Why do people with an anxiety disorder utilize more nonmental health care than those without?

OBJECTIVE: It is unclear why nonmental healthcare utilization is greater among those with psychological problems. The authors examined healthcare utilization in HMO patients to determine whether greater utilization in anxiety disorder (AD) patients was explained by anxiety symptoms (increasing sensitivity to physical symptoms) or comorbid illness (causing greater need for services). DESIGN: Patients were randomly selected from the database of a multi-specialty practice and 1,041 completed a survey assessing psychological symptoms, health behaviors, and demographics. Anxiety symptoms were assessed by questionnaire and the presence of an AD was determined from the medical chart. Healthcare encounters and medication use were abstracted from medical charts and HMO claims data. MAIN OUTCOME MEASURES: Healthcare utilization. RESULTS: Both AD and anxiety symptoms predicted utilization, but symptoms were not associated with utilization in a model that also included AD. Comorbid illness was significantly associated with utilization independent of AD and somewhat reduced the strength of the AD-utilization association. The results were replicated in comparison of those with any psychiatric disorder to those without. CONCLUSION: Among those with AD, greater utilization is not explained by anxiety symptoms but is partly explained by greater comorbid illness. Further study is needed to understand excess healthcare utilization among AD patients.     

All the Lonely People...Where Do They All Belong?

The author uses humor and fosters empathy in order to establish a fragile group cohesion for five isolated patients at a group analytic training institute. Self-psychological concepts, in particular the alter ego or twinship transference, help explain the profound and painful yearnings of these unlikely group members, whose great need for relatedness was generally trumped by the terror of it. The group's poignant wish for affiliation (somewhat paralleled in the therapist's joining a training program) was similarly impeded by a fear of an aversive affiliation, a fear which for these group members remained understandably powerful after a lifetime of false and failed affiliative starts. The author concludes that it is these lonely people who should be (and can be) served by analytic group work.     

The Main Problem with USC Libertarianism

Libertarians like Robert Kane believe that indeterminism is necessaryfor free will. They think this in part because they hold both (1) thatmy being the ultimate cause of at least part of myself is necessary forfree will and (2) that indeterminism is necessary for this ``ultimateself-causation'. But seductive and intuitive as this ``USCLibertarianism' may sound, it is untenable. In the end, nometaphysically coherent (not to mention empirically valid) conception ofultimate self-causation is available. So the basic intuition motivatingthe USC Libertarian is ultimately impossible to fulfill.     

Hemispheric asymmetries for global and local visual perception: effects of stimulus and task factors.

Although neurotogical and physiological studies indicate a right hemisphere superiority in global processing and a left hemisphere superiority in local processing of Navon-type hierarchical letters (D. Navon, 1977), most investigations of lateralized perception in healthy participants report neither asymmetry. In 6 experiments the authors examined the influence of attentional demands, stimulus properties, and mode of response on perceptual asymmetries for global and local perception. Consistent with their theoretical predictions, asymmetries were more robust on divided- than focused-attention tasks and in response to stimuli in which local and global levels were equally salient compared with those with greater global than local saliency. Contrary to their prediction, perceptual asymmetries were not influenced by the complexity of the motor response.     

Contributions of Behavioural Decision Theory to Research in Political Science

Cet article aborde la question de l'application de la Théorie de la Décision Comportementale (BDT) à deux domaines de la recherche en Sciences-Politiques, le comportement électoral et les relations internationales. On commence par un bref survol de la BDT, puis on passe à ce qui n'est maintenant que l'amorce de l'exploitation de la BDT dans les Sciences-Politiques. Dans le premier exemple, notre intérêt est focalisé sur les décisions prises par le public et dans le second sur celles prises par les élites politiques, mais la distinction masse-élite peut se révéler secondaire par rapport aux situations dans lesquelles émergent les décisions électorales ou de politique étrangère. Dans la présentation de ces deux exemples, on tente de replacer l'investigation reposant sur les aperçus de la BDT dans le contexte plus vaste de la recherche dans ce secteur.
This paper discusses the application of behavioural decision theory (BDT) to two areas of political science research: voting behaviour and international relations. We begin with a brief overview of BDT, and then turn to what is now only the beginnings of the utilisation of BDT in political science. In the first instance we focus on decision making by the mass public, and in the second on decision making by political elites, but, as we shall see, the mass-elite distinction may not be as important as the different situations or contexts in which voting and foreign policy decisions are typically made. In both instances, we will try to put research relying on the insights of behavioural decision theory into a broader context of research in the field.