Should providers of treatment be regarded as a random factor? If it ain't broke, don't "fix" it: a comment on Siemer and Joormann (2003)

In their criticism of B. E. Wampold and R. C. Serlin's analysis of treatment effects in nested designs, M. Siemer and J. Joormann argued that providers of services should be considered a fixed factor because typically providers are neither randomly selected from a population of providers nor randomly assigned to treatments, and statistical power to detect treatment effects is greater in the fixed than in the mixed model. The authors of the present article argue that if providers are considered fixed, conclusions about the treatment must be conditioned on the specific providers in the study, and they show that in this case generalizing beyond these providers incurs inflated Type I error rates.     

Cholinergic-dopaminergic interactions in radial-arm maze performance

Although acetylcholine and dopamine are believed to play complementary roles in motor function, a comparable neurochemical interaction has not been established for cognitive function. The muscarinic receptor blocker scopolamine and the dopaminergic antagonist haloperidol have been found to impair choice accuracy of rats in the radial-arm maze. In the present study, low doses of these two drugs were administered intraperitoneally either alone or in combination to rats trained on a working memory task (food reward) in an eight-arm radial maze. Scopolamine, 0.125 mg/kg, produced a significant decrease in choice accuracy (i.e., arm entries until an error). Haloperidol, 0.0625 mg/kg, did not cause a significant decrease in accuracy, but there was a trend in that direction. The combination of haloperidol with scopolamine attenuated significantly the amnestic effect of scopolamine. These results suggest that, like motor behavior, cognitive function may be influenced by the balance between acetylcholine and dopamine.     

Religion and medicine: How are they related?

This paper provides a comprehensive and dynamic profile of religion-medicine interrelationships. This profile is drawn from the respective characteristics of religion and medicine, as well as from historic and contemporary literature regarding their interconnections. Six symbiotic functions are identified and discussed with respect to their bearing on clinical practice, medical education, and research.The authors thank Drs. Chester R. Burns, Thomas H. Murray, and Ronald A. Carson for their comments on drafts of this paper.     

Realisms

It is argued that the general thesis of realism is ill-defined, as are various versions of its denial. Only specific theses of the form There areK's make clear sense. It is also argued that various efforts to deny realism always turn out to deny specific existential theses. Thus, it is argued, van Fraassen and Schwartz deny the existence of electrons.     

Gender differences in predicting loneliness from social network characteristics

In two studies we examined gender differences in predicting loneliness from measures of social network structure and a measure of perceived social support. The results showed that social network characteristics, especially density, were consistently better predictors of perceived loneliness for men than for women. Study 1 used the traditional measure of network density in which the number of relationships among network members was determined. Study 2 used a newly developed index of density that assessed the extent of closeness of relationships between pairs of network members. Uniformly, male subjects with more highly interconnected, cohesive sets of friends reported themselves to be less lonely, whereas density had little relation to loneliness in female subjects. These results are discussed as possibly indicating that men and women use different standards in evaluating whether they are lonely. It is suggested that men may use more group-oriented criteria in evaluating loneliness, whereas women focus more on the qualities of dyadic relationships.     

The Discursive Underside of Psychoanalysis: Comments on Cooper’s “Blurring Boundaries”

Surprising for a discipline so dependent on unverifiable reports and theoretical consensus building, psychoanalysis pays little formal attention to its own rhetoric and discourse. In Steven H. Cooper’s thought-provoking challenge to the now highly conventionalized use of the term “boundary” in the mental health field, he raises important questions about the strategies of psychoanalytic theory. While placing Cooper’s proposals in a historical context, this discussion of his paper explores the possibility that closer formal attention to our linguistic habits and the way we play games with words would benefit our capacity for creative clinical thinking.     

MTHFR: Addressing Genetic Counseling Dilemmas Using Evidence-Based Literature

The 5, 10 methylenetetrahydrofolate reductase (MTHFR) enzyme is a catalyst in the folate metabolism pathway, the byproducts of which are involved in the remethylation of homocysteine to methionine. Methionine is a precursor for a major DNA methyl donor and is important for DNA methylation and gene regulation. Rare mutations in the MTHFR gene have been associated with autosomal recessive MTHFR deficiency leading to homocystinuria. In addition, two polymorphic variants in this gene (C677T and A1298C) have been implicated in a mild form of MTHFR deficiency associated with hyperhomocysteinemia. Mild to moderate hyperhomocysteinemia has been previously implicated as a risk factor for cardiovascular disease. Further, the presence of these variants, with and without mildly elevated levels of homocysteine, has been studied in relation to several multifactorial disorders including recurrent pregnancy loss, neural tube defects and congenital anomalies, cancer, and neurodevelopmental disorders. Given this wide spectrum of purported clinical implications and the prevalence of these polymorphisms, genetic counselors may encounter questions regarding the significance of MTHFR polymorphisms in a variety of settings. Here we present a brief background of the MTHFR polymorphisms, review of the literature regarding clinical considerations, and discussion of relevant genetic counseling aspects through case vignettes. Educational resources for patients and providers are also included.     

Emotional intelligence: impact on post-secondary academic achievement

This research examined the simultaneous influences of emotional intelligence, adjustment to university, authoritative versus other parenting style, and high school average on first year university students’ grade point average (GPA) via structural equation modeling. The participants were 299 first year students from the social science faculty at Laurentian University, Canada. The sample was comprised of 86 males (28.7 %) and 213 females (71 %); most students (96.7 %) were between the ages of 17 and 23. The results showed that high school average had a direct influence on first year university GPA. Emotional Intelligence was not directly associated with first year university GPA, but it was significantly associated with adjustment to university which in turn was significantly associated with the first year GPA. This tends to suggest that the influence of emotional intelligence on academic achievement may be mediated by adjustment to university. Furthermore, parenting style (authoritative versus other) had a significant influence on adjustment to university but not on emotional intelligence and university GPA. Students who came from families with authoritative parenting styles tended to be better adjusted than students who came from families with other parenting styles (authoritarian and permissive). Problem behaviors such as alcohol use, academic dishonesty and academic procrastination were found to have a negative influence on university GPA and adjustment to university. In conclusion, emotional intelligence and an authoritative parenting style are influential in enhancing adjustment to university which in turns affects academic achievement in university.     

The Psychological Construct of Word Fluency

Measures of word fluency have been convincingly linked in the literature to damage in the left prefrontal lobe region. Yet, a reduction in word fluency has also been reported with diffuse, multifocal and nonfrontal lobe damage. Despite the undisputed neuropsychological application of multiple word fluency measures, the psychological construct underlying this measure is not well understood. In a sample of 360 normal adults stratified by age, gender, and level of education, we found that auditory attention and word knowledge were among the most important determinants. With respect to memory, short-term memory was not significantly correlated, but long-term memory was. Despite these three determinants, a large share of the variance of the multiple regression was still not accounted for, which underscores the partial independence of word fluency per se. Thus, we propose a distinction between (1) poor word fluency secondary to deficient verbal attention, word knowledge, and/or verbal long-term memory and (2) impaired word fluency without these three areas concurrently affected. Based on a review of the literature, it seems likely that in the latter condition, the profile is more associated with prefrontal lobe impairment, versus in the former condition, diffuse multifocal or nonfrontal lobe factors can play a role.