A randomized controlled trial of mother–infant psychoanalytic treatment: I. Outcomes on self‐report questionnaires and external ratings

Mother–infant relationship disturbances occur in three domains: maternal distress, infant functional problems, and relationship difficulties. They constitute common clinical problems. In Sweden, they are usually handled by nurses as part of public Child Health Centre care. Severe cases are referred to child psychiatry services. This randomized controlled trial compared two groups of mother–infant dyads in a Stockholm sample. One received only Child Health Centre care (the “CHCC” group) while the other received mother–infant psychoanalytic treatment plus CHCC (the “MIP” group). Eighty dyads of mothers and infants under 1½ years of age where the mothers had serious concerns about themselves in their role as mothers, their infants' well‐being, or the mother–baby relationship were randomly selected for either the MIP or the CHCC group. The primary outcomes were mother‐reported depression, mother‐reported infant functional problems, and interviewer‐based relationship assessments, all at 6 months after joining the project. Secondary outcomes were mother‐reported stress and general psychic distress, externally rated video‐recorded interactions, and the consumption of healthcare at the CHC, again all after 6 months. Intent‐to‐treat analyses of Treatment × Time effects significantly favored MIP treatment for maternal depression, mother–infant relationships, and maternal sensitivity. Effects were nearly significant on maternal stress, but nonsignificant on mother‐reported infant functional problems, general psychic distress, maternal interactive structuring and nonintrusiveness, infant responsiveness and involvement, and healthcare consumption. MIP treatment improved mother–infant relationships and maternal sensitivity and depression, all of which are known to influence child development. If effects persist and are reproduced, MIP treatment holds promise for more widespread use.     

(Neuro)predictions,Dangerousness, and Retributivism

Through the criminal justice system so-called dangerous offenders are, besides the offence that they are being convicted of and sentenced to, also punished for acts that they have not done but that they are believe to be likely to commit in the future. The aim of this paper is to critically discuss whether some adherents of retributivism give a plausible rationale for punishing offenders more harshly if they, all else being equal, by means of predictions are believed to be more dangerous than other offenders. While consequentialism has no problem, at least in principle, with this use of predictions most retributivists have been opponents of punishing offenders on the basis of predictions. How can an offender deserve to be punished for something that he has not done? But some retributivists like Anthony Duff and Stephen Morse have argued in favor of punishing offenders who are considered to be dangerous in the future more harshly than non-dangerous offenders. After having reconstructed their arguments in detail, it will be argued that both Duff’s and Morse’s attempts to give a retributivistic justification have several shortcomings.     

Filial Piety,Generativity and Older Adults’ Wellbeing and Loneliness in Denmark and China

The article considers the potential of intergenerational encounters and family and social ties for alleviating loneliness and promoting older adults’ wellbeing. Loneliness has been widely recognized as one of the factors that are most deeply and pervasively detrimental to older adults’ wellbeing. We combine theoretical reflections with a comparative study of older adults in Denmark and China. Both countries have to deal with an aging population and growing number of cases of isolation and loneliness in an increasingly individualized society. They differ, however, with regard to how far they have developed a system of institutionalized care, as well as with regard to their culture-specific views of family life and parent-child relationships. We apply the notions of filial piety, known from Confucian philosophy but often misinterpreted as conservative and conformist, and generativity, to qualitative studies of older adults in Denmark and China. The great potential of intergenerational ties is confirmed. Our study also shows that filial piety is still highly valued, in both China and Denmark, and can be maintained even in a highly individualized society. There is, however, considerable uncertainty among both older adults and their younger relatives as to what is required and what can be expected; realism, and an emphasis on the quality, rather than the quantity of interaction, may be sensible coping strategies, but can also lead to unnecessary acquiescence and self-abnegation. Our study also serves to distinguish different aspects and effects on wellbeing of intergenerational relationships.

     

Religion,Morality, and Democratic Virtues: A Liberal Theological Approach to Pastoral Care

Starting from a general definition of pastoral care and politics, it is argued that pastoral care can have nothing to do with party politics. Instead, the theme of pastoral care and politics should be regarded as a sub-set of the larger issue of religion and politics in a democratic society. Adopting the view that political philosophy is at bottom an exercise in moral reflection, this article focuses on two interrelated issues: the compatibility of religion and democracy, and the connection between religion and morality. The argument proceeds in three steps. In the first section, it is demonstrated why and how major political philosophers deem it necessary to impose certain limitations on the role of religion in the public square. In the second section, Kierkegaard’s interpretation of the biblical story of Abraham’s near-sacrifice of Isaac (Gen. 22) is treated as a problematic tradition in Christian theology of admiring authoritarian faith. Finally, as a means of overcoming these difficulties, a plea is made for returning to the tradition of liberal theology and its emphasis on the internal connection between religion and morality, and on developing conscience and civic virtues by way of self-culture.     

Relationship quality,divorce, and well-being: Findings from a three-year longitudinal study

Recent studies indicate that divorce sometimes is positive for subjective well-being, but we lack knowledge about the circumstances under which this is the case. Further, we lack knowledge about the possible different associations between divorce and life satisfaction (LS) vs. positive affect (PA). The current study is based on the Norwegian Mother and Child Cohort Study (MoBa). Change in LS and PA over a three-year period was examined in women who divorced and women who did not divorce (N > 37,000). Relationship quality and relationship status at follow-up were included in the models. The results indicated that divorce predicted higher LS and PA when initial relationship quality was poor. Furthermore, divorce predicted higher PA for women who, after divorce, reported being in a new romantic relationship. The associations between relationship quality and LS and PA were stronger among not-divorced than divorced women, indicating that relationship quality affects LS and PA.     

Does Low Dose Ionizing Radiation Cause Cancer? The Interplay of Epistemology and Ethics in Radiation Protection

In order to investigate the relationship between scientific evidence and social commitments this article addresses three questions: (1) does low dose ionizing radiation cause cancer? (2) Is the answer to this question different in a social setting than in a scientific context? (3) What are the consequences of the answers of 1 and 2 for the relationship between epistemology and ethics as played out in radiation protection? Conceptual analysis with basis in the philosophy of science, in particular traditional theories of causality. Whether low dose ionizing radiation causes cancer deeply depends on what we mean by causality. According to traditional scientific conceptions of causality it is not warranted to say that low dose ionizing radiation causes cancer. Standard approaches in radiation protection, however, imply that there is a causal connection, which is due to the strong social commitment in the field. There is a close relationship between social and scientific conceptions of causality, posing a series of challenges: one being that scientists covertly become moral experts, another one that the general public can be misinformed. There is a difference between causality in science and in policy making. Mixing these conceptions, as sometimes is done in radiation protection, can be misleading. Whether low dose ionizing radiation causes cancer is a social and not only a scientific issue. As such those who are warranted to have a say.     

Over-Determined Harms and Harmless Pluralities

A popular strategy for meeting over-determination and pre-emption challenges to the comparative counterfactual conception of harm is Derek Parfit’s suggestion, more recently defended by Neil Feit, that a plurality of events harms A if and only if that plurality is the smallest plurality of events such that, if none of them had occurred, A would have been better off. This analysis of ‘harm’ rests on a simple but natural mistake about the relevant counterfactual comparison. Pluralities fulfilling these conditions make no difference to the worse for anyone in the over-determination cases that prompted the need for revising the comparative conception of harm to begin with. We may choose to call them harmful anyway, but then we must abandon the idea that making a difference to the worse for someone is essential to harming. I argue that we should hold on to the difference-making criterion and give up the plural harm principle. I offer an explanation of why Parfit’s and Feit’s plural harm approach seems attractive. Finally, I argue that the consequences of giving up the plural harm principle and holding on to the simple comparative counterfactual analysis of harm are less radical than we may think, in relation to questions about wrongness and responsibility.