The development of ego defenses in adolescence

This study tested a model for developmental transitions in defense use in adolescence based on an integration of psychoanalytic views of adolescence and Loevinger's theory of ego development. Loevinger's test for ego development and the Defense Mechanism Inventory were administered to 31 male and 35 female adolescents. Results supported several hypothesized developmental transitions: decrease in aggression outward defenses (e.g., displacement), increase in turning against the self, and an unpredicted increase in defenses entailing reversal (repression, denial, and reaction formation). Results failed to support a hypothesized increase in intellectualization and a decrease in projection. Results supported ego development over chronological age as a more valid index of maturity to apply to the investigation of the development of defenses. Implications of these findings are discussed and directions for future research are suggested.This research was partially funded by the Psychology Department at Boston UniversityAffiliations at the time when this study was conducted were Department of Psychology, Boston University, and Departments of Psychiatry at Beth Israel and McLean Hospitals/Harvard Medical School. Now Clinical Psychologist, Outpatient Psychiatry Service, Baystate Medical Center, Springfield, Massachusetts. Received Ph.D. in clinical psychology from Boston University. Research interests include ego defenses, psychotherapy research, gender, and sex roles.     

Moral atrophy in the welfare state

The welfare state is often accused of being counterproductive: as the scope of public responsibility expands, private morality (especially altruism and benevolence) atrophies. This essay surveys psychological findings for evidence, which turns out to be broadly consistent with either of two models of moral development, each bearing distinct policy implications. The model of morally keeping in practice that is implicit in the term moral atrophy suggests the need for frequent opportunities to exercise moral skills, which would seem inconsistent with the welfare state. Alternatively, the model of moral character-building favoured by both philosophers and ordinary discourse would require only occasional reminders of one's moral principles. On this model, benevolence could usefully supplement the welfare state.     

The need to know versus the right to know: privacy of patient medical data in an information-based society

"Whatever, in connection with my professional practice, or not in connection with it, I see or hear, in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret."(1) "Safeguards to privacy in individual health care information are imperative to preserve the health care delivery relationship and the integrity of the patient record."(2) As early as the fourth and fifth centuries B.C., Hippocrates contemplated the importance of medical information to the care and treatment of patients. His oath suggests that privacy of a patient's medical information creates the foundation upon which a patient reposes trust in his or her physician. While defining the earliest version of the physician-patient privilege, the oath does not envision the extent of modern day access to healthcare information. A patient's relationship with the modern healthcare delivery system often includes a team of physicians, nurses, and other clinical support personnel. This relationship extends beyond direct caregivers and may include healthcare administrators, payor organizations, and persons unfamiliar with a patient's identity, such as researchers and public health officials. Accessing a patient's medical information links these participants to the patient's healthcare delivery relationship. The Hippocratic Oath does not contemplate such broad access, nor does it contemplate the emerging privacy crisis resulting from the application of computer technology to medical record storage and retrieval. The combination of broad access, individual privacy rights, and computer technology requires a rethinking of measures designed to protect the realities of the modern medical information society.     

Explaining “Pain and Suffering” Awards: The Role of Injury Characteristics and Fault Attributions

The present research explored factors thought to affect compensatory awards for non-economic ham (pain and suffering) in personal injury cases. Experiment 1 showed that the nature and severity of the plaintiffs injury had a strong effect on perceptions of the extent of harm suffered and on award amounts. The parties' relatively active or passive roles in causing the injury affected assessments of their degree of fault, but perceived fault had little influence on awards. Experiment 2 replicated with more varied cases the strong impact of injury severity on harm perception and on awards for pain and suffering. In both studies, the disability and the mental suffering associated with injuries were stronger predictors of awards than were pain and disfigurement.