions that support and affirm an individual’s gender identity when it conflicts with the gender they were assigned at birth. In June, the U.S. Supreme Court agreed to consider the constitutionality of SB1 in its new term that begins Oct. 7. Media reports indicate that 26 Republican-controlled states in the past three years have enacted laws restricting such care for minors.

In its brief, the ABA outlines its lengthy record of supporting LGBTQ rights, first urging the repeal of laws criminalizing private sexual relations between consenting adults more than a half century ago. Most recently in August, the ABA House of Delegates adopted policy urging legal protection of access to gender-affirming care.

“The right of patients to access treatment without arbitrary governmental interference is grounded in the common-law right of bodily integrity and self-determination, as well as liberty interests protected by the Fourteenth Amendment,” the brief says, citing the U.S. Supreme Court’s prior decisions.

The ABA brief in U.S. v. Skrmetti, which asks that the Supreme Court reverse the appeals court decision upholding the law, is here. The law firm of Arnold & Porter Kaye Scholer LLP filed the brief pro bono on behalf of the ABA.

Consensus, controversy, and chaos in the attribution of characteristics to the morally exceptional

Fleeson, W., Furr, R. et al. (2023).

Journal of Personality, 92(3), 715–734.

https://doi.org/10.1111/jopy.12867

Abstract

Objective

What do people see as distinguishing the morally exceptional from others? To handle the problem that people may disagree about who qualifies as morally exceptional, we asked subjects to select and rate their own examples of morally exceptional, morally average, and immoral people.

Method

Subjects rated each selected exemplar on several enablers of moral action and several directions of moral action. By applying the logic underlying stimulus sampling in experimental design, we evaluated perceivers’ level of agreement about the characteristics of the morally exceptional, even though perceivers rated different targets.

Results

Across three studies, there was strong subjective consensus on who is morally exceptional: those who are empathetic and prone to guilt, those who reflect on moral issues and identify with morality, those who have self-control and actually enact moral behaviors, and those who care about harm, compassion, fairness, and honesty. Deep controversies also existed about the moral directions pursued by those seen as morally exceptional: People evaluated those who pursued similar values and made similar decisions more favorably.

Conclusion

Strong consensus suggests characteristics that may push a person to go beyond normal expectations, that the study of moral exceptionality is not overly hindered by disagreement over who is morally exceptional, and that there is some common ground between disagreeing camps.

The article is linked above.

Here are some thoughts:

The research explores the perception of morally exceptional individuals compared to those deemed typically moral or immoral, revealing a significant consensus on the characteristics that distinguish moral exceptionalism. Across three studies, participants identified that those considered morally exceptional possess traits such as empathy, self-control, and a strong moral identity, which enable them to act on their moral judgments. This consensus offers optimism for further research into moral exceptionalism, suggesting that despite widespread disagreement on specific moral issues, there is a shared understanding of the enablers of moral behavior.

The findings indicate that while there is agreement on the attributes of morally exceptional individuals, controversies arise regarding the moral judgments they make. Notably, individuals who share similar moral values with perceivers are more likely to be recognized as morally exceptional. This highlights a potential area for future research to explore these dynamics further.

The results also contribute to the understanding of moral pluralism, indicating that while there is consensus on the processes that characterize moral exceptionality, there remains considerable debate over the specific moral domains valued by these individuals. This suggests that moral exemplars may not exhibit unified virtue across all moral domains, prompting further investigation into how moral understanding can be enhanced through recognition of moral processes rather than solely focusing on moral content.

In summary, the research reveals a complex landscape of moral perception, where agreement exists on the enablers of moral action, yet significant differences persist in the moral judgments made by individuals. This duality presents opportunities for fostering dialogue and understanding across diverse moral perspectives.

New Ethics Opinion Addresses Obligations Associated With Collateral Information

Moran, M. (2024).

Psychiatric News, 59(09). 

https://doi.org/10.1176/appi.pn.2024.09.9.12

What are a psychiatrist’s ethical obligations regarding confidentiality of sources of collateral information obtained in the involuntary hospitalization of a patient?

In a new opinion added to “The Principles of Medical Ethics With Annotations Especially Applicable to Psychiatry,” the APA Ethics Committee underscored that a psychiatrist’s overriding ethical obligation is to the safety of the patient, and that there can be no guarantee of confidentiality to family members or other sources who provide information that is used during involuntary hospitalization.

“Psychiatrists deal with collateral information in clinical practice routinely,” said Ethics Committee member Gregory Barber, M.D. “It’s a standard part of the job to collect collateral information in cases where a patient is hospitalized, especially involuntarily, and there can be a lot of complicated interpersonal dynamics that come up when family members provide that information.

“We obtain collateral information from people who know a patient well as a way to ensure we have a full clinical picture regarding the patient’s situation,” Barber said. “But our ethical obligations are to the patient and the patient’s safety. Psychiatrists do not have an established doctor-patient relationship with the source of collateral information and do not have obligations to keep the source hidden from patients. And we should not make guarantees that the information will remain confidential.”

The info is linked here and above.

Here are some thoughts:

Psychiatrists' ethical obligations regarding confidentiality of collateral information in involuntary hospitalization prioritize patient safety. While they should strive to protect sources' privacy, this may be secondary to ensuring the patient's well-being. Transparency and open communication with both the patient and the collateral source are essential for building trust and preventing conflicts.

How a Leading Chain of Psychiatric Hospitals Traps Patients

Jessica Silver-Greenberg & Katie Thomas

The New York Times

Originally posted 1 September 24

Acadia Healthcare is one of America’s largest chains of psychiatric hospitals. Since the pandemic exacerbated a national mental health crisis, the company’s revenue has soared. Its stock price has more than doubled.

But a New York Times investigation found that some of that success was built on a disturbing practice: Acadia has lured patients into its facilities and held them against their will, even when detaining them was not medically necessary.

In at least 12 of the 19 states where Acadia operates psychiatric hospitals, dozens of patients, employees and police officers have alerted the authorities that the company was detaining people in ways that violated the law, according to records reviewed by The Times. In some cases, judges have intervened to force Acadia to release patients.

Some patients arrived at emergency rooms seeking routine mental health care, only to find themselves sent to Acadia facilities and locked in.

A social worker spent six days inside an Acadia hospital in Florida after she tried to get her bipolar medications adjusted. A woman who works at a children’s hospital was held for seven days after she showed up at an Acadia facility in Indiana looking for therapy. And after police officers raided an Acadia hospital in Georgia, 16 patients told investigators that they had been kept there “with no excuses or valid reason,” according to a police report.

The info is here.

Here are some thoughts:

Acadia Healthcare, a leading provider of psychiatric hospitals in the United States, has seen significant revenue growth amid the ongoing mental health crisis. However, an investigation by The New York Times revealed that the company has been accused of detaining patients against their will, even when it wasn't medically necessary.

The investigation uncovered numerous instances where patients, employees, and police officers reported Acadia's practices violating the law. Patients were often held for longer than necessary, sometimes for financial reasons rather than medical ones. Some patients were even lured into facilities under false pretenses.

Despite the allegations, Acadia has maintained that its practices are driven by medical necessity and patient safety. However, the company has faced multiple investigations and settlements related to its practices.

The investigation raises serious questions about the quality of care provided by for-profit psychiatric hospitals and the potential for abuse when financial incentives outweigh patient needs.

Remotely administered non-deceptive placebos reduce COVID-related stress, anxiety, and depression

Guevarra, D. A., Webster, C. T, et al. (2024).

Applied Psychology Health and Well-Being.

https://doi.org/10.1111/aphw.12583

Abstract

Research suggests that placebos administered without deception (i.e. non-deceptive placebos) may provide an effective and low-effort intervention to manage stress and improve mental health. However, whether non-deceptive placebos administered remotely online can manage distress for people at risk for developing high levels of affective symptoms remains unclear. Volunteers experiencing prolonged stress from the COVID-19 pandemic were recruited into a randomized controlled trial to examine the efficacy of a non-deceptive placebo intervention administered remotely online on affective outcomes. COVID-related stress, overall stress, anxiety, and depression were assessed at baseline, midpoint, and endpoint. Compared with the control group, participants in the non-deceptive placebo group reported significant reductions from baseline in all primary affective outcomes after 2 weeks. Additionally, participants in the non-deceptive placebo group found the intervention feasible, acceptable, and appropriate for the context. Non-deceptive placebos, even when administered remotely online, offer an alternative and effective way to help people manage prolonged stress. Future large-scale studies are needed to determine if non-deceptive placebos can be effective across different prolonged stress situations and for clinical populations.

The article is linked above.

Here are some thoughts:

Non-deceptive placebos (NDPs) have shown promise as an effective and low-effort intervention for managing stress and improving mental health, even when administered remotely online. A randomized controlled trial examined the efficacy of NDPs on volunteers experiencing prolonged stress from the COVID-19 pandemic. The study found that participants in the NDP group reported significant reductions in COVID-related stress, overall stress, anxiety, and depression compared to the control group after just two weeks. The effect sizes were comparable to those seen in self-guided online cognitive behavioral therapy programs. Participants in the NDP group also reported high expectations of benefits and found the intervention feasible, acceptable, and appropriate for the context. These findings suggest that NDPs, even when administered remotely, can help moderately at-risk individuals manage their psychological health during prolonged stressful situations. The study's results are consistent with previous research showing positive effects of NDPs on affect-related outcomes. However, the researchers noted some limitations, including a small and demographically limited sample size, potential response bias, and the need for more diverse and larger-scale studies. Despite these limitations, the study highlights the potential of NDPs as a scalable, easily implementable secondary intervention to help prevent medium-risk populations from progressing to clinical levels of affective symptoms. Future research should focus on examining the efficacy of NDPs across different stress situations and for clinical populations, as well as investigating the mechanisms through which NDPs exert their effects.

I often think about psychotherapy's potential placebo effects (and how to possibly incorporate this into my informed consent to treatment). Psychotherapy's relationship to placebo effects is a complex and debated topic in the field of mental health. While psychotherapy shares some key mechanisms with placebos, such as the importance of patient expectations, the therapeutic alliance, and nonspecific factors like empathy and attention, it would be overly reductive to label psychotherapy as merely a placebo. Psychotherapy has specific, theorized mechanisms of action and has been shown in well-designed studies to outperform placebo controls, albeit sometimes by small margins. However, the similarities between psychotherapy and placebo effects highlight the importance of these "common factors" in treatment outcomes.  Mental health professionals need to consider the potential placebo effects in psychotherapy.

Death threats, legal risk and backlogs weigh on clinicians treating trans minors

Emma Davis

NBC news

Originally posted 28 August 24

Dr. Kade Goepferd has received death threats for their work treating transgender youths at Children’s Minnesota Hospital, but Goepferd said the harassment isn’t the most worrying part of the job. 

“The waitlist is what keeps me up at night,” said Goepferd, who uses they/them pronouns. “It has grown every year, and it got particularly long after the bans went into effect.”

Goepferd is the medical director of the hospital’s Gender Health Program, the only multispeciality pediatric gender clinic in Minnesota. The program has experienced a 30% increase in calls since surrounding states outlawed gender-affirming care for minors, and the waitlist is now at least a year for new patients, even after Goepferd hired additional staff to help the hundreds of trans youths requesting appointments.

Twenty-six states now have restrictions on transgender health care for minors, according to the LGBTQ think tank Movement Advancement Project. The laws have left those still able to provide this type of care, like Goepferd, struggling to keep up with demand.

NBC News spoke to a dozen clinicians in states where gender-affirming care for minors remains legal, from Connecticut to California, and found all are treating transgender youths fleeing bans. Not only does the surge in out-of-state and newly relocated patients create logistical challenges — from waitlists to insurance denials — it also presents a legal risk for health care professionals. Although some states have enacted protections for gender-affirming care providers, these shield laws remain untested in court, and they have done little to deter anti-trans attacks. Many doctors said they’ve had to take added security measures as transphobic rhetoric has intensified.

“There’s been a growing awareness over the last year that the environment is only getting more and more dangerous for providers,” said Kellan Baker, executive director of the Whitman-Walker Institute, a nonprofit advancing LGBTQ health care.

The info is here.

Here are some thoughts:

The situation described in this article raises significant concerns across multiple domains. The long waitlists and limited availability of gender-affirming care pose serious ethical issues, conflicting with the principle of beneficence in medical ethics and potentially exacerbating mental health issues among transgender youth.

The threats and harassment faced by healthcare providers not only raise concerns about their safety and wellbeing but also could deter professionals from offering essential care. The legal ambiguity surrounding gender-affirming care in different states puts providers in a difficult position, forcing them to navigate between professional judgment and legal risks. This hostile environment, combined with the constant legal uncertainties, is likely causing significant stress and burnout among healthcare providers, which could impact the quality of care they're able to provide.

The healthcare system itself faces numerous challenges, including strained resources due to the influx of out-of-state patients, insurance and cost barriers creating healthcare equity issues, and limitations on training opportunities for new providers potentially leading to future workforce shortages. These issues reflect broader societal concerns, including the politicization of healthcare and potential discrimination against transgender individuals, raising civil rights concerns.

The current state of transgender rights presents a complex interplay of ethical, psychological, and systemic challenges that require careful consideration and balanced approaches to ensure both patient care and provider safety. Moving forward, it will be crucial for policymakers, healthcare professionals, and society at large to engage in thoughtful dialogue and evidence-based decision-making to address these multifaceted issues.