Insight-Related Challenges in the Treatment of Hoarding

Compulsive hoarding is a chronic and debilitating condition that has proven difficult to treat. The cognitive behavioral approaches that have otherwise been successful for people suffering from obsessive-compulsive disorder do not work very well for hoarding (Abramowitz, Franklin, Schwartz, & Furr, 2003). Many have suggested that this is due to the ego-syntonic nature of the symptoms and the accompanying lack of insight. This paper describes several challenges related to insight that limit the effectiveness of traditional cognitive behavioral approaches for compulsive hoarding. Problems with anosognosia, overvalued ideation, and defensiveness that characterize hoarding are described and suggestions offered for dealing with them.     

Deliberating About the Public Interest

Although the idea of the public interest features prominently in many accounts of deliberative democracy, the relationship between deliberative democracy and the public interest is rarely spelt out with any degree of precision. In this article, I identify and defend one particular way of framing this relationship. I begin by arguing that people can deliberate about the public interest only if the public interest is, in principle, identifiable independently of their deliberations. Of course, some pluralists claim that the public interest is an implausible idea, which casts doubt on the idea that there might be something for people to deliberate about. Yet while, following Brian Barry, we can get around this problem by defining the public interest as an interest in which everyone shares qua member of the public, what still needs to be explained is why people should be prepared to privilege this particular capacity. I argue that the account of political equality with which deliberative democracy is bound up offers a compelling explanation of this sort, even if it also gives rise to some difficult questions of feasibility. I conclude by considering the charge that any political scheme that framed the relationship between deliberative democracy and the public interest in this way would be undesirable.     

Introduction

Spiritual and religious beliefs and practices are commonplace in the general population of North America today. In recognition of this fact, research on the interplay of spirituality, religion, and psychological variables increased substantially over the past 3 decades; a recent PsycInfo search identified over 28,000 scientific contributions to this area. However, the relevance of spirituality and religion to clinical practice remains poorly understood. As a result, many practitioners of empirically supported treatments may be reticent to address spirituality and religion in the course of their work. The intent of this special series is to help demystify this topic with the hope of increasing dissemination of spiritually sensitive, empirically supported treatments. The authors in this series cast some light on this understudied topic by highlighting several salient spiritual and religious issues in behavior change. Moreover, based on case material, the authors illustrate how to assess for and address both adaptive and maladaptive utilizations of spirituality and religion in the practice of cognitive behavior therapy. This introductory paper presents a rationale for why it is important to address this topic, and provides an overview of recent research developments in the creation of spiritually integrated psychosocial treatments.     

Computer scoring of the Levels of Emotional Awareness Scale

The Levels of Emotional Awareness Scale (LEAS; Lane, Quinlan, Schwartz, Walker, & Zeitlan, 1990) is the most commonly used measure of differentiation and complexity in the use of emotion words and is associated with important clinical outcomes. Hand scoring the LEAS is time consuming. Existing programs for scoring open-ended responses cannot mimic LEAS hand scoring. Therefore, Leaf and Barchard (2006) developed the Program for Open-Ended Scoring (POES) to score the LEAS. In this article, we report a study in which the reliability and validity of POES scoring were examined. In the study, we used three participant types (adult community members, university students, children), three LEAS versions (paper based, computer based, and the LEAS for children), and a diverse set of criterion variables. Across this variety of conditions, the four POES scoring methods had internal consistencies and validities that were comparable to hand scoring, indicating that POES scoring can be used in clinical practice and other applied settings in which hand scoring is impractical.     

Vegetative state: efforts to curb misdiagnosis

Media reports on the case of Rom Houben have constituted a new reminder of the risks of misdiagnosis with cases with apparent vegetative state, particularly when following the clinical consensus of the care team as diagnostic criterion. Systematic use of behavioral and non-behavioral assessment strategies (e.g., behavioral scales, event-related potentials, and neuro-imaging) may help reduce the aforementioned risks. A new learning assessment strategy could also be considered part of the assessment to extend the evaluation process. Signs of learning might be viewed as forms of concrete knowledge representing a basic level of non-reflective consciousness.     

Unexpected changes in direction of motion attract attention

Under some circumstances, moving objects capture attention. Whether a change in the direction of a moving object attracts attention is still unexplored. We investigated this using a continuous tracking task. In Experiment 1, four grating patches changed smoothly and semirandomly in their positions and orientations, and observers attempted to track the orientations of two of them. After the stimuli disappeared, one of the two target gratings was queried and observers reported its orientation; hence direction of the gratings' motion across the screen was an irrelevant feature. Despite the irrelevance of its motion, when the nonqueried grating had collided with an invisible boundary within the last 200 msec of the trial, accuracy reporting the queried grating was worse than when it had not. Attention was likely drawn by the unexpected nature of these changes in direction of motion, since the effect was eliminated when the boundaries were visible (Experiment 2). This tendency for unexpected motion changes to attract attention has important consequences for the monitoring of objects in everyday environments.     

Authenticity in the Zhuangzi ? Contemporary Misreadings of Zhen 真and an Alternative to Existentialism

This essay reviews the Zhuangzian notion of zhen 真, often through the text’s advancement of the zhenren 真人 (“genuine person,” “true person”) or zhenzhi 真知 (“genuine knowledge,” “true knowledge”). Contemporary scholarship, in both Chinese and English, often presents zhen as analogous to the existentialist theory of authenticity, which correspondingly reflects on interpretations of the “self,” and thereby the zhen person. Much of the Zhuangzi is a reaction to the Lunyu, including an ironic response to the Confucian cultivation project. If we establish our interpretation of the “self” against this background then we find that zhen in the Zhuangzi is actually used to argue against the Confucian identification of the person and self through social roles or conventions. However, advocating zhen does not suggest that there is some essential or core “self” to refer to; instead, it implies a natural state of responsiveness where the person acts efficaciously by being in line with what is obvious or affirmed in the situation. This essay thereby presents a reading of zhen that is historically and culturally consistent, and sets up the Zhuangzi as an alternative, and not an echo, to some of the major issues dealt with by the existentialist movement.     

Framing Persuasive Appeals: Episodic and Thematic Framing, Emotional Response, and Policy Opinion

Those seeking to frame political issues to their advantage recognize the power of emotional appeals. Yet the study of framing has focused mainly on the cognitive effects of framing rather than on its emotional effects. This study presents the results of two experiments designed to explore the effect of episodic and thematic framing on emotional response and policy opinion. Participants were randomly assigned to read a column arguing against mandatory minimum sentencing that employed either a thematic or one of two episodic frames featuring a woman who received a harsh sentence under the policy. Episodic framing was more emotionally engaging. Furthermore, the specific emotions elicited by the episodic frame—sympathy and pity for the woman featured in the column—were associated with increased opposition to mandatory minimum sentencing. Yet the thematic frame was actually more persuasive once this indirect effect of frame on emotional response was taken into account. The results are consistent with the conclusion that framing effects on policy opinion operate through both affective and cognitive channels. The theoretical and practical implications of the study are discussed.