Posttraumatic stress disorder and criminal violence: Basic concepts and clinical-forensic applications

In a small number of felony murder cases, posttraumatic stress disorder (PTSD) has been used as an affirmative defense to plead not guilty by reason of insanity or to argue for diminished capacity as a mitigating factor at sentencing. This article traces the history of PTSD as a legal defense; describes the clinical criteria for diagnosing and assessing PTSD; outlines the legal criteria for the affirmative defense of not guilty by reason of insanity (NGRI) and mitigation on the grounds of diminished capacity; and discusses the applications and pitfalls of using PTSD as an exculpatory factor in crimes of violence, including murder.     

Hand preference and its flexibility according to the position of the object: a study in cercopithecines examining spontaneous behaviour and an experimental task (the Bishop QHP task)

The extant literature on manual laterality in non-human primates is inconclusive, plagued by inconsistent or contradictory findings and by disturbing methodological issues (e.g. uncontrolled influential factors, comparability issues). The present study examined hand preference and its flexibility in 15 red-capped mangabeys (C. t. torquatus) and 13 Campbell's monkeys (C. c. campbelli), two species that differ in their degree of arboreality. We investigated the influence of the spatial position of the object on hand preference for reaching. We considered spontaneous behaviour (reaching for food during daily feeding) and an experimental task: the QHP task. The QHP is a task that is used in humans. This is a simple reaching task that involves high spatial constraints on hand use. In our study, the subject had to reach for items that were placed on a semi-circle in front of it on five positions, including in the centre position, in the ipsilateral space and in the contralateral space. We assessed hand preference for reaching in front (baseline condition), and we examined how this preference changed when reaching in lateral positions. For reaching in front, about half of the subjects were lateralized and no group-level bias occurred, for both spontaneous and experimental conditions. When considering reaching in the lateral positions, we observed that the position of the object influenced hand use: individuals used the hand that was closest to the object. The results are discussed in relation to previous findings in humans and in non-human primates and regarding theories on handedness and flexibility of hand preference.     

An ethical framework for the responsible management of pregnant patients in a medical disaster

The ethics of managing obstetric patients in medical disasters poses ethical challenges that are unique in comparison to other disaster patients, because the medical needs of two patients--the pregnant patient and the fetal patient--must be considered. We provide an ethical framework for doing so. We base the framework on the justice-based prevention of exploitation of populations of patients, both obstetric and non-obstetric, in medical disasters. We use the concept of exploitation to identify a spectrum from ethically acceptable, to ethically challenging, to ethically unacceptable, management of obstetric patients in medical disasters. We also address the ethics of the care of obstetric and neonatal patients when the resources of a hospital are completely overwhelmed in a large-scale medical disaster.     

The Yin and Yang of cell cycle progression and differentiation in the oligodendroglial lineage

In white matter disorders such as leukodystrophies (LD), periventricular leucomalacia (PVL), or multiple sclerosis (MS), the hypomyelination or the remyelination failure by oligodendrocyte progenitor cells involves errors in the sequence of events that normally occur during development when progenitors proliferate, migrate through the white matter, contact the axon, and differentiate into myelin-forming oligodendrocytes. Multiple mechanisms underlie the eventual progressive deterioration that typifies the natural history of developmental demyelination in LD and PVL and of adult-onset demyelination in MS. Over the past few years, pathophysiological studies have mostly focused on seeking abnormalities that impede oligodendroglial maturation at the level of migration, myelination, and survival. In contrast, there has been a strikingly lower interest for early proliferative and differentiation events that are likely to be equally critical for white matter development and myelin repair. This review highlights the Yin and Yang principles of interactions between intrinsic factors that coordinately regulate progenitor cell division and the onset of differentiation, i.e. the initial steps of oligodendrocyte lineage progression that are obviously crucial in health and diseases.     

The relationship between moral philosophy and medical ethics reconsidered

Medical ethics often is treated as applied ethics, that is, the application of moral philosophy to ethical issues in medicine. In an earlier paper, we examined instances of moral philosophy's influence on medical ethics. We found the applied ethics model inadequate and sketched an alternative model. On this model, practitioners seeking to change morality "appropriate" concepts and theory fragments from moral philosophy to valorize and justify their innovations. Goldilocks-like, five commentators tasted our offerings. Some found them too cold, since they had already abandoned applied ethics; others too hot, since they still find the applied ethics model to their taste. We reply that the appropriation model offers an empirically testable account of the historical relationship between moral philosophy and medical ethics that explains why practitioners appropriate concepts and fragments from moral philosophy. In contrast, the now fashionable common morality theory neither explains moral change nor why practitioners turn to moral philosophy.     

The effect of aging in recollective experience: the processing speed and executive functioning hypothesis

This study was designed to investigate the effects of aging on consciousness in recognition memory, using the Remember/Know/Guess procedure (Gardiner, J. M., & Richarson-Klavehn, A. (2000). Remembering and Knowing. In E. Tulving & F. I. M. Craik (Eds.), The Oxford Handbook of Memory. Oxford University Press.). In recognition memory, older participants report fewer occasions on which recognition is accompanied by recollection of the original encoding context. Two main hypotheses were tested: the speed mediation hypothesis (Salthouse, T. A. (1996). The processing-speed theory of adult age differences in cognition. Psychological Review, 3, 403–428) and the executive-aging hypothesis (West, R. L. (1996). An application of prefrontal cortex function theory to cognitive aging. Psychological Bulletin, 120, 272–292). A group of young and a group of older adults took a recognition test in which they classified their responses according to Gardiner, J. M., & Richarson-Klavehn, A. (2000). Remembering and Knowing. In E. Tulving & F. I. M. Craik (Eds.), The Oxford Handbook of Memory. Oxford University Press. remember-know-guess paradigm. Subsequently, participants completed processing speed and executive function tests. The results showed that among the older participants, R responses decreased, but K responses did not. Moreover, a hierarchical regression analysis supported the view that the effect of age in recollection experience is determined by frontal lobe integrity and not by diminution of processing speed.     

Linguistic context and children's recall in a probe word task

A probe word task was used to test first-, third-, and fifth-grade children's recall of words in varying linguistic contexts. Consistent with expectations based on short-term memory considerations, words that occurred in meaningful sentence contexts were better recalled than those appearing in strings of unrelated words, and words that appeared toward the end of the sentence or string were better recalled than those occurring toward the beginning. At the same time, the effects of prior text on recall, seen clearly in tasks used in constructive memory research, were not present in this short-term memory task. These findings suggest that while within-sentence semantic relational and syntactic information may be used for partial analysis while material is still in working memory, this state does not permit access to already analyzed information in prior text.The authors express appreciation to Richard Schwartz, Ronnie Wilbur, and Harlan Schweer for their suggestions throughout the course of the study.     

Compounding of discriminative stimuli from the same and different sensory modalities

Rats' responding was maintained by fixed-interval schedules of reinforcement in the presence of a tone or two separate lights. The lights were either of low, moderate, or high intensity. Compounds of these single discriminative stimuli each maintained a greater frequency of response than did the single stimuli, and the compound composed of stimuli from different sensory modalities (light+tone) maintained a greater level of responding than did the compound composed of stimuli from the same sensory modality (light+light). Combining lights of different intensity had no differential effect on responding. However, in the second experiment, a compound composed of a light and a tone, each of greater intensity than the light and tone of another compound, initially maintained a higher frequency of response, demonstrating intensity effects during stimulus compounding when the increase in intensity occurs through the component stimuli. This intensity effect, however, was only transitory.     

Pluralism,philosophies of medicine and the varieties of medical ethics: A commentary on Thomasma and Pellegrino

Some problems that arise in the account given by Thomasma and Pellegrino [6] of the foundations of medical ethics in a philosophy of medicine are addressed, in particular questions of a conceptual character about treating therelatum of medicine as health. Which concept of health is appropriate and which will bear the burden of the position thomasma and Pellegrino advance? It is argued that the proper relationship of medicine is one between a healer and developing embodied minds. As a consequence, the project of providing a univocal account of the nature of medicine fails. Instead, pluralism infects philosophy and medicine, resulting in different philosophies of medicine. From these philosophies of medicine will follow not a single medical ethics but a variety.