See me,hear me: Using film in health-care classes

This essay argues that film deserves a place within the medical humanities curriculum and demonstrates effective strategies for employing it within medical ethics and humanities classrooms. Part One of the article emphasizes how and why medical ethics teachers can utilize documentary and fictional films, such as “Thomas Szasz and the Myth of Mental Illness,” “The Deadly Deception,”Whose Life Is It Anyway? and “Voices From the Front” in their courses. Such films encourage students to move beyond abstract debates and confront the human pain inherent in all ethical dilemmas. Part Two focuses on documentary and fiction film in the medical humanities classroom. In this section, the author details how to incorporates films, such asThe Doctor, The Waterdance andHospital, into the humanities classroom, juxtaposing them with various literary works, such asOther Women's Children, Borrowed Time, andCeremony. Part Three of the essay presents a detailed discussion ofThe Elephant Man andFrankenstein, illustrating how visual and literary texts compliment each other within the humanities classroom. Overall, the author demonstrates how films function as engaging and complex visual texts providing unique insights in the particularities of American health care and, as such, can become valuable components within medical ethics and humanities classrooms.     

Prepulse inhibition of the startle eyeblink as an indicator of temporal summation

The inhibition of the human startle eyeblink response was assessed in three experiments in which the duration of the prepulse was manipulated. In all cases, inhibition of startle was more pronounced as prepulse duration increased from 6 to 50 msec. Inhibition of startle amplitude for single prepulses was not significantly different from that for paired prepulses (Experiment 1), but inhibition was more pronounced as prepulse intensity increased (Experiment 3). Varying the interval between prepulse offset and startle-stimulus onset had no significant effect on inhibition (Experiment 2). These data demonstrate the sensitivity of startle inhibition to prepulse duration, and suggest that this response system can be used to evaluate early temporal summation in the auditory system.     

A behavioral link between the oculomotor and cardiovascular systems

Although the eyes and the heart serve very different purposes, each receives autonomic innervation. Capitalizing on recent theoretical and technological innovations in the understanding and assessment of oculomotor and cardiovascular behavior, three experiments measured behavioral covariation between the oculomotor and cardiovascular systems. Measures of dark focus and dark vergence indexed oculomotor tone, and the spectral decomposition of variations in heart rate indexed cardiovascular control mechanisms. In Experiment 1, individual differences in cardiovascular parameters could predict individuals’ dark vergence (R²=.806) but not their dark focus (R²=.404). In Experiment 2, the same parameters were measured from subjects who experience either panic attacks (n=11) or blood phobia (n=9). Heart rate was positively correlated with dark vergence and the two subject groups were separable based on both oculomotor and cardiovascular variables. Using a within-subjects approach, Experiment 3 found that both dark vergence and dark focus tended to be nearer during sympathetic dominance of the heart than during parasympathetic dominance, within-subjects variations in cardiovascular parameters could predict dark focus, and between-subjects variations in interbeat intervals could predict dark vergence. Shared patterns of autonomic activation may be responsible for this eye-heart link.     

Consciousness: A neurobiological approach

Consciousness and the disorders of consciousness can be more fully understood once they are integrated with the neurobiology of mental events. After a review of animal and human research, we found several anatomical structures in the central nervous system are required for consciousness. Identification of the critical structures, however, depends on what is meant by consciousness. In the general sense of mental responsivity, the reticular activating system must be intact. Consciousness has also been defined as the awareness of the sights, sounds, and feelings of everyday experience. In this sense, the system of sensory inputs and outputs of the anterior temporal cortex, amygdala, and the hippocampus must be functional. There is no neural evidence for “higher” consciousness.     

Book reviews

Integrative Psychological and Behavioral Science -     

A pointing technique for rapidly collecting localization responses in auditory research

A technique is described for rapidly collecting responses in auditory-localization experiments. Subjects indicate the perceived direction of the sound by pointing at a 20-cm-diam spherical model. In Experiment 1, the subjects judged the direction of a broadband signal, which could originate from any of 239 directions ranging through 360° of azimuth and between ?45° and +90° of elevation. Using this technique, the subjects responded 2–8 times more rapidly than previous subjects who used either a verbal-reporting technique or a head-pointing technique. Localization judgments were as accurate as they had been with verbal reports, but were not as accurate as judgments collected using the head-pointing technique. In Experiment 2, the signal was turned off and the experimenter read the spherical coordinates of the signal location to the subjects. The subjects pointed to these coordinates more accurately than they had judged the direction of the sounds in Experiment 1, suggesting that the response technique had not been the limiting factor in that experiment. Circumstances relevant to the choice of response techniques for auditory-localization experiments are discussed.     

Three- and four-year-olds’ perceptual confusions for spoken words

Although infants have the ability to discriminate a variety of speech contrasts, young children cannot always use this ability in the service of spoken-word recognition. The research reported here asked whether the reason young children sometimes fail to discriminate minimal word pairs is that they are less efficient at word recognition than adults, or whether it is that they employ different lexical representations. In particular, the research evaluated the proposal that young children’s lexical representations are more “holistic” than those of adults, and are based on overall acoustic-phonetic properties, as opposed to phonetic segments. Three- and four-year-olds were exposed initially to an invariant target word and were subsequently asked to determine whether a series of auditory stimuli matched or did not match the target. The critical test stimuli were nonwords that varied in their degree of phonetic featural overlap with the target, as well as in terms of the position(s) within the stimuli at which they differed from the target, and whether they differed from the target on one or two segments. Data from four experiments demonstrated that the frequency with which children mistook a nonword stimulus for the target was influenced by extent of featural overlap, but not by word position. The data also showed that, contrary to the predictions of the holistic hypothesis, stimuli differing from the target by two features on a single segment were confused with the target more often than were stimuli differing by a single feature on each of two segments. This finding suggests that children use both phonetic features and segments in accessing their mental lexicons, and that they are therefore much more similar to adults than is suggested by the holistic hypothesis.     

Enhancing possible selves in Mexican American students

This project assessed the modifiability of possible selves in young Mexican American children. Three intervention conditions were compared in a pre- and posttest design: child-only intervention, parent and child intervention, and a no-intervention control. Following eight intervention sessions, children in the two intervention groups showed significant gains in understanding the characteristics associated with becoming a good student and in recognizing the value of education in bringing about future occupational goals. Children in the intervention conditions also reported greater interest in becoming a physician, judge, or pilot — occupations they had directly experienced during training. The parent intervention phase contributed little to augmenting the positive results attributable to the child intervention component.This research was conducted under the auspices of NIH Grant HD-24003. We wish to thank Maritza Robles and the staff of the Bilingual program of the South Bend, IN, Corporation for their support.     

Impact of a prevention program on aggressive children's friendships and social adjustment

A group of 46 aggressive boys aged 8 to 9 years participated in a prevention program aimed at reducing their externalizing problems in the short term and at preventing delinquency in the long term. Outcome measures were collected during the 3-year period following the prevention program. At that time, the boys were 10, 11, and 12 years old. Outcome measures included teacher ratings of aggressiveness and self-reports of delinquent behaviors. The boys' friends were rated on disruptive behaviors by their classmates. The experimental boys' outcome measures were compared to the measures obtained from 58 aggressive boys in a control group. The disruptive ratings of the experimental and control subjects' best friends were also compared. Differences in teacher-rated aggressiveness between the two groups increased from one year to the next for the 3-year followup period. Similarly, the friends' disruptive scores differed increasingly between the two groups over the 3-year period. The effect of the prevention program on the subjects' friendships and the mediating impact of friends with regard to social adjustment were stressed.This study was funded by the following agencies: National Welfare Grants Program of the Canadian Ministry of Health and Welfare, Conseil Québécois de la Recherche Sociale, Conseil de la Santé et des Services Sociaux Régional du Montréal Métropolitain, Fondation Cité des Prairies, Fonds FCAR-Centre et Equipes, Institut de la Recherche en Psycho-Education de Montréal, Centre d'Accueil le Mainbourg. Lucie Bertrand, Rita Béland, Michel Bouillon, Raymond Labelle, Hélène O'Reilly, and Daniel Reclus-Prince supervised or administered the intervention.     

Propositional attitudes and formal ontology

This paper develops — within an axiomatic theory of properties, relations, and propositions which accords them well-defined existence and identity conditions — a sententialist-functionalist account of belief as a symbolically mediated relation to a special kind of propositional entity, theproxy-encoding abstract proposition. It is then shown how, in terms of this account, the truth conditions of English belief reports may be captured in a formally precise and empirically adequate way that accords genuinely semantic status to familiar opacity data.I am deeply indebted to Edward Zalta for many helpful comments and suggestions.