More appraisal please: a commentary on Pfaff et al. (2007) "Relations between mechanisms of CNS arousal and mechanisms of stress"

This article provides a brief commentary on Pfaff et al's timely review of the relations between mechanisms of CNS arousal and mechanisms of stress. Pfaff and colleagues use the review as a platform to propose the existence of a coherent stress-arousal state. We suggest that this proposal is, on a number of grounds, flawed. In turn, we counter that the while the states of stress and arousal are related they are as entities fundamentally separate. Moreover, we propose that any productive attempt to unite the two states must acknowledge the importance of and therefore centrally include higher order integrative phenomena, such as, appraisal.     

The Montreal Jewish Community and the Holocaust

In 1933 Hitler and the Nazi party came to power in Germany. At the same time, in Canada in general and in Montreal in particular, anti-Semitism was becoming more widespread. The Canadian Jewish Congress, as a result of the growing tension in Europe and the increase in anti-Semitism at home, was reborn in 1934 and became the authoritative voice of Canadian Jewry. During World War II the Nazis embarked on a campaign that resulted in the systematic extermination of millions of Jews. This article focuses on the Montreal Jewish community, its leadership, and their response to the fate of European Jewry. The study pays particular attention to the Canadian Jewish Congress which influenced the outlook of the community and its subsequent actions. As the war progressed, loyalty to Canada and support for the war effort became the overriding issues for the community and the leadership and concern for their European brethren faded into the background.     

How experienced phenomena relate to things themselves: Kant,Husserl, Hoche,and reflexive monism

What we normally think of as the “physical world” is also the world as experienced, that is, a world of appearances. Given this, what is the reality behind the appearances, and what might its relation be to consciousness and to constructive processes in the mind? According to Kant, the thing itself that brings about and supports these appearances is unknowable and we can never gain any understanding of how it brings such appearances about. Reflexive monism argues the opposite: the thing itself is knowable as are the processes that construct conscious appearances. Conscious appearances (empirical evidence) and the theories derived from them can represent what the world is really like, even though such empirical knowledge is partial, approximate and uncertain, and conscious appearances are species-specific constructions of the human mind. Drawing on the writings of Husserl, Hoche suggests that problems of knowledge, mind and consciousness are better understood in terms of a “pure noematic” phenomenology that avoids any reference to a “thing itself.” I argue that avoiding reference to a knowable reality (behind appearances) leads to more complex explanations with less explanatory value and counterintuitive conclusions—for example Hoche’s conclusion that consciousness is not part of nature. The critical realism adopted by reflexive monism appears to be more useful, as well as being consistent with science and common sense.     

Cognitive neuropsychiatry and delusional belief

Cognitive neuropsychiatry is a new field of cognitive psychology which seeks to learn more about the normal operation of high-level aspects of cognition such as belief formation, reasoning, decision making, theory of mind, and pragmatics by studying people in whom such processes are abnormal. So far, the high-level cognitive process most widely studied in cognitive neuropsychiatry has been belief formation, investigated by examining people with delusional beliefs. This paper describes some of the forms of delusional belief that have been examined from this perspective and offers a general two-deficit cognitive-neuropsychiatric account of delusional belief.     

Social anxiety and the shame of psychosis: a study in first episode psychosis

Social anxiety disorder (SaD) or social phobia is a co-morbid affective disorder in schizophrenia, present in up to one in three individuals. We employ 'social rank' theory to predict that one pathway to social anxiety in schizophrenia is triggered by the anticipation of a catastrophic loss of social status that the stigma of schizophrenia can entail. A group of 79 people with a first episode of psychosis were assessed for social anxiety: hypotheses were tested comparing 23 socially anxious and 56 non-anxious patients on measures of cognitive appraisals of shame/stigma of psychosis and perceived social status, controlling for depression, psychotic symptoms and general psychopathology. Participants with social anxiety experienced greater shame attached to their diagnosis and felt that the diagnosis placed them apart from others, i.e., socially marginalised them and incurred low social status. We propose a stigma model of social anxiety that makes testable predictions about how the shame beliefs may contaminate social interaction and thereby exacerbate and maintain social phobia.     

Measuring Stigma Toward Mental Illness: Development and Application of the Mental Illness Stigma Scale1

Guided by theory on stigma, a Likert‐type scale was developed to measure 7 factors of attitudes toward people with mental illness: interpersonal anxiety, relationship disruption, poor hygiene, visibility, treatability, professional efficacy, and recovery. The scale was validated among college students and community members, measuring attitudes toward people with mental illness, depression, bipolar disorder, and schizophrenia. In a second application, college students completed the scale from their own perspective, then from an imagined perspective of someone with mental illness, while psychiatric patients completed the scale from their own perspective, then from an imagined viewpoint of someone without mental illness. Psychiatric patients assumed that they were stigmatized to a greater extent than was admitted by the student sample.     

A Two Dimensional Tense-modal Sortal Logic

We consider a formal language whose logical syntax involves both modal and tense propositional operators, as well as sortal quantifiers, sortal identities and (second order) quantifiers over sortals. We construct an intensional semantics for the language and characterize a formal logical system which we prove to be sound and complete with respect to the semantics. Conceptualism is the philosophical background of the semantic system.     

Desire for euthanasia or physician-assisted suicide in palliative cancer care.

OBJECTIVE: To investigate the attitudes of terminally ill individuals toward the legalization of euthanasia or physician-assisted suicide (PAS) and to identify those who would personally desire such a death. DESIGN: In the Canadian National Palliative Care Survey, semistructured interviews were administered to 379 patients who were receiving palliative care for cancer. Patients who expressed a desire for physician-hastened death were followed prospectively. MAIN OUTCOME MEASURES: Attitudes toward the legalization of euthanasia or PAS were determined, as was the personal interest in receiving a hastened death. Demographic and clinical characteristics were also recorded, including a 22-item structured interview of symptoms and concerns. RESULTS: There were 238 participants (62.8%) who believed that euthanasia and/or PAS should be legalized, and 151 (39.8%) who would consider making a future request for a physician-hastened death. However, only 22 (5.8%) reported that, if legally permissible, they would initiate such a request right away, in their current situations. This desire for hastened death was associated with lower religiosity (p=.010), reduced functional status (p=.024), a diagnosis of major depression (p<.001), and greater distress on 12 of 22 individual symptoms and concerns (p<.025). In follow-up interviews with 17 participants, 2 (11.8%) showed instability in their expressed desire. CONCLUSION: Among patients receiving palliative care for cancer, the desire to receive euthanasia or PAS is associated with religious beliefs; functional status; and physical, social, and psychological symptoms and concerns. Although this desire is sometimes transitory, once firmly established, it can be enduring.     

The Escalating Incidence of Suicide Among African Americans: Implications for Counselors

Suicide rates have soared among African Americans within the past 2 decades. Curiously, this fact remains poorly understood within and outside the African American community. This article includes a review of M. Compton, N. Thompson, and N. Kaslow's (2005) study, recently published in Social Psychiatry and Psychiatric Epidemiology, and identifies important implications for counseling professionals.