The structure of PTSD among two cohorts of returning soldiers: before, during, and following deployment to Iraq

Evidence suggests either a four-factor emotional numbing or dysphoria model likely reflects the underlying structure of posttraumatic stress disorder (PTSD). Questions remain as to which of these structures best represents PTSD, how the structure changes with time, the applicability of models to returning veterans, and the validity of the symptom clusters. The present study addresses these questions among two longitudinal samples of National Guard soldiers assessed prior to, during, and following a combat deployment to Iraq. Findings support a four-factor intercorrelated dysphoria model of PTSD that remains stable across samples and time points. Differential associations were observed among PTSD symptom clusters over time and between symptom clusters and both depression and combat exposure, supporting important distinctions between symptom clusters.     

Lifespan extension and the doctrine of double effect

Recent developments in biogerontology—the study of the biology of ageing—suggest that it may eventually be possible to intervene in the human ageing process. This, in turn, offers the prospect of significantly postponing the onset of age-related diseases. The biogerontological project, however, has met with strong resistance, especially by deontologists. They consider the act of intervening in the ageing process impermissible on the grounds that it would (most probably) bring about an extended maximum lifespan—a state of affairs that they deem intrinsically bad. In a bid to convince their deontological opponents of the permissibility of this act, proponents of biogerontology invoke an argument which is grounded in the doctrine of double effect. Surprisingly, their argument, which we refer to as the ‘double effect argument’, has gone unnoticed. This article exposes and critically evaluates this ‘double effect argument’. To this end, we first review a series of excerpts from the ethical debate on biogerontology in order to substantiate the presence of double effect reasoning. Next, we attempt to determine the role that the ‘double effect argument’ is meant to fulfil within this debate. Finally, we assess whether the act of intervening in ageing actually can be justified using double effect reasoning.     

A Mixed-Method Taxonomy of Child Poverty – the Case of Ethiopia

In this paper, we use mixed methods to develop a taxonomy of poverty and vulnerability to study the situation of children and their households in rural Ethiopia over time. The taxonomy is built using qualitative data from Young Lives, a long-term study of childhood poverty, with the specific purpose of analysing the context of children’s life trajectories using both quantitative and qualitative data. The approach aims to yield insights into changes over time as well as to reflect multiple dimensions and consider issues of current well-being and future ‘well-becoming’. It potentially allows for the identification of underlying mechanisms that influence and determine life trajectories. Until recently, quantitative and qualitative approaches towards the analysis of chronic and transient poverty have developed in isolation with little cross-disciplinary interaction. In this paper, we add to this body of research by using a mixed-method approach to develop a hybrid taxonomy of child poverty and well-being that can be used for a dynamic analysis. The paper also complements existing research and evidence on child poverty and well-being in the context of Ethiopia.     

Spiritual care in psychiatry: Professionals’ views

In this study we explored the views of Mental Health professionals and general practitioners (GPs) regarding spiritual care and the effect of personal and cultural background on their views. Data were collected through anonymous questionnaires posted to hospital nursing and medical staff at Hollins Park Hospital, Warrington, UK, and to all GPs within the hospital catchments area. Forty-five percent of GPs, 33% of psychiatrists, and 76% of nursing staff (p < 0.05) felt strongly that human beings are made up of spirit as well as body. More nurses felt that spiritual care is equally as important as other forms of care (52%) compared with psychiatrists (33%) and GPs (29%). A higher percentage of nursing than medical staff had previous training in this area and were more likely than medical staff to consider themselves appropriate to give spiritual advice. A total of 20% of GPs and 33% of psychiatric staff stated the need for training in this area and GPs especially felt they lacked time. Professionals’ views are influenced by cultural and religious backgrounds, with significantly more non-UK born respondents feeling strongly that human beings all have a spiritual component. Many doctors do not consider spiritual care has a role for them to be involved in and many feel too pressured in daily life to take this on. Nurses are more inclined to take a holistic approach to care in this respect. Some people with mental health problems have spiritual care needs and we should be aware of this as an important facet to therapy.     

Attachment Styles and Attraction to Death: Diversities Among Eating Disorder Patients

The current research was aimed at examining how attachment styles are connected to attraction to death among eating disorder (ED) patients. A sample of 34 anorexic and 34 bulimic patients was matched by age, sex, and socioeconomic status to 37 normal controls. They were administered the Adult Attachment Scale, the Beck Depression Inventory, and the Multi-Attitude Suicidal Tendency Scale. Results show that ED patients scored significantly higher on the insecure attachment scale and were less attracted to and more repulsed by life than controls. No significant differences were found on death variables. A significant difference between the three attachment styles was found beyond depression. The results suggest a model that may explain the diversities of attachment styles and the relationship with death among ED patients. Insecure attachment style may explain the repulsion by life, while the illness itself may serve as a false “secure base” and may protect from the fear of death. Clinicians may thus attempt to replace the “illness secure base” by enriching the attraction to life.     

Self-representing dreams

SUMMARY

Certain dreams are particularly striking for the way they represent themselves and the manner in which they are told within a psychotherapeutic relationship. Within such a dream is contained a picture of the dream's function and significance as part of the transaction between patient and psychotherapist. This phenomenon illustrates the nature and function of unconscious phantasy, the relations that hold between phantasy and mechanisms of defence, and the manifestations of phantasy within the transference.

Three examples are given of self-representing dreams which have been reported and re-enacted by trainee psychiatrists in psychotherapy supervision.     

READING IS NOT A GUESSING GAME‐THE GREAT DEBATE REVISITED

The present study describes preschool read-alouds in terms of the types of texts to which children are exposed. The methods involved analyzing the genre and instructional foci of 426 titles read by 13 teachers throughout an entire academic year. Additionally, associations between teacher characteristics and texts teachers read in their classrooms were examined. Findings indicated that (a) narrative texts were the dominate genre read-aloud; (b) children's exposure to alphabet books, nursery rhymes, books featuring math concepts, and multicultural content occurred at generally low rates; and (c) few significant associations exist between quantity of books read and teacher characteristics.     

Does degree of asymmetry relate to performance? A reply to Boles and Barth

In a recent critique Boles and Barth (2011) argue that their prior study investigating asymmetry/performance relationships (Boles, Barth, & Merrill, 2008) uncovered the “true” association (i.e., negative correlation) between lateralization of visual lexical processes and word recognition performance. They contend that our study reporting positive correlations of lexical asymmetry and reading performance (Chiarello et al., 2009) was flawed and hence inconclusive. In this response we address the two major objections raised by Boles and Barth (2011) regarding our selection of tasks and asymmetry measures. We conclude that the Boles and Barth principle of task purity is not relevant to the stated aims of our investigation, and that our linear regression method of measuring asymmetry is valid given the high level of accuracy for the tasks we reported. Because the aims of each investigation differed, we argue that it is unwise to attempt to fit each study into the framework favored by Boles and Barth (2011).