The utility of the A1 and A2 criteria in the diagnosis of PTSD

In the field of posttraumatic stress disorder (PTSD), the revisions to the DSM-IV definition of a potentially traumatic event are contentious. Proponents praise the subjective emphasis, while others contend that the changes to the criterion broadened the conceptualization of PTSD. This study examined the predictive utility of Criterion A events, examining the stressor (A1) and subjective emotional response (A2) components of the definition of a traumatic event. Rates of Criterion A events and PTSD were calculated for three diverse samples, and predictive power, sensitivity, specificity, and ROC curves were computed to determine the predictive utility of Criterion A requirements for PTSD symptom, duration, and functional impairment diagnostic criteria. Across all samples, the current Criterion A requirements did not predict much better than chance. Specifically, A2 reports added little to the predictive ability of an A1 stressor, though the absence of A2 predicted the absence of PTSD-related symptoms, their duration, and impairment. Notably, the combination of three A1 and A2 criteria showed the best prediction. Confronted events also showed less predictive ability than experienced events, with more variable performance across samples. These results raise fundamental questions about the threshold or "gate" that Criterion A ought to play in our current nosology.     

Naturalism and the A Priori

Philosophical Studies -     

A meta-analysis of the reliability and validity of the Rorschach

The results of a meta-analysis of Rorschach studies indicate that reliabilities in the order of .83 and higher and validity coefficients of .45 or .50 and higher can be expected for the Rorschach--when hypotheses supported by empirical or theoretical rationales are tested using reasonably powerful statistics. Three important determinants of variance accounted for in a variety of Rorschach scores were identified in 530 statistics from 39 papers published in the Journal of Personality Assessment from 1971 to 1980. The a priori theoretical or empirical evidence determining the likelihood of obtaining significant results, and the power of the statistic used to measure the results, as well as the interaction between the likelihood of results and the power of the statistic used, were all significant determinants of the proportion of variance accounted for in the Rorschach measures reported.     

A Century of Suicide in Italy: A Comparison between the Old and the Young

This study analyzes suicide rates from 1887 to 1993 in the Italian population between the ages of 15 and 24 years old and over 65 years of age, based on official data published in the Health Statistics Year Book. The rates of death by suicide (per 100,000) subjects) are calculated for each year and for 10-year periods, as are the mortality rates relative to each method of suicide, standardized by gender. The latter analysis was possible starting from 1951 only, when it became customary to record method. The findings indicate an increase in the suicide phenomenon in the elderly population in Italy over the test period. Rates are at least 3 times higher for men than for women. The highest rates are reported for elderly men, but there appears to have been a greater proportional increase in the number of suicides committed by elderly women. The rise was statistically significant in both males and females. By contrast, a rather constant decrease in suicide rates in young people emerges from the beginning of the century through to the present date. This decrease is more marked in females, although suicide rates are lower for females than for males. Over the study period, substantial changes have come about in the suicide methods used by both young and old people. There was an increase in poisoning by care exhaust fumes, jumping from heights, hanging, and firearms.     

A note on Putnam and the transitivity of the real

Professor Putnam's argument that future happenings are already real is clarified and examined. It is argued that, contrary to other claims in the literature, Putnam's premises are consistent, but that the field of the relation R on which he bases his conclusion is such that the conclusion does not in fact follow.     

A reappraisal of the Emma episode and the specimen dream

Schur's (1966, 1972) speculations that the "specimen dream" exculpates Fliess rather than Freud and that Freud was unaware of this are challenged. Schur's assertion that Freud was not aware of "current conflict" when writing The Interpretation of Dreams is countered with the previously unpublished "Completion of the Analysis" of the dream of "Running up the Stairs," which illustrates Freud's withholding of "current conflict" from his published associations. The view is advanced that Freud's and Fliess's treatment of Emma Eckstein might have been an important element in Freud's self-analysis because it was a repetition of his childhood conflicts. The identities of Emma Eckstein (operated on by Fliess) and Anna Hammerschlag Lichtheim, together with the previously unnoticed, published exchange between Abraham and Freud, are used to add further insight into Freud's interpretation of the dream. In addition, new material concerning Freud's father's terminal illness, beginning in July, 1985, casts further light on the specimen dream as well as others. It is argued that concerns about Martha Freud's sixth pregnancy and wishes for improved contraception were important determinants of the dream and part of the undisclosed associations. It is also argued that rivalrous elements of the associations are elaborated in the later non vixit dream.     

Culture and the organization of infant sleep: A study in the Netherlands and the U.S.A.

This study investigates differences in the amount and structure of infant sleep in two cultural places with previously documented, divergent parental beliefs and practices. Eight-month-old infants (n = 24 per site) were recruited from towns in the Netherlands and the eastern U.S.A. To evaluate sleep, infants’ physical activity was recorded at home for 24 h using a miniature actigraph, while parents kept a diary of infant activities. Measures derived from actigraphy include total sleep, longest sleep episode, longest wake episode, number of sleep episodes, and percent of sleep during nighttime, as well as time in the stages of Quiet and Active Sleep. Measures based on the parental diaries include most of these aspects as well, except those related to sleep stages. Results based on the more precise actigraphy method indicate that (1) the Dutch infants averaged 13.65 h of sleep per 24 h, 1.67 h more than the U.S. infants; this difference was mostly due to daytime sleep; (2) The Dutch infants’ longest wake episode averaged less than that of the U.S. infants, while their longest sleep episode appeared slightly longer. (3) The Dutch infants, compared to the U.S. sample, spent more time in the Quiet, rather than the Active phase of sleep; (4) They began their Quiet sleep earlier in the evening than did their U.S. counterparts. Measures derived from parental diaries are largely in agreement with the actigraph findings. These results are consistent with reported and observed practices and beliefs in the two communities. The pattern of differences – less apparent maturity among the Dutch in the amount of sleep, but greater apparent maturity in the structure of sleep -- illustrates that behavioral and neurological maturity can be assessed only in the context of the developing child’s adaptation to the specific demands and affordances of the culturally structured developmental niche.     

A Review and Systematization of the Trolley Problem

The trolley problem, first described by Foot (1967) and Thomson (The Monist, 59, 204–217, 1976), is one of the most famous and influential thought experiments in deontological ethics. The general story is that a runaway trolley is threatening the lives of five people. Doing nothing will result in the death of those persons, but acting in order to save those persons would unavoidably result in the death of another, sixth person. It appears that, depending on the situation, we have different moral judgments about the permissibility of action. We will review and systematize all the proposals in the literature of the past 35 years that have attempted to grasp our moral intuitions in a simple deontological principle. In particular, seventeen proposals will be classified: six algorithmic, seven psychological, and four other invalid accounts. This review and classification sheds light on some subtle differences and clarify a few issues.     

A Priori Conditionals and the Conceivability of Zombies

Abstract

The conditional analysis of phenomenal concepts, as proposed independently by Hawthorne (2002), Stalnaker (2002) and Braddon-Mitchell (2003), is used to undermine Chalmers's (1996) conceivability argument in a way that is compatible with our having the zombie intuition. The aim of this paper is twofold: (1) To remove current misconceptions concerning how the analysis is to be applied. It will be explained how there are two distinct ways the analysis can be used to undermine the conceivability argument. (2) To employ this exposition to defend the analysis from objections leveled against it by Chalmers (2005) and Alter (2007).     

A hermeneutical sketch of memory and the immemorial

In one of his more recent works, Paul Ricoeur attempts to re-instate the philosophical discussion of memory at the very center of a more general discourse on human existence. In his exposition, Ricoeur relies upon what he himself characterizes as a phenomenology of memory. It is the aim of the present article to supplement the phenomenological account of memory discussed by Ricoeur with a hermeneutics of memory conscious of its own limitations. Such a hermeneutical supplement would not only be of complementary value but also provoke a rethinking of the relation between key concepts in the western discourse on memory, such as image, imprint, and trace. In this regard, the proposed hermeneutical reconfiguration of memory exceeds its own limitations and overflows into an investigation of the primordial passive and past ground, which motivates and allows the hermeneutical activity in the first place. Following the analyses of Emmanuel Lévinas, I will argue that this immemorial past must be conceived in terms of a responsibility that cannot be fulfilled.