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PubMed1991

Socialization and temperament in the development of guilt and conscience.

Toddlerhood antecedents of conscience were examined in 58 8-10-year-old children. The measures of conscience, such as general affective/moral orientation, the extent of reparation, and the intensity of guilt feelings, were assessed from children's narratives produced in response to semiprojective stories involving transgressions, distress, and conflict. Maternal endorsed socialization orientations and observed rearing behaviors that deemphasized the use of power were associated with the children's internalized conscience 6 years later. However, these findings were significant only for children who were relatively prone to fearful arousal. The capacity for self-regulation, indexed by early compliance and noncompliance to maternal socialization, predicted children's internalized conscience 6 years later. There was preliminary evidence that compliance obtained in a rearing context that deemphasized power assertion was most conducive to the development of conscience. The findings are discussed in view of the interplay of socialization and temperament in moral development.

Arousal↗

PubMed1994

Maternal reports of conscience development and temperament in young children.

Multiple manifestations of emerging conscience, their development, organization, and links with temperament were studied in 171 21-70-month-old children. A new parental report instrument was designed to measure conscience, with good psychometric qualities and predictive of children's behaviors in a laboratory. For most aspects of conscience, the major developmental shifts occurred around age 3.2 components of early conscience emerged in factor analyses: Affective Discomfort, significantly higher for girls, that encompassed guilt, apology, concern about good feelings with the parent following wrongdoing, and empathy with others, and Active Moral Regulation/Vigilance, which included confession and reparation following wrongdoing, internalization of rules of conduct (self-regulation), and concern about others' wrongdoing. Children's temperament, assessed by maternal reports, was associated with conscience. Low impulsivity and high inhibitory control were associated with Active Moral Regulation/Vigilance for both sexes and, for girls only, also with Affective Discomfort. For girls, temperamental reactivity related positively to Affective Discomfort and negatively to Active Moral Regulation/Vigilance.

Affect↗

PubMedDate not supplied

Conscience clauses offer little protection. Most are deficient, and many have been met with hostile judicial interpretations.

Although the federal government and most states have enacted laws protecting healthcare providers' rights to refuse to provide or participate in procedures to which they have moral or religious objections, most such laws are deficient and many have been met with hostile judicial interpretations that have diminished their scope and strength. Deficiencies found in nearly all conscience clause laws include limitations on the specific conduct or procedures protected, restrictive definitions of the healthcare providers covered, and inadequate implementing procedures and remedies. Most conscience clause statutes fail to provide more than token protection for healthcare providers' rights of conscience. Increasing duress on healthcare providers who assert rights of conscience can be expected from three sources. First, some medical schools have considered refusal to participate as a negative factor in the admission process. Second, greater financial pressures on the American healthcare system may cause nonmonetary factors to be sacrificed to the exigencies of the moment. Third, all healthcare reform plans propose an increase in the federal government's role in providing healthcare. At present, the only federal statutory protection for healthcare providers' rights of conscience covers participants in only a few federal programs, is poorly conceived, and is sorely inadequate.

Abortion, Legal↗

PubMed2005

Conscience in childhood: old questions, new answers.

Although conscience has been the focus of reflection for centuries, fundamental questions regarding its organization have not been fully answered. To address those questions, the authors applied structural equation modeling techniques to longitudinal data comprising multiple behavioral measures of children's conscience, obtained in parallel fashion at 33 and 45 months. The measures encompassed moral emotion (guilt and empathic distress) and rule-compatible conduct (internalization of maternal prohibitions and requests and of another adult's rules). Confirmatory factor analyses supported a differentiated view of conscience with 2 latent factors at both ages: Moral Emotion and Rule-Compatible Conduct. The structure of conscience was remarkably stable over time. The coherence between Moral Emotion and Rule-Compatible Conduct factors increased as children grew older.

Child↗

PubMedDate not supplied

Physician-assisted suicide and euthanasia: German Protestantism, conscience, and the limits of purely ethical reflection.

In this essay I shall describe and analyse the current debate on physician assisted suicide in contemporary German Protestant church and theology. It will be shown that the Protestant (mainly Lutheran) Church in Germany together with her Roman Catholic sister church has a specific and influential position in the public discussion: The two churches counting the majority of the population in Germany among their members tend to "organize" a social and political consensus on end-of-life questions. This cooperation is until now very successful: Speaking with one voice on end-of-life questions, the two churches function as the guardians of a moral consensus which is appreciated even by many non-believers. Behind this joint service to society the lines of the theological debate have to be ree-discovered. First it will be argued that a Protestant reading of the joint memoranda has to be based on the concept of individual conscience. The crucial questions are then: Whose conscience has the authority to decide? and: Can the physician assisted suicide be desired faithfully? Prominent in the current debate are Ulrich Eibach as a strict defender of the sanctity of life, and on the other side Walter Jens and Hans Kung, who argue for a right to physician assisted suicide under extreme conditions. I shall argue that it will be necessary to go beyond this actual controversy to the works of Gerhard Ebeling and Karl Barth for a clear and instructive account of conscience and a theological analysis of the concepts of life and suicide. On the basis of their considerations, a conscience-related approach to physician assisted suicide is developed.

Attitude to Death↗

PubMed1991

Conceptualization of conscience in normal children and adolescents, ages 5 to 17.

In order to determine how normal children and adolescents conceptualize their conscience, the Stilwell Conscience Interview was given to 125 normal subjects between the ages of 5 and 17. Responses to questions 1, 2 and 11 (including the drawing of conscience) were empirically analyzed, resulting in a five-stage developmental model. The responses were then randomly presented to two blinded raters to assign them to one of the five stages. Highly acceptable interrater reliability was found, Kappa = 0.90. The relationship of age to stage demonstrated a highly significant positive correlation, indicating that the conceptualization of conscience in normal development follows an invariant, hierarchical pattern of organization. A commentary regarding each stage is presented. The value of this conceptualization model as a comparative standard of normality in the clinical assessment of youngsters suffering from psychopathology is discussed relative to assessment, psychotherapy, and future research.

Adolescent↗

PubMed1994

Moral-emotional responsiveness: a two-factor domain of conscience functioning.

OBJECTIVE: The purpose of this study was to assess the progression in development of moral-emotional responsiveness in children and adolescents and to examine the relationship of this progression with previously identified stages of conceptualization of conscience. METHOD: Using three semistructured questions from the Stilwell Conscience Interview, 132 normal volunteers between the ages of 5 and 17 years were assessed regarding comprehension of their emotional responses to moral stimuli. RESULTS: Rational analysis of the responses identified six items; each item was scaled for complexity into five stages. Factor analysis of the six items revealed two factors: moral-emotional responsiveness 1 contained items relating to external anxiety, internal anxiety, and mood; more-emotional responsiveness 2 contained items relating to the restoration of psychophysiological equilibrium through the processes of reparation and healing. Differences between conceptualization stages, with the moral-emotional responsiveness factors serving as dependent variables, were accounted for by stage differences in age and the positive correlations between the moral-emotional responsiveness factors and age. CONCLUSIONS: Moral-emotional responsiveness is a two-factor domain of the conscience. The findings provide additional developmental guidelines for assessing conscience development and functioning both in clinical practice and in research.

Adolescent↗

PubMed2006

Development and initial validation of the Stress of Conscience Questionnaire.

Stress in health care is affected by moral factors. When people are prevented from doing 'good' they may feel that they have not done what they ought to or that they have erred, thus giving rise to a troubled conscience. Empirical studies show that health care personnel sometimes refer to conscience when talking about being in ethically difficult everyday care situations. This study aimed to construct and validate the Stress of Conscience Questionnaire (SCQ), a nine-item instrument for assessing stressful situations and the degree to which they trouble the conscience. The items were based on situations previously documented as causing negative stress for health care workers. Content and face validity were established by expert panels and pilot studies that selected relevant items and modified or excluded ambiguous ones. A convenience sample of 444 health care personnel indicated that the SCQ had acceptable validity and internal consistency (Cronbach's alpha exceeded 0.83 for the overall scale). Explorative factor analysis identified and labelled two factors: 'internal demands' and 'external demands and restrictions'. The findings suggest that the SCQ is a concise and practical instrument for use in various health care contexts.

Adult↗

PubMed1996

Conscience: the professional and the personal.

Conscience is sometimes thought of as private, personal, individual, possibly religious, and not be questionned. This paper seeks to present and make plausible an account of conscience as social, possibly secular, and fallible (and hence corrigible). In the light of this account of professional conscience is offered and conclusions are drawn about the questions that should be answered in the event of a nurse making an appeal to conscience.

Conscience↗

PubMed1996

Children's narratives about hypothetical moral dilemmas and objective measures of their conscience: mutual relations and socialization antecedents.

We explored children's conscience using narrative measures that utilized responses to hypothetical moral dilemmas and objective measures (observed moral conduct and mothers' reports). Children and mothers were studied at Time 1 (N = 103, 26-41 months) and at Time 2 (N = 99, 43-56 months). The first goal was to examine correspondence between both sets of measures. There were meaningful links between the narratives, administered at Time 2, and children's observed and mother-reported conscience at Times 1 and 2. Children who produced many antisocial narrative themes were less internalized, whereas children who produced many themes of commitment to and concern about good behavior were more internalized on the objective measures. The second goal was to test the prediction that maternal power assertion is detrimental to conscience. Children who experienced more power-assertive maternal discipline produced fewer themes of commitment to and concern about good behavior in their narratives and were more poorly internalized on observed and mother-reported measures at Time 1 and Time 2. Girls were more internalized on the narrative and objective conscience measures.

Age Factors↗

PubMed1998

Moral volition: the fifth and final domain leading to an integrated theory of conscience understanding.

OBJECTIVES: To define discrete developmental levels of understanding of the ways in which normal children and adolescents link autonomy and will to moral obligation and to study the correlation between this progression and previously identified stages of conscience conceptualization. METHOD: One hundred thirty-two normal volunteers between the ages of 5 and 17 years were individually interviewed using the moral volition section of the semistructured Stilwell Conscience Interview. Analysis of the interviews resulted in five levels of understanding of moral self-evaluation and volitionally chosen behavior. RESULTS: Analyses of variance and covariance showed that the five levels of moral volition had significant correlation with five conceptualization stages, with stage criteria showing a stronger correlation than age. Self-identified tasks of oughtness were hierarchically defined beginning with those defining a morality of restraint followed by moralities of mastery/sufficiency, virtuous striving, idealization, and individual responsibility. Perception of increased independence of self in interaction with conscience was noteworthy at stages 4 and 5. CONCLUSIONS: Moral volition is the domain of conscience functioning that defines understanding of moral self-evaluation and volitionally chosen actions; five levels of understanding can be demonstrated in normal children between the ages of 5 and 17 years.

Adolescent↗

PubMed1996

Moral valuation: a third domain of conscience functioning.

OBJECTIVE: To assess development of moral valuation in normal children and adolescents, that is, how moral rules for living are derived and justified, and to examine the relationship of this progression with previously identified stages of conceptualization of conscience. METHOD: Using three semistructured questions from the Stilwell Conscience Interview, 132 normal volunteers between the ages of 5 and 17 years were assessed. All moral valuation responses were examined within three aspects of social reference: authority-derived, self-derived, and peer-derived. Each aspect was scaled for complexity into six anchored levels. RESULTS: The levels of all three aspects correlated positively with conceptualization stages as well as with each other. When the covariate, age, was taken into consideration, peer-derived valuation was significantly correlated with both age and stage. CONCLUSIONS: Moral valuation is a domain of conscience functioning in which moral rules and their justifications are socially referenced in relationship to authority, self, and peers. Anchored levels of these three aspects of moral valuation provide developmental guidelines for mental status examinations in patients between 5 and 17 years of age as well as providing criteria for future comparative studies in various diagnostic categories of psychopathology.

Adolescent↗

PubMed1999

Moral development and psychopathological interference in conscience functioning among adolescents after trauma.

OBJECTIVES: To compare moral development and psychopathological interference with conscience functioning (PI) among adolescents exposed to different degrees of earthquake-related trauma and to investigate the relationship of moral development and PI to exposure to trauma, severity of posttraumatic stress disorder (PTSD) symptoms, postearthquake adversities, and extent of loss of nuclear family members. METHOD: Adolescents (N = 193) from 2 cities at different distances from the epicenter were evaluated. The Stilwell Structured Conscience Interview was used to assess moral development and PI. Structured self-report instruments were used to obtain ratings of severity of earthquake-related trauma, posttraumatic stress symptoms, and postearthquake adversities. RESULTS: Adolescents in the city near the epicenter manifested advanced moral development as compared with their counterparts in the less affected city. Concomitantly, they endorsed responses indicating PI. Levels of PI were significantly correlated with severity of PTSD symptoms. CONCLUSION: In the aftermath of a catastrophic natural disaster, children assume greater responsibilities and confront a multitude of morally challenging interpersonal situations which may result in an advancement of their moral development. Yet, at the same time, PTSD symptoms and negative schematizations of self and others may give rise to disturbances in conscience functioning. The findings suggest that therapeutic consideration should be given to assisting children in integrating the horror of their traumatic experiences and the harshness of posttrauma adversities into an adaptive schema of good and evil in themselves and the world.

Adolescent↗

PubMedDate not supplied

Mother-child discourse, attachment security, shared positive affect, and early conscience development.

The separate literatures on parental discipline, maternal discourse about emotion, and autobiographical memory support the idea that parent-child discourse in the context of a supportive relationship plays a role in a child's early conscience development, and this study was designed to examine this issue. Forty-two preschool children and their mothers took part in a 45-min structured laboratory session, and at their homes, mothers completed the Attachment Q-Set. As part of the laboratory session, each mother was asked to discuss with her child one incident that occurred within the last week in which her child behaved well and one in which her child misbehaved. These conversations were transcribed verbatim and coded for maternal references to feelings, rules, consequences of the child's actions, and moral evaluatives. Each child also took part in a behavioral measure of internalization and several compliance tasks, and mothers completed a maternal report of the child's early conscience development. Consistent with attachment theory, attachment security predicted maternal and child references to feelings and moral evaluatives. Attachment security, shared positive affect between the mother and child, and maternal references to feelings and moral evaluatives also predicted specific aspects of early conscience development.

Adult↗

PubMedDate not supplied

Maternal parenting and children's conscience: early security as moderator.

Socialization research is shifting from direct links between parenting and children's outcomes toward models that consider parenting in the context of other factors. This study proposed that the effects of maternal responsive, gentle parenting on child conscience are moderated by the quality of their relationship, specifically, early security. A 2-process model of early conscience development was proposed and confirmed in this longitudinal study. The child's security and trust in the caregiver, assessed at 14 months in the Strange Situation, rendered him or her receptive and eager to accept the caregiver's socialization agenda. That early security then enhanced the effectiveness of parental adaptive parenting style, observed from 14 to 45 months, in terms of promoting conscience at 56 months, which encompassed moral conduct, moral cognition, and moral self.

Cognition↗

PubMed1983

Guilt and conscience in major depressive disorders.

The authors propose definitions of guilt as a self-critical feeling state and of conscience as a set of standards, to permit independent assessment of their prevalence in a sample of 93 depressed, 29 schizophrenic, and 43 normal subjects. Patients with feelings of guilt tended to have a more severe conscience and lower self-esteem. While guilt is prominent in a moderate percentage of depressed patients, negative self-esteem may form one of the cornerstones for depressed patients of all types. The authors propose that the operational definition of psychoanalytic concepts such as guilt and conscience permits a valid and more rigorous test of clinical generalizations.

Adolescent↗

PubMed1997

Conscience and conscientious actions in the context of MCOs.

Managed care organizations can produce conflicts of obligation and conflicts of interest that may lead to problems of conscience for health care professionals. This paper provides a basis for understanding the notions of conscience and conscientious objection and offers a framework for clinicians to stake out positions grounded in personal conscience as a way for them to respond to unacceptable pressures from managers to limit services.

Complicity↗

PubMed1997

Moralization of attachment: a fourth domain of conscience functioning.

OBJECTIVES: To define discrete developmental levels of understanding regarding the ways in which normal children and adolescents link remembered and current attachment experiences to their moral belief system and to study the correlation between this progression and previously identified stages of conscience conceptualization. METHOD: Using the moralization of attachment section from the semistructured Stilwell Conscience Interview, 132 normal volunteers between the ages of 5 and 17 years were individually interviewed. Analysis of the interviews resulted in five levels of understanding. RESULTS: By analyses of variance and covariance, the five attachment levels showed significant correlation with the five conceptualization stages. Conceptualization stage showed a stronger correlation than age. CONCLUSIONS: In normal development, moralization of attachment is a domain of conscience functioning which follows a five-level hierarchical developmental progression; first, the child's sense of security and empathic responsiveness become paired with a sense of moral obligation; caretaker rules are then incorporated; an understanding of how empathy modifies strict rule-following develops; idols and ideals are chosen that reflect earlier learning in attachment relationships; finally, a visualization of the self as moral standard-bearer or teacher unfolds.

Adolescent↗