What Does Diffusion Tensor Imaging Reveal About the Brain and Cognition in Fetal Alcohol Spectrum Disorders?

Over the past 5 years, Diffusion Tensor Imaging (DTI) has begun to provide new evidence about the effects of prenatal alcohol exposure on white matter development. DTI, which examines microstructural tissue integrity, is sensitive to more subtle white matter abnormalities than traditional volumetric MRI methods. Thus far, the available DTI data suggest that white matter microstructural abnormalities fall on a continuum of severity in Fetal Alcohol Spectrum Disorder (FASD). Abnormalities are prominent in the corpus callosum, but also evident in major anterior-posterior fiber bundles, corticospinal tracts, and cerebellum. These subtle abnormalities are correlated with neurocognitive deficits, especially in processing speed, non-verbal ability, and executive functioning. Future studies using larger samples, increasingly sophisticated DTI methods, and additional functional MRI connectivity measures will better characterize the full range of abnormalities in FASD. Ultimately, these measures may serve as indices of change in future longitudinal studies and in studies of interventions for FASD.     

“All You Need is Holt”—Is the Socio-cultural Phenomenon a Problem for a Neorealist Ecological Psychology?

The aim of this paper is to discuss Charles’s (2011) attempt to turn E.B. Holt’s theoretical approach into the only possible bridge to connect Gibsonian ecological psychology with social psychology. Criticism of Charles’s claims is carried out at four different conceptual levels: historiographical, logico-epistemological, methodological, and theoretical. From this critical perspective, Charles’s resort to Holt’s ideas is viewed as an effort to legitimate Charles’s own line of work. Moreover, far from being this the only possible approach to the subject, many other rich alternatives to the application of Gibsonian principles to the explanation of socio-cultural phenomena already exist. In fact, it is questionable whether Holt’s behavioral neorealism allows dealing with many of the most complex socio-cultural issues, particularly those related to purposive behavior and intersubjective contexts. In order to address these questions from a Holtian point of view, Charles is forced to make a number of argumentative leaps and epistemological transgressions. In the last analysis, his insistence on keeping to the Holtian stance leads him to lose sight of the Gibsonian framework and to modify the very nature of his object of study, the social phenomenon—which, along the lines of classic neorealist behaviorism, becomes reduced to a simple consideration of behavioral purposiveness.     

Aus der Wohnungslosigkeit zum Pantheon

Mit diesem Fallbericht soll einerseits das Modell der Liaisonpsychiatrie in der Wohnungslosenbetreuung dargestellt werden sowie andererseits die besondere Bedeutung langfristiger Beziehungsarbeit und auf Freiwilligkeit beruhender Behandlungsangebote hervorgehoben werden. Viele schwer kranke Patientinnen und Patienten haben – oft schon vor Jahrzehnten – unangenehme bis traumatisierende Erlebnisse bei station?ren Aufnahmen mitgemacht und lehnen psychiatrische Behandlung ab, weil sie sie mit Zwang und massiven Nebenwirkungen assoziieren. In der Folge soll berichtet werden, wie eine Patientin wieder Vertrauen zu medizinischen Angeboten und somit eine wesentlich bessere Lebensqualit?t finden konnte.     

Learning and Living Systemic: Exploring the Personal Effects of Family Therapy Training

Despite growing recognition that systemic family therapists need to be adept at personal reflection and managing the therapeutic relationship, little research has explored the effects of training beyond the development of skills. This article provides a report on a qualitative study focussed on the personal effects of family therapy training, with particular reference to the aspects of training that foster personal reflection and growth. Twenty three trainees from three training institutions were interviewed, utilizing the practices of grounded theory. Trainees reported a deepening relational awareness, which applied to both personal and professional domains and included shifts in perspectives on relationships with loved ones. Five aspects of training were identified as responsible: (1) personally challenging experiences with clients; (2) supervisors who live the paradigm; (3) the demystification of theory; (4) a safe supervisory space; and (5) the development of trusting peer relationships. Interns also described, in turn, how their personal development affected their clinical work, particularly in the development of compassion and empathy. This study serves to highlight training practices that support reflective practice in systemic family therapy.     

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.     

Being realistic about common knowledge: a Lewisian approach

Defined and formalized several decades ago, widely used in philosophy and game theory, the concept of common knowledge is still considered as problematic, although not always for the right reasons. I suggest that the epistemic status of a group of human agents in a state of common knowledge has not been thoroughly analyzed. In particular, every existing account of common knowledge, whether formal or not, is either too strong to fit cognitively limited individuals, or too weak to adequately describe their state. I provide a realistic definition of common knowledge, based on a formalization of David Lewis’ seminal account and show that it is formally equivalent to probabilistic common belief. This leads to a philosophical analysis of common knowledge which answers several common criticisms and sheds light on its nature.     

Communication between domestic dogs and humans: effects of shelter housing upon the gaze to the human

It is widely known that gaze plays an essential role in communicative interactions. Domestic dogs tend to look at the human face in situations of conflict and uncertainty. This study compares the gaze of shelter and pet dogs during acquisition and extinction phases in a situation involving a reward in sight but out of reach. Even though no significant differences between the groups were recorded during acquisition, gaze duration decreased in both groups during extinction, with shelter dogs showing a significant shorter duration. This could be related to their different living conditions and to the fact that through their ordinary everyday interactions, pet dogs have more opportunities to learn to persist in their communicative responses when they do not get what they want. These results highlight the relevance of learning experiences during ontogeny, which would therefore modulate communicative responses.     

Training and Education in Religion/Spirituality Within APA-Accredited Clinical Psychology Programs: 8 Years Later

This study was a follow up investigation of Brawer et al.’s (Prof Psychol Res Pr 33(2):203–206, 2002) survey of education and training of clinical psychologists in religion/spirituality. Directors of clinical training were surveyed to determine whether changes had occurred in the coverage of religion and spirituality through course work, research, supervision, and in the systematic coverage of the content area. Results indicated an increased coverage in the areas of supervision, dedicated courses, inclusion as part of another course, and research. There was no increase in systematic coverage, but significantly more programs provided at least some coverage. The current study also assesses other areas of incorporation as well as directors’ opinions regarding the importance of religion/spirituality in the field of psychology.