Respect for the developmentally disabled and forgoing life-sustaining treatment

A developmentally disabled person should be treated at all times as a unique individual and not as some anonymous "disabled person." The developmentally disabled should not be subjected to invasive medical treatment that is unduly burdensome or nonbeneficial, or be forced to endure a quality of life not meaningful to them as individuals. They have a right to refuse or accept treatment that a surrogate must exercise on behalf of each individual in a responsible and careful manner. Three cases and a preliminary approach to the ethical analysis of decisions to allow developmentally disabled persons to die by forgoing medical treatment are offered. The "best interests" of a developmentally disabled individual, properly understood, can serve as a useful and ethically defensible standard for determining the ethical propriety of surrogate decision making about forgoing life-sustaining medical treatment of the disabled.     

Editorial

Editorial Commentary

Editorial     

Functional neuroanatomy of emotions: A meta-analysis

The application of functional neuroimaging to the study of human emotion has yielded valuable data; however, the conclusions that may be drawn from any one study are limited. We applied novel statistical techniques to the meta-analysis of 106 PET and fMRI studies of human emotion and tested predictions made by key neuroscientific models. The results demonstrated partial support for asymmetry accounts. Greater left-sided activity was observed for approach emotions, whereas neural activity associated with negative/withdrawal emotions was symmetrical. Support was also found for affect program emotion accounts. The activation distributions associated with fear, disgust, and anger differed significantly. These emotions were most consistently associated in activity in regions associated with selective processing deficits when damaged: the amygdala, the insula and globus pallidus, and the lateral orbitofrontal cortex, respectively. In contrast, the distributions for happiness and sadness did not differ. These findings are considered in the context of conceptualizations of the neural correlates of human emotion.     

Discrete varieties of care in the clinical pastoral tradition: continuing the dialogue

In the current cultural context, clinically trained ministers, lay and ordained, offer themselves to troubled souls through at least three distinct varieties of assistance: pastoral care, pastoral counseling, and pastoral psychotherapy. This essay delineates three accepted disciplines, emphasizing the importance of ascertaining, and perhaps re-evaluating, the particular needs and desires of persons who are in physical, mental, or spiritual distress. "Pastoral care," "pastoral counseling," and "pastoral psychotherapy" each play an important role in fulfilling the traditional mandate for "the cure of souls."     

The Reduction(?) of Thermodynamics to Statistical Mechanics

Philosophical Studies -     

Psychometric Aspects of Verbal Pragmatic Ratings

This study examined the psychometric aspects of a verbal pragmatic rating scale. The scale contained six pragmatic features (i.e., Conciseness, Lexical Selection, Quantity, Relevancy, Specificity, and Topic Maintenance) based on Grice's cooperative principles. Fifteen right brain-damaged (RBD), 15 left brain-damaged (LBD), and 16 healthy normal control (NC) right-handed adult participants produced narratives while recollecting emotional and nonemotional experiences. Naive raters evaluated each pragmatic feature for appropriateness on a 5-point Likert scale. When reliability was examined, the overall internal consistency of the pragmatic scale was extremely high (alpha =.96). Factor analysis was conducted to examine the theoretical relations among the six pragmatic features. Three meaningful factors involving discourse content, conceptual unity, and parsimony were identified. Findings are discussed in light of Grice's model and the construct validity of the scale.     

Mental Simulations, Affect, and Subjective Confidence: Timing Is Everything

Three studies demonstrated that mental simulations and affect are related to temporal changes in subjective confidence. In Study 1, students' confidence in their midterm exam performance lessened from the first day of class (3.5 weeks before the exam) to exam day, and confidence correlated negatively with upward simulations (i.e., simulations that are better than reality) and negative affect. In Study 2, manipulated upward simulations produced low confidence and negative mood even when the exam was viewed from a distance; students who were forced to think about upward simulations 1 month prior to the exam felt no more confident than did students on exam day. In Study 3, manipulated negative moods produced low confidence and more upward simulations when students anticipated laboratory tasks, and again distal and proximal confidence did not differ. Discussion centers around reciprocal relations between mental simulations and affect, and a possibly integrative account of previous explanations.     

The semantic side of decision making

The research reported in this paper follows the perspective that decision making is a meaningful act that conveys information. Furthermore, the potential meanings associated with decision options may affect the decisions themselves. This idea is examined in the contexts of compensation, donation, and exchange. In general, judgments were relation dependent and meaning dependent. Furthermore, the results show nonmonotonicities and limited substitutability in a pattern that challenges straightforward ways of mapping decisions onto a common currency of utility.     

Full statistical mediation of the relationship between trauma and depressive symptoms

Owing to the potentially devastating effects of trauma‐induced depression, explaining the relationship between trauma and depressive symptoms is important. In this study, we measured lifelong exposure to potentially traumatic events and depressive symptoms in 370‐female undergraduates. We also measured anxiety, past negative time perspective and dissociation as potential mediators. Trauma exposure and depressive symptoms were related with a small but significant effect size (r = .16). Trauma was not associated with dissociation. We found that past negative time perspective and anxiety were full statistical mediators of this trauma‐depressive symptoms relationship. These two mediators combined accounted for all of the variance in that association. Anxiety accounted for more of the variance than past negative time perspective. A proposed explanation is that trauma both affectively elevates anxiety and cognitively creates an enduring focus on the events. Chronic anxiety and a past negative time perspective may lead to depression over time. The clinical implications are possible explanations as to why some treatments work.