The split professional identity of the chaplain as a spiritual caregiver in contemporary Dutch health care: are there implications for the United States?

The professional identity of the chaplain in Dutch health care institutions is in need of a new theoretical underpinning. The continued employment of the "spiritual caregiver," as the professional is called in the Netherlands, may be at stake. In former days, she or he was primarily a religious office holder fulfilling ecclesiastical functions. Against the background of secularization and individualization of religions and worldviews, the spiritual caregiver now turns more and more into an existential counselor, focusing on the search for meaning and life-orientation of all the clients/patients/residents, irrespective of their religion or philosophy of life. This brings along the need for a conceptualization of spiritual care. What is the spiritual caregiver's particular contribution to care and treatment, compared to that of, for instance, psychotherapists and social workers? What are the specific aims, methods, and key images of the profession? This brief communication sketches the specific context in which the Dutch spiritual caregiver has to work and the identity dilemmas he or she faces.     

Individual differences in generalization and imitation: what is the role of brain development?

Jones and Herbert describe research on deferred imitation and how this research reflects on the development of explicit memory in infancy. The article raises several interesting questions about how the medial temporal lobe memory system develops. In this commentary, I discuss some of the additional theoretical and empirical questions that are raised by the target article, and propose ways that these questions could be addressed in future research. Copyright © 2006 John Wiley & Sons, Ltd.     

Effectiveness and safety of epilepsy surgery: what is the evidence?

Evidence from a recent randomized controlled trial of surgical versus medical therapy of temporal lobe epilepsy proves that antero-mesial resection is safe and more effective than medical therapy. The number of patients needed to treat for one patient to become free of disabling seizures is two, which is superior to most interventions in neurology. A meta-analysis of non-randomized trials gives almost identical results; about two-thirds of patients become seizure-free, compared with only 8% with medical therapy. The results are remarkably similar among studies from different parts of the world. Quality of life improves early after epilepsy surgery, the improvements are both statistically and clinically significant, and they are sustained. Surgical morbidity with clinically important permanent sequelae is 2%. Epilepsy surgery remains underutilized in developed countries and it does not exist in all but a few developing countries. Current randomized trials are underway to explore the effect of early surgery versus optimum medical therapy on the prevention of disability in patients with mesial temporal lobe epilepsy, and to examine the effectiveness of novel interventions, such as minimally invasive surgery and brain stimulation.     

Children's memory of recurring events: is the first event always the best remembered?

Three experiments were conducted to examine the effect of age (4–5 and 6–8 years) and retention interval on children's ability to remember separate occurrences of a repeated event that varied in terms of content (items, dialog, etc.) Experiment 1 explored children's ability to recall the first versus last occurrence of a series of six events, at either one week or six weeks delay. Experiments 2 and 3 explored children's ability to identify the position of items in terms of their order of presentation within the series across two retention intervals. Overall, the results revealed clear age differences in children's performance. In general, the 6‐ to 8‐year‐old children performed better on all tasks than the 4‐ to 5‐year‐old children. Further, the older children showed relatively good memory of the first and last items compared to the middle items, although the last items were more likely to be forgotten or misplaced in the sequencing tasks over time than the first items. For the younger children, the patterns of results were sometimes but not always consistent with that of the older children. The relevance and generalisability of these findings to the legal setting are discussed as well as directions for future research. Copyright © 2002 John Wiley & Sons, Ltd.     

In what sense is the no-no paradox a paradox?

Philosophical Studies - Cook regards Sorenson’s so-called ‘the no-no paradox’ as only a kind of ‘meta-paradox’ or ‘quasi-paradox’ because the symmetry...     

Alexithymia in the interpersonal domain: A general deficit of empathy?

Alexithymia and empathy have been related but very little is known on shared variance between their respective affective and cognitive dimensions. We examined this question with correlations, as well as both exploratory and confirmatory analyses, and controlled for anxiety and depression. The responses of 645 young adults to self-report questionnaires of alexithymia (TAS-20), empathy (IRI), anxiety (STAI-T) and depression (BDI-13) were examined. We observed associations between the proposed cognitive components of alexithymia (externally-oriented thinking) and that of empathy (perspective taking, fantasy) as well as empathic concern, which were insensitive to anxiety or depression. In contrast, associations between the proposed affective components of alexithymia (difficulty identifying feelings, difficulty describing feelings) and empathy (personal distress) were largely due to shared covariance with anxiety. A model encompassing an affective and a cognitive (including empathic concern) latent factors emerged, even after controlling for dysphoric affects. These findings suggest specific associations between cognitive and affective components of both constructs that were dissimilarly affected by anxiety and depression. The allocation of empathic concern to the cognitive factor is also discussed.     

Transsaccadic representation of layout: what is the time course of boundary extension?

How rapidly does boundary extension occur? Across experiments, trials included a 3-scene sequence (325 ms/picture), masked interval, and repetition of 1 scene. The repetition was the same view or differed (more close-up or wide angle). Observers rated the repetition as same as, closer than, or more wide angle than the original view on a 5-point scale. Masked intervals were 100, 250, 625, or 1,000 ms in Experiment 1 and 42, 100, or 250 ms in Experiments 2 and 3. Boundary extension occurred in all cases: Identical views were rated as too "close-up," and distractor views elicited the rating asymmetry typical of boundary extension (wider angle distractors were rated as being more similar to the original than were closer up distractors). Most important, boundary extension was evident when only a 42-ms mask separated the original and test views. Experiments 1 and 3 included conditions eliciting a gaze shift prior to the rating test; this did not eliminate boundary extension. Results show that boundary extension is available soon enough and is robust enough to play an on-line role in view integration, perhaps supporting incorporation of views within a larger spatial framework.     

A confirmatory factor analysis on the DSM-IV ADHD and ODD symptoms: what is the best model for the organization of these symptoms?

Confirmatory factor analysis (CFA) was used to evaluate five different models for the organization of the DSM-IV ADHD and oppositional defiant disorder (ODD) symptoms (Model 1: a single factor model; Model 2: an ADHD and ODD two factor model; Model 3a: an inattention (INA), hyperactivity/impulsivity (HYP/IMP), and ODD three factor model; Model 3b: an INA, HYP/IMP, and ODD three factor model where the three IMP symptoms cross-load on the ODD factor; Model 4: an INA, HYP, IMP, and ODD four factor model). To evaluate these models, maternal ratings of ADHD and ODD symptoms were obtained at outpatient pediatric clinics on 742 children not in treatment and 91 children in treatment for ADHD. Model 3a resulted in a good fit as well as a significantly better fit than Model 2. Model 3a was also equivalent across treatment status, gender, and age groupings for the most part. Though Models 3b and 4 provided a statistically better fit than Model 3a, the improvement in fit was small and other model selection criteria argued against these more complex models.     

Influence of suggestion in the DRM paradigm: what state of consciousness is associated with false memory?

We assessed the effect of suggestion on the Deese–Roediger–McDermott paradigm and associated it with the Remember–Know–Guess paradigm. Undergraduate students were given either lists of semantically related words or texts containing these words. After the recall task, if participants did not produce the critical lure, the experimenter suggested that the word had been present, using either a question (moderate suggestion) or an assertion (strong suggestion); these conditions were compared to a condition without suggestion. Afterwards, participants took a recognition test. The results showed that strong suggestions lead to more false recognitions than other conditions and the state of consciousness associated with false recognitions tends to be a feeling of knowing rather than remembering, regardless of the verbal version (list or text). Therefore moderate suggestions did not lead to more false recognitions compare to no suggestion. We discuss the impact of suggestion on consciousness associated with false memories.     

Age rationing and the just distribution of health care: is there a duty to die?

The author analyzes the argument that a policy involving distributive justice in the allocation of scarce health care resources, based on the strategy of rational self interest maximation under a veil of ignorance (Rawls/Daniels), would result in an age rationing system of voluntary, socially encouraged, direct termination of the lives of the elderly rather than their medical abandonment. She maintains that such a policy would be a fair response only in a situation of substantial scarcity of resources that cannot be relieved without introducing greater injustices. Battin suggests that some of the current pressure on resources could be reduced by pruning waste and the expenses attributable to paternalistic imposition of treatment and to the practice of defensive medicine. She also advocates reconsideration of societal priorities assigned to various social goods.     

Batterer men in prison and in court-referred treatment programmes: what is the difference?

This paper describes the demographic, gender violence and psychopathological characteristics of 399 men in a specialized treatment programme for gender violence. Furthermore, a comparison of all the variables studied among the subjects referred by the court to the treatment programme (n = 276) and those who were imprisoned (n = 123) was conducted. The results showed the existence of numerous statistically significant differences between groups, primarily in psychopathological variables and in cognitive bias about women and violence use. In general, imprisoned batterers showed more irrational beliefs both about women and about violence as a strategy to cope with everyday difficulties. Moreover, batterers in prison had significantly higher scores on all psychopathological symptoms as assessed by SCL-90-R, as well as in most of STAXI-2 subscales. According to these results, batterers in prison showed a higher severity in variables studied than those who were referred by the court to the treatment programme. Implications of these results for further research and clinical practice are also commented on.     

Lipreading in the prelingually deaf: what makes a skilled speechreader?

Lipreading proficiency was investigated in a group of hearing-impaired people, all of them knowing Spanish Sign Language (SSL). The aim of this study was to establish the relationships between lipreading and some other variables (gender, intelligence, audiological variables, participants' education, parents' education, communication practices, intelligibility, use of SSL). The 32 participants were between 14 and 47 years of age. They all had sensorineural hearing losses (from severe to profound). The lipreading procedures comprised identification of words in isolation. The words selected for presentation in isolation were spoken by the same talker. Identification of words required participants to select their responses from set of four pictures appropriately labelled. Lipreading was significantly correlated with intelligence and intelligibility. Multiple regression analyses were used to obtain a prediction equation for the lipreading measures. As a result of this procedure, it is concluded that proficient deaf lipreaders are more intelligent and their oral speech was more comprehensible for others.     

What is the best and easiest method of preventing counting in different temporal tasks?

The aim of the present study was to determine the best and easiest method of suppressing spontaneous counting in a temporal judgment task. Three classic methods used to avoid counting—instructions not to count, articulatory suppression, and administration of an interference task—were tested in temporal generalization, bisection, and reproduction tasks with two duration ranges (1–4 and 2–8 s). All the three no-counting conditions prevented participants from counting, counting leading to estimates that were more accurate and less variable and to violations of the fundamental scalar property of timing. With regard to the differences between the no-counting conditions, the interference task distorted time perception more strongly and increased variability in temporal estimates to a greater extent than did articulatory suppression, as well as the no-counting instructions condition. In addition, articulatory suppression produced more noise in behavioral outcome than did the no-counting instruction condition. In sum, although all methods have disadvantages, the instructions not to count actually constitute the simplest and more efficient method of preventing counting in timing tasks. However, further studies must now concentrate on the role of explicit instructions in our experience of perception.     

Searching for Shereshevskii: what is superior about the memory of synaesthetes?

Some individuals with superior memory, such as the mnemonist Shereshevskii (Luria, 1968), are known to have synaesthesia. However, the extent to which superior memory is a general characteristic of synaesthesia is unknown, as is the precise cognitive mechanism by which synaesthesia affects memory. This study demonstrates that synaesthetes tend to report subjectively better than average memory and that these reports are borne out with objective testing. Synaesthetes experiencing colours for words show better memory than matched controls for stimuli that induce synaesthesia (word lists) relative to stimuli that do not (an abstract figure). However, memory advantages are not limited to material that elicits synaesthesia because synaesthetes demonstrate enhanced memory for colour per se (which does not induce a synaesthetic response). Our results suggest that the memory enhancement found in synaesthetes is related to an enhanced retention of colour in both synaesthetic and nonsynaesthetic situations. Furthermore, this may account for the fact that synaesthetic associations, once formed, remain highly consistent.     

Therapeutic tasks: what kind of help is sought in psychotherapeutic sessions?

One of the main conditions for a good psychotherapeutic alliance is the agreement on therapeutic tasks and goals. This article explores the kind of help that clients expect from therapeutic sessions. By means of a written questionnaire, the clients of a private psychotherapy center, prior to the sessions, expressed their priorities regarding the work to be carried out in them. The assessment of 873 questionnaires showed that clients prefer to participate in therapeutic work that helps them plan actions, understand what is happening, and assess possibilities for change. Also important are therapeutic tasks that help clients evaluate their own actions, both past and planned. The importance that clients attach to different kinds of help varies above all according to how near they feel to resolving their problems. Nine different kinds of psychotherapeutic tasks are identified, which cover the possible requests a client can make of his/her therapist. This article discusses the clinical application of this model as a basis for planning and classifying psychotherapeutic interventions.     

Orientation specificity in spatial memory: what makes a path different from a map of the path?

Three studies investigated the factors that lead spatial information to be stored in an orientation-specific versus orientation-free manner. In Experiment 1, we replicated the findings of Presson and Hazelrigg (1984) that learning paths from a small map versus learning the paths directly from viewing a world leads to different functional characteristics of spatial memory. Whether the route display was presented as the path itself or as a large map of the path did not affect how the information was stored. In Experiment 2, we examined the effects of size of stimulus display, size of world, and scale transformations on how spatial information in maps is stored and available for use in later judgments. In Experiment 3, we examined the effect of size on the orientation specificity of the spatial coding of paths that are viewed directly. The major determinant of whether spatial information was stored and used in an orientation-specific or an orientation-free manner was the size of the display. Small displays were coded in an orientation-specific way, whereas very large displays were coded in a more orientation-free manner. These data support the view that there are distinct spatial representations, one more perceptual and episodic and one more integrated and model-like, that have developed to meet different demands faced by mobile organisms.