Family Impact of Tourette's Syndrome

Tourette's syndrome (TS) is a neuropsychological disorder characterized by vocal and motor tics. TS is also associated with several behavior disorders such as Attention Deficit Hyperactivity Disorder, Oppositional Defiant Disorder, conduct disorder, and Obsessive-Compulsive Disorder. We examined the impact of Tourette's syndrome with and without comorbid psychiatric disorders on the family. TS complicated by comorbid disorders had a greater impact on the family than uncomplicated TS. Tourette's symptom severity was significantly correlated with the level of impact on the family and with the number of comorbid disorders. TS is a disorder with effects that extend beyond motor and vocal tics.     

When hoarding is a symptom of OCD: A case series and implications for DSM-V

Hoarding, the excessive collection and failure to discard objects of apparently little value, can represent a serious psychiatric problem and pose a threat to public health. Hoarding has traditionally been considered a symptom (or symptom dimension) of Obsessive-Compulsive Disorder (OCD), but its nosological status has recently been debated. Mounting evidence suggests that, once other primary causes are ruled out, hoarding may be a discrete diagnostic entity, recently named Hoarding Disorder. However, hoarding can sometimes be a genuine OCD symptom. This can be confusing and clinicians may sometimes struggle making the differential diagnosis. To illustrate this, we describe 10 OCD patients with severe hoarding behavior that is better conceptualized as a symptom of OCD. We focus on the motivations for hoarding and the overlapping of hoarding with other obsessive-compulsive symptom dimensions. We estimate that this clinical presentation is relatively rare and accounts for a minority of severe hoarding cases. We discuss the unique characteristics of hoarding as a symptom of OCD and the implications for DSM-V.     

Symmetry, ordering and arranging compulsive behaviour

Compulsive ordering and arranging, and a preoccupation with symmetry are features of obsessive-compulsive disorder (OCD) that have not been examined experimentally. Three connected studies were conducted to examine this phenomenon: a self-report measure of this behaviour was developed and validated, participants were asked to engage in tasks designed to assess preferences for order, and to assess the interference of disorderly surroundings in the completion of a stressful activity. The self-report measure has sound psychometric properties and validity. Participants with a strong preference for order were made more anxious by having to complete a difficult task in a disorganized environment. Participants without this preference did not show this effect. The results are discussed in terms of the phenomenology of compulsive ordering and arranging, and its relationships with both OCD and normal human behaviour. It is suggested that compulsive ordering and a drive for symmetry are extreme manifestations of the common preference for order and symmetry.     

Media Violence and Freedom of Speech: How to Use Empirical Data

Susan Hurley has argued against a well known argument for freedom of speech, the argument from autonomy, on the basis of two hypotheses about violence in the media and aggressive behaviour. The first hypothesis says that exposure to media violence causes aggressive behaviour; the second, that humans have an innate tendency to copy behaviour in ways that bypass conscious deliberation. I argue, first, that Hurley is not successful in setting aside the argument from autonomy. Second, I show that the empirical data are irrelevant to statutory regulation of media violence. They do not yield a sufficiently strong correlation between exposure to media violence and non-autonomously copied criminal violence, and they do not yield a way ex ante to individuate the viewers who will be affected by media violence.

Alief——影响心血管康复的潜在心理状态

心血管康复是涉及医学评价、处方运动、心血管危险因素矫正、教育、咨询和行为干预等的长期综合治疗程序,以改善心血管病的生理和心理状态,减少再次心肌梗死和猝死的危险,控制心血管症状,稳定或逆转动脉硬化过程和改善患者的心理和职业状态。心血管康复干预具体包括药物治疗、行为干预和心理介入等治疗。其中涉及一系列的心理-行为现象及概念。最近,心理医学领域提出了介于信念和想象的状态——Alief,这一具象派状态可以很好地解释与心血管康复相关的一些心理-行为现象,本文就此作一论述。     

Untangling the Debate: The Ethics of Human Enhancement

Human enhancement, in which nanotechnology is expected to play a major role, continues to be a highly contentious ethical debate, with experts on both sides calling it the single most important issue facing science and society in this brave, new century. This paper is a broad introduction to the symposium herein that explores a range of perspectives related to that debate. We will discuss what human enhancement is and its apparent contrast to therapy; and we will begin to tease apart the myriad intertwined issues that arise in the debate: (1) freedom & autonomy, (2) health & safety, (3) fairness & equity, (4) societal disruption, and (5) human dignity.

Need for speed: Evaluating slopes of OCD recovery in behavior therapy enhanced with d-cycloserine

Evidence suggests that the antibiotic d-cycloserine (DCS) enhances the treatment effects of exposure and response prevention (ERP) for Obsessive-Compulsive Disorder (OCD). Further, evidence suggests that the effects of DCS diminish partway through treatment, but it is unclear to what extent. In an effort to evaluate these issues, the current study re-analyzes data from a 10-session randomized controlled trial of ERP + DCS versus ERP + placebo in a sample of 22 adults with OCD. We analyzed repeated-measures mixed models with random slopes and intercepts across different intervals: sessions 1-10, 1-5, and 6-10. The results indicate that the course of ERP was 2.3 times faster over the full 10 sessions for the DCS compared to the placebo group, and nearly six times quicker in the first half of ERP. Further interpretation of the results suggests that DCS does not amplify the effects of ERP, but instead initiates treatment effects sooner in treatment. In addition, DCS does not necessarily lose its effect over repeated use, but instead may exhaust its maximum utility after effectively jump-starting ERP. Ultimately, DCS may provide a means for curtailing treatment costs, decreasing treatment dropout and refusal rates, and enhancing access to care.     

Beliefs in conditionals vs. conditional beliefs

On the basis of impossibility results on probability, belief revision, and conditionals, it is argued that conditional beliefs differ from beliefs in conditionals qua mental states. Once this is established, it will be pointed out in what sense conditional beliefs are still conditional, even though they may lack conditional contents, and why it is permissible to still regard them as beliefs, although they are not beliefs in conditionals. Along the way, the main logical, dispositional, representational, and normative properties of conditional beliefs are studied, and it is explained how the failure of not distinguishing conditional beliefs from beliefs in conditionals can lead philosophical and empirical theories astray.

Effects of suppressing neutral and obsession-like thoughts in normal subjects: beyond frequency

Recent cognitive-behavioral theories on obsessive-compulsive disorder (OCD) show that deliberate attempts to suppress intrusive and undesirable thoughts lie at the genesis of clinical obsessions. In this paper the results of an experimental study on the suppression of neutral and obsession-like thoughts in normal subjects are presented. Eighty-seven university students performed in three experimental periods: (1) base-line monitoring, (2) experimental instruction, and (3) monitoring. For each of these periods, the frequency of the occurrence of a "white bear" thought or a personally relevant intrusive thought was registered. Half of the subjects received instructions to suppress the target-thought in period 2, and the other half were instructed to only monitor the target-thought in each of the experimental periods. Several measures were also obtained before and after the experiment: annoyance caused by the intrusion, suppression effort, subjective success, and evaluative appraisals of the target-thought. The results showed neither immediate nor delayed frequency increases of the target thought. However, evidence was found that deliberate thought suppression efforts, regardless of their content, had greater negative consequences than did non suppression. These results are discussed in relation to the recent cognitive proposals about OCD.     

精神自由与心灵自由——庄子与萨特自由精神之比较

庄子和萨特虽然都不约而同地呼唤自由,但他们关于自由的理念却是有很大的区别的。庄子的精神自由是消极的,萨特的心灵自由是积极的。庄子认为要想实现自由理想,就要顺任自然、“洗心去欲”;萨特则认为“人命定是自由”,实现自由理想,就是要让人认识到自己是自由的,勇于自我选择、自我造就、自我实现。     

Motor vehicle accident trauma exposure: Personality profiles associated with posttraumatic diagnoses

Abstract

Personality profiles associated with diagnostically distinct posttraumatic responses were examined. Profiles were compared between three groups defined on the basis of posttraumatic diagnosis following motor vehicle accident (MVA) trauma exposure. The diagnostic groups were: Posttraumatic Stress Disorder (PTSD), Acute Stress Disorder (ASD) without progression to PTSD, and subclinical responses. Participants were male and female community volunteers aged 18 to 77 (N = 83) who had all been exposed to an MVA meeting the DSM-IV diagnostic criteria for a traumatic event. The Personality Assessment Inventory (Morey, 1991) was used to assess psychological variables in the framework of posttraumatic diagnostic groups. The PTSD group scored significantly higher than the ASD and subclinical groups on scales assessing somatic complaints, anxiety, anxiety related disorders, depression, non-psychotic symptoms of schizophrenia, and negative relationships. The profile of the ASD group was characterized by self report of greater interpersonal warmth and a trend for greater egocentricity than the PTSD group. There were no significant differences in the personality profiles of the ASD and subclinical groups. The role of personality factors in posttraumatic adjustment is discussed in the context of previous literature.     

试论病人的自主性与医主之间的关系

病人具有自主性,应该受到医生的尊重。由于病人的自主性受到一些条件的限制,因而医主仍具有继续存在的价值。但是,除在一些特定情况下外,病人的自主性应优先于医主,然而医生又不能放弃自己的责任。     

The development of an autonomy scale

The purpose of this study was to develop a valid and relaible instrument to measure four areas of autonomy. The instrument is composed of four subscales that measure the following constructs of autonomy: (a) family loyalty autonomy, (b) value autonomy, (c) emotional autonomy, and (d) behavioral autonomy. A detailed four-step procedure was used to provide the scale with construct, content, and predictive validity. Presented here is the four-stage process used to develop the Autonomy Scale, data supporting the validity and reliability of the scale, and the final version of the instrument.This article is based on dissertation research in partial fulfillment of degree requirements at Texas Woman's University.     

The functional nature of conspiracy beliefs: Examining the underpinnings of belief in the Da Vinci Code conspiracy

Focusing on a contemporary conspiracy theory popularized in the novel The Da Vinci Code (Brown, 2002), we examined the underlying psychological factors and individual differences that may predict belief in conspiracy theories, and assessed such beliefs’ resistance to counterevidence. Our results suggest that belief in the Da Vinci Code conspiracy may be associated with coping with existential threat and death-related anxiety. In addition, the extent to which participants believed in the conspiracy was associated with the endorsement of congruent (New Age spiritual) and competing (Christian religious) beliefs, in opposite directions. Finally, exposure to counterevidence resulted in belief reduction, specifically among more religious participants (i.e. among those endorsing a competing belief system). We suggest that belief in modern conspiracy theories may help individuals attain or maintain a sense of meaning, control, and security.