U.S. policymakers are more confident than their Chinese counterparts that the use of nuclear weapons could remain limited; the contrasting views could make easier an escalation to unlimited nuclear war

Dangerous Confidence? Chinese Views on Nuclear Escalation. Fiona S. Cunningham and M. Taylor Fravel. International Security, Volume 44, Issue 2, Fall 2019, p.61-109, October 28, 2019. https://doi.org/10.1162/isec_a_00359

Abstract: Chinese views of nuclear escalation are key to assessing the potential for nuclear escalation in a crisis or armed conflict between the United States and China, but they have not been examined systematically. A review of original Chinese-language sources and interviews with members of China's strategic community suggest that China is skeptical that nuclear escalation could be controlled once nuclear weapons are used and, thus, leaders would be restrained from pursuing even limited use. These views are reflected in China's nuclear operational doctrine (which outlines plans for retaliatory strikes only and lacks any clear plans for limited nuclear use) and its force structure (which lacks tactical nuclear weapons). The long-standing decoupling of Chinese nuclear and conventional strategy, organizational biases within China's strategic community, and the availability of space, cyber, and conventional missile weapons as alternative sources of strategic leverage best explain Chinese views toward nuclear escalation. China's confidence that a U.S.-China conflict would not escalate to the use of nuclear weapons may hamper its ability to identify nuclear escalation risks in such a scenario. Meanwhile, U.S. scholars and policymakers emphasize the risk of inadvertent escalation in a conflict with China, but they are more confident than their Chinese counterparts that the use of nuclear weapons could remain limited. When combined, these contrasting views could create pressure for a U.S.-China conflict to escalate rapidly into an unlimited nuclear war.

Discussion

In this article, we have argued that China’s strategic community is relatively confident about the ability of China to avoid nuclear escalation in a conflict with the United States. The most important reason is that the members of this community believe that once nuclear weapons are used, subsequent use by either side cannot be controlled. Thus, they do not believe that a limited nuclear warwouldstaylimited. Instead, it would likely escalate into an unlimite done. Chinese experts expect that these features of nuclear war will lead U.S. and Chinese decisionmakers to avoid any nuclear use and resolve any conflict at the conventional level. They also believe that the United States will exercise sufficient control over a crisis involving a U.S. ally or partner so that the use of nuclear weapons is not considered.
China’s operational doctrine for the use of its nuclear weapons and its nuclear force structure are consistent with these views about the difficulty of controlling escalation. That is, China’s operational doctrine does not contain plans to wage a limited nuclear war, which China might pursue if it believed nuclear escalation could be controlled. The focus of China’s nuclear operations remains on how to retaliate after China is attacked with nuclear weapons to deter such attacks in the first place. Similarly, although China’s nuclear arsenal is expanding, China is not developing forces that would be optimized for use in a limited nuclear war, especially tactical nuclear weapons. The long-standing decoupling of conventional and nuclear strategy, theavailabilityofnonnuclear strategic weapons such as cyberweapons, and the organizational biases of nuclear experts and the PLA’s missile commanders explain this relative confidence about avoiding escalation. Chinese experts likely overestimate their leaders’ ability to control escalation, because they underplay the pressures to escalate to a nuclear war that their leaders could not control—for example, if an adversary overreacts or misperceives Chinese signaling with nuclear or nonnuclear strategic weapons.
Several implications follow from our analysis, all of which raise concerns about crisis stability and the ability of the United States and China to prevent nuclear escalation in a crisis between the two states. First, China’s approach to deterrence may be suboptimal—at least from the perspective of deterring either U.S. conventional strikes against its nuclear infrastructure or limited U.S. nuclear strikes against its nuclear arsenal. Although China maintains some ambiguity over whether it would respond to a conventional strike on its nuclear forces with nuclear weapons, China’s overall confidence that a U.S.China conventional conflict would not escalate to nuclear war may reduce the effectiveness of its deterrent against this kind of attack by persuading an adversary that such strikes would not elicit nuclear retaliation. China’s confidence could even embolden an adversary to gamble that a limited nuclear first strike against China would not elicit nuclear retaliation. This, in turn, would increase the odds of such U.S. attacks and create strong pressure for China to retaliate to deter further attacks on its nuclear forces, resulting in nuclear escalation.
Our research, however, does not indicate how the small size of China’s arsenal compared with that of the United States would affect its response to U.S. limited nuclear strikes. China could respond with limited nuclear retaliatory strikes; it could threaten or pursue unlimited nuclear retaliation; it could respond with nonnuclear forces; or it could respond in another way, including terminating the conflict. More research is needed to explore the relationship between the size and vulnerability of China’s arsenal and its views of nuclear escalation control.
Second, the United States and China hold opposing beliefs about escalation above and below the nuclear threshold that may also contribute to instability. U.S. experts worry more than Chinese experts that the two countries might not be able to control the escalation of a conventional war to high levels of intensity, which could push a conflict over the nuclear threshold, but are more sanguineabout(oratleastaredividedaboutthepossibilityof)controllingnuclear escalation after nuclear weapons have been used.174 This likely reflects the overwhelming superiority of U.S. nuclear forces (especially against a smaller nuclear power), decades of nuclear planning for a range of scenarios (including limited nuclear warfighting), and an emphasis on achieving dominance in conventional operations.
As this article demonstrates, however, Chinese experts hold an opposing perspective. They are quite pessimistic about controlling nuclear escalation once the threshold for the use of nuclear weapons has been crossed. By contrast, however, they are quite confident (perhaps overly confident) about controlling conventional escalation before the nuclear threshold is crossed. As noted earlier, almost all of the available literature from Chinese military sources on escalation examines conventional escalation and not nuclear escalation. At least in the post–Cold War era, U.S. conventional operations against other militaries have emphasized seizing and exploiting air superiority, meaning that control of conventional escalation was not a concern for the United States because it had the luxury of fighting adversaries with no plausible means to escalate. Although China has not fought a war since 1979, it has engaged mostly in limited uses of force in local conflicts or displays of force and has certainly not achieved conventional dominance over an adversary to the same extent as the United States.
These contrasting beliefs about the feasibility of controlling conventional and nuclear escalation suggest that a conventional conflict is more likely to escalate to high levels of intensity, increasing the chances of nuclear escalation. China, for example, could take actions it believes will deter the United States at the conventional level, only to be confronted with a U.S. desire to overmatch China in response and establish the same extent of conventional dominance that the United States has enjoyed for several decades against other adversaries.175 Yet, such actions could include steps to degrade China’s nuclear forces, either inadvertently by targeting China’s conventional missiles or intentionally to force China to either surrender or escalate to nuclear war. Those U.S. attacks might create strong pressures on China to engage in nuclear signaling or mobilization of its land-based nuclear missiles and ballistic missile submarines to protect its deterrent or even threaten nuclear use to deter further attacks on its nuclear arsenal. In response, the United States may attempt a large-scale nuclear strike to try to eliminate China’s nuclear forces or at least limit damage from China’s use of nuclear weapons. If the two countries have different views about when the natural firebreaks in a conflict will occur, they may focus on negotiating an end to the conflict at different times in this escalatory spiral and therefore miss opportunities to negotiate an end to the conflict altogether.176 In short, based on differing views about controlling escalation, escalation at both the conventional and nuclear levels may be more likely.
The flip side, however, might be enhanced caution. China may anticipate U.S. efforts to escalate a conventional war to achieve conventional dominance while the United States may anticipate a disproportionate Chinese nuclear response if it were to conduct limited nuclear strikes in a conflict. Both countries may therefore be extremely cautious in a crisis or low-intensity conflict. Further, despite the views outlined above, the two countries have not always acted on their confidence about controlling conventional or nuclear escalation. Historically, China has exercised more caution (most of the time) when facing a superior adversary, based on the imperative of conserving its forces. Despite models that show U.S. nuclear superiority and the ability to limit damage using a nuclear first strike,177 U.S. leaders have appeared reluctant to accept significant nuclear risk, especially in the post–Cold War era.178
Ironically, one factor that contributes to these opposing views is China’s no-first-use policy. Many U.S. analysts do not believe that it is a credible pledge, because China has not stated how it plans to end a conventional war it is losing.179 China perhaps does not feel a need to reveal such plans, either because of its experience in fighting and ending limited wars without achieving its initial ambitions (in Korea and perhaps in Vietnam) or because it would not want to reveal such plans to a stronger adversary that could then exploit them. On the other hand, Chinese experts view the pledge as the guiding principle for the role of Chinese nuclear weapons in any future conflict with the United States. As they do not plan to use nuclear weapons first, even when losing, they may not explore this point in their writings. Chinese experts may also discount the likelihood that its actions in a crisis or conflict could be mistaken by the United States as preparations to use nuclear weapons first.
Third, greater attention to nuclear escalation is needed in China. The gap between its strategic community and the PLARocket Force needs to be bridged. Looking forward, the new Strategic Planning Office under the CMC may endeavor to pursue greater coordination between China’s overall strategy and the role of nuclear weapons in crises and conflicts. A fourth implication of Chinese views of nuclear escalation for U.S.-China crisis stability concerns whether these views may change in the future. We suggest that China’s strategic community is unlikely to change its view that further nuclear escalation cannot be controlled once it is engaged in a crisis or conventional conflict with the United States. Nevertheless, several possibilities should be considered. First, Chinese experts may revise their views about the ability of the United States to control its allies and avoid a nuclear confrontation with China, points on which China’s views currently diverge with the arguments of the Cold War skeptics. The realization in a crisis or conflict that the United States may be unable or unwilling to control its allies, or willing to run the risk of a nuclear war with China to defend them, could deter China from engaging in a highintensity conventional conflict with a U.S. ally. It could also prompt China to engage in nuclear signaling to try to deter a U.S. first strike, which could in turn be misperceived by Washington.
A second possibility is that proponents of nuclear escalation control and limited use, who may exist within the PLA Rocket Force, increase the force’s historically limited influence over nuclear strategy formulation within China, thus changing Chinese views toward escalation control. The availability of precise theater capabilities and tactical delivery systems, currently deployed with conventional payloads only, would allow China to develop options for limited war with relative ease, if a political decision to do so is made.180
A final possibility is that Chinese views could change without a crisis or a conflict as a catalyst. China may change its views that nuclear escalation would not be controlled if current U.S. attention to limited nuclear war leads Chinese experts to agree that preparing for limited retaliatory nuclear strikes is the best way to deter U.S. limited nuclear use and further nuclear use. Any U.S. actions that would encourage China to consider limited nuclear use, whether to deter the United States or to de-escalate a conventional conflict, would likely increase regional instability and risks to the United States and its allies.

Specialized psychological treatment for offending: Treatment was associated with offense-specific & general recidivism reductions; those with consistent input from a qualified psychologist had best results

Does specialized psychological treatment for offending reduce recidivism? A meta-analysis examining staff and program variables as predictors of treatment effectiveness. Theresa A. Gannon et al. Clinical Psychology Review, Volume 73, November 2019, 101752. https://doi.org/10.1016/j.cpr.2019.101752

Highlights
• This meta-analysis examined psychological offense treatment and recidivism.
• Overall, 70 studies were identified; including over 55,000 individuals.
• Treatment was associated with offense-specific and general recidivism reductions.
• Programs with consistent input from a qualified psychologist had best results.

Abstract: A meta-analysis was conducted to examine whether specialized psychological offense treatments were associated with reductions in offense specific and non-offense specific recidivism. Staff and treatment program moderators were also explored. The review examined 70 studies and 55,604 individuals who had offended. Three specialized treatments were examined: sexual offense, domestic violence, and general violence programs. Across all programs, offense specific recidivism was 13.4% for treated individuals and 19.4% for untreated comparisons over an average follow up of 66.1 months. Relative reductions in offense specific recidivism were 32.6% for sexual offense programs, 36.0% for domestic violence programs, and 24.3% for general violence programs. All programs were also associated with significant reductions in non-offense specific recidivism. Overall, treatment effectiveness appeared improved when programs received consistent hands-on input from a qualified registered psychologist and facilitating staff were provided with clinical supervision. Numerous program variables appeared important for optimizing the effectiveness of specialized psychological offense programs (e.g., arousal reconditioning for sexual offense programs, treatment approach for domestic violence programs). The findings show that such treatments are associated with robust reductions in offense specific and non-offense specific recidivism. We urge treatment providers to pay particular attention to staffing and program implementation variables for optimal recidivism reductions.

Keywords: Offense treatmentMeta-analysisSexual offendingDomestic violenceGeneral violence


8.4. Future policy and practice directions

The outcomes of this meta-analysis are the first to suggest that specialized psychological programs that target various offending behaviors are effective. Although there was significant heterogeneity across the outcomes of individual studies, our review suggests ways that policy makers and program providers might optimize program outcomes. First, the results indicate that program developers should provide qualified psychologists who are consistently present in hands-on treatment; and second, facilitators should be provided with supervision opportunities that are similar across the program. Interestingly, less than one in five programs consistently used qualified psychologists in hands-on facilitation and the majority of these (83.3%; n = 10) were implemented in the 1970s, 1980s, or 1990s rather than more recently. The provision of supervision was more evenly spread. We recognize the significant pressures that policy makers face providing cost effective programs to large numbers of individuals (Gannon & Ward, 2014). As an indication of this, correctional systems in a number of international jurisdictions have been moving away from the direct involvement of psychologists as treatment providers, with therapeutic activities such as running manual-based groups being delegated to correctional program officers who may have little or no formal clinical training. Ironically, it seems that this variable is correlated with optimum behavioral change and yet qualified psychologist hands-on input is lacking in programs implemented in recent years. This may explain why we did not find more modern treatments to bring about improved outcomes (see also Lösel & Schmucker, 2005). Qualified psychological staff and regular supervision come at a clear financial cost. Program providers could consider the benefits of pruning down staff facilitation numbers as a compensatory financial strategy given that individual and co-facilitated programs seem to be equally beneficial. Program providers might also want to consider methods for tightly controlling program implementation given that we found single site treatments seemed to fare better than multisite treatments.

Further offense specific practice implications are available for those involved in sexual offense and domestic violence policy. Regarding sexual offense programming, the results indicate that best practice guidelines in this area should be revised to include (1) cautionary messages regarding polygraph use within the therapeutic context, and (2) further commentary on—and expansion of—the evidence base around behavioral reconditioning as a treatment tool. Those tasked with developing and managing programs for those who have been domestically violent should seek out the best educational materials possible and consider how such materials can be skilfully woven into program facilitation to produce optimal results.

Longer-term psychotherapies are not always more effective than the initial therapy contact, suggesting that the mere thought that one is being helped counts

The effectiveness of initial therapy contact: A systematic review. Katie Aafjes-van Doorn, Kristen Sweeney. Clinical Psychology Review, November 9 2019, 101786. https://doi.org/10.1016/j.cpr.2019.101786

Highlights
• Few empirical studies have examined the direct effect of initial therapy contacts.
• Initial therapy contact is more effective than no treatment or a waiting list.
• Initial therapy contact might be as effective as 6-session treatment.
• Several effective initial therapy formats and approaches reduce patients' symptoms.

Abstract
‘Initial therapy contacts’, defined as (the first) 3 h or less of face-to-face psychological treatment, encompassing both the early phase of a longer therapy and one-off single session therapies, are seen as a critical phase of treatment. However, little is known about the direct effect of initial therapy contacts on change in common symptoms typically presented by patients in psychological therapy services. Our systematic literature search resulted in 35 identified empirical studies on the effect of initial therapy contacts. These studies were analyzed in three stages: 1) A systematic comparison of study characteristics using the preferred reporting items for systematic reviews and meta-analyses; 2) A domain-based evaluation of methodological rigor of the studies, in line with Cochrane's guidelines on assessing risk of bias; 3) A narrative synthesis of reported findings.

The considerable variability in therapy format (a stand-alone single session, 2 + 1 format, or initial session of multisession therapy) and study design (post/pre-post measurement, with/without control) limited comparability of studies. The quality assessment indicated that the majority of studies had relatively weak methodologies overall. Qualitative synthesis of the effectiveness results suggests that a significant proportion of patients reported benefits, including symptom change. This positive effect is especially clear when compared to no-treatment controls, and appears to be maintained at follow-up. The findings suggest that a broad range of initial therapy formats, could in itself be beneficial to patients in primary care treatment settings, and that further research is warranted.

Keywords: Initial sessionsSingle-sessionEffectSystematicReview

Discussion

Thirty-five empirical studies on the effectiveness of initial therapy contacts were identified. In line with previous reviews (e.g. Hymmen et al., 2013), our quality assessment indicated that the majority of reviewed studies had relatively weak overall methodologies. Studies widely differed in the rigor of their research design and, for example, included four uncontrolled single-case designs, as well as twentyone controlled studies, of which twelve RCTs and three efficacy studies. Findings of the present review support the conclusion that (the first) 3 hours or less of therapy can possibly be an effective intervention in itself for adults with mild to moderate mental health problems. Importantly, reported effects appeared to last over time. All studies that included a follow-up measurement in their design reported that the positive effect of the initial therapy contact had been maintained several months or even years after the intervention, even if no further therapy occurred after the initial therapy contact. Some studies stated that a proportion of patients (e.g. 30% in Abbass et al., 2008) derived sufficient benefit that they did not require further treatment. Although this was not specifically addressed in any of the studies, there appeared to be no difference in outcomes between the effects of initial therapy contact when it consisted of stand-alone sessions (n = 27) or when it consisted of the start of longer therapy (n = 8). For example, a 3-hour stand-alone therapy spread over different sessions (e.g. 2 + 1) appeared to have comparable outcomes to a 3hour session at the start of a longer treatment (Abbass et al., 2008). This suggests that these very brief interventions may be effective in a variety of different formats. Stand-alone session(s). The majority of studies in this review reported on stand-alone session(s). Two specific types of effective stand-alone therapies were identified. First, a “single session therapy”, referred to a planned single-session intervention. The single session may be previously scheduled or provided in a “walkin counselling clinic” (e.g. Hymmen et al., 2013). Another type of effective standalone initial therapy contact has been developed by Barkham and colleagues (Barkham, Shapiro, Hardy, & Rees, 1999). Their “two-plus-one model” (2+1) reflects a very brief three session intervention, comprising of two 1-hour sessions one week apart, followed by a third 1-hour session three months later. The results of this review are in line with other reviews of single-session therapies (e.g. Bloom, 2001; Cameron, 2007; Rockwell & Pinkerton, 1982) and stand-alone therapeutic assessments (Poston & Hanson, 2010), which showed that stand-alone single session(s) in a variety of therapies are effective in reducing symptoms.  Initial session(s) in multisession therapy. In contrast to stand-alone sessions, “initial sessions” refer to the first session(s) of several, or rather, the start to longer therapy. Of the 35 reviewed studies, only 8 studies examined the effectiveness of initial session(s). As mentioned previously, these studies showed comparable outcomes to stand-alone single session(s) intervention. Notably, only one of these eight studies was conducted as RCT (Dunn, Neighbors, & Larimer, 2006), the others used relatively weaker study designs. This means more research comparing the effect of an initial session to overall pre- post treatment change is needed to identify any “first session gains” (Busch, Kanter, Landes, & Kohlenberg, 2006) that set the course of the therapy as a whole (Lambert & Ogles, 2004).  There are several hypotheses as to why initial sessions of multisession therapy might be particularly effective. Frank’s (1974) theory of remoralization suggests that the first hours of therapy are likely to lead to a decrease in symptoms because they help to clarify a patient’s problems, inspire hope and provide experiences of success (see also Howard’s phase model of change; Howard, Lueger, Maling, & Martinovich, 1993; Stulz & Lutz, 2007). In addition to remoralization, others have drawn on goal-setting theory (Locke & Latham, 2006) and the Theory of Planned Behavior (Ajzen, 1988) and emphasized the importance of early changes in the patient’s expectations of therapy (e.g., anticipatory beliefs about what will happen during or because of therapy) (Constantino, 2012; DeFife & Hilsenroth, 2011). According to Ajzen’s (1988) Theory of Planned Behavior, beliefs about expected outcome, self-efficacy concerning necessary ‘patient role’ behaviors and motivation to achieve improvement determine intention to engage and, therefore, the success of therapy. Locke and Latham’s (2006) goal setting theory similarly suggests that an individual’s expectations of therapy may be linked to how much the individual is motivated to engage in working towards their goals and, therefore, achieve symptom change. It has to be noted, however, that these theories of remoralization, goals, and planned behavior not necessarily explain therapeutic benefits of planned singlesession therapy or very brief interventions as stand-alone treatment. Moreover, these theories do not explain why initial therapy contact seemed to be effective irrespective of treatment modality that was used, with vast theoretical and technical differences. Whilst it should be stressed that no statistical comparison between the different models has been attempted, the findings appear to be congruent with the ‘equivalence paradox’ or ‘Dodo-bird verdict’ (Luborsky et al., 2002). These common factors may have an effect on initial therapy contact irrespective of further therapy offered and thus seem to contradict the expectations hypothesis (Constantino, 2012; Greenberg, Constantino & Bruce, 2006). Similarly, the fact that longer-term therapies were not always more effective than the initial therapy contact is inconsistent with the dose-effect literature which identified a relatively larger effect early in therapy, and continuing but diminishing levels of improvement over time. 

The extent to which conclusions can be drawn from the reviewed studies was limited by their respective internal validity (i.e. whether the study results can be attributed to the effect of the initial therapy contact, or whether they might be a result of other factors, such as concurrent treatments, type of control group or therapist effects unrelated to the model of treatment) and external validity (i.e. whether the findings can be legitimately generalized to other people and situations in clinical practice). First, it is possible that we have underrated the overall quality of the reviewed studies in our methodological assessment. For example, two welldesigned efficacy studies (Gellis et al., 2013; Goerling et al., 2014), received an overall weak quality rating, due to their reported low participation rates. Also, attempts to assess risk of bias are often hampered by incomplete reporting of what happened during the conduct of the study (Higgins & Green, 2008). It is therefore possible that the reviewed studies were of higher internal validity than indicated in our systematic review, because important details of the applied study methodologies were left out in the final publications of the studies. Second, publication bias may have impacted the results of this systematic review by alluding to a treatment efficacy when non-published studies failed to replicate such findings (Liberati et al., 2009). Whilst a publication bias should be considered within any systematic review, the existence of negative reporting (e.g. Hutchinson & Krippner, 1988) suggests that it is unlikely a publication bias would have significantly impacted the findings of the current review. Notably, the majority of the more robust study designs were reported in the most recent publications, possibly indicating the current focus in psychotherapy research on evidence-based practice and increased standards of peer-reviewed journals. Third, some of the results of the descriptive studies might have been affected by a response bias, when patients’ inclination to give positive feedback when contacted by the service (Battaglia, Shapiro & Zell, 1996), which could explain why the patients in both the longer-term therapy control groups and the initial therapy contact reported symptom improvement/ recovery in the phone-interviews. Alternatively, in the case of the study by Askevold (1983), the results might also have been affected by patients’ memory of the content, as there was an extraordinary nine years between intervention and follow-up.  Besides these aspects of internal validity, evidence for the external validity of the findings also appears to be mixed. The populations in the studies appear representative of mainstream adult mental health services with respect to age and gender balance (Barkham et al., 2001). However, many relevant patient and therapy
characteristics were not reported. Future research would, for example, benefit from detailed descriptions of treatment setting (e.g., outpatient, crisis clinic), level of therapist training, therapist orientation and location of services (e.g., rural/urban). Moreover, the majority of the studies involved patients with mild to moderate mental health problems, often subclinical, which means that the conclusions are confined to treatments for patients with relatively mild problems, that is, consistent with the severity of problems of patients seen in primary care mental health services (Barkham et al., 2001; Haaga, 2000). However, this also resulted in a small scope for reduction in scores on standardized measures, and might thus understate the potential efficacy of initial therapy contacts. The impact of initial therapy contacts on interpersonal or personality problems was not addressed in the majority of studies reviewed and, therefore, the current studies cannot challenge the existing notion that these difficulties take longer to change (Hardy et al., 1995; Lambert & Ogles, 2004; Merbaum & Butcher, 1982). It may be useful, in future research, to explore the impact of initial therapy contacts for more severe presentations, such as those seen in, for example, secondary and tertiary care services. To know beforehand for whom ultra-brief therapy is enough (e.g. patient factor) would be extremely important knowledge for the cost-effectiveness and efficiency of mental health services.  In order to develop the evidence-base of initial therapy contact further, it is crucial to determine not only the patient and treatment moderators but also the mediators of improvement. An important next step could be to examine the relative benefits of key process elements, such as alliance (Hilsenroth & Cromer, 2007), expectations and hope (Constantino, Arnkoff, Glass, Ametrano, & Smith, 2011) that form early in therapy and are assumed to mediate the effectiveness of initial sessions (Messer & Wampold, 2002). Given that the reviewed empirical studies did not report on moderation or mediation analyses, future researchers should address this gap in the psychotherapy literature.  As next step in future research, the effectiveness as well as relevant moderators and mediators of initial therapy contact should be examined in a metaanalysis. In this review, meta-analytic strategies could not be applied because only a small number of studies (n = 13) (e.g. Abbass et al., 2008; Armento et al., 2012) reported significance levels, and the vast majority of studies did not provide enough information to enable calculation of effect sizes. When researchers ensure that the intervention and treatment effect (or effect size) is reported consistently from one study to the next, meta-analysis can be used to numerically pool the results of the studies and arrive at a summary estimate to identify this effect of initial therapy contact. Subgroup analyses and meta regression can then be conducted to test if there are subsets of research that capture the summary effects. This next step will then help test hypotheses around the relative importance of the length, format or therapy model of the initial therapy contact in determining symptom change.  Further research might illuminate whether patients who substantially improve during the initial sessions of longer therapy would have done so even if treatments were planned to be only ultra-brief (3 hours or less). Building on our findings, future researchers may clarify if initial therapy contacts with varying total treatment dose are equally effective (see dose-effect model; Howard et al., 1986), or if rate of change is related to total dose of therapy (see the good-enough level model of change; Baldwin, Berkeljon, Atkins, Olsen & Nielsen, 2009).


Clinical Implications.

The reported risks of bias in the reviewed studies precludes drawing any strong conclusions about the effectiveness of each specific intervention. However, for clinicians it will be important to know that, in contrast to the review of single-session debriefing after trauma (Bisson, 2010; Rose et al., 2003), there were no indications of any significant harm or distress following the initial therapy contacts applied in general outpatient services. In other words, initial therapy contacts (as a stand-alone intervention or as part of longer treatment) may constitute a beneficial therapeutic intervention in itself. The self-reported patient outcomes suggest that there might be a number of initial therapy formats (singlesession, 2-1, & initial session), which could potentially benefit patients in primary care treatment settings, more than no treatment or being on a waiting list.  Understanding the direct effect of these initial therapy contacts is thus of great significance to clinicians who, in this managed-care era, are under pressure to provide effective relief in the shortest time possible. Clinicians will want to know who gets better and what it is that leads to that improvement, to stratify selection or alter therapy content accordingly. Moreover, by identifying the most important factors associated with change in initial therapy contacts, we may aid the development of therapist training to maximize the beneficial impact of this critical stage in therapy. Ultimately, effective initial treatment sessions might not only benefit patients, but might also aid service providers, when these early outcomes translate into lower non-attendance or drop-out rates in clinical services. Similarly, the very brief 2+1 therapies are likely to harness the effects of elapsed time within the service context and may thus be both cost effective and clinically effective. Service administrators may view single session therapy as a less risky and more long term cost-effective alternative to lengthy waitlists and may argue that one session of therapy may be all that many patients need (Boyhan, 1996; Talmon, 1990). Therefore, the application of these very brief interventions in clinical services also raises ethical concerns that decisions to limit the number of sessions available to patients may be based on budgetary constraints rather than clinical judgements (Campbell, 2012; Hurn, 2005).

Recent research has revealed that the Visual Aesthetic Sensitivity Test (VAST) has several psychometric problems; these authors introduce a new conception of visual aesthetic sensitivity

A new conception of visual aesthetic sensitivity. Guido Corradi  Erick G. Chuquichambi  Juan Ramón Barrada  Ana Clemente  Marcos Nadal. British Journal of Psychology, October 6 2019. https://doi.org/10.1111/bjop.12427

Abstract: Aesthetic sensitivity has been defined as the ability to recognize and appreciate beauty and compositional excellence, and to judge artistic merit according to standards of aesthetic value. The Visual Aesthetic Sensitivity Test (VAST) has often been used to assess this ability, but recent research has revealed it has several psychometric problems. Such problems are not easily remedied, because they reflect flawed assumptions inherent to the concept of aesthetic sensitivity as traditionally understood, and to the VAST itself. We introduce a new conception of aesthetic sensitivity defined as the extent to which someone's aesthetic valuation is influenced by a given feature. Experiment 1 aimed to characterize aesthetic sensitivity to four prominent features in visual aesthetics: complexity, symmetry, contour, and balance. Experiment 2 aimed to replicate the findings of Experiment 1 and to assess the test–retest reliability of an instrument designed to measure aesthetic sensitivity to these features using an abridged set of stimuli. Our results reveal that people differ remarkably in the extent to which visual features influence their liking, highlighting the crucial role of individual variation when modelling aesthetic preferences. We did not find clear relations between the four measures of aesthetic sensitivity and personality, intelligence, and art interest and knowledge. Finally, our measurement instrument exhibited an adequate‐to‐good test–retest reliability.

We should not assume that women equally pursue orgasm in their sexual encounters, and that this important individual difference can help explain differences in orgasm occurrence between women

The role of women's orgasm goal pursuit in women's orgasm occurrence. Staci Gusakova et al. Personality and Individual Differences, November 8 2019, 109628. https://doi.org/10.1016/j.paid.2019.109628

Abstract: Heterosexual women's low orgasm rates are widely acknowledged within sexuality research. However, researchers have not accounted for whether women are even pursuing orgasm (actively and purposefully attempting to orgasm) in their sexual encounters with men. Given that heterosexual sexual scripts often deprioritize women's pleasure, women may vary in their orgasm goal pursuit – whether they set orgasm as a goal and strive to have an orgasm – in any given sexual encounter, with some women being less likely to pursue orgasm than others. Across two studies, we investigated the association between women's orgasm goal pursuit and orgasm occurrence. By examining the variations in women's orgasm goal pursuit, we aimed to explain why some women orgasm in their sexual encounters and other women do not. Women who reported greater orgasm pursuit were more likely to report that they orgasmed in their most recent sexual encounter. These findings suggest that researchers should not assume that women equally pursue orgasm in their sexual encounters, and that this important individual difference can help explain differences in orgasm occurrence between women.

Keywords: OrgasmOrgasm gapWomen's sexualityOrgasm goal pursuitSexual scripts

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Women who have sex with men (WSM) report that they frequently do not have orgasms in their partnered sexual encounters (Frederick, John, Kate, Garcia, & Lloyd, 2018; Richters, DeVisser, Rissel, & Smith, 2006). In two national samples of U.S. adults, researchers found that only 65% of heterosexual women reported that theyusually or always orgasm during heterosexual sexual encounters (Fredericketal.,2018) and only 69% of women reported that they orgasmed in their most recent sexual encounter with a man (Richters et al., 2006).Thepatterns for bisexual women's orgasm rates are similar, with only 66% of bisexual women reporting that they usually or always orgasm during their sexual encounters with men (Frederick et al., 2018). Moreover, research has found that, compared to women who have sex with women, WSM are less likely to orgasm across various sexual activities (including clitoral manipulation by self and by partnerandoralsexbut not during vaginal intercourse); however, these results were not examined based on participants’ self-reported sexual orientations (Blair, Cappell & Pukall, 2018). In contrast to the orgasm rates for heterosexual and bisexual women, 95% of heterosexual men and 88% of bisexual men reported that they usually or always orgasm during sexual encounters (Frederick et al., 2018) and 95% of heterosexual men orgasmed in their most recent sexual encounter with a woman (Richters etal.,2006). The low frequency of orgasm in women has led some researchers to draw conclusions about women's anatomy, biology and health, with the implication that women's bodies are simply not designed to have orgasms at the same frequency as men (Brody & Costa, 2017; Emhardt, Siegel & Hoffman, 2016). Likewise, the findings about WSM's low orgasm rates have created the assumption that the problem of low orgasm frequency lies in women themselves because they are difficult to please, their bodies are difficult to navigate, their biology is to blame(Bell& McClelland, 2018; Butler, 2013; Matsick, Conley & Moors, 2016; Nicolson & Burr, 2003). Thus, WSM often end up internalizing beliefs that they are sexually dysfunctional (at least vis-a-vismen),particularly if they do not orgasm during penile-vaginal intercourse. These instances of self-blame most likely occur because women compare themselves against their perception that “normal” women should be capable of orgasming (Nicolson & Burr,2003). Given these messages about women's orgasmic abilities, it is conceivable that WSM end up with differing levels of investment in and desire to pursue orgasm.Although some women do not considerorgasm to be essential to their sexual satisfaction (McClelland, 2014), many women still consider orgasm to be important with research showing that approximately 80% of the women surveyed considered orgasm to be rather important or very important (Kontula & Miettinen, 2016). Moreover, the women who considered orgasm to be important were more likelyto orgasm compared to womenwho reported orgasm was not important to them (Kontula & Miettinen, 2016). However, it remains unclear why ascribing importance to orgasm is associated with orgasms occurring and what mechanisms may be behind this association. For example, although the types and variety of sexual acts that women engage in influence whether they orgasm (Frederick et al., 2018; Fugl-Meyer, Öberg, Lundberg, Lewin & Fugl-Meyer, 2006;  Herbenick et al., 2010), no research to our knowledge has explored whether women are engaging in specific sexual acts or in a greater variety of sexual activities with the goal of pursuing orgasm. In the present research we pose the question: do WSM work to make orgasm possible? If orgasm is something some WSM consider important, do they then pursue orgasm, thereby acting in accordance with their belief that orgasm is important? To answer this question, we integrate research on goal pursuit to offer the conceptual framework of orgasm goal pursuit. Orgasm goal pursuit is defined as the setting and striving towards having an orgasm in a given sexual encounter. In examining WSM's orgasm goal pursuit, we measure whether they are purposefully acting in ways that they believe will result in orgasm for them. In the present study, we examined the association between orgasm goal pursuit and orgasm occurrence in WSM's most recent sexual encounters. Our goal was not to explainhow or why WSM pursue orgasm, but whether they pursueit–that is, whether they engagedinany actions for the purpose of improvingtheir chances of orgasm. 'We expected orgasm goal pursuit would explain WSM' slow rates of orgasm: women who are not pursuing orgasm–perhaps because they do not feel entitled to pursueit–are almost certainlyless likely to orgasm. In this research, we predicted that orgasm goal pursuit maybe an individual difference among women that can explain why some WSM orgasm in theirsexual encounters and others do not.

Conclusion
Given the societal importance placed on orgasm as a proxy for healthy and pleasurable sex, we extended research to address how women differ in the extent to which they perceive orgasmas important and the degree towhich theypursueorgasm.We foundthat women's endorsement of orgasm goal pursuit predicted whether a woman orgasmed in her most recent encounter. These findings suggest that orgasm is not simply something that happens to women but, instead, women can have different intentions for their sexual experiences with some women more actively pursue orgasm than others. We suggest that future researchers consider orgasm goal pursuit as a critical individual difference when trying to understand assumptions about women's orgasmic capabilities and the orgasm gap between WSM and men who have sex with women.

Overlooked reproductive function of the clitoris: It has both procreative (reproductive) and recreative (pleasure) functions of equal importance, contrary to mainstream opinion until recently

The Clitoris—An Appraisal of its Reproductive Function During the Fertile Years: Why Was It, and Still Is, Overlooked in Accounts of Female Sexual Arousal. Roy J. Levin. Clinical Anatomy, November 5 2019. https://doi.org/10.1002/ca.23498

Abstract: Stimulating the clitoris activates the brain to instigate changes in the female genital tract, namely, the enhancement of vaginal blood flow that increases vaginal luminal pO2, vaginal transudate (lubrication) facilitating painless penile penetration and partial neutralization of the basal luminal acidic pH, vaginal tenting, and ballooning delaying sperm transport and allowing semen de‐coagulation and capacitation (sperm activation) factors to act until arousal ends (often by orgasm induction). All these genital changes taken together are of major importance in facilitating the possibility of reproductive success (and thus gene propagation) no matter how or when the clitoris is stimulated—they reveal its overlooked reproductive function. Of course, also commensurate with these changes, is its activation of sexual pleasure. The clitoris thus has both procreative (reproductive) and recreative (pleasure) functions of equal importance. Clitoridectomy creates not only sexual disability but also a reproductive disability.

FINAL COMMENTS
Freud (1905) stated that the function of the clitoris was “namely, of transmitting the excitation of the adjacent female sexual parts, just as—to use a simile—pine shavings can be kindled in order to get a log of harder wood on fire.” His main bias against the clitoris was because it facilitated sexual arousal far too easily in the early formative female years and that for so‐called sexual maturity or full femininity to occur it had to be replaced by penile‐vaginal dominated sexual arousal, namely, “The elimination of clitoral sexuality is a necessary precondition for the development of femininity.” Remarkably, similar concepts are still promoted by a few contemporary neo‐Freudians whose simplistic concept of women's orgasmic sexuality is that it has but three stages of development, namely, clitoral orgasm is best an intermediate state between global anorgasmia and being fully vaginally orgasmic (Brody, 2007). An even more draconian claim by Brody (2010) is that using clitoral stimulation for sexual arousal, because it avoids the possible gene‐propagating features of PVI, is “punished” by evolution resulting in “noxious consequences” (see Levin, 2014, 2018 for full discussion). This is a misrepresentation of evolution as a “judging mechanism,” as Kauth (2006) pointed out “Nature is not moral and takes no position on what ‘ought’ to be.” Costa and Brody (2014) speculated further that “vaginal orgasm evolved to promote PVI and consequent gene transmission in the situations of better fitness potential” but they completely overlooked the pre‐orgasmic “better fitness potential” created in the female reproductive tract for facilitating sperm fertilizing potential induced by clitoral stimulation per se despite the fact that all the changes were well documented in the current literature.

In relation to Freud (1915), during the time that he practiced, the detailed physiological responses of the female genital tract to sexual arousal were not yet identified and described. It would also be some 36 years later before the details of sperm capacitation, independently discovered by Austin (1951) and Chang (1951), the process essential to their becoming fertile, and some 60 years later when Masters and Johnson (1966) described the changes in the female genital tract activated during sexual arousal. As these are now current and scientifically accepted, Freud's proposal can be reassessed in light of these essential reproductive mechanisms. Namely, the reproductive task of the clitoris is to activate the brain to induce the combination of changes needed in the female genital tract to ensure with pleasure that if, in any ensuing following sexual scenario, coitus with semen ejaculation occurs into the vagina, then the best possible conditions are created for it to achieve reproductive success and thus maintain reproductive fitness. In terms that evolutionists employ, this reproductive function of the clitoris is its “proximate” function with regards to facilitating “ultimate” reproductive success in the female's fertile years. While challenging major belief and values may prove to be difficult for some, the reappraisal of the functions of the clitoris as both reproductive as well as recreative are of equal importance is clearly now unavoidable.

Data from China: When parents leave behind the children to work afar there is a significant negative effect on children’s non-cognitive development

Parental Migration, Investment in Children, and Children’s Non-cognitive Development: Evidence from Rural China. Hanchen Jiang and Xi Yang.
http://www.econ2.jhu.edu/jobmarket/2019/JiangH/OtherThesisPapers/Chapter3JiangH.pdf

Abstract: Many children worldwide are left behind by parents who are migrating for work. While previous literature has studied the effect of parental migration on children’s educational outcomes and cognitive achievements, this study focuses on how parental migration affects children’s non-cognitive development. We use longitudinal data of children in rural China and adopt labor market conditions in destination provinces as instrumental variables for parental endogenous migration choice. We find that parental migration has a significant negative effect on children’s non-cognitive development. Differentiating inter- and intra-provincial migrations suggests that the negative effect of parental migration is mainly driven by inter-provincial migrations. We test four different mechanisms of how parental migration affects child development including parental financial inputs, parental time inputs, household bargaining, and children’s own time input. Our results provide insights into the relative importance of different mechanisms in determining the effect of parental migration on children’s non-cognitive skill formation.

Keywords: Left-behind Children, Parental Migration, Parental Input, Non-cognitive
Development, China
JEL Classification: J12, J13, J24, J61, R23

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Full text, notes, references in the link above. Excerpts follow.

6.5 Parenting Style and Parental Health

In addition to the mechanisms we have tested so far, the literature has emphasized other
important determinants of child development. One is parenting style (Dooley and Stewart,
2007; Fiorini and Keane, 2014; Doepke and Zilibotti, 2017). Although there are no consistent
measurements of parental style so far, the few papers that considered these kinds of variables
commonly find that parenting style has an impact on child developmental outcomes. For
example, Dooley and Stewart (2007) find that different aspects of parenting (positiveness,
hostility, consistency, and punitiveness) are more important than family income in terms of
determining children’s behavior and emotional outcomes. Fiorini and Keane (2014) find that
parental warmth and effective discipline lead to better non-cognitive outcomes for children.
More recently, Doepke and Zilibotti (2017) develops a theory to explain how parenting style
plays an important role in determining children’s welfare and economic success. Parenting
style can be an important channel through which parental migration affects child develop
ment. The GSCS provides limited information on parenting style. Nevertheless, we define
harsh parenting style by the mother’s and child’s answer to the question “whether you beat
your child/you are beaten when misbehaved.” Using the baseline fixed effects model with
instrumental variables, our results in Appendix Table A7 show that the effect of the father’s
migration on parenting style is insignificant. These results, however, do not imply that par
enting style is not important in terms of explaining the link between a father’s migration
and his children’s development outcomes. Future work needs to measure parenting styles in
a more comprehensive way to better test this mechanism.

The other determinant that was mentioned in the literature is parent’s health condition,
which may have an impact on the quality of time parents spend with their children. For
example, Ronda (2016) and Herbst (2017) find that maternal psychological distress and de
pression may have a negative impact on children’s outcomes. In the meantime, the migration
literature has provided some evidence that migration increases the probability of being in
poor physical and mental health (Antman, 2010; Barrett and Mosca, 2013). To test this
mechanism, we investigate whether the father’s migration has an impact on the self-assessed
health status of the father and mother.41 Appendix Table A7 provides the estimation re
sults, showing that the father’s migration does not increase the probability of parents in
poor health condition. However, we are reluctant to conclude that parent health status
is not an important mechanism behind the link between parental migration and a child’s
development, considering that our measure of health status is self-reported and does not
differentiate between mental health and physical health. This is a mechanism worth testing
in the future. 42


7 Discussion of Sub-sample Results

Table 15 reports the sub-sample estimation results and highlights some interesting patterns.43
First, columns (1) and (2) show that the effects of father’s migration are larger among male
children (-0.057 and -0.028) than those for female children (-0.065 and -0.047). We hypoth
esize that there are several explanations for this gender difference. First, the left-behind
mother communicates better with girls while having difficulty dealing with teen boys. Sec
ond, lacking a positive male role model has a negative impact on a boy’s development. Thus,
maternal input could be a poorer substitute for the lack of paternal inputs when it comes to
raising a boy. Third, as proposed in Bertrand and Pan (2013), the non-cognitive development
of boys, unlike that of girls, appears extremely responsive to the quality of parental inputs,
which is negatively associated with parental migration.44 Nonetheless, we are not intending
to decompose these different channels, and we leave it for future studies. This kind of gender
difference has also been documented in recent child development literature, which finds that
father absence, usually caused by divorce, has a greater influence on boys than girls. For
example, Bertrand and Pan (2013) find that boys do especially poorly and are much more
likely to develop behavior problems in broken families, which are usually associated with
worse parental inputs. Figlio et al. (2019) find that family disadvantage disproportionately
impedes the development of boys by using birth certificates matched to schooling records in
Florida.

Columns (3)-(6) divide the sample children by their parents’ education levels. We find
that the negative effect of the father’s migration is more evident if parents, especially mothers,
are less educated. For example, if the mother has not graduated from elementary school,
then the father’s migration reduces internalizing and externalizing scores by 0.036 and 0.071
points. But if the mother has graduated from elementary school, the two coefficients are
reduced to 0.025 and 0.05. These results suggest that mothers with better education are
more likely to engage in high-quality parenting and can better mitigate the adverse effect
caused by the father’s absence (Carneiro et al., 2013).

Moreover, as previously discussed, lack of time inputs seems to be the major mechanism
through which the father’s migration affects his children’s development. In that sense, it is
possible that better infrastructure, such as having access to a telephone service, may help
left-behind children connect and communicate with their fathers. In columns (7) and (8)
of Table 15, we divide our sample children by whether their resident village has telephone
services, but the negative effect of father’s migration does not vary much across the two
groups. This may be because telephone communication is not a good substitute for face-to
face communication in terms of parenting or because the telephone is not widely used among
migrant families to maintain effective communication between the migrant father and his
children left behind.

8 Conclusion
This paper sets out to identify the effects of a father’s migration on his children’s non
cognitive development. By exploiting a longitudinal data set and using instrumental variables
based on the destination provinces, we identify a negative effect of a father’s migration.
We explore several possible mechanisms behind this negative effect. First, we find that a
fathers’ migration is associated with an increase in family income, which, however, does
not lead to an increase in child-related spending. In the meanwhile, our results show that
a fathers migration increases his decision power on financial allocation within the family,
which provides a potential explanation of the observed divergence in family income and
spending. More important, a father’s migration reduces the time both parents spend talking
and playing with their children. Overall, the father’s migration reduces both parent financial
and time inputs, which might be the two major driving forces behind the negative effect of
a father’s migration on left-behind children.

These results expand the scope of current literature by uncovering negative consequences
of parental migration that is rarely studied in the literature. More important, our discussion
on potential mechanisms suggest that relevant policies are urgently needed to help migrant
parents improve their financial and time inputs on children. Considering that non-cognitive
skill is a vital dimension of human capital, these policies would have an important impact
on increasing inter-generational mobility and on reducing rural-urban inequality.

Oct 2019: India is trying to build the world's biggest facial recognition system

India is trying to build the world's biggest facial recognition system. Julie Zaugg. CNN Business, October 18, 2019. https://edition.cnn.com/2019/10/17/tech/india-facial-recognition-intl-hnk/index.html

Excerpts:

In July, Bhuwan Ribhu received some very good news.

The child labor activist, who works for Indian NGO Bachpan Bachao Andolan, had launched a pilot program 15 months prior to match a police database containing photos of all of India's missing children with another one comprising shots of all the minors living in the country's child care institutions.

He had just found out the results. "We were able to match 10,561 missing children with those living in institutions," he told CNN. "They are currently in the process of being reunited with their families." Most of them were victims of trafficking, forced to work in the fields, in garment factories or in brothels, according to Ribhu.

This momentous undertaking was made possible by facial recognition technology provided by New Delhi's police. "There are over 300,000 missing children in India and over 100,000 living in institutions," he explained. "We couldn't possibly have matched them all manually."

Locating thousands of missing children is just one of the challenges faced by India's overstretched police force in a nation of 1.37 billion people.

[...]

[India's federal] government now has a much more ambitious plan. It wants to construct one of the world's largest facial recognition systems. The project envisions a future in which police from across the country's 29 states and seven union territories would have access to a single, centralized database.

The potential role of illness expectations in the progression of medical diseases

The potential role of illness expectations in the progression of medical diseases. Francesco Pagnini. BMC Psychology, volume 7, Article number: 70 (2019). Nov 8 2019. https://bmcpsychology.biomedcentral.com/articles/10.1186/s40359-019-0346-4

Abstract
To what extent can one’s mind promote direct changes to the body? Can one’s beliefs about the body become a physical reality, without mediating effects from behaviors? Specifically, can medical symptoms and the course of a disease be directly affected by a person’s mindset about the illness?
There is a vast literature about placebo and nocebo effects, that promote physical changes by creating the expectation of a change through a primer (for example, a fake pill). Placebos, however, often imply deception, or at least ambiguity, to be effective. The concept of Illness Expectation describes the expectations, both implicit and explicit, that a person who has received a diagnosis makes about the course of the disease. It can be characterized by different degrees of rigidity, and it is argued here that these expectations can ultimately lead to changes in the disease progression. These changes may happen through behavior modifications, or through a non-behavioral pathway, which may deserve exploration efforts from the scientific literature.

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Effects of expectations on the body

One of the main operational mechanisms of placebos is represented by cognitive expectations, which in turn are expected to promote the occurrence of physiological changes in the body [11]. In general, placebo and nocebo effects have been studied with a primer, such as a sugar pill, that influences or conditions the person to anticipate an effect. The expectation of a medical effect promotes both subjective and objective (physiologic) changes, with clinical improvements or worsening [12]. However, expectations are not only prompted by drugs or interventions. In fact, every individual with a medical condition develops a certain mindset toward the illness [13], with expectations that spontaneously emerge. These expectations, which represent the result of the elaboration process of the information collected about the disease [14], can promote different physiological effects [15]. For example, blood glucose levels in people with type II diabetes are influence by perceived time and expected values, rather than being a mere physiological process [16]. Furthermore, expectations can influence the ageing process: older adults who think about ageing as associated with negative characteristics tend to experience a greater loss of physical function and a reduced survival, compared to those who held positive expectations [17].

Illness perceptions and health beliefs

Expectations about the disease are a central component of illness perceptions and health beliefs, which are well-established concepts in health psychology [18]. Illness Perception is often explored within the theoretical framework of the Common Sense Model (CSM) of Illness Representation [19]. In the CSM theory, patient’s illness perceptions include beliefs about what precipitated the illness (causes), how long it will last (timeline), the impact on the patient’s life (consequences), which symptoms are attributed to the illness (identity), and how the condition can be controlled or cured by the patient’s behavior (personal control) or by the treatment (treatment control). In the CSM, expectations are considered as an underlying component of the different beliefs [20, 21]. Emotional components are another key aspect of the CSM, which may interfere with cognitive processing, and it could be a source of confusion during the assessment process. For example, one of the most utilized instruments for the assessment of illness perception, the Brief Illness Perception Questionnaire [22] includes items like “How much does your illness affect you emotionally?”, which are somehow related to the expectations, but refer directly to the emotional domain. The same concern deals with questions about consequences in everyday life (e.g., “My illness has serious economic and financial consequences”, from the Illness Perception Questionnaire Revised [23]).

Thus far, most published research referencing the Illness Perception construct focuses on the role of disease representations in explaining both coping and outcomes in patients with a wide range of health conditions [24, 25]. Specifically, health psychologists have explored how disease representations can lead to lifestyle modifications, eventually leading to changes in the medical outcomes [26]. For example, adherence to the medical treatment, or lifestyle choices like eating, exercising, or smoking, can be influenced by illness representations. A person who perceives that nothing can change the course of the disease, for example, may be more prone to avoid exercising or taking prescribed medicine [27]. In other words, the effects of Illness Perceptions on the body (namely, on the course of the disease or its symptoms) have been mainly explored as mediated by behavior changes [28]. The main difference between the construct of Illness Perception and Illness Expectation is their specificity: while the former is a multifaceted concept that includes several aspects of the illness experience, the latter is a specific element, the anticipation of the future illness-related scenarios, which is merely cognitive.

Emotions and somatic changes

[...] Briefly, we know that negative emotions (e.g., depression, stress) have, among other effects, a strong impact on human physiology [29], often reflecting on poorer medical outcomes, in the case of chronic diseases. For example, depressive states and stress have been associated with reduced survival rate in patients with cancer [30]. The mechanisms underlying these associations are still under investigation.

[Full free text in the link above]

The study found auto-written news stories were rated as more objective, credible (both message and medium credibility), and less biased

Is Automated Journalistic Writing Less Biased? An Experimental Test of Auto-Written and Human-Written News Stories. Yanfang Wu. Journalism Practice, Oct 29 2019. https://doi.org/10.1080/17512786.2019.1682940

ABSTRACT: By administering an online experiment, this study examined how source and journalistic domains affect the perceived objectivity, message credibility, medium credibility, bias, and overall journalistic quality of news stories among an adult sample (N = 370) recruited using Amazon’s Mechanical Turk (MTurk) service. Within the framework of the cognitive authority theory, the study found auto-written news stories were rated as more objective, credible (both message and medium credibility), and less biased. However, significant difference was found between a combined assessment condition (news stories with source and author information) and a message only assessment condition (news stories without source and author information) in the ratings of objectivity and credibility, but not bias. Moreover, significant differences were found in the objectivity and credibility ratings of auto-written and human-written news stories in the journalistic domains of politics, finance and sports news stories. In auto-written news stories, sports news stories were rated more objective and credible, while financial news stories were rated as more biased. In human-written stories, financial news stories were rated as more objective and credible. However, political news stories were rated as more biased among human-written news stories, and in cases where auto-written and human-written stories were combined.

KEYWORDS: Cognitive authority, auto-written, human-written, automated journalistic writing, experimental test, objectivity, credibility, bias

Discussion
The study found that auto-written news stories were rated as significantly more objective than human-written news stories. This finding is in line with previous researchers’ assumptions about the inherent objectivity of algorithms, the limits of humans’ subjective “gut feeling” in the evaluation of newsworthiness and news inclusion, and the advantages of algorithms in overcoming inherent human biases and limitations (Carlson 2018; Toraman and Can 2015). Also, the results corroborated Cleary and coauthor’s(2011) conclusion that Natural Language Generation software could augment accuracy, Clerwall’s (2014) result that text generated by algorithms is perceived as more informative, accurate, and objective, and Melin and coauthor’s(2018) finding that auto-written content tend to be rated more accurate, trustworthy and objective. Additionally, these findings echoed Thurman and coauthors’ (2017) conclusion on automaton and the increase of objectivity in news stories. The reason why automatic journalistic writing was rated as more objective could be that readers favor stories distinguishing facts and opinions clearly, which NGL, the generation method used for the texts chosen in this study, was recognized as being able to generate stories of this nature in Melin and coauthor’s(2018) conclusion. Further, Graefe and coauthor’s(2018) recent studies concluded that algorithms, such as NLG, are more accurate on factual information. Moreover, choosing the right vocabulary that represents the information in numbers is major task for journalists. Word choice is always influenced by the journalist’s personal interpretation, which may reduce a news story’s objectivity. For example, Carlson (2018, 1764) believed journalists have inherent human subjectivity because they apply learned knowledge to professionally valid interpretations. In contrast, algorithms have the unthinking objectivity of computer programs, and are the apotheosis of journalistic knowledge production – objectivity. Furthermore, specialized algorithms have a narrow domain focus reducing the options for word choice, thereby increasing objectivity (McDonald 2010). Gillespie (2014) used the term “algorithmic objectivity” to describe the power of algorithms in strengthening objectivity. Additionally, the integration of automation and datafication in news reporting may increase objectivity. For example, web analytics are found to be useful tools in increasing the precision of journalists’ news judgement (Wu, Tandoc, and Salmon2018). Data driven journalism not only empowers journalists to report stories in new and creative ways (Anderson 2018), it is also believed to increase objectivity (Parasie and Dagiral 2013). Another interesting finding is that auto-written stories were even perceived as more credible (both message and medium credibility) than human-written news stories. This finding aligns with Haim and Graefe’s(2017), Van der Kaa and Krahmer’s (2014), Clerwall’s (2014), and Melin’s(2018) conclusions that readers tend to perceive auto-written news as more credible than human-written stories. The finding also aligns with Wolker and Powell’s (2018) claim that there are equal perceptions of credibility between auto-written and auto and-human-combined-written content. Although auto-written algorithms lack the skills in using nuances of languages, human reporters may produce less credible news stories due to failing to express views, or distinguish facts from opinions clearly (Meyer, Marchionni, and Thorson 2010). However, an algorithm is viewed as a “credible knowledge logic” (Gillespie 2014, 191) because it is considered a force that could eliminate human biases or errors (Linden 2017a). Algorithms also create many more possibilities for detecting falsehood (such as bias, inaccuracy) automatically and verifying truth more effectively (Kaczmarek 2008). Stories developed by programmers from multi-sourced data can fulfill functions of professional journalism and may even align with more traditional journalistic standards (Parasie and Dagiral 2013; Dörr 2016). Furthermore, algorithms may perform better than human reporters in data verification, as algorithms restrict themselves to a specialized area with a very stipulated content (Perloff 1993; Hassan and Azmi 2018).

This experimental design distinguished the effect of source and journalists’ authorship from text on readers’ ratings of quality of journalism, which is one of the major contributions of this study. This study further verified that readers consider automatic journalistic writing more objective when source and journalists’ affiliation information were not disclosed. Moreover, the message and medium credibility of automated journalistic writing were rated significantly higher without source and authorship. These findings align with Graefe et al.’s(2018) results on the confounding effect of source on readers’ ratings of credibility – the declaration of an article written by a journalist substantially increase the ratings of readability. The findings also showed a decline of trust in traditional media and human writers in producing good journalism, which was reflected in a recent survey by Knight Foundation and Gallup poll – a majority of surveyed Americans reported they had lost trust in American media due to inaccuracy, bias, fake news, alternative facts, a general lack of credibility, and reporters are “based on opinions or emotions” (Ingram 2018). Automated journalistic writing, however, showed strength in objectivity and credibility.

The confounding effect of source and authorship was also identified in the ratings of bias. In particular, whether journalists’ political belief affects the presentation of the subject is one of the important indexes of message credibility in this study. Human written stories were rated more biased than auto-written news stories. However, when source and authorship information were included, human-written stories were rated less biased. Although impartiality is recognized as one of the important journalistic ideologies, human journalists were tagged as partisan actors whose political beliefs affected their news decisions, although they define themselves as news professionals committed to a form of journalism marked by objectivity and neutrality (Patterson and Donsbagh 1996; DellaVigna and Kaplan 2007; Oosterhoff, Shook, and Ford 2018; Linden 2017a). Gaziano and McGrath (1986) identified that political bias was important factor affecting credibility in news reporting, particularly accuracy, fairness, responsibility, and role in criticism of government. With the proliferation of data, human-written news stories may contextualize the automated-generated content by using it as a multi-source from different perspectives (Carlson 2015; Thurman, Dörr, and Kunert 2017). This was described by Carlson (2018) as “a visible incursion of algorithmic judgment in the space of human editorial judgment” and Wolker and Powell (2018) as the well-rounded future of journalism. These applications are feasible to reduce human bias in journalism.

Participants in the message only assessment condition rated auto-written news stories as both more objective and more credible (both message credibility and medium credibility) than human-written news stories compared to participants in the combined assessment condition. According to the hypothesized news assessment model based on the cognitive authority theory, readers rely on textual authority (intrinsic plausibility) – whether the content is “accurate, authentic and believable” (Appelman and Sundar 2016, 73) – to execute evaluation when the affiliation of the news organization and the journalist’s name were removed from the stories. However, when institutional authority and personal authority were combined with textual authority, readers combine textual authority with whether the source of message is “authoritative, reliable, reputable and trustworthy” (Appelman and Sundar 2016, 74) to make judgment. The results showed that this combined assessment process reduced news stories’ perceived objectivity and credibility. In the internet age, readers may assess news stories with greater emphasis on textual authority due to the insufficient bandwidth for storing information (Sundar 2008). The findings from this study corroborates Wilson’s (1983) cognitive authority theory. When source – personal authority and institutional authority – are not revealed, readers have to use textual type authority (document type), and intrinsic plausibility authority (content of text) to evaluate the credibility of a news story. This may change how news quality is assessed in digital journalism. The findings further verified the result that auto-written news content is perceived as more objective and credible than human-written news stories.

Although automated journalistic writing received higher credibility ratings, it is also more likely to distribute fake news due to its dependence on data for source, processing and output. Ethical issues may arise when data is used without proper verification, transparency about the source and content in generation algorithms (Graefe 2016). In addition, whether the programmer, reporter, or editor will be responsible for the collection, analysis and presentation of data, and who should be held accountable for automated journalistic writing in which human reporters contributed to contextualize generated content, and algorithms acted as an intelligence augmenter, remain controversial topics in the field of automated journalistic writing.

Journalistic domains were found to affect readers’ evaluations of objectivity, message credibility, and medium credibility, but not bias. Sports news stories were rated more objective and credible (both message and medium credibility) than finance and political newsstories in auto-written news tories. Financial news stories were rated more objective and credible than sports and political newsstories among human-written stories. Financial news stories were rated more biased than sports and political news stories among autowritten news stories. However, political news stories were rated as more biased than financial and sports news stories in human-written news stories. Political news stories were rated as more biased than sports and finance news stories when auto-written and human-written stories were combined. Multiple business motivations may result in journalistic domains havinganeffect on readers’ assessment of news stories. First, thepublishers’ or new organizations’ political stance was found to greatly affect that of its reporters’. or example, news stories of ABC, CBS, NBC and Fox were believed to exhibit political leanings. Subsequently, political bias may be more salient in story constructions or patterns of bias in news stories (Groeling 2008). Similarly, participants’ political ideology may affect their views towards The Associated Press, The New York Times, and The Washington Post. Secondly, social identity – the sense of whether one belongs to a perceived ingroup or out-group – may affect bias in sports news. Previous studies found that American sportscasters tended to report favorably on athletes from the United States and highlight them more frequently. In-group favoritism is more pronounced when their participants’ team won (Bryant and Oliver 2009; Wann 2006). However, financial news stories, which are mostly free from political standing and social identity, were the least biased when compared to politics and sports stories in the human-written group. On the contrary, when neither political stance nor social identity plays a role, financial news stories were rated the most biased in the auto-written group.

After controlling for some of the main confounding factors identified in the literature, we find that individuals with higher cognitive abilities are more financially literate

The Role of Cognitive Abilities on Financial Literacy: New Experimental Evidence. Melisa Muñoz-Murillo et al. Journal of Behavioral and Experimental Economics, November 8 2019, 101482. https://doi.org/10.1016/j.socec.2019.101482

Highlights
• Financial literacy research focuses on why, how, and when people acquire financial knowledge, shape their financial attitudes, and adapt their financial behaviors.
• The literature demonstrates that some demographic characteristics highly correlate with financial literacy.
• Demographic factors mask the ultimate determinants of financial literacy acquisition.
• We offer experimental evidence supporting the key role of cognitive ability in financial literacy acquisition.
• After controlling for some of the main confounding factors identified in the literature, we find that individuals with higher cognitive abilities are more financially literate

Abstract: Financial literacy research focuses on why, how, and when people acquire financial knowledge, shape their financial attitudes, and adapt their financial behaviors. The literature demonstrates that some demographic characteristics highly correlate with financial literacy. However, demographic factors often mask the ultimate determinants of financial literacy acquisition such as risk aversion, time preferences, cognitive and behavioral biases, personality traits, cognitive and non-cognitive abilities, among others. Theory suggests that cognitive ability is one of the fundamental factors in explaining financial literacy. We offer experimental evidence supporting the key role of cognitive ability in financial literacy acquisition. Our experimental setting allows us to (a) overcome particular limitations of the traditional multiple-choice questions survey designs, (b) provide compatible incentives to make participants exert an appropriate level of effort to solve the assigned tasks, and (c) use a well-known measure of cognitive abilities. We find that individuals with higher cognitive abilities are more financially literate. Our main result holds even after controlling for some of the main confounding factors identified in the literature. In contrast to previous studies, we find no role for gender in explaining financial literacy once we control for cognitive abilities.

Keywords: Cognitive abilityfinancial literacyexperiment

6 Discussions
We are cautious in interpreting our results. We acknowledge that the omission of a third variable that affects cognitive ability as well as financial literacy in the same direction might generate the positive correlation we find between the two variables. In our case, the omission of relevant variables yield inconsistent estimators (Cameron & Trivedi, 2005), i.e., the estimated coefficient for CRT scores might not converge to the population value of the parameter. According to Kautz, Heckman, Diris, Ter Weel, and Borghans (2014), other non-cognitive abilities–that we do not consider in this study–as the Big Five of Personality (Openness, Consciousness, Extraversion, Agreeability, and Neuroticism–OCEAN) also matter for the acquisition of new abilities and knowledge. That said, it is worth noting that the theoretical literature supports a causal effect of cognitive abilities on financial literacy (see Delavande et al. (2008)) and that we control for some of the main confounding factors (i.e., educational achievement, non-cognitive abilities, and parental characteristics).9 On
 the other hand, potential multicollinearity problems may arise with the inclusion of many independent variables. In our case, multicollinearity may embed the acceptance of the no significance null hypothesis. In this regard, we compute correlations and run variable inflation factor (VIF) tests to investigate the extent to which the presence of multicollinearity was a problem in our study. Appendix B shows the results according to which none of the included variables have high correlations with other independent variables or high VIF test values reducing concerns about multicollinearity affecting our results. The main limitations of our work are related with the main limitations of laboratory experiments in general: (a) selection bias and, therefore, external validity, and (b) budgetary constraints. 10 First, since students decided whether to register in our database for economic experiments, we do not have a random sample of our target population. In other words, our sample lacks external validity and our inferences are valid only to the sample we examine. In this regard, the external validity of the empirical findings in this research will be subject to the same criticisms of previous works. However, the literature in experimental economics increasingly recognizes that participants in economic experiments are mostly comprised by university students who voluntarily choose to participate. In this regard, student and selection bias have been discussed in Exadaktylos, Esp´ın, and Branas-Garza (2013). In a rigorous study about social preferences, these authors find that a sample of self-selected university students provide reliable results. In addition, due to time and budgeting constraints, we do not include competing measures of cognitive ability. However, we acknowledge it would be convenient to test the validity of our measure and, even more important, to build a more comprehensive measure of cognitive ability.
Despite these limitations, and given the difficulty of replicating the real conditions in which individuals make economic decisions, the results of the present study are expected to provide valuable information regarding the role played by cognitive abilities in determining financial literacy levels. If through laboratory experiments it is possible to establish that individuals with higher cognitive abilities are more financially literate, such information would be useful and difficult to ignore to support public policy decisions. Moreover, our results should be interpreted with care since we do not deal with the identification of empirical causality. However, as we claim before, the relation between cognitive ability and financial literacy has strong theoretical and empirical support. In our view, causality can go in either direction: from cognitive ability to financial literacy and vice versa. At least during childhood, cognitive ability is affected by environmental factors related to financial literacy like socioeconomic conditions, parental influences, poor sanitary conditions, low birth weight, domestic stimulation, and school attendance (Ayaz et al., 2012; Santos et al., 2008). In addition, as we claim, cognitive ability can lower the cost of financial literacy acquisition (e.g., financial knowledge and behaviors). However, establishing causality in a our laboratory setting would have implied to introduce changes to cognitive ability while controlling all other potential variables affecting financial literacy. In our view, such a task is difficult to achieve in the lab. Our results, nonetheless, point out to the need of establishing causality in other empirical settings which can measure changes in individuals’ cognitive abilities and disentangle how these variation affect financial literacy.


7 Conclusions
The literature demonstrates that some demographic characteristics explain people financial literacy levels. Demographic factors often mask the ultimate factors causing any given phenomena. Since most of the empirical evidence on the determinants of financial literacy focuses on demographic factors, we provide new experimental evidence to understand the fundamental or ultimate factors that influence financial literacy. In particular, we examine the empirical link between cognitive ability and financial literacy. Our results show that individuals with higher cognitive abilities are more financially literate. Other ultimate factors explaining people’s financial literacy acquisition could be such things as risk aversion, time preferences, cognitive and behavioral biases, personality traits, cognitive and non-cognitive abilities, etc. In this paper, we offer experimental evidence supporting the key role of cognitive ability in financial literacy acquisition. Our experimental setting allows us to overcome particular limitations of the traditional multiple-choice questions survey designs, provide compatible incentives to make participants exert an appropriate level of effort to solve the assigned tasks, and use a well-known measure of cognitive abilities. Our results indicate that individuals with higher cognitive ability are more financially literate. These results hold even after controlling for some of the main confounding factors identified in the literature. In contrast to previous studies, once we control for cognitive abilities we find no evidence of a gender gap on financial literacy levels. This result suggests that the gender gap documented in the empirical literature may be driven by differences in cognitive abilities not accounting for in previous studies. Further research is needed to understand better the fundamental factors underlying the relationship between gender and financial literacy.

Our society celebrates failure as a teachable moment. Yet in five studies (total N = 1,674), failure did the opposite: It undermined learning

Not Learning From Failure—the Greatest Failure of All. Lauren Eskreis-Winkler, Ayelet Fishbach. Psychological Science, November 8, 2019. https://doi.org/10.1177/0956797619881133

Abstract: Our society celebrates failure as a teachable moment. Yet in five studies (total N = 1,674), failure did the opposite: It undermined learning. Across studies, participants answered binary-choice questions, following which they were told they answered correctly (success feedback) or incorrectly (failure feedback). Both types of feedback conveyed the correct answer, because there were only two answer choices. However, on a follow-up test, participants learned less from failure feedback than from success feedback. This effect was replicated across professional, linguistic, and social domains—even when learning from failure was less cognitively taxing than learning from success and even when learning was incentivized. Participants who received failure feedback also remembered fewer of their answer choices. Why does failure undermine learning? Failure is ego threatening, which causes people to tune out. Participants learned less from personal failure than from personal success, yet they learned just as much from other people’s failure as from others’ success. Thus, when ego concerns are muted, people tune in and learn from failure.

Keywords: learning, feedback, failure, ego threat, motivation, open data, open materials, preregistered

The true self is not easily expressed face-to-face: On the Internet, people can express what they intrinsically think and believe with fewer concerns about others’ disapproval & judgments

The expression of the true self in the online world: a literature review. Chuan Hu, Sameer Kumar, Jiao Huang & Kurunathan Ratnavelu. Behaviour & Information Technology, Nov 4 2019. ttps://doi.org/10.1080/0144929X.2019.1685596

ABSTRACT: The true self is one of the essential parts of people’s self-concept and identity, but it is not easily expressed in face-to-face communications. On the Internet, people can express what they intrinsically think and believe with fewer concerns about others’ disapproval and judgments. Increasingly more researchers have started to investigate people’s expression of the true self in the online context. However, the existing research is quite diverse and fragmented. A rigorous and comprehensive review of the emerging literature is called for. The present study conducted a systematic literature review to examine what is already known about the expression of the true self online. This paper analysed the selected studies on the basis of research contexts, research methods, and research themes. Our review offers readers an easy access to the current status of research in this field; it also provides some insightful suggestions for future studies.

KEYWORDS: Literature review, the true self, self-expression, online world