The Medical Offset Effect: Patterns in Outpatient Services Reduction for High Utilizers of Health Care

Psychosocial intervention has been found to be related to subsequent reductions in health care use. Studies generally measure this “offset effect” by combining medical use categories into one outcome variable, such as outpatient doctor visits. However, using a general outcome variable may obscure more specific patterns of reduction. In an effort to identify potential “targets” for mental health intervention, outpatient care for health screening, illness visits, laboratory/X-ray, and urgent care were considered. Health care use reductions were most prominent for high utilizers and were found across a number of different types of outpatient care. With high utilizers, those who participated in MFT showed significant reductions of 68% for health screening visits, 38% for illness visits, 56% for laboratory/X-ray visits, and 78% for urgent care visits.     

Natural,Artifactual, and Moral Goodness

In Natural Goodness, Philippa Foot (2001) aims to provide an account of moral evaluation that is both naturalistic and cognitivist. She argues that moral evaluation is a variety of natural evaluation in the sense that moral judgments of human action and character have the same “grammar” or “conceptual structure” as natural judgments of the goodness (e.g., health) of plants and animals. We argue that Foot’s naturalist project can succeed, but not in the way she envisions, because her central thesis that moral evaluation is a variety of natural evaluation is not entirely correct. We show that both moral and natural evaluation are species of kind evaluation, which encompasses moral, natural, and artifact evaluation. Kind evaluation is a form of evaluation, according to which things are evaluated qua members of a kind, in such a way that the kind into which something is classified informs the standards of evaluation (or norms) for things of that kind. Because the source of the normative standards for moral evaluation is different from the source of the normative standards for natural evaluation, moral evaluation is not a species of natural evaluation. However, both are varieties of kind evaluation. This account of moral evaluation as a variety of kind evaluation is still an effective response to non-naturalism and to non-cognitivism.     

Predictors of Health Care Use Among Individuals Seeking Therapy for Marital and Family Problems: An Exploratory Study

A number of studies have examined variables associated with health care use. However, no study is known to have considered health care use among people seeking services for marital and family problems. In this study, health care use of persons (N = 110) seeking these services was investigated to determine the strongest psychosocial correlates of health care use. The goal was to identify potential “targets” of clinical intervention that may be driving excessive health care use. “Informational support” and “somatization” were the strongest correlates for the complete sample, with the model explaining 24% of the variance in health care use. For “high users” of health care, “hostility” was the strongest correlate, accounting for more than 36% of the variance in health care use.     

Prolegomenon to a Theory of Philosophical Transposition,with Reference to Confucianism in America

What factors shape the movement of systems of thought from one historical‐cultural context to another? This paper provides a preliminary answer to this question by constructing an analytic framework drawn from the sociology of philosophy, and it uses this framework to consider the prospects for the contemporary transposition of Confucianism from China to America. The central, though still provisional, conclusion is that while global power dynamics matter, the particular conditions of the “philosophical fields” of both the original and the recipient locations are of primary importance in determining the extent and significance of any particular case of philosophical transposition. Therefore, due to the dynamics of the philosophical fields in both countries, it is unlikely that Confucianism will gain greater intellectual and political influence in the United States.     

Early-life and parental predation risk shape fear acquisition in adult minnows

Animal Cognition - Exposure to predation risk can induce a fearful baseline state, as well as fear reactions toward novel situations (i.e., neophobia). Some research indicates that risk exposure...     

Analyse me

The poem Analyse Me evolved from my desire to understand where and how the creative fitted into the scheme of military veteran mental health treatments in Australia. In 2016, as an Australian Army veteran and a creative writer, I undertook to conduct craft of writing workshops for veterans. However, I found creative arts, in all modes, were not as widely incorporated into treatments and research as I thought. The poem is a creative response to my frustration and disbelief of the results of my research and is a representation of my findings conceptualised to be the clinical and externally measurable treatment modes at one extreme, contrasted against the less definable use of the imagination or the creative at the other. The poem highlights the broad expanse between these extremes. It underlines a view on the difference of gender in treatment and the divide between the detached, clinical analysis and the more personal, intuitive creative response. Analyse Me does not deny the use of one modality over, or to the exclusion, of the other but rather indicates they both have purpose and can be mutually supportive and beneficial.     

The Cost of Oppositional Defiant Disorder and Disruptive Behavior: A Review of the Literature

This purpose of this paper is to review the literature on the treatment of Oppositional Defiant Disorder, with a specific focus on cost analyses. In general the literature shows that while there has been substantial research on Oppositional Defiant Disorder there has been little focus on the costs involved. A search of the major databases in psychology and the social sciences yielded only seven articles even marginally appropriate for a review of costs associated with Oppositional Defiant Disorder and related disruptive behavior. Interestingly, only two of these studies investigated treatment costs specifically associated with Oppositional Defiant Disorder. These studies showed that the treatment of Oppositional Defiant Disorder is much less expensive than the treatment of Conduct Disorder and family therapy is the most cost effective approach. Overall, the review showed that there is a dearth of literature related to treatment costs, which leads to the conclusion that much more research is needed on the cost of treating Oppositional Defiant Disorder.     

Method,MacIntyre, and Pedagogy: Inviting Students to Participate in Theology as a Living Conversation

Teaching theology within academic institutions with confessional commitments and theologically conservative students requires holding together, in creative tension, two pedagogical goals. The challenge is to promote rigorous academic inquiry by encouraging student openness to engagement with perspectives that challenge their own beliefs while simultaneously constructing a course that is experienced as a safe space where students do not feel their personal faith is under attack. This essay presents the argument that a methodological framework for introductory theology courses informed by Alasdair MacIntyre's reflections on the nature of living traditions holds great promise for achieving these objectives. The essay will also describe how a creative extended analogy drawn from the game of basketball facilitates student comprehension of this initially abstract intellectual framework. Finally, the essay will offer some representative examples of student participation in course online discussion forums in order to illustrate the effectiveness of this approach for student learning.     

Autobiographical memory specificity and emotional disorder

The authors review research showing that when recalling autobiographical events, many emotionally disturbed patients summarize categories of events rather than retrieving a single episode. The mechanisms underlying such overgeneral memory are examined, with a focus on M. A. Conway and C. W. Pleydell-Pearce's (2000) hierarchical search model of personal event retrieval. An elaboration of this model is proposed to account for overgeneral memory, focusing on how memory search can be affected by (a) capture and rumination processes, when mnemonic information used in retrieval activates ruminative thinking; (b) functional avoidance, when episodic material threatens to cause affective disturbance; and (c) impairment in executive capacity and control that limits an individual's ability to remain focused on retrieval in the face of distraction.     

Does state self-control depletion predict relationship functioning and partner aggression? An ecological momentary assessment study of community couples

Intimate relationship functioning depends upon the ability to accommodate one's partner and to inhibit retaliatory and aggressive impulses when disagreements arise. However, accommodation and inhibition may be difficult when self-control strength is weak or depleted by prior exertion of self-control. The present study considered whether state self-control depletion prospectively predicts male and female self-reports of anger with partner and arguing with partner. Consistent with the I³ Model (Finkel, 2014, Adv Exp Soc Psychol, 49, 1–104), we also considered whether the association between elevated anger and arguing (i.e., instigation) and partner aggression was stronger when state self-control (i.e., inhibition) was depleted or among people high in negative urgency. In this ecological momentary assessment (EMA) study, heavy drinking married and cohabiting heterosexual couples (N = 191) responded to three randomly signaled reports each day for 30 days. Depletion predicted anger and arguing with partners both cross-sectionally and prospectively for men and women. However, after controlling for prior levels of anger and arguing, these effects were diminished, and supplemental analyses revealed that anger and arguing with partner predicted subsequent depletion. Anger and arguing were strongly associated with concurrent reports of partner aggression perpetration and victimization (verbal and/or physical). However, neither state self-control depletion nor negative urgency moderated these effects. Overall, results suggest a modest impact of depletion on daily couple functioning as well as a potential cyclical effect of arguing on depletion.