Moral Injury, Traumatic Stress, and Threats to Core Human Needs in Health-Care Workers: The COVID-19 Pandemic as a Dehumanizing Experience

Hagerty, S. L., & Williams, L. M. (2022)

Clinical Psychological Science. 

https://doi.org/10.1177/21677026211057554

Abstract

The pandemic has threatened core human needs. The pandemic provides a context to study psychological injury as it relates to unmet basic human needs and traumatic stressors, including moral incongruence. We surveyed 1,122 health-care workers from across the United States between May 2020 and August 2020. Using a mixed-methods design, we examined moral injury and unmet basic human needs in relation to traumatic stress and suicidality. Nearly one third of respondents reported elevated symptoms of psychological trauma, and the prevalence of suicidal ideation among health-care workers in our sample was roughly 3 times higher than in the general population. Moral injury and loneliness predict greater symptoms of traumatic stress and suicidality. We conclude that dehumanization is a driving force behind the psychological injury resulting from moral incongruence in the context of the pandemic. The pandemic most frequently threatened basic human motivations at the foundational level of safety and security relative to other higher order needs.

From the General Discussion

A subset of respondents added context to their experiences of moral injury in the form of narrative responses. These powerful accounts of the lived experiences of health-care workers provided us with a richer understanding of the construct of moral injury, especially as it relates to the novel context of the pandemic. Although betrayal is a known facet of moral injury from prior work (Bryan et al., 2016), our qualitative analysis suggests that dehumanization may also be a key phenomenon that underlies pandemic-related moral injury. Given our findings, we suggest that it may be important to attend to both betrayal and dehumanization when researching or intervening on the psychological sequelae of the pandemic. Our results support this because experiences of dehumanization in our sample were associated with greater symptoms of traumatic stress.

Another lens through which to view the experiences of health-care workers in the pandemic is through unsatisfied basic human motivations. Given the obvious barriers the pandemic presents to human connection (Hagerty & Williams, 2020), we had an a priori interest in studying loneliness. Our results indeed suggest that need of social connection appears relevant to the mental-health experiences of health-care workers during the pandemic such that loneliness was associated with greater traumatic stress, moral injury, and suicidal ideation. Echoing the importance of this social factor are findings from prior research suggesting that social connectedness buffers the association between moral injury and suicidality (Kelley et al., 2019) and buffers the impact of PTSD symptoms on suicidal behavior (Panagioti et al., 2014). Thus, our work further highlights lack of social connection as possible risk factor among individuals who face moral injury and traumatic stress and demonstrates its relevance to the mental health of health-care workers during the pandemic.

The research is here.

Could we fall in love with robots?

Rich Wordsworth

eandt.theiet.org

Originally published 6 DEC 21

Here is an excerpt:

“So what are people’s expectations? They’re being fed a very particular idea of how [robot companions] should look. But when you start saying to people, ‘They can look like anything,’ then the imagination really opens up.”

Perhaps designing companion robots that deliberately don’t emulate human beings is the answer to that common sci-fi question of whether or not a relationship with a robot can ever be reciprocal. A robot with a Kindle for a head isn’t likely to hoodwink many people at the singles bar. When science fiction shows us robotic lovers, they are overwhelmingly portrayed as human (at least outwardly). This trips something defensive in us: the sense of unease or revulsion we feel when a non-human entity tries to deceive us into thinking that it’s human is such a common phenomenon (thanks largely to CGI in films and video games) that it has its own name: ‘the Uncanny Valley’. Perhaps in the future, the engineering of humanoid robots will progress to the point where we really can’t tell (without a signed waiver and a toolbox) whether a ‘person’ is flesh and blood or wires and circuitry. But in the meantime, maybe the best answer is simply not to bother attempting to emulate humans and explore the outlandish.

“You can form a friendship; you can form a bond,” says Devlin of non-humanlike machines. “That bond is one-way, but if the machine shows you any form of response, then you can project onto that and feel social. We treat machines socially because we are social creatures and it’s almost enough to make us buy into it. Not delusionally, but to suspend our disbelief and feel a connection. People feel connections with their vacuum cleaners: mine’s called Babbage and I watch him scurrying around, I pick him up, I tell him, ‘Don’t go there!’ It’s like having a robot pet – but I’m perfectly aware he’s just a lump of plastic. People talk to their Alexas when they’re lonely and they want to chat. So, yes: you can feel a bond there.

“It’s not the same as a human friendship: it’s a new social category that’s emerging that we haven’t really seen before.”

As for the question of reciprocity, Devlin doesn’t see a barrier there with robots that doesn’t already exist in human relationships.

“You’ll get a lot of people going, ‘Oh, that’s not true friendship; that’s not real.’,” Devlin says, sneeringly. “Well, if it feels real and if you’re happy in it, is that a problem? It’s the same people who say you can’t have true love unless it’s reciprocated, which is the biggest lie I’ve ever heard because there are so many people out there who are falling in love with people they’ve never even met! Fictional people! Film stars! Everybody! Those feelings are very, very valid to someone who’s experiencing them.”

“How are you guys doing here?” The waitress asks with perfect waitress-in-a-movie timing as Twombly and Catherine sit, processing the former’s new relationship with Samantha in silence.

“Fine,” Catherine blurts. “We’re fine. We used to be married but he couldn’t handle me; he wanted to put me on Prozac and now he’s madly in love with his laptop.”

In 2013, Spike Jonze’s script for ‘Her’ won the Academy Award for Best Screenplay (it was nominated for four others including Best Picture). A year later, Alex Garland’s script for ‘Ex Machina’ would be nominated for the same award while arguably presenting the same conclusion: we are a species that loves openly and to a fault. 

The info is here.

Confidence and gradation in causal judgment

O'Neill, K., Henne, P, et al.

Cognition

Volume 223, June 2022, 105036

Abstract

When comparing the roles of the lightning strike and the dry climate in causing the forest fire, one might think that the lightning strike is more of a cause than the dry climate, or one might think that the lightning strike completely caused the fire while the dry conditions did not cause it at all. Psychologists and philosophers have long debated whether such causal judgments are graded; that is, whether people treat some causes as stronger than others. To address this debate, we first reanalyzed data from four recent studies. We found that causal judgments were actually multimodal: although most causal judgments made on a continuous scale were categorical, there was also some gradation. We then tested two competing explanations for this gradation: the confidence explanation, which states that people make graded causal judgments because they have varying degrees of belief in causal relations, and the strength explanation, which states that people make graded causal judgments because they believe that causation itself is graded. Experiment 1 tested the confidence explanation and showed that gradation in causal judgments was indeed moderated by confidence: people tended to make graded causal judgments when they were unconfident, but they tended to make more categorical causal judgments when they were confident. Experiment 2 tested the causal strength explanation and showed that although confidence still explained variation in causal judgments, it did not explain away the effects of normality, causal structure, or the number of candidate causes. Overall, we found that causal judgments were multimodal and that people make graded judgments both when they think a cause is weak and when they are uncertain about its causal role.

From the General Discussion

The current paper sought to address two major questions regarding singular causal judgments: are causal judgments graded, and if so, what explains this gradation?

(cut)

In other words, people make graded causal judgments both when they think a cause is weak and also when they are uncertain about their causal judgment. Although work is needed to determine precisely why and when causal judgments are influenced by confidence, we have demonstrated that these effects are separable from more well-studied effects on causal judgment. This is good news for theories of causal judgment that rely on the causal strength explanation: these theories do not need to account for the effects of confidence on causal judgment to be useful in explaining other effects. That is, there is no need for major revisions in how we think about causal judgments. Nevertheless, we think our results have important implications for these theories, which we outline below.

The research is here.

The prejudices of expert evidence

Chin, J., Cullen, H. J., & Clarke, B. 

(2022, February 14).

https://doi.org/10.31222/osf.io/nxcvy

Abstract

The rules and procedures regulating the admission of potentially unreliable expert evidence have been substantially weakened over the past several years. We respond to this trend by focusing on one aspect of the rules that has not been explicitly curtailed: unfair prejudice. Unfair prejudice is an important component of trial judges’ authority to exclude evidence, which they may do when that unfair prejudice outweighs the evidence’s probative value. We develop the concept of unfair prejudice by first examining how it has been interpreted by judges and then relating that to the relevant social scientific research on the characteristics of expertise that can make it prejudicial. In doing so, we also discuss the research behind a common reason that judges admit expert evidence despite its prejudice, which is that judicial directions help jurors understand and weigh it. As a result, this article provides two main contributions. First, it advances knowledge about unfair prejudice, which is an important part of expert evidence law that has received relatively little attention from legal researchers. Second, it provides guidance to practitioners for challenging expert evidence under one of the few avenues left to do so.

(cut)

What should courts do about the prejudices of expert evidence?

While we recognise that balancing probative value with unfair prejudice is fact-specific and contextual, the analysis above suggests considerable room for improvement in how courts assess putatively prejudicial expert evidence. Specifically, the research we reviewed indicates that courts do not fully appreciate the degree to which laypeople may overestimate the reliability of scientific claims. But, more than that, the judicial approach has been myopically focused on the CSI Effect (and in at least one case, significantly misconstrued it), rather than other well-researched expert evidence stereotypes and misconceptions. Accordingly, we recommend that judges apply the discretions to exclude evidence in sections 135 and 137 of the UEL in a way that is more sensitive to empirical research. For example, courts should recognise that experts, or counsel that emphasise the expert’s status and years of experience, also feed into that evidence’s prejudicial potential. Moreover, technical jargon and the general complexity of the evidence can serve to heighten that prejudice, such that these features of expert evidence may build upon each other in a way that is more than additive.

The expert evidence jurisprudence is even more insensitive to research on the factors that make evidence difficult or impossible to test. For example, we struggled (as others have) to find decisions acknowledging that unconscious cognitive processes and associated biases invite prejudice because the unconscious is difficult to cross-examine. Moreover, the closest decision we could find acknowledging adversarial imbalance as a limit on adversarial testing was a US decision in obiter.  And troublingly, courts sometimes simply mistake previously admitted evidence with evidence that has been adversarially tested. With evidence that defies testing, the first step for courts is to acknowledge this research on prejudice and incorporate it into the exclusionary calculus in sections 135 and 137. The next step, as we will see in the following part, is to use this knowledge to better understand the limitations of judicial directions aimed at mitigating prejudice – and perhaps craft better directions in the future. 

The info is here.

The Content of Our Character

Brown, Teneille R.

Available at SSRN: https://ssrn.com/abstract=3665288

Abstract

The rules of evidence assume that jurors can ignore most character evidence, but the data are clear. Jurors simply cannot *not* make character inferences. We are so driven to use character to assess blame, that we will spontaneously infer traits based on whatever limited information is available. In fact, within just 0.1 seconds of meeting someone, we have already decided if we think they are intelligent, trustworthy, likable, or kind--based just on the person’s face. This is a completely unregulated source of evidence, and yet it predicts teaching evaluations, electoral success, and even sentencing decisions. Given the pervasive and unintentional nature of “spontaneous trait inferences” (STIs), they are not susceptible to mitigation through jury instructions. However, recognizing that witnesses will be viewed as more or less trustworthy based just on their face, the rules of evidence must permit more character evidence, rather than less. This article harnesses undisputed findings from social psychology to propose a reversal of the ban on character evidence, in favor of a strong presumption against admissibility for immoral traits only. This removes a great deal from the rule’s crosshairs and re-tethers it to its normative roots. My proposal does not rely on the gossamer thin distinction between propensity and non-propensity uses, because once jurors hear about past act evidence, they will subconsciously draw an impermissible character inference. However, in some cases this might not be unfairly prejudicial, and may even be necessary for justice. The critical contribution of this article is that while shielding jurors from character evidence has noble origins, it also has unintended, negative consequences. When jurors cannot hear about how someone acted in the past, they will instead rely on immutable facial features—connected to racist, sexist and classist stereotypes—to draw character inferences that are even more inaccurate and unfair.

Here is a section

Moral Character Impacts Ratings of Intent

Previous models of intentionality held that for an act to be considered intentional, three things had to be present. The actor must have believed that an action would result in a particular outcome, desired this outcome, and had full awareness of his behavior. Research now challenges this account, “showing that individuals attribute intentions to others even (and largely) in the absence of these components.”  Even where an actor could not have acted otherwise, and thus was coerced to kill, study participants found the actor to be more morally responsible for an act if he “identified” with it, meaning that he desired the compelled outcome. These findings do not fit with our typical model of blame, which requires freedom to act in order to assign responsibility.  However, they make sense if we adopt a character-based approach to

blame. We are quick to infer a bad character and intent when there is very little evidence of it.  

An example of this is the hindsight bias called the “praise-blame asymmetry,” where people blame actors for accidental bad outcomes that they caused but did not intend, but do not praise people for accidental good outcomes that they likewise caused but did not intend. The classic example is the CEO who considers a development project that will increase profits. The CEO is agnostic to the project’s environmental effects and gives it the go-ahead. If the project’s outcome turns out to harm the environment, people say the CEO intended the bad outcome and they blame him for it. However, if instead the project turns out to benefit the environment, the CEO receives no praise. Our folk conception of intentionality is tied to morality and aversion to negative outcomes. If a foreseen outcome is negative, people will attribute intentionality to the decision-maker, but not if the foreseen outcome is positive; the overattribution of intent only seems to cut one way. Mens rea ascriptions are “sensitive to moral valence . . . . If the outcome is negative, foreknowledge standardly suffices for people to ascribe intentionality.” This effect has been found not just in laypeople, but also in French judges. If an action is considered immoral, then our emotional reaction to it can bias mental state ascriptions.

The law review is here.

Parents think—incorrectly—that teaching their children that the world is a bad place is likely best for them

J. D. W. Clifton & Peter Meindl (2021)

The Journal of Positive Psychology

DOI: 10.1080/17439760.2021.2016907

Primal world beliefs (‘primals’) are beliefs about the world’s basic character, such as the world is dangerous. This article investigates probabilistic assumptions about the value of negative primals (e.g., seeing the world as dangerous keeps me safe). We first show such assumptions are common. For example, among 185 parents, 53% preferred dangerous world beliefs for their children. We then searched for evidence consistent with these intuitions in 3 national samples and 3 local samples of undergraduates, immigrants (African and Korean), and professionals (car salespeople, lawyers, and cops;), examining correlations between primals and eight life outcomes within 48 occupations (total N=4,535) . As predicted, regardless of occupation, more negative primals were almost never associated with better outcomes. Instead, they predicted less success, less job and life satisfaction, worse health, dramatically less flourishing, more negative emotion, more depression, and increased suicide attempts. We discuss why assumptions about the value of negative primals are nevertheless widespread and implications for future research.

From the General Discussion

When might very positive primals be damaging illusions (i.e., associated with negative outcomes)? Study 2 was a big-net search for these contexts. We examined eight outcomes, six samples, 4,535 unique subjects, and 48 occupations (n ≥ 30), including lawyers, doctors, police officers, professors, and so forth. This unearthed 1,860 significant correlations between primals and outcomes, and the overall pattern was clear. In 99.7% of these relationships, more negative primals were associated with worse outcomes, roughly categorized as slightly less job success, moderately less job satisfaction, much less life satisfaction, moderately worse health, much increased frequency of negative emotion and other depression symptoms, dramatically decreased psychological flourishing, and moderately increased likelihood of having attempted suicide. We also found no empirical justification for the popular moderation approach. In 297 of 297 significant differences in outcomes, those who saw the world as somewhat positive always experienced worse outcomes than those who saw the world as very positive. In sum, a robust correlational relationship exists between more negative primals and more negative outcomes, even when comparing positive beliefs to positive beliefs, even when comparing within occupation. The seemingly widespread meta-belief that associates negative primals with positive outcomes is unsupported.

The research is here.

A pdf to the research is here.

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High rates of burnout among college mental health counselors is compromising quality of care, survey says

Brooke Migdon

thehill.com

Originally posted 17 FEB 22

College counselors and clinicians are reporting increasingly high levels of burnout and stress as the pandemic enters its third year. Experts say it’s going to get worse before it gets better.

Just under 93 percent of clinicians on college campuses reported feeling burned out and stressed during the fall semester this year, according to a survey by Mantra Health, a digital mental health clinic geared at young adults. More than 65 percent of respondents reported a heavier workload and longer hours worked compared to the fall semester in 2020. 

Another 60 percent said their workload had compromised the quality of care they were able to provide to students in the fall.

Caseloads aren’t expected to fall anytime soon, as overworked clinicians are leaving the field at a rate similar to that of students asking for help, according to David Walden, the director of Hamilton College’s counseling center. Qualified candidates are also hard to come by.

“Over the last year college counseling centers have seen an uptick in professionals leaving the field and a smaller pool of applicants to refill their positions while the demand from students seeking treatment continues to rise,” he said Thursday in a statement.

Walden noted that, importantly, clinicians are also contending with their own pandemic anxieties that impact their ability to care for themselves, let alone others.

It is “increasingly difficult for directors and clinicians to avoid burnout while institutions of higher education are having increasing trouble hiring and retaining quality mental health staff,” he said.

With college-aged students reporting alarming rates of depression, anxiety and substance abuse, providing quality on- and off-campus care is critical.

The info is here.

Autonomy and the Folk Concept of Valid Consent

Demaree-Cotton, J., & Sommers, R. 

(2021, August 17). 

https://doi.org/10.31234/osf.io/p4w8g

Abstract

Consent governs innumerable everyday social interactions, including sex, medical exams, the use of property, and economic transactions. Yet little is known about how ordinary people reason about the validity of consent. Across the domains of sex, medicine, and police entry, Study 1 showed that when agents lack autonomous decision-making capacities, participants are less likely to view their consent as valid; however, failing to exercise this capacity and deciding in a nonautonomous way did not reduce consent judgments. Study 2 found that specific and concrete incapacities reduced judgments of valid consent, but failing to exercise these specific capacities did not, even when the consenter makes an irrational and inauthentic decision. Finally, Study 3 showed that the effect of autonomy on judgments of valid consent carries important downstream consequences for moral reasoning about the rights and obligations of third parties, even when the consented-to action is morally wrong. Overall, these findings suggest that laypeople embrace a normative, domain-general concept of valid consent that depends consistently on the possession of autonomous capacities, but not on the exercise of these capacities. Autonomous decisions and autonomous capacities thus play divergent roles in moral reasoning about consent interactions: while the former appears relevant for assessing the wrongfulness of consented-to acts, the latter plays a role in whether consent is regarded as authoritative and therefore as transforming moral rights.

Conclusion 

Before these studies, it remained an open possibility that “valid consent” as a rich and normatively complex force existed only as a technical concept used in philosophical, legal and academic domains. We found, however, that the folk concept of consent involves normative distinctions between valid and invalid consent that are sensitive to the consenter’s autonomy, even if the linguistic utterance of “yes” is held constant, and that this concept plays an important role in moral reasoning. 

Specifically, the studies presented here examined the relationship between autonomy and intuitive judgments of valid consent in several domains: medical procedures, sexual relations, police searches, and agreements between buyers and sellers.  Across scenarios, we found that judgments of valid consent carried a specific relationship to autonomy: whether an agent possesses the mental capacity to make decisions in an autonomous way has a consistent impact on whether their consent is regarded as valid, and thus whether it was regarded as morally transformative of the rights and obligations of the consenter and of third parties.  Yet, whether the agent in fact makes their decision in an autonomous, rational way—based on their own authentic values and what is right for them—has little impact on perceptions of consent or associated rights, although it has relevance for whether the consent-obtainer is acting wrongly.  Autonomy thus has a subtle role in the ordinary reasoning about morally transformative consent, where consent given by an agent with autonomous capacities has a distinctive role in downstream moral reasoning.

The research is here.