Self-fulfilling Research Articles

Renal Denervation in Heart Failure Treatment: Data for a Self-Fulfilling Prophecy

Renal denervation (RDN), a transcatheter renal sympathetic nerve ablation procedure, is a relatively novel established procedure for the treatment of hypertension, with it being recognized as a third option for hypertension management in the most recent European guidelines, together with pharmacotherapy, for achieving blood pressure targets. Given the relationship between both hypertension and sympathetic overdrive and the development of heart failure (HF), even studies at the dawn of research on RDN explored it as a treatment to overcome diuretic resistance in those patients. As it is now recognized that RDN does not only have organ-specific but also systemic effects, several investigators have aimed to delineate whether renal sympathetic denervation could alter the prognosis, symptoms, and adverse events of HF patients. Data are available in both HF patients with reduced and preserved ejection fraction. As the significance of neuromodulation is gaining grounds in the HF therapeutic arsenal, in this review, we aim to provide a rationale for using RDN in HF and an up-to-date overview of available data in both HF phenotypes, as well as discuss the future of neuromodulatory therapy in HF management.

An ouroboros of oppression: The self-perpetuating, inequitable high school outcomes of middle school tracking

This study investigated the impact middle school tracking has on outcomes in high school and the factors associated with those outcomes. Utilizing data from a large, diverse school district, this quantitative study investigated the relationships between middle school and high school English course enrollment among 4,503 middle school students. The conceptual framework of the Ouroboros, combining the theories of Lucas’s effectively maintained inequality (EMI) and Merton’s self-fulfilling prophecy (SFP), was used to examine and challenge the status quo of educational tracking systems. We identified three major findings from the study. First, chi-square analysis indicated a statistically significant difference between enrollment rates in accelerated or AP English courses between students who came from tracked and detracked middle school English programs. Second, logistic regression models indicated socioeconomic status, race/ethnicity, GATE-identification, gender, and eighth-grade English course enrollment were significant predictors of student enrollment in an accelerated or AP English class in high school. Third, chi-square analysis indicated that there was a significant association between a student’s eighth-grade English course label and their high school English course enrollment choices. Findings of this study suggest that detracking English classes at the middle school level represents an important stride forward in closing gaps in education.

Essentializing Happiness Mitigates the Changes in Subjective Well-Being Following Negative Life Events.

People hold different beliefs about the changeability of happiness. Some believe that happiness is biologically predetermined and thus unchangeable (essentialist beliefs), while others believe that it is malleable and can be changed (non-essentialist beliefs). Do these beliefs have a tangible impact on how individuals actually experience well-being? Here, we predict and empirically demonstrate that endorsing essentialist beliefs about happiness (EBH) can result in a self-fulfilling prophecy that buffers the changes in subjective well-being (SWB) following life events. Through a series of four studies utilizing diverse methodologies (total N = 7,364), we provide converging evidence that happiness essentialists, compared to non-essentialists, experience relatively stable levels of SWB following life events, particularly negative ones. We find that this pattern also emerges when people recall past events or anticipate hypothetical or impending future events. Together, happiness essentialism extends beyond mere belief and has real-world implications for how individuals experience fluctuations in SWB.

Антиутопии как «самосбывающиеся пророчества» об использовании технологий искусственного интеллекта в информационной войне

The article defines and demonstrates the predictive potential of literary anti-utopias as “self-fulfilling prophecies” describing certain aspects of artificial intelligence technologies and the risks of their application in the context of one of the key threats of technological development of digital society accompanying the global crisis – fifth-generation information warfare. For the first time the texts of literary anti-utopias are scientifically actualised and socio-philosophically and discursively analysed to identify the risks of AI application in modern information warfare. Two groups of risks related to the development of artificial intelligence technologies, in general, and their application in the sphere of information warfare are presented and described from the perpective of modern information warfare. The author concludes that most of the risks described in anti-utopias have come true or are currently coming true, thus demonstrating that the potential of literary anti-utopias is that they not only identify risks, but also, as “self-fulfilling prophecies”, represent possible and realised consequences of the technological development of digital society. Accordingly, they fulfil a prognostic and preventive function. The results of this article can be used to develop appropriate measures in the socio-political sphere, as well as to inform the public about the threats of modern information warfare, including the application of artificial intelligence technologies in this sphere.

Palliative Care and the Self-Fulfilling Prophecy in Stroke Patients: is There Anything to Fear? A Retrospective Study of Patients Who Died During Hospitalization in a Quaternary Care Hospital

Background and Purpose Primary palliative care (PC) aims to improve the quality of life for patients with acute ischemic stroke but is often misinterpreted as withdrawal of care. The self-fulfilling prophecy withdrawal bias is feared in this context of PC’s early implementation. This study evaluates stroke patients who died in the hospital to determine the impact of PC evaluation. Methods A retrospective descriptive analysis of patients who died from acute ischemic stroke was conducted. The study included patients aged ≥18 years admitted to the Stroke Unit of a quaternary hospital in Brazil from January 2017 to December 2018. The impact of PC assessment on outcomes was analyzed, with significance set at 5%. Results Among the patients who died during hospitalization as a result of an ischemic stroke (n = 77), 39 (%) were assessed by the palliative care team. There was no difference in the total length of stay or duration of antibiotic therapy. Logistic regression corrected for significant variables from the univariate analysis revealed that PC evaluation was associated with a 31-fold increase in opioid use ( P < 0.001), a nearly 14-fold increase in discharges to the ward, and a threefold reduction in ICU length of stay ( P = 0.011). Conclusion PC team involvement was associated with higher rates of discharge to the floors, inferring more time spent with family and increased opioid use, suggesting better symptom control, without reducing the overall length of stay or duration of antibiotic therapy. This underscores that PC does not equate to withdrawal of care.

Performance of the ERC/ESICM-recommendations for neuroprognostication after cardiac arrest: Insights from a prospective multicenter cohort

AimTo investigate the performance of the 2021 ERC/ESICM-recommended algorithm for predicting poor outcome after cardiac arrest (CA) and potential tools for predicting neurological recovery in patients with indeterminate outcome. MethodsProspective, multicenter study on out-of-hospital CA survivors from 28 ICUs of the AfterROSC network. In patients comatose with a Glasgow Coma Scale motor score ≤3 at ≥72 h after resuscitation, we measured: (1) the accuracy of neurological examination, biomarkers (neuron-specific enolase, NSE), electrophysiology (EEG and SSEP) and neuroimaging (brain CT and MRI) for predicting poor outcome (modified Rankin scale score ≥4 at 90 days), and (2) the ability of low or decreasing NSE levels and benign EEG to predict good outcome in patients whose prognosis remained indeterminate. ResultsAmong 337 included patients, the ERC-ESICM algorithm predicted poor neurological outcome in 175 patients, and the positive predictive value for an unfavourable outcome was 100% [98–100]%. The specificity of individual predictors ranged from 90% for EEG to 100% for clinical examination and SSEP. Among the remaining 162 patients with indeterminate outcome, a combination of 2 favourable signs predicted good outcome with 99[96–100]% specificity and 23[11–38]% sensitivity. ConclusionAll comatose resuscitated patients who fulfilled the ERC-ESICM criteria for poor outcome after CA had poor outcome at three months, even if a self-fulfilling prophecy cannot be completely excluded. In patients with indeterminate outcome (half of the population), favourable signs predicted neurological recovery, reducing prognostic uncertainty.

The self-fulfilling prophecy in medicine

This article first describes the mechanism of any self-fulfilling prophecy through discussion of its four conditions: credibility, employment, employment sensitivity, and realization. Each condition is illustrated with examples specific to the medical context. The descriptive account ends with the definition of self-fulfilling prophecy and an expansion on collective self-fulfilling prophecies. Second, the normative account then discusses the moral relevance of self-fulfilling prophecies in medicine. A self-fulfilling prophecy is typically considered problematic when the prediction itself changes the predicted outcome to match the prediction (transformative self-fulfillment). I argue that also self-fulfilling prophecies that do not change the outcome but change the ways in which the outcome was realized (operative self-fulfillment), have significant ethical and epistemic ramifications. Because it is difficult to distinguish, retrospectively, between a transformative and an operative self-fulfilling prophecy, and thus between a false or true positive, it becomes equally difficult to catch mistakes. Moreover, since the prediction necessarily turns out true, there is never an error signal warning that a mistake might have been made. On the contrary, accuracy is seen as the standard for quality assurance. As such, self-fulfilling prophecies inhibit our ability to learn, inviting repetition and exacerbation of mistakes. With the rise of automated diagnostic and prognostic procedures and the increased use of machine learning and artificial intelligence for the development of predictive algorithms, attention to self-fulfilling feedback loops is especially warranted. This account of self-fulfilling prophecies is practically relevant for medical research and clinical practice. With it, researchers and practitioners can detect and analyze potential self-fulfilling mechanisms in any medical case and take responsibility for their ethical and epistemic implications.

A Self-Fulfilling Prophecy Pandemic: The 1977 “Russian flu”

A Self-Fulfilling Prophecy Pandemic: The 1977 “Russian flu”

Predicting student success with and without library instruction using supervised machine learning methods

PurposeThe main purpose of this analysis was to demonstrate the value of predictive modeling of student success and identify the key groups of students for which library instruction could provide the most impact.Design/methodology/approachData regarding the attendance of library instruction associated with a first-year writing course were combined with student demographic and academic data over a four year period representing over 10,000 students. We applied supervised machine learning methods to determine the most accurate model for predicting student outcomes, including course outcome, persistence and graduation. We also assessed the impact of library instruction on these outcomes.FindingsThe gradient-boosted decision tree model provided the most accurate predictions. The impact of library instruction was modest but still was second only to the previous grade point average (GPA). The value of this metric, however, was greatest for students who were struggling, especially those who were first-generation students, regardless of ethnicity. More notably, the impact of library instruction was substantially greater for specific student demographics, including students with lower cumulative GPAs.Research limitations/implicationsFeatures of the models were limited to high-level academic metrics, some of which may not be very useful in predicting outcomes. Measures more closely related to learning styles, the course or course of study could provide for greater accuracy.Practical implicationsPrediction modeling could allow for a more selective approach to outreach and offers information that the librarian can use to customize instruction sessions and reference interactions.Social implicationsTargeting students who may be at risk of not succeeding in a course has ethical implications either way. If used to bias the subjective assessments, these predictions could produce self-fulfilling prophecies. Conversely, to ignore indicators of possible difficulties the student may have with the material is a disservice to the education of that student.Originality/valueThere are few studies that have incorporated library instruction into models of predicting student outcomes. Library resources and services can play a major role in the success of students, particularly those who have had less exposure to the resources and skills needed to use these resources.

Civilizations at Odds: The Persistent Conflict Between Israel and Palestine

The question whether the issues in the Middle East stem from a clash of values or from Western imperialist intervention has long been a subject of scholarly discourse. This article posits around the discourse of ‘clash of civilizations’, which is an endeavor to uphold Western hegemony in the Middle East. Furthermore, it contends the narrative, that it functions as a self-fulfilling prophecy, exacerbating ongoing conflicts within the region. A complex interplay of factors encompassing ethnic, national, historical, and religious shapes the Israeli-Palestinian conflict. The degree to which religion influences non-religious players, the identities of conflicting parties, the practical issues at hand, the relevant legislation, and their attitudes are not well acknowledged. This paper explains why West uses a distorted portrayal of conflicting civilizations as a powerful political tool and the risk of this narrative becoming a self-fulfilling prophecy that reshapes modern politics.

Can names shape facial appearance?

Our given name is a social tag associated with us early in life. This study investigates the possibility of a self-fulfilling prophecy effect wherein individuals' facial appearance develops over time to resemble the social stereotypes associated with given names. Leveraging the face-name matching effect, which demonstrates an ability to match adults' names to their faces, we hypothesized that individuals would resemble their social stereotype (name) in adulthood but not in childhood. To test this hypothesis, children and adults were asked to match faces and names of children and adults. Results revealed that both adults and children correctly matched adult faces to their corresponding names, significantly above the chance level. However, when it came to children's faces and names, participants were unable to make accurate associations. Complementing our lab studies, we employed a machine-learning framework to process facial image data and found that facial representations of adults with the same name were more similar to each other than to those of adults with different names. This pattern of similarity was absent among the facial representations of children, thereby strengthening the case for the self-fulfilling prophecy hypothesis. Furthermore, the face-name matching effect was evident for adults but not for children's faces that were artificially aged to resemble adults, supporting the conjectured role of social development in this effect. Together, these findings suggest that even our facial appearance can be influenced by a social factor such as our name, confirming the potent impact of social expectations.

The affective and relational correlates of algorithmic beliefs among U.S. online daters: Extension of two previous studies

Previous studies have forwarded a self-fulfilling prophecy explanation for how algorithmic beliefs may shape affective and relational outcomes of online dating (Hu & Rui, 2023; Sharabi, 2021). The current work examined this self-fulfilling prophecy explanation by investigating relevant online dating correlates of algorithmic beliefs. Secondary analyses were conducted on data from a nationally representative sample of U.S. adults (N = 6034) with model comparison procedures. Collectively, results showed that, among currently single relationship-seeking online daters, algorithmic beliefs were negatively related to online dating disappointment; However, findings for online dating excitement were mixed. Additionally, among past online daters, algorithmic beliefs were positively related to being in a relationship with someone they met in online dating. Consistencies and differences between the current findings and previous findings were discussed to offer theoretical and practical implications.

Refining the prevalence inflation hypothesis: Disentangling overinterpretation from self-fulfilling prophecies

The prevalence inflation hypothesis suggests that mental health awareness efforts can lead to an increase in rates of mental illness, first because awareness efforts encourage individuals with subclinical levels of distress to see their problems as mental illnesses (“overinterpretation”), and second because these individuals may then think and act in ways that promote actual mental illness (“self-fulfilling prophecy”). In this discussion paper, I argue that these two components are best understood—and best studied—as two distinct hypotheses. I present each hypothesis, discuss early evidence regarding each one, and outline the benefits of studying them independently.

Self-fulfilling prophecy in livelihood sustainability: Rural tourism in Pingqian Village, China

This study proposes a conceptual model of villagers' risk perceptions of poverty recurrence. Integrating the sustainable livelihoods framework (SLF) with the concept of self-fulfilling prophecy, the study employed a mixed-method approach in the empirical analyses using data collected over four years in Pingqian Village, China. The study revealed that rural tourism empowered the villagers to improve their physical and financial capital by reducing dependence on cropland. However, interactive vulnerabilities can significantly impact their risk perceptions of poverty recurrence, thus shaping their behaviors in investment decisions and business operations in rural tourism. This raises concerns about potential overreliance on tourism in rural communalities that may undermine sustainability goals. In practical terms, the study presents a mechanism to monitor villagers’ risk perceptions of poverty recurrence at different risk levels. The conceptual and empirical results enrich the SLF and sustainability literature and practice by highlighting the bidirectional relationship between vulnerabilities and livelihood assets.

Self-fulfilling Prophecy and Muslim Radicalization: Cases of France and the United States

This paper investigates the relationship between radicalization and self-fulfilling prophecy, focusing on the Western contexts with case studies from France and the United States. In France, historical marginalization and "symbolic ghettoization" of Muslim immigrants created an "in-group" versus "out-group" dynamic, intensified by political actions and media portrayals, leading to alienation and radicalization among young Muslim men. Similarly, in the United States, conservative media narratives post-9/11 have portrayed Muslims as threats, influencing public opinion and policy decisions, and setting the stage for potential future radicalization. The paper emphasizes the formation of these restrictive identities pushes marginalized individuals towards radicalism, underscoring the need to reject prejudices for effective radicalization mitigation. It warns of the dangers of symbolic segregation, highlighting the importance of understanding and addressing self-fulfilling prophecies in political and media discourse to combat radicalization in contemporary societies.

Epilepsy, Antiepileptic Drugs, and Adverse Pregnancy Outcomes, 1: Examination and Interpretation of Recent Research.

The age-standardized global prevalence of epilepsy is about 0.3% in women. Seizures are associated with morbidity and mortality risks; so, women with epilepsy (WWE) are usually advised antiepileptic drug (AED) treatment even during pregnancy. Women may also knowingly or unknowingly be exposed during pregnancy to AEDs advised for other on- or off-label indications. In this context, a meta-analysis of 35 adverse gestational outcomes examined in 76 observational studies found that WWE were at increased risk of most of the adverse outcomes, regardless of gestational exposure to AEDs. AEDs, especially in polytherapy, further increased at least a few of the gestational risks, including risks of congenital conditions, neonatal intensive care unit admission, small for gestational age, low birth weight, and neonatal/infant death (it is unclear whether the lack of statistical significance for the remaining risks was because AED exposure was truly limited to these risks or whether the nonsignificant analyses were underpowered). Reassuringly, the increases in risk were mostly in the small to modest range. This meta-analysis pooled unadjusted risks (which would probably be larger than adjusted risks), so readers are informed about expected findings in the population but not about cause-effect relationships that may be cautiously hypothesized from adjusted analyses. A take-home message is that, because of the wide range of outcomes for which risk is increased, WWE should be closely monitored and followed all through pregnancy, regardless of treatment with AEDs. This article also provides readers with suggestions on how to critically interpret literature with regard to 8 matters: confounding by indication and confounding by severity of indication, as specific to the indication for AED prescription; unadjusted and adjusted analyses; the base rate of an outcome in the population; the examination of multiple outcomes; the uniform direction of findings; the sample numbers; the timing of AED exposure; and self-fulfilling prophecies.

A Self-Fulfilling Prophecy Pandemic: The 1977 "Russian Flu".

Surprisingly, the 1977 "Russian flu" H1N1 pandemic influenza virus was genetically indistinguishable from strains that had circulated decades earlier but had gone extinct in 1957. This essay puts forward the most plausible chronology to explain the reemergence of the 1977 H1N1 pandemic virus: (1) in January-February 1976, a self-limited small outbreak of a swine H1N1 influenza virus occurred among Army personnel at Fort Dix, New Jersey; (2) in March 1976, the US launched a nationwide H1N1 swine influenza vaccine program; (3) other countries then also launched their own H1N1 R&D efforts; (4) a new H1N1 outbreak, genetically unrelated to the Fort Dix swine virus but indistinguishable from previously extinct H1N1 viruses, was detected early in 1977 in China; (5) the leading Chinese influenza virologist later disclosed that the Chinese military had conducted large H1N1 vaccine R&D studies in 1976. It is likely that the resurrected H1N1 influenza viruses were laboratory-stored strains that were unfrozen and studied as part of the emergency response to a perceived epidemic threat, and that accidentally escaped. The fear of a possible H1N1 pandemic was the critical factor that gave rise to the actual H1N1 pandemic, resulting in an avoidable "self-fulfilling prophecy pandemic."

Hard-to-reach schools? Discrimination experienced by parents with a migrant background. A participatory research approach

ABSTRACT This study investigated the discrimination experienced by parents with a migrant background in German schools. For this, we shifted the perspective from speaking about to speaking with parents using the critical incident technique as a participatory research approach. The sample included 40 parents from 20 countries of origin, with different languages of origin who had lived in Germany for between two and ten years. The most frequently reported experiences were of low expectations of competence, stereotypical attributions and the deliberate withholding of information. Parents described the pathologising of behaviours due to their family backgrounds that was equated with problem behaviour and the need for treatment. Additionally, school staff alleged that parents were unable or unwilling to support their children in academic matters, giving their ‘migrant status’ as justification. Schools did not offer opportunities for clarification or made it a requirement to seek expert opinion on a child’s mental health before providing opportunities for clarification. Further discriminatory effects, such as the outcomes of self-fulfilling prophecies; feelings of humiliation, helplessness and exclusion; and the fear of being disadvantaged, became evident, which exhausted families mentally and physically. The discussed implications aim at establishing concepts that raise awareness of discrimination and the consequences.

Multimodal assessment improves neuroprognosis performance in clinically unresponsive critical-care patients with brain injury

Accurately predicting functional outcomes for unresponsive patients with acute brain injury is a medical, scientific and ethical challenge. This prospective study assesses how a multimodal approach combining various numbers of behavioral, neuroimaging and electrophysiological markers affects the performance of outcome predictions. We analyzed data from 349 patients admitted to a tertiary neurointensive care unit between 2009 and 2021, categorizing prognoses as good, uncertain or poor, and compared these predictions with observed outcomes using the Glasgow Outcome Scale–Extended (GOS-E, levels ranging from 1 to 8, with higher levels indicating better outcomes). After excluding cases with life-sustaining therapy withdrawal to mitigate the self-fulfilling prophecy bias, our findings reveal that a good prognosis, compared with a poor or uncertain one, is associated with better one-year functional outcomes (common odds ratio (95% CI) for higher GOS-E: OR = 14.57 (5.70–40.32), P < 0.001; and 2.9 (1.56–5.45), P < 0.001, respectively). Moreover, increasing the number of assessment modalities decreased uncertainty (OR = 0.35 (0.21–0.59), P < 0.001) and improved prognostic accuracy (OR = 2.72 (1.18–6.47), P = 0.011). Our results underscore the value of multimodal assessment in refining neuroprognostic precision, thereby offering a robust foundation for clinical decision-making processes for acutely brain-injured patients. ClinicalTrials.gov registration: NCT04534777.

Unfair heuristics and treatment: the self-affirming effects of feeling depleted and anticipating the worst

PurposeThis research examines the extent overall supervisor injustice reduces self-control resources while simultaneously enhancing anticipatory injustice beliefs. Minimized self-control resources, in turn, are expected to alter the anticipatory supervisor injustice beliefs’ impact on subsequent unjust encounters. Self-control resources therefore act as boundary conditions in the continued receipt of unjust treatment, potentially highlighting Pygmalion effects (self-fulfilling prophecies) connected with subordinates’ overall injustice judgments.Design/methodology/approachUsing a two-survey, time-separated design, we test our hypothesized model in structural equation modeling (SEM) in MPlus with a sample of 163 US-employed adults recruited through online panel services. Main, interactive, and conditional indirect effects were used to examine our proposed relationships.FindingsEmpirical results showed that lower self-control resources and higher ASI beliefs resulted from subordinates holding high overall supervisor injustice judgments. Further, ASI beliefs were found to only explain the relationships of overall supervisor injustice with interpersonal injustice encounters, not informational justice encounters. This effect emerged when the subordinate’s self-control resources were low, not high.Originality/valueThis paper integrates fairness heuristics and ego depletion theories to highlight a previously understudied phenomenon–Pygmalion effects (e.g. expectations or anticipations becoming reality) pertaining to subordinates who hold high overall supervisor injustice judgments. The theoretical contribution and results offer a tantalizing lens regarding how anticipation may adversely affect future supervisor-subordinate interactions.