The 9th annual INDUS-EM 2013 Emergency Medicine Summit, “Principles,Practices, and Patients,” a level one international meeting,Kerala University of Health Sciences and Jubilee Mission Medical College and Research Institute,Thrissur, Kerala,India, October 23–27, 2013

INDUS-EM is India’s only level one conference imparting and exchanging quality knowledge in acute care. Specifically, in general and specialized emergency care and training in trauma, burns, cardiac, stroke, environmental and disaster medicine. It provides a series of exchanges regarding academic development and implementation of training tools related to developing future academic faculty and residents in Emergency Medicine in India. The INDUS-EM leadership and board of directors invited scholars from multiple institutions to participate in this advanced educational symposium that was held in Thrissur, Kerala in October 2013.     

Theory and observation: The experimental nexus

Philosophical discussions of experiment usually focus exclusively on testing predictions. In this paper I compare G. Morpurgo's experimental test of the Gell‐Mann/ Zweig quark hypothesis with two neglected uses of experiment: constructing representations of new phenomena and inventing the instruments that produce such phenomena. These roles are illustrated by J. B. Biot's 1821 observations of electromagnetism and by Michael Faraday's invention of the first electromagnetic motor, also in 1821. The comparison identifies similarities between observation and experiment, showing how both observation and experiment actively engage the natural world and how each engagement shapes representation and subsequent empirical work. This challenges the post‐empiricist assumption of the sufficiency of knowing only the outcomes of experiments. I conclude that traditional views of observational access have looked in the wrong place for empirical constraints on theorizing. The active character of observation implies that a realist interpretation of experimenters’ discourse should be grounded in the fine structure of experimental practice rather than the supposedly decisive, golden events favoured by hypothetico‐deductive methodology.     

Are defeat and entrapment best defined as a single construct?

The concepts of defeat and entrapment have been employed in evolutionary accounts of clinical phenomena such as depression and suicide. Recently theorists have argued that both concepts may be best conceptualised as a single distinct factor. The current study is the first to empirically test this assertion. A sample of 305 students completed measures of defeat and entrapment. Their responses were then analysed via exploratory factor analysis. The results strongly suggest that a single factor underlies both defeat and entrapment. These findings have considerable implications for past studies and theoretical accounts that rely on the distinction between defeat and entrapment.     

Perceptual biases in psychosis-prone individuals.

College students screened for psychosis-proneness using the Chapman scales were compared on 4 free-vision tasks that typically yield left-spatial-field biases. The tasks included 2 chimeric face tests, consisting of happy/neutral faces and male/female faces, and 2 nonface tasks, consisting of pairs of dot-filled or gradient-filled rectangles. Participants endorsing perceptual aberration items, magical ideation items, or both (n = 98) and control participants (n = 112) were left-biased on all tasks but gradients and were most biased on emotion faces; in contrast, i.e., social anhedonia participants (n = 40) displayed very little or no left-field biases. For all groups, task intercorrelations were greatest between the 2 face tasks and between the 2 nonface tasks. These findings suggest patterns of atypical perceptual asymmetry in psychosis-prone individuals.     

An investigation of aspects of the cry of pain model of suicide risk: the role of defeat in impairing memory

AIM: Feelings of defeat and deficits in autobiographical memory are thought to be central to the formation of suicidal thoughts and behaviours. However, no work has established the role of defeat, specifically, in directly leading to memory problems. This study sought to assess whether a defeating event and associated defeated mood impaired memory for a story. METHOD: Participants were from a student population. Those in the experimental condition (n=37) experienced an event which was designed to induce defeat prior to both the encoding and verbal retrieval of a story. Participants in control condition (n=37) experienced no such defeating event. Visual analogue scales of five mood states were taken at baseline, prior to encoding and prior to retrieval. RESULTS: Participants in the experimental condition reported increased feelings of defeat following baseline, and recalled fewer story units relative to the control condition. DISCUSSION: These results show that appraising an event as defeating increased subsequent defeated mood and led to impaired episodic memory, independently of low mood in general, thus suggesting a causal role of a specific negative mood state on impaired memory. Implications for clinical research are discussed.     

Trait reappraisal amplifies subjective defeat, sadness, and negative affect in response to failure versus success in nonclinical and psychosis populations

Perceptions of defeat have been linked to a range of clinical disorders including psychosis. Perceived defeat sometimes increases in response to failure, but the strength of this association varies between individuals. The present research investigated whether trait reappraisal, a thought-focused coping style, amplified response to stressful events. Two studies (Study 1, n = 120 nonclinical participants; Study 2, n = 77 participants with schizophrenia-spectrum disorders) investigated whether trait reappraisal amplified feelings of defeat following an experience of failure versus success. Frequent reappraisers showed the largest increases in subjective defeat after failure versus success in both studies, with nonclinical participants with greater habitual reappraisal also showing larger increases in sadness and general negative affect. Frequent use of reappraisal may confer vulnerability to subjective defeat in response to stressful life events among nonclinical and clinical populations and could be an area for relapse prevention interventions to target.     

An empirical investigation of the effectiveness of the broad-minded affective coping procedure (BMAC) to boost mood among individuals with posttraumatic stress disorder (PTSD)

The broaden-and-build theory postulates that positive emotions broaden people's cognitions and actions, and facilitate the building of personal and social resources which enhance resilience in a range of clinical populations. The Broad-Minded Affective Coping procedure (BMAC) is a recently developed clinical technique which utilizes the recall of positive autobiographical memories and mental imagery to elicit positive affect. This study aims to investigate the ability of the BMAC to boost mood among 50 individuals diagnosed currently (n=31) or previously (n=19) with Posttraumatic Stress Disorder (PTSD). To assess mood, a series of Visual Analog Scales (VASs) and Likert scales measuring feelings of sadness, calmness, happiness, hopelessness, defeat and frustration were administrated at baseline, immediately following the completion of the BMAC and two hours and two days afterwards. Participants in the BMAC condition demonstrated greater increases in self-reported levels of positive emotions and greater reductions in self-reported levels of negative emotions following the BMAC technique compared to those in the control condition. The results suggest that the BMAC is a useful clinical technique which can be incorporated into other clinical interventions such as cognitive behavioral therapy to elicit positive affect and promote resilience.     

Shattered Illusions: The Effect of Explicit Memory Mediation on an Indirect Memory Test

Four experiments were conducted to explore the possible involvement of explicit memory in an indirect memory test in which white noise accompanying old sentences was judged to be quieter than white noise accompanying new sentences (Jacoby, Allan, Collins, & Larwill, 1988). Experiment 1 established that this effect lasted up to 1 week. Experiment 2 found that a group of amnesic patients showed a noise effect that was marginally above chance and not significantly less than that of their matched controls after a delay of one day. Effects of time pressure at test (Experiment 3) and divided attention at study (Experiment 4) suggested that the memory processes mediating the noise effect were not automatic, although the possibility that the processes involve enhanced fluency is also discussed.