Resurrecting the Empathy–Bullying Relationship with a Pro-Bullying Attitudes Mediator: the Lazarus Effect in Mediation Research

The purpose of this study was to determine whether pro-bullying attitudes are capable of mediating the low empathy–bullying relationship in the absence of a significant unmediated correlation between low empathy and bullying behavior. Using three waves of self-report data from 1371 (677 boys, 694 girls) pre-adolescent/early adolescent members of the Illinois Study of Bullying and Sexual Violence (ISBSV), the mediating effect of pro-bullying attitudes on the low empathy–bullying connection was examined. A path analysis revealed that pro-bullying attitudes successfully mediated the pathway running from low empathy to bully perpetration even though the unmediated relationship between low empathy and bullying perpetration was non-significant. A control or comparison pathway running from bully perpetration to pro-bullying attitudes to low empathy was also tested and found to be non-significant. It would appear that low empathy contributes to bullying perpetration by stimulating pro-bullying attitudes which, in turn, promote bullying perpetration. The theoretical, research, and practical implications of these results are discussed.     

The triumph of American psychiatry: How it created the modern therapeutic state

Over the past 170 years, American psychiatry has progressively asserted its authority over a larger segment of the American population. From the mid-1800s to the end of World War II, psychiatry had authority over the asylum population, which markedly increased in the first half of the twentieth century due to the influence of eugenics, an ideology that argued the ‘mentally ill’ had to be segregated from society. After the war, American psychiatry adopted Freudian conceptions of mental disorders, which enabled it to begin treating people in the community who were ‘neurotic’ in some way, which dramatically expanded its influence in society. Then, in the 1970s, when many in American society were questioning psychiatry’s legitimacy as a branch of medicine, the American Psychiatric Association (APA) responded by adopting a disease model for diagnosing mental disorders, which it set forth in the third edition of its Diagnostic and Statistical Manual. There were no scientific discoveries that led to this new model, but soon the APA was informing the American public that mental disorders were diseases of the brain, and that psychiatric drugs helped fix those diseases, ‘like insulin for diabetes.’ The APA, in concert with pharmaceutical companies, has successfully exported this belief system to much of the developed world. In order to break free of this ‘therapeutic state,’ the public needs to understand the history of how it came to be, and see the social injury it has caused.     

A Survey of Patients’ Experiences with the Cancer Genetic Counseling Process: Recommendations for Cancer Genetics Programs

In order to promote ongoing quality improvement of not only the Penn State Cancer Genetics Program, but also other cancer risk assessment programs throughout the country, we developed, piloted and conducted a survey to explore patient expectations, experiences, and satisfaction with the cancer genetic counseling process. The comprehensive survey was mailed to 340 eligible patients, 156 (45.9%) of whom returned the completed survey within the allotted time. Responses to closed-ended questions were tallied and open-ended questions were content analyzed. Major findings show that: (1) Patients were seeking cancer-related information and support throughout the cancer risk assessment process and were interested in participating in available research studies; (2) The setting in which patients are seen for cancer risk assessment may pose potential emotional ramifications; (3) Misperceptions regarding insurance discrimination and lack of insurance coverage persist; (4) Patients view the genetic counselor as responsible for updating them about new discoveries. Specific recommendations for cancer genetics programs are included.     

Possible knowledge of unknown truth

Fitch’s argument purports to show that for any unknown truth, p, there is an unknowable truth, namely, that p is true and unknown; for a contradiction follows from the assumption that it is possible to know that p is true and unknown. In earlier work I argued that there is a sense in which it is possible to know that p is true and unknown, from a counterfactual perspective; that is, there can be possible, non-actual knowledge, of the actual situation, that in that situation, p is true and unknown. Here I further elaborate that claim and respond to objections by Williamson, who argued that there cannot be non-trivial knowledge of this kind. I give conditions which suffice for such non-trivial counterfactual knowledge.     

The Relation between Individual and Group Conflicts in Psychotherapy

Abstract

I describe three constellations of group life and group process: resistance, rebellion, and refusal. In resistance, an individual or group remains antagonistic to conscious but not unconscious thinking, the latter manifested in derivatives, including symbol and symptom formation, transference–countertransference, and enactment. Rebellion functions on the level of conscious thinking, manifested in challenge, defiance, and the possibility of sociopolitical action. The basic premises and values of the group and/or leader are at the center of the controversy, to be addressed on that level. Refusal establishes a mental boundary between what is considered appropriate and inappropriate. Unconsciousaswellasconscious processes of feeling, thinking, and meaning making are refused entry, left undeveloped, rejected, or obstructed. Working with refusal requires appreciating how and why the mind and its thinking operations are being suspended. The theoretical framework is applied to a case example.     

Childhood Abuse,Head Injuries,and Use of Medical Emergency Services in People with Severe Mental Illness

People with severe mental illness (SMI) report high rates of traumatic experiences. This study analyzes data collected from 183 people diagnosed with SMI on reports of childhood trauma, head injuries, and emergency room (ER) services. More than half the cohort (56.7%) reported 3 to 7 cooccurring categories of childhood abuse (CAB). People who reported 6 and 7 categories of CAB had a 5-fold risk of experiencing a head injury. If they have used the ER for reasons other than psychiatric illness they endorse more traumatic experiences in their childhood when compared to those who did not. People with SMI and cooccurring CAB experiences might be predisposed to a higher risk of head injuries and more frequent use of the ER.