human behavior research articles

Articles on Human behavior

Displaying 1 - 20 of 34 articles.

Trust in the shadows: How loyalty fuels illicit economic transactions

Oliver Schilke , University of Arizona

What social robots can teach America’s students

Gerald K. LeTendre , Penn State

Persuading businesses and people to reduce climate emissions is key to slowing climate change – research-based techniques and new approaches from the behavioral sciences can show how to do it

Kira Barrett , The Conversation

Ancient DNA helps reveal social changes in Africa 50,000 years ago that shaped the human story

Elizabeth Sawchuk , University of Alberta ; Jessica Thompson , Yale University , and Mary Prendergast , Rice University

Making healthy choices for the people we care for may increase our own  self-indulgence

Anika Schumacher , Grenoble École de Management (GEM)

Giving food pantry clients choices – and gently nudging them toward nutritious foods – can lead to healthier diets

Caitlin Caspi , University of Connecticut and Marlene B. Schwartz , University of Connecticut

Ancient eggshells and a hoard of crystals reveal early human innovation and ritual in the Kalahari

Jayne Wilkins , Griffith University and Sechaba Maape , University of the Witwatersrand

Seat belts and smoking rates show people eventually adopt healthy behaviors – but it can take time we don’t have during a pandemic

Randy P. Juhl , University of Pittsburgh

Prehistoric human footprints reveal a rare snapshot of ancient human group behavior

William E.H. Harcourt-Smith , Lehman College, CUNY and Briana Pobiner , Smithsonian Institution

Your brain evolved to hoard supplies and shame others for doing the same

Stephanie Preston , University of Michigan

Americans disagree on how risky the coronavirus is, but most are changing their behavior anyway

Wändi Bruine de Bruin , University of Southern California ; Anya Samek , USC Dornsife College of Letters, Arts and Sciences , and Daniel Bennett , USC Dornsife College of Letters, Arts and Sciences

Think twice before shouting your virtues online – moral grandstanding is toxic

Joshua B. Grubbs , Bowling Green State University

How to use habit science to help you keep your New Year’s resolution

Wendy Wood , USC Dornsife College of Letters, Arts and Sciences

Empathy is the secret ingredient that makes cooperation – and civilization – possible

Arunas L. Radzvilavicius , University of Pennsylvania

Spending too much time on your phone? Behavioral science has an app for that

Ashley Whillans , Harvard University

You can’t characterize human nature if studies overlook 85 percent of people on Earth

Daniel Hruschka , Arizona State University

Speaking with: law professor Cass Sunstein, on why behavioural science is always nudging us

Josh Nicholas, The Conversation

The infantilization of Western culture

Simon Gottschalk , University of Nevada, Las Vegas

The brainwashing myth

Rebecca Moore , San Diego State University

Why proactive leadership is important – or how Congress could have prevented Trump’s Helsinki fiasco

Thomas S. Bateman , University of Virginia and Mike Crant , University of Notre Dame

Related Topics

• Anthropology
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• Coronavirus
• Donald Trump
• Human behaviour
• Nudge theory
• Social norms

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OPINION article

Challenges and opportunities for human behavior research in the coronavirus disease (covid-19) pandemic.

• 1 Department of General Psychology, University of Padova, Padua, Italy
• 2 Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy

The COVID-19 pandemic is a serious public health crisis that is causing major worldwide disruption. So far, the most widely deployed interventions have been non-pharmacological (NPI), such as various forms of social distancing, pervasive use of personal protective equipment (PPE), such as facemasks, shields, or gloves, and hand washing and disinfection of fomites. These measures will very likely continue to be mandated in the medium or even long term until an effective treatment or vaccine is found ( Leung et al., 2020 ). Even beyond that time frame, many of these public health recommendations will have become part of individual lifestyles and hence continue to be observed. Moreover, it is implausible that the disruption caused by COVID-19 will dissipate soon. Analysis of transmission dynamics suggests that the disease could persist into 2025, with prolonged or intermittent social distancing in place until 2022 ( Kissler et al., 2020 ).

Human behavior research will be profoundly impacted beyond the stagnation resulting from the closure of laboratories during government-mandated lockdowns. In this viewpoint article, we argue that disruption provides an important opportunity for accelerating structural reforms already underway to reduce waste in planning, conducting, and reporting research ( Cristea and Naudet, 2019 ). We discuss three aspects relevant to human behavior research: (1) unavoidable, extensive changes in data collection and ensuing untoward consequences; (2) the possibility of shifting research priorities to aspects relevant to the pandemic; (3) recommendations to enhance adaptation to the disruption caused by the pandemic.

Data collection is very unlikely to return to the “old” normal for the foreseeable future. For example, neuroimaging studies usually involve placing participants in the confined space of a magnetic resonance imaging scanner. Studies measuring stress hormones, electroencephalography, or psychophysiology also involve close contact to collect saliva and blood samples or to place electrodes. Behavioral studies often involve interaction with persons who administer tasks or require that various surfaces and materials be touched. One immediate solution would be conducting “socially distant” experiments, for instance, by keeping a safe distance and making participants and research personnel wear PPE. Though data collection in this way would resemble pre-COVID times, it would come with a range of unintended consequences ( Table 1 ). First, it would significantly augment costs in terms of resources, training of personnel, and time spent preparing experiments. For laboratories or researchers with scarce resources, these costs could amount to a drastic reduction in the experiments performed, with an ensuing decrease in publication output, which might further affect the capacity to attract new funding and retain researchers. Secondly, even with the use of PPE, some participants might be reluctant or anxious to expose themselves to close and unnecessary physical interaction. Participants with particular vulnerabilities, like neuroticism, social anxiety, or obsessive-compulsive traits, might find the trade-off between risks, and gains unacceptable. Thirdly, some research topics (e.g., face processing, imitation, emotional expression, dyadic interaction) or study populations (e.g., autistic spectrum, social anxiety, obsessive-compulsive) would become difficult to study with the current experimental paradigms ( Table 1 ). New paradigms can be developed, but they will need to first be assessed for reliability and validated, which will undoubtedly take time. Finally, generalized use of PPE by participants and personnel could alter the “usual” experimental setting, introducing additional biases, similarly to the experimenter effect ( Rosenthal, 1976 ).

Table 1 . Possible consequences of non-pharmacological interventions for COVID-19 on human behavior research.

Data collection could also adapt by leveraging technology, such as running experiments remotely via available platforms, like for instance Amazon's Mechanical Turk (MTurk), where any task that programmable with standard browser technology can be used ( Crump et al., 2013 ). Templates of already-programmed and easily customizable experimental tasks, such as the Stroop or Balloon Analog Risk Task, are also available on platforms like Pavlovia. Ecological momentary assessment is another feasible option, since it was conceived from the beginning for remote use, with participants logging in to fill in scales or activity journals in a naturalistic environment ( Shiffman et al., 2008 ). Increasingly affordable wearables can be used for collecting physiological data ( Javelot et al., 2014 ). Web-based research was already expanding before the pandemic, and the quality of the data collected in this way is comparable with that of laboratory studies ( Germine et al., 2012 ). Still, there are lingering issues. For instance, for some MTurk experiments, disparities have been evidenced between laboratory and online data collection ( Crump et al., 2013 ). Further clarifications about quality, such as consistency or interpretability ( Abdolkhani et al., 2020 ), are also needed for data collected using wearables.

Beyond updating data collection practices, a significant portion of human behavior research might change course to focus on the effects of the pandemic. For example, the incidence of mental disorders or of negative effects on psychological and physical well-being, particularly across populations of interest (e.g., recovered patients, caregivers, and healthcare workers), are crucial areas of inquiry. Many researchers might feel hard-pressed to not miss out on studying this critical period and embark on hastily planned and conducted studies. Multiplication and fragmentation of efforts are likely, for instance, by conducting highly overlapping surveys in widely accessible and oversampled populations (e.g., university students). Moreover, rushed planning is bound to lead to taking shortcuts and cutting corners in study design and conduct, e.g., skipping pre-registration or even ethical committee approval or using not validated measurement tools, like ad hoc surveys. Surveys using non-probability and convenience samples, especially for social and mental health problems, frequently produce biased and misleading findings, particularly for estimates of prevalence ( Pierce et al., 2020 ). A significant portion of human behavior research that re-oriented itself to study the pandemic could result in to a heap of non-reproducible, unreliable, or overlapping findings.

Human behavior studies could also aim to inform the planning and enforcement of public health responses in the pandemic. Behavioral scientists might focus on finding and testing ways to increase adherence to NPIs or to lessen the negative effects of isolation, particularly in vulnerable groups, e.g., the elderly or the chronically ill and their caretakers. Studies could also attempt to elucidate factors that make individuals uncollaborative with recommendations from public health authorities. Though all of these topics are important, important caveats must be considered. Psychology and neuroscience have been affected by a crisis in reproducibility and credibility, with several established findings proving unreliable and even non-reproducible ( Button et al., 2013 ; Open Science Collaboration, 2015 ). It is crucial to ensure that only robust and reproducible results are applied or even proposed in the context of a serious public health crisis. For instance, the possible influence of psychological factors on susceptibility to infection and potential psychological interventions to address them could be interesting topics. However, the existing literature is marked by inconsistency, heterogeneity, reverse causality, or other biases ( Falagas et al., 2010 ). Even for robust and reproducible findings, translation is doubtful, particularly when these are based on convenience samples or on simplified and largely artificial experimental contexts. For example, the scarcity of medical resources (e.g., N-95 masks, drugs, or ventilators) in a pandemic with its unavoidable ethical conundrum about allocation principles and triage might appeal to moral reasoning researchers. Even assuming, implausibly, that most of the existent research in this area is robust, translation to dramatic real-life situations and highly specialized contexts, such as intensive care, would be difficult and error-prone. Translation might not even be useful, given that comprehensive ethical guidance and decision rules to support medical professionals already exist ( Emanuel et al., 2020 ).

The COVID-19 pandemic and the corresponding global public health response pose significant and lasting difficulties for human behavior research. In many contexts, such as laboratories with limited resources and uncertain funding, challenges will lead to a reduced research output, which might have further domino effects on securing funding and retaining researchers. As a remedy, modifying data collection practices is useful but insufficient. Conversely, adaptation might require the implementation of radical changes—producing less research but of higher quality and more utility ( Cristea and Naudet, 2019 ). To this purpose, we advocate for the acceleration and generalization of proposed structural reforms (i.e., “open science”) in how research is planned, conducted, and reported ( Munafò et al., 2017 ; Cristea and Naudet, 2019 ) and summarize six key recommendations.

First, a definitive move from atomized and fragmented experimental research to large-scale collaboration should be encouraged through incentives from funders and academic institutions alike. In the current status quo, interdisciplinary research has systematically lower odds of being funded ( Bromham et al., 2016 ). Conversely, funders could favor top-down funding on topics of prominent interest and encourage large consortia with international representativity and interdisciplinarity over bottom-up funding for a select number of excellent individual investigators. Second, particularly for research focused on the pandemic, relevant priorities need to be identified before conducting studies. This can be achieved through assessing the concrete needs of the populations targeted (e.g., healthcare workers, families of victims, individuals suffering from isolation, disabilities, pre-existing physical and mental health issues, and the economically vulnerable) and subsequently conducting systematic reviews so as to avoid fragmentation and overlap. To this purpose, journals could require that some reports of primary research also include rapid reviews ( Tricco et al., 2015 ), a simplified form of systematic reviews. For instance, The Lancet journals require a “Research in context” box, which needs to be based on a systematic search. Study formats like Registered Reports, in which a study is accepted in principle after peer review of its rationale and methods ( Hardwicke and Ioannidis, 2018 ), are uniquely suited for this change. Third, methodological rigor and reproducibility in design, conduct, analysis, and reporting should move to the forefront of the human behavior research agenda ( Cristea and Naudet, 2019 ). For example, preregistration of studies ( Nosek et al., 2019 ) in a public repository should be widely employed to support transparent reporting. Registered reports ( Hardwicke and Ioannidis, 2018 ) and study protocols are formats that ensure rigorous evaluation of the experimental design and statistical analysis plan before commencing data collection, thus making sure shortcuts and methodological shortcomings are eliminated. Fourth, data and code sharing, along with the use of publicly available datasets (e.g., 1000 Functional Connectomes Project, Human Connectome Project), should become the norm. These practices allow the use of already-collected data to be maximized, including in terms of assessing reproducibility, conducting re-analyses using different methods, and exploring new hypotheses on large collections of data ( Cristea and Naudet, 2019 ). Fifth, to reduce publication bias, submission of all unpublished studies, the so-called “file drawer,” should be encouraged and supported. Reporting findings in preprints can aid this desideratum, but stronger incentives are necessary to ensure that preprints also transparently and completely report conducted research. The Preprint Review at eLife ( Elife, 2020 ), in which the journal effectively takes into review manuscripts posted on the preprint server BioRxiv, is a promising initiative in this direction. Journals could also create study formats specifically designed for publishing studies that resulted in inconclusive findings, even when caused by procedural issues, e.g., unclear manipulation checks, insufficient stimulus presentation times, or other technical errors. This would both aid transparency and help other researchers better prepare their own experiments. Sixth, peer review of both articles and preprints should be regarded as on par with the production of new research. Platforms like Publons help track reviewing activity, which could be rewarded by funders and academic institutions involved in hiring, promotion, or tenure ( Moher et al., 2018 ). Researchers who manage to publish less during the pandemic could still be compensated for the onerous activity of peer review, to the benefit of the entire community.

Of course, individual researchers cannot implement such sweeping changes on their own, without decisive action from policymakers like funding bodies, academic institutions, and journals. For instance, decisions related to hiring, promotion, or tenure of academics could reward several of the behaviors described, such as complete and transparent publication regardless of the results, availability of data and code, or contributions to peer review ( Moher et al., 2018 ). Academic institutions and funders should acknowledge the slowdown of experimental research during the pandemic and hence accelerate the move toward more “responsible indicators” that would incentivize best publication practices over productivity and citations ( Moher et al., 2018 ). Funders could encourage submissions leveraging existing datasets or developing tools for data re-use, e.g., to track multiple uses of the same dataset. Journals could stimulate data sharing by assigning priority to manuscripts sharing or re-using data and code, like re-analyses, or individual participant data meta-analyses.

Author Contributions

CG and IC contributed equally to this manuscript in terms of its conceivement and preparation. All authors contributed to the article and approved the submitted version.

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Acknowledgments

This work was carried out within the scope of the project “use-inspired basic research”, for which the Department of General Psychology of the University of Padova has been recognized as “Dipartimento di eccellenza” by the Ministry of University and Research.

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Keywords: open science, data sharing, social distancing, preprint, preregistration, coronavirus disease, neuroimaging, experimental psychology

Citation: Gentili C and Cristea IA (2020) Challenges and Opportunities for Human Behavior Research in the Coronavirus Disease (COVID-19) Pandemic. Front. Psychol. 11:1786. doi: 10.3389/fpsyg.2020.01786

Received: 29 April 2020; Accepted: 29 June 2020; Published: 10 July 2020.

Reviewed by:

Copyright © 2020 Gentili and Cristea. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Claudio Gentili, c.gentili@unipd.it

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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• v.43(1); 2020 Mar

Current Diversification of Behaviorism

Positive Behavior Supports Corporation, 1645 Ala Wai Blvd, Apt 508, Honolulu, HI 96815 USA

Over the last few decades, behaviorism as a philosophy of the science of psychology, especially in the field of behavior analysis and related areas, has diversified to the point that scholars from inside and outside the field are often confused about what exactly behaviorism is. The aim of this study is to analyze how such diversification of behaviorism has arisen over time and what factors might have contributed to it using evolutionary biology’s concept of adaptive radiation as an analogical process. Diversification of behaviorism has occurred in many areas over time as behaviorism has extended its field of practice. Although some characteristics of behaviorism remained, other characteristics were modified. One such characteristic that went through extensive modification is the agent-free approach to the analysis of behavior: the agent problem. This approach has met criticism from inside and outside the field and has been under a strong selective pressure. The present article discusses how the agent problem in a different niche has shaped behaviorism into new forms that we see today.

Over the last few decades, behaviorism as a philosophy of science of psychology, especially in the field of behavior analysis and related areas, has diversified to the point that scholars from inside and outside the field are often confused about what exactly behaviorism is. For example, Foxall ( 2008 ), reviewing comments from fellow behaviorists on his paper on intentional behaviorism, wrote, “A difficulty that arises in discussing radical behaviorism is that its adherents claim that it exists in more than one form and these forms are incommensurable. . . .” (p. 114) and suggests a review of such differences. The aim of the present study is not to discuss the similarities and differences of various forms of behaviorism proposed by contemporary behaviorists, but rather to analyze what factors might have contributed to such diversification of behaviorism we see today.

Table ​ Table1 1 shows a list of major behaviorisms proposed in recent decades after B. F. Skinner’s radical behaviorism in 1945. It is safe to say that these current versions of behaviorism have developed as a reaction to radical behaviorism in one way or another. The focus of the present article is to understand how these reactions reached the point at which they became their own versions of behaviorism. In order to investigate the factors that might have contributed to the diversification of behaviorism in recent decades, this article uses evolutionary biology’s concept of adaptive radiation as an analogical process. Adaptive radiation refers to an emergence of different species from one ancestry species over time and place (diversification) due to a selection process based on differences in environment (niches/geographical isolation), the availability of resources, and competition for the resources against other species, among other factors (Schluter, 2000 ). Simply put, one species diverges into a different species as it migrates from its original niche to a new niche, where the nature of the resources and the competition for resources among species of different ancestry origins differ from its original niche. When this selection process is repeated over time, many new species emerge from the single ancestry species: the process of adaptive radiation. A famous example is Darwin’s finches. The ancestral finch built a nest on the ground and ate seeds on one of the Galapagos Islands. As it migrated to other islands, it diverged into 13 different species with different sizes and shapes of the beaks. Some nested in cactuses and ate seeds. Some nested in trees and ate insects. It is a tradition in behavior analysis to use biological evolution as an analogical process to understand the social dynamics of behavior analysts (e.g., Rider, 1991 ).

List of Behaviorisms and Their Characteristics

Behaviorism can be seen as a species: a field of practice (Skinner calls this a verbal community) is a niche, other professionals in the same field are the competitors, and the reinforcing consequences of their behavior in their verbal community are the resources. For example, radical behaviorism is the species, experimental psychology (and its journals and academia) is the niche, cognitive psychology, social psychology, and neuropsychology are the competitors, and the resources are financial rewards, reputation, career rewards, social interaction, scientific discovery, and knowledge (e.g., on the rewards for scientists’ activities, see Lam, 2011 ). Suppose that radical behaviorism is the ancestral species, adaptive radiation occurs as it migrates to other niches. As it migrates to other niches, it undergoes different selective pressures to the point that it diverges into a new form of behaviorism. Thus, we see the current diversification of behaviorism.

Niches and Their Resources

At present, behaviorists are in the fields of experimental psychology, experimental analysis of behavior, applied behavior analysis, comparative psychology, clinical psychology/psychotherapy, education, behavioral economics, and philosophy of science, to name a few. A variety of resources and competition in each niche might have been contributing factors in the diversification of behaviorism that we see today. Behaviorists themselves often discuss their niches and resources to encourage this point of view. For example, Hayes and Hayes ( 1992 ) described their clinical psychology niche as:

The context of emotional control is a core issue for many clients. It is common for clients to come into therapy with a list of undesirable thoughts, feelings, memories, and bodily sensations that seemingly need to be removed, altered, or avoided, and indeed we as therapists name most of the disorders we treat and the treatments themselves in the same way. (p. 244)

That is, in the field of psychotherapy, the ones who address subjective experiences obtain the resources. The resources, in this case, can be the increase in client referrals, financial success, treatment success, fame, and so on. Because both the therapists and the clients in this verbal community expect therapy to reflect on such issues as thought, feeling, and other cognitive processes, naturally a therapist of any kind adapts to such demands in order to obtain resources. Hayes and Hayes continued:

A few early behavior therapists encouraged a focus on overt behavior only, on the assumption that thoughts (and feelings, etc.) would change on their own. The current mainstream position in behavior therapy is that a change in thoughts will produce changes in overt activity. Traditional associationistic forms of behavior therapy and cognitive therapy do not differ in this regard. (p. 239)

An interesting point is that behavior therapists have adapted and behaved like cognitive therapists in this community due to its selective pressure. Thus, when radical behaviorism, one of which characteristics is to disregard subjective experiences as a controlling variable of behavior, entered in this community it faced the same selective pressure to adopt the niche’s need of addressing subjective experience, and the outcome was contextualistic behaviorism (Hayes & Hayes, 1992 ). This niche’s selective pressures were twofold. One was that the niche rewarded a cognitive approach. The other was that there were already behavior therapists in the niche as a competitor. It is possible to see contextualistic behaviorism as a result of these two selective pressures. To distinguish itself from other behavior therapists as well as from cognitive therapists, contextualistic behaviorism adopts radical behaviorism’s functional approach that behavior is an outcome of the interaction with the environment (context). The authors wrote, “Skinner defined behavior both mechanically and interactively. . . . As a result, some Skinnernians have defined behavior . . . as movement in a frame of reference. . . . Conversely, some radical behaviorists view behavior as an event of a whole organism interacting in and with a context. . . .” (p. 228), and declares to adopt the latter interpretation. They criticize cognitive therapy and other behavior therapy as mechanistic and only focusing on a part of the organism such as cognition, thought, and feeling and not the organism as a whole. They suggest that this distinction from other forms of therapy would enable contextualistic behaviorisms to obtain resources in this niche. They wrote, “We suspect that contextualism represents a more palatable philosophical position for clinical workers than did traditional mechanistic behaviorism” (p. 234). At the same time, contextualistic behaviorism must adapt to this community’s preference for subjective experience. To do so, the authors place emphasis on the stimulus equivalence phenomenon as a behavioristic way to understand cognition and psychological disorders, and spend the majority of time discussing its implications in psychotherapy to appeal to the traditional audience in this field. Contextualistic behaviorism can be seen as a result of radical behaviorism migrating to the field of psychotherapy.

Another example can be observed in Rachlin ( 2011 ). In this paper, Rachlin discusses how both Baum’s molar multiscale view (Baum, 2002 ) and his teleological behaviorism (Rachlin, 1994 ) came about in the field of behavior analysis, how they were similar to each other, and how they differed from radical behaviorism. Rachlin attributes the causes of their similarities to their shared past as the graduate students, the professors they had studied under, the experiments they had conducted together, and a success they had entertained. Unlike Catania, who studied under Skinner at Harvard University and remained a radical behaviorist throughout his career (Baum, 2011b ), Rachlin and Baum were under the influence of Skinner, Stevens, and Herrnstein. Rachlin discusses how all three professors specified the nature of the resources in this particular niche and shaped Raclin and Baum’s scientific activities. Rachlin, describing the successful experiments he had conducted with Baum under Herrnstein, wrote, “these experiments made us dedicated molarists” (p. 210) and indicates that their works afterwards were largely an extension of those early experiments. Thus, came teleological behaviorism and the molar multiscale view, two modern versions of behaviorism.

These adaptations have occurred in many areas over time as behaviorism, especially radical behaviorism in recent years, has expanded its niches. Although some characteristics of behaviorism such as the emphasis on behavior, scientific approach, and pragmatism worked favorably for its survival in new niches, other characteristics faced challenges. One such characteristic that went through extensive selective pressure is what this article calls the agent problem.

The Agent Problem

In this article, the agent is defined as a hypothetical entity that is present across time and environments and changes behavior according to the differences in time and environments. A typical psychology-related niche demands its inhabitants to be interested in dealing with some form of an agent such as the mind, cognition, personality, perception, sensation, emotion, physiology, and the like. Kantor ( 1963 ) showed that, for the last 2,000 years, the subject matter of psychology has mainly been the mind, and the behavior was seen as a result of the working of the mind. In other words, there is a general demand in the field of psychology and, at least in Western culture, that psychologists be interested in studying some aspect of the agent that is responsible for the occurrence of behavior. Most fields of psychology today still carry this tradition. Moreover, almost all the fields beyond psychology such as education, economics, and entertainment take such a view for granted. On the other hand, behaviorism traditionally has either negated or downplayed the role of the agent. Baum ( 2013 ) described:

In commonsense folk psychology, behavior is done by an agent, and behavioral events or actions seem to be a different category. . . . [To the behaviorists, however,] The organism . . . is only the medium of the behavior as water may be the medium of a chemical reaction. . . . This aspect of behavior analysis puts it at odds with common sense and most philosophy of mind. (p. 284)

This behaviorist approach has met criticism wherever behaviorism went, and the handling of the agent problem is a crucial selective pressure that determines behaviorism’s survival not only in the field of psychology but also in every other field of practice. Thus, the current diversification of behaviorism can be seen mainly as a result of facing the agent problem as they migrated to different niches.

When Watson first introduced behaviorism in the field of experimental psychology in 1913 , it was a success largely due to the community’s preference for scientific methodology. At the time, there was an increasing demand and aspiration to a “hard” science such as physics and chemistry, and the competitors in the field such as mentalism, functionalism, and structuralism failed to provide a satisfactory answer to the community’s demand. Behaviorism, as a new species in psychology based partly on the works of Ivan Pavlov, who applied a rigorous scientific method of physiology to study the phenomenon he called conditioned reflexes (Pavlov, 1927/ 1960 ), became a dominant force in the field (Day, 1980 ; Kantor, 1963 ). With its rigorous scientific methodology, behaviorism at the time introduced the idea that any event that was not directly observable was not an appropriate subject matter of psychological investigation, rejecting the studies of the mind. Watson’s interest was the reaction of the whole animal in its relation to a given stimulus (Watson, 1930/ 1957 , p. 11). That is, Watson considered the relationship between a stimulus and a response as a complete and independent phenomenon of itself and did not take it as a manifestation of the mind as the structuralists or the mentalists did or of brain activity as Pavlov did (Pavlov, 1927/ 1960 , p. 7). Likewise, Kantor ( 1933 ) viewed behavior as a “complete body action . . . a total neuro-musculo-glandular configuration” (p. 331) and wrote that behaviorism’s S-R formulation rejects the existence of an agent as an isolated, independent factor that can be a cause of its action or a subject matter of its study. This rejection of the agent as an independent causal factor and the subject matter of psychology has remained one of the defining characteristics of behaviorism to this day. Skinner’s radical behaviorism and its three-term contingency also maintained behaviorism’s agent-free characteristic.

Mainstream Experimental Psychology and Behaviorism

Behaviorism was largely successful in scientific psychology at the time and influenced the fields of experimental psychology, learning, psychophysics, and comparative psychology, among other fields, and demanded other disciplines to adopt a behavioristic approach to the study of their interests (Day, 1980 ). However, as other disciplines had begun embracing the scientific methodology and regained popularity (e.g., the cognitive revolution), behaviorism had begun losing the favor of the niche and left with the criticism that behaviorists did not pay attention to the agent. Behaviorists were well aware that such an agent-free view was not a mainstream view of their culture. In fact, opposition to behaviorism’s agent-free approach has been loud and continuous since behaviorism was first introduced. Kantor ( 1933 ) described scholars’ oppositions to the S-R conceptualization: the S-R formulation paid no attention to “the dynamic character of the organism” (p. 325) and psychological phenomena were not reducible to or to be ignored by studying a physiological stimulus and response relationship. When scholars had adapted behaviorism’s scientific approach in the field of experimental psychology, Hull, Spence, and Tolman had all begun studying the intervening variable or an organismic variable, O, in their S-O-R formulation (Smith, 1986, as cited in Moore, 2001 ), whose activities led to the cognitive revolution and brought the agent back as the main subject of study in psychology. These cognitivists, also called neobehaviorists and methodological behaviorists, had adapted the scientific rigor of behaviorism to the study of their subject matter, cognition, using a hypothetico-deductive approach, and became the mainstream approach of scientific psychology we see today. Cognitivists had an evolutionary advantage over behaviorism such that their interest in the working of the mind met the demand of the niche.

Many behaviorists have adapted to the change in trend and embraced cognitivism. A recent exemplary adaptation of behaviorism to cognitivism is Killeen’s emergent behaviorism (Killeen, 1984 ) and Staddon’s theoretical behaviorism (Staddon, 2001 , 2017 ). Emergent behaviorism suggests that cognitive processes are not the same as behavioral processes as Skinner suggested and advocates that they are a proper subject of scientific psychology. It views cognitive processes as a part of a causal chain between a stimulus and a response and can be studied scientifically using a hypothetico-deductive method. By doing so, emergent behaviorism rejects several characteristics of radical behaviorism such as atheoretical approach, the exclusion of the agent, and positivism, while maintaining its anti-dualistic stance, empiricism, and pragmatism. Likewise, Staddon ( 2017 ) stated that radical behaviorism was not successful in explaining experimental phenomena due to its atheoretical approach. He suggests adding a “state,” a construct that includes behavioral repertoire of the organism, a motivational state, and a species type to the three-term contingency as stimulus, state, response, and consequence in order to accurately depict changes in behavior of one organism across different conditions, much like the S-O-R formula of early scholars. And the way in which to study this “state” is through a hypothetico-deductive method. Both emergent behaviorism and theoretical behaviorism assume the presence of the agent, a theoretical construct such as memory or a state, that produces different responses given different experimental conditions. For them, Skinner’s three-term contingency is not an independent, isolated phenomenon but a part of a larger system, the agent. Staddon ( 2017 ) wrote, “As the organism learns, behavior adapts, reinforcement rate increases, and the repertoire shrinks to a class of responses defined by their consequences and controlled by a class of stimuli that are a reliable signal of the contingencies. This is Skinner’s three-term operant” (p. 42). For theoretical behaviorism, the organism carries many sets of three-term contingencies across environments and time, and some sets are called upon given a situation and others are latent. This is different from Skinner’s approach to three-term contingency, which does not assume an agent that stores multiple three-term contingencies.

It is a reasonable accommodation given the present state of mainstream experimental psychology that emergent behaviorism and theoretical behaviorism include an agent. Experimental psychologists today are rewarded by building a system (whether it is a hypothetical nervous system, neurological system, or a mathematical model) that can account for behavior change across different situations and time. Both emergent behaviorism and theoretical behaviorism criticized radical behaviorism’s atheoretical and agent-free approaches as a product of the time where data collection and mathematical methods were not as precise as those of today. In addition, Malone ( 2004 ) pointed out that these behaviorists’ emphasis on a theory building comes from the growing demand of the field of experimental psychology to predict proximal causes of behavior in different environments. A subtle, but statistically significant, difference in behavior across different experimental conditions is an important indicator of whether their theories are sound or not. For example, in the field of temporal perception, scholars are interested in whether the point of subjective equality is at 4 or 5 s because such a difference would determine the fate of some major theories (e.g., Gibbon, 1981 ; Killeen, Fetterman, & Bizo, 1997 ). In this field, the survival of a theory, the agent, is directly related to the survival in the niche.

Radical Behaviorism

Away from the mainstream experimental psychology, Skinner established a new niche, the experimental analysis of behavior (the field and its journal), in which radical behaviorism thrived without competitors. In this analogy, a paradigm shift (Kuhn, 1970 ) can be seen as an establishment of a new niche and the domination of resources. Although radical behaviorism maintained the agent-free approach to the analysis of behavior, its version was different from those of Watson and Kantor. For Watson and Kantor, the functioning of the agent was manifested in the observed behavior but not isolated as a controlling variable of behavior. They viewed behavior as the working of a whole organism of which the agent is a part. On the other hand, Skinner’s radical behaviorism treated behavior as an independent and stand-alone phenomenon emerging as a consequence of manipulating the environmental variables. Baum ( 2013 ) wrote, “Skinner . . . implicitly assume that even though function or outcome defines an activity, agency plays no part. . .” (p. 284). This is similar to a chemist observing an emergence of water by mixing hydrogen gas and oxygen gas together in high temperature or a meteorologist creating a tornado in a lab. In both cases, a phenomenon arises as a result of environmental manipulations and a resulting phenomenon is not seen as an act of some mediating agent. In behavioral research, this view can be employed to explain a phenomenon completely agent-free. For example, a researcher can place a pigeon, a keylight, and food in an operant box in a specific order and produce a keypeck (e.g., Brown & Jenkins, 1968 ). In this view, one does not interpret that the pigeon “understands” that when the keylight is lit, food follows. Instead, the pigeon is not the center of interest nor a mediating whole between a keylight, food, and a keypeck, but simply one of the factors necessary to produce a keypeck. That is, the pigeon is a variable that is equally important as a keylight, food, and an operant box, but no more than them. Just like behaviorists do not study physics of the keylight or computer chips that operate the operant box, they do not study biology/physiology of the pigeon. By removing the agent from his equation, Skinner successfully established the principles of behavior. Baum stated, “Behavior analysis is the science of behavior; it is about behavior and not about organisms. It views behavioral events as natural events to be explained by other natural events” (Baum, 2007 , abstract).

Radical behaviorism and private events

Radical behaviorism was not immune to criticism on the agent-free approach from outside its niche. Criticism from nonbehaviorists on this issue abounds. For example, Bandura ( 1986 ) wrote that the three-term contingency cannot accommodate observational learning without referring to cognitive processes and advocated for the study of such a process. Chomsky (1959, as cited in MacCorquodale, 1970 ) indicated that Skinner’s treatment of language was too simple and urged analysis of complex cognitive and neurological processes in order to understand human linguistic behavior. These criticisms stemmed from the assumption that there is an agent that governs social and linguistic activities, something Skinner’s agent-free approach did not assume.

Nevertheless, radical behaviorism’s treatment of private events is clearly a response to such criticisms. Skinner’s antecedent to write a book Verbal Behavior was Professor Whitehead’s comment that Skinner’s analysis of behavior was plausible for all human behavior except human language (Claus, 2007 ). In addition, Skinner wrote:

Methodological behaviorism and certain versions of logical positivism could be said to ignore consciousness, feelings, and states of mind, but radical behaviorism does not thus “behead the organism”; it does not “sweep the problem of subjectivity under the rug”; it does not “maintain a strictly behavioristic methodology by treating reports of introspection merely as verbal behavior”; and it was not designed to “permit consciousness to atrophy.” (Skinner, 1974, quoted in Day, 1983 , p. 219

Skinner’s willingness to address the agent problem led to one of the most heated discussions in radical behaviorism: the status of private events. In this article, the private event can be seen as a subcategory of the agent problem.

Although maintaining the position that radical behaviorism is interested in dealing with private events and strictly adhering to the three-term contingency analysis of behavior, Skinner’s approach to this issue had changed over time (Day, 1980 ). In the early phase of his career, Skinner had used the operational definition approach to tackle this problem. For example, Estes and Skinner ( 1941 ) operationally defined anxiety as an observable behavior, a decrease in the rat’s lever-pressing behavior, and studied its occurrence while presenting a shock-paired light. The operational definition approach to the agent problem is to identify an observable behavior that causes an experimenter to infer a supposed inner state (or an intervening variable) and reveals the behavior’s function in its relation to environmental events. In the folk psychological view, anxiety would “cause” a decrease in lever-pressing, but the operational definition approach indicates that anxiety was inferred from the observation of a decrease in behavior. Private events are revealed as a tautological label of the observed behavior and not an explanation (or a cause) of the observed behavior, thus eliminating the agent. Later in his career, Skinner used the functional/contingency analysis of verbal behavior (Moore, 2007 ; Skinner, 1945 ) as well as the analysis of the history of reinforcement of such verbal operants in a given verbal community (Catania, 2011 ; Skinner, 1957 ). That is, the use of a word that is associated with private events such as “I have a toothache” is a) a function of contingency such as getting attention from others and b) taught by other members of the community who did not have direct access to the person’s private event. Thus, analyzing these two aspects of verbal behavior would reveal the controlling variables of the verbal report of a toothache in the environment and eliminate the agent. Skinner and other radical behaviorists argue that these approaches to private events are the heart of radical behaviorism, and some scholars indicate these approaches to private events make radical behaviorism comprehensive against criticism from others (e.g., Moore, 2001 ).

It is noted that some scholars’ differences in the interpretations of Skinner’s radical behaviorism might partly stem from Skinner’s changing attitude toward private events over time (see Foxall, 2008 ). Behaviorists such as Baum and Staddon often cite Skinner’s early works such as Behavior of Organisms (Skinner, 1938/ 1990 ) as a reference, whereas Catania, Moore, and others usually resort to his later works such as Verbal Behavior (Skinner, 1957 ). At one point, Day ( 1969 ) suggested distinguishing these as “early” Skinner and “late” Skinner to clarify the confusion as philosophers do with “early” and “late” Wittgenstein.

Experimental Analysis of Behavior after Radical Behaviorism

In the field of experimental analysis of behavior, new behaviorisms have emerged after radical behaviorism. Although the niche is relatively stable and without competitors from outside (but see the cultural pressure of the agent problem among behavior analysts in Branch & Malagodi, 1980 ), behaviorists are still competing for resources: scientific discoveries. As new behavioral phenomena were discovered, such as matching law, free-operant avoidance behavior, and reconceptualization of contingency (as opposed to contiguity), scholars were forced to see operant behavior in different ways, which led to an update of radical behaviorism. These include multiscale behaviorism (Hineline, 2001 ; Shimp, 2013 ), teleological behaviorism (Rachlin, 1994 ), and the molar multiscale view (Baum, 2002 ). What they have in common is that they maintained the basic characteristics of radical behaviorism such as the atheoretical approach, anti-dualism, and the agent-free approach, while updating the scale of operant behavior to embrace a broader framework. They call a radical behaviorist a molecular behaviorist because radical behaviorism’s unit of analysis of behavior is the three-term contingency and distinguish themselves as molar behaviorists, whose analysis of behavior includes multiple sets of three-term contingencies across time and environments. Shimp ( 2013 ) wrote:

A molecular analysis describes how reinforcement shapes and organizes continuous, moment-to-moment behaving into new higher order patterns, and a molar analysis describes how reinforcement affects averages of aggregates of different instances of the same behaviors that occurred at different times. (p. 295)

The molar behaviorists are facing the same challenge as emergent and theoretical behaviorisms: how to account for a change in behavior that is not directly a function of the immediate antecedent and contingent stimuli, such as in a choice situation, contrast effect, and contingency analysis, where behavior change is a function of the differences in the accumulated rate of reinforcement across different environments and time. In addition, although emergent and theoretical behaviorisms use an agent such as memory and the decision-making process to account for these phenomena, molar behaviorists cannot invoke an agent. Baum ( 2002 ) is aware of the challenge and offers an alternative:

Any science that deals with change, whether phylogenetic change, developmental change, or behavioral change, requires entities that can change and yet retain their identity . . . because only such entities provide historical continuity. In other words, because only individuals can change and yet maintain historical continuity, such a science must deal with individuals. Although individual usually means individual organism in everyday discourse, philosophers mean something more general. Organisms exemplify cohesive wholes, but so too do activities or allocations. (p. 108)

The molar behaviorists’ solution is to look at time and activities. To resolve the issue of behavior change across time and environments without using the agent, the molar multiscale view sees behavior as activities, a chain of responses, instead of the molecular behaviorists’ position that a response is a discrete unit. By using activities as a unit of operant, the molar multiscale view states that time (or reinforcement frequency within a given timeframe) selects different activities (behavior chains) across different environments instead of a single reinforcement that selects a single response in a single condition in a single moment as in Skinnerian and molecular behaviorist views (Baum, 2012 ). Unlike a single instance of reinforcement specific to one environmental condition, response class, and moment, time is present across environments and selects activities that produce the maximum rate of reinforcement per situation. That is, instead of looking at behavior across environments and time as completely unrelated instances of the three-term contingencies as the molecular behaviorists do or a “behavior change” of one agent as the cognitivists do, the molar behaviorists view behavior in different environments as separate activities, each competes for time. By doing so, the molar multiscale view can account for “behavior change” beyond the scope of the single three-term contingency without introducing the agent.

Because the molar behaviorists do not see the need to include the agent in its analysis of “behavior change” across time and environments, their take on the private events, a subcategory of the agent problem, is also dismissive. The molar multiscale view takes the stance that private events are not needed to explain, predict, and control behavior (Baum, 2011b ). Likewise, teleological behaviorism takes a position that “behaviorism is the study of the overt behavior, over time, of the organism as a whole in its temporal and social context . . . an organism’s mental life resides in its overt behavior” (Rachlin, 2013 , p. 209). Differences aside, their approaches have been in favor of their niche, the journals such as the Journal of the Experimental Analysis of Behavior , and they succeeded radical behaviorism’s agent-free approach despite the differences between the molecular and molar stances.

Radical Behaviorism in Applied Behavior Analysis

The mainstream experimental psychology’s interest in the proximal causes of behavior and theory development is in stark contrast to the field of clinical psychology/psychotherapy, especially in applied behavior analysis, where radical behaviorism still dominates. In discussing the characteristics of applied behavior analysis, Baer, Wolf, and Risley ( 1968 ) point out that a small change in behavior is not important in clinical settings and therefore not emphasized in applied behavior analysis. They wrote:

Non-applied research often may be extremely valuable when it produces small but reliable effects, in that these effects testify to the operation of some variable which in itself has great theoretical importance. In application, the theoretical importance of a variable is usually not at issue. Its practical importance, specifically its power in altering behavior enough to be socially important, is the essential criterion. (p. 96)

Thus, the selective pressure in clinical psychology is different from that of experimental psychology and such a difference shapes behaviorism differently (see also Rider, 1991 ).

It is not to say that radical behaviorism in applied behavior analysis is free of the agent problem. As discussed above, this problem is deeply rooted in Western culture and in the field of clinical psychology/psychotherapy as seen in the development of contextualistic behaviorism. The struggle is evident in the field of applied behavior analysis as well. Although radical behaviorism in applied behavior analysis maintains its agent-free approach, it largely operates in clinical and educational settings and with people with autism spectrum disorder and other developmental disabilities. These clinical/educational settings are not different from other fields where the agent is seen as the controller of behavior. The pressure to include an agent in the analysis of behavior is high and behavior analysts are often asked to “translate” their terminologies to “a layperson’s” language in order to appeal to the general public (e.g., Rolider & Axelrod, 2005 ). Unlike Baum ( 2011a ), who assumes that a therapist needs only to pay attention to a therapeutic effect on behavior and not to subjective feelings, therapists in this niche have long recognized that a client’s and family’s subjective experience of the therapy is an important variable in the survival of their method in this niche (Wolf, 1978 ). This selective pressure can be seen in a recent modification of the three-term contingency. Two such examples are the treatment of motivation and genes.

Although the concept of motivation is accepted without scrutiny in folk psychology as a controlling variable of behavior, behavior analysis has been taking a conservative stance. Miguel ( 2013 ) described how the concept of a drive/motivation has been treated in the field of behavior analysis over time. He points out that the concept of a drive was originally used by learning theorists as an internal hypothetical construct to explain the effect of reinforcement. “Early” Skinner had adapted the use of the drive concept as an internal intervening state (Skinner, 1938/1990), but gradually shifted his position to describe it as an environmental operation (Skinner, 1957 ) such that food deprivation replaced hunger and water satiation replaced the reduction of thirst (Miguel, 2013 ; Sundberg, 2013 ). For Skinner, motivational operations remained independent of the three-term contingency similar to the choice of animal species and the operant box arrangement.

Later, Skinner’s effort to externalize the concept of a drive/motivation was extended by Michael ( 1982 , 1993 ) in applied behavior analysis. Given Michael’s concept of the motivating operations, Sundberg ( 1993 ) proposed reconceptualizing the three-term contingency as a four-term contingency by including the concept of motivating operations: motivating operation, antecedent, behavior, and consequence. Although treating the motivating operation as an independent variable is operationally sound, to include it in the three-term contingency implies the presence of the agent whose state influences the effectiveness of the environmental stimuli across time and environments. This is evident in Michael’s ( 1993 ) description of the concept:

An establishing operation . . . is an environmental event, operation, or stimulus condition that affects an organism by momentarily altering (a) the reinforcing effectiveness of other events and (b) the frequency of occurrence of that part of the organism’s repertoire relevant to those events as consequences. (p. 192; emphasis in original)

Michael assumes that the motivating operation affects “organism” that carries and executes multiple sets of three-term contingencies (“repertoire”) given different environments. One can foresee that the logical extension of this approach is the introduction of the agent in the three-term contingency just like in the S-O-R formula in which the drive concept played a significant role in the explanation of behavior. One of the reasons behind Michael’s reconceptualization of motivational variables was that behavior analysis would become vulnerable to criticisms by others in psychology without addressing motivation (Sundberg, 2013 ). Here, one can see behavior analysts’ struggle to stay agent-free while adapting to the demand of the niche.

Another example is the treatment of genetic factors. As applied behavior analysts expanded their professional niches to the area of clinical psychology, especially in the field of developmental disabilities, the role of genetic factors became potent. Langthorne and McGill ( 2008 ) discussed the importance of incorporating genetic influence on the development of self-injurious behavior (SIB) with people with certain developmental disabilities such as Down syndrome and Rett syndrome. Their model of the early development of SIB was an extended version of the three-term contingency incorporating factors such as genes and motivations. They indicated that genetic events influence the nature of motivation, topographies of behavior later conditioned to be an operant, stimuli that are later discriminated, and contingencies that would function as a reinforcer. The authors suggest that acknowledging and incorporating genetic influence in the analysis would enhance a therapist’s ability to assess, treat, and prevent SIB among people with a given disability. Again, just like Michael, the incorporation of the genetic variable in the three-term contingency also implies the presence of the agent whose state alters the effectiveness of the environmental variables across time and settings.

A similar issue can be seen when behavior analysts migrated to the animal training field. Behavior analysts had been criticized for the use of a limited kind of animal species as their experimental subjects and disregarding a species-specific behavior or instincts in their analyses of behavior. When Breland and Breland ( 1961 ), animal training specialists, adapted the behavior analytic approach to animal training, they encountered a similar issue such that they had difficulty conditioning the behavior of different species of animals in a uniform fashion without taking into consideration each animal’s instinctive behavior pattern. They offered a way to redefine instincts in a behavior analytic term and urged operant psychologists to incorporate and study animals ethologically and as a whole in their experimental works. Here, too, is an emphasis to include an agent, an animal as a whole, in behavior analysis.

In all cases, the agent problem is a constant selective pressure that demands responses from behavior analysts. Instead of introducing the agent directly, applied behavior analysts extended its three-term contingency formula to respond to such a demand, but the inclusion of variables such as the motivating operation and the subject variable as an extension of the three-term contingency could lead to something similar to the cognitivists’ S-O-R formula in the future.

Human Behavior and Behaviorism

The agent problem is most salient in the niche where human behavior is of interest. This is even more so in the niche where the behavior of typically developing, language-able adult humans is concerned. In the field of economics, intentional behaviorism (Foxall, 2007 , 2008 ) actively incorporates the agent, a language-able person, into its formula. Foxall ( 2008 ) points out that radical behaviorism cannot account for “(a) behavior at the personal level (as opposed to accounting for behavior-environment relationships), (b) the continuity of behavior over time and space, and (c) the delimitation of interpretations of behavior” (p. 119). Foxall argues that even though radical behaviorism is sufficient in predicting and controlling behavior using extensional (objective) language, it still misses information at the personal level, such as subjective experience, without which the analysis of human behavior is not complete. By including the personal level with the analysis of intentional idioms (statements using the first-person point of view such as “I think,” I believe,” and “I want”), intentional behaviorism aims to fill the gap between the external stimulations (antecedents and contingencies) and behavior, providing continuity of behavior (Foxall, 2007 , 2008 ). By incorporating intentional explanations in behaviorism, Foxall argues that one can interpret behavior even though one does not have access to information about antecedents, contingencies, and history of reinforcement of a person of interest in the everyday situation, un-limiting behavioral interpretation.

Unlike emergent behaviorism and theoretical behaviorism, which incorporate the agent in the form of a hypothetical construct such as memory and attention, intentional behaviorism permits a person to mediate time and environments. In this case, a person is a language-able human being who uses first-person statements. Personal experience and a report of it, Foxall argues, would not be reducible to the functional analysis as radical behaviorism proposed nor could it be broken down into mathematical or cognitive mechanisms as emergent behaviorism and theoretical behaviorism proposed. He wrote, “The intentional terms ascribed in intentional behaviorism result entirely from an attempt to overcome radical behaviorism's problem of legitimately applying theoretical terms of an intentional nature. Intentionality is ascribed only to the person not to sub-personal entities” (Foxall, 2008 , p. 129). Foxall provides an example:

We can say that the fact that he is looking for his glasses is “something he knows ” without scrutinizing or making reference to his past or future behaviors . . . it is to argue that the man does not need to say, to himself at least, that he is enacting behavior that has culminated in his finding his glasses in the past. There is a level of understanding of his behavior, expressed in terms of what the man knows without external reference, that cannot be expressed in language other than the intentional. (p. 126; emphasis in original)

Here, intentional behaviorism assumes that the “man” is the mediator between the environmental events and his own behavior who is to look for the glasses. Unlike the molar behaviorists who would argue that one can explain this person’s behavior if one extends the observation in space and time, Foxall argues 1) the man’s self-report suffices the identification of the cause of his behavior and 2) subjective experience is unattainable to such an observer and requires incorporation of the subjective dimension into the analysis. In this case, intentional behaviorism indicates that there is a qualitative difference between the exensional (objective, third-person) and intentional (subjective, first-person) statements that a person verbalizes. Thus, intentional behaviorism advocates for the inclusion of reports of subjective experience (the use of intentional idioms) as a part of a comprehensive analysis of human behavior.

When dealing with typically developing, language-able humans, one’s subjective experience is difficult to exclude as a subject of study and the agent-free approach is least understood. As a means of adapting, intentional behaviorism makes a bold modification: its only concern is human activities and it actively incorporates a person as the agent in its formula as the interest of its study, both of which are a drastic move away from the other behaviorisms. Such an adaptation can be seen as a result of the selective pressure of the niche. In the field of economics, theories of human economic behavior heavily employ the concepts such as “satisfice,” “optimal decision making,” “nudging,” and “preference,” all of which infer a person (i.e., the agent) when explaining the results of quantified human economic behavior (e.g., Foxall, 2017 ). Intentional behaviorism’s adaptation is evident in Foxall’s ( 2017 ) statement, “. . . consumer behavior analysis has sought to meld behavioral psychology, behavioral economics, and marketing science into a unified whole that comprehends consumer behavior in a unique way” (p. 309). For a person whose aim is to incorporate behavior analysis into this niche, it is understandable that their version of behaviorism takes a shape of intentional behaviorism.

An interesting comparison can be made between intentional behaviorism and contextualistic behaviorism where both claim that their subject matter is human behavior and no other animals. They differ in their attitude toward the agent problem. Whereas intentional behaviorism embraces the agent as a necessary component of the analysis of behavior, contextualistic behaviorism diminishes it as a mechanistic component that does not represent a whole organism. Although intentional behaviorism preserves a separate analysis to a person’s subjective experience, contextualistic behaviorism redefines the “psychological level of analysis as the study of whole organisms interacting in and with a context,” and indicates that the agent in its isolation from the context is not appropriate for their analysis of behavior (Hayes & Hayes, 1992 ). How can two behaviorisms that both focus on human behavior differ? A factor that could have influenced this difference might be their competitors in their niches. As discussed above, contextualistic behaviorism competes with behavior therapists who embraced cognitivism in their understanding of human behavior. Thus, accepting the agent in a causal chain of behavior would not distinguish contextualistic behaviorism from the rest. On the other hand, intentional behaviorism is in the field of behavioral economics where psychological behaviorism is a new perspective. It would be difficult for intentional behaviorism to stay agent-free and be accepted by such a niche.

Pragmatism and Diversification

Behaviorism is unique in the way that it is adaptive to a given environment compared to other schools of philosophy. One characteristic of behaviorism that permits such flexibility is pragmatism, and all the new versions of behaviorism discussed above adhere to this characteristic. This aspect of behaviorism has provided success in many niches where behaviorists have migrated. Its commitment to pragmatic success in changing behavior is often one of the strengths against its competitors in a given field such as clinical psychology. As discussed above, this aspect of behaviorism also allows it to change its own shape to adapt to a given niche. On the other hand, such adaptation to the niches often causes a debate among behaviorists of different niches as to what the subject matter of their study is, what measurement and criteria are to be used, and how to interpret the results. The practicality of using theory is emphasized by emergent behaviorism and theoretical behaviorism. The use of time and activities are advocated by molar behaviorists. The inclusion of intentional terms is suggested by intentional behaviorism. A socially significant behavior change is emphasized by radical behaviorists in applied behavior analysis and contextualistic behaviorism. Baum ( 2002 ) writes, for example, when discussing the unit of analysis of his dependent variable, “Where should subdividing stop, and how does one define the parts? Answers would depend on the purpose of the analysis, whether it be therapeutic intervention, basic research, or something else” (p. 111). Some scholars are cautious about the pragmatic nature of behaviorism. Burgos ( 2003 ) discusses the danger of pragmatism by pointing out that, “. . . Jamesian pragmatism is the most discussed form of pragmatism in philosophy and science (behaviorism and behavior analysis included. . . ). Under Jamesian pragmatism, anything goes, even nonsense, as long as it is useful to someone. . .” (p. 42). He also writes, “Pragmatism leads to a relativism that is seriously at odds with an emphasis on science as the best way of knowing” (Burgos, 2007 , p. 63). Thus, one can argue that the diversification seen in this article is a result of behaviorists not strictly adhering to the original core values that early behaviorism advocated. Staddon ( 2018 ) also argued that the diversification of social science is disadvantageous to the field because it would prevent a healthy and open scientific communication and criticism between niches. Likewise, Rider ( 1991 ) shows a concern that there has been less and less communication between the experimental analysis of behavior and applied behavior analysis. On the other hand, diversification is a natural phenomenon that is a product of the environment and is largely uncontrollable. It is a part of the survival of the species without which no behaviorisms would exist today. Time will only show which behaviorism will survive tomorrow.

This article reviewed the diversification of behaviorism in recent decades using the concept of adaptive radiation as a guiding principle. As behaviorism migrated from its original niche of experimental psychology into new niches such as clinical psychology and economics, it has diversified into new forms. Although some characteristics of behaviorism remained, other characteristics were modified. One such characteristic that went through extensive modification was the agent-free approach to the analysis of behavior. The article discussed the agent problem as one of the major selective pressures that influenced the shape of new kinds of behaviorism in different niches. The presence of competitors and the nature of the resources were also factors in the emergence of new forms. Thus, variations in present-day behaviorism can be thought of as a product of the selective pressure of each niche.

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Considering Humans in Human-Centred Research

Self-empathy helps you navigate complex and sensitive interviews..

Posted May 23, 2024 | Reviewed by Michelle Quirk

• The Importance of Empathy
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• Human-centred design guides innovative solutions to complex and sensitive issues.
• Researching sensitive topics may surface strong emotions and reactions in both researchers and participants.
• Self-empathy as a skill guides a researcher to navigate triggers and tricky moments in interviews.

As the demand for innovative solutions to complex and sensitive issues continues to grow, design thinking and human-centred design are becoming increasingly vital. Design methodologies focus on identifying deeper needs to craft effective solutions. This begins with initial research aimed at gathering insights to guide the design process. Unfortunately, deeper needs don’t come neatly packaged and easily accessible. Understanding these deeper needs requires more than just data collection—it demands empathy. And effectively empathising requires researchers to be equipped.

Depending on the issues, a researcher may need to research delicate situations. Investigating sensitive topics or working with individuals who have had challenging and sometimes traumatic experiences takes advanced empathy skills.

On the one hand, researchers must create a trusting environment where participants feel safe sharing their experiences. On the other hand, when the participant does confide, researchers may need to listen to and respectfully hold content that can be unsettling to themselves.

This post explores the challenges of empathic research in sensitive contexts and offers strategies for researchers to navigate these challenges effectively.

Challenges in Sensitive Research

The inherent nature of sensitive topics is that they are difficult to talk about. They surface strong emotions and potential reactions in both researcher and participant. For example, a health-related project in Africa highlighted the stark contrast between the resources and living conditions of interviewers and interviewees. Interviewers often felt guilt over their privileges, while interviewees viewed them as potential "saviours" able to rescue them from their dire circumstances. In another project, researchers found descriptions of trauma and abuse to be heartbreaking, devastating, and too hard to accept.

These examples highlight that triggers can arise in both the interviewer and the interviewee, posing stagnating challenges. When this happens, researchers need to make decisions to ensure the interview progresses productively while safeguarding the well-being of all involved.

What Can Researchers Do?

If you want to know where to draw the line as a researcher between what you can handle with interviewees and when you need to call in external help, you need to know your own mind and triggers first. Self-empathy is therefore crucial. By understanding your own triggers, setting ethical boundaries , and setting guidelines for when to seek external help, you can enter your interviews with greater confidence and composure, irrespective of the trauma that might come up. It’s essential to reflect on ethical responsibilities and develop a set of guidelines with the design team to navigate these challenges effectively (perhaps some "rules" on which type of situation needs to be referred to professionals/NGOs/counselors, etc. immediately).

At the same time, listening to numerous traumatic stories can also impact you personally, potentially leading to emotional numbness and affecting your interpretation of research results. Having self-empathy as a skillset can help slow down that process and might even prevent it from happening at all.

Empathy Starts With Self-Empathy

All empathy starts with self-empathy. To genuinely care for, and understand, your participants, you need to be empathic. But if you don’t have self-empathy, practising empathy with others is often a very messy mix of emotions and impressions. To deliver the care you want to deliver and gather insightful data, it helps to make sense of that mix.

Here are questions to help you prepare for sensitive research:

Identifying Triggers and Challenges

• What specific challenging situations do you encounter in your research?
• What does that trigger or challenge in you?
• How can you recognize when you or your participant are experiencing a trigger?
• How do these triggers affect your ability to conduct research?

Handling Your Triggers

• What do you do to manage your triggers during research?
• How effective are these strategies, and how can they be improved?

Deciding When to Retreat

• What signs indicate that you need to take a step back from the research?
• What actions should you take when you decide to retreat?

Seeking Specialised Help for Participants

• How do you determine when a participant needs specialised help?
• What are the steps for referring a participant to external support?

Establishing Common Guidelines

• What common "rules" do you have in place for helping participants?
• How can you ensure these guidelines are followed consistently?

Handling Traumatic Stories

• What methods do you use to listen to and process traumatic stories?
• How do you take care of your emotional well-being after hearing such stories?

By considering these questions, researchers can better prepare themselves for the emotional challenges of empathic research on sensitive topics, ensuring both their well-being as well as the well-being of their participants and the integrity of their work.

Lidewij Niezink, Ph.D., and Katherine Train, Ph.D., are the co-founders of Empathic Intervision.

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Over recent months, tech companies have been laying workers off by the thousands. It is estimated that in 2022 alone, over 120,000 people have been dismissed from their job at some of the biggest players in tech – Meta , Amazon , Netflix , and soon Google – and smaller firms and starts ups as well. Announcements of cuts keep coming.

Recent layoffs across the tech sector are an example of “social contagion” – companies are laying off workers because everyone is doing it, says Stanford business Professor Jeffrey Pfeffer. (Image credit: Courtesy Jeffrey Pfeffer)

What explains why so many companies are laying large numbers of their workforce off? The answer is simple: copycat behavior, according to Jeffrey Pfeffer, a professor at the Stanford Graduate School of Business .

Here, Stanford News talks to Pfeffer about how the workforce reductions that are happening across the tech industry are a result mostly of “social contagion”: Behavior spreads through a network as companies almost mindlessly copy what others are doing. When a few firms fire staff, others will probably follow suit. Most problematic, it’s a behavior that kills people : For example, research has shown that layoffs can increase the odds of suicide by two times or more .

Moreover, layoffs don’t work to improve company performance,  Pfeffer adds. Academic studies have shown that time and time again, workplace reductions don’t do much for paring costs. Severance packages cost money, layoffs increase unemployment insurance rates, and cuts reduce workplace morale and productivity as remaining employees are left wondering, “Could I be fired too?”

For over four decades, Pfeffer, the Thomas D. Dee II Professor of Organizational Behavior, has studied hiring and firing practices in companies across the world. He’s met with business leaders at some of the country’s top companies and their employees to learn what makes – and doesn’t make – effective, evidence-based management. His recent book Dying for a Paycheck: How Modern Management Harms Employee Health and Company Performance–And What We Can Do About It (Harper Business, 2018) looks at how management practices, including layoffs, are hurting, and in some cases, killing workers.  

This interview has been edited for length and clarity.

Why are so many tech companies laying people off right now?

The tech industry layoffs are basically an instance of social contagion, in which companies imitate what others are doing. If you look for reasons for why companies do layoffs, the reason is that everybody else is doing it. Layoffs are the result of imitative behavior and are not particularly evidence-based.

I’ve had people say to me that they know layoffs are harmful to company well-being, let alone the well-being of employees, and don’t accomplish much, but everybody is doing layoffs and their board is asking why they aren’t doing layoffs also.

Do you think layoffs in tech are some indication of a tech bubble bursting or the company preparing for a recession?

Could there be a tech recession? Yes. Was there a bubble in valuations? Absolutely. Did Meta overhire? Probably. But is that why they are laying people off? Of course not. Meta has plenty of money. These companies are all making money. They are doing it because other companies are doing it.

What are some myths or misunderstandings about layoffs?

Layoffs often do not cut costs, as there are many instances of laid-off employees being hired back as contractors, with companies paying the contracting firm. Layoffs often do not increase stock prices, in part because layoffs can signal that a company is having difficulty. Layoffs do not increase productivity. Layoffs do not solve what is often the underlying problem, which is often an ineffective strategy, a loss of market share, or too little revenue. Layoffs are basically a bad decision.

Companies sometimes lay off people that they have just recruited – oftentimes with paid recruitment bonuses. When the economy turns back in the next 12, 14, or 18 months, they will go back to the market and compete with the same companies to hire talent. They are basically buying labor at a high price and selling low. Not the best decision.

People don’t pay attention to the evidence against layoffs. The evidence is pretty extensive, some of it is reviewed in the book I wrote on human resource management, The Human Equation: Building Profits by Putting People First. If companies paid attention to the evidence, they could get some competitive leverage because they would actually be basing their decisions on science.

You’ve written about the negative health effects of layoffs. Can you talk about some of the research on this topic by you and others?

Layoffs kill people, literally . They kill people in a number of ways. Layoffs increase the odds of suicide by two and a half times. This is also true outside of the United States, even in countries with better social safety nets than the U.S., like New Zealand.

Layoffs increase mortality by 15-20% over the following 20 years.

There are also health and attitudinal consequences for managers who are laying people off as well as for the employees who remain . Not surprisingly, layoffs increase people’s stress . Stress, like many attitudes and emotions, is contagious. Depression is contagious , and layoffs increase stress and depression, which are bad for health.

Unhealthy stress leads to a variety of behaviors such as smoking and drinking more , drug taking , and overeating . Stress is also related to addiction , and layoffs of course increase stress.

What was your reaction to some of the recent headlines of mass layoffs, like Meta laying off 11,000 employees?

I am concerned. Most of my recent research is focused on the effect of the workplace on human health and how economic insecurity is bad for people. This is on the heels of the COVID pandemic and the social isolation resulting from that, which was also bad for people.

We ought to place a higher priority on human life.

If layoffs are contagious within an industry, could it then spread across industries, leading to other sectors cutting staff?

Of course, it already has. Layoffs are contagious across industries and within industries. The logic driving this, which doesn’t sound like very sensible logic because it’s not, is people say, “Everybody else is doing it, why aren’t we?”

Retailers are pre-emptively laying off staff, even as final demand remains uncertain. Apparently, many organizations will trade off a worse customer experience for reduced staffing costs, not taking into account the well-established finding that is typically much more expensive to attract new customers than it is to keep existing ones happy.

Are there past examples of contagious layoffs like the one we are seeing now, and what lessons were learned?

After the Sept. 11, 2001, terrorist attacks, every airline except Southwest did layoffs. By the end of that year, Southwest, which did not do any layoffs, gained market share. A.G. Lafley, who was the former CEO of Procter and Gamble, said the best time to gain ground on your competition is when they are in retreat – when they are cutting their services, when they are cutting their product innovation because they have laid people off. James Goodnight, the CEO of the software company SAS Institute, has also never done layoffs – he actually hired during the last two recessions because he said it’s the best time to pick up talent.

Any advice to workers who may have been laid off?

My advice to a worker who has been laid off is when they find a job in a company where they say people are their most important asset, they actually check to be sure that the company behaves consistently with that espoused value when times are tough.

If layoffs don’t work, what is a better solution for companies that want to mitigate the problems they believe layoffs will address?

One thing that Lincoln Electric, which is a famous manufacturer of arc welding equipment, did well is instead of laying off 10% of their workforce, they had everybody take a 10% wage cut except for senior management, which took a larger cut. So instead of giving 100% of the pain to 10% of the people, they give 100% of the people 10% of the pain.

Companies could use economic stringency as an opportunity, as Goodnight at the SAS Institute did in the 2008 recession and in the 2000 tech recession. He used the downturn to upgrade workforce skills as competitors eliminated jobs, thereby putting talent on the street. He actually hired during the 2000 recession and saw it as an opportunity to gain ground on the competition and gain market share when everybody was cutting jobs and stopped innovating. And it is [an opportunity]. Social media is not going away. Artificial intelligence, statistical software, and web services industries – none of these things are going to disappear.

• Open access
• Published: 27 May 2024

The importance and feasibility of hospital interventions to prevent and manage patient aggression and violence against physicians in China: a Delphi study

• Yuhan Wu   ORCID: orcid.org/0000-0003-4340-4390 1 ,
• Martina Buljac-Samardzic 1 ,
• Dahai Zhao 2 &
• C. T. B. Ahaus 1  

Human Resources for Health volume  22 , Article number:  34 ( 2024 ) Cite this article

Metrics details

Aggression and violence by patient (and their relatives/friends) is widely acknowledged as a serious occupational hazard, with physicians being particularly susceptible to witnessing and experiencing such incidents within hospitals. Research has shown that the negative consequences of such aggression and violence are not only felt at the individual level, but also at the team and organizational levels. Understanding how to prevent and manage this behavior towards physicians in hospitals is urgent and not fully researched. While there are many potentially effective interventions, it is unclear which ones would be valuable and feasible for Chinese hospitals. Because patient aggression and violence may occur more frequently in Chinese hospitals than in other countries, this suggests that cultural differences play a role and that tailored interventions may be needed.

We conducted a Delphi study to reach a consensus on the importance and feasibility of hospital interventions to prevent and manage patient (and their relatives/friends) aggression and violence against physicians in Chinese hospitals. Seventeen experts in China were invited to complete online questionnaires over three rounds.

After three rounds, consensus was achieved concerning 44 interventions, five other interventions were rejected, and no consensus was reached on another two. These interventions were clustered into eight categories: environment design, access and entrance, staffing and working practices, leadership and culture, training and education, support, during/after-the-event actions, and hospital policy. Each category is considered important in preventing and managing patient (and their relatives/friends) aggression and violence towards physicians in Chinese hospitals. This study also investigated the feasibility of the suggested interventions and found that 36 of the 44 interventions were considered not only relevant, but also feasible for implementation in Chinese hospitals.

Conclusions

This study provides an overview of interventions that can be implemented in Chinese hospitals to prevent and manage patient (and their relatives/friends) aggression and violence before, during, and after a violent incident occurs.

Peer Review reports

Introduction

Workplace violence in healthcare settings is recognized as a serious occupational hazard, and especially in hospitals [ 1 , 2 ]. Many healthcare professionals worldwide experience verbal and physical violence at some point in their careers [ 3 , 4 ]. Among healthcare professionals, physicians are particularly likely to witness and experience aggression and violence in the workplace [ 4 , 5 ]. Although physicians encounter violence from different sources, patient and their relatives/friends have been identified as the most prevalent source of aggression and violence in hospitals [ 6 , 7 ]. Consequently, this study focuses on patient (and their relatives/friends) aggressive and violent actions against physicians in hospitals.

The risk factors for the occurrence of aggression and violence are present at multiple levels, such as patient-related factors (e.g., under the influence of alcohol) physician-related factors (e.g., poor medical skills), and patient–physician interactions factors (e.g., poor physician–patient communication) [ 8 ]. Although inadequate services can also have negative impact on the patient [ 9 ], this study focuses on the multifaceted negative consequences for hospitals. At the individual level, it can have severe adverse effects on physicians’ psychology, emotions, work functioning (e.g., reduced job satisfaction, higher level of stress, and loss of confidence) [ 10 , 11 , 12 ] and even extend into their personal lives, resulting in an increasing need for family support and negative interactions with family members [ 6 , 9 ]. Although the individual-level consequences have received most attention, this aggression and violence also affects behavior and performance at the team and organizational levels such as in influencing the team climate, lowering performance, increasing compensation costs, and reputational damage [ 13 , 14 , 15 ].

Given the detrimental impact of aggression and violence in healthcare settings, numerous studies have concentrated on preventing and managing workplace violence. The World Health Organization (WHO) proposed a guideline framework to prevent and manage workplace violence in healthcare that addressed preconditions, organizational interventions, environment interventions, individual-focused interventions, and after-the-event interventions [ 16 ]. The US Occupational Safety and Health Administration (OSHA) provided five guidelines for preventing workplace violence in healthcare that addressed: management commitment and worker participation, worksite analysis and hazard identification, hazard prevention and control, safety and health training, and recordkeeping and program evaluation [ 17 ]. Kumari et al. also suggested possible interventions to reduce workplace violence against physicians: at the individual level (e.g., training and communication skills); the organizational level (e.g., infrastructure changes and management policies); and the societal level (e.g., unbiased media reporting) in their review [ 18 ].

However, there is a lack of evidence on the effectiveness of these interventions. Therefore, Morpet et al. in a scoping review reviewed the effectiveness of interventions adopted by hospitals and identified risk assessment, staff education, and aggression management teams as evidence-based interventions that can reduce consumer-perpetrated violence [ 19 ]. Another systematic review categorized evidence-based interventions into three categories: pre-event preventive measures (e.g., violence prevention programs and risk assessment), interventions during the event (e.g., staying calm and applying de-escalation techniques), and post-incident measures (e.g., reflecting on incidents and organizational support) [ 1 ].

Given that the scope of workplace violence is broader than patient aggression and violence, including internal violence (violence from leaders/colleagues) and external violence (violence from patients/visitors) [ 20 ], it is sensible to place a particular emphasis on focused interventions for preventing and managing a specific source of violence against a specific type of healthcare professionals. The unique nature of patient (and their relatives/friends) aggression and violence against physicians necessitates tailored interventions to effectively address its challenges and negative effects.

Compared to European countries, physicians working in Asian countries experience more patient aggression and violence [ 21 ]. In the specific context of China, this problem has unique dimensions and challenges that require comprehensive investigation and addressing. Surveys conducted by the Chinese Hospital Management Society in 2005 revealed that the majority (over 73%) of healthcare staff in China were victims of such violence, including threats and taunts from patients and their relatives within hospital settings [ 21 ]. Furthermore, over the past few decades, the prevalence of patient aggression and violence against physicians has increased in China [ 22 ]. A recent systematic review conducted in China found that 62.4% of Chinese healthcare workers reported experiencing actual workplace violence, and particularly from patients [ 23 ].

The distinctive cultural, socioeconomic, and healthcare system factors in China underscore the need for a thorough examination of the importance and feasibility of hospital interventions tailored to the Chinese healthcare system. Although there are many suggested interventions, and some studies have examined the effectiveness of interventions elsewhere, it is not clear which are relevant and feasible in China given its cultural differences. Therefore, it is important to examine the importance and feasibility of interventions suggested in the literature in China.

As such, the main objective of this study is to reach a consensus regarding the importance and feasibility of hospital interventions to curtail and manage patient (and their relatives/friends) aggression and violence against physicians in Chinese hospitals. For these reasons, a Delphi study was conducted, aiming to contribute valuable insights and evidence-based recommendations that can enhance the safety and well-being of both patients and healthcare providers in China’s evolving healthcare landscape.

Methodology

Based on the above analysis and given the scarcity and difficulty of experiment-based studies on interventions to prevent and manage patient (and their relatives/friends) aggression and violence [ 24 , 25 ], this study opted to conduct a Delphi study. The Delphi method is mainly adopted when the existing knowledge is incomplete or subject to uncertainty and higher levels of evidence cannot be provided using other methods [ 26 ]. In this, we were aiming to reach a consensus among Chinese experts on the importance of hospital interventions, and to explore their feasibility to counter patient (and their relatives/friends) aggression and violence against physicians in Chinese hospitals. Three rounds were sufficient to reach consensus.

The panel of experts were recruited using authors’ own network and contained four types of participants: (1) management team members of Chinese hospitals and dedicated staff members (e.g., HR manager, quality and safety advisor) who hold the portfolio of patient aggression and violent behavior; (2) experts with experience in developing hospital policies on workplace violence (e.g., national/local health commission of China); (3) scientists who were specialized in patient–physician relationship (e.g., patient aggression and violence, patient–physician communication) in Chinese healthcare settings (scientists with a PhD degree and/or working experience > 10 years); (4) physicians who had experienced/witnessed patient (and their relatives/friends) aggression and violence in Chinese hospitals. We invited a maximum of two experts per region, hospital and research organization to ensure diversity of data sources. Since our aim was to derive hospital-level interventions, patients were not a target group.

The initial list of interventions (as presented in the first round of our Delphi study) was based on the results of our published systematic review about patient aggression and violence against physicians in hospitals, and that aimed to investigate the prevalence, risk factors, consequences, and prevention and management of patient (and their relatives/friends) aggression and violence against physicians in hospitals [ 8 ]. We started with an inventory of interventions mentioned in papers we had identified for our review plus additional papers found through a snowballing technique. Eventually, a list of 47 interventions were extracted from 32 related articles. Drawing on the WHO and OSHA guidelines [ 16 , 17 ], we grouped the 47 measures into eight categories: (1) environment design, (2) access and entrance, (3) staffing and working practices, (4) leadership and culture, (5) training and education, (6) support, (7) during/after-the-event actions, and (8) hospital policy. All the interventions were translated from English into Chinese using the standard translation/back-translation technique by two researchers before each round of data collection [ 27 ].

The respondents completed online questionnaires during three Delphi rounds, where they rated each intervention as to ‘how important and how feasible is the intervention to prevent, cope, and/or manage patient (and their relatives/friends) aggression and/or violence against physicians in Chinese hospitals?’. More specifically, experts were asked to rate the importance and feasibility of each intervention relative to each other. A four-point scale was used (1 = not important to 4 = very important; and 1 = not feasible to 4 = very feasible). The first round took place in June 2023, the second in July 2023, and the third in August 2023. In each round, respondents were allowed three weeks to complete the questionnaire. After rating each intervention’s importance and feasibility, respondents had the opportunity to reformulate the intervention. At the end of each round, respondents also had the opportunity to add new interventions. In the second and third Delphi rounds, the list of interventions was based on the responses given in the previous round, including newly added, reformulated, and unchanged interventions that had scored somewhere between definite inclusion and exclusion (i.e., importance scores between 51 and 80%). The rules adopted for inclusion and exclusion of items were consistent with other Delphi studies [ 28 , 29 , 30 ].

Interventions that were rated as ‘very important’, or ‘important’ by at least 80% of the experts were immediately retained in the final list and those that were rated as ‘not important’, or only ‘moderately important’ by more than 50% the experts were excluded. New interventions, as well as interventions deemed important by 51% to 80% of the experts, were retained for re-evaluation in the next round of the Delphi study. This method, which includes feedback and the opportunity to reconsider initial answers, allowed the experts to reach consensus on all the interventions. In the third round, interventions that were not perceived as important by at least 80% of the experts were categorized as not achieving a consensus. Note that the exclusion and inclusion criteria in this study were based on the importance scores and not on the feasibility scores as it is not meaningful for hospitals to adopt feasible but unimportant interventions. However, our method can provide insight into the boundary implementation conditions for important but infeasible interventions.

Seventeen experts participated in all three rounds of this Delphi study, with no dropouts (response rate = 100%). Detailed information on the respondents is presented in Table  1 .

Table 2 shows the flow of items through this Delphi study. During the three rounds, the panel added four new interventions to the list of 47 elements that we had gathered during the literature study. After three rounds, saturation was achieved with a final list including 44 items.

Table 3 shows the 44 interventions that made it through to the final list, together with their mean, level of agreement, SD, and assigned category. The interventions that were excluded or on which no consensus (NC) was reached are provided in Table  4 . We discuss the level of importance in relationship to the level of feasibility of the included interventions, and particularly highlight differences in importance and feasibility.

Environment design There were seven suggested interventions in this category that were perceived as important and viable, referring to “hospital security”, “alarm system”, “assigning security personnel”, “surveillance cameras”, “adequate air conditioning” and “relaxing and attractive colors”. Four interventions (i.e., separation of dangerous patients from other patients, escape routes and safe rooms dedicated to physicians, protective measures in contact moments between physician and patient (and their relatives/friends), and electronic boards indicating approximate waiting times) were deemed important but less feasible. One expert suggested that interventions to separate dangerous patients from other patients, especially in emergency departments, is infeasible because it is difficult to identify potentially dangerous patients and execute separation measures without aggravating the patient. Although the intervention referring to applying odor control was rejected by the panel, one expert suggested that Chinese hospitals should increasingly prioritize enhancing the overall patient experience through environmental design, including plans for future improvements in waiting areas, dining spaces, and restroom facilities.

Access and entrance The interventions referring to security checks and risk assessment of patients were important, but the feasibility of the latter was questioned by most of the panel. In response to the feasibility of risk assessment, the experts had two points of concern. First, some experts commented that risk assessment was important, but that this intervention would require a complex linking of information between hospitals, and that this would currently be challenging to implement. Second, some experts expressed concerns that flagging patients based on a risk assessment might lead to patient stigmatization and the infringement of patient privacy, potentially exacerbating physician–patient conflicts and mistrust. This contradicted the view of some experts who believe that hospitals should construct blacklists based on risk assessments. Two interventions, referring to a ‘one patient–one accompanying person policy’ and ‘restricting visiting hours’, failed to achieve a consensus.

Staffing and working practices The interventions referring to gaining valid consent from patients (and their relatives, if necessary) before treatment and the adequate presence of staff at peak periods were important, but no consensus was reached on the feasibility of the latter. One expert explained that the number of physicians in hospitals was fixed, and the adequate presence of staff in this area might increase the workload of other physicians. Two interventions that referred to escorting physicians were rejected by the panel.

Leadership and culture All the interventions in this category were perceived as both important and feasible. Leadership plays a pivotal role in managing and coping with patient (and their relatives/friends) aggression and violence. Leaders can facilitate the establishment of an organizational safety climate by paying attention to the negative effects of aggression and violence for physicians, encouraging physicians to report violent incidents, and providing support to physicians who experience aggression and violence.

Training and education Most of the interventions related to training and education to prevent and manage patient (and their relatives/friends) aggression and violence were considered important and feasible. One expert suggested that training should encompass more than just managing and coping with aggressive and violent patients (and relatives/friends), and that identifying potentially aggressive and violent patients is also vital. Only two interventions (i.e., training physicians in self-defense, and informing patients and their relatives/friends of the consequences of their aggression and/or violence against physicians) did not achieve a full consensus on their feasibility. One expert commented that it is hard to inform patients and their relatives/friends at the hospital level because public education largely relies on government initiatives, social media campaigns, and other external channels. In addition, one expert commented that hospitals should recruit professionals or experienced physicians for training activities.

Support According to the panel, seeking support from both peers and organizations is not only important, but also feasible. One expert suggested that support from leaders is crucial since China is characterized by a high power-distance culture.

During/after-the-event actions All the identified interventions in this category were perceived as important and feasible.

Hospital policy All the related interventions were perceived as important and feasible by the panel. Two experts had the same comments on the ‘zero-tolerance policy regarding patient (and their family/relatives) aggression and/or violence’: that any zero-tolerance policy needs to be backed up at the national legal level, and is difficult for individual hospitals to implement.

The aim of this Delphi study was to explore the importance and feasibility of hospital interventions related to patient (and their relatives/friends) aggression and violence towards physicians in China. Consensus was reached on 44 interventions that were perceived as important for the prevention and management of patient (and their relatives/friends) aggression and violence against physicians in Chinese hospitals. These interventions were clustered into eight categories: environment design, access and entrance, staffing and working practices, leadership and culture, training and education, support, during/after-the-events actions, and hospital policy. Our findings indicated that all these intervention categories are important in preventing and managing patient aggression and violence. Saturation was reached after three rounds, as in the third round, the panel did not reformulate or put forward new interventions. There were only two interventions on which a consensus was not achieved. This study also investigated their feasibility and found that most of the important interventions were also considered feasible for implementation in Chinese hospitals.

In terms of environment design, respondents could consider two types of interventions: environmental factors and workplace design in hospitals. Among environment-related factors, our study found that air conditioning and color schemes (i.e., adequate air condition, and relaxing and attractive colors) in the hospital were considered both important and feasible. These supportive environmental factors have an influence not only on patient outcomes, but also on the satisfaction levels of both patients and physicians [ 31 , 32 ], reducing the likelihood of patient aggression and violence. In terms of workplace design, hospitals should focus on security, alarm systems, reliable response systems, and surveillance cameras with video recording. These interventions also are widely reported elsewhere as part of a workplace violence prevention strategy in healthcare settings [ 33 , 34 ]. The effectiveness of adopting surveillance cameras has also been considered in other studies [ 18 , 19 , 35 ]. More specifically, physical violence is decreased by the introduction of surveillance cameras and continuous monitoring of surveillance footage allows for the quick identification and rapid response to escalating behavior [ 35 ].

In terms of the interventions in the access and entrance category, security checks (e.g., metal detectors) at a hospital’s main entrance should be considered by Chinese hospitals since this intervention was perceived as important and feasible. This result is consistent with previous research which emphasizes security services at the main entrance and using weapon and metal detectors [ 16 , 36 ]. However, whether patient risk assessments can be used in Chinese hospitals needs further consideration. Although our study deemed this intervention important, its feasibility was questioned by the experts. The same concerns are reflected in previous studies. Risk assessment advocates claim that risk assessments can be employed by hospitals to safeguard physicians and to reduce the incidence of violence [ 19 , 35 , 37 ]. However, its opponents are concerned that applying policies and procedures that flag individuals would lead to patient stigmatization and damage patient privacy [ 38 , 39 ]. Although implementation of patient risk assessments is controversial, some countries have adopted practical measures to flag patient based on risk assessment. For example, the methods of flagging patient in some Canadian hospitals include a combination of symbols and colors (e.g., ‘purple dot’ sticker on patient charts) to indicate the risk [ 38 ]. However, such interventions are not straightforwardly translatable from one context to another since aggression and violence in healthcare settings is a culturally dependent concept [ 40 ]. Therefore, to enhance the feasibility of patient risk assessments in Chinese hospitals requires further research.

Leadership plays a pivotal role in preventing and managing patient aggression and violence in hospitals. Leaders should encourage physicians to report a violent incident as this has also been identified as an important and feasible intervention in other studies. More specifically, incident reporting is a key method for identifying trends in the causes of violence and factors for prevention [ 1 , 41 , 42 ]. Reported data can inform the development of appropriate and relevant prevention and response strategies for hospitals [ 42 , 43 ]. Reflecting Chinese culture, which can be characterized as having a high power-distance [ 44 ], we found that support from managers and hospital administration is significant at the hospital level. This finding is in line with previous studies that emphasize the benefits of senior management support for safety programs in fostering hospital safety climates [ 45 ]. The Braverman seven-step workplace violence-prevention plan similarly stresses that getting support from the top is an essential step in workplace violence prevention [ 46 ].

In addition to support from leaders, this study showed that support from peers is also important and feasible, which is in line with other studies. Previous research has shown that implementing a peer support program for assaulted employees can lead to a reduction in the frequency of aggression and violence [ 47 ]. The buffering effect of support is significant when physicians experience patient aggression and violence [ 48 ]. Seeking peer support may provide the emotional support necessary to navigate challenging working conditions [ 14 ]. Further, having supportive and collaborative coworkers can foster motivation, increase job satisfaction, and enhance overall well-being in the workplace [ 49 ].

Moreover, providing training and education is seen as a key approach to preventing and managing patient aggression and violence in Chinese hospitals. Our study found that enhancing physicians’ skills including de-escalation techniques and communication skills, and in managing and coping with aggressive and violent patients (and relatives/friends) is important and feasible. These results are in line with other studies. In this regard, communication, de-escalation, and recognizing risky behaviors and triggers were identified as core elements to be addressed in training, and recognized as effective and person-centered mitigation strategies to reduce aggression and violence [ 1 , 19 ]. Notably, our finding that self-defense techniques were not feasible has been similarly shown in other studies. Physicians have difficulty in applying self-defense techniques learned in training [ 50 , 51 ] and there is no evidence that self-defense training reduces the incidence of violence in hospitals [ 19 ].

Furthermore, hospital policies for patient (and their relatives/friends) aggression and violence are also needed. A weapons prohibition policy for patients and visitors, and respecting patient’s privacy, were considered significant and viable methods for reducing patient aggression and violence, again a finding consistent with previous studies [ 16 , 19 ]. Although having a zero-tolerance policy was perceived as important and feasible in our study, the effectiveness of this has been questioned in other studies. A major concern with a zero-tolerance policy is that it fails to discriminate between different causes of violence. This has resulted in employees in many healthcare settings not applying their ‘Refusal to Treat’ policy [ 19 ]. It has been recognized that zero-tolerance policies have not effectively reduced workplace violence among healthcare workers in Britain [ 52 ].

Importantly, the experiences of the experts in our study suggest a vital role for support staff within Chinese hospitals. Unlike patients in Western countries who often initially seek help from their general practitioner (GP) before they are admitted to a hospital, Chinese patients typically go directly to hospitals for treatment. This can lead to healthcare staff being overloaded in Chinese hospitals, especially in tertiary hospitals [ 53 ]. Consequently, patients without a GP referral and diagnosis have to rely heavily on support staff working on information and registration desks and on triage staff to guide them to the appropriate department for consultation and treatment. Mistakes made by support staff, such as directing patients to the wrong department, can easily trigger patient frustration and even violence towards physicians. Therefore, clarifying the responsibilities of support staff, standardizing workflows, and enhancing work accuracy to prevent such negative patient emotions and potential violence is considered an important intervention to avoid triggering violent patient behavior in China.

Implications and limitations

Our study has practical implications for Chinese hospitals in terms of preventing and managing patient (and their relatives/friends) aggression and violence in different stages. To manage the period before violent events potentially occur, hospitals should provide professional training for physicians, especially in communication skills, skills on identifying potentially aggressive patients, and de-escalation approaches. Hospital policy should be established with the primary purpose of protecting the safety of physicians and clarifying when incidents of aggression and/or violence by patients (and their relatives/friends) fall under civil law. In addition, the design of the hospital environment, its access and entrance (e.g., security checks), and staff assignment should be considered in preventing and mitigating patient (and their relatives/ friends) aggression and violence before it takes place. During ongoing violent events, actions should focus on comforting measures for patient (and their relatives/friends), and de-escalation techniques. After such violent events, hospitals should provide support to physicians who have experienced aggression and violence in the workplace, in the form of leader support, peer support, and management support (e.g., representation and legal aid and medical support).

Our study has limitations that should be acknowledged. At first, since experts were recruited using authors’ own network, a selection bias might have occurred. The severity of the selection bias is limited as respondents were selected from a broad network of two authors and therefore include a diversity of participants from multiple hospitals, regions, and research organizations. In addition, it is crucial to note that patient aggression and violence are highly context-dependent phenomena. Therefore, interventions should take account of the specific national context, including the underlying risk factors associated with aggression and violence within Chinese hospitals. This contextual consideration is essential for ensuring the practical relevance and effectiveness of any interventions. Consequently, the generalizability of our findings to other cultures and contexts is limited. Nevertheless, this study can serve as starting point for other developing countries.

This investigation, by conducting a three-round Delphi study, identified a broad consensus among experts on the importance and feasibility of hospital-based interventions for mitigating patient aggression and violence against physicians in China. In total, 44 interventions, later clustered in eight categories (i.e., environment design, access and entrance, staffing and working practices, leadership and culture, training and education, support, during/after-the-events actions, and hospital policy) were considered important. All the identified interventions that fall within the categories of leadership and culture, support, during/after-the-events actions, and hospital policy were deemed both important and feasible.

Availability of data and materials

The data collection scales and datasets created and/or analyzed through the present study are available from the corresponding author upon reasonable request.

Abbreviations

The World Health Organization

Occupational Safety and Health Administration

No consensus

General practitioner

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Acknowledgements

We extend our heartfelt gratitude to the participants who generously contributed to this study. Their invaluable insights have significantly enriched our understanding of hospital interventions addressing patient aggression and violence. Furthermore, we would like to express our appreciation to Hujie Wang for his invaluable assistance in translating English into Chinese for each round of this study.

This work was supported by the China Scholarship Council (No. 202107720007; receiver: Yuhan Wu). This funder had no role in the study design, data collection and analysis, interpretation of data, or writing the manuscript.

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Wu, Y., Buljac-Samardzic, M., Zhao, D. et al. The importance and feasibility of hospital interventions to prevent and manage patient aggression and violence against physicians in China: a Delphi study. Hum Resour Health 22 , 34 (2024). https://doi.org/10.1186/s12960-024-00914-z

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Human Voices More Terrifying to Australian Marsupials Than Other Apex Predators

The human voice is terrifying to animals, including marsupials.

Human Voice Terrifies Australian Marsupials

Numerous studies conducted in the Northern Hemisphere have found that human sounds are more scary than those of other apex predators. A new study  conducted in the Southern Hemisphere has reached the same conclusion.

When Australian marsupials were tested in Tasmania, the sound of human voices was at least 2.4 times more likely to cause them to run than the sound of any other predator.

Ecologist Katherine McGann of the University of Tasmania and colleagues noted in their research, "Wildlife worldwide evidently recognize that it is humans who are the largest source of danger."

McGann and colleagues were interested in seeing if human voices also caused the greatest dread in mammals that haven't evolved alongside many huge animals since last year. Researchers found that mammals on the African savannah fear human sounds even more than lions.

Because some Australian marsupials exhibit silent or nonexistent reflexes to Northern Hemisphere predators such as foxes or dogs, they are considered predator-naive . This has enabled invading predators to terrorize many weaker species.

For example, the tammar wallaby ( Notamacropus eugenii ) does not respond to the sounds of dingoes; it only reacts to their sight. According to ethologist Daniel Blumstein  and colleagues, this could be because predators' visual cues are more recognizable than their vocalizations. For improved depth perception, all predators, for instance, have eyes that face forward.

The lack of major mammalian predators on the Australian continent for the past 50,000 years has been cited as the reason for the naiveté of Australian marsupials towards predators. However, these findings ignore the existence of people. Per McGann , this is an excellent example of what has long been a very common error in ecology -- failing to acknowledge or consider the role of humans as predators.

Thus, the researchers played the noises of sheep, dogs, Tasmanian devils, wolves, and humans for wild kangaroos, wallabies, pademelons , and possums. The sound of humans caused the marsupials to flee 2.4 times more frequently in 684 recordings that captured their reactions to exposure than the species they reacted to the second most, which was dogs.

Even though they had the lowest chance of running away, brushtail possums showed alertness by rising on their hind legs.

ALSO READ: Human Sounds Bring More Terror to 95% Wildlife Species Than Lions' Snarling and Growling

Human Sounds Bring More Terror to 95% of Wildlife Species That Lion's Growling

Lions ought to be the most fearsome land predators since they are the largest group-hunting predators on the planet. However, in another study of 10,000 recordings of wildlife  from the African savannah , 95% of the species responded markedly more scared when they heard the sound from humans.

Ecologist Liana Zanette of Western University and her colleagues played different vocalizations and sounds into waterholes in the Greater Kruger National Park of South Africa to see how the animals reacted. This protected area has the largest lion population still alive ( Panthera leo ); therefore, other species are aware of the threat these carnivores pose.

In addition to recording gunfire and dog barking typical of human hunting, the researchers also recorded human speech in Tsonga , Northern Sotho , English, and Afrikaans. The researchers also played the sounds of lions interacting—snarling and growling. Lions' vocalization is similar to humans having a conversation.

The researchers noticed that nearly all 19 of the studied animal species were twice as likely to leave the waterholes when they heard human voices compared to the sound they heard from lions or hunting predators.

RELATED ARTICLE: What Animal Kills the Most Humans?

Check out more news and information on Wildlife  in Science Times.

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• Published: 16 November 2022

Climate change and human behaviour

Nature Human Behaviour volume  6 ,  pages 1441–1442 ( 2022 ) Cite this article

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Climate change is an immense challenge. Human behaviour is crucial in climate change mitigation, and in tackling the arising consequences. In this joint Focus issue between Nature Climate Change and Nature Human Behaviour , we take a closer look at the role of human behaviour in the climate crisis.

In the late 19th century, the scientist (and suffragette) Eunice Newton Foote published a paper suggesting that a build-up of carbon dioxide in the Earth’s atmosphere could cause increased surface temperatures 1 . In the mid-20th century, the British engineer Guy Callendar was the first to concretize the link between carbon dioxide levels and global warming 2 . Now, a century and a half after Foote’s work, there is overwhelming scientific evidence that human behaviour is the main driver of climatic changes and global warming.

The negative effects of rising temperatures on the environment, biodiversity and human health are becoming increasingly noticeable. The years 2020 and 2016 were among the hottest since the record keeping of annual surface temperatures began in 1880 (ref. 3 ). Throughout 2022, the globe was plagued by record-breaking heatwaves. Even regions with a naturally warm climate, such as Pakistan or India, experienced some of their hottest days much earlier in the year — very probably a consequence of climate change 4 . According to the National Centers for Environmental Information of the United States, the surface global temperature during the decade leading up to 2020 was +0.82 °C (+1.48 °F) above the 20th-century average 5 . It is clear that we are facing a global crisis that requires urgent action.

During the Climate Change Conference (COP21) of the United Nations in Paris 2015, 196 parties adopted a legally binding treaty with the aim to limit global warming to ideally 1.5 °C and a maximum of 2 °C, compared to pre-industrial levels. A recent report issued by the UN suggests that we are very unlikely to meet the targets of the Paris Agreement. Instead, current policies are likely to cause temperatures to increase up to 2.8 °C this century 6 . The report suggests that to get on track to 2 °C, new pledges would need to be four times higher — and seven times higher to get on track to 1.5 °C. This November, world leaders will meet for the 27th time to coordinate efforts in facing the climate crisis and mitigating the effects during COP27 in Sharm El-Sheikh, Egypt.

This Focus issue

Human behaviour is not only one of the primary drivers of climate change but also is equally crucial for mitigating the impact of the Anthropocene. In 2022, this was also explicitly acknowledged in the report of the Intergovernmental Panel on Climate Change (IPCC). For the first time, the IPCC directly discussed behavioural, social and cultural dynamics in climate change mitigation 7 . This joint Focus highlights some of the aspects of the human factor that are central in the adaptation to and prevention of a warming climate, and the mitigation of negative consequences. It features original pieces, and also includes a curated collection of already published content from across journals in the Nature Portfolio.

Human behaviour is a neglected factor in climate science

In the light of the empirical evidence for the role of human behaviour in climatic changes, it is curious that the ‘human factor’ has not always received much attention in key research areas, such as climate modelling. For a long time, climate models to predict global warming and emissions did not account for it. This oversight meant that predictions made by these models have differed greatly in their projected rise in temperatures 8 , 9 .

Human behaviour is complex and multidimensional, making it difficult — but crucial — to account for it in climate models. In a Review , Brian Beckage and colleagues thus look at existing social climate models and make recommendations for how these models can better embed human behaviour in their forecasting.

The psychology of climate change

The complexity of humans is also reflected in their psychology. Despite an overwhelming scientific consensus on anthropogenic climate change, research suggests that many people underestimate the effects of it, are sceptical of it or deny its existence altogether. In a Review , Matthew Hornsey and Stephan Lewandowsky look at the psychological origins of such beliefs, as well as the roles of think tanks and political affiliation.

Psychologists are not only concerned with understanding and addressing climate scepticism but are also increasingly worried about mental health consequences. Two narrative Reviews address this topic. Neil Adger et al. discuss the direct and indirect pathways by which climate change affects well-being, and Fiona Charlson et al. adopt a clinical perspective in their piece. They review the literature on the clinical implications of climate change and provide practical suggestions for mental health practitioners.

Individual- and system-level behaviour change

To limit global warming to a minimum, system-level and individual-level behaviour change is necessary. Several pieces in this Focus discuss how such change can be facilitated.

Many interventions for individual behaviour change and for motivating environmental behaviour have been proposed. In a Review , Anne van Valkengoed and colleagues introduce a classification system that links different interventions to the determinants of individual environmental behaviour. Practitioners can use the system to design targeted interventions for behaviour change.

Ideally, interventions are scalable and result in system-level change. Scalability requires an understanding of public perceptions and behaviours, as Mirjam Jenny and Cornelia Betsch explain in a Comment . They draw on the experiences of the COVID-19 pandemic and discuss crucial structures, such as data observatories, for the collection of reliable large-scale data.

Such knowledge is also key for designing robust climate policies. Three Comments in Nature Climate Change look at how insights from behavioural science can inform policy making in areas such as natural-disaster insurance markets , carbon taxing and the assignment of responsibility for supply chain emissions .

Time to act

To buck the trend of rising temperatures, immediate and significant climate action is needed.

Natural disasters have become more frequent and occur at ever-closer intervals. The changing climate is driving biodiversity loss, and affecting human physical and mental health. Unfortunately, the conversations about climate change mitigation are often dominated by Global North and ‘WEIRD’ (Western, educated, industrialized, rich and democratic) perspectives, neglecting the views of countries in the Global South. In a Correspondence , Charles Ogunbode reminds us that climate justice is social justice in the Global South and that, while being a minor contributor to emissions and global warming, this region has to bear many of the consequences.

The fight against climate change is a collective endeavour and requires large-scale solutions. Collective action, however, usually starts with individuals who raise awareness and drive change. In two Q&As, Nature Human Behaviour entered into conversation with people who recognized the power of individual behaviour and took action.

Licypriya Kangujam is a 10-year-old climate activist based in India. She tells us how she hopes to raise the voices of the children of the world in the fight against climate change and connect individuals who want to take action.

Wolfgang Knorr is a former academic who co-founded Faculty for a Future to help academics to transform their careers and address pressing societal issues. In a Q&A , he describes his motivations to leave academia and offers advice on how academics can create impact.

Mitigation of climate change (as well as adaptation to its existing effects) is not possible without human behaviour change, be it on the individual, collective or policy level. The contents of this Focus shed light on the complexities that human behaviour bears, but also point towards future directions. It is the duty of us all to turn this knowledge into action.

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Climate change and human behaviour. Nat Hum Behav 6 , 1441–1442 (2022). https://doi.org/10.1038/s41562-022-01490-9

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DOI : https://doi.org/10.1038/s41562-022-01490-9

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