Relationship between religion-related factors and obsessive compulsive disorder

This exploratory study sought to determine whether selected religion-related factors differentiated between 86 patients with obsessive compulsive disorder (OCD), 73 patients with panic disorder, and 292 patients with other psychiatric (non-anxiety) disorders. A standard history questionnaire was used to obtain information from patients concerning religion of origin, involvement in religious activities, religious conflict, and perceived religiousness of parents. It was found that the percentage of patients who reported experiencing religious conflict was significantly higher for the OCD group than for the other two groups. Other findings suggested associations between Catholicism and OCD and between Protestantism and panic disorder, but further research is needed to clarify these relationships. This article is based on a paper presented at the 98th annual convention of the American Psychological Association, Boston, August 1990.     

Multiple listing for organ transplantation: autonomy unbounded

Recently, debate about the distribution of scarce organs for transplantation has focused on whether patients should have the right to place themselves on waiting lists at several transplant centers, thereby gaining an advantage over other potential recipients. This article explores the social and ethical issues raised by multiple listing, contrasting policies adopted at the national level with those implemented in New York State. It concludes by examining the implications of the debate for broader questions about entitlement and access to health care.     

Work,leisure, and psychological well-being in a sample of young adults

This study of 20 ‘white-collar’ workers aged 20–30 measured motivation, enjoyment and access to various categories of experience in both work and leisure, and examined their relationship with psychological well-being on a number of dimensions. The method used a short questionnaire, psychological scales and the innovatory ‘experience sampling methodology’ (ESM) where respondents answer questions in a diary on the receipt of a signal from a pre-programmed watch or radio pager eight times a day for 1 week. The results show, in line with other studies, that intrinsic motivation in daily life is correlated with happiness but that, not previously reported, when motivation at work is examined both extrinsic motivation and instances where a person had to do the activity but did not wish to be doing something else, i.e. ‘positive motivational change’, are correlated with positive aspects of psychological well-being, while instances where a person wanted to do the activity but wished to be doing something else, i.e. ‘negative motivational change’, correlated with negative aspects. The results also show that enjoyment in both work and leisure correlates with aspects of psychological wellbeing; and that macro ‘flow’ experiences, where high skills and high challenges are perceived as equal, are enjoyable and interesting and come primarily from work. The study also shows that categories of experience considered important for psychological well-being and deemed to come primarily from work can be obtained in leisure. The results are discussed in the context of person—situation interactions and processes, and it is advocated that these should be studied in a variety of samples.     

Case vignette: premature surrender

Three commentaries are offered on the following case: George, age 57, is a previously healthy man who recently underwent surgery for removal of a low-grade malignant thymoma. At the time of admission to the hospital, George stressed to the staff that he had long ago signed a "living will," which he renewed immediately after he learned of his cancer diagnosis. At the time of surgery, the tumor was found to extend into his mediastinum; although it was removable, this required revision of part of the sternum and grafting of the vessels feeding the heart chambers. Because of the resultant tissue damage and neuronal hyperactivity, George experienced postoperative episodes of cardiac arrhythmia and bronchospasm. Unanimous medical opinion was that this situation was a temporary problem that would resolve itself as the tissues healed. Until that time, however, it will be difficult to wean him from ventilatory support. When his stay in the intensive care unit became prolonged, George and his family began to insist that his status be changed to "do not resuscitate" and reminded the staff about his longstanding living will. All of this is happening despite the fact that the patient and family seemingly comprehend that although the short-term interventions are invasive, there is a high probability of a successful outcome. George's cancer prognosis is excellent, and, although he may well have an episode of life-threatening arrhythmia, he is likely to respond to resuscitation interventions. Once the immediate postoperative period is over, his potential for a long and productive life with full capacities is excellent. Consider the following questions: (a) Should George's expressed wishes be respected, or should the staff take additional steps to help him survive the postoperative period, even if that means violating his stated wishes? and (b) What steps might the staff follow in sorting through this problem?     

Making peace in gestational conflicts

Mary Anne Warren's claim that there is room for only one person with full and equal rights inside a single human skin ([1], p. 63) calls attention to the vast range of moral conflict engendered by assigning full basic moral rights to fetuses. Thereby, it serves as a goad to thinking about conflicts between pregnant women and their fetuses in a way that emphasizes relationships rather than rights. I sketch out what a care orientation might suggest about resolving gestational conflicts. I also argue that the care orientation, with its commitment to the significance of the partial and the particular, cannot be absorbed within standard, impartialist moral theory.     

Reducing problem behaviors in a residential unit using structural analysis and staff management procedures: A preliminary study

A structural analysis of the problem behaviors of 32 adults with mental retardation living together in a residential facility showed that a disproportionate number of these behaviors were associated with a period of time scheduled for leisure activities. A staff management program was implemented during this time which included activity and staff scheduling, staff inservice training, and staff performance monitoring and feedback. The results showed an 83% decrease in problem behaviors when the program was implemented during the leisure period and no decrease in problem behaviors during adjacent time periods where the program was not utilized. Follow-up assessments indicated maintenance of these decreased levels of behavior at 3 and 6 months. It was concluded that this approach of combining a structural analysis with staff management procedures was effective in reducing a high level of problem behavior in a residential setting. The results are discussed with regard to pragmatic strategies for the pretreatment analysis of problem behaviors in residential settings, and the role of organizational behavior management techniques in habilitative programing for individuals with behavior disorders.     

Application of chaos theory to biology and medicine

The application of “chaos theory” to the physical and chemical sciences has resolved some long-standing problems, such as how to calculate a turbulent event in fluid dynamics or how to quantify the pathway of a molecule during Brownian motion. Biology and medicine also have unresolved problems, such as how to predict the occurrence of lethal arrhythmias or epileptic seizures. The quantification of a chaotic system, such as the nervous system, can occur by calculating the correlation dimension (D2) of a sample of the data that the system generates. For biological systems, the point correlation dimension (PD2) has an advantage in that it does not presume stationarity of the data, as the D2 algorithm must, and thus can track the transient non-stationarities that occur when the systems changes state. Such non-stationarities arise during normal functioning (e.g., during an event-related potential) or in pathology (e.g., in epilepsy or cardiac arrhythmogenesis). When stochastic analyses, such as the standard deviation or power spectrum, are performed on the same data they often have a reduced sensitivity and specifity compared to the dimensional measures. For example, a reduced standard deviation of heartbeat intervals can predict increased mortality in a group of cardiac subjects, each of which has a reduced standard deviation, but it cannot specify which individuals will or will not manifest lethal arrhythmogenesis; in contrast, the PD2 of the very same data can specify which patients will manifest sudden death. The explanation for the greater sensitivity and specificity of the dimensional measures is that they aredeterministic, and thus are moreaccurate in quantifying the time-series. This accuracy appears to be significant in detecting pathology in biological systems, and thus the use of deterministic measures may lead to breakthroughs in the diagnosis and treatment of some medical disorders.     

Low-dimensional chaos maps learning in a model neuropil (olfactory bulb)

Quantification of a chaotic system can be made by calculating the correlation dimension (D2) of the data that the system generates (Packard et al., 1980). The D2 algorithm, however, requires stationarity of the generator, a feature that biological data rarely reflect (Mayer-Kress et al., 1988). So we developed the “point correlation dimension” (PD2), an algorithm that accurately tracks D2 in linked data of different dimensions (Carpeggiani et al., 1991). We now present a mathematical argument that, for stationary data, individual PD2s converge to D2 and we demonstrate that the algorithm rejects contributions made by bursts of noise. Data were obtained from the surface of the olfactory bulb of the conscious rabbit (64 electrodes, 640 Hz each, 1.3 sec epochs) before and after presentation of a novel or habituated odor. D2 could be calculated in only 1 of 10 novel-odor trials, whereas PD2 could be calculated in all. Both algorithms indicated that a novel odor evokes a spatially uniform dimensional increase. The PD2 uniquely exhibited the dimensional decreases that occur during inspiration and the gradients of mean dimension present during the nonstimulated control state. These control gradients remained unchanged without odor experience, but showed spatially specific PD2 increases following odor habituation. It is interpreted that, 1) the PD2 issensitive, accurate, and appropriate for dimensional assessment of biological data, 2) that during analysis of unfamiliar information a singleglobal process is transiently evoked in the neuropil, and 3) after experience multiplespatially specific processes tonically map the sites of learning. Grant Support: National Institutes of Health, HL 31164 and NS27745     

Haptic probing: Perceiving the length of a probe and the distance of a surface probed

Knowing about the properties of objects by wielding them and knowing about the distances of surfaces by striking them with objects as probes are examples of dynamic or effortful touch. Six experiments focused on the invariant mechanical parameters that couple the time-varying states (displacements, velocities) of hand-held rods to the time-varying torques and forces imposed upon them by wielding and probing. There were three major conclusions. First, when a probe is wielded without contact, perceived probe length is a function of the probe’s rotational inertia; however, with contact, perceived probe length is affected by the rotational inertia and the distance of the point of contact from the probe’s center of percussion. Second, when a surface is struck with a probe, perceived surface distance is affected by the probe’s rotational inertia and the angle of inclination of the probe at contact. Third, under seemingly identical conditions of probing, either probe length or surface distance can be perceived selectively without confusion. Results were discussed in terms of haptic information, haptic attention, and the dynamics of probing.