Narrative unity and clinical judgment

Alasdair MacIntyre's recent thinking both about the concept of a practice and the existence of narrative unity in human life raises important questions about how we should view clinical medicine today. Is it possible for clinical medicine to pursue patient well-being in a society (allegedly) afflicted with what he calls ‘modernity’? Here it is argued that MacIntyre's pessimistic view of the individual in contemporary society makes his call for patient autonomy in the clinical setting pointless. Finally, recent work in gerontology is cited to make three points: first, MacIntyre's pessimism about us is too extreme; second, the concept of a ‘fictionalized’ personal history is closer to reality than either MacIntyre's notion of narrative unity or the ideas of his imagined opponent (Sartre); and finally, we should not expect clinical medicine to produce patient well-being, when this is understood narratively.     

Adaptation effects and reversible figures: A comment on Horlitz and O’Leary

In a recent article, Horlitz and O’Leary (1993) offer a reinterpretation of the results of several studies over the past 40 years that have employed the prolonged-inspection technique in the investigation of reversible figures. Specifically, they contend that, contrary to the favored interpretation of neural adaptation effects, the results of these studies reveal the combined influence of such topdown processes as attention and perceptual learning as well as such methodological difficulties as unwanted demand characteristics. In this note, we examine their analysis of the literature, their alternative theoretical model, and the supporting conclusions they draw from their two experiments. We argue that there is considerable evidence from a variety of studies for the joint role of bottom-up and top-down processes in reversible figures. Moreover, we propose that Horlitz and O’Leary’s own research, rather than eliminating the possibility of neural-adaptation effects, is best conceptualized as providing additional evidence for the role of higher-order processes in these phenomena.     

The contribution of visual persistence to the perceived duration of brief targets

Two experiments were conducted to examine the role of sensory persistence on tasks of perceived duration employing very brief visual stimuli. Using a standard temporal judgment task, the first experiment replicated both the “size effect” and “empty-filled” illusion reported by previous investigators. However, entirely comparable results were also found with a probematching task, which theoretically assesses the degree of persistence exhibited by a stimulus. The second experiment examined the effect of target luminance on perceived duration. Consistent with a sensory persistence interpretation, judgments of duration increased with increasing luminance. The results from the two experiments were discussed in terms of varying degrees of retinal persistence produced by different stimuli. This view was contrasted with currently dominant interpretations that postulate changes in perceived duration to reflect different information-processing requirements across stimulus conditions.     

The effects of spatial frequency and target type on perceived duration

Two experiments are reported that attempt to demonstrate a critical role played by sensory persistence on a standard perceived-duration task employing brief visual stimuli. Experiment 1 examined the effect on perceived duration of varying the spatial frequency of a target. For both 40- and 70-msec flashes, increased spatial frequency resulted in reduced estimates of perceived duration. These results were contrasted with predictions derived from cognitive processing models of duration perception. In Experiment 2, three typical types of target employed in current research (an outlined circle, a “noise”-filled circle, and a completely filled circle) were shown to differ significantly in their perceived duration and in their sensitivity to increases in physical duration. The results were discussed in terms of variable degrees of retinal persistence produced by the three types of targets. The possible implications for specific discrepancies in the literature and across-study comparisons in general were enumerated.     

Aerobic conditioning and stress reduction: Participation or conditioning?

The efficiency of an aerobic conditioning program (jogging) is compared to cognitive therapy (stress inoculation) and a waiting list control in modifying self-reported chronic stress. The participants were community residents; 48 were females and 25 were males. Treatment sessions were conducted over a 10-week period with subjects meeting in small groups for 1$\text{1}\text{2}$ hours per week. The State/Trait Inventories, a Tension Thermometer and a submaximal bicycle ergometer test were administered pre, post and follow-up. Repeated measures, multivariate analysis of variance indicated that both treatments were effective in reducing stress compared to the waiting list control and that these changes were maintained at 3-month follow-up. Multivariate analysis indicated that participants with higher initial levels of aerobic fitness did not report less stress, while participants who obtained higher levels of fitness during the conditioning program fared no better in reducing stress than their counterparts who obtained lower levels of aerobic fitness. These findings are of interest because they suggest that the psychosocial components of the fitness program were active ingredients of treatment rathee than the effects of improved cardiovascular functioning.     

Somatic complaints in anxious children

Although stomachaches and headaches are considered characteristic of children with anxiety disorders, there is converging evidence that a broader range of somatic symptoms may be associated with children's expressions of anxiety. The purpose of this study was to determine the prevalence of somatic complaints in anxious children. The results indicated that children with anxiety disorders endorsed the presence of many different somatic complaints, and that contrary to clinical intuition, stomaches and headaches were not among the most commonly reported symptoms. In addition, the anxious children endorsed significantly more somatic complaints when compared to normal controls. Furthermore, the symptom pattern reported by anxious children indicated the presence of both the somatic and cognitive components usually associated with panic attacks, although none of the children met diagnostic criteria for panic disorder. The results are discussed in terms of the contribution of somatic symptoms to the understanding of anxiety disorders in children.     

慢性腹痛

慢性腹痛病史较长,性质不定。引起慢性腹痛的原因很多,除器质性疾病外,一些功能性疾病也引起,如最终找不出具体原因,则可称之为功能性腹痛综合征。诊断比较困难,也容易误诊,甚至误治,外科医生应特别慎重。误诊的思维原因包括对引起慢性腹痛的原因认识不全面,思维惰性,辩证思维不周密和思维简化等。     

Co-occurrence of Rape Myth Acceptance, Sexism, Racism, Homophobia, Ageism, Classism, and Religious Intolerance

Rape myth acceptance has been extensively studied. Little research is available, however, on the relationship of this variable to other oppressive belief systems. A sample of 492 male and 506 female college students completed the Illinois Rape Myth Acceptance Scale, the Attitudes Toward Women Scale (short form), the Neosexism Scale, the Modern and Old Fashioned Racism Scale, the Modern Homophobia Scale, a modified version of the Economic Belief Scale, the Fraboni Scale of Ageism, and the Marlowe–Crowne Social Desirability Scale (short form). Because there were no existing measures of intolerance toward multiple religions, the Religious Intolerance Scale was developed for this study (using relevant items from the Godfrey Richman Isms Scale). Findings here suggested that greater racism (both modern and old fashioned), sexism (both modern and old fashioned), homophobia (toward both gay men and lesbians), ageism, classism, and religious intolerance were each associated with greater rape myth acceptance. Moreover, each belief system collectively added to the prediction of rape myth acceptance, although sexism has the highest overlap with rape myth acceptance. Although gender did not moderate the relationship between oppressive belief systems and rape myth acceptance, results, across analyses, did indicate that men reported greater rape myth acceptance than women did. Results point to the interrelatedness of rape myth acceptance, racism, sexism, homophobia, classism, ageism, and religious intolerance.     

对植物状态生存的理性思考

分析植物状态生存的判定和分类,从人的本质分析植物状态的生存价值,从生物学、社会学角度分析植物状态生存与死亡的区别与联系,认为植物人仅仅是生物学上的不完全生命状态,在社会学意义上,他是死亡个体。对我国卫生费用的现状进行评估,从医学、社会学和经济学角度对植物状态生存者维持或放弃治疗进行了理性分析。