Clinical interpretation: The hermeneutics of medicine

I argue that clinical medicine can best be understood not as a purified science but as a hermeneutical enterprise: that is, as involved with the interpretation of texts. The literary critic reading a novel, the judge asked to apply a law, must arrive at a coherent reading of their respective texts. Similarly, the physician interprets the text of the ill person: clinical signs and symptoms are read to ferret out their meaning, the underlying disease. However, I suggest that the hermeneutics of medicine is rendered uniquely complex by its wide variety of textual forms. I discuss four in turn: the experiential text of illness as lived out by the patient; the narrative text constituted during history-taking; the physical text of the patient's body as objectively examined; the instrumental text constructed by diagnostic technologies. I further suggest that certain flaws in modern medicine arise from its refusal of a hermeneutic self-understanding. In seeking to escape all interpretive subjectivity, medicine has threatened to expunge its primary subject — the living, experiencing patient.     

Contributions of survey research to the understanding of memory

This article reviews the results of survey methodological research that illustrate phenomena of potential interest to investigators of memory, and also reviews psychological research designed to explore some of these phenomena under controlled laboratory conditions. We classify the phenomena reviewed into broad categories of remembering what events occurred, remembering when events occurred, and estimation and reconstruction processes used in reporting recurring events. We delineate the contributions of this research for our understanding of memory phenomena and show where this research has revealed gaps in our existing theories and knowledge. These findings present challenges for future collaboration between cognitive psychologists and survey methodologists.     

Family preservation using multisystemic treatment: Long-term follow-up to a clinical trial with serious juvenile offenders

In a randomized clinical trial, multisystemic family preservation was shown to significantly reduce rates of criminal activity and incarceration in a sample of 84 serious juvenile offenders and their multi-need families. In the current study, archival records were searched for re-arrest an average of 2.4 years post-referral. Survival analysis showed that youths who received multisystemic family preservation were less likely to be re-arrested than were youths who had received usual services. Such results represent the first controlled demonstration that family preservation, when delivered via a clearly specified treatment model, has lasting effects with serious juvenile offenders. Implications for family preservation and juvenile justice research are discussed.     

Sexual Attitudes of Males and Females as Predictors of Interpersonal Attraction and Marital Compatibility1

Two investigations examine the effect of similarity of sexual attitudes on (a) attraction to a stranger and (b) marital sexual satisfaction. In an experiment using undergraduates, manipulation of subject-stranger similarity in general affective orientation to sexuality affected attraction and other evaluative dependent variables. In the second investigation, married couples revealed sexual attitudes and sexual satisfaction. Husbands and wives were similar (r= 0.58, p < 0.001) in their affective orientations to sexuality. Discrepancy between the partners’ scores predicted sexual dissatisfaction in both partners. In addition, the wife's affective orientation to sexuality predicted more indices of sexual satisfaction and adjustment in both the wife and the husband than did the husband's affective orientation to sexuality. Finally, spouses with a positive affective orientation to sexuality were more accurate when judging their partner's sexual enjoyment, compared to spouses with a negative orientation. The findings have implications for the effects of similarity of attitudes on interpersonal attraction and on relationship quality.