Kohlberg's theory of moral development explores the roles of cognition and emotion but focuses primarily on cognition. Contemporary post-formal theories lead to the conclusion that skills resulting from cognitive-affective integration facilitate consistency between moral judgement and moral behaviour. Rest's four-component model of moral development delineates these skills specifically. The components, moral motivation, moral sensitivity, moral reasoning and moral character, operate as multidimensional processes that facilitate moral development and subsequently promote moral behaviour. The relationships between these components have been relatively unexplored, thereby missing the opportunity to unpack the processes underlying moral growth and development. In this study, moral motivation (spirituality), moral sensitivity (postformal skills) and moral reasoning are operationalized to examine the mediational effects of moral sensitivity of medical students. In the complex moral environment of medical students opportunities arise to question values and develop cognitive-affective skills, among them spirituality and post-formal thinking which are linked to increases in post-conventional moral reasoning. The models tested indicate that moral sensitivity mediates the relationship between moral motivation and moral reasoning.

This study extends previous research evaluating the association between the CHIP intervention, change in body weight, and change in psychological health. A randomized controlled health intervention study lasting 4 wk. was used with 348 participants from metropolitan Rockford, Illinois; ages ranged from 24 to 81 yr. Participants were assessed at baseline, 6 wk., and 6 mo. The Beck Depression Inventory (BDI) and three selected psychosocial measures from the SF-36 Health Survey were used. Significantly greater decreases in Body Mass Index (BMI) occurred after 6 wk. and 6 mo. follow-up for the intervention group compared with the control group, with greater decreases for participants in the overweight and obese categories. Significantly greater improvements were observed in BDI scores, role-emotional and social functioning, and mental health throughout follow-up for the intervention group. The greater the decrease in BMI through 6 wk., the better the chance of improved BDI score, role-emotional score, social functioning score, and mental health score, with odds ratios of 1.3 to 1.9. Similar results occurred through 6 mo., except the mental health variable became nonsignificant. These results indicate that the CHIP intervention significantly improved psychological health for at least six months afterwards, in part through its influence on lowering BMI.

The present study compared the performance of English- and Spanish-speaking healthy controls (HCs) on the Spanish translation of the Dementia Rating Scale-Second edition (ST-DRS-2) and examined the classification accuracy of the ST-DRS-2 and Mini-Mental State Examination (MMSE) with an age- and education-matched clinical sample. In contrast to previous findings with English-speakers, a stronger relationship was observed between ST-DRS-2 Total scores and education than with age, and despite being matched on both of these variables, English-speaking HCs significantly out-performed their Spanish-speaking counterparts on the ST-DRS-2. The greatest between-group difference was found on the Memory subscale, wherein the majority of errors committed by Spanish-speaking HCs were significantly related to level of acculturation. ST-DRS-2 Total and Memory subscale scores produced greater classification accuracy than the MMSE; however, ST-DRS-2 Total scores yielded the greatest corresponding rates of sensitivity and specificity. Normative data are provided and recommended to improve the ST-DRS-2's diagnostic accuracy with Spanish-speakers.

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