Smith on Indexicals

In this paper, I advance a new view of the semantics of indexicals, using a paper by Quentin Smith as my starting point. I make use of Smith’s examples, refined and expanded upon by myself to argue, as Smith does, that the standard view, that indexicals refer to some prominent features of the context according to an invariant rule called the character, does not agree with a wide range of phenomena. I depart from Smith, however, in denying that we need more complex rules, which he does not give, called metacharacters to account for all the deviations, and instead argue for a view of indexicals as just being special cases of demonstratives. I show how demonstratives can be substituted for indexicals to support this view, and I adduce recent work in the semantics of demonstratives to explain how it can work.     

Prediction of treatment outcome among patients with irritable bowel syndrome treated with group cognitive therapy

Using a sample of over 125 patients with irritable bowel syndrome (IBS) who were treated with cognitive therapy administered in small groups, we sought to predict end of treatment and 3-month follow-up improvement in two changes indices of gastrointestinal (GI) symptoms (Pain/Discomfort Index which assessed change in abdominal pain, abdominal tenderness and bloating and Bowel Regularity Index which assessed change in diarrhea and constipation). We also sought to predict scores on IBS specific quality of life (QOL) and overall level of psychological distress using the Global Severity Index (GSI) of the Brief Symptom Inventory (BSI). Significant, but modest, levels of prediction were found for prediction of improvement in GI symptoms (4-15% of variance). Stronger significant prediction was obtained for the QOL and global psychological distress measure with R(2)'s ranging from 0.36 to 0.50. A wide variety of demographic, GI symptom, psychological status and psychiatric status variables entered the final prediction equations.     

Cognitive therapy for irritable bowel syndrome is associated with reduced limbic activity, GI symptoms, and anxiety

This study sought to identify brain regions that underlie symptom changes in severely affected IBS patients undergoing cognitive therapy (CT). Five healthy controls and 6 Rome II diagnosed IBS patients underwent psychological testing followed by rectal balloon distention while brain neural activity was measured with O-15 water positron emission tomography (PET) before and after a brief regimen of CT. Pre-treatment resting state scans, without distention, were compared to post-treatment scans using statistical parametric mapping (SPM). Neural activity in the parahippocampal gyrus and inferior portion of the right cortex cingulate were reduced in the post-treatment scan, compared to pre-treatment (x, y, z coordinates in MNI standard space were -30, -12, -30, P=0.017; 6, 34, -8, P=0.023, respectively). Blood flow values at these two sites in the controls were intermediate between those in the pre- and post-treatment IBS patients. Limbic activity changes were accompanied by significant improvements in GI symptoms (e.g., pain, bowel dysfunction) and psychological functioning (e.g., anxiety, worry). The left pons (-2, -26, -28, P=0.04) showed decreased neural activity which was correlated with post-treatment anxiety scores. Changes in neural activity of cortical-limbic regions that subserve hypervigilance and emotion regulation may represent biologically oriented change mechanisms that mediate symptom improvement of CT for IBS.     

Monozygotic twins with schizoform psychosis and hypothalamic-induced hypogonadotropic hypogonadism

It is reported about an uniovular male pair of twins which has been permanently hospitalized because of an intermittently progressing schizoform psychosis. A hypothalamically conditioned hypogonadotropic hypogonadism provable beyond that substantiates the possibility of the common causal genetic embodiment of both the clinical pictures which is disputed in literature.     

A study of abortion and problems in decision-making

This paper is directed to those individuals who are sufficiently disturbed by the complex realities of problem pregnancies and who are prepared to think beyond the confines of ideology. Rigid ideological positions tend to create distance from the hard complexities surrounding concrete human situations and to limit the realities of pain and helplessness that may exist for each of the parties to an unwanted pregnancy. Pregnancy is more than a biological condition or an isolated emotional entity giving rise to joy or grief. Pregnancy introduces a new relational component to an already existing relational network, and, conversely, abortion is neither simply the evacuation of the products of conception nor an endpoint to emotional stress. It is, in actuality, a broken relationship. In the clinical experience of these authors a sense of sadness frequently accompanies a woman's choice to undergo an abortion. Some problem pregnancy counselors maintain that they have never known a woman who terminated pregnancy without sadness. This information reinforces these authors' observations that facing a decision to have an abortion is not easy, often stressful, and an occasion when a woman should feel entitled to obtain the help of her total relationship system in arriving at a decision. The decision to continue or to terminate a problem pregnancy is rooted in a complex network of relationship factors that have an effect on the decision-making process. Repeated occurrences of unwanted pregnancies in the family are more than individual and disconnected events. Relational strategies that effect decision-making in problem pregnancies are effective in the hands of helping agents who value conjoint, intergenerational reciprocity as a therapeutic paradigm.