Isotonic ordinal probabilistic models (ISOP)

The concept of an ordinal instrumental probabilistic comparison is introduced. It relies on an ordinal scale given a priori and on the concept of stochastic dominance. It is used to define a weakly independently ordered system, or isotonic ordinal probabilistic (ISOP) model, which allows the construction of separate sample-free ordinal scales on a set of subjects and a set of items. The ISOP-model is a common nonparametric theoretical structure for unidimensional models for quantitative, ordinal and dichotomous variables.Fundamental theorems on dichotomous and polytomous weakly independently ordered systems are derived. It is shown that the raw score system has the same formal properties as the latent system, and therefore the latter can be tested at the observed empirical level.I wish to thank 3 reviewers and 2 editors who contributed a lot to the readability and precision of the article.     

Existentialism and postmodernism. Continuities,breaks, and some consequences for medical theory

Since existentialism lost its influence in philosophy in the 1960s, postmodern theory has taken over criticizing basic concepts of western thought. From a postmodern point of view, the main shortcomings of existentialism is that it criticizes traditional unitarian concepts, while re-inventing new unitarian models. Against these unitarian approaches postmodernism holds that the world can only be described in terms of difference. In this article the postmodern program and its differences from existentialism are explained in reference to three concepts of western philosophy: subject, truth, and ethics. Applying these concepts, the relevance of postmodernism for medical theory is illustrated.     

Development of lateral asymmetry in the perception of sequentially touched fingers

In order to investigate lateral asymmetry in tactile perception, two or four fingers of normal primary school children were touched sequentially. Stimulation was either unimanual or bimanual and either verbal or nonverbal responses were required. Right hand advantage was demonstrated subsequent to uni- and bimanual stimulation in both the verbal and nonverbal response conditions. Neither an age nor a sex effect on laterality was found. Right hand advantage was affected by direction of stimulation in the bimanual condition. Left hemispheric dominance was argued to be related to the temporal nature of the tasks.     

The effect of uncertainty on the detection of frequency modulation at low modulation rates

Frequency modulation detection performance is compared in two conditions of stimulus variability. The data show that when the modulation rate is randomized within an experimental block, performance is somewhat poorer than when the modulation rate is fixed. The results are interpreted within the framework of a template matching model for modulation detection. They suggest that a template is acquired in part from experimental context and in part from a multistage template matching process.     

The integration of family therapy in a psychiatric day hospital

The clients, who present themselves at our psychiatric day hospital in Amsterdam, often have long-standing problems. These problems are usually of a complex nature, and the age of the clients plays an imporant role in this. Their age varies from seventeen to forty, with an average of twenty-eight.
Efforts were made over a long period to facilitate solutions to the clients' family conflicts. During this time an extensive range of problems within the family were presented of which the symptoms of the client represent just a part.
Working as a family therapist in a psychiatric day hospital, where clients are admitted individually, places the family therapist in a number of dilemmas, especially when many working in the hospital see the problems only as individual ones.     

Considerations in the choice of interobserver reliability estimates

Two types of interobserver reliability values may be needed in treatment studies in which observers constitute the primary data-acquisition system: trial reliability and the reliability of the composite unit or score which is subsequently analyzed, e.g., daily or weekly session totals. Two approaches to determining interobserver reliability are described: percentage agreement and "correlational" measures of reliability. The interpretation of these estimates, factors affecting their magnitude, and the advantages and limitations of each approach are presented.