Reply to Letter to the Editor

The current policy of the National Institute of Health designed to increase the participation of women and minorities is radically different from previous policies designed to protect minorities from abuses in research studies. The principal arguments to support this policy are twofold: 1) Increased representation of minorities and women in research would increase the generalizability of research data and allow for valid analyses of differences in subpopulations; and 2) being in a clinical research study is advantageous to participants regardless of the final research study results. It remains unclear whether minorities find these arguments compelling. Instead of telling minorities that participation in research is good for them, the research community should focus on understanding what minority communities want from clinical research and then tailoring the message to meet this need. Persuasive arguments to promote long-term increased representation of minorities in clinical research must come from within minority communities.     

Posttraumatic Symptoms, Functional Impairment, and Coping among Adolescents on Both Sides of the Israeli–Palestinian Conflict: A Cross-Cultural Approach

This study assessed the effects of the ongoing violence on the mental health of Palestinian and Israeli youths. Parallel instruments were developed and adapted, as part of a collaborative project, in order to assess, in each society: (1) differential rates of exposure to the conflict, (2) the association between exposure and the severity of posttraumatic symptoms (PTS), and (3) the inter‐relationships among PTS, functional impairment, somatic complaints, and coping strategies. Participants were 1,016 Israeli and 1,235 Palestinian adolescents. A self‐report questionnaire assessed exposure. PTS was measured using the UCLA PTSD Reaction Index, functional impairment and somatic complaints were measured with the DISC, and coping strategies were assessed with Brief Cope. In both societies, greater exposure to conflict‐related violence was associated with more PTS and more somatic complaints, with girls reporting more distress than boys. A total of 6.8 per cent of the Israeli students and 37.2 per cent of the Palestinian students met criteria for Post Traumatic Stress Disorder (PTSD). In both societies, but more pronounced in the Palestinian Authority, adolescents reported significant levels of functional impairment, mainly in the area of school functioning. Students with PTSD reported more somatic complaints as well as greater functional impairment. The results show the serious psychological impact of the ongoing violent conflict on Israeli and Palestinian students and point to the need to develop appropriate school‐based interventions to address their mental health needs. Cette étude évalue les effets de la violence continuelle sur la santé mentale des jeunes palestiniens et israéliens. Des instruments analogues ont été développés et adaptés, dans le cadre d’un projet de collaboration, afin d’évaluer dans chaque société: (1) les différences de taux d’exposition au conflit, (2) l’association entre l’exposition et la sévérité des symptômes post‐traumatiques (PTS) et (3) les interrelations entre les PTS, les troubles fonctionnels, les plaintes somatiques et les stratégies de faire‐face. 1016 adolescents israéliens et 1235 adolescents palestiniens ont participéà cette étude. Un questionnaire auto‐administré mesure l’exposition au conflit. Les PTS sont mesurés par l’utilisation de l’UCLA PTSD Reaction Index, les troubles fonctionnels et les plaintes somatiques sont approchés par le DISC, et les stratégies de faire‐face par le Brief Cope. Dans les deux sociétés, une plus grande exposition au conflit et à ses violences est associée à des PTS plus importants et à plus de plaintes somatiques, les filles manifestant plus de détresse que les garçons. Un total de 6.8% des étudiants israéliens et 37.2% des étudiants palestiniens répondent à des critères du Post Traumatic Stress Disorder (PTSD). Dans les deux sociétés, mais de façon plus prononcée dans l’Autorité palestinienne, les adolescents rapportent des niveaux significatifs de troubles fonctionnels, principalement dans le domaine du fonctionnement scolaire. Les étudiants avec PTSD manifestent plus de plaintes somatiques, il en va de même pour les troubles fonctionnels. Les résultats montrent le sérieux impact psychologique d’un conflit violent et continuel sur les étudiants israéliens et palestiniens et signale le besoin de développer des interventions scolaires appropriées à leurs besoins en matière de santé mentale.     

LEIBNIZ ON BODY, MATTER AND EXTENSION

This paper explores Leibniz's conception of body and extension in the 1680s and 1690s. It is argued that one of Leibniz's central aims is to undermine the Cartesian conception of extended substance, and replace it with a conception on which what is basic to body is force. In this way, Leibniz intends to reduce extension to something metaphysically more basic in just the way that the mechanists reduce sensible qualities to size, shape and motion. It is also argued that this move is quite distinct from the reduction of body to monads and their appetitions and perceptions, so prominent in his later writings.     

Testing a model of pain appraisal and coping in children with chronic abdominal pain.

This prospective study of children with recurrent abdominal pain (N=133; ages 8--15 years) used path analysis to examine relations among dispositional pain beliefs and coping styles, cognitions and behavior related to a specific pain episode, and short- and long-term outcomes. Children believing they could not reduce or accept pain appraised their episode-specific coping ability as low and reported passive coping behavior. Dispositional passive coping had direct effects on both episode-specific passive coping and long-term symptoms and disability. Accommodative coping (acceptance and self-encouragement) was associated with reduced episode-specific distress, which itself predicted reduced depressive symptoms 3 months later. Results suggest that coping-skill interventions for children with chronic pain should target reductions in passive coping and consider the potential benefits of accommodative coping strategies.     

Gesture offers insight into problem‐solving in adults and children

When asked to explain their solutions to a problem, both adults and children gesture as they talk. These gestures at times convey information that is not conveyed in speech and thus reveal thoughts that are distinct from those revealed in speech. In this study, we use the classic Tower of Hanoi puzzle to validate the claim that gesture and speech taken together can reflect the activation of two cognitive strategies within a single response. The Tower of Hanoi is a well‐studied puzzle, known to be most efficiently solved by activating subroutines at theoretically defined choice points. When asked to explain how they solved the Tower of Hanoi puzzle, both adults and children produced significantly more gesture‐speech mismatches—explanations in which speech conveyed one path and gesture another—at these theoretically defined choice points than they produced at non‐choice points. Even when the participants did not solve the problem efficiently, gesture could be used to indicate where the participants were deciding between alternative paths. Gesture can, thus, serve as a useful adjunct to speech when attempting to discover cognitive processes in problem‐solving.