The Moment of a Star: The Ethics of Narration

The main theme of the following presentation of Ric?ur's philosophical preoccupations with religion is the interrelationship between reflection and revelation. In a first section, Ric?ur's philosophical profile is outlined in order to indicate the tone between sadness and joy, negativity and affirmation, in which religion has its existential and philosophical ambience. The following part discusses the pertinence of Ric?ur's position in light of contemporary debates about divine otherness and kenosis. Finally, a third section examines the antagonism between philosophy of reflection and biblical revelation, which marks the range and limits of Ric?ur's hermeneutic philosophy. The kind of dependency or heteronomy implied in religion, especially in the biblical idea of the absolute as an external truth-event, presents a genuine challenge to both phenomenology and hermeneutics. This problem is addressed in Ric?ur's theories of revelation and testimony.     

Couples' Experience of Enactments and Softening in Marital Therapy 1

Abstract

Beginning therapists are not prepared to deal with the complexity that families bring to the therapeutic setting and have a reductionistic approach to understanding what is occurring in a family. In order to move beyond a simplified approach, therapists with the assistance of a supervisor have the power to leave the security of their own being and can learn to take risks. This paper explores the development of a “therapeutic story” with the goal of assisting the beginning therapist in approaches that can be utilized to incorporate all available resources that will help to empower a family to change.     

Emotional Stroop via Internet among individuals with eating disorders

The present study investigated whether Stroop interference in eating disordered individuals for food - and body-related words, as repeatedly found previously using standard emotional Stroop tasks, would also be demonstrated when using an Internet based emotional Stroop task. Participants were anorexic women (n= 13), bulimic women (n= 20), non-clinically eating disordered women nevertheless over-concerned about eating and body appearance (n= 27) and normal control women (n= 31). Bulimic individuals showed Stroop interference for body-related words whereas anorexic individuals showed Stroop interference for food-related words. The present results thus suggest that administration of the emotional Stroop task is possible via the Internet. Furthermore, it is possible that the time consuming response delivery, relative to previous studies, could lead to Stroop interference only for the most emotionally significant information, in turn, differentiating between the core concerns of anorexic and bulimic individuals.     

A dichotic listening study of attention control in older adults

The influence of age on attentional control of bottom-up processing was investigated with a dichotic-listening paradigm. The typical right-ear-advantage (REA) without specific attentional instructions was used as a measure of bottom-up processing (non-forced condition). Top-down attentional control was evaluated by instructing subjects to report only the right or left ear stimulus of the dichotic pair (forced-right, forced-left conditions). Both young and old participants showed a REA in the non-forced condition and an increased REA in the forced-right condition. The old group failed, however, to use attention to modulate the REA to the same degree as the younger participants in the forced-left condition. Only the young group showed a significant left ear advantage (LEA). The results are discussed in relation to cognitive decline in normal aging and in early stages of dementia.     

Political Liberalism and the Interests of Children: A Reply to Timothy Michael Fowler

Timothy Michael Fowler has argued that, as a consequence of their commitment to neutrality in regard to comprehensive doctrines, political liberals face a dilemma. In essence, the dilemma for political liberals is that either they have to give up their commitment to neutrality (which is an indispensible part of their view), or they have to allow harm to children. Fowler??s case for this dilemma depends on ascribing to political liberals a view which grants parents a great degree of freedom in deciding on the education of their children. I show that ascribing this view to political liberals rests upon a misinterpretation of political liberalism. Since political liberals have access to reasons based upon the interests of children, they need not yield to parent??s wishes about the education of their children. A correct understanding of political liberalism thus shows that political liberals do not face the dilemma envisaged by Fowler.     

Internet-based treatment of depression: a randomized controlled trial comparing guided with unguided self-help

Internet-delivered self-help for depression with therapist guidance has shown efficacy in several trials. Results from meta-analyses suggest that guidance is important and that self-help programs without support are less effective. However, there are no direct experimental comparisons between guided and unguided internet-based treatments for depression. The present study compared the benefits of a 10-week web-based unguided self-help treatment with the same intervention complemented with weekly therapist support via e-mail. A waiting-list control group was also included. Seventy-six individuals meeting the diagnostic criteria of major depression or dysthymia were randomly assigned to one of the three conditions. The Beck Depression Inventory (BDI-II) was used as the primary outcome measure. Secondary outcomes included general psychopathology, interpersonal problems, and quality of life. Sixty-nine participants (91%) completed the assessment at posttreatment and 59 (78%) at 6-month follow-up. Results showed significant symptom reductions in both treatment groups compared to the waiting-list control group. At posttreatment, between-group effect sizes on the BDI-II were d = .66 for unguided self-help versus waiting-list and d = 1.14 for guided self-help versus waiting-list controls. In the comparison of the two active treatments, small-to-moderate, but not statistically significant effects in favor of the guided condition were found on all measured dimensions. In both groups, treatment gains were maintained at 6-month follow-up. The findings provide evidence that internet-delivered treatments for depression can be effective whether support is added or not. However, all participants were interviewed in a structured diagnostic telephone interview before inclusion, which prohibits conclusions regarding unguided treatments that are without any human contact.     

Cost-effectiveness of Internet-based cognitive behavior therapy vs. cognitive behavioral group therapy for social anxiety disorder: results from a randomized controlled trial

Social anxiety disorder (SAD) is highly prevalent and associated with a substantial societal economic burden, primarily due to high costs of productivity loss. Cognitive behavior group therapy (CBGT) is an effective treatment for SAD and the most established in clinical practice. Internet-based cognitive behavior therapy (ICBT) has demonstrated efficacy in several trials in recent years. No study has however investigated the cost-effectiveness of ICBT compared to CBGT from a societal perspective, i.e. an analysis where both direct and indirect costs are included. The aim of the present study was to investigate the cost-effectiveness of ICBT compared to CBGT from a societal perspective using a prospective design. We conducted a randomized controlled trial where participants with SAD were randomized to ICBT (n = 64) or CBGT (n = 62). Economic data were assessed at pre-treatment, immediately following treatment and six months after treatment. Results showed that the gross total costs were significantly reduced at six-month follow-up, compared to pre-treatment in both treatment conditions. As both treatments were equivalent in reducing social anxiety and gross total costs, ICBT was more cost-effective due to lower intervention costs. We conclude that ICBT can be more cost-effective than CBGT in the treatment of SAD and that both treatments reduce societal costs for SAD.     

Appraised psychological workload, musculoskeletal symptoms, and the mediating effect of fatigue: a structural equation modeling approach

The aim of the present study was to test two structural models of the relationship between appraised psychological workload and musculoskeletal symptoms from the neck, shoulder, and upper and lower back with different aspects of perceived fatigue as mediating variables. In this cross-sectional study a questionnaire survey was conducted among employees at three Swedish assembly plants (n= 305). The proposed models were tested for one general fatigue dimension--lack of energy--and four specific fatigue dimensions--physical discomfort, physical exertion, lack of motivation, and sleepiness--using structural equation modeling. The results indicate that the role of perceived fatigue in the relationship between appraised workload and musculoskeletal symptoms is different for different aspects of fatigue. The general fatigue dimension, lack of energy, does not mediate the relationship. As regards the specific fatigue dimensions, the relationship is partially mediated by physical discomfort and lack of motivation but not by physical exertion or sleepiness. Appraised psychological workload has a unique effect on musculoskeletal symptoms not mediated by fatigue.