The six most essential questions in psychiatric diagnosis: a pluralogue. Part 4: general conclusion

In the conclusion to this multi-part article I first review the discussions carried out around the six essential questions in psychiatric diagnosis – the position taken by Allen Frances on each question, the commentaries on the respective question along with Frances’ responses to the commentaries, and my own view of the multiple discussions. In this review I emphasize that the core question is the first – what is the nature of psychiatric illness – and that in some manner all further questions follow from the first. Following this review I attempt to move the discussion forward, addressing the first question from the perspectives of natural kind analysis and complexity analysis. This reflection leads toward a view of psychiatric disorders – and future nosologies – as far more complex and uncertain than we have imagined.     

Doing Good, Feeling Good, and Having More: Resources Mediate the Health Benefits of Altruism Differently for Males and Females with Lumbar Spine Disorders

We evaluated whether resources mediate and/or moderate the relationship between altruism and health outcomes in adults with lumbar spine disorders. Hierarchical regression modeling on 243 persons with lumbar spine disorders evaluated gender differences and whether physical, emotional, and economic resources mediated or moderated the relationship between altruism (Schwartz Altruism) and health (Rand-36, PROMIS Pain Impact). Men and women had similar altruism subscale scores, but there were gender differences in the altruism-health relationships. Both men and women had better mental health with higher levels of Community Connection, after adjusting for Community Pressure, and this effect was mediated by emotional resources. Women evidenced better physical health and less pain impact when they endorsed higher levels of Community Connection and/or General Helping aspects of altruism. Physical and economic resources partially but did not fully mediate women??s altruism-physical health link. The altruism-pain impact link was not significant after adjusting for covariates. Men and women report similar levels of altruism but enjoy different benefits. Emotional resources explained the altruism-mental health link in both genders, but women experienced a physical health benefit of altruism that was not mediated by resources. Future research should test causal relationships.     

Draw me a dream

Journal of Contemporary Psychotherapy -     

Empathy and the relationship between attitudinal similarity and attraction

Subjects varying in their levels of trait empathy encountered an attitudinally similar or dissimilar other. Replicating past research, subjects expressed much greater attraction for a similar rather than dissimilar other. Extending past research, the relationship between attitudinal similarity and attraction was much stronger among those having a strong rather than weak empathic tendency. Explanations, theoretical implications, and limitations are discussed.     

Self-esteem and reactance: Further evidence of attitudinal and motivational consequences

The present experiments were designed to explore further the relationship between self-esteem and reactance within the domains of achievement and persuasion. Previous research in the achievement context has shown that self-esteem and reactance are positively related. Experiment 1 sought to extend this relationship into the persuasion setting. As predicted, a positive self-esteem/reactance relationship was obtained. The second experiment was designed to identify a factor that might moderate the relationship between self-esteem and reactance: degree of freedom threat. Previous research in the persuasion context has shown that the aforementioned self-esteem/reactance relationship is attenuated or even reversed when freedom threat is low rather than high. Experiment 2 sought to extend this relationship into the achievement context. As predicted, the positive self-esteem/reactance relationship was considerably weakened in the low-threat environment of Experiment 2, especially in comparison to previous research in which freedom threat was considerably higher. Taken together, the present and previous studies show consistent relationships between self-esteem and reactance across achievement and persuasion domains, suggesting that the essence of reactance is similar in these two domains. Practical implications are also discussed.     

THE NATURAL GOD: A GOD EVEN AN ATHEIST CAN BELIEVE IN

Abstract. In this paper, I attempt to dissolve the theism/atheism boundary. In the first part, I consider last things, according to mainstream science. In the second part, I define the Natural God as the Force of Nature—evolving, unifying, maximizing—and consider Its relation to last things. Finally, I discuss our knowledge of the Natural God and Its relevance to our personal lives. I argue that we can know the Natural God through scientific reason combined with global intuition, and that this knowledge, from the perspective of last things, may help us achieve universal love, ethical action, and personal salvation.     

The physician's influence on informed consent for bone marrow transplantation

The influence of physician judgment on the disclosure, competency, understanding, voluntariness, and decision aspects of informed consent for bone marrow transplantation are described. Ethical conflicts which arise from the amount and complexity of the information to be disclosed and from the barriers of limited time, patient anxiety and lack of prior relationship between patient and physician are discussed. The role of the referring physician in the decision-making is considered. Special ethical issues which arise with use of healthy related bone marrow donors are discussed, as is the physician's discretion in raising questions of competency. It is concluded that in this setting, regardless of the theoretical goals of the physician, patients appear to utilize informed consent discussions to assess their capacity to trust the physician rather than as a time to weigh the large amount of relevant data. The conscientious physician best serves the patient with recommendation of the best medical alternative rather than with attempts to remain neutral.     

Reactions to uncertainty: A comparison of three motivational theories

This study attempted to explicate some of the variables underlying preference, pleasure, and reward. In order to accomplish this, Jones's (1966, 1969) information drive theory, Berlyne's (1967, 1971, 1973, 1978) optimal arousal potential theory, Helson's (1964, 1966, 1971, 1973) adaptation-level theory, and McClelland and Clark's (1953) discrepancy hypothesis were experimentally contrasted. Subjects (316) rated the hedonic tone, perceived uncertainty, arousing properties, and interest value of two series of visual stimuli of specified uncertainty. Regression analyses revealed that immediately prior experience with stimuli varying in uncertainty affected rating of perceived uncertainty and arousing properties but had no major effects on ratings of hedonic tone and interest value. The results did not support Jones's and McClelland and Clark's models. Berlyne's model seemed to account for the affective hedonic tone and interest results, while Helson's model best explained the nonaffective perceived uncertainty and arousal data. It was concluded that nonaffective variables are affected by short-term experience with uncertainty while affective variables are not. Speculations concerning the phenomenon of interest value were then offered.Jewish Child Care AssociationThis article is based on a dissertation submitted to the New School for Social Research in partial fulfillment of the Ph.D. requirements. I would like to thank Drs. Nathan Brody and Nathan Kogan for their help in conducting this experiment and preparing this article.