Being skeptical about the medical humanities

In this paper the author challenges the prevailing view that contemporary writing in the medical humanities is serving the needs of the various health care disciplines. The current medical humanities literature assumes that physicians are the appropriate target group. This is most notably the case within health care ethics literature. There appears to be an unexamined assumption that physician-centric approaches to clinical ethical decision-making are the standard by which appropriate ethical practice is judged. The author challenges this assumption and addresses the problems that this approach engenders. The medical humanities literature appears to reinforce hierarchical, patriarchal arrangements which are themselves not morally neutral.     

Prevalence of traumatic brain injury in an inpatient psychiatric population

This study investigated the prevalence of traumatic brain injury (TBI) in an inpatient psychiatric population. We hypothesized increased prevalence of TBI relative to the general population due to a variety of risk factors observed in psychiatric patients. One hundred (mean age = 34) psychiatric inpatients completed the revised Head Injury Questionnaire. Chart review of 17 subjects reporting injuries established whether injuries were documented in medical records. Sixty-eight percent of this psychiatric population reported one or more injuries in which they were unconscious or dazed. This number is higher than the prevalence in the general population. Injuries were generally of mild to moderate severity; multiple injuries were common. Chart review of 17 subjects reporting TBI indicated that histories of TBI had not been noted in the medical record. Finally, 63% of TBI subjects reported that their injury predated the onset of their psychiatric symptoms. These results suggest a possible role of TBI in psychiatric symptomatology and have implications for psychiatric treatment in this population.     

Event-related brain potentials to grammatical errors and semantic anomalies

Event-related brain potentials (ERPs) were recorded while subjects silently read several prose passages, presented one word at a time. Semantic anomalies and various grammatical errors had been inserted unpredictably at different serial positions within some of the sentences. The semantically inappropriate words elicited a large N400 component in the ERP, whereas the grammatical errors were associated with smaller and less consistent components that had scalp distributions different from that of the N400. This result adds to the evidence that the N400 wave is more closely related to semantic than to grammatical processing. Additional analyses revealed that different ERP configurations were elicited by open-class (“content”) and closed-class (“function”) words in these prose passages.     

Influences of semantic and syntactic context on open- and closed-class words

Event-related potentials (ERPs) were recorded as subjects read semantically meaningful, syntactically legal but nonsensical and random word strings. The constraints imposed by formal sentence structure alone did not reduce the amplitude of the N400 component elicited by open-class words, whereas semantic constraints did. Semantic constraints also eliminated the word-frequency effect of a larger N400 for low-frequency words. Responses to closed-class words exhibited reduced N400 amplitudes in syntactic and congruent sentences, indicating that formal sentence structure placed greater restrictions on closed-class words than it did on open-class words. However, unlike the open-class results, the impact of sentence context on closed-class words was stable across word positions, suggesting that these syntactic constraints were applied only locally. A second ERP component, distinct from the N400, was elicited primarily by congruent closed-class words.     

Who drops-out? Do measures of risk to self and to others predict unplanned endings in primary care counselling?

Aims: Unplanned endings, where clients unilaterally end therapy, are of concern for psychological therapy services generally as they raise questions about the appropriateness of the treatment and it's delivery for some clients. Limited available data indicates that those who drop-out often have more severe symptoms at entry, and have poorer clinical outcomes. This raises further questions about risk to self and others for those clients who leave therapy prematurely and how these clients might be identified and kept engaged. Method: This paper uses a large dataset of CORE data collected routinely in a primary care counselling service between 2000 and 2003. Logistic regression was utilised to consider different measures of risk and other client characteristics recorded at assessment to predict drop-out from the service. Results: These indicate that younger age, greater psychological distress at assessment, an addiction problem and greater risk to others, are associated with an unplanned ending. However, no reliable logistic regression model could be produced. This may be partly due to data quality issues or important characteristics not being available in the data. Implications for practice: The paper concludes that counsellors should actively seek to minimise unplanned endings, as amongst them may be represented the more distressed and risky clients referred to primary care counselling.     

The Effect of Evidential Impact on Perceptual Probabilistic Judgments

In a series of three behavioral experiments, we found a systematic distortion of probability judgments concerning elementary visual stimuli. Participants were briefly shown a set of figures that had two features (e.g., a geometric shape and a color) with two possible values each (e.g., triangle or circle and black or white). A figure was then drawn, and participants were informed about the value of one of its features (e.g., that the figure was a “circle”) and had to predict the value of the other feature (e.g., whether the figure was “black” or “white”). We repeated this procedure for various sets of figures and, by varying the statistical association between features in the sets, we manipulated the probability of a feature given the evidence of another (e.g., the posterior probability of hypothesis “black” given the evidence “circle”) as well as the support provided by a feature to another (e.g., the impact, or confirmation, of evidence “circle” on the hypothesis “black”). Results indicated that participants’ judgments were deeply affected by impact, although they only should have depended on the probability distributions over the features, and that the dissociation between evidential impact and posterior probability increased the number of errors. The implications of these findings for lower and higher level cognitive models are discussed.     

A Safety and Coping Planning Intervention for Suicidal Adolescents in Acute Psychiatric Care

Transitioning from an acute psychiatric care setting to a less restrictive environment after a suicidal event is arguably the most critical period of suicide risk for adolescents, making comprehensive safety and coping plans for this population ever more critical. In this paper we provide theoretical and empirical rationale for the need for developmental adaptations to current safety planning procedures for suicidal adolescents, as well as the standardization of pediatric safety plans for broader use across settings that provide acute psychiatric care to adolescents. We describe how we developed the Adolescent Safety and Coping Plan (ASCP) using qualitative in-depth interviews with 20 adolescents and their parents, explain the specific components of the ASCP, and give a case example of the ASCP being used with a young adolescent and her parents. Finally, we conclude with a discussion of the barriers and facilitators of the use of the ASCP in settings that provide acute psychiatric care, as well as the need for future research to test the ASCP with diverse adolescent and family populations and settings.     

Introduction to the Proceedings of the 8th International Conference on Spatial Cognition: Cognition and Action in a Plurality of Spaces (ICSC 2021)

Cognitive Processing -     

Causal illusion as a cognitive basis of pseudoscientific beliefs

Causal illusion has been proposed as a cognitive mediator of pseudoscientific beliefs. However, previous studies have only tested the association between this cognitive bias and a closely related but different type of unwarranted beliefs, those related to superstition and paranormal phenomena. Participants (n = 225) responded to a novel questionnaire of pseudoscientific beliefs designed for this study. They also completed a contingency learning task in which a possible cause, infusion intake, and a desired effect, headache remission, were actually non-contingent. Volunteers with higher scores on the questionnaire also presented stronger causal illusion effects. These results support the hypothesis that causal illusions might play a fundamental role in the endorsement of pseudoscientific beliefs.