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PubMed2006

Autonomy and relatedness with parents and romantic development in African American adolescents.

The influence of adolescents' autonomy and relatedness to parents on romantic relationships was examined longitudinally over 5 years in 76 middle-class African American late adolescents (mean age = 18.43 years). Relatedness to parents in early adolescence led to longer duration and more supportive romantic relationships in late adolescence, but longer duration was concurrently associated with more negative romantic relationships. Cluster analyses yielded 3 profiles of early adolescent autonomy and relatedness; early adolescents who were high in relatedness and low in autonomy to parents in early adolescence reported longer duration romantic relationships in late adolescence than did adolescents who were moderate or high in relatedness and high in autonomy. The implications for romantic development in African American middle-class youth are discussed.

Adolescent↗
PubMed2004

Parenting and adolescent self-regulation.

This study examined the relationship between adolescents' academic and non-academic self-regulation (SR), authoritative parenting (as demonstrated by high levels of Involvement, Strictness, and Autonomy Granting), and parent self-efficacy in four areas. Participants were 214 Australian high school students and their parents. There was a moderate correlation (r = 0.63) between academic and non-academic SR. Adolescents and their parents differed significantly in their perceptions of parenting behaviours, with parents rating themselves higher than their children on Involvement, Autonomy Granting, and Strictness behaviours. A model of the relationships between the constructs was developed showing a strong path from parent self-efficacy to both academic and non-academic SR via high parental Involvement (as perceived by adolescents). Strict parenting and the granting by parents of psychological autonomy to their adolescent children did not appear to be important in the development of young people's self-regulatory behaviours.

Achievement↗
PubMed2006

There's nothing more practical than a good theory: integrating motivational interviewing and self-determination theory.

In this article we compare and integrate two well-established approaches to motivating therapeutic change, namely self-determination theory (SDT; Deci & Ryan, 1985, ) and motivational interviewing (MI; Miller & Rollnick, 1991, ). We show that SDT's theoretical focus on the internalization of therapeutic change and on the issue of need-satisfaction is fully compatible with key principles and clinical strategies within MI. We further suggest that basic need-satisfaction might be an important mechanism accounting for the positive effects of MI. Conversely, MI principles may provide SDT researchers with new insight into the application of SDT's theoretical concept of autonomy-support, and suggest new ways of testing and developing SDT. In short, the applied approach of MI and the theoretical approach of SDT might be fruitfully married, to the benefit of both.

Health Services Needs and Demand↗
PubMed2001

Rehabilitation in nursing homes.

Rehabilitation is a key concept in the government's plans to modernize the NHS. Its aim is to restore a person's autonomy, although there are sometimes barriers to making effective rehabilitation a reality, some of which are explored here, along with ways of helping teams in nursing homes to undertake more effective rehabilitation.

Aged↗
PubMed2006

Parental control, parental warmth, and psychosocial adjustment in a sample of substance-abusing mothers and their school-aged and adolescent children.

Parenting interventions for substance-abusing adults have been broadly based on two approaches, one emphasizing parental control as a means to managing children's behavior and the second emphasizing parental warmth and sensitivity as means to fostering children's psychological development. In this investigation, we examined associations of parental control and parental warmth, respectively, with children's behavioral and psychological adjustment in a sample of 98 women enrolled in methadone maintenance and their school-aged and adolescent children. Using collateral data collected during the baseline phase of a randomized clinical trial (Luthar, S. S., Suchman, N. E., & Altomare, M. [in press]. Relational Psychotherapy Mothers Group: A randomized clinical trial for substance abusing mothers [in preparation]), we tested predictions that (a) parental control would be more strongly associated with children's behavioral adjustment and (b) parental warmth would be more strongly associated with children's psychological adjustment. Both predictions were generally confirmed, although some crossover among parenting and child dimensions was also evident. Results support the theoretical stance that parental limit setting and autonomy support, as well as nurturance and involvement, are important factors, respectively, in children's behavioral and psychological adjustment.

Adaptation, Psychological↗
PubMed2006

Self-regulation and the problem of human autonomy: does psychology need choice, self-determination, and will?

The term autonomy literally refers to regulation by the self. Its opposite, heteronomy, refers to controlled regulation, or regulation that occurs without self-endorsement. At a time when philosophers and economists are increasingly detailing the nature of autonomy and recognizing its social and practical significance, many psychologists are questioning the reality and import of autonomy and closely related phenomena such as will, choice, and freedom. Using the framework of self-determination theory (Ryan & Deci, 2000), we review research concerning the benefits of autonomous versus controlled regulation for goal performance, persistence, affective experience, quality of relationships, and well-being across domains and cultures. We also address some of the controversies and terminological issues surrounding the construct of autonomy, including critiques of autonomy by biological reductionists, cultural relativists, and behaviorists. We conclude that there is a universal and cross-developmental value to autonomous regulation when the construct is understood in an exacting way.

Choice Behavior↗
PubMed2003

Autonomy reconfigured: incorporating the role of the unconscious.

The principle of respect for autonomy has served as a pillar of American bioethics. Through its application in response to physician paternalism and as the basis for informed consent, it has attained preeminent status in the discipline. New challenges in health care warrant a re-examination of the origins of our autonomy. Developmental psychology, cognitive neuroscience, and behavioral neurology all emphasize the intimate relationship between our cognitive and emotional development, and through this, our conscious and unconscious minds. Our intellectual, and particularly our moral development, are instilled in us by our moral mentors, and consequently by our community as a whole. Autonomy and community are therefore inextricably interlinked, and our emphasis on liberty, rights, and privacy without the inclusion of family, community, and social responsibility is biologically unsound. Appreciation of this reality should lead to a more balanced set of bioethical norms.

Communication↗
PubMed2003

[Ethics, culture and psychiatry: the ethics of Mediterranean Europe].

The defence of the rights of the person, in Mediterranean ethics, is based on a synthesis of civic humanism and liberalism, derived from the spirit of Greek democracy and Enlightenment, and including the achievements of the XIX and XX centuries. It tempers liberalism with the principles of social welfare. Present bioethics, specialy in European countries, try to integrate both the mediterranean ethics of virtues and the anglosaxon ethics of principles, further adding and integrating a social element, the principle of solidarity and distributive justice (equity). Therefore, European ethics do not proclaim the autonomy of persons and the independence of the individual from society, but the interdependency of persons and nations. They advocate a greater equity and a better management of resources in health care.

Cultural Characteristics↗
PubMedDate not supplied

The suppressed legacy of Nuremberg.

The story of patient self-determination cannot be told without the Nuremberg trials. Patient autonomy was the first criterion enunciated by the Nuremberg judges and has served as a touchstone for human subject research and patient care ever since. Yet this ideal was in an important sense irrelevant at the moment it was originally proclaimed.

Decision Making↗
PubMed1993

Response to: What counts as success in genetic counselling?

Clinical genetics encompasses a wider range of activities than discussion of reproductive risks and options. Hence, it is possible for a clinical geneticist to reduce suffering associated with genetic disease without aiming to reduce the birth incidence of such diseases. Simple cost-benefit analyses of genetic-screening programmes are unacceptable; more sophisticated analyses of this type have been devised but entail internal inconsistencies and do not seem to result in changed clinical practice. The secondary effects of screening programmes must be assessed before they can be properly evaluated, including the inadvertent diagnosis of unsought conditions, and the wider social effects of the programmes on those with mental handicap. This has implications for the range of prenatal tests that should be made available. While autonomy must be fully respected, it cannot itself constitute a goal of clinical genetics. The evaluation of these services requires interdepartmental comparisons of workload, and quality judgements of clients and peers.

Abortion, Eugenic↗
PubMed2006

The role of affect in UK commuters' travel mode choices: an interpretative phenomenological analysis.

Previous research has suggested that the choice between public transport and private car use is not solely based on utility considerations, such as time and cost. However, affective considerations tend not to be targeted in policy interventions to reduce car use. This may be due, in part, to a lack of clarity about which affective responses to car use are important and how they may affect willingness to switch to public transport. This study sought to clarify the role of affective responses in transport mode choice. An interpretative phenomenological analysis (IPA) of car users' accounts was conducted to (i) explore affect associated with decisions to drive or use public transport to get to work; and (ii) describe the role of affect on such transport decisions, and its relationship to utility considerations. Semi-structured interviews were conducted with 18 car users employed at a medium-sized UK university. Four affect themes were identified: These were journey-based affect (JBA), personal space, autonomy and identity. Typical 'utility' factors such as time, cost and reliability had important affective effects, and these were considered alongside utility components (e.g. getting to work on time). However, these effects were not always additive, and the role of affect depended on participants' own assessment of their circumstances. Implications for interventions are discussed.

Adult↗
PubMed2004

Interactions between mothers and children: impacts of maternal and child anxiety.

This study, an expansion of an earlier study of parenting behaviors of anxious mothers, examined the relationship of both mother and child anxiety disorders to mother behavior in parent--child interactions. Participants were 68 mother--child dyads with children ranging in age from 7 to 15 years. Mothers and children completed diagnostic evaluations and engaged in conversational tasks; behaviors were rated by coders who were blind to diagnosis. Mothers of anxious children, regardless of their own anxiety, were less warm (p <.05) toward their children. They also granted less autonomy (p <.01). There was an interaction between mother and child anxiety in predicting maternal catastrophizing (p <.01), with anxious mothers and nonanxious mothers of anxious children likely to catastrophize. Theoretical and research implications are discussed.

Adolescent↗
PubMedDate not supplied

Appraisal of values in the choice of treatment.

The Gortner Values in the Choice of Treatment Inventory is a set of declarative statements to which respondents can indicate agreement or disagreement in a Likert-type format. The statements are based on the moral principles of Autonomy, Beneficence/Nonmaleficence, and Justice as conceptualized by Beauchamp and Childress (1979). The first trial was reported for 15 families in 1980. The second trial was part of a larger study in June 1981 to April 1982 of 100 families, of whom 70 had a member undergoing coronary artery bypass surgery, and 30 had a member under medical treatment for coronary artery disease. Spearman rank order correlations were used to evaluate responses within families and between groups at Time 1 and Time 2. Surgical family correlations for Autonomy were weak, but were moderately strong for Beneficence/Nonmaleficence. A highly significant main-effect finding, using repeated measures ANOVA, was that all patients and spouses showed mean Autonomy scores that were significantly higher than those for Beneficence/Nonmaleficence and Justice. Principal components factor analysis followed by varimax rotation supported two of the three hypothesized constructs. Surgical families emerged as the key reference group for further analysis.

Adult↗
PubMed2003

Sociotropy and autonomy: an examination of interpersonal and work adjustment.

One-hundred and sixty-five undergraduate students completed measures of sociotropy, autonomy, and adjustment. Autonomy was associated with poor social adjustment but was not associated with work role adjustment. Sociotropy failed to evidence a significant relation with work role or social adjustment. In past research, autonomy has primarily been theorized to contribute to depression when achievement needs are not met. Our results raise the possibility that autonomy may be linked to depression through the pathway of low social support and interpersonal difficulties. In addition, the results suggest that sociotropic individuals may not have objectively poor social adjustment despite their concerns regarding this area. Likewise, autonomous individuals may not have better or worse work adjustment despite their efforts to achieve.

Adaptation, Psychological↗
PubMed2005

Democracy and genetic privacy: the value of bodily integrity.

The right to genetic privacy is presently being incorporated in legal systems all over the world. It remains largely unclear however what interests and values this right serves to protect. There are many different arguments made in the literature, yet none takes into account the problem of how particular values can be justified given the plurality of moral and religious doctrines in our societies. In this article theories of public reason are used in order to explore how genetic privacy could be justified in a way that is sensitive to the "fact of pluralism". The idea of public reason is specified as the idea that governments should appeal only to values and beliefs that are acceptable to all reasonable citizens in the justification of rights. In examining prevalent arguments for genetic privacy--based on the value of autonomy or on the value of intimacy--it is concluded that they do not meet this requirement. In dealing with this deficiency in the literature, an argument is developed that genetic privacy is fundamental to the democratic participation of all citizens. By referring to the preconditions of democratic citizenship, genetic privacy can be justified in a way that respects the plurality of comprehensive doctrines of morality and religion in contemporary societies.

Democracy↗