Rates and Correlates of DSM-IV Diagnoses in Women Newly Diagnosed with Breast Cancer

Although the presence of psychological distress has been documented in women with breast cancer, previous studies have not established rates of DSM-IV diagnoses in this population, nor have prior investigations compared the utility of diagnostic interviewing vs. symptom checklists to assess distress. DSM-IV diagnoses of anxiety disorders and major depression, symptoms of anxiety and depression, and quality of life were examined in 207 women with newly diagnosed breast cancer. Eighteen percent of breast cancer patients met criteria for a current DSM-IV anxiety or depressive disorder and 54% met criteria for a disorder at some point in their lifetime. These rates are comparable to those found in recent community epidemiological studies (e.g., R. C. Kessler, K. A. McGonagle, S. Zhao, C. B. Nelson, M. Hughes, S. Esheman, et al., 1994). Sensitivity, specificity, and positive predictive value for anxiety and depression symptoms as predictors of DSM disorders were relatively poor. However, after accounting for demographic, treatment, and cancer variables, self-reported anxiety symptoms were significantly related to the presence of an anxiety disorder and self-reported depressive symptoms were significantly related to a diagnosis of a depressive disorder. Symptoms of anxiety and depression contributed significantly and uniquely to physical, medical, and sexual quality of life; DSM-IV diagnoses were not significantly related to quality of life after controlling for symptoms of depression and anxiety. The importance of measuring both symptoms of distress and psychiatric diagnoses in cancer patients and the clinical practice implications of the results are discussed.     

Comments on Jason Stanley's “On the Linguistic Basis for Contextualism”

Philosophical Studies -     

The therapeutic alliance: Adolescent perspectives

This paper presents a conceptualisation of the therapeutic alliance from the adolescent perspective and discusses implications for practitioners. The main aim of the study was to focus on the factors that participants identified as important in relationship formation and maintenance. Eighteen individuals were interviewed using a semi‐structured format. Three major themes were identified: therapeutic environment, uniqueness of the therapeutic relationship, and therapist characteristics. Participants identified both positive and negative aspects of the therapeutic relationship. A strong alliance was found to be necessary in that the perception of the therapist as accepting, supportive and trustworthy influenced the adolescent's evaluation of the appropriateness of therapeutic tasks and goals. Participants stressed the importance of the supportive nature of the relationship in their willingness to collaborate in therapeutic interventions.     

Personal epistemology and theory of mind: deciphering young children's beliefs about knowledge and knowing

The beliefs that individuals hold about knowledge and knowing have been the focus of a growing body of work on “personal epistemology.” There has been general agreement among researchers about a developmental trajectory of epistemological understanding that takes place in adolescence and adulthood. Rarely has this research included children, however, and we know little about the origins of epistemological awareness or its early development. A separate group of researchers have investigated children's “theory of mind,” or the ability to understand others’ beliefs, actions, and desires, with primary attention to the onset of this cognitive achievement between the ages of 3 and 5. This article reviews the theoretical foundation for a proposed relation between these constructs, and reports on an exploratory investigation with 3–5 year olds, in which epistemological level was significantly related to theory of mind ability. Results are discussed in relation to a general timeline depicting the development of children's beliefs about knowledge and knowing, a process that involves an ongoing tension between objective and subjective perspectives. We propose that the trajectory of epistemological development be expanded to include an initial period of egocentric subjectivity that characterizes epistemological thinking prior to the achievement of theory of mind.     

Reasons for Reason-giving in a Public-Opinion Survey

This paper explores why respondents to a telephone public-opinion survey often give reasons for answering as they do, even though reason-giving is neither required nor encouraged and it is difficult to see the reasons as attempts to deal with disagreement. We find that respondents give reasons for the policy claims they make in their answers three times as frequently as they give reasons for value or factual claims, that their reasons tend to involve appeals to personal experience, and that they often talk about their thought processes, especially when the evidentiary stakes are high. We then explore several ways of explaining these findings. We suggest that one useful approach is to see the reason-giving in the survey interviews as deliberative, reflexive argumentation of the sort described as `critical thinking. We further suggest that the reason such argumentation is often conducted out loud in the interviews, rather than internally, is that it functions in the service of rhetorical ethos, in particular the need to display the fact that one is human, with human autonomy and agency. Doing this may be particularly important in contexts such as anonymous survey interviews in which people are at risk of being treated like machines.     

A Type Hierarchy of Selection Processes for the Evaluation of Evolutionary Analogies

In this paper I propose a type-hierarchy approach to provide an intersubjective framework for the evaluation of evolutionary analogies. This approach develops David Hull’s and others’ attempts to provide full generalisation for selection processes, in order to show that sociocultural development and, particularly, scientific change can be considered as an instance of Darwinian selection. I argue that the recent work by Eileen Cornell Way on type hierarchies can offer the kind of generalisation needed to solve the main problems that still affect Hull’s theory and to show that the evolutionary analogy is, after all, only a particular way of grouping phenomena together. If Hull’s main objective is a unified theory of selection, which supports the idea that science selection and natural selection obey the same laws, I also argue that the type hierarchy approach to models shows that this objective is unsustainable as it stands, and is in need of further development. I will firstly introduce the general outline of the type hierarchy approach to models. Then, after a brief recapitulation of Hull’s main points and difficulties, I will try and construct a hierarchy for a general abstraction of selection processes. Finally I will introduce the main criticisms that Hull’s work has faced from philosophers and scientists, and show how they compare with my proposal.     

Prismatic Lenses Shift Time Perception

ABSTRACT— Previous studies have demonstrated the involvement of spatial codes in the representation of time and numbers. We took advantage of a well-known spatial modulation (prismatic adaptation) to test the hypothesis that the representation of time is spatially oriented from left to right, with smaller time intervals being represented to the left of larger time intervals. Healthy subjects performed a time-reproduction task and a time-bisection task, before and after leftward and rightward prismatic adaptation. Results showed that prismatic adaptation inducing a rightward orientation of spatial attention produced an overestimation of time intervals, whereas prismatic adaptation inducing a leftward shift of spatial attention produced an underestimation of time intervals. These findings not only confirm that temporal intervals are represented as horizontally arranged in space, but also reveal that spatial modulation of time processing most likely occurs via cuing of spatial attention, and that spatial attention can influence the spatial coding of quantity in different dimensions.     

The efficacy of a short version of a cognitive-behavioral treatment followed by booster sessions for binge eating disorder

This waitlist-controlled study evaluated the efficacy of a short version of a group CBT for BED followed by booster sessions after the active treatment phase. Thirty-six females with BED were randomly assigned to CBT (eight weekly sessions during active treatment plus five booster sessions during follow-up) or a waitlist condition. At the end of the active treatment, binge eating was significantly reduced relative to waitlist. Furthermore, at 12-month follow-up short-term CBT produced significant improvements in binge eating symptoms relative to baseline. Findings suggest that the short-term CBT followed by booster sessions may provide a valuable treatment option for patients with BED.     

Can Attention Deficit Hyperactivity Disorder and Fetal Alcohol Spectrum Disorder be differentiated by motor and balance deficits?

There is an ongoing debate regarding the diagnostic overlap between Attention Deficit Hyperactivity Disorder (ADHD) and Fetal Alcohol Spectrum Disorder (FASD). Differential diagnosis is important because of treatment implications. Children aged 7–10 years (47 ADHD, 30 FASD, 39 controls) participated. The Movement Assessment Battery for Children (M-ABC) and the Clinical Observations of Motor and Postural Skills (COMPS) were used. Force plate and electromyography data were collected during static balance and balance perturbation. On the M-ABC both children with ADHD and FASD had more motor problems than controls. The ADHD-Combined and the ADHD-Predominantly Inattentive subgroups were similarly affected in their fine motor skills. On the COMPS, the majority of children in both groups performed in the normal range, but for those children clinically affected, it was the children with ADHD who were more likely to be severely impaired. The children with ADHD were characterized by early onset latencies of the tibialis anterior muscles and increased amplitudes of the gastrocnemius muscles. Difficulty scaling muscle force reflecting medial cerebellar involvement may be the key problem in ADHD. Cerebellar involvement in the postural instability in FASD awaits further study.     

Effect of fatigue on double pole kinematics in sprint cross-country skiing

The aim of the present study was to examine the effect of fatigue (physiological, mechanical, and muscular parameters) induced by a sprint simulation on kinematic parameters (cycle, phases, and joints angles) of the double pole technique. Eight elite skiers were tested for knee extensor strength and upper body power both before and after a three-bout simulation of sprint racing. They were video analyzed during the final part of the test track of bouts 1 and 3 using a digital camera. Results showed that skiers were in a fatigue state (decrease of the knee extensors voluntary force (-10.4+/-10.4%) and upper body power output (-11.1+/-8.7%) at the end of the sprint. During bout 3, the final spurt and cycle velocities decreased significantly (-7.5+/-12.3%; -13.2+/-9.5%; both p<.05). Angular patterns were only slightly modified between bouts 1 and 3 with trunk, hip, and pole angles being significantly greater for the third bout. The decrease of hip and trunk flexion and the lower inclination of the pole during the poling phase suggested a reduced effectiveness of the force application which could lead to a decrease in the cycle velocity.