Should scientists think? Comment on Machado and Silva (2007)

The author has previously claimed that neural activity in a medial frontal brain area represents conscious motor intentions. A. Machado and F. J. Silva attempted to challenge this claim by arguing that such intentions are not necessarily causally effective and must be caused by something else, so that they therefore cannot be the unmoved first movers in action. The author's reply is that he made no such claims about the causal status and origin of conscious intentions. In fact, he has elsewhere presented empirical evidence in support of the idea that intentions are not necessarily causal. But this does not stop researchers from studying the neural basis for the conscious impression that one intends and wills one's actions. One can feel and attend to such intentions, be they causal or not. The author's claim is that there is neural activity in the medial frontal wall that reflects such conscious feelings. Other recent empirical evidence that supports this view is described.     

‘Are you a woman—or a flower?’: The capacity to experience beauty1

Being surprised by beauty, being drawn to and moved by it and surrendering to its sensory nature are all part of beauty's emotionally transformative power. And yet, psychoanalysis has had little to say about such an enriching dimension of psychological life. The author highlights how experiencing beauty is a capacity that is not isolated but is part of the lifelong experience of being changed by and changing the experience of the world we live in. She suggests that the capacity to experience beauty takes different forms at distinct points in development and in psychoanalytic treatments. The author describes two clinical occasions from a case where an analytic pair struggled to develop a greater capacity to experience beauty over time. She discusses how a theory of the aesthetic conflict was useful in helping to understand her patient's inner object world but was not sufficient when it came to understanding the experience of beauty. She shows how for both patient and analyst, experiencing beauty's full effect required responding to the call toward emotional life, surrendering to the surprise and the unknown, and letting go of the mind's struggle to find meaning and opening up to transforming and being transformed through sensory experience.     

Should Extremely Premature Babies Get Ventilators During the COVID-19 Crisis?

Abstract

In a crisis, societal needs take precedence over a patient’s best interests. Triage guidelines, however, differ on whether limited resources should focus on maximizing lives or life-years. Choosing between these two approaches has implications for neonatology. Neonatal units have ventilators, some adaptable for adults. This raises the question of whether, in crisis conditions, guidelines for treating extremely premature babies should be altered to free-up ventilators. Some adults who need ventilators will have a survival rate higher than some extremely premature babies. But surviving babies will likely live longer, maximizing life-years. Empiric evidence demonstrates that these babies can derive significant survival benefits from ventilation when compared to adults. When “triaging” or choosing between patients, justice demands fair guidelines. Premature babies do not deserve special consideration; they deserve equal consideration. Solidarity is crucial but must consider needs specific to patient populations and avoid biases against people with disabilities and extremely premature babies.     

Expulsion prevention: Framework for the role of infant and early childhood mental health consultation in addressing implicit biases

Young children of color—especially boys—are at disproportionate risk for suspension and expulsion from early care and education settings. Infant and Early Childhood Mental Health Consultation (IECMHC) is an approach associated with lower than expected expulsion rates, but the mechanisms through which it may influence preschool expulsion are unknown. This paper reflects on the parallels between IECMHC and interventions created to reduce implicit bias. Based on interviews with leaders in IECMHC practice, implementation, and evaluation, a theoretical framework was created to articulate how IECMHC is hypothesized to affect expulsion by first reducing the influence of implicit bias on disciplinary decisions. Implications for practice and research are provided.     

The interactive effects of duality expertise and coping frames on responses to ambivalent messages

We examine the interactive effects of biculturals' duality expertise and externally provided coping resources on attitudinal responses to ambivalence. Three studies reveal that ambivalence is associated with greater discomfort for biculturals more (vs. less) conflicted about their cultural duality and with limited exposure to accessing their two cultural knowledge systems simultaneously. Among biculturals with lower duality expertise, coping frames lower their negative evaluation of messages that elicit ambivalence because coping frames help these biculturals resolve the discomfort associated with ambivalence. Provision of coping frames does not impact attitudes of biculturals with greater levels of duality expertise.     

Self-Interest, Symbolic Attitudes, and Support for Public Policy: A Multilevel Analysis

This paper examines the role of self-interest and symbolic attitudes as predictors of support for two domestic policy issues—guaranteed jobs and incomes and national health insurance—in the American National Election Survey (ANES) between 1972 and 2004. As was the case in 1976 when Sears, Lau, Tyler, and Allen (1980 ) first explored this topic, symbolic attitudes continue to be much more important predictors of policy attitudes than various indicators of self-interest over the 30 years we analyze. We explore this finding further to determine whether any individual/internal and external/contextual variables affect the magnitude of self-interest effects on policy support. Five possible internal moderators of self-interest effects are examined: (1) political knowledge, (2) issue publics, (3) political values, (4) social identifications, and (5) emotions, but none are found to boost the magnitude of the self-interest effect. However, we do find some evidence that contextual variables representing the social/information environment moderate the impact of self-interest on public opinion.     

Parental Narratives About Genetic Testing for Hearing Loss: A One Year Follow Up Study

Few studies examine whether and how parental attitudes towards genetic testing change over time. In this study we interviewed parents of 14 children with newly identified hearing loss at two time points: after referral to genetics and 1 year later. Qualitative analyses of parental narratives indicate that parental attitudes did not change significantly over this time. Parents who perceived genetic testing to be useful continued to value it after testing, while parents who did not perceive it as being useful for their child’s future held the same view a year later. The only parents who changed their views regarding the usefulness of genetic testing for hearing loss were those who reported that their children underwent significant changes in their hearing loss or were faced with other life threatening conditions. Parents were also often unaware of the role of the genetic counselor and how genetic counseling could help address many of their lingering questions and concerns. These emergent themes indicate the need for geneticists and genetic counselors to be aware of and sensitized to the questions and attitudes that bring parents to a genetic evaluation, as well as the reasons why parents may not follow up with genetic testing for hearing loss when recommended.     

PTSD symptom trajectories: from early to chronic response

This study aimed to identify posttraumatic stress disorder (PTSD) symptom trajectories across the first 12 months following traumatic injury. Three hundred and seven consecutively admitted injury survivors were assessed for severity of PTSD symptoms just prior to discharge, and at 3 and 12 months postinjury. Growth modeling was used to determine the curve that best fit the trajectory for each symptom cluster over the 12-month period. Individuals with 12-month PTSD showed significantly higher re-experiencing, arousal, and avoidance symptoms at eight days posttrauma relative to those without, and these symptoms escalated over time. Those without PTSD maintained their relatively low symptom levels. These findings highlight that individuals who will go onto develop PTSD have a distinctly different symptom course than those who recover.