Senator Bill Frist and the Medical Jeremiad

This essay analyzes Senator Bill Frist's 2001 address to the American Society of Thoracic Surgeons. The author argues that the address represents an attempt to reframe physicians' political identity to authorize more active participation by them. Frist authorizes and demands such participation through the construction of a medical jeremiad. He argues that American physicians must have greater involvement to preserve the health of the body politic and to reassert physician control over the biomedical system. Although Frist's arguments are built on an apparently democratic form of address, his jeremiad illustrates aristocratic possibilities in medico-political rhetoric.     

Evaluative conditioning in social psychology: Facts and speculations

The aim of the present paper is to examine the contribution of evaluative conditioning (EC) to attitude formation theory in social psychology. This aim is pursued on two fronts. First, evaluative conditioning is analysed for its relevance to social psychological research. We show that conditioned attitudes can be acquired through simple co-occurrences of a neutral and a valenced stimulus. Moreover, we argue that conditioned attitudes are not confined to direct contact with a valenced stimulus, but can be formed and dynamically reformed indirectly, through association chains. Second, social research is examined in an effort to identify evaluative learning mechanisms. We suggest that several important phenomena in social psychology (e.g., ingroup favouritism, prejudice, name letter effect) are at least partly due to simple mechanisms of evaluative learning. The implications for attitude formation theory and for applied settings are discussed.     

Chronic Fatigue Syndrome: The Need for Subtypes

Chronic fatigue syndrome (CFS) is an important condition confronting patients, clinicians, and researchers. This article provides information concerning the need for appropriate diagnosis of CFS subtypes. We first review findings suggesting that CFS is best conceptualized as a separate diagnostic entity rather than as part of a unitary model of functional somatic distress. Next, research involving the case definitions of CFS is reviewed. Findings suggest that whether a broad or more conservative case definition is employed, and whether clinic or community samples are recruited, these decisions will have a major influence in the types of patients selected. Review of further findings suggests that subtyping individuals with CFS on sociodemographic, functional disability, viral, immune, neuroendocrine, neurology, autonomic, and genetic biomarkers can provide clarification for researchers and clinicians who encounter CFS characteristically confusing heterogeneous symptom profiles. Treatment studies that incorporate subtypes might be particularly helpful in better understanding the pathophysiology of CFS. This review suggests that there is a need for greater diagnostic clarity, and this might be accomplished by subgroups that integrate multiple variables including those in cognitive, emotional, and biological domains.     

Care of the Self and Patient Participation in Genetic Discourse: A Foucauldian Reading of the Surgeon General's “My Family Health Portrait” Program

Critics of genetic discourse are concerned that deterministic and discriminatory views of genetics are increasingly becoming adopted. These views argue that current genetic discourse becomes a source of power whereby powerful institutions harm people with so-called “bad” genes. This essay argues that current analyses of the power of genetics discourse are grounded in an improper reading that disempowers patients. Deploying Michel Foucault's concept “care of the self,” this essay claims that genetics discourse is better understood as a way that patients take on power through rhetoric rather than a force that has power over patients. Through a close reading of the “My Family Health Portrait” program, this paper argues that patients experience a process of “subjection” wherein they become agents of and objects of genetics discourse both. This alternative mode of analyzing the power of genetics discourse has implications for our collective understanding of the operations of the care of the self and the uses of genetic information that we propose.     

Response speeding mediates the contributions of cue familiarity and target retrievability to metamnemonic judgments

Metamnemonic judgments are influenced by the retrievability of the target memory in question, but also by the familiarity of the cue used to elicit such judgments. However, there have been few suggestions as to what factors mediate the influence of these different sources of information on metamnemonic judgments. In this experiment, I examined the interactions between prediction time pressure and variables that promote either cue familiarity or target retrievability. The data reveal that target retrievability plays a larger role than does cue familiarity in fostering predictions of future recall made under unpressured conditions, but that cue familiarity influences predictions that are speeded. This pattern is interpreted by analogy with recognition memory: Mnemonic evidence based on familiarity is more impervious to the demands of time pressure than are the products of deliberative retrieval. Several explanations for this effect are suggested.     

Using criminalization and due process to reduce scientific misconduct

The issue of how to best minimize scientific misconduct remains a controversial topic among bioethicists, professors, policymakers, and attorneys. This paper suggests that harsher criminal sanctions against misconduct, better protections for whistleblowers, and the creation of due process standards for misconduct investigations are urgently needed. Although the causes of misconduct and estimates of problem remain varied, the literature suggests that scientific misconduct-fraud, fabrication, and plagiarism of scientific research-continues to damage public health and trust in science. Providing stricter criminal statutes against misconduct is necessary to motivate whistleblowers and deter wrongdoers, and the provision of basic due process protections is necessary for ensuring a fair and balanced misconduct investigation.     

How does context affect intimate relationships? linking external stress and cognitive processes within marriage

Stressors external to the marriage frequently affect the way spouses evaluate their marital quality. To date, however, understanding of the interplay between external stress and internal relationship processes has been limited in two ways. First, research has generally examined only the short-term consequences of stress. Second, the mechanisms through which external stressors influence relationship outcomes are unclear. This study addressed both limitations by examining relationship cognitions that may mediate the effects of external stress throughout 4 years of marriage. Analyses confirmed that stressful experiences were associated with the trajectory of marital quality overtime. Furthermore, both the content and the organization of spouses' specific relationship cognitions mediated this effect. That is, stress negatively influenced the nature of spouses' marital perceptions as well as the way spouses interpreted and processed those perceptions. These findings draw attention to ways that the context of relationships shapes and constrains relationship processes.     

Dimensions of impulsivity and aggression associated with suicide attempts among bipolar patients: a preliminary study

Impulsivity and hostility are often thought to be interrelated among depressed patients with suicidal behavior, but few studies have examined this relationship empirically. In this study, we assessed trait impulsivity and hostility among 52 DSM-IV bipolar subjects with and without histories of suicide attempts. Impulsivity and hostility were correlated among attempters (r = .41, p = .03) but not non-attempters (r = .22, p = .28). As compared to non-attempters, attempters had significantly higher levels of overall hostility, more extensive subcomponents of hostility, and a trend toward higher overall impulsivity. Associations between lifetime suicide attempts and overall hostility were significant while controlling for current depression severity and lifetime illness duration. Aggression and impulsivity appear linked among bipolar patients with lifetime suicide attempts but may be independent constructs among non-attempters. The presence of both factors may elevate risk for suicidal behavior.     

Index of suspicion: feeling not believing

Throughout the U.S., state laws require professionals who work with children to report cases of suspected child abuse to child protection services. Both practically and conceptually, however, significant problems arise from a lack of clarity regarding the threshold that has been set for reporting. Specifically, there is no consensus as to what constitutes reasonable suspicion, and little direction for how mandated reporters should gauge their legal and professional responsibilities when they harbor suspicion. In this paper we outline the context of the problem, discuss the nature and scope of its conceptual underpinnings, and offer recommendations for moving towards a concrete, practical solution.     

Human foraging behavior in a virtual environment

We have developed an experimental platform that allows a large number of human participants to interact in real time within a common virtual world. Within this environment, human participants foraged for resources distributed in two spatially separated pools. In addition to varying the relative replenishment rate for the two pools (50-50, 65-35, or 80-20), we manipulated whether the participants could see each other and the entire resource distribution or had their vision restricted to resources at their own location. Two empirical deviations from an optimal distribution of the participants were found. First, the participants were more scattered within a resource pool than the resources were themselves. Second, there was systematic underutilization of the richer pool. For example, the participants distributed themselves 73% and 27% to resource pools that had replenishment rates of 80% and 20%, respectively. In addition, there were oscillations in the harvesting rate of the pools across time, revealed by a Fourier analysis with prominent power near 50 sec per cycle. The suboptimalities and oscillations were more apparent when the locations of the participants and the food were not visible. Individual participant knowledge thus affects the efficiency with which a population of participants harvests resources.