Narrative unity and clinical judgment

Alasdair MacIntyre's recent thinking both about the concept of a practice and the existence of narrative unity in human life raises important questions about how we should view clinical medicine today. Is it possible for clinical medicine to pursue patient well-being in a society (allegedly) afflicted with what he calls ‘modernity’? Here it is argued that MacIntyre's pessimistic view of the individual in contemporary society makes his call for patient autonomy in the clinical setting pointless. Finally, recent work in gerontology is cited to make three points: first, MacIntyre's pessimism about us is too extreme; second, the concept of a ‘fictionalized’ personal history is closer to reality than either MacIntyre's notion of narrative unity or the ideas of his imagined opponent (Sartre); and finally, we should not expect clinical medicine to produce patient well-being, when this is understood narratively.     

Conceptualising,designing and drafting a monthly multi-family therapy programme and manual for adolescents with anorexia nervosa

The written transmission of therapists' expertise in manuals is an important issue which is highlighted in the literature. Manuals are essential for research, training and therapeutic guidance. However, the conceptualisation, design and drafting of therapy manuals have received little attention. Our team conceptualised and designed a 10-monthly session multi-family therapy programme for adolescents suffering from anorexia nervosa. This paper presents the methodology used to evolve from training and theoretical models to designing a programme and drafting the accompanying manual. We then describe how our team reached a consensus regarding the role to be attributed to food-related symptoms in the programme. These arduous tasks were rewarded by fruitful discussions among team members, which led to a shared theory of treatment. The methodology presented here is drawn from both the experience of specialised teams and from that of families in providing care to adolescents with anorexia nervosa.     

Rice-farming areas report more anxiety across two years of the COVID-19 pandemic in China

Cultures responded to the COVID-19 pandemic differently. We investigated cultural differences in mental health during the pandemic. We found regional differences in people's reports of anxiety in China over two years from 2020 to 2021 (N = 1186). People in areas with a history of rice farming reported more anxiety than people in wheat-farming areas. Next, we explored more proximal mechanisms that could help link the distal, historical factor of rice farming to people's modern experience of anxiety. Rice areas scored higher on collectivism and tight social norms than wheat areas, and collectivism, rather than norm tightness, mediated the rice-anxiety relationship. These findings advance our understanding of the distal sources of cultural differences, the proximal mechanisms, and mental health problems during the pandemics.     

A method of determining unbiased distribution in the latin square

The paper describes a method of constructing Latin-square designs in which treatment sequences are unbiased with regard to serial order as well as position of treatment. The procedure is useful for those Latin squares in which the number of cells in each column (or row) is an even number, which, when written in ascending and descending series, contain corresponding ordered numbers prime to each other. Such numbers are 2, 4, 6, 10, 12, 16, 18, 22, 28, 30, 36, etc.     

Geometrical representation of two methods of linear least squares multiple correlation

Geometrical properties and relationships of the Doolittle and square root methods of multiple correlation, as represented in the variable subspace of an orthogonal person space, are shown. The method of representation is also useful for depicting zero-order and partial correlations, as well as for the more general problem of the combination of variables.     

Some multiple correlation and predictor selection methods

The Doolittle, Wherry-Doolittle, and Summerfield-Lubin methods of multiple correlation are compared theoretically as well as by an application in which a set of predictors is selected. Wherry's method and the Summerfield-Lubin method are shown to be equivalent; the relationship of these methods to the Doolittle method is indicated. The Summerfield-Lubin method, because of its compactness and ease of computation, and because of the meaningfulness of the interim computational values, is recommended as a convenient least squares method of multiple correlation and predictor selection.     

Individual differences in perception of appropriate pay differentials in the U.S.A. and Sweden

The present research investigates the relationships between demographic characteristics and employees' perceptions of appropriate pay-differentials (APD's). In order to investigate this relationship, we examined organizations in two different countries with different social philosophies. The dependent variable (APD's) is defined as what is felt and/or perceived by the individual to be the appropriate pay-differentials among positions with different responsibilities and at different organizational levels. Two different subject groups were used: 137 salaried employees from an automotive engineering company in the U.S.A., and 107 salaried employees from an engineering company in Sweden. Questionnaires constructed in English and Swedish included: (1) questions about individual demographics; (2) job factors; and (3) perception of appropriate pay-differentials using eight organizational charts. Results indicated that the influence of social philosophy, as expressed by organizational socialization processes, was limited in scope. Individual differences associated with employees' perceptions of appropriate pay-differentials should be taken into account when determining pay and compensation policies. These considerations may encourage employee participation in decision making and lead to better organizational outcomes.deceased.     

Dispositional Optimism/Pessimism and Coping Strategies: Predictors of Psychosocial Adjustment of Rheumatoid and Osteoarthritis Patients1

Because rheumatoid arthritis (RA) has a more unpredictable course than osteoarthritis (OA), we hypothesized that generalized expectancies (optimistic/ pessimistic) influence the psychosocial adjustment of RA patients, whereas disease severity influences the adjustment of OA patients. Path analysis (LISREL VI) revealed that pessimistic RA patients (N= 107) and the more physically disabled OA patients (N= 108) reported poorer adjustment. The hypothesized mediating role of coping was supported for the RA but not the OA sample; that is, pessimism was associated with poor adjustment through greater use of wishful thinking coping. Unexpectedly, problem-solving coping was not found to mediate the optimism adjustment relationship.     

The Future of Psychology in Departments of Psychiatry

Health care reform has put increasing pressure on faculty of medical schools to become self-supporting. Opportunities for clinical revenue will decrease, but psychologists who are able to generate research funding will become increasingly competitive, albeit as mercenaries, i.e., capable of paying their own way plus generating a profit to support departmental operations and educational programs. Changes in the health care system signal an end to psychiatry's paternalistic relationship to psychology and present opportunities for psychology proactively to influence its future role in health care. Research, political action, and revised scientific mission, models, and roles represent important strategies in the redefining of psychology as a basic science and major profession in health care.