Everyday worry in adolescents with and without chronic pain: a diary study

Young people report frequent worry, but we know little about the extent, character, or consequence of worry in adolescence, or individual differences associated with worry. Adolescents with chronic pain are one population that are known to have high levels of anxiety, which is associated with higher levels of disability and depression, impairing function. In this study we report a diary study: adolescents (N = 60; aged 16–18) recorded their worry over seven days. Our first aim was to describe the characteristics of adolescent worry and its consequences in a community sample. Our second aim was to compare the experience of girls to boys, and to compare the experience of those with and without chronic pain. Adolescents reported characteristics of each worry they had throughout the week, including content, frequency, strength, interference, emotion, and the strength of emotion associated with worry content. Adolescents reported the consequence for each content and the strength of the consequence. Worry content and consequences were categorised into four categories; health, relationship, personal competence, and other. Adolescents reported 675 unique episodes of worry over the seven-day period that were predominantly about personal competence. The strength of worry content was (M = 6.61, SD = 1.27) and the strength associated with the worry consequence was (M = 5.59, SD = 1.41). Worries were not reported as highly interfering (M = 4.14, SD = 1.61). Contrary to predictions, there were no differences in worry characteristics between adolescents with and without chronic pain. To conclude, worry is a frequent occurrence in older adolescents and the characteristics of worry are discussed. Adolescents worry mostly about personal competence. Adolescents with and without chronic pain reported similar worry characteristics.     

Kant’s deductions of morality and freedom

It is commonly held that Kant ventured to derive morality from freedom in Groundwork III. It is also believed that he reversed this strategy in the second Critique, attempting to derive freedom from morality instead. In this paper, I set out to challenge these familiar assumptions: Kant’s argument in Groundwork III rests on a moral conception of the intelligible world, one that plays a similar role as the ‘fact of reason’ in the second Critique. Accordingly, I argue, there is no reversal in the proof-structure of Kant’s two works.     

Homage to David Thomasma: Introduction

Theoretical Medicine and Bioethics -     

How mediation (and other) approaches may improve ethics consultants' outcomes

Articles in this issue of JCE recommend a number of approaches to clinical ethics consultation. Given these various approaches, how should ethics consultants proceed?     

Form follows function: Learning about function helps children learn about shape

Object functions help young children to organize new artifact categories. However, the scope of their influence is unknown. We explore whether functions highlight property dimensions that are relevant to artifact categories in general. Specifically, using a longitudinal training procedure, we assessed whether experience with functions highlights shape as important for categorization. Seventeen-month-olds were provided experience with novel categories of similarly shaped objects. In Study 1, the function group learned about the objects’ shape-based functions; a control group did not. In Study 2, 17-month-olds were trained on the same categories, but the objects’ shapes and functions were no longer causally related. Only the function group in Study 1 subsequently used shape reliably when categorizing novel objects. These results suggest that function is instrumental in establishing a ‘shape bias’ in early categorization and that it does so via conceptually based processes.     

Introduction: Special Issue on Positive Psychology and Adult Development

An adult seems to articulate surprisingly similar meaning themes and similar processes about relationships in several widely disparate domains of behavior, domains of both non-pathological and pathological types. Whether the person is consciously describing early relationships with parental figures, unconsciously acting them out in current relationships, experiencing relationships with God or the Transcendent, or acting on the basis of relational delusions during psychotic episodes, his or his experienced relational reality seems to be filtered through a single, coherent, personally unique spiritual, existential, and epistemological relational lens. Conflicts may involve other relational meanings, but may be conflicts because of the existence of that dominant lens. Two parts of that dominant lens system, specifically the part relating the person’s concept of God to the other parts of the system and the part relating the specifics of psychotic breaks and spiritual emergence to other parts of the system, are seldom discussed. Both understanding the person’s dominant relational lens and the implications of that person’s using the lens to see reality, and sharing that knowledge with the individual (if he or he has stabilized to some degree) can help the troubled or disoriented individual. That person can gradually give a more adaptive meaning to consistent distortions in the many areas of meaning and behavior attached to relationships, and even to very skewed behavior such as hallucinations and delusions during psychotic breaks. Distortions during experiences of spiritual emergence also can be made clearer to the disturbed client if the therapist has a better understanding of the person’s overall coherent relational meaning system and its implications, and can translate the language of that system into spiritually transformative terms. A case is summarized and discussed as an example of these ideas. Then, two theories are described. A useful theory of human-felt connection and a cognitive developmental theory of Postformal Complex Thought have been developed by the author and described in earlier publications. These two theories help make sense of the multiple but coherent themes, cognitive dimensions of theme genesis and change, and the nature of the relational lenses used. Suggestions about interventions in the person’s system of coherently distorted relational themes, suggestions based on the two theories, are discussed. The recommendation is made that all therapists become fluent in the languages of, and especially the connections among, all of the relational areas named in the title of this paper that are part of the coherent relational theme.     

Everyday scale errors

Young children occasionally make scale errors – they attempt to fit their bodies into extremely small objects or attempt to fit a larger object into another, tiny, object. For example, a child might try to sit in a dollhouse-sized chair or try to stuff a large doll into it. Scale error research was originally motivated by parents' and researchers' informal accounts of these behaviors. However, scale errors have only been documented using laboratory procedures designed to promote their occurrence. To formally document the occurrence of scale errors in everyday settings, we posted a survey on the internet. Across two studies, participants reported many examples of everyday scale errors that are similar to those observed in our labs and were committed by children of the same age. These findings establish that scale errors occur in the course of children's daily lives, lending further support to the account that these behaviors stem from general aspects of visual processing.     

Top-down control of visual perception: attention in natural vision

Top-down perceptual influences can bias (or pre-empt) perception. In natural scenes, the receptive fields of neurons in the inferior temporal visual cortex (IT) shrink to become close to the size of objects. This facilitates the read-out of information from the ventral visual system, because the information is primarily about the object at the fovea. Top-down attentional influences are much less evident in natural scenes than when objects are shown against blank backgrounds, though are still present. It is suggested that the reduced receptive-field size in natural scenes, and the effects of top-down attention contribute to change blindness. The receptive fields of IT neurons in complex scenes, though including the fovea, are frequently asymmetric around the fovea, and it is proposed that this is the solution the IT uses to represent multiple objects and their relative spatial positions in a scene. Networks that implement probabilistic decision-making are described, and it is suggested that, when in perceptual systems they take decisions (or 'test hypotheses'), they influence lower-level networks to bias visual perception. Finally, it is shown that similar processes extend to systems involved in the processing of emotion-provoking sensory stimuli, in that word-level cognitive states provide top-down biasing that reaches as far down as the orbitofrontal cortex, where, at the first stage of affective representations, olfactory, taste, flavour, and touch processing is biased (or pre-empted) in humans.     

Camera perspective bias in videotaped confessions: evidence that visual attention is a mediator

Several experiments have demonstrated a camera perspective bias in evaluations of videotaped confessions: videotapes with the camera focused on the suspect lead to judgments of greater voluntariness than alternative presentation formats. The present research investigated potential mediators of this bias. Using eye tracking to measure visual attention, Experiment 1 replicated the bias and revealed that changes in camera perspective are accompanied by corresponding changes in duration of fixation on the suspect and interrogator. A path analysis indicated that visual attention partially mediated the bias, with at least one additional factor independently contributing to it. A proposed second factor was changes in available visual content that naturally coincide with alterations in camera perspective. Experiment 2 directly manipulated observers' focus and thus more conclusively established visual attention as one mediator of the camera perspective bias. Together the two experiments provide plausible evidence that differences in visual content may also mediate the bias.