Rethinking Medical Humanities

This paper questions different conceptions of Medical Humanities in order to provide a clearer understanding of what they are and why they matter. Building upon former attempts, we defend a conception of Medical Humanities as a humanistic problem-based approach to medicine aiming at influencing its nature and practice. In particular, we discuss three main conceptual issues regarding the overall nature of this discipline: (i) a problem-driven approach to Medical Humanities; (ii) the need for an integration of Medical Humanities into medicine; (iii) the methodological requirements that could render Medical Humanities an effective framework for medical decision-making.     

A Cross-Sectional and Longitudinal Investigation of the External Correlates of Sluggish Cognitive Tempo and ADHD-Inattention Symptoms Dimensions

The objective was to determine if the external correlates of sluggish cognitive tempo (SCT) and ADHD-inattention (IN) dimensions were the same in cross-sectional and longitudinal analyses. Teachers and aides rated SCT, ADHD-IN, ADHD-hyperactivity/impulsivity (HI), oppositional defiant disorder (ODD), and depression along with academic impairment in 758 Spanish children (55 % boys) on three occasions (twice at the end of the first grade year [6-week separation] and then again 12-months later at the end of the second grade year). Three of eight SCT symptoms showed substantial loadings on the SCT factor and substantially higher loadings on the SCT factor than the ADHD-IN factor for teachers and aides at each assessment (seems drowsy, thinking is slow, and slow moving). Cross-sectional and longitudinal analyses yielded similar results with SCT and ADHD-IN factors having different and unique external correlates (higher scores on SCT predicted lower scores on ADHD-HI and ODD while higher scores on ADHD-IN predicted higher scores on ADHD-HI and ODD with SCT and ADHD-IN both uniquely predicting academic impairment and depression). Developmental and methodological reasons are discussed for the failure to find an inconsistent alertness SCT factor (daydreams, alertness fluctuates, absent-minded, loses train of though, and confused).     

Commentary on Wolford,Taylor, and Beck: The conjunction fallacy?

AlthoughP(A&B|X) can never exceedP(A|X) (the conjunction rule), it is possible forP(X|A&B) to exceedP(X|A). Hence, people who rankA&B as more probable thanA are not necessarily violating any normative rule if the ranking is done in terms of the probability of these events to yield an eventX. Wolford, Taylor, and Beck (1990) have argued that this indeed is what happens in some problems (e.g. Tversky& Kahneman’s [1983] Linda problem). The claim made here is that the Linda problem is hard to reconcile with this interpretation; that there is little if any evidence that subjects utilize this interpretation; and that in any case, representativeness can account for all Linda problem results.     

Sinusoidal plucks and bows are not categorically perceived,either

Cutting and Rosner (Perception & Psychophysics, 1974,16, 564–570) reported that two acoustic nonspeech continua varying in rise time were categorically perceived. We have already shown (Rosen & Howell,Perception & Psychophysics, 1981,30, 156–168) that the reason their sawtooth continuum was perceived in such a way, and in particular why it exhibited a midcontinuum peak in the discrimination function, was entirely due to the stimuli not having the intended rise times. The other nonspeech continuum that varied in rise time and was reported to be categorically perceived used a sinusoidal carrier. Although the labeling functions obtained were not as sharp as those obtained with sawtooth stimuli, the characteristic midcontinuum discrimination peak was found. We generated such a set of sinusoidal stimuli and found no evidence of categorical perception. Just as we have previously found for sawtooth stimuli, discrimination is best at the short rise-time end of the continuum and decreases monotonically with increasing rise time.     

Maternal Relationship Insecurity and Depressive Symptoms as Moderators of Home Visiting Impacts on Child Outcomes

The purpose of this study was to determine the extent to which maternal relationship insecurity and severe depressive symptoms moderate home visiting impacts on developmental and behavioral outcomes in 2-year old children. In an experimental trial of the Healthy Families Alaska home visiting program, families (N = 249) were randomly assigned to home visiting (n = 126) or community services as usual (n = 123). Maternal severe depressive symptoms (CES-D ≥ 24) and relationship insecurity were measured using the Center for Epidemiologic Studies Depression Scale and the Attachment Style Questionnaire at baseline. Child cognitive and psychomotor development and behavior problems were measured with the Bayley Scales of Infant Development and the Child Behavior Checklist at follow-up. The results revealed that home visiting significantly impacted three outcomes—child cognitive development, internalizing behavior, and externalizing behavior. Home visiting impacts were limited to subgroups defined by maternal depressive symptoms and relationship insecurity. Home visiting improved cognitive development (B = 6.02, p < .03), and decreased internalizing behavior (B = ?3.83, p = .02) and externalizing behavior problems (B = ?3.74, p = .03) in children of mothers with either severe depressive symptoms or high levels of discomfort with trust at baseline, but not both. Family engagement in home visiting seems to play a role in mediating these moderating effects. These findings reflect the importance of screening for maternal relationship insecurity and depressive symptoms to distinguish family subgroups likely to benefit from home visiting from those for whom an enhanced service model might be needed.     

Middlesex: A Pastoral Theological Reading

This article, written for the Group for New Directions in Pastoral Theology’s conference on the theme of “Emotion, Mood, and Temperament,” focuses on Middlesex, a Pulitzer Prize-winning novel by Jeffrey Eugenides, Professor of Creative Writing in the Lewis Center for the Arts at Princeton University. The novel, set in 20th century America and written as a fictional memoir, is a coming-of-age story of Cal/Calliope, a man with an intersex condition caused by 5-alpha-reductase deficiency. The mission statement of the Intersex Society of North America (ISNA) states that the organization is “devoted to systemic change to end shame, secrecy, and unwanted genital surgeries for people born with an anatomy that someone decided is not standard for male or female.” This essay employs the resources of pastoral theology to assist in the project of ending shame regarding intersex conditions by offering a pastoral theological reading of Middlesex. As such, this essay is an example of the discipline of pastoral theology being employed in the field of medical humanities in particular and the field of clinical humanities more broadly, and it also serves as an example as to how one might offer a pastoral theological reading of a novel.     

Impact of Sluggish Cognitive Tempo and Attention-Deficit/Hyperactivity Disorder Symptoms on Adults’ Quality of Life

The symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD) have been linked to dysfunction in numerous life domains for both children and adults. As such, it is likely that individuals with these and other related symptoms (e.g., sluggish cognitive tempo, SCT) may also experience impaired quality of life. The current study examines the association between ADHD and SCT symptoms and quality of life (QOL) in a community sample of adults. Quality of life data collected from 983 participants (M age = 45.6 years) were analyzed primarily through a series of hierarchical multiple regressions employing SCT and ADHD symptom clusters, demographic, and anxiety and depression scale variables as predictors. Results generally supported the hypothesis that ADHD and SCT symptoms would negatively associate with QOL. Amongst the indicators, inattention and SCT emerged as the strongest predictors of low QOL. These findings underscore the negative impact of ADHD symptoms in adulthood, the independent contribution of SCT, and the importance of considering QOL in prospective research and intervention.     

Poor communication in psycholinguistics: Review of four new textbooks

Four new textbooks on psycholinguistics are reviewed:Psycholinguistics: A Cognitive View of Language by H. S. Cairns and C. E. Cairns;Experimental Psycholinguistics by S. Glucksberg and J. H. Danks;Psycholinguistics: Introductory Perspectives by J. F. Kess, andIntroduction to Psycholinguistics by I. Taylor. Three general issues about psycholinguistics are considered in detail: (1) Psycholinguists should attempt to provide psychological tests of competing linguistic theories. (2) More attention should be given by psycholinguists to the work done in the field of human information processing. (3) There is evidence for the Whorfian hypothesis, even in its strong version, at the phonetic level of language. It is concluded that improvement is needed in the communication between psycholinguistics and related disciplines and among the subdivisions of psycholinguistics.     

Causal Decision Theory and EPR correlations

The paper argues that on three out of eight possible hypotheses about the EPR experiment we can construct novel and realistic decision problems on which (a) Causal Decision Theory and Evidential Decision Theory conflict (b) Causal Decision Theory and the EPR statistics conflict. We infer that anyone who fully accepts any of these three hypotheses has strong reasons to reject Causal Decision Theory. Finally, we extend the original construction to show that anyone who gives any of the three hypotheses any non-zero credence has strong reasons to reject Causal Decision Theory. However, we concede that no version of the Many Worlds Interpretation (Vaidman, in Zalta, E.N. (ed.), Stanford Encyclopaedia of Philosophy 2014) gives rise to the conflicts that we point out.     

Fuzzy logic and approximate reasoning

The term fuzzy logic is used in this paper to describe an imprecise logical system, FL, in which the truth-values are fuzzy subsets of the unit interval with linguistic labels such as true, false, not true, very true, quite true, not very true and not very false, etc. The truth-value set, ?, of FL is assumed to be generated by a context-free grammar, with a semantic rule providing a means of computing the meaning of each linguistic truth-value in ? as a fuzzy subset of [0, 1]. Since ? is not closed under the operations of negation, conjunction, disjunction and implication, the result of an operation on truth-values in ? requires, in general, a linguistic approximation by a truth-value in ?. As a consequence, the truth tables and the rules of inference in fuzzy logic are (i) inexact and (ii) dependent on the meaning associated with the primary truth-value true as well as the modifiers very, quite, more or less, etc. Approximate reasoning is viewed as a process of approximate solution of a system of relational assignment equations. This process is formulated as a compositional rule of inference which subsumes modus ponens as a special case. A characteristic feature of approximate reasoning is the fuzziness and nonuniqueness of consequents of fuzzy premisses. Simple examples of approximate reasoning are: (a) Most men are vain; Socrates is a man; therefore, it is very likely that Socrates is vain. (b) x is small; x and y are approximately equal; therefore y is more or less small, where italicized words are labels of fuzzy sets.     

Pharmacological analysis of conditioning in sensorimotor cortex neurons in a model

In awake mobile rabbits, with electrodes implanted in the medial lemniscus, midbrain tegmental reticular nucleus, and pyramidal tract, combined stimulation of two brain structures resulted in elaboration of conditional connections in sensorimotor cortex neuronal populations. The main criterion of the conditioning was the appearance of changes in the neuronal activity on omission of the second stimulus. These changes represented a complex of electrical events, some of which were similar to and others different from the evoked responses to the second stimulus. Application of atropine, sulfate, chlorpromazine hydrochloride, serotonin creatinine sulfate, andγ-aminobutyric acid (GABA) to the cortex at the site of the recording exerted a modulating effect on the conditional neuronal activity patterns. Of the above substances, GABA and atropine had the most pronounced effect. The GABA removed the short-latency components of the conditional changes which were similar to evoked responses. The atropine abolished the long-latency changes which differed from evoked responses.     

Comparison of Peabody,Leiter, WISC,and academic achievement scores among emotionally disturbed children

The present study examined the utility of employing tests such as the PPVT and the AALIPS as viable alternatives to the WISC in the prediction of academic achievement with emotionally disturbed children. The three IQ instruments and the California Achievement Test were administered to a group of 50 male emotionally disturbed children. Intercorrelations among the three tests were all significant and all three successfully predicted academic achievement. However, both the PPVT and the AALIPS consistently resulted in higher IQ estimates than did the WISC. Results supported the use of the PPVT and the AALIPS as equally viable alternatives to the more comprehensive WISC.     

Evidence-Based Assessment in Children and Adolescents with Obsessive–Compulsive Disorder

The assessment of varied psychiatric disorders, including obsessive–compulsive disorder (OCD), is shifting towards the use of evidence-based assessments (EBAs). This shift has fostered the development, validation and adaptation of several measures to rate obsessive–compulsive symptoms and other related problematic areas such as functional impairment or family attitudes among others. The aim of this paper is to present a systematic review of psychometric studies on pediatric OCD-specific measures to classify these according to assessment evidence-based criteria. Selection criteria that determined which studies were included in the review were: (1) analyzing an OCD measure and (2) including participants’ age being 18 years or younger. The literature search procedure was conducted in Medline, PsycINFO, PsycARTICLES, ERIC, Cochrane Library, and Scholar Google databases and enabled us to locate 42 studies which analyzed psychometric properties of 14 OCD measures studied in children and adolescents. Instruments were grouped into the following assessment areas: symptom presence and severity, functional impairment, family functioning and cognitive dimensions of OCD. Psychometric data regarding internal structure, internal consistency, reliability, validity and diagnostic precision were also reported. Further, measures were classified as well-established, approaching well-established and promising assessments in terms of reliability and validity. We concluded that the assessment of OCD in pediatric populations is a growing field that in a short-medium term could provide a wide variety of EBAs for the evaluation obsessive–compulsive symptoms and other OCD-related dimensions. The paper concludes by highlighting directions for future research.     

Examining the Internal Consistency Reliability and Construct Validity of the Authentic Happiness Inventory (AHI) among Iranian EFL Learners

Unlike other measures of happiness that have tended to capture current levels of happiness, the Authentic Happiness Inventory (AHI) (Peterson, 2005; Seligman et al. in The American Psychologist 60:410–421, 2005) assesses changes in happiness based on the creation of positive emotions (the pleasant life), engagement in activities that facilitate the utilization of one’s strengths (the engaged life), and serving a more worthwhile purpose than merely the self’s pleasures (the meaningful life). Nonetheless, there is little published data regarding the construct validation of the AHI. The present study, which is part of a larger research project in assessing the effectiveness of integrating happiness intervention programs in the foreign language teaching curriculum at private English institutes and universities in Iran, attempts an examination of the psychometric quality and the construct validation of the Persian version of AHI (hereafter AHI-PV) using data collected from 234 Iranian learners of English as a Foreign Language (EFL), mainly through employing the Exploratory Factor Analysis (EFA). The AHI was translated into Persian to ensure item comprehension by the Iranian participants. The results show that the AHI-PV enjoys a high internal consistency (alpha?=?.93). Further, having determined a ‘marvelous’ factorability of the present sample through the Kaiser-Meyer-Olkin (KMO) test of Sampling Adequacy (.94) and Bartlett’s Test of Sphericity (p?Principal Component Analysis (PCA) and the Scree test indicated that, in contrast to earlier findings, a four-factor solution provides a more parsimonious grouping of the items in the inventory. Having analyzed the items on the scale, we labeled the four factors as ‘Meaningful and Purposeful Life’, ‘Pleasures and Positive Emotions’, ‘Engagement in Life Activities’, and ‘Interpersonal Connectedness’, hence the alignment of these new factors to Seligman’s (2002) conceptualization of authentic happiness.     

Promotion of Sexual Health and Sexual Responsibility in Women’s Health and Men’s Health Magazines

This study analyzed the promotion of sexual health and sexual responsibility in Women’s Health and Men’s Health magazines as characterized by the Surgeon General’s Call to Action along with sexual health objectives targeted by Healthy People 2020 and sexual healthy behavior outcomes established by the Centers for Disease Control and Prevention. This study also identified the most frequently addressed sexual health topics included in Women’s Health and Men’s Health. Two coders conducted a content analysis of a total of 599 articles from 64 issues (32 Women’s Health and 32 Men’s Health) published between January 2009 and November 2012. More than half of all articles addressing sexual health were found to promote sexual health (57 %). Promotion of sexual responsibility was rare with variables such as ensuring that pregnancy occurs only when desired, recognition and tolerance for diversity, limiting the number of sexual partners, and using birth control consistently each mentioned in <3 % of articles in this study sample. Among topics coded, improving sex life (29 %), what men like (19 %), and what women like (18 %) were the most common in Women’s Health while What women like (46 %), improving sex life (27 %), and other men’s sexual health (16 %) were the most frequent topics in Men’s Health. Among the least common topics mentioned were homosexuality (0.16 %) and HIV/AIDS (0.33 %). No articles addressed rape or dating violence.     

Stability and Change of ODD,CD and ADHD Diagnosis in Referred Preschool Children

Longitudinal studies have shown that preschool children’s diagnosis of Oppositional Defiant Disorder (ODD), Conduct Disorder (CD) and Attention-Deficit/Hyperactivity Disorder (ADHD) are likely to persist into school age. However, limited attention has been paid to instability of diagnosis. The aim of the present study, therefore, was to investigate both stability and change of ODD, CD and ADHD diagnosis in children aged 3.5–5.5 years. For diagnosing these disorders, a semi-structured diagnostic parent interview, i.e., the Kiddie-Disruptive Behavior Disorder Schedule (K-DBDS), was used at the first assessment and at follow-up assessments (9 and 18 months). Five diagnostic stability groups (chronic, partial remission, full remission, new onset, no diagnosis) were compared with regard to impairment and number of symptoms. Participants were referred preschool children with externalizing behavioral problems (N?=?193; 83 % male) and typically developing (TD) children (N?=?58; 71 % male). Follow-up assessments allowed to distinguish children belonging to the chronic group of ODD, CD or ADHD from those belonging to one of the remission groups. In addition, there was a substantial number of children with a new onset diagnosis. In conclusion, as a complement to studies showing stability of ODD, CD and ADHD diagnosis into school age, present findings point to changes of diagnosis in the preschool and early school period. Diagnostic reassessments therefore are needed in this age group.     

Psychosocial development and friendship functions in adolescence

This study concerns the relationship between friendship variables and adolescent psychosocial development, in particular identity and psychosocial intimacy as envisaged by E. Erikson [(1950), Childhood and Society, New York: Norton; (1968), Identity: Youth and Crisis, New York: Norton]. Two hundred and twenty-three secondary school and college students were surveyed regarding friendship networks, beliefs about friendship, functions of friendship in general, and aspects of a best friendship. Intimacy and identity measures were obtained using the Erikson Psychosocial Stage Inventory [D. Rosenthal, R. Gurney, and S. Moore (1981), “From Trust to Intimacy: A New Measure for Examining Erikson's Stages of Psychosocial Development,” Journal of Youth and Adolescence, Vol. 10, pp. 525–537]. Four developmental style groups (Dual High Scorers, High Identity, High Intimacy, and Dual Low Scorers) were formed from these measures. There were no differences between the sexes in their choice of developmental style. Those in the high-identity-high-intimacy and the high-identity-low-intimacy groups were more satisfied with their friendships, which appeared affectively richer. Sex differences showed that while friendship variables were more strongly associated with development for boys, girls viewed their relationships as closer and ascribed more importance to this closeness.