Is continence enough?

The ideal of virtue demands not only right choice and right behavior but also right desire in the emotions. Homosexual desire, then, even if it does not result in overt homosexual behavior, is contrary to virtue, and the completion of virtue demands right desire. If a homosexual has no plan to marry, then right desire implies only the removal of homosexual desire and not the revival of heterosexual desire at which reorientation therapy aims. On the other hands, if a homosexual is married or plans to marry, then right desire includes heterosexual desire for one's spouse. If homosexual desire is viewed as an emotional disorder, and not merely as a moral defect, then it may require reorientation therapy to bring about heterosexual desire. The pursuit of virtue, then, may recommend reorientation therapy, but even this recommendation is fairly limited, since reorientation therapy may be burdensome and may not be that effective. In conclusion, married homosexuals or homosexuals planning to marry may have a limited moral obligation to pursue reorientation therapy.     

The clinical psychologist as program consultant: When is enough enough?

One of the most influential roles clinical psychologists play in health care settings is as consultant to medical colleagues. The psychologist consultant typically approaches either clinical or programmatic questions intending to tap both empirical research and clinical judgment perspectives in trying to answer them. This paper describes a specific “program consultation case,” a not atypical consultation situation in which graduate medical education directors asked for advice about their residency training program. The purpose is to use this example to generate ideas and provoke discussion about such consultation processes and their usefulness in the health care training and service delivery world. The psychologist may be faced with questions that have meaningful implications beyond the specific consultation. What if the concerns being posed by this particular program are concerns which have been raised before, have been researched before, and have generated reasonable suggestions, conclusions, and strategies for improvement? And what if no one has paid attention, so that the questions are being raised again? When empirical and clinical data consistently combine to identify problems within health-related training or service delivery systems, and when suggestions or alternatives for their solutions have been presented and, also presumably, ignored, what does the clinical psychologist consultant do next?     

When is it time to stop? When good enough becomes bad enough

This article draws on Winnicott’s concept of the good enough mother to discuss how to know whether a therapeutic situation is good enough to continue or bad enough to end. This dilemma is explored in terms of clinical syndromes, such as anorexia and pathological gambling, but focuses mainly on analyst-initiated endings, which are termed the ‘Casablanca dilemma’, based on an amplification of the ending of the film Casablanca. The author goes on to discuss such one-sided endings, drawing on interviews with 40 analysts and therapists about their clinical experience. A typology of bad enough endings is presented. The psychological differences between a good enough analysis as opposed to a bad enough one are explored through the ideas of Winnicott and Neumann.     

When is enough, enough? A comment on Grodzinsky and Marek's "Algorithmic and heuristic processes revisited"

In this comment I argue that although Y. Grodzinsky & A. Marek's (1983, Brain and Language, 33, 216-225) criticism of the conclusions reached by A. Caramazza and E. B. Zurif (1976, Brain and Language, 3, 572-582) in their paper on comprehension disorders in so-called agrammatic patients is not entirely without technical merit, its impact on the claims made by Caramazza and Zurif is inconsequential. I show that there are deeper theoretical and methodological reasons which undermine the claims made by Caramazza and Zurif and the only superficially different proposal of Grodzinsky and Marek.     

Explaining neurocognitive aging: is one factor enough?

As an introduction to the special issue on neurocognitive factors underlying age effects, we discuss a number of recent developments in the literature on aging. The classic distinction between generalized and process-specific cognitive changes with old age has reappeared in the distinctions between the frontal lobe hypothesis and more differentiated views of neurocognitive aging. We argue that neurological decay in the frontal cortex has important implications for cognitive control, but that the frontal lobe hypothesis does not capture the plethora of changes that characterize aging and incorrectly suggests a unitary effect.     

How bad can a good enough parent be?

Almost everyone accepts that parents must provide a good enough upbringing in order to retain custodial rights over children, but little has been said about how that level should be set. In this paper, I examine ways of specifying a good enough upbringing. I argue that the two dominant ways of setting this level, the Best Interests and Abuse and Neglect Views, are mistaken. I defend the Dual Comparative View, which holds that an upbringing is good enough when shortfalls from the best alternative upbringing in terms of the child's interests are no more significant than the parents' interest.     

Auditory comprehension: is multiple choice really good enough?

Auditory comprehension is commonly measured with multiple choice tasks. The sensitivity of these tasks in identifying deficits, however, is limited by credit given for correct guesses by forced choice. In this study, we compare performance on the multiple choice task to an alternative word/picture verification task, in 122 subjects with acute left hemisphere stroke. As predicted, word/picture verification identifies significantly more subjects with deficits in auditory comprehension. Furthermore, the pattern of errors in the two tasks is consistent with a current distributed model of semantic memory, and inconsistent with alternative local models.     

Is Adhikāra good enough for ‘rights'?

The paper considers the question of whether ‘rights’ as we have it in modern Western thinking has an equivalence within the Indian framework of Dharma. Under Part I we look at purusārthas to see if the desired human goals imply rights by examining the tension between aspired ‘values’ and the ‘ought’ of duty. Next, a potential cognate in the term ’adhikāra’ is investigated via the derivation of a refined signification of ‘entitlements’, especially in the exegetical hermeneutics of the Mimāmsā. Finally, adhikāra's re‐emergence in the Bhagavadgitā is considered. We suggest that while the boundary is significantly extended, the Gitā too appears to be circumspect in opening up the discourse in the more abstract and absolute sense which the term ‘rights’ nowadays enjoys.     

Is evidence-based practice diverse enough? Philosophy of science considerations

In its policy rationale for evidence-based practice in psychology (EBPP), the APA Presidential Task Force on Evidence-Based Practice claims to have constituted itself with "scientists and practitioners from a wide range of perspectives and traditions, reflecting the diverse perspectives within the field" (p. 273). We applaud this attention to diversity but contend that an entire perspective of the debate was omitted in the Task Force's newly approved policy and its underlying report. The failure to consider a philosophy of science perspective led the Task Force to make a number of epistemological assumptions that are not based on evidence or rationale and that thus violate the very spirit of evidence-based decision making. In this comment, we reveal a few of these assumptions and discuss their detrimental consequences.     

Creativity,consciousness, and “becoming wise fast enough”

Thirteen 11th-grade students in enriched mathematics and 9 in a regular course solved nine word problems that varied in the ease with which they could be solved by verbal-logical or visual strategies. A pervasive use of verbal-logical solution methods was noted for both groups. Significant differences were found in the final solution strategies. In the course of solving each problem, students tried different strategies. Enriched students alternated almost exclusively between verbal-logical and visual solution methods, whereas regular students alternated equally between verbal-logical and visual solution methods or between verbal-logical strategies and trial and error.     

Just health care (I): Is beneficence enough?

Few in our society believe that access to health care should be determined primarily by ability to pay. We believe instead that society has an obligation to assure access to adequate health care for all. This is the view explicitly endorsed in the President's Commission Report Securing Access to Health Care. But there is an important moral ambiguity here, for this obligation may be construed as being either beneficence-based or justice-based. A beneficience-based construal would yield a much weaker obligation with respect to the distribution of health care. In the first section of this paper I argue that the President's Commission is committed only to this weaker construal of this obligation. In the second section I argue that such a beneficence-based obligation is really rooted in a libertarian conception of justice, similar to that recently articulated by Engelhardt, and that this conception is seriously flawed when it comes to effecting a just distribution of health care.     

Children and the Test of Memory Malingering: Is one trial enough?

There is a growing body of research suggesting that the first trial of the TOMM may provide an accurate screener of effort in children. During neuropsychological assessments, some circumstances result in only one completed trial of the TOMM. Research on adults reflects that passing scores on Trial 1 (based on Trial 2 cutoff) are highly predictive of passing scores on Trial 2 and the TOMM overall. Pediatric research found that 100% of children and adolescents who passed Trial 1 of the TOMM also passed Trial 2. Our research hypothesis is that children who pass Trial 1 will also pass Trial 2. Data from 75 clinically diagnosed children (ages 6–18 years) found that 64% performed above the published adult TOMM cutoff on Trial 1. All children who passed Trial 1 also passed Trial 2 suggesting support for the research hypothesis. Sensitivity was 1.0, specificity was 0.72, positive predictive value was .33, and negative predictive value was 1.0. These findings suggest that in this sample, the children who performed above the Trial 2 cutoff on Trial 1 also all passed Trial 2 (so there were no false negatives, thus a perfect sensitivity and negative predictive value). Of the 36% of children who did not pass the Trial 1 cutoff, 67% passed on Trial 2. Data clearly support that children passing Trial 1 have a high likelihood of passing Trial 2, thus drawing conclusions about performance validity after passing Trial 1. Conclusions after failing Trial 1 require further investigation.     

Sexual assault on college campuses: Is an ounce of prevention enough?

This article provides a construct-by-construct review of the effectiveness of sexual asault prevention programs in modifying sexual assault-related attitudes, cognitions, emotions, and behaviors. This article also discusses variables that may moderate program effectiveness, variables that may mediate program effectiveness, methodological issues, programs for special populations, and iatrogenic effects. In general, sexual assault prevention programs have been shown to be effective in producing short-term reductions in rape-supportive attitudes. There is insufficient evidence, however, to conclude that such programs are effective in reducing the incidence of sexual assault.     

Sexual assault on college campuses: Is an ounce of prevention enough?

This article provides a construct-by-construct review of the effectiveness of sexual asault prevention programs in modifying sexual assault-related attitudes, cognitions, emotions, and behaviors. This article also discusses variables that may moderate program effectiveness, variables that may mediate program effectiveness, methodological issues, programs for special populations, and iatrogenic effects. In general, sexual assault prevention programs have been shown to be effective in producing short-term reductions in rape-supportive attitudes. There is insufficient evidence, however, to conclude that such programs are effective in reducing the incidence of sexual assault.     

How much observational data is enough? An empirical test using marital interaction coding

Using three different samples of couples (clinic, nondistressed community, and engaged), we found that 15 minutes was sufficient to witness enough behavior to make reliable (i.e., internally consistent) estimations of most Rapid Marital Interaction Coding System (Heyman & Vivian, 1993) code frequencies. Ten minutes is sufficient for many codes of interest. The ease in which "how much time is necessary" calculations can be made should entice behavioral investigators from a variety of content areas to publish such figures. By empirically investigating a factor that in most fields becomes reified through convention, investigators can conduct observational research that is both maximally efficient and maximally scientifically defensible.