Solidarity and Difference: A Contemporary Reading of Paul's Ethics – David G. Horrell

Book reviewed:
Solidarity and Difference: A Contemporary Reading of Paul's Ethics , David G. Horrell, T&T Clark International 2005 (0-5670-4322-3), xvi + 338 pp., pb £49.95     

Affect Labeling to Facilitate Inhibitory Learning: Clinical Considerations

Exposure-based treatments known to be effective for a wide range of psychopathology are thought to work via inhibitory learning, where new learning acquired during exposure exercises inhibits previously learned fear and avoidance responses. One way in which this inhibitory learning may be enhanced is through affect labeling, during which clients verbalize their internal emotional experiences. Theoretically, affect labeling may be a subtle, implicit form of emotion regulation and may facilitate more explicit forms of extinction learning. Experimental research suggests that affect labeling may lead to attenuated fear responses to emotionally evocative stimuli in healthy samples and may be a helpful strategy in reducing physiological arousal experienced during exposure tasks, particularly for clients with inhibitory deficits. Research with clinical samples is limited and mixed, at best. Case examples illustrate how affective labeling may help get a client “unstuck” from unproductive processing loops, can contribute to shifts in perspective and meaning making, and may modulate distress and promote distress tolerance. We argue that routine use of affect labeling in clinical care is premature. When used, it should be employed strategically within a broader case conceptualization and may be of a limited benefit beyond what is already employed in quality exposure therapy.     

Constructing Nonagency at the Beginning of Psychotherapy: The 10DT model

This study examined how nine clients discursively constructed non-agency in their first session of individual psychotherapy. With open reading and linguistic analysis of the transcribed first sessions, combined with theory-based considerations, we created a model of discursive means for ascribing agentic and non-agentic positions, the 10 Discursive Tools model (10DT). There was large variability in how the tools functioned to create the impression of problematic agency, and the clients could not be classified according to their tool use patterns. The study shows the potential of the 10DT model for the detailed examination of presentations of “not-being-able” produced by psychotherapy clients.     

Serious Ethical Violations in Medicine: A Statistical and Ethical Analysis of 280 Cases in the United States From 2008–2016

Serious ethical violations in medicine, such as sexual abuse, criminal prescribing of opioids, and unnecessary surgeries, directly harm patients and undermine trust in the profession of medicine. We review the literature on violations in medicine and present an analysis of 280 cases. Nearly all cases involved repeated instances (97%) of intentional wrongdoing (99%), by males (95%) in nonacademic medical settings (95%), with oversight problems (89%) and a selfish motive such as financial gain or sex (90%). More than half of cases involved a wrongdoer with a suspected personality disorder or substance use disorder (51%). Despite clear patterns, no factors provide readily observable red flags, making prevention difficult. Early identification and intervention in cases requires significant policy shifts that prioritize the safety of patients over physician interests in privacy, fair processes, and proportionate disciplinary actions. We explore a series of 10 questions regarding policy, oversight, discipline, and education options. Satisfactory answers to these questions will require input from diverse stakeholders to help society negotiate effective and ethically balanced solutions.     

Best Practices in the Multidisciplinary Assessment of Emotional Disturbances: A Primer for Counselors

Emotional and behavioral difficulties often interfere with children's acquisition of academic, career, and social skills. Counselors assume an important role in the mandated multidisciplinary evaluation of children with emotional disturbance (ED), but the field lacks a standard battery of assessment procedures for working with children who have ED. The authors review the current issues related to students with ED, describe instruments and procedures used to assess ED, and discuss the counselor's role in the assessment process.     

Child sexual abuse, early family risk, and childhood parentification: pathways to current psychosocial adjustment.

In this study, the authors examined the role of parentification (children assuming adult-like roles in the family) as it relates to family risk (parental psychopathology, parental illness, and domestic violence), child sexual abuse (CSA), and psychosocial adjustment in 499 college women. Structural equation modeling was used to test a model of direct, indirect, and mediational pathways through which CSA, family risk, and parentification contributed to later psychosocial maladjustment. Results indicate that CSA and family risk independently and directly predicted higher levels of maladjustment, but only family risk positively predicted parentification in childhood. Parentification was unexpectedly related to less maladjustment. Parentification failed to mediate the relation between early family risk and maladjustment. Findings suggest that family risk factors may contribute to parentification and that parentification is not always related to poorer psychosocial outcomes. Future research should examine the impact of parentification on other aspects of functioning and should assess how individual, familial, and cultural variables (e.g., age, gender, duration, perceived fairness, ethnicity, and family support) moderate the impact of parentification on long-term adjustment.     

The timing of verbal/vocal communications between mothers and their infants: a longitudinal cross-cultural comparison

Early dialogues between parent and child constitute an important factor for the acquisition of culture and hence verbal interaction is considered to be a universal parenting system. Parenting strategies and socialization practices are strongly influenced by the cultural conception of the self, prototypically defined as the model of independence and interdependence. Our study focuses on the temporal organization of spontaneous verbal/vocal behavior of 20 German middle-class and 28 Cameroonian Nso mother–infant dyads. The infants and their mothers were observed weekly in a 5 min free-play interaction scene from 0 to 3 months of age. We hypothesized to find different amounts of vocalization time, synchronous vocalizations, and contingent maternal responses in the verbal/vocal patterns of the two samples. The findings indicate cross-cultural differences in the temporal structure of verbal/vocal interactions already during the first three months of life, reflecting underlying differences in the culture-specific modes of verbal interaction.     

The use of perceptual features in categorization by orangutans (<Emphasis Type="Italic">Pongo abelli</Emphasis>)

The extent to which categorization of natural classes in animals reflects a generalization based on perceptual similarity versus an abstract conceptual representation remains unclear. Here, two experiments were conducted to identify the perceptual features used by orangutans when categorizing pictures. In Experiment 1, subjects were trained and tested for transfer on a concrete discrimination (gorillas or orangutans vs. other primates). Analysis of performance on both positive and negative exemplars revealed that performance was best on photos with faces, particularly close-ups. Moreover, error trials did not seem to reflect instances of mistaken identity, but rather, exemplars that may have been distracting for other reasons, such as novel coloration or morphology. In Experiment 2, photos were modified to test the effects of various features. Color modifications caused the biggest decrease in performance, and eye modifications also affected performance deleteriously. Therefore, two perceptual features, namely eye regions and color, played a key role in subjects' ability to categorize. However, performance based on an underlying concept cannot be ruled out, because both of these features are highly relevant in terms of defining category membership. Although a subset of features was identified as playing a key role in categorization, these features differed depending on whether feature-use was studied indirectly, as in Experiment 1, or directly, as in Experiment 2.