Weighing Outcome vs. Intent Across Societies: How cultural models of mind shape moral reasoning

Mental state reasoning has been theorized as a core feature of how we navigate our social worlds, and as especially vital to moral reasoning. Judgments of moral wrong-doing and punish worthiness often hinge upon evaluations of the perpetrator’s mental states. In two studies, we examine how differences in cultural conceptions about how one should think about others’ minds influence the relative importance of intent vs. outcome in moral judgments. We recruit participation from three societies, differing in emphasis on mental state reasoning: Indigenous iTaukei Fijians from Yasawa Island (Yasawans) who normatively avoid mental state inference in favor of focus on relationships and consequences of actions; Indo-Fijians who normatively emphasize relationships but do not avoid mental state inference; and North Americans who emphasize individual autonomy and interpreting others’ behaviors as the direct result of mental states. In study 1, Yasawan participants placed more emphasis on outcome than Indo-Fijians or North Americans by judging accidents more harshly than failed attempts. Study 2 tested whether underlying differences in the salience of mental states drives study 1 effects by inducing Yasawan and North American participants to think about thoughts vs. actions before making moral judgments. When induced to think about thoughts, Yasawan participants shifted to judge failed attempts more harshly than accidents. Results suggest that culturally-transmitted concepts about how to interpret the social world shape patterns of moral judgments, possibly via mental state inference

Gender Gap in Parental Leave Intentions: Evidence from 37 Countries

Despite global commitments and efforts, a gender-based division of paid and unpaid work persists. To identify how psychological factors, national policies, and the broader sociocultural context contribute to this inequality, we assessed parental-leave intentions in young adults (18–30 years old) planning to have children (N = 13,942; 8,880 identified as women; 5,062 identified as men) across 37 countries that varied in parental-leave policies and societal gender equality. In all countries, women intended to take longer leave than men. National parental-leave policies and women’s political representation partially explained cross-national variations in the gender gap. Gender gaps in leave intentions were paradoxically larger in countries with more gender-egalitarian parental-leave policies (i.e., longer leave available to both fathers and mothers). Interestingly, this cross-national variation in the gender gap was driven by cross-national variations in women’s (rather than men’s) leave intentions. Financially generous leave and gender-egalitarian policies (linked to men’s higher uptake in prior research) were not associated with leave intentions in men. Rather, men’s leave intentions were related to their individual gender attitudes. Leave intentions were inversely related to career ambitions. The potential for existing policies to foster gender equality in paid and unpaid work is discussed.Gender Gap in Parental Leave Intentions: Evidence from 37 CountriespublishedVersio

Gender Gap in Parental Leave Intentions: Evidence from 37 Countries

Despite global commitments and efforts, a gender-based division of paid and unpaid work persists. To identify how psychological factors, national policies, and the broader sociocultural context contribute to this inequality, we assessed parental-leave intentions in young adults (18–30 years old) planning to have children (N = 13,942; 8,880 identified as women; 5,062 identified as men) across 37 countries that varied in parental-leave policies and societal gender equality. In all countries, women intended to take longer leave than men. National parental-leave policies and women’s political representation partially explained cross-national variations in the gender gap. Gender gaps in leave intentions were paradoxically larger in countries with more gender-egalitarian parental-leave policies (i.e., longer leave available to both fathers and mothers). Interestingly, this cross-national variation in the gender gap was driven by cross-national variations in women’s (rather than men’s) leave intentions. Financially generous leave and gender-egalitarian policies (linked to men’s higher uptake in prior research) were not associated with leave intentions in men. Rather, men’s leave intentions were related to their individual gender attitudes. Leave intentions were inversely related to career ambitions. The potential for existing policies to foster gender equality in paid and unpaid work is discussed

Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Weathering the Storm: Supernatural belief and cooperation in an insecure world

Religious and supernatural beliefs may facilitate social life by promoting and sustaining cooperation, but the specific cooperation problems each society faces may lead to unique belief systems adapted to local socio-ecological conditions. As societies mix and belief systems spread, local and introduced belief systems may present conflicting solutions to the same social problem. How do we choose among these different solutions? The present study recruits participation from villagers living on Yasawa Island, Fiji (N=179), who espouse both Christian and traditional beliefs that promote different expectations about local and distant others. This study focuses on the relationships among existential/ resource insecurity and supernatural beliefs across these belief systems using an experimental priming procedure and a dictator game to allocate food resources. Though reminders of insecurity had no impact on allocations, the effects of being reminded of Christian or Traditional belief depended on (was moderated by) how worried participants were about resource availability and beliefs about the Christian God’s tendency toward punishment or forgiveness. Analyses of interview data suggest Christian and Traditional imagery may evoke different conceptions of Gods as either supportive (Christian) or authoritarian (Traditional). Results highlight belief content as key for sustaining different social support networks and traditional belief/ knowledge systems as a source of community resilience against threats like natural disasters

Weathering the Storm: Supernatural belief and cooperation in an insecure world

Societies have countless cultural adaptations to promote and sustain the cooperation, but how do we balance multiple belief systems? This study uses an experimental dictator game on food resources among villagers on Yasawa Island, Fiji, to examine this balance. Christian and traditional beliefs promote different expectations about local and distant others. Participants were reminded of insecurity by recalling a recent destructive cyclone and uncertainty about resources (½ reminded before, ½ after the game). This insecurity manipulation had no impact on allocations, but Christian and Traditional imagery primes were sensitive to individual resource uncertainty and beliefs about the Christian God’s punishment/ forgiveness. Textual analysis of interview answers suggest Christian vs. Traditional imagery may evoke different conceptions of God as either supportive (Christian) or authoritarian (Traditional). Results highlight belief content as key for sustaining different social support networks and traditional belief/ knowledge systems as a source of community resilience against natural disasters

When does it matter that God is watching? : differential effects of large and small gods on cheating as a function of material insecurity in Yasawa, Fiji

Previous work on religion’s potential to suppress behaviours that threaten sustained cooperation is extended to villagers in Yasawa, Fiji. Yasawans’ co-existing Christian (Bible God) and local, deified ancestor spirit (Kalou-vu) beliefs provide comparisons of different kinds of deities’ impact on prosocial behaviour in a small-scale society. If religion promotes prosociality through the threat of supernatural punishment (the ‘supernatural monitor’) in this context, then villagers should cheat less when they believe a deity is more punitive and more when they think the deity is more forgiving. Prosociality was measured in this study using a die rolling game to assess covert cheating in favour of self or in-group vs. out-group. Perceptions of the Bible God and Kalou-vu are as forgiving or punitive significantly predicted cheating as a function of material insecurity. Specifically, perceptions of a punishing Bible God predicted fewer coins to the self or in-group (thus less cheating) when material insecurity was low or at average levels, but more coins (more cheating) when material insecurity was high. Punishing Kalou-vu showed a similar effect that was showed more statistically significant relationships with probable cheating. These effects are more strongly driven by expected food insecurity for years (long-term) to come than by expected insecurity in the coming months (short-term). Additional analysis using perceptions of national secular authority as represented by police showed that a more punishing view of police predicted more cheating, though this effect dropped out of significance when police negativity was considered in separate analyses. This suggests that, unlike urban contexts, secular authority may have little psychological impact on sustaining cooperation in this relatively isolated social context. Further, the results of this study suggest the impact of perceptions about supernatural agents may depend upon both the kind of deity involved and the individual’s sense of resource availability. Implications for the evolution of religion and its place in the evolution of large-scale societies are discussed.Arts, Faculty ofPsychology, Department ofGraduat