An Anatomy of Illness

Because it focuses primarily on the sick body (disease), medicine ignores many of the concerns and needs of sick people. By listening to the stories of patients in the clinic, on the Internet, and in published book form, health care providers could gain a better understanding of the impact of disease on the person (illness), what it means to patients over and above their physical symptoms and what they might require over and above surgery or chemotherapy. Only by familiarizing themselves with the entire emotional landscape of illness, which includes fear, anger, shame, guilt, and above all loneliness, can the healthy--medicine as well as society in general--hope to heal in a comprehensive manner.     

Always on call: thoughts from a neophyte physician

This commentary describes a new physician who encountered a patient in crisis in a nonmedical environment. It discusses professional obligations, ethical principles, errors committed, and reasoning behind such errors. Unusual circumstances, uncertainty about how to properly identify oneself as a physician, self-doubt, and discomfort with practicing outside one's scope of training are recognized as reasons behind these errors. Medical students should be reminded of their ethical obligation to offer emergency care within their limitations, instructed how to identify themselves, and guided to become competent team leaders. Resident doctors should continue to receive instruction as they internalize ethical principles and identify their scopes of practice. Practicing physicians should be competent in offering basic emergency care if needed.     

Fechner as a pioneering theorist of unconscious cognition

Fechner remains virtually unknown for his psychological research on the unconscious. However, he was one of the most prominent theorists of unconscious cognition of the 19th century, in the context of the rise of scientific investigations on the unconscious in German psychology. In line with the models previously developed by Leibniz and Herbart, Fechner proposes an explanative system of unconscious phenomena based on a modular conception of the mind and on the idea of a functional dissociation between representational and attentional activity. For Fechner, the unconscious is a state of consciousness resulting from the isolation of representational activity from the rest of psychical life. Unconscious mental phenomena are unattended mental states that behave autonomously while remaining able to act on consciousness. This paper aims to revisit Fechner's contribution to the history of the unconscious, but also the theoretical significance of the Fechnerian unconscious vis-à-vis current research on the cognitive unconscious.     

Commentary on “Mediation analysis and categorical variables: The final frontier” by Dawn Iacobucci

The commentary discusses several topics in Dr. Iacobucci's article on mediation analysis with categorical variables including the lack of equivalency of mediated effect measures, ab, and c–c′, that are algebraically equivalent in ordinary least squares regression models. The commentary raises the issue of correlated mediation coefficients and presents formulas to include the correlation in the test of significance. References to new developments in causal mediation analysis for categorical variables are given and the importance of programs of research to establish a mediation theory is emphasized.     

Attachment Theory and Mindfulness

We initiate a dialog between two central areas in the field of psychology today: attachment theory/research and mindfulness studies. The impact of the early mother-infant relationship on child development has been well established in the literature, with attachment theorists having focused on the correlation between a mother’s capacity for self-regulation and connection (e.g., attunement) with children’s health and developmental outcomes. Because the transition to parenthood is often a stressful one, research has also focused on the importance of the mother’s external and internal support (e.g., self-awareness, recognition of needs) in promoting healthy mother-infant relationships. One promising field in relation to increased internal support is mindfulness, a practice shown to increase emotional regulation while decreasing stress and anxiety. Described as non-judgmental, present-moment awareness, mindfulness has received significant empirical attention over the past three decades and has recently been theorized as an important contributing factor in healthy mother–child relationships. Recognizing the potentially beneficial effects of mindfulness training on healthy attachment, this article reviews relevant literature in presenting a case for exploratory and empirical research into the dynamic relationship between mindfulness, attachment style, maternal health, and children’s development. Grounds for this convergence, as well as suggestions for future research, are presented.     

Parental Divorce, Familial Risk for Depression, and Psychopathology in Offspring: A Three-Generation Study

Research suggests a link between parental divorce and negative child outcomes; however, the presence of parental depression may confound this relationship. Studies exploring the simultaneous effects of depression and parents’ divorce on the adjustment of their children are scarce and rarely have a longitudinal design. This is the first three-generation study of the relative effects of depression and divorce on offspring psychopathology, based on data from a 25-year longitudinal study with families at high and low risk for depression. One hundred seventy-eight grandchildren (mean age?=?13.9?years) of depressed and nondepressed parents and grandparents were evaluated by raters blind to their parents’ and grandparents’ clinical status. We found that in both low and high-risk children, divorce had a limited impact on child adjustment over and above familial risk for depression. Divorce had a significant effect on child outcomes only among high-risk grandchildren with a depressed grandparent and non-depressed parents, with this group showing a threefold risk for anxiety disorders. Results support previous findings suggesting that familial risk for depression largely overshadows the effect of parental divorce on child psychopathology. Possible reasons for the lack of association between divorce and child psychopathology among low-risk offspring are discussed.     

Is academic buoyancy anything more than adaptive coping?

Academic buoyancy refers to a positive, constructive, and adaptive response to the types of challenges and setbacks experienced in a typical and everyday academic setting. In this project we examined whether academic buoyancy explained any additional variance in test anxiety over and above that explained by coping. Two hundred and ninety-eight students in their final two years of compulsory schooling completed self-report measures of academic buoyancy, coping, and test anxiety. Results suggested that buoyancy was inversely related to test anxiety and unrelated to coping. With the exception of test-irrelevant thoughts, test anxiety was positively related to avoidance coping and social support. Test-irrelevant thoughts were inversely related to task focus, unrelated to social support, and positively related to avoidance. A hierarchical regression analysis showed that academic buoyancy explained a significant additional proportion of variance in test anxiety when the variance for coping had already been accounted for. These findings suggest that academic buoyancy can be considered as a distinct construct from that of adaptive coping.     

Can you McGurk yourself? Self-face and self-voice in audiovisual speech

We are constantly exposed to our own face and voice, and we identify our own faces and voices as familiar. However, the influence of self-identity upon self-speech perception is still uncertain. Speech perception is a synthesis of both auditory and visual inputs; although we hear our own voice when we speak, we rarely see the dynamic movements of our own face. If visual speech and identity are processed independently, no processing advantage would obtain in viewing one’s own highly familiar face. In the present experiment, the relative contributions of facial and vocal inputs to speech perception were evaluated with an audiovisual illusion. Our results indicate that auditory self-speech conveys a processing advantage, whereas visual self-speech does not. The data thereby support a model of visual speech as dynamic movement processed separately from speaker recognition.     

The Three Domains of Disgust Scale: factor structure, psychometric properties, and conceptual limitations

This investigation examined the measurement properties of the Three Domains of Disgust Scale (TDDS). Principal components analysis in Study 1 (n = 206) revealed three factors of Pathogen, Sexual, and Moral Disgust that demonstrated excellent reliability, including test-retest over 12 weeks. Confirmatory factor analyses in Study 2 (n = 406) supported the three factors. Supportive evidence for the validity of the Pathogen and Sexual Disgust subscales was found in Study 1 and Study 2 with strong associations with disgust/contamination and weak associations with negative affect. However, the validity of the Moral Disgust subscale was limited. Study 3 (n = 200) showed that the TDDS subscales differentially related to personality traits. Study 4 (n = 47) provided evidence for the validity of the TDDS subscales in relation to multiple indices of disgust/contamination aversion in a select sample. Study 5 (n = 70) further highlighted limitations of the Moral Disgust subscale given the lack of a theoretically consistent association with moral attitudes. Lastly, Study 6 (n = 178) showed that responses on the Moral Disgust scale were more intense when anger was the response option compared with when disgust was the response option. The implications of these findings for the assessment of disgust are discussed.