Randomised trial of expressive writing for distressed metastatic breast cancer patients

Women with metastatic breast cancer and significant psychological distress (N?=?87) were assigned randomly to engage in four home-based sessions of expressive writing or neutral writing. Women in the expressive writing group wrote about their deepest thoughts and feelings regarding their cancer, whereas women in the neutral writing group wrote about their daily activities in a factual manner. No statistically significant group differences in existential and psychological well-being, fatigue and sleep quality were found at 8-weeks post-writing. However, the expressive writing group reported significantly greater use of mental health services during the study than the neutral writing group (55% vs. 26%, respectively; p?<?0.05). Findings suggest that expressive writing may improve the uptake of mental health services among distressed cancer patients, but is not broadly effective as a psychotherapeutic intervention.     

Illness representations in patients with multimorbid long-term conditions: Qualitative study

Most research on illness representations explores how patients view single conditions, but many patients report more than one long-term condition (known as multimorbidity). It is not known how multimorbidity impacts on patient illness representations. This exploratory qualitative study examined patients’ representations of multimorbid long-term conditions and sought to assess how models of illness representation might need modification in the presence of multimorbidity. We explored two major issues: (1) the impact of multimorbidity on patient representations of their individual conditions and (2) the representation of multimorbidity itself. Twenty eight adults with at least two long-term conditions (mean of 4) were interviewed. The presence of multimorbidity impacted on patient illness representations in relation to the dimensions of identity, perceived cause, coherence and consequences. Representations of multimorbidity itself concerned representations of the burden of medication and perceived priorities among conditions and synergies and antagonisms between conditions and their management. The results have implications for the measurement of multimorbidity (through scales such as the Illness Perception Questionnaire) and the use of illness representations in the design and delivery of interventions to improve health behaviour and outcomes of patients with multiple long-term conditions.     

Agreement between Parents and Children on Ratings of Post-Concussive Symptoms Following Mild Traumatic Brain Injury

The level of parent-child agreement on post-concussive symptoms (PCS) was examined in children following mild traumatic brain injuries (TBI). As part of a larger longitudinal study, 186 children with mild TBI and 99 with orthopedic injuries (OI), from 8 to 15 years of age, were recruited prospectively. Parents and children completed the PCS Interview (PCS-I) and the Health and Behavior Inventory (HBI) at 2 weeks, 1 month, 3 months, and 12 months postinjury. Item-level correlations between child and parent ratings on both measures of PCS were significant but modest in both groups. Parent-child correlations for composite scales on the HBI and the total score on the PCS-I were significant in both groups, but somewhat higher in the OI group than in the mild TBI group. Mean symptom ratings tended to be significantly higher for children as compared to parents, especially for somatic symptoms. Parents and children display modest agreement when reporting PCS; their ratings correlate significantly, but children report higher mean levels of symptoms than parents.     

Executive functioning in individuals with a history of ASDs who have achieved optimal outcomes

Executive functioning (EF) is examined among children and adolescents once diagnosed with an autism spectrum disorder (ASD), but who no longer meet diagnostic criteria. These individuals have average social and language skills, receive minimal school support and are considered to have achieved “optimal outcomes” (OOs). Since residual impairments in these individuals might be expected in deficits central to autism, and in developmentally advanced skills, EF was examined in 34 individuals who achieved OOs, 43 individuals with high-functioning autism (HFA), and 34 typically developing (TD) peers. Groups were matched on age (M = 13.49), gender, and nonverbal IQ (NVIQ) but differed on verbal IQ (VIQ; HFA < TD, OO). On direct assessment, all three groups demonstrated average EF; however, the OO and HFA groups exhibited more impulsivity and less efficient planning and problem-solving than the TD group, and more HFA participants exhibited below average inhibition than did OO and TD participants. Parent-report measures revealed average EF among the OO and TD groups; however, the OO group exhibited more difficulty than the TD group on set-shifting and working memory. HFA participants demonstrated more difficulty on all parent-reported EF domains, with a clinical impairment in attention-shifting. Results suggest that EF in OO appears to be within the average range, even for functions that were impaired among individuals with HFA. Despite their average performance, however, the OO and TD groups differed on measures of impulsivity, set-shifting, problem-solving, working memory, and planning, suggesting that the OO group does not have the above-average EF scores of the TD group despite their high-average IQs.     

The meditations and the logic of testimony

This paper argues that an examination of the ontology that underpins Descartes’s Fifth Meditation ontological proof of God’s existence will contribute to a better understanding of the nature and structure of the proof. Attention to the Cartesian meditator’s development of this ontology in earlier meditations also makes clear why this proof could not have been asserted before the Fifth Meditation. Finally, it is argued that Kant’s objections against the ontological proof have no force against Descartes’ particular version of the proof.     

Book review

Raison et déraison d'État. Théoriciens et theories de la raison d'État aux XVIe et XVIIe siècles sous la direction de Yves Charles Zarka Paris, Presses Universitaires de France, 1994 pp. 436, 248 FF. ISBN 9–782130–461616.

Beverly C. Southgate: ’Covetous of Truth’: The Life and Work of Thomas White, 1593–1676 Dordrecht: Kluwer Academic Publishers, 1993. 189 pp. £60.00 ISBN 0–7923–1926–5

George Dicker: Descartes: An Analytical and Historical Introduction Oxford University Press, 1993 (248 pp.) £14.95 pbk. ISBN 0–19–507590–0

Theo Verbeek: Descartes and the Dutch: Early Reactions to Cartesian Philosophy, 1637–1650. Carbondale and Edwardsville, Southern Illinois University Press, 1992, x + 168 pp. $30.00 ISBN 0–8093–1617‐X

David Berman: George Berkeley: Idealism and the Man Oxford University Press, 1994. £27.50 ISBN 0–19–826746–0

Joseph Mali: The Rehabilitation of Myth: Vico's New Science Cambridge: Cambridge University Press, 1992. pp. xv + 275. £35.00 ISBN 0–521–41952–2

R. C. Solomon and K. W. Higgins (eds): The Age of German Idealism Routledge: London, 1993. Pp. 408. £55.00 (hbk) ISBN 0–415–05604–7

T. L. S. Sprigge: James and Bradley: American Truth and British Reality Chicago and La Salle, Illinois: Open Court, 1993 Pp. xiv + 630. $66.95 (hbk), $29.95 (pbk). ISBN 0–8126–9227–6 (pbk)

A. W. Moore: The Infinite Routledge, London and New York (1990). First published in paperback, 1991. xiv + 268 pp., £10.99 ISBN 0–415–07048–1     

The Contributions of Oral and Silent Reading Fluency to Reading Comprehension

Silent reading fluency has received limited attention in the school-based literatures across the past decade. We fill this gap by examining both oral and silent reading fluency and their relation to overall abilities in reading comprehension in fourth-grade students. Lower-level reading skills (word reading, rapid automatic naming) and vocabulary were included in structural equation models in order to determine their impact on reading fluency and comprehension. Results suggested that oral and silent reading fluency represent separate constructs, but only oral reading fluency contributed to reading comprehension. Vocabulary was found to contribute uniquely to comprehension even after controlling for reading fluency.     

Normal and Natural, or Burdensome and Terrible? Women with Spinal Cord Injuries Discuss Ambivalence about Menstruation

Literature on women’s reproductive health experiences after spinal cord injuries (SCI) documents a temporary period of amenorrhea after women’s injuries. However, research is lacking on how women with SCI feel about amenorrhea or menstruation. That is, we do not know the meanings that women with permanent, physical disability ascribe to their experiences of simultaneously “normal” and “abnormal” reproductive processes. Prioritizing a feminist disability perspective and using interview data from a snowball sample of 20 women with SCI in Detroit, Michigan, in the United States, we outline how interviewees are ambivalent (yet also slightly negative) towards menstruation and amenorrhea within the context of their disability, and may be both different from and similar to able-bodied women in their attitudes and experiences as a result.     

A Comparison of American and Nepalese Children's Concepts of Freedom of Choice and Social Constraint

Recent work has shown that preschool‐aged children and adults understand freedom of choice regardless of culture, but that adults across cultures differ in perceiving social obligations as constraints on action. To investigate the development of these cultural differences and universalities, we interviewed school‐aged children (4–11) in Nepal and the United States regarding beliefs about people's freedom of choice and constraint to follow preferences, perform impossible acts, and break social obligations. Children across cultures and ages universally endorsed the choice to follow preferences but not to perform impossible acts. Age and culture effects also emerged: Young children in both cultures viewed social obligations as constraints on action, but American children did so less as they aged. These findings suggest that while basic notions of free choice are universal, recognitions of social obligations as constraints on action may be culturally learned.     

Neither separate nor equivalent: Relationships between feature representations within bound objects

Evidence suggests that binding, or encoding a feature with respect to other features in time and space, can convey cognitive advantages. However, evidence across many kinds of stimuli and paradigms presents a mixed picture, alternatively showing cognitive costs or cognitive advantages associated with maintaining bound representations. We examined memory for colored letters drawn from similar and distinct color sets under circumstances that encouraged or discouraged the maintenance of color-letter binding. Our results confirmed previous change recognition research showing feature recognition improvement under explicit instructions to maintain binding. Color memory improved during binding, showing a reduced detrimental effect of feature similarity on retrieval, particularly when the letter served as the retrieval cue for a letter-color object. We found that feature recognition improved when two conditions were met: 1) relationships between features were to-be-remembered, and 2) the feature conjunction was relevant at test. Our results further suggest that this feature advantage arises because the encoded relationship between the features facilitates retrieval, not because features and objects are represented simultaneously in separate buffers.