Lost at Sea: A New Route to Metaphysical Skepticism

Global metaphysical skepticism is the view that we have no knowledge of any substantive metaphysical thesis. Various reasons have been provided in support of global metaphysical skepticism. I provide a new one. The reason, very roughly, is this. Metaphysical theses come together as packages. Such packages are very different from each other. Because the packages are so different, we cannot know of any one of the packages that it isn't true. And because we cannot know of any one of them that it isn't true, we cannot know any substantive metaphysical thesis at all. My paper makes this argument much more precise and defends each of the premises in detail.     

Moral Foundations Theory and Its Implications for Counseling

Moral foundations theory has recently emerged from the field of social psychology as a means for understanding cultural, political, and religious differences between individuals and groups. The authors review the moral foundations theory literature to help counselors in understanding the roots of their clients' and their own moral belief systems and how these systems contribute to decision-making pertaining to morally laden topics. Lastly, the authors present a model for self-awareness around moral issues along with a fictional case study intended to illustrate the use of the model.     

Effectiveness of testosterone therapy for masculinizing voice in transgender patients: A meta-analytic review

Background: Testosterone therapy is the predominant treatment for voice masculinization in transgender patients. Although lowering of voice fundamental frequency (f₀) occurs with testosterone therapy, evidence suggests voice and gender identity may not fully align—i.e., voice-gender congruence may not be achieved—with its use.

Aim: This meta-analytic review evaluates the effectiveness of testosterone therapy to masculinize voice in transgender patients.

Methods: Multiple electronic databases were queried (inclusion dates: from database inception up to October 27, 2017) to identify original research on voice masculinization using testosterone therapy. Nineteen articles were included in this meta-analytic review, which followed PRISMA guidelines. In addition to qualitative analyses, random effects proportion meta-analyses were performed on data related to f₀, voice-gender congruence, voice problems, and satisfaction with voice.

Results: A meta-analysis on f₀ data showed after 1 year of testosterone therapy a combined estimate of 21% of participants (95% confidence interval [CI]: 5%–43%; I²: 59.9%) did not achieve cisgender male normative frequencies (f₀ ≤ 131 Hz). Meta-analyses on incomplete voice-gender congruence and voice problems indicated combined estimates of 21% (95% CI: 10%–34%; I²: 0.0%) and 46% (95% CI: 14%–79%; I²: 90.2%), respectively. Regarding incomplete satisfaction with voice, a meta-analysis showed a combined estimate of 16% (95% CI: 7%–28%; I²: 0.0%).

Discussion: We found that not all transgender patients using testosterone therapy to masculinize voice should expect f₀ lowering to cisgender male normative frequencies after 1 year. The vocal transition may involve voice problems for many patients, and some might not achieve voice-gender congruence without additional, voice-specific intervention. Given these findings, a voice evaluation should occur prior to initiating testosterone therapy and involve counseling on expectations for voice. Transgender patients who pursue voice masculinization may need management from laryngology and speech and language therapy to improve voice-gender congruence, mitigate voice problems, and increase satisfaction with voice.     

A Descriptive Examination of Prisonization through the Lens of Post-Exoneration Offending

Prisonization, which seeks to explain criminal behavior as a function of past prison experiences, has been examined through many lenses; however, more novel approaches to exploring prisonization have been lacking. This study uniquely explores the concept of prisonization by describing the post-release behavior of 118 wrongfully convicted individuals, known as exonerees.

Conclusions were drawn from a dataset of exonerees and criminal history background searches. Comparative analyses show that exonerees without priors serve longer sentences and demonstrate a shorter time to failure (as measured by post-release offending). Offending among this cohort may suggest that otherwise law-abiding citizens were negatively affected by their experience in prison and, furthermore, may indirectly support the notion that being imprisoned fosters criminality in individuals. These results can support conceptual and practical advancements.     

UNDERSTANDING PARENTING STRESS AND CHILDREN'S BEHAVIOR PROBLEMS AMONG HOMELESS,SUBSTANCE‐ABUSING MOTHERS

This article tested a model of parenting stress as a mediator between maternal depressive symptoms, emotion regulation, and child behavior problems using a sample of homeless, substance‐abusing mothers. Participants were 119 homeless mothers (ages 18–24 years) and their young children (ages 0–6 years). Mothers responded to questions about their depressive symptoms, emotion regulation, parenting stress, and child behavior problems. A path analysis showed that maternal depressive symptoms were positively associated with child behavior problems through increased parenting stress whereas maternal cognitive reappraisal was negatively associated with child behavior problems through decreased parenting stress. Moreover, maternal expressive suppression was negatively related to child externalizing problems. Findings support the parenting stress theory and highlight maternal parenting stress as a mechanism associated with homeless children's mental health risk. This study has significant implications for understanding the parenting processes underlying child's resilience in the context of homelessness and maternal substance use.     

Learning efficient visual search for stimuli containing diagnostic spatial configurations and color-shape conjunctions

Visual search is often slow and difficult for complex stimuli such as feature conjunctions. Search efficiency, however, can improve with training. Search for stimuli that can be identified by the spatial configuration of two elements (e.g., the relative position of two colored shapes) improves dramatically within a few hundred trials of practice. Several recent imaging studies have identified neural correlates of this learning, but it remains unclear what stimulus properties participants learn to use to search efficiently. Influential models, such as reverse hierarchy theory, propose two major possibilities: learning to use information contained in low-level image statistics (e.g., single features at particular retinotopic locations) or in high-level characteristics (e.g., feature conjunctions) of the task-relevant stimuli. In a series of experiments, we tested these two hypotheses, which make different predictions about the effect of various stimulus manipulations after training. We find relatively small effects of manipulating low-level properties of the stimuli (e.g., changing their retinotopic location) and some conjunctive properties (e.g., color-position), whereas the effects of manipulating other conjunctive properties (e.g., color-shape) are larger. Overall, the findings suggest conjunction learning involving such stimuli might be an emergent phenomenon that reflects multiple different learning processes, each of which capitalizes on different types of information contained in the stimuli. We also show that both targets and distractors are learned, and that reversing learned target and distractor identities impairs performance. This suggests that participants do not merely learn to discriminate target and distractor stimuli, they also learn stimulus identity mappings that contribute to performance improvements.     

Efficacy of Guided iCBT for Depression and Mediation of Change by Cognitive Skill Acquisition

Guided internet CBT (iCBT) is a promising treatment for depression; however, it is less well known through what mechanisms iCBT works. Two possible mediators of change are the acquisition of cognitive skills and increases in behavioral activation. We report results of an 8-week waitlist controlled trial of guided iCBT, and test whether early change in cognitive skills or behavioral activation mediated subsequent change in depression. The sample was 89 individuals randomized to guided iCBT (n = 59) or waitlist (n = 30). Participants were 75% female, 72% Caucasian, and 33 years old on average. The PHQ9 was the primary outcome measure. Mediators were the Competencies of Cognitive Therapy Scale–Self Report and the Behavioral Activation Scale for Depression–Short Form. Treatment was Beating the Blues plus manualized coaching. Outcomes were analyzed using linear mixed models, and mediation with a bootstrap resampling approach. The iCBT group was superior to waitlist, with large effect sizes at posttreatment (Hedges’ g = 1.45). Dropout of iCBT was 29% versus 10% for waitlist. In the mediation analyses, the acquisition of cognitive skills mediated subsequent depression change (indirect effect = -.61, 95% bootstrapped biased corrected CI: -1.47, -0.09), but increases in behavioral activation did not. iCBT is an effective treatment for depression, but dropout rates remain high. Change in iCBT appears to be mediated by improvements in the use of cognitive skills, such as critically evaluating and restructuring negative thoughts.