A seven year follow-up of treating rumination with dietary satiation

”Fred“, a man with profound mental retardation who was 24 years old at the beginning of this study, was referred for treatment of rumination. A number of minimally restrictive interventions, including administration of Zantac, extra fluids, and delivery of peanut butter after meals, had been used without success. In April of 1989 Fred began a satiation diet with ad libitum access to starchy foods or to fruits and vegetables, in addition to his regular meals. His baseline weight was 82 pounds and he ruminated during 58% of 10 s intervals measured during 20 min post-meal observations. During the first month of the satiation diet, Fred's ruminating declined to 6% of measured intervals, he consumed a mean of 163 fluid ounces of extra food per day, and his weight increased to 90 pounds. After 4 months' treatment, Fred's ruminating had declined to zero, his food consumption had stabilized at approximately 65 extra ounces of food per day, and his weight had stabilized at about 120 pounds. Starting in August 1990, in an effort to minimize weight gain, extra food was limited to 50% of Fred's ad libitum food consumption (averaged over the previous 6 weeks). Fred's weight gradually declined to about 100 pounds with zero rumination over the next two years. In August 1992 Fred's ruminating accelerated to 17% of intervals and he was again offered ad libitum food access. Over the next 7 months, rumination declined to zero and his weight increased slightly to about 105 pounds. This study shows that rumination that had not responded to less restrictive procedures was suppressed for 7 years via dietary satiation. Although dietary satiation is not without some risk, Fred has suffered no adverse effects from the procedure, other than gaining approximately one-third of his baseline weight. © 1997 John Wiley & Sons, Ltd.     

The Argument from Moral Experience

It is often said that our moral experience, broadly construed to include our ways of thinking and talking about morality, has a certain objective-seeming character to it, and that this supports a presumption in favor of objectivist theories (according to which morality is a realm of facts or truths) and against anti-objectivist theories like Mackie’s error theory (according to which it is not). In this paper, I argue that our experience of morality does not support objectivist moral theories in this way. I begin by arguing that our moral experience does not have the uniformly objective-seeming character it is typically claimed to have. I go on to argue that even if moral experience were to presuppose or display morality as a realm of fact, we would still need a reason for taking that to support theories according to which it is such a realm. I consider what I take to be the four most promising ways of attempting to supply such a reason: (A) inference to the best explanation, (B) epistemic conservatism, (C) the Principle of Credulity, and (D) the method of wide reflective equilibrium. In each case, I argue, the strategy in question does not support a presumption in favor of objectivist moral theories.

Adults' memories of childhood: Affect,knowing, and remembering

Adult questionnaire respondents reported, for each of a number of events, if they had experienced that event during childhood and, if so, if they remembered the experience or merely knew it had happened. Respondents also rated the emotion of each event and judged whether they would remember more about each reportedly experienced event if they spent more time trying to do so. Study 1 respondents were 96 undergraduates, whereas Study 2 tested 93 community members ranging widely in age. Respondents often reported no recollections of reportedly experienced events. Reportedly experienced events rated as emotional were more often recollected than those rated as neutral, and those rated as positive were more often recollected than those rated as negative. Predicted ability to remember more was related to current memory. Claims of remembering reportedly experienced events increased with age, but predicted ability to remember more about them declined with age.     

PREVENTING BACK INJURIES IN HOSPITAL SETTINGS: THE EFFECTS OF VIDEO MODELING ON SAFE PATIENT LIFTING BY NURSES

This study evaluated video scoring and feedback about scoring as a safety intervention among 6 nursing staff. The dependent variable was safety behavior on one‐person transfers. Following baseline, 5 nursing staff participated in an information phase. A video scoring phase was then introduced for all 6. A feedback phase was added for 2 participants. All participants experienced treatment withdrawal. Information resulted in improvements for all 5 participants who received it. Further improvements were observed during video scoring for the 5 participants who improved following information. No improvements were observed for the participant who received only video scoring. Safety feedback further improved safety for the 2 participants who received it. However, participants' behavior returned to video scoring levels during withdrawal.     

Myopic social prediction and the solo comparison effect

Four experiments explored the psychological processes by which people make comparative social judgments. Each participant chose how much money to wager on beating an opponent on either a difficult or a simple trivia quiz. Quiz difficulty did not influence the average person's probability of winning, yet participants bet more on a simple quiz than on a difficult quiz in the first 3 experiments. The results suggest that this effect results from a tendency to attend more closely to a focal actor than to others. Experiment 4 directly manipulated focusing; when participants were led to focus on the opponent instead of themselves, the effect was reversed. The discussion relates the results to other literatures including overly optimistic self-evaluation, false consensus, overconfidence, and social comparison.     

Book reviews

The Popularization of Medicine 1650–1850 Roy Porter (ed.), 1992 London, Routledge pp. x + 296, £50 (hardback) ISBN 0415 07217 4

Quantum Mechanics: An Empiricist View Bas Van Fraassen, 1991 Clarendon Press, Oxford pp. 558, £17.50 (paperback), ISBN 019 8239807