What we talk about when we talk about pediatric suffering

Theoretical Medicine and Bioethics - In this paper I aim to show why pediatric suffering must be understood as a judgment or evaluation, rather than a mental state. To accomplish this task, first I...     

Mind Perception Is the Essence of Morality

Mind perception entails ascribing mental capacities to other entities, whereas moral judgment entails labeling entities as good or bad or actions as right or wrong. We suggest that mind perception is the essence of moral judgment. In particular, we suggest that moral judgment is rooted in a cognitive template of two perceived minds—a moral dyad of an intentional agent and a suffering moral patient. Diverse lines of research support dyadic morality. First, perceptions of mind are linked to moral judgments: dimensions of mind perception (agency and experience) map onto moral types (agents and patients), and deficits of mind perception correspond to difficulties with moral judgment. Second, not only are moral judgments sensitive to perceived agency and experience, but all moral transgressions are fundamentally understood as agency plus experienced suffering—that is, interpersonal harm—even ostensibly harmless acts such as purity violations. Third, dyadic morality uniquely accounts for the phenomena of dyadic completion (seeing agents in response to patients, and vice versa), and moral typecasting (characterizing others as either moral agents or moral patients). Discussion also explores how mind perception can unify morality across explanatory levels, how a dyadic template of morality may be developmentally acquired, and future directions.     

精神疾病诊断:科学的判断?伦理的判断?

自精神病学纳入医学的范畴之后,精神疾病的诊断因为其所声称的科学手段而被认为是科学的判断.20世纪中叶开始的反精神病学运动全面否定其科学性,认为精神疾病的诊断是单纯的伦理价值判断.两种观点都显得过于极端.精神疾病的特殊性决定了精神疾病的诊断是科学判断基础上的伦理判断.其中科学的判断不是决定性的,而是基础性的.决定性的是伦理的判断,只是这种伦理判断必须建立在科学判断的基础之上而已.     

Mind Perception Is the Essence of Morality

Mind perception entails ascribing mental capacities to other entities, whereas moral judgment entails labeling entities as good or bad or actions as right or wrong. We suggest that mind perception is the essence of moral judgment. In particular, we suggest that moral judgment is rooted in a cognitive template of two perceived minds-a moral dyad of an intentional agent and a suffering moral patient. Diverse lines of research support dyadic morality. First, perceptions of mind are linked to moral judgments: dimensions of mind perception (agency and experience) map onto moral types (agents and patients), and deficits of mind perception correspond to difficulties with moral judgment. Second, not only are moral judgments sensitive to perceived agency and experience, but all moral transgressions are fundamentally understood as agency plus experienced suffering-that is, interpersonal harm-even ostensibly harmless acts such as purity violations. Third, dyadic morality uniquely accounts for the phenomena of dyadic completion (seeing agents in response to patients, and vice versa), and moral typecasting (characterizing others as either moral agents or moral patients). Discussion also explores how mind perception can unify morality across explanatory levels, how a dyadic template of morality may be developmentally acquired, and future directions.     

道德判断中心理状态和事件因果关系的作用:兼对道德判断双加工过程理论的检验

考察青少年儿童和成人在道德判断中利用心理状态和事件因果关系信息的差异,并验证道德判断双加工过程理论.以道德判断中“行为坏的”程度和“应担负的道德责任程度”作为判断问题类型,共有10～11岁和13～15岁的青少年儿童及大学生各120名,完成道德判断测试任务.结果表明在不同的道德判断问题类型下,事件中他人愿望和信念、因果关系信息的作用模式是不同的,支持道德判断双加工过程理论.10～11岁儿童和13～15岁青少年在判断行为坏的程度时,利用心理状态信息和因果关系信息与成人类似.在判断应担负的道德责任程度时,10～11岁儿童更注重行为结果,并且不能综合应用心理状态信息和事件的因果关系信息.13～15岁青少年的道德判断中心理状态信息和事件因果关系信息的作用与成人的情况类似,但在进行应担负的道德责任程度判断时,还不能融合信念与因果关系信息进行道德判断.研究结果为道德判断双加工过程理论提供了支持,而且表明从儿童青少年到成人,利用心理状态和因果关系信息进行道德判断存在不断发展和成熟的过程.     

Distinction between mental pain and psychic suffering as separate entities in the patient's experience

Abstract

Mental pain and psychic suffering are herein defined as two separate concepts in psychoanalysis. The concept of mental pain lies at the core of psychoanalysis; it was introduced by Freud and was further elaborated by a number of investigators, mostly by Bion. Mental pain refers to a pain that the patient reports as being impossible to describe in words, and lacking any associations, whereas psychic suffering can be both named and described by the patient. Mental pain is derived from non-tolerance on the part of the psychic apparatus when it is harmed by very painful emotions. In contrast to psychic suffering, mental pain resists elaboration and transformation by dream-work. How to address and transform the patient's mental pain is a major challenge facing the analyst in his clinical work because mental pain may halt or slow the progression of the analytical process. To overcome this hindrance, the work of the analyst is focused on helping patients to modify their mental pain into psychic suffering, that is, to reactivate in the patient the chain of transformations that generates thought. The analyst is also challanged with the mental pain of the patients because he has himself to tolerate the mental patient induced by counter transference. Suggestions for the analyst on how to deal with the mental pain of the patient during psychoanalytic therapy are proposed.     

大学生对网瘾和作弊的责任推断与应对策略

运用情景模拟和角色扮演的方法,研究大学生对网瘾和作弊的责任归因结构及其应对策略。对416名被试的研究结果显示：（1）责任归因的心理结构是一个“责任推断→责任情感→责任行为”的一元结构模式。（2）我国大学生的责任推断过程与维纳的经典理论基本一致,但在行为应对策略上存在一定的文化差异。（3）大学生对网瘾和作弊的责任推断倾向明显并与情感体验基本保持一致,但与行为应对策略存在一定的冲突。（4）大学生在网瘾和作弊的责任推断、情感体验以及应对策略上存在一定差异。     

Physician Aid-in-Dying and Suicide Prevention in Psychiatry: A Moral Crisis?

Involuntary psychiatric commitment for suicide prevention and physician aid-in-dying (PAD) in terminal illness combine to create a moral dilemma. If PAD in terminal illness is permissible, it should also be permissible for some who suffer from nonterminal psychiatric illness: suffering provides much of the justification for PAD, and the suffering in mental illness can be as severe as in physical illness. But involuntary psychiatric commitment to prevent suicide suggests that the suffering of persons with mental illness does not justify ending their own lives, ruling out PAD. Since both practices have compelling underlying justifications, the most reasonable accommodation might seem to be to allow PAD for persons with mental illness whose suffering is severe enough to justify self-killing, but prohibit PAD for persons whose suffering is less severe. This compromise, however, would require the articulation of standards by which persons’ mental as well as physical suffering could be evaluated. Doing so would present a serious philosophical challenge.     

Hand mental rotation is not systematically altered by actual body position: Laterality judgment versus same–different comparison tasks

It is commonly believed that during mental rotation of body parts, participants tend to imagine their own body part moving toward the stimulus, thus using an egocentric strategy. Several studies have also shown that the mental rotation of hands is affected by the actual hand position, especially if the hand is kept in an awkward position. However, this hand posture effect, as well as the use of an egocentric strategy during mental rotation of body parts, is not systematic. Several experiments have demonstrated that manipulating the stimulus features or the paradigm could induce a shift to visual and allocentric strategies. Here, we studied the effects of hand posture and biomechanical constraints on one-hand mental rotation (laterality judgment task), two-hand mental rotation (same–different judgment task), and mental rotation of one or two alphanumeric symbols (control tasks). Effects of posture and biomechanical constraints were observed solely for the laterality judgment task. Response times in the same–different hand mental rotation items were influenced by the angular disparity between the stimuli. We interpreted our result as evidence of the use of different strategies for each task. Future research should focus on disentangling the exact subprocesses in which an egocentric strategy is used, in order to propose better tests for participants with motor impairments.     

How do children coordinate information about mental states with social norms?

We investigated how 3-7-year-olds weigh and coordinate information about specific mental states with social norms in the domain of contextually conventional rules. With increasing age, participants increasingly took into account an actor's mental state to predict that actor's behavior. In a criticism judgment task, 7-year-olds could assign criticism conditional on mental state, with response patterns similar to those of adults; 5-year-olds assigned criticism regardless of the actor's mental state. Three-year-olds tended not to assign criticism at all, irrespective of the actor's mental state. Results indicated that the ability to weigh and coordinate information about mental states with understanding of norms depends on age and on the particular type of judgment being made. To some extent, our results may also reflect the influence of culture and parenting.     

左右侧颞顶联合区对道德意图信息加工能力的共同作用——基于经颅直流电刺激技术

行为人的意图动机是我们对日常行为的对错做出判断的重要依据。以往研究表明,左右侧颞顶联合区(TPJ)都可能与信念意图的整合加工能力相关,尤其是近年来越来越多的神经刺激研究为TPJ区域与心理状态归因能力之间的因果关系提供了证据。然而,这些研究在实验任务的选取,实验设计的优化,实验结论的稳健性上仍然有改进的空间。基于此,本研究开展了两个在设计上互相补充的实验。实验中被试的TPJ区域会接受一段时间的经颅直流电刺激,并完成一系列的道德判断任务,任务是由意图和结果,以及负性和中性2×2双变量构成的4种条件的故事:无伤人、伤人未遂、意外伤人和伤人成功,被试要对故事主角的行为做出谴责程度的道德判断。结合道德判断的谴责程度和决策时间数据发现,当人们在处理信念意图信息时,左右侧TPJ区域可能是协同互动、共同发挥作用的。在激活右侧TPJ并限制左侧TPJ的情况下,人们对负性结果的谴责程度变高,人们变得更加依赖于行为结果做出道德判断;而在限制右侧TPJ并激活左侧TPJ的情况下,人们对负性意图的谴责程度变高,人们变得更加依赖于行为者的动机做出道德判断。     

Koran reading and negotiation with jinn: strategies to deal with mental ill health among Swedish Somalis

In this paper, we discuss traditional Somali concepts of mental ill health. Qualitative interviews were conducted with some 20 Swedish Somali interviewees about factors causing mental ill health, traditional classification, strategies to deal with mental ill health, and attitudes to the mental health care services in Sweden. Social mobilisation and religious healing are cornerstones of traditional Somali measures to deal with mental suffering. Traditional Somali views of mental ill health stand in stark contrast to classification of mental ill health in the western biomedical model. These views deserve attention since they may have an impact on health-seeking behaviour among Somali immigrants in western countries. Yet a too strong focus on cultural aspects may over-shadow the fact that much mental suffering among Somali migrants must be understood within social, economic, and political contexts.     

Selective effects of motor expertise in mental body rotation tasks: comparing object-based and perspective transformations

Brain imaging studies provide strong evidence for the involvement of the human mirror system during the observation of complex movements, depending on the individual's motor expertise. Here, we ask the question whether motor expertise not only affects perception while observing movements, but also benefits perception while solving mental rotation tasks. Specifically, motor expertise should only influence the performance in mental body rotation tasks (MBRT) with left-right judgment, evoking a perspective transformation, whereas motor expertise should not affect the MBRT with same-different judgment, evoking an object-related transformation. Participants with and without motor expertise for rotational movements were tested in these two conditions in the MBRT. Results showed that motor experience selectively affected performance in the MBRT with the left-right judgment, but not with same-different judgment. More precisely, motor expertise only benefited performance when human figures were presented in (for non-experts) unfamiliar, upside-down body orientations.     

自我和物体为参照系的心理旋转分离：内旋效应

采用虚拟的旋转不同角度左、右手模型,构建“左右手判断(Left and right hand judgment: LR)”任务和“相同－不同判断(same and different judgment: SD)”任务,考察这两种实验任务是否都存在内旋效应和角度效应,以此推论被试采用何种旋转策略。结果发现：（1） 两种实验任务结果均表现出显著的角度效应。（2）在LR任务条件下,存在显著的内旋效应,而在SD任务中不存在内旋效应。从而表明当人手图片作为心理旋转材料时,它具有双重角色。被试心理旋转加工时究竟选用何种参照系的旋转策略,与实验材料和实验任务两者都密不可分     

自我责任归因与推断的心理结构与特征

基于日常经验取向,运用问卷调查的方法,探索自我责任归因与推断的心理结构及其基本特征。对382名被试问卷调查的统计分析结果显示：（1）自我责任归因与推断结构是一种一元单向决定模式,即“责任推断→责任情感→责任行为”。（2）个体倾向于较多地将挫折或失败的原因归咎于可控起因,而较少归因于不可控起因。（3）个体在进行自我责任推断时,可控性程度仅对责任的大小构成影响,并不影响对是否承担责任的推断。（4）在自身应为挫折或失败承担责任时,个体在情感体验上较多自我责备,较少自我同情;在行为反应上,较多积极应对,较少甚至不大会消极应对。     

Judgment in Fiction

Abstract

In this paper, I show that in order to gain an understanding of the facts about fiction it is more fruitful to pursue an analysis of judgment in fiction than an analysis of truth in fiction. I do so in two steps. First I take the analyses of truth in fiction which David Lewis provides in “Truth in Fiction”, which are formulated in terms of possible worlds, and provide counterpart analyses of judgment in fiction, formulated in terms of (mental) models and rules for the construction of (mental) models. In the course of discussion I identify various problems for Lewis’s account of truth in fiction and solve or dissolve them using the account of judgment in fiction. Second, I show that once we have an analysis of judgment which appeals to rules, we can extend the account of judgment by using Lewis’s account of accommodation and resistance in “Scorekeeping in a Language Game” to explain the evolution of the genres of fiction, construed as systems of rules. The result is to provide a dynamic account of judgment which does justice to modern poststructuralist observations in the philosophy of literature.     

概率判断中的合取谬误

概率判断中的合取谬误是指违反事件发生概率的合取规则而认为包含多个独立事件的复合事件的发生可能性大于其中某些事件的发生可能性的一种概率判断偏差现象。合取谬误的界定存在一定争议, 相关的解释机制有因果模型理论、确认理论、惊奇理论等, 影响合取谬误的因素有频率效应、训练效应以及个体差异等等。未来研究应联系逆转合取谬误的心理机制来完善已有的理论, 同时注意应用研究以及其非理性的探讨。     

Exploring the rabbit hole of possibilities by myself or with my group: The benefits and liabilities of activating counterfactual mind‐sets for information sharing and group coordination

The current experiment explored the effect of activating a counterfactual mind‐set on the discussion of unique information and group judgment accuracy. Evidence suggests that a counterfactual mind‐set is characterized by a focused, analytic mental state and, when activated at the group level, improves group judgment accuracy in the murder mystery paradigm (a hidden profile task). We hypothesized that the beneficial effect of the counterfactual mind‐set would only help group problem‐solving tasks if the mind‐set had been activated at the group level, allowing the analytical mind‐set to play out in an atmosphere of synergistic coordination. In contrast, if this highly focused mental state is activated at the individual level, it could impair group judgment quality because inwardly focused analytical individuals may fail to coordinate their behavior with other group members. Consistent with our hypothesis, activating a counterfactual mind‐set at the individual level had a debilitating effect on the group judgment task, whereas activating a counterfactual mind‐set at the group level had a facilitative effect, increasing information sharing, synergistic coordination and judgment accuracy. Copyright © 2004 John Wiley & Sons, Ltd.     

心理账户的作用机制与儿童认知发展

心理账户是普遍存在于个体心理中的一套或者多套记账体系。这种体系往往是以非预期的形式存在,并对个体的行为决策产生潜在的影响。由于心理账户的存在,使得个体在行为决策时往往无意识地偏离正常的价值判断或者计算法则,从而做出非理性的决策。心理账户的非替代性作用机制可以解释儿童心理理论、价值判断、情感决策以及自我控制等认知能力的发展。     

Does Skeptical Theism Lead to Moral Skepticism?

The evidential argument from evil seeks to show that suffering is strong evidence against theism. The core idea of the evidential argument is that we know of innocent beings suffering for no apparent good reason. Perhaps the most common criticism of the evidential argument comes from the camp of skeptical theism, whose lot includes William Alston, Alvin Plantinga, and Stephen Wykstra. According to skeptical theism the limits of human knowledge concerning the realm of goods, evils, and the connections between values, undermines the judgment that what appears as pointless evil really is pointless. For all we know the suffering of an innocent being, though appearing pointless, in fact leads to a greater good. In this paper I argue that no one who accepts the doctrines of skeptical theism has a principled way of avoiding moral skepticism.