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1.
The reliability of psychiatric diagnoses   总被引:1,自引:0,他引:1  
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Over the past fifteen years or so, advocates of a relational theory of psychoanalytic process have developed a compelling challenge to the classical approach to clinical work. Their critique of a fixed "standard technique," applicable across the board to all analyzable patients, has been particularly effective. The new approach opens the possibility of tailoring technique to individual analysands, negotiating the best way of working within each unique analytic dyad. But despite the openness of relational theory, many of the most influential clinical vignettes in the recent literature emphasize the analyst's risk-taking, engaging patients in a highly personal way that breaks the traditional analytic frame. Various implications of the tendency of relational analysts to emphasize this sort of intervention are discussed, and questions raised about the way this may affect how relational thinking is received.  相似文献   

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A fully automated psychiatric diagnostic system is outlined that would rely on picture-preference items rather than verbal ones and that would involve a tailored approach rather than conventional “brute-strength” testing. The conditions under which such a system can diagnose patients in a way that might arouse their interest and cooperation are discussed. These include a set of diagnostic categories (perhaps a subset from DSM-III), availability of a single-frame video disk unit allowing random access to each frame, a microprocessor system with a memory capacity of about 32,000 bytes, known base rates of the population of interest, and known probabilities of a particular response to the items for each diagnostic category. Some futuristic extensions of the proposed system are suggested.  相似文献   

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What is the effect of seductive details on learning outcomes? What are the boundary conditions of seductive detail effects? How do seductive details affect learning? These are the kinds of questions addressed in this special issue on seductive details. This special issue contains 11 articles presenting original results that take a new look at seductive details.  相似文献   

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In the recent literature there has been some debate between advocates of deflationist and fictionalist positions in metaontology. The purpose of this paper is to advance the debate by reconsidering one objection presented by Amie Thomasson against fictionalist strategies in metaontology. The objection can be reconstructed in the following way. Fictionalists need to distinguish between the literal and the real content of sentences belonging to certain areas of discourse. In order to make that distinction, they need to assign different truth-conditions to the real and the literal content. But it is hard to see what more is required for the literal content to be true than for the real content to be true. So, fictionalism is an unsatisfactory position. Here I offer a novel reply to Thomasson’s challenge. I argue that the literal and the real content need not be distinguished in terms of their truth-conditions; rather, they can be distinguished in terms of their different subject-matters, leaving it open whether their truth-conditions coincide or not. I explain how replying to Thomasson’s objection is crucial for deepening our understanding of fictionalist strategies in metaontology.  相似文献   

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In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article will take up the first two questions. With the first question, invited commentators express a range of opinion regarding the nature of psychiatric disorders, loosely divided into a realist position that the diagnostic categories represent real diseases that we can accurately name and know with our perceptual abilities, a middle, nominalist position that psychiatric disorders do exist in the real world but that our diagnostic categories are constructs that may or may not accurately represent the disorders out there, and finally a purely constructivist position that the diagnostic categories are simply constructs with no evidence of psychiatric disorders in the real world. The second question again offers a range of opinion as to how we should define a mental or psychiatric disorder, including the possibility that we should not try to formulate a definition. The general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances.  相似文献   

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A crucial question in cognitive science is how linguistic and visual information are integrated. Previous research has shown that eye movements to objects in the visual environment are locked to linguistic input. More surprisingly, listeners fixate on now-empty regions that had previously been occupied by relevant objects. This 'looking at nothing' phenomenon has been linked to the claim that the visual system constructs sparse representations of the external world and relies on saccades and fixations to extract information in a just-in-time manner. Our model provides a different explanation: based on recent work in visual cognition and memory, it assumes that the visual system creates and stores detailed internal memory representations, and that looking at nothing facilitates retrieval of those representations.  相似文献   

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In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM ?C whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part 1 of this article took up the first two questions. Part 2 took up the second two questions. Part 3 now deals with Questions 5 & 6. Question 5 confronts the issue of utility, whether the manual design of DSM-III and IV favors clinicians or researchers, and what that means for DSM-5. Our final question, Question 6, takes up a concluding issue, whether the acknowledged problems with the earlier DSMs warrants a significant overhaul of DSM-5 and future manuals. As in Parts 1 & 2 of this article, the general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances.  相似文献   

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The fairy tale of Rumpelstiltskin is studied in conjunction with related tales to provide a fuller understanding of its meaning than previous studies have done. The content of these tales depicts ambivalence about childhood magic and ambivalence about adult reality, which are uneasily resolved by eliminating magic and dwelling in a disenchanted world. Enchantment is retained formally in the telling of the story. To the extent that transference is enchantment, similar conflicts occur during psychoanalysis: is the patient better off adhering to transference or relinquishing it--or can it be integrated with day-to-day experience?  相似文献   

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David Blinder 《Topoi》1986,5(2):137-148
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The present study aimed to take fresh look at the nature and psychological meaning of consistency in character traits and virtuous behaviour as manifested in everyday life. To this end, a 10‐day experience‐sampling study was conducted. Using smartphone technology, a sample of 83 working mothers and fathers provided a total of 4,342 momentary behavioural reports while being in the role of the parent versus being in the job role. Consistent with recent research on personality traits, the findings of the present study showed that people express a wide range of virtue states in their everyday lives. Within‐person changes in virtue states were not random but were contingent on people's current role context and also meaningfully related to their momentary affective experiences. At the same time, people's average level of virtue states, their degree of variation in virtue states, and their signature ways of reacting to role contexts turned out to be stable, trait‐like individual difference characteristics. Discussion focuses on the implications for the conception of character traits in scientific psychology and beyond.  相似文献   

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Abstract - In two studies, a newly devised test (framed-line test) was used to examine the hypothesis that individuals engaging in Asian cultures are more capable of incorporating contextual information and those engaging in North American cultures are more capable of ignoring contextual information. On each trial, participants were presented with a square frame, within which was printed a vertical line. Participants were then shown another square frame of the same or different size and asked to draw a line that was identical to the first line in either absolute length ( absolute task ) or proportion to the height of the surrounding frame ( relative task ). The results supported the hypothesis: Whereas Japanese were more accurate in the relative task, Americans were more accurate in the absolute task. Moreover, when engaging in another culture, individuals tended to show the cognitive characteristic common in the host culture.  相似文献   

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