The ‘Medical Body’ As Philosophy's Arena

Medicine, as Byron Good argues, reconstitutes thehuman body of our daily experience as a medical body,unfamiliar outside medicine. This reconstitution can be seen intwo ways: (i) as a salutary reminder of the extent to which thereality even of the human body is constructed; and (ii) as anarena for what Stephen Toulmin distinguishes as theintersection of natural science and history, in which many ofphilosophy's traditional (and traditionally abstract) questionsare given concrete and urgent form.This paper begins by examining a number of dualities between themedical body and the body familiar in daily experience. Toulmin's epistemological analysis of clinical medicine ascombining both universal and existential knowledge is thenconsidered. Their expression, in terms of attention,respectively, to natural science and to personal history, isexplored through the epistemological contrasts between themedical body and the familiar body, noting the traditionalphilosophical questions which they in turn illustrate.     

A model for brief assessment of attachment and its application to women in inpatient treatment for trauma-related psychiatric disorders

We adapted self-report measures of attachment style to the psychological assessment of women in specialized inpatient treatment for trauma-related disorders. The study employed 2 measures of adult attachment style, the Relationship Questionnaire (Bartholomew & Horowitz, 1991) and the Adult Attachment Scale (Collins & Read, 1990) as well as our Current Attachment Relationships questionnaire, which assesses the extent of social support in secure attachments. We administered these measures to 99 patients and to a convenience sample of 154 women in the community. We found modest correspondence between the 2 attachment style measures and substantial relations between attachment styles and range of secure attachment relationships. Women in the trauma sample reported insecure attachment styles and relatively few secure attachment figures. We discuss the implications of these findings for clinical assessment.     

Multisystemic therapy for young offenders: families' experiences of therapeutic processes and outcomes

Multisystemic Therapy (MST) has been found to be effective in reducing youth antisocial behavior, but little is known about the process and impact of MST from the perspective of families themselves. This qualitative study explored parents' and young people's experiences of MST, focusing on aspects of the intervention that promoted or limited change. Thirty-seven semistructured interviews were conducted with a consecutive sample of 21 families (21 parent interviews, 16 young people) who had participated in a randomized controlled trial of MST for young offenders in the United Kingdom. Thematic analysis yielded 10 themes, organized into two domains: (a) engagement in MST and initial processes of change captures the central importance of the therapeutic relationship and the MST engagement model in families' positive experiences of MST; and (b) outcomes are complex reflects the range of positive outcomes reported (notably increased parental confidence and skills, improved family relationships, a return to education, and greater reflection and aspiration on the part of the young person) and mixed behavior outcomes. Even when the young person had reoffended, respondents indicated a range of other benefits for the family. The findings support the MST theory of change as well as point to some outcomes not usually measured in MST outcome studies. They also suggest some adaptations that may increase the impact of the intervention, including more attention to the influence of deviant peers, and ongoing support for families struggling to maintain strategies beyond the prescribed treatment period.     

Childhood poverty and young adults' allostatic load: the mediating role of childhood cumulative risk exposure

Childhood poverty is linked to a host of physical and psychological disorders during childhood and later in life. In the study reported here, we showed that the proportion of childhood spent in poverty from birth to age 9 was linked to elevated allostatic load, a marker of chronic physiological stress, in 17-year-olds. Furthermore, this prospective longitudinal relationship was mediated by cumulative risk exposure at age 13. The greater the duration of early life spent in poverty, the greater the exposure to cumulative risk. This, in turn, leads to elevated allostatic load. Multiple psychological, biological, and neurological pathways likely account for the social patterning of psychological and physical disease.     

The Hispanic Stress Inventory--Adolescent Version: a culturally informed psychosocial assessment

A 2-phase study was conducted to develop a culturally informed measure of psychosocial stress for adolescents: the Hispanic Stress Inventory--Adolescent Version (HSI-A). Phase 1 involved item development through the collection of open-ended focus group interview data (n = 170) from a heterogeneous sample of Hispanic youths residing in the southwest and northeast United States. In Phase 2, we examined the psychometric properties of the HSI-A (n = 1,651), which involved the use of factor analytic procedures to determine the underlying scale structure of the HSI-A for foreign-born and U.S.-born participants in an aggregated analytic approach. An 8-factor solution was established, with factors that include Family Economic Stress, Acculturation-Gap Stress, Culture and Educational Stress, Immigration-Related Stress, Discrimination Stress, Family Immigration Stress, Community and Gang-Related Stress, and Family and Drug-Related Stress. Concurrent, related validity estimates were calculated to determine relations between HSI-A and other measures of child psychopathology and behavioral and emotional disturbances. HSI-A total stress appraisal scores were significantly correlated with both the Children's Depression Inventory and the Youth Self Report (p < .001). Reliability estimates for the HSI-A were conducted, and they yielded high reliability coefficients for most factor subscales, with the HSI-A total stress appraisal score reliability alpha at .92.     

Civilian Response Corps Force Review: The Application of Multi‐Criteria Decision Analysis to Prioritize Skills Required for Future Diplomatic Missions

Created by the State Department's Office of the Coordinator for Reconstruction and Stabilization, the Civilian Response Corps (CRC) contains a diverse pool of qualified and ready‐to‐deploy civilian professionals that support conflict prevention and response efforts in countries or regions that are at risk of, are currently in, or are transitioning from conflict or civil strife. As such, it is vital to optimize the CRC's skill groupings to maximize adaptability and responsiveness to highly uncertain and trying political conditions and crises across the globe. The nature of the CRC value proposition is such that determining which skill set compositions deliver the greatest benefit requires a multi‐faceted perspective that looks at a number of attributes and factors, both tangible and intangible. To meet these needs, an organizational decision‐making approach utilizing multi‐criteria decision analysis (MCDA) was applied to ensure that skill‐grouping allocations were determined in a logical and robust manner. The MCDA analysis allowed for a wide range of worldviews and perspectives, drawn from select members of academia and partner agencies of the CRC who provided their expert opinions on the expected demand for skill groupings commonly identified as most necessary in a civilian ‘surge’ capacity. These skills were assessed with reference to a values hierarchy of representative country scenarios, missions and sub‐missions identified by the Office of the Coordinator for Reconstruction and Stabilization. Of particular interest was the use of the MCDA method to prioritize CRC skill groupings and to help inform the Department of State's understanding of the ‘ideal’ proportion and types of civilian skills for inclusion in the CRC. Copyright © 2012 John Wiley & Sons, Ltd.     

Negative triangles: simple geometric shapes convey emotional valence

It has been suggested that downward pointing triangles convey negative valence, perhaps because they mimic an underlying primitive feature present in negative facial expressions (Larson, Aronoff, and Stearns, 2007). Here, we test this proposition using a flanker interference paradigm in which participants indicated the valence of a central face target, presented between two adjacent distracters. Experiment 1 showed that, compared with face flankers, downward pointing triangles had little influence on responses to face targets. However, in Experiment 2, when attentional competition was increased between target and flankers, downward pointing triangles slowed responses to positively valenced face targets, and speeded them to negatively valenced targets, consistent with valence-based flanker compatibility effects. These findings provide converging evidence that simple geometric shapes may convey emotional valence.     

Young children can tell strategic lies after committing a transgression

This study investigated whether young children make strategic decisions about whether to lie to conceal a transgression based on the lie recipient's knowledge. In Experiment 1, 168 3- to 5-year-olds were asked not to peek at the toy in the experimenter's absence, and the majority of children peeked. Children were questioned about their transgression in either the presence or absence of an eyewitness of their transgression. Whereas 4- and 5-year-olds were able to adjust their decisions of whether to lie based on the presence or absence of the eyewitness, 3-year-olds did not. Experiments 2 and 3 manipulated whether the lie recipient appeared to have learned information about children's peeking from an eyewitness or was merely bluffing. Results revealed that when the lie recipient appeared to be genuinely knowledgeable about their transgression, even 3-year-olds were significantly less likely to lie compared with when the lie recipient appeared to be bluffing. Thus, preschool children are able to make strategic decisions about whether to lie or tell the truth based on whether the lie recipient is genuinely knowledgeable about the true state of affairs.