Spousal caregiver confidence and recovery from ambulatory activity limitations in stroke survivors.

OBJECTIVE: This study examined whether spousal confidence in care-recipient recovery can predict recovery from activity limitations following stroke and how spousal confidence relates to stroke survivor self-efficacy for recovery. DESIGN: A prospective design was used. Measures were gathered from stroke survivor/spouse dyads at two time points, both postdischarge from the hospital following stroke (N=109). MAIN OUTCOME MEASURES: The dependent variable was recovery from ambulatory activity limitations over 6 weeks, as measured by the Functional Limitations Profile. A single spousal confidence item was tailored to an ambulatory behavior that the stroke survivors could not perform at Time 1. RESULTS: Spousal confidence was correlated with ambulation recovery (r=-0.23, p<.05) and stroke survivor self-efficacy for recovery (r=.25, p<.05). Higher spousal confidence was associated with a better recovery and greater stroke survivor self-efficacy for recovery, but not with initial health status or practical support received. CONCLUSION: The relationship between caregiver confidence, care-recipient self-efficacy for recovery, and recovery outcomes needs further elucidation.     

Scott Soames on Gilbert Ryle

In his exceptionally well‐received history of analytic philosophy,¹ Scott Soames presents accounts of the work of Wittgenstein and Ryle that rest on his acceptance of metaphysical preconceptions that these philosophers implicitly question in their writings. Their shared expressive third‐person treatments of the mind, for example, serve to emphasise the inadequacy of Soames's distinction between private mental states and physical states/behaviour, which he regularly employs in assessing their views. His treatment of Gilbert Ryle in particular, reflects the radically different conceptions held by Ryle and Soames of the nature of philosophical investigation. Soames charges Ryle with a failure to recognise the distinction between the necessary and the analytic. He also harbours a clear understanding that philosophical problems arise naturally and directly from “our ordinary ways of thinking,”² where these ways of thinking, the reader discovers, involve metaphysical preconceptions. This is at odds with Ryle's claim that certain category mistakes, playing the role, roughly, of Wittgenstein's misleading pictures, underlie some of the main problems of philosophy. The purpose of this paper is to assess how well Ryle, occasionally aided by Wittgenstein, can be seen to parry Soames's direct onslaught on his work in parts of Dilemmas and in The Concept of Mind.     

Akrasia and the Problem of the Unity of Reason

Joseph Raz and Sergio Tenenbaum argue that the Guise of the Good thesis explains both the possibility of practical reason and its unity with theoretical reason, something Humean psychological theories may be unable to do. This paper will argue, however, that Raz and Tenenbaum face a dilemma: either the version of the Guise of the Good they offer is too strong to allow for weakness of will, or it will lose its theoretical advantage in preserving the unity of reason. 1     

Precipitating Circumstances of Suicide among Active Duty U.S. Army Personnel Versus U.S. Civilians, 2005–2010

To help understand suicide among soldiers, we compared suicide events between active duty U.S. Army versus civilian decedents to identify differences and inform military prevention efforts. We linked 141 Army suicide records from 2005 to 2010 to National Violent Death Reporting System (NVDRS) data. We described the decedents’ military background and compared their precipitators of death captured in NVDRS to those of demographically matched civilian suicide decedents. Both groups commonly had mental health and intimate partner precipitating circumstances, but soldier decedents less commonly disclosed suicide intent.     

Loose Connections and Liberal Theology: Blurring the Boundaries in Two Church‐Based Communities of Spiritual Practice

We used a mixed methods approach—including ethnographic fieldwork, interviews, and a survey—to study two innovative Christian contemplative worship services housed in a mainline Protestant congregation in a midwestern city. These services employed boundary‐blurring practices designed to attract the “de‐churched”—those who had been involved in a Christian congregation in the past but who had at some point disengaged from organized religion. Though attracting some formerly de‐churched participants, these services were far more successful in attracting several other constituencies united by their liberal theology and by a preference for loose connections. We argue that these worship services are best understood as thriving communities of sustained spiritual practice where contemplative rituals sacralize both theistic and extra‐theistic, Christian and non‐Christian, symbols and beliefs.     

Turning a deaf ear to fear: impaired recognition of vocal affect in psychopathic individuals

The processing of emotional expressions is fundamental for normal socialization and interaction. Reduced responsiveness to the expressions of sadness and fear has been implicated in the development of psychopathy (R. J. R. Blair, 1995). The current study investigates the ability of adult psychopathic individuals to process vocal affect. Psychopathic and nonpsychopathic adults, defined by the Hare Psychopathy Checklist-Revised (PCL-R; R. D. Hare, 1991), were presented with neutral words spoken with intonations conveying happiness, disgust, anger, sadness, and fear and were asked to identify the emotion of the speaker on the basis of prosody. The results indicated that psychopathic inmates were particularly impaired in the recognition of fearful vocal affect. These results are interpreted with reference to the low-fear and violence inhibition mechanism models of psychopathy.     

The Nature of Generalized Anxiety in Older Primary Care Patients: Preliminary Findings

Clinical features of older primary care patients with GAD (PC-GAD; n = 22) were examined relative to older patients with GAD recruited for two academic clinical trials (M. A. Stanley, J. G. Beck, et al., 2003; J. L. Wetherell, M. Gatz, & M. G, Craske, 2003) and to a sample of older primary care patients without psychiatric diagnoses (No Dx; n = 10). Comparisons revealed similar levels of worry, anxiety, depressive symptoms, quality of life, and functional status between the PC-GAD subsample and patients recruited for academic trials, although primary care patients were older, less well educated, and more ethnically diverse. The PC-GAD subgroup, however, reported greater symptom severity, reduced quality of life, and poorer perceived general health, mental health, and vitality than the No Dx subgroup (² = .23–.43). Service utilization was not different between PC-GAD and No Dx subgroups, with the exception of psychotropic medication use. The Penn State Worry Questionnaire (PSWQ) and an abbreviated version of this measure may be useful for identifying late-life GAD in primary care. Cutoff scores of 50 and 22 on the full and abbreviated versions of the PSWQ, respectively, demonstrated excellent specificity, sensitivity, and positive predictive value. Negative predictive value was less impressive, probably as a result of high base rates for GAD in this sample.     

Reinforcer pathology II: Reward magnitude,reward delay,and demand for alcohol collectively relate to college students' alcohol related problems

The reinforcer pathologies model of addiction posits that two characteristic patterns of operant behavior characterize addiction. Specifically, individuals suffering from addiction have elevated levels of behavioral economic demand for their substances of abuse and have an elevated tendency to devalue delayed rewards (reflected in high delay discounting rates). Prior research has demonstrated that these behavioral economic markers are significant predictors of many of college students' alcohol-related problems. Delay discounting, however, is a complex behavioral performance likely undergirded by multiple behavioral processes. Emerging analytical approaches have isolated the role of participants' sensitivity to changes in reinforcer magnitude and changes in reinforcer delay. The current study uses these analytic approaches to compare participants' discounting of money versus alcohol, and to build regression models that leverage these new insights to predict a wider range of college students' alcohol related problems. Using these techniques, we were able to 1) demonstrate that individuals differed in their sensitivity to magnitudes of alcohol versus money, but not sensitivity to delays to those commodities and 2) that we could use our behavioral economic measures to predict a range of students' alcohol related problems.