How to be an infallibilist

Philosophical Studies - While fallibilism has been the dominant view in epistemology in recent times, the field has witnessed the rise of a new form of infallibilism. In a recent book, Jessica...     

Examining Direct and Indirect Mechanisms of Parental Influences on Youth Physical Activity and Body Mass Index

Journal of Child and Family Studies - This study used social cognitive theory to compare the direct versus indirect effects of parent physical activity, sedentary behavior, and body mass index...     

Trust as performance

It is argued that trust is a performative kind and that the evaluative normativity of trust is a special case of the evaluative normativity of performances generally. The view is shown to have advantages over competitor views, e.g., according to which good trusting is principally a matter of good believing (e.g., Hieronymi, 2008; McMyler, 2011), or good affect (e.g., Baier, 1986; Jones, 1996), or good conation (e.g., Holton, 1994). Moreover, the view can be easily extended to explain good (and bad) distrust, where the latter is understood as aimed (narrow-scoped) forbearance from trusting. The overarching framework—which assimilates the evaluative norms of trusting (and distrusting) to performance-theoretic norms—supplies us with an entirely new lens to view traditional philosophical problems about what is involved in trusting and distrusting well and badly, and thus, places our capacity to make progress on problems in this area on a new footing.     

The temporal structure of goal-directed and habitual operant behavior

Operant behavior can reflect the influence of goal-directed and habitual processes. These can be distinguished by changes to response rate following devaluation of the reinforcing outcome. Whether a response is goal directed or habitual depends on whether devaluation affects response rate. Response rate can be decomposed into frequencies of bouts and pauses by analyzing the distribution of interresponse times. This study sought to characterize goal-directed and habitual behaviors in terms of bout-initiation rate, within-bout response rate, bout length, and bout duration. Data were taken from three published studies that compared sensitivity to devaluation following brief and extended training with variable-interval schedules. Analyses focused on goal-directed and habitual responding, a comparison of a habitual response to a similarly trained response that had been converted back to goal-directed status after a surprising event, and a demonstration of contextual control of habit and goal direction in the same subjects. Across experiments and despite responses being clearly distinguished as goal directed and habitual by total response rate, analyses of bout-initiation rate, within-bout rate, bout length, and bout duration did not reveal a pattern that distinguished goal-directed from habitual responding.     

Increased wait-list time predicts dropout from outpatient enhanced cognitive behaviour therapy (CBT-E) for eating disorders

Between 30 and 70% of patients with eating disorders drop out from outpatient treatment. However, research has been unable to identify factors that consistently predict dropout from eating disorder treatment. Most studies have exclusively investigated the role that individual patient characteristics play in dropout and have ignored more process-based factors such as expectations about treatment, the therapeutic alliance, or time spent on a treatment waiting list. This study aimed to investigate the roles of both individual patient characteristics and process-based factors in dropout from outpatient treatment for eating disorders. The study involved data collected from consecutive eating disorder referrals to the only public specialist eating disorder service for youth and adults in Perth, Western Australia. The standard treatment provided at this service is Enhanced Cognitive Behaviour Therapy on an individual basis. The study involved 189 patients referred to the service between 2005 and 2010. Forty five percent of this sample dropped out of treatment. Results showed that, in this sample, two individual factors, lowest reported weight and the tendency to avoid affect, and one process-based factor, time spent on the wait list for treatment, were significant predictors of dropout. These findings are valuable because a process-based factor, such as wait-list time, may be easier to address and modify than a patient's weight history or the trait of mood intolerance. Increased resources for eating disorder services may reduce waiting list times which would help to reduce dropout and maximize treatment outcomes.     

Peripheral oxytocin administration buffers autonomic but not behavioral responses to environmental stressors in isolated prairie voles

Negative social experiences such as social stressors and isolation influence mental and physical illnesses, including affective disorders and heart disease. Studies focused on socially monogamous prairie voles can provide insight into neurobiological systems that underlie the consequences of negative social interactions. Female prairie voles were exposed to 28 days of social isolation or pairing with a female sibling (control). Voles were administered daily oxytocin [20 μg/50 μl, subcutaneous (sc)] or saline vehicle (50 μl, sc) for 14 days and exposed to two behavioral stressors [elevated plus maze (EPM) and resident-intruder test]. Brain tissue was collected for analysis of central peptide levels in the hypothalamic paraventricular nucleus (PVN). Isolation produced autonomic changes [increased heart rate (HR) and decreased HR variability) during both acute stressors and increased anxiety behaviors in the EPM. Oxytocin injection prevented the autonomic consequences of the acute stressors in isolated prairie voles, but did not affect the behaviors tested under the present conditions. Oxytocin had no effect on the behavioral or autonomic responsiveness in paired prairie voles. Oxytocin injection may exert a beneficial effect on autonomic responses to stressors in isolated animals through increasing the number of oxytocin-containing neurons and decreasing the number of corticotropin-releasing hormone-containing neurons in the PVN. Oxytocinergic mechanisms may serve to compensate for autonomic responses associated with chronic isolation and exposure to both social and non-social acute stressors.     

Seeing through The Bell Jar: Investigating Linguistic Patterns of Psychological Disorder

As a means of conveying difficult personal experiences, illness narratives and their analysis have the potential to increase awareness of patients' lives and circumstances. Becoming sensitised to the linguistic texture of narrative offers readers a means of increasing narrative understanding. Using the fictional narrative of The Bell Jar, this paper outlines a novel method for exploring the language of illness narratives. Corpus stylistics provides new insights into narrative texture and demonstrates the importance of recurrent linguistic features in shaping meaning. The paper concludes by proposing the application of a similar methodology to non-fictional illness narratives in therapeutic contexts.     

Patient role orientations,doctor-patient fit,and visit satisfaction

Abstract

Two studies were conducted using the Patient-Practitioner Orientation Scale (PPOS), an instrument that measures the role orientations of patients. In the first, 297 students responded to a pool of 61 items concerning their attitudes about doctor-patient relationships (e.g., about power-sharing and the importance of physicians' supportiveness). The scale was reduced, and associations between PPOS scores and gender, race, country of origin as well as Health Locus of Control were found. In Study 2, 90 additional students filled out the PPOS, read two doctor-patient scenarios, and rated their satisfaction as if they had been the patient. In one, the physician exhibited a controlling style, and in the other a more open style. As predicted, patient-centered physicians generated higher satisfaction, and patients were most satisfied with a physician whose style matched their own role orientation. These studies suggest the potential usefulness of the PPOS as an indicator of patient attitudes and doctor-patient fit, and as an predictor of visit satisfaction.     

Assessment of cognitive domains during treatment with OROS methylphenidate in adolescents with ADHD

Aim: To psychometrically assess cognitive domains in adolescents with ADHD during long-term open treatment with robust dosing of extended-release methylphenidate (OROS MPH).

Methods: Data were derived from a prospective clinical study of adolescent ADHD, employing the Cambridge Neuropsychological Test Automated Battery (CANTAB), before and after up to one year of treatment with OROS MPH. In the absence of placebo control, a similar age and gender group of youth without ADHD served as comparators.

Results: During the course of treatment with OROS MPH, ADHD youth’s performance significantly improved across multiple CANTAB tasks, including spatial working memory, rapid visual processing, verbal recognition memory, set shifting, and inhibition/vigilance. ADHD subjects’ scores in several CANTAB tasks, including spatial working memory, planning, and set shifting, were significantly more impaired at baseline compared to the non-ADHD comparison group; these significant differences were no longer seen at endpoint.

Conclusions: Statistically significant improvements in multiple cognitive domains were observed in a sample of adolescents with ADHD over the course of 12 months of robust treatment with extended-release methylphenidate. Rigorous, monitored stimulant treatment may be associated with objectively determined cognitive benefits; however, practice effects in this open trial cannot be ruled out. Further study on this important topic is warranted.