医学与文学的传统及创新

论述医学与文学关系的文章习惯以阿波罗开头。文学与医学直到最近才成为医学人文学里的一个新的学术分支 ,但文学与医学的关系至少可追溯到古希腊。本文中 ,我将讨论如何看待医学与文学关系的四种传统方式 :其一 ,疾病的形象 (ｉｍａｇｅｓ) ,即文学中患病、苦难和死亡的主题 ;其二 ,治疗者的形象 ;其三 ,医生—诗人或医生—作家类型 ;其四 ,文学作为一种治疗方法。然后 ,我将简要讨论文学在今日医学教育中的作用并提供一个思辨性的结论。1　传统1 1　患病、苦难和死亡的主题与医学一样 ,文学关涉患病、苦难和死亡这些与人类同样古老的主题…     

Neural mechanisms of affective interference in schizotypy

Negatively valenced stimuli foster cognitive impairment in schizotypy and schizophrenia. To identify relevant brain mechanisms, the authors had 16 positive-schizotypy and 16 control participants perform an emotional Stroop task, judging the ink color of negative and neutral words during functional magnetic resonance imaging (fMRI) of regional brain activity. Schizotypy individuals showed increased right and decreased left activity in dorsolateral prefrontal cortex, indicating a deficit in maintenance of attentional set in the presence of negative emotional distractors. They also showed abnormal activity in ventral limbic areas, including decreased activity in nucleus accumbens and increased activity in hippocampus and amygdala, a circuit involved in the integration of cognitive and affective processes. These results indicate that aspects of emotion-cognition processes and the brain mechanisms that implement them are similar in schizotypy and schizophrenia.     

Establishing derived requesting skills in adults with severe developmental disabilities

This project examined whether a history of reinforced relational responding would result in derived requesting skills in 3 adults with disabilities. Participants were first taught to request preferred items using pictures; they were then taught conditional discriminations between pictures and their dictated names and between dictated names and their corresponding text. Finally, requests for preferred items using corresponding text were evaluated. All 3 participants demonstrated derived requesting skills.     

A case study of mediated learning, delayed auditory feedback, and motor repatterning to reduce stuttering

A case study of DW, an 11-yr. old monolingual, English-speaking boy who exhibits stuttering, language delay, and ADHD is presented. DW experienced only limited improvement during stuttering therapy received in public schools, according to parents and the public school clinician. The purpose of this case study was to assess whether fluency treatment which incorporated Mediated Learning, Delayed Auditory Feedback, and Speech Motor Repatterning would enhance progress. Therapy was delivered in two treatments, with each treatment being 5 wk. of intense therapy, separated by one year. Treatment 1 of combined Mediated Learning and Delayed Auditory Feedback yielded improvement in fluency, judged by parents and the teacher to be clinically significant. The improved fluency was maintained for one year when DW was pretested for participation in Treatment 2, which combined Mediated Learning, Delayed Auditory Feedback, and Speech Motor Repatterning Exercises. As no conclusions are possible, further study is needed.     

Intervention Groups for Adolescents With Conduct Problems: Is Aggregation Harmful or Helpful?

Past research has suggested that the aggregation of deviant peers during treatment may cause harmful effects (T. J. Dishion, J. McCord, & F. Poulin, 1999). This study compared the effectiveness of problem-solving skills training groups in which all members had conduct problems (pure group condition) with groups that consisted of adolescents with and without behavior problems (mixed group condition). Participants were 139 sixth- and seventh-graders (mean age = 12.7; 63% male; 55% White) enrolled at public middle schools. Pre-, post-, and 6-month follow-up data were collected, along with intervention process variables. Results showed that, contrary to the deviancy training hypothesis, adolescents in the pure-group condition engaged in more adaptive in-session behavior and received lower scores on the parent and teacher ratings of externalizing behavior at postintervention than those in the mixed-group condition. Mediation analyses showed that the deviancy training that occurred in the mixed-group condition accounted for their worse postintervention scores, findings consistent with the deviancy training hypothesis.     

Sequential processing in hemispheric word recognition: the impact of initial letter discriminability on the OUP naming effect

The cerebral hemispheres have been proposed to engage different word recognition strategies: the left hemisphere implementing a parallel, and the right hemisphere, a sequential, analysis. To investigate this notion, we asked participants to name words with an early or late orthographic uniqueness point (OUP), presented horizontally to their left (LVF), right (RVF), or both fields of vision (BVF). Consistent with past foveal research, Experiment 1 produced a robust facilitatory effect of early OUP for RVF/BVF presentations, indicating the presence of sequential processes in lexical retrieval. The effect was absent for LVF trials, which we argue results from the disadvantaged position of initial letters of words presented in the LVF. To test this proposition, Experiment 2 assessed the discriminability of various letter positions in the visual fields using a bar-probe task. The obtained error functions highlighted the poor discriminability of initial letters in the LVF and latter letters in the RVF. To confirm that this asymmetry in initial letter acuity was responsible for the absent OUP effect for LVF presentations, Experiment 3 replicated Experiment 1 using vertical stimulus presentations. Results indicated a marked facilitatory effect of early OUP across visual fields, supporting our contention that the lack of OUP effect for LVF presentations in Experiment 1 resulted from poor discriminability of the initial letters. These findings confirm the presence of sequential processes in both left and right hemisphere word recognition, casting doubt on parallel models of word processing.     

The Effect of Competitive Outcome and Task-Involving,Ego-Involving,and Cooperative Structures on the Psychological Well-Being of Individuals Engaged in a Co-Ordination Task: A Self-Determination Approach

Differing task and motivational characteristics of the competitive setting (viz., task-involving/ego-involving climates, cooperative/individual, and win/loss competitive outcome) were explored in relation to need satisfaction and subjective well-being (SWB). Participants, one-on-one or in pairs, were required to participate in a physical co-ordination task. Results revealed participants exposed to a task-involving condition and those who worked in cooperation to report higher levels of need satisfaction and SWB. Conversely, individuals exposed to ego-involving conditions and those who competed individually experienced higher levels of negative affect. Winning resulted in higher levels of need satisfaction and SWB, whereas losing led to higher levels of negative affect. Losing individually in an ego-involving condition led to the highest levels of negative affect responses and attenuated levels of reported need satisfaction and SWB. Via structural equation modeling, a model of motivational processes grounded in self-determination theory was supported in which elements of the competitive situation that facilitated need satisfaction led to increments in reported indices of SWB.     

Book Reviews : Dane R. Gordon and David C. Durst (eds.), Civil Society in Southeast Europe,Rodopi, Amsterdam/New York, 2004.

Studies in East European Thought -     

Silent reading rate and memory span

This paper reports two experiments concerned with the form of the linear function relating memory span to pronunciation rate. Experiment 1 asked whether the intercept of the equation is attributable to an interaction between modality, word-length, and serial position. The results lead us to reject this possibility. Experiment 2 examined the shape of the span function for visual presentation of lists read aloud or silently. The results show that the intercept of the span function disappears for silent presentation but not for aloud presentation. The results are discussed in terms of a balance between two opposing effects of word-length.