Emotional responsiveness and obsessive-compulsive behaviour

Abstract

Several clinicians have proposed that patients with obsessive-compulsive disorder (OCD) are unusually sensitive to unpleasant events. We tested a non-clinical sample of obsessive-compulsive (O-C) subjects who reported in diagnostic interviews that they experienced significant problems with obsessions and/or compulsions. Excerpts from three emotion-eliciting films were shown to 10 O-C males, 12 O-C females, 12 normal males, and 12 normal females. Emotional response was measured by using a self-report instrument and by recording facial expressions, which were coded for both appropriate emotional reactions as well as reactions that may represent efforts to mask or control the display of negative emotion. The groups did not differ with regard to subjective response to the film clips, but facial responses indicated that O-C subjects made more efforts to suppress the expression of fear (inappropriate smiles/laughs) during the frightening film clip. In spite of these responses, male O-C subjects also tended to reveal more frightened facial expressions than male control subjects. This finding is believed to illustrate one component of a model in which exaggerated emotional response is a precursor to the development of OCD.     

Social Function and Autism Spectrum Disorder in Children and Adults with Neurofibromatosis Type 1: a Systematic Review and Meta-Analysis

In light of the proliferation of recent research into social function in neurofibromatosis type 1 (NF1), a systematic review and meta-analysis is required to synthesise data and place findings within the context of a theoretical framework. This paper reviews findings from research into social function and autism spectrum disorder (ASD) in children and adults with NF1 and integrates these findings with the Socio-Cognitive Integration Abilities Model (SOCIAL). It also critically appraises links between social outcomes, internal and external factors moderating social functioning, cognitive domains implicated in social functioning, and underlying neural pathology in NF1. A systematic literature search conducted in MedLine (Ovid), PsycINFO (Ovid), Embase (Ovid), and PubMed electronic databases yielded 35 papers that met inclusion criteria for the systematic review. Out of these papers, 22 papers provided sufficient data for meta-analysis. Findings from this review and meta-analysis provide evidence that children and adults with NF1 exhibit significantly higher prevalence and severity of social dysfunction and ASD symptomatology. To date, very few studies have examined social cognition in NF1 but results indicate the presence of both perceptual and higher-level impairments in this population. The results of this review also provide support for age, gender, and comorbid ADHD as moderating factors for social outcomes in NF1. Suggestions for future research are offered to further our understanding of the social phenotype in NF1 and to facilitate the development of targeted interventions.     

“I Didn’t Expect to Learn as Much as I Did”: Rewards of Caregiving in Young Adulthood

While much attention is given to unpaid caregivers in midlife, there is a notable gap in the literature regarding young adults in family caregiving roles. Although two out of 5 family caregivers are between the ages of 18 and 40, we know relatively little about these younger relatives providing support to ill and disabled family members. Understanding the experiences of this under-researched population is critical to effective social service provision for this new wave of caregivers. In addition, the challenges associated with caregiving are well documented, yet examining the positive aspects of caregiving is necessary to provide a balanced picture of caregiving. The purpose of this qualitative study was to explore the gains experienced by family caregivers in young adulthood. In-depth telephone interviews were conducted with a diverse sample of 22 individuals who were (or had previously been) caregivers while in young adulthood. Analysis of the data resulted in identification of four themes concerning gains experienced by young adult caregivers: a strengthening of family relationships, character growth, personal satisfaction in the care provided, and material benefit. This study sheds some understanding on rewards experienced by a subgroup of family caregivers who has received little attention—young adult caregivers.     

Intentions,Permissibility, and Choice

T. M. Scanlon has argued that the intentions with which one acts, or more specifically, one’s reasons for acting, are non-derivatively irrelevant to the moral permissibility of one’s actions. According to one of his arguments in favor of that thesis, it can be permissible to act for one reason rather than another only if one can choose to act for a reason but, since that choice is impossible since believing as will is impossible, one can be permitted to act but one cannot be permitted to act for a reason. This paper aims to show that that argument is unsound. It first argues that the assumption that choosing an action is necessary for it being an object of a moral duty or permission cannot be made consistent with Scanlon’s idea that the same does not hold for an action being an object of blame. It then argues that even if direct control over forming beliefs is impossible, it is not impossible to choose one’s reason for action and, therefore, to be permitted or forbidden to act for it.     

Conscientious objection and person-centered care

Person-centered care offers a promising way to manage clinicians’ conscientious objection to providing services they consider morally wrong. Health care centered on persons, rather than patients, recognizes clinicians and patients on the same stratum. The moral interests of clinicians, as persons, thus warrant as much consideration as those of other persons, including patients. Interconnected moral interests of clinicians, patients, and society construct the clinician as a socially embedded and integrated self, transcending the simplistic duality of private conscience versus public role expectations. In this milieu of blurred boundaries, person-centered care offers a constructive way to accommodate conscientious objection by clinicians. The constitutionally social nature of clinicians commits and enables them, through care mechanisms such as self-care, to optimize the quality of health care and protect the welfare of patients. To advance these conditions, it is recommended that the medical profession develop a person-centered culture of care, along with clinician virtues and skills for person-centered communication.     

Don't sit so close to me: unconsciously elicited affect automatically provokes social avoidance

Behavior may be automatically prompted by cues in our social environment. Previous research has focused on cognitive explanations for such effects. Here we hypothesize that affective processes are susceptible to similar automatic influences. We propose that exposure to groups stereotyped as dangerous or violent may provoke an anxiety response and, thus, a tendency to move away. In the present experiment, we subliminally exposed participants to images of such a group, and found that they displayed greater avoidance in a subsequent interaction. Critically, this effect was explained by their increased sensitivity to threat-related information. These findings demonstrate an affective mechanism responsible for nonconscious priming effects on interpersonal behavior.