The necessity and the value of placebo

The use of placebo in clinical trials has been repeatedly challenged as being unacceptable from an ethical point of view. The present paper responds to this criticism by taking up the issue in the light of the pertinent provisions of the Helsinki Declaration. Examples from different therapeutic areas are given that highlight the importance of placebo in situations in which its use is acceptable according to the Declaration. Particular emphasis is given to the question of active control trials, which, under conditions of low assay sensitivity, may become an ethically less acceptable approach than the use of a placebo control. An earlier version of this paper was presented at an international conference, “Placebo: Its Action and Place in Health Research Today,” held in Warsaw, Poland on 12–13 April, 2003.     

The paradoxical effects of suppressing anxious thoughts during imminent threat

In line with the ironic processing theory of Wegner (Psychol. Rev. 101 (1994) 34), it is often argued that the suppression of anxiety-related thoughts results in a paradoxical increase of anxiety and thought intrusions, both after and during the thought suppression. In a sample of undergraduate students (14 men, 18 women), we investigated the effects of suppressing anxious thoughts about an imminent painful electrocutaneous stimulus. During thought suppression, self-reported anxiety and frequency of anxious thoughts did not increase, and duration of anxious thoughts decreased. After thought suppression, participants experienced an increase in self-reported anxiety and the frequency of anxious thoughts. There was no effect upon thought duration. The results support the idea that suppression of anxiety-related thoughts may result in a paradoxical increase in anxiety, and may cause and/or maintain anxiety problems.     

Viewpoint dependence in visual and haptic object recognition

On the whole, people recognize objects best when they see the objects from a familiar view and worse when they see the objects from views that were previously occluded from sight. Unexpectedly, we found haptic object recognition to be viewpoint-specific as well, even though hand movements were unrestricted. This viewpoint dependence was due to the hands preferring the back "view" of the objects. Furthermore, when the sensory modalities (visual vs. haptic) differed between learning an object and recognizing it, recognition performance was best when the objects were rotated back-to-front between learning and recognition. Our data indicate that the visual system recognizes the front view of objects best, whereas the hand recognizes objects best from the back.     

Gorbatschews “Erneuerung des Sozialismus” — Ideologie in der Krise des Kommunismus

Ohne Zusammenfassung     

Zu Husserls Wahrnehmungsbegriff

Ohne Zusammenfassung     

Feedback-related brain activity predicts learning from feedback in multiple-choice testing

Different event-related potentials (ERPs) have been shown to correlate with learning from feedback in decision-making tasks and with learning in explicit memory tasks. In the present study, we investigated which ERPs predict learning from corrective feedback in a multiple-choice test, which combines elements from both paradigms. Participants worked through sets of multiple-choice items of a Swahili–German vocabulary task. Whereas the initial presentation of an item required the participants to guess the answer, corrective feedback could be used to learn the correct response. Initial analyses revealed that corrective feedback elicited components related to reinforcement learning (FRN), as well as to explicit memory processing (P300) and attention (early frontal positivity). However, only the P300 and early frontal positivity were positively correlated with successful learning from corrective feedback, whereas the FRN was even larger when learning failed. These results suggest that learning from corrective feedback crucially relies on explicit memory processing and attentional orienting to corrective feedback, rather than on reinforcement learning.     

Maximal care considerations when treating patients with end-stage heart failure: ethical and procedural quandaries in management of the very sick

Deciding who should receive maximal technological treatment options and who should not represents an ethical, moral, psychological and medico-legal challenge for health care providers. Especially in patients with chronic heart failure, the ethical and medico-legal issues associated with providing maximal possible care or withholding the same are coming to the forefront. Procedures, such as cardiac transplantation, have strict criteria for adequate candidacy. These criteria for subsequent listing are based on clinical outcome data but also reflect the reality of organ shortage. Lack of compliance and non-adherence to lifestyle changes represent relative contraindications to heart transplant candidacy. Mechanical circulatory support therapy using ventricular assist devices is becoming a more prominent therapeutic option for patients with end-stage heart failure who are not candidates for transplantation, which also requires strict criteria to enable beneficial outcome for the patient. Physicians need to critically reflect that in many cases, the patient’s best interest might not always mean pursuing maximal technological options available. This article reflects on the multitude of critical issues that health care providers have to face while caring for patients with end-stage heart failure.     

On the role of goal relevance in emotional attention: disgust evokes early attention to cleanliness

Prior evidence has shown that aversive emotional states are characterised by an attentional bias towards aversive events. The present study investigated whether aversive emotions also bias attention towards stimuli that represent means by which the emotion can be alleviated. We induced disgust by having participants touch fake disgusting objects. Participants in the control condition touched non-disgusting objects. The results of a subsequent dot-probe task revealed that attention was oriented to disgusting pictures irrespective of condition. However, participants in the disgust condition also oriented towards pictures representing cleanliness. These findings suggest that the deployment of attention in aversive emotional states is not purely stimulus driven but is also guided by the goal to alleviate this emotional state.