Understanding physician power: a review of The Social Transformation of American Medicine

Paul Starr's 1983 book on how physicians emerged with the power and authority to shape American health care institutions is reviewed. Daniels contends that Starr's analysis has important philosophical implications because it demonstrates that the medical profession, perhaps blinded by its own ethic, egregiously violated the common obligation of all citizens to promote justice in the design of institutions.     

Frames and images: sequential effects in mental rotation

Recent studies have shown that response time in mental rotation increases with the angular deviation between the current and preceding stimuli, suggesting a frame rotation process in which the intrinsic frame of the previous stimulus is brought into congruence with the coordinates of the current stimulus. In contrast, we show that this process involves image rotation in which the present stimulus is brought into alignment with the orientation of the previous stimulus. Such "backward alignment" succeeds only for shape-preserving sequences (i.e., identical stimuli at different orientations). Four experiments show that the backward alignment process (a) competes with the uprighting process typically found in mental rotation, and the response is determined by the process requiring the shortest rotational path; (b) is related to the tendency to repeat the previous response; (c) is insensitive to the position of the vertical; (d) is indifferent to the representation of the stimulus in long term memory; and (e) is different from the process underlying preparation for a stimulus in a specified orientation.     

The temperamental nature of personality

Historically, the terms ‘temperament’, ‘character’, and ‘personality’ have been used to refer to what we now mean by the term ‘personality’. Temperament refers to the raw material out of which personality evolves. Personality is a person's coherent manner of interacting with himself/herself and with the environment. The concept of temperament has been prominent with Eastern European psychologists and with developmental psychologists in North America. A number of developmental theories of temperament are discussed, and differences and similarities between temperament parameters and personality parameters are described. The genetics of personality are presented and evaluated. Mechanistic and dynamic interactions are distinguished, and the multidimensional interaction model of anxiety and relevant research are discussed. A preliminary interaction model of anxiety, stress, and coping is presented. Finally, the temperamental nature of personality is discussed, and suggestions for possible rapprochements between personality and temperament are presented.     

The correlation of feature identification and category judgments in diagnostic radiology

Expert and novice radiologists were given films accompanied by clinical histories that supported a diagnosis either of bronchiolitis or of normal. To provide a plausible task context, some films were radiologically unambiguous and were accompanied by histories consistent with them. For a set of radiologically difficult films from confirmed normal or bronchiolitis patients, fictitious normal or abnormal histories were counterbalanced with the films. The clinical histories affected ratings both of diagnosis and of features present on the difficult films. Thus, uncertainty about individual features evidently was affected by history, and features did not act as an independent source of information. The dependence of feature calls on an overall judgment was also suggested by intra-observer agreement in another study in which an explicit diagnosis was not requested. It is unclear whether the history increased discrimination between normal and abnormal films, or indiscriminately added evidence for or against the disease. Factors are discussed that make it appropriate for feature identification to be partially dependent on category identification.     

Unresolved Childhood Sexual Abuse: Are Older Adults Affected?

This article presents case studies and discussions regarding three observed characteristics of unresolved childhood sexual abuse in adult survivors over 65 years of age. Specifically, chronic depression, elder abuse, and the misdiagnoses of residual abuse trauma as dementia or mental illness are compared to parallel issues identified by researchers in younger adult survivors. A brief overview of the childhood abuse literature and recommendations regarding professional training, the development of new services, and additional research are included.     

Interactionism revisited: Reflections on the continuing crisis in the personality area

The current status of the personality area is critically examined with the view that problems in the discipline voiced two decades ago are still prevalent. Recurring problems in the personality area have important ramifications for much of contemporary theoretical and applied psychology. The interactional approach to personality came to the fore in the 1970s and early 1980s as an explicit attempt to resolve a number of perceived weaknesses in the personality area. While it has become common for researchers to publicly advocate an interactional position, in practice little interactional research has been conducted recently. The historical developments of the trait and situationism models of personality research and relevant assessment issues are outlined. This history is of interest because it helps to illuminate why and how many current personality researchers continue to perpetuate problems in the personality area. The interactional model of personality is also examined. Finally, the development of an interactional model for the study of anxiety is examined as a specific example of the theoretical, research, and practical benefits of this approach.     

Coping with coping assessment: A critical review

The recent literature on self-report measures of coping reactions and strategies is reviewed and critically evaluated. Most of the coping research has focused on assessing several basic coping behaviours or reactions. These include dimensions such as task-oriented coping, emotion-oriented coping, and avoidance-oriented coping. In general, most of the coping scales that have been developed have a variety of psychometric inadequacies. This state of affairs has created at least two major problems in the coping literature: (1) The proliferation of problematic coping scales, sometimes measuring different constructs, makes it difficult to generalize from one population and/or one health problem to another. (2) Since psychometrically sound instruments are a precondition for studying the relationships among coping, personality, and health, scales with psychometric problems preclude obtaining valid and generalizable information about coping behaviour. Methodological problems in the area have seriously restricted the development of a systematic body of theory and empirical knowledge about coping.     

Regress and the Doctrine of Epistemic Original Sin

Existing solutions to the epistemic regress problem, and the theories of justification built upon them, are inadequate, for they fail to diagnose the root source of the problem. The problem is rooted in our attachment to a pernicious dogma of modern epistemology: the idea that a judgement must be supported by some kind of reason or evidence to be justified. The epistemic analogue of the doctrine of original sin, this idea renders every judgement in need of redemption – guilty until shown to be innocent – distorting our understanding of reason at a very deep level, and preventing us from conceptualizing a satisfactory solution to the problem. If we opt for a more context–sensitive mechanism for assigning default epistemic status, however, we get a more plausible picture of justification, an epistemology more in tune with epistemic practice, and an elegant solution to the regress problem.