Exposure-based Interventions for the management of individuals with high levels of needle fear across the lifespan: a clinical practice guideline and call for further research

Needle fear typically begins in childhood and represents an important health-related issue across the lifespan. Individuals who are highly fearful of needles frequently avoid health care. Although guidance exists for managing needle pain and fear during procedures, the most highly fearful may refuse or abstain from such procedures. The purpose of a clinical practice guideline (CPG) is to provide actionable instruction on the management of a particular health concern; this guidance emerges from a systematic process. Using evidence from a rigorous systematic review interpreted by an expert panel, this CPG provides recommendations on exposure-based interventions for high levels of needle fear in children and adults. The AGREE-II, GRADE, and Cochrane methodologies were used. Exposure-based interventions were included. The included evidence was very low quality on average. Strong recommendations include the following. In vivo (live/in person) exposure-based therapy is recommended (vs. no treatment) for children seven years and older and adults with high levels of needle fear. Non-in vivo (imaginal, computer-based) exposure (vs. no treatment) is recommended for individuals (over seven years of age) who are unwilling to undergo in vivo exposure. Although there were no included trials which examined children < 7 years, exposure-based interventions are discussed as good clinical practice. Implementation considerations are discussed and clinical tools are provided. Utilization of these recommended practices may lead to improved health outcomes due to better health care compliance. Research on the understanding and treatment of high levels of needle fear is urgently needed; specific recommendations are provided.     

Exploring linguistic correlates of social anxiety in romantic stories

The current study used computerized linguistic analysis of stories about either going on a date or taking a walk down a street to examine linguistic correlates of social anxiety in a sample of undergraduate students. In general, linguistic analysis revealed associations of social anxiety with several linguistic variables, including negative emotion, affect, and anxiety words. Participants higher in social anxiety wrote fewer affect words. The relationship between social anxiety and anxiety words depended on gender, whereas the relationship between social anxiety and negative emotion words depended on both gender and the nature of primes (supraliminal vs. subliminal) received. Overall, our findings highlight the potential utility and benefits of using linguistic analysis as another source of information about how individuals higher in social anxiety process romantic stimuli.     

Pathways of Risk and Resilience: Impact of a Family Resilience Program on Active‐Duty Military Parents

Over the past decade, studies into the impact of wartime deployment and related adversities on service members and their families have offered empirical support for systemic models of family functioning and a more nuanced understanding of the mechanisms by which stress and trauma reverberate across family and partner relationships. They have also advanced our understanding of the ways in which families may contribute to the resilience of children and parents contending with the stressors of serial deployments and parental physical and psychological injuries. This study is the latest in a series designed to further clarify the systemic functioning of military families and to explicate the role of resilient family processes in reducing symptoms of distress and poor adaptation among family members. Drawing upon the implementation of the Families Overcoming Under Stress (FOCUS) Family Resilience Program at 14 active‐duty military installations across the United States, structural equation modeling was conducted with data from 434 marine and navy active‐duty families who participated in the FOCUS program. The goal was to better understand the ways in which parental distress reverberates across military family systems and, through longitudinal path analytic modeling, determine the pathways of program impact on parental distress. The findings indicated significant cross‐influence of distress between the military and civilian parents within families, families with more distressed military parents were more likely to sustain participation in the program, and reductions in distress among both military and civilian parents were significantly mediated by improvements in resilient family processes. These results are consistent with family systemic and resilient models that support preventive interventions designed to enhance family resilient processes as an important part of comprehensive services for distressed military families.     

Developmental Trajectories of Religious Service Attendance: Predictors of Nicotine Dependence and Alcohol Dependence/Abuse in Early Midlife

Journal of Religion and Health - This longitudinal study assesses the associations between developmental trajectories of religious service attendance from mean age 14 to mean age 43 and nicotine...     

Two approaches to natural kinds

Philosophical treatments of natural kinds are embedded in two distinct projects. I call these the philosophy of science approach and the philosophy of language approach. Each is characterized by its own set of philosophical questions, concerns, and assumptions. The kinds studied in the philosophy of science approach are projectible categories that can ground inductive inferences and scientific explanation. The kinds studied in the philosophy of language approach are the referential objects of a special linguistic category—natural kind terms—thought to refer directly. Philosophers may hope for a unified account addresses both sets of concerns. This paper argues that this cannot be done successfully. No single account can satisfy both the semantic objectives of the philosophy of language approach and the explanatory projects of the philosophy of science approach. After analyzing where the tensions arise, I make recommendations about assumptions and projects that are best abandoned, those that should be retained, and those that should go their separate ways. I also recommend adopting the disambiguating terminology of “scientific kinds” and “natural kinds” for the different notions of kinds developed in these different approaches.

     

Epistemic buck-passing and the interpersonal view of testimony

Two ideas shape the epistemology of testimony. One is that testimony provides a unique kind of knowledge. The other is that testimonial knowledge is a social achievement. In traditional terms, those who affirm these ideas are anti-reductionists, and those who deny them are reductionists. There is increasing interest, however, in the possibility of affirming these ideas without embracing anti-reductionism. Thus, Sanford Goldberg uses the idea of epistemic buck-passing to argue that even reductionists can accept the uniqueness of testimonial knowledge, and Jennifer Lackey gives both speaker and hearer an essential role in testimonial justification, rejecting both reductionism and anti-reductionism in favor of what she calls dualism. After distinguishing a weaker and a stronger notion of buck-passing, we show how anti-reductionists can use the stronger notion to motivate their position, and to answer Goldberg’s and Lackey’s challenges.     

Does Han Fei have a conception of justice?

Han Fei’s political theory is widely characterized as eschewing any connection with morality; so, can he have any conception of justice? In this paper, I accept the interpretation of Han Fei jettisoning any moral commitment, but I argue that he gives heed to an understanding of justice. This conception of justice arises naturally from the ordinary human sentiment of resentment for wrongs done and becomes a moral staple in the consciousness of ordinary people. Such a conception of justice has these features: all and only the guilty receive punishment, and the punishments are in some sense proportionate to the crime. Since disregarding this popular conception of justice results in resentment and political instability, Han Fei, without any moral commitment to it, accepts the popular conception of justice on prudential and consequentialist grounds.     

THE BLOOD CRISIS: <Emphasis Type="Italic">A CHOICE BETWEEN DYING AND REARRANGING?</Emphasis>

I began my Ferenczi studies in the fall of 1987, a year before the English translation of his Clinical Diary was published. Since then, I have demonstrated in writing, teaching, working, and living that there is scarcely a passage in this “laboratory notebook of psychoanalysis” that fails to illuminate the clinical and the personal. And above all is Ferenczi’s late awareness that his personality had been constructed upon false assumptions. This is a reckoning of thirty years’ conscious and unconscious usage of Ferenczi’s experience to illustrate, to interpret, and to expose the clinical and personal dimensions of my own life lived as “the will of another person.” What constitutes, what allows, a choice between dying and rearranging? Now that I am long past Ferenczi’s fifty-nine years, I take the risk every day, and I know it.     

Cognitive deficits, schizophrenia, and the anterior cingulate cortex

Cognitive deficits are thought to be responsible for some of the symptoms and dysfunction in schizophrenia. Recent research on the anterior cingulate cortex supports this assumption. More detailed and definitive evidence for this association will require identification of specific neural networks whose abnormal structure, connections or activity create the cognitive deficits in question.