Narrative Understanding in Acute Psychosis

Hermeneutical premises are adequate in understanding the psychotic patient. It is more important to hear and try to understand the patient's story told by the latter as an equal partner in conversation than understand events through stories in which the meanings are already determined. Understanding is dependent on the unique way in which the feelings, thoughts, and actions of the patient are connected with those of the ward staff, i.e., mutual knowledge. In this way understanding conforms to the preunderstanding of the interpreter as well as adequately captures the intentions of its originator. These are the preconditions for the integration of the need-adapted approach to the treatment of schizophrenia.     

The social concept of disease

In the discussion of such social questions as “how should alcoholics be treated by society?” and “what kind of people are responsible in the face of the law?”, is “disease” a value-free or value-laden notion, a natural or a normative one? It seems, for example, that by the utterance ‘alcoholism should be classified as a disease’ we mean something like the following: the condition called alcoholism is similar in morally relevant respects to conditions that we uncontroversially label diseases, and therefore we have a moral obligation to consider alcoholism a disease. So there are grounds to think that, in the discussion of social questions, our concept of disease is strongly value-laden. However, it does not follow that the medical concept of disease is likewise value-laden. In this paper I distinguish between the medical and social concepts of disease, arguing that the naturalist-normativist debate is concerned with the former, but not the latter. Therefore, we need not settle the naturalist-normativist debate in order to conclude that the social concept of disease is value-laden.     

Distribution and ignorance

Synthese - According to the so-called presumption of equality, a person who does not know whether there is an acceptable reason for differential treatment should just presume the similarity of the...     

Historical inductions,Old and New

Synthese - I review prominent historical arguments against scientific realism to indicate how they display a systematic overshooting in the conclusions drawn from the historical evidence. The root...     

Maternal and infant characteristics connected to shared pleasure in dyadic interaction

The aim of the study was to analyze which maternal factors (depressive symptoms, effect of life events, maternal sensitivity and structuring) and infant characteristics (temperament, social withdrawal symptoms, interactive behavior, genotype, gender) contribute to shared pleasure (SP) in parent–infant interaction. Participants were 113 mother–infant dyads. The mothers filled in the Edinburgh Postnatal Depression Scale, the Infant Behavior Questionnaire, and the Life Events Questionnaire. The dyads were videotaped in a free-play situation, and the videos were analyzed using the Alarm Distress Baby Scale and the Emotional Availability Scales. The infants were genotyped for four genes involved in emotion regulation. The occurrence and duration of SP (SP-MD) in mother–infant interactions were analyzed from the videotapes. Higher maternal sensitivity and depressive symptoms, better infant responsiveness, and the infant having the GG variant of the gene tryptophan hydroxylase isoform 2 (TPH2) -307 were associated with the occurrence of SP. Lower level depressive symptoms, better maternal structuring, and greater infant involvement were associated with the longer duration of SP. Those dyads where the mother and infant were best able to read each other's positive cues and to respond to them were more likely to experience mutual positive affect, as seen in SP.     

Shame and Dissociation in Survivors of High and Low Betrayal Trauma

Shame and dissociation cooccur in trauma survivors. Bypassed shame theory posits that dissociation reduces pain by interrupting shame. We tested this theory by inducing dissociation. The hypothesis that higher baseline shame would predict larger increases in dissociation following the induction was marginally supported. However, in contrast to bypassed shame theory, shame scores increased rather than decreased following the induction. An alternative theory, betrayal trauma theory (BTT), proposes that dissociation reduces awareness of betrayal to protect a needed relationship. Shame might also serve this function. We aimed to replicate prior research indicating traumas higher in betrayal (HBT) are uniquely related to both shame and dissociation compared to traumas lower in betrayal (LBT). The hypothesis that HBT would relate to higher shame was supported. The results suggest that other explanations than bypassed shame theory, such as BTT, might better account for the relationship between shame and dissociation in trauma survivors.     

Profiles of Contextual Risk at Birth and Adolescent Substance Use

This study examined whether there are subgroups of families with distinct profiles of prenatal/birth contextual risk, and whether subgroup membership was differentially related to adolescent substance use. Data from the Northern Finland Birth Cohort 1986 were used. A five-class model provided the most meaningful solution. Large Family Size (7.72%) and Low Risk (69.69%) groups had the lowest levels of alcohol, cigarette, and illegal drug use. Similar high levels for each of the three substance-related outcomes were found for Parent Substance Misuse (11.20%), Maternal School Dropout (4.66%), and Socioeconomic Disadvantage (6.72%) groups. Maternal smoking and drinking while pregnant and paternal heavy alcohol use were found to be key prenatal risk factors that tended to cluster together and co-occur with other prenatal risk factors differently for different subgroups of youth.