“The Notion of Neutrality in Clinical Ethics Consultation”

Clinical ethics consultation (CEC), as an activity that may be provided by clinical ethics committees and consultants, is nowadays a well-established practice in North America. Although it has been increasingly implemented in Europe and elsewhere, no agreement can be found among scholars and practitioners on the appropriate role or approach the consultant should play when ethically problematic cases involving conflicts and uncertainties come up. In particular, there is no consensus on the acceptability of consultants making recommendations, offering moral advice upon request, and expressing personal opinions. We translate these issues into the question of whether the consultant should be neutral when performing an ethics consultation. We argue that the notion of neutrality 1) functions as a hermeneutical key to review the history of CEC as a whole; 2) may be enlightened by a precise assessment of the nature and goals of CEC; 3) refers to the normative dimension of CEC. Here, we distinguish four different meanings of neutrality: a neutral stance toward the parties involved in clinical decision making, toward the arguments offered to frame the discussion, toward the values and norms involved in the case, and toward the outcome of decision making, that is to say the final decision and action that will be implemented. Lastly, we suggest a non-authoritarian way to intend the term “recommendation” in the context of clinical ethics consultation.     

IMPACT OF PARENTAL BINGE EATING DISORDER: EXPLORING CHILDREN'S EMOTIONAL/BEHAVIORAL PROBLEMS AND THE QUALITY OF PARENT–CHILD FEEDING INTERACTIONS

This study examines psychopathological problems in children of parents with binge eating disorder (BED), particularly the effect of parental diagnosis on their offspring's psychopathology and the mediating power of the quality of parent–infant feeding interactions. Two hundred parents and their offspring were administered a questionnaire for the assessment of their children's psychopathology at 18 (T1) and 36 (T2) months of age. An observational measure to evaluate feeding interactions was administered at T1. Children with both parents with BED showed the highest affective, anxiety, oppositional/defiant, and autism spectrum problems, but no influence of paternal diagnosis was found on the offspring's psychopathology. Maternal BED had an influence on children's affective and autism spectrum problems, and diagnosis of BED in both parents had an effect on infants’ affective problems. Paternal BED had an effect on oppositional/defiant problems through the quality of father–infant interactions, and maternal BED had an effect on the offspring's affective and anxiety problems through the mediation of mother–infant interactions. These results suggest the importance of intervention programs focusing both on parental psychopathology and on mother–child and father–child feeding interactions in families with parents with BED.     

Parental Mediation of COVID-19 News and Children’s Emotion Regulation during Lockdown

Journal of Child and Family Studies - The COVID-19 outbreak resulted in a large amount of emotionally charged messaging that is believed to have a tremendous psychological impact, particularly on...     

Processing of representations in declarative and procedural working memory

The article investigates the relation between declarative and procedural working memory (WM; Oberauer, 2009). Two experiments test the assumption that representations in the two subsystems are selected for processing in analogous ways. Participants carried out a series of decisions on memorized lists of digits. For each decision, they had to select declarative and procedural representations. Regarding declarative representations, participants selected a memory set and a digit within this set as the input to each decision. With respect to the procedural representations, they selected a task set to be applied to the selected digit and a response within that task set. We independently manipulated the number of lists and the number of tasks to be switched among (one, two, or three; Experiment 1) and preparation time for a list switch (Experiment 2). For three effects commonly observed in task-switch studies, analogues in declarative WM were found: list-switch costs, mixing costs, and residual switch costs. List- and task-switch costs were underadditive, suggesting that declarative and procedural representations are selected separately and in parallel. The findings support the hypothesis of two analogous WM subsystems.     

The body one has and the body one is: Understanding the transsexual’s need to be seen

The transsexual individual confronts the analyst with a disturbing otherness. How this otherness is understood, that is, how the analyst ‘looks’ at the patient through her distinctive theoretical lens impacts, in turn, on the patient’s experience and what transpires between them. In this paper the author outlines a developmental model rooted in attachment and object relations theory to provide one alternative way of ‘looking’ at some of these patients’ experiences in the clinical setting. It is suggested that in some cases of transsexuality the primary object(s) did not mirror and contain an early experience of incongruity between the given body and the subjective experience of gender: it remains unmentalized and disrupts self‐coherence leading to the pursuit of surgery that is anticipated to ‘guarantee’ relief from the incongruity. Through an account of work with a male to female (MtF) transsexual who underwent surgery during her five years of psychotherapy, the author explores how a focus on the transsexual’s experience of ‘being seen’, that is, of being taken in (or not) visually and mentally by the object in their state of incongruity, affords another window through which to approach the transsexual’s experience in the transference–countertransference dynamics.     

The evolution of alexia in two cases of posterior cortical atrophy

Posterior cortical atrophy (PCA) is an uncommon presentation of Alzheimer's disease (AD), characterised by prevalent anatomo-functional involvement of posterior cortical areas. Accordingly, the main clinical features at onset are disorders of high-order visual processing, such as alexia and impairments of visuo-spatial and visuo-constructional abilities. The clinical features in the early stages of disease are variable, and they have been suggested to stem from prevalent ventral or dorsal brain pathology, and/or asymmetric hemispheric involvement. With disease progression, these differences tend to blur with the increasing severity of neuropsychological dysfunction. We report two PCA patients showing different patterns of reading impairment (respectively, letter-by-letter reading and neglect dyslexia). A follow-up study suggested that the qualitative features of alexia remain distinctive with disease evolution. In addition, single photon emission tomography (SPECT) studies revealed different patterns of hypoperfusion, consistent with the alexia types. A careful reading assessment can provide important insights to the pattern of progression of the disease in patients with PCA up to the late stages of the pathology.     

Exploring urban students' constructions about school, work, race, and ethnicity

This qualitative study is an exploration of 32 urban high school students' narratives about the connection between school, work, and societal expectations of their future success related to their racial and ethnic background. The sample varied along 2 contextual dimensions: participation in a psychoeducational intervention (Tools for Tomorrow) and developmental status (i.e., half the sample were 9th-grade students and the other half were 12th-grade students). Using consensual qualitative research, the narratives revealed 3 major domains: future orientation; students' perceptions of society's expectations based on race and ethnicity; and students' perception of the role of their race and ethnicity in future success. Results reveal that the majority of students endorse a connection between school and work, believe that society holds low expectations for them based on their racial and ethnic background, and cannot predict their future success based on their background.     

Migration Flows and Quality of Life in a Metropolitan Area: the Case of Barcelona-Spain

The phenomenon of human migration is certainly not new and it has been studied from a variety of perspectives. Yet, the attention on human migration and its determinant has not been fading over time as confirmed by recent contributions (see for instance Cushing and Poot 2004 and Rebhun and Raveh 2006). In this paper we combine the recent theoretical contributions by Douglas (1997) and Wall (2001) with the methodological advancements of Guimarães et al. (2000, 2003) to model inter-municipal migration flows in the Barcelona area. In order to do that, we employ two different types of count models, i.e. the Poisson and negative binomial and compare the estimations obtained. Our results show that, even after controlling for the traditional migration factors, QoL (measured with a Composite Index which includes numerous aspects and also using a list of individual variables) is an important determinant of short distance migration movements in the Barcelona area.     

Consequences of brain tumour resection on emotion recognition

Emotion processing impairments are common in patients undergoing brain surgery for fronto-temporal tumour resection, with potential consequences on social interactions. However, evidence is controversial concerning side and site of lesions causing such deficits. This study investigates visual and auditory emotion recognition in brain tumour patients with the aim of clarifying which lesion sites are related to impairments in emotion processing from different modalities. Thirty-four patients were evaluated, before and after surgery, on facial expression and emotional prosody recognition; voxel-based lesion–symptom mapping (VLSM) analyses were performed on patients’ post-surgery MRI images. Results showed that patients’ performance decreased after surgery in both visual and auditory modalities, but, in general, recovered 3 months after surgery. In facial expression recognition, left brain-damaged patients showed greater post-surgery deterioration than right brain-damaged ones, whose performance specifically decreased for sadness and fear. VLSM analysis revealed two segregated areas in the left hemisphere accounting for post-surgery scores for happy (fronto-temporo-insular region) and surprised (middle frontal gyrus and inferior fronto-occipital fasciculus) facial expressions. Our findings demonstrate that surgical removal of tumours in the fronto-temporal region produces impairment in facial emotion recognition with an overall recovery at 3 months, suggesting a partially different representation of positive and negative emotions in the left and right hemispheres for visually – but not auditory – presented emotions; moreover, we show that deficits in specific expression recognition are associated with discrete lesion locations.