Changes in natural language use as an indicator of psychotherapeutic change in personality disorders

Word use has been shown to reflect various psychological processes and psychological change. This study examines the self-view in personality disorders (PDs) and its change over the course of therapy using the Linguistic Inquiry and Word Count analysis procedure. A sample of 299 participants with PDs and 108 community control participants wrote short essays about their lives. Patients repeated the assignment three times over two years and completed assessments of PD-pathology, general psychopathology, PD-beliefs, and quality of life. Results show that as hypothesized the use of words in the 1st Person Singular Pronouns, Negative Emotion, Causation, Past and Future Tense Verbs categories significantly declines over the course of treatment, while the use of Present Tense Verbs and Positive Emotion increases. These categories tend to distinguish patients from non-patients prior to treatment. We also found 12 additional word categories changing over time, including Word Count and Negations. Change in word use statistically predicts better treatment outcome on all outcome measures (p < .001). Reductions in the use of Negative Emotion Words and Negations are the strongest predictors of outcome. The non-hypothesized role of Negations was explored and seemed to reflect that PD-patients miss a lot in their lives. Reduction of what they miss seems central to recovery. This issue seems relatively neglected in theoretical and treatment models of PDs. An increased focus on what patients miss in their lives might improve our understanding and treatment of PDs. In sum, Negative Emotion and Negation word categories appear to reflect key treatment targets.     

Body image, shape, and volumetric assessments using 3D whole body laser scanning and 2D digital photography in females with a diagnosed eating disorder: preliminary novel findings

We piloted three-dimensional (3D) body scanning in eating disorder (ED) patients. Assessments of 22 ED patients (including nine anorexia nervosa (AN) patients, 12 bulimia nervosa (BN) patients, and one patient with eating disorder not otherwise specified) and 22 matched controls are presented. Volunteers underwent visual screening, two-dimensional (2D) digital photography to assess perception and dissatisfaction (via computerized image distortion), and adjunctive 3D full-body scanning. Patients and controls perceived themselves as bigger than their true shape (except in the chest region for controls and anorexia patients). All participants wished to be smaller across all body regions. Patients had poorer veridical perception and greater dissatisfaction than controls. Perception was generally poorer and dissatisfaction greater in bulimia compared with anorexia patients. 3D-volume:2D-area relationships showed that anorexia cases had least tissue on the torso and most on the arms and legs relative to frontal area. The engagement of patients with the scanning process suggests a validation study is viable. This would enable mental constructs of body image to be aligned with segmental volume of body areas, overcoming limitations, and errors associated with 2D instruments restricted to frontal (coronal) shapes. These novel data could inform the design of clinical trials in adjunctive treatments for eating disorders.     

Sex differences in how erotic and painful stimuli impair inhibitory control

Witnessing emotional events such as arousal or pain may impair ongoing cognitive processes such as inhibitory control. We found that this may be true only half of the time. Erotic images and painful video clips were shown to men and women shortly before a stop signal task, which measures cognitive inhibitory control. These stimuli impaired inhibitory control only in men and not in women, suggesting that emotional stimuli may be processed with different weights depending on gender.     

Mobility: Disability and Life in the Spirit

Abstract : The author employs the narrative of his own personal experience of disability as an entry to several large issues: the place of body; the challenge of mobility; the processes of medical treatment, therapy, and fitness training; the network of dependence upon family, friends, and society; and the challenge to actively avail oneself of the resources of this network. The power of the human spirit is affirmed as the prerequisite for moving the body and attaining the possibilities of one's life. This power is the work of God's Spirit. A concept of body‐spiriting is suggested. The argument is framed in two parts: (1) in the world in my own skin, and (2) living in the presence of God.     

Maximal care considerations when treating patients with end-stage heart failure: ethical and procedural quandaries in management of the very sick

Deciding who should receive maximal technological treatment options and who should not represents an ethical, moral, psychological and medico-legal challenge for health care providers. Especially in patients with chronic heart failure, the ethical and medico-legal issues associated with providing maximal possible care or withholding the same are coming to the forefront. Procedures, such as cardiac transplantation, have strict criteria for adequate candidacy. These criteria for subsequent listing are based on clinical outcome data but also reflect the reality of organ shortage. Lack of compliance and non-adherence to lifestyle changes represent relative contraindications to heart transplant candidacy. Mechanical circulatory support therapy using ventricular assist devices is becoming a more prominent therapeutic option for patients with end-stage heart failure who are not candidates for transplantation, which also requires strict criteria to enable beneficial outcome for the patient. Physicians need to critically reflect that in many cases, the patient’s best interest might not always mean pursuing maximal technological options available. This article reflects on the multitude of critical issues that health care providers have to face while caring for patients with end-stage heart failure.     

X-rated material and perpetration of sexually aggressive behavior among children and adolescents: is there a link?

Longitudinal linkages between intentional exposure to x-rated material and sexually aggressive behavior were examined among youth 10-15 year olds surveyed nationally in the United States. At Wave 1 in 2006, participants (n = 1,588) were queried about these exposures and outcomes in the preceding 12 months. Wave 2 data (n = 1,206) were collected approximately 12 months after Wave 1 and Wave 3 data (n = 1,159) were collected approximately 24 months after Wave 1. Thus, data for this project represent a 36-month time frame. A marginal model with generalized estimating equations was used to represent the population-average odds of sexually aggressive behavior over the 36 months as a function of exposure to x-rated material over the same time and to account for clustering in the data within person over time. An average of 5% of youth reported perpetrating sexually aggressive behavior and 23% of youth reported intentional exposure to x-rated material. After adjusting for other potentially influential proximal (i.e., sexual aggression victimization) and distal characteristics (e.g., substance use), we found that intentional exposure to violent x-rated material over time predicted an almost 6-fold increase in the odds of self-reported sexually aggressive behavior (aOR: 5.8, 95% CI: 3.2, 10.5), whereas exposure to nonviolent x-rated material was not statistically significantly related (aOR: 1.7, 95% CI: 0.94, 2.9). Associations were similar for boys and girls (boys nonviolent x-rated material aOR = 2.0, 95% CI: 0.8, 4.7; violent x-rated material aOR = 6.5, 95% CI: 2.7, 15.3; girls nonviolent x-rated material aOR = 1.2, 95% CI: 0.5, 3.2; violet x-rated material aOR = 6.1, 95% CI: 2.5, 14.8).     

Contour entropy: a new determinant of perceiving ground or a hole

Figure-ground perception is typically described as seeing one surface occluding another. Figure properties, not ground properties, are considered the significant factors. In scenes, however, a near surface will often occlude multiple contours and surfaces, often at different depths, producing alignments that are improbable except under conditions of occlusion. We thus hypothesized that unrelated (high entropy) lines would tend to appear as ground in a figure-ground paradigm more often than similarly aligned ordered (low entropy) lines. We further hypothesized that for lines spanning a closed area, high line entropy should increase the hole-like appearance of that area. These predictions were confirmed in three experiments. The probability that patterned rectangles were seen as ground when alternated with blank rectangles increased with pattern entropy. A single rectangular shape appeared more hole-like when the entropy of the enclosed contours increased. Furthermore, these same contours, with the outline shape removed, gave rise to bounding illusory contours whose strength increased with contour entropy. We conclude that figure-ground and hole perception can be determined by properties of ground in the absence of any figural shape, or surround, factors.     

The effect of commitment on relative left frontal cortical activity: tests of the action-based model of dissonance

The action-based model of dissonance and recent advances in neuroscience suggest that commitment to action should cause greater relative left frontal cortical activity. Two experiments were conducted in which electroencephalographic activity was recorded following commitment to action, operationalized with a perceived choice manipulation. Perceived high as compared to low choice to engage in the action, regardless of whether it was counterattitudinal or proattitudinal, caused greater relative left frontal cortical activity. Moreover, perceived high as compared to low choice caused attitudes to be more consistent with the action. These results broaden the theoretical reach of the action-based model by suggesting that similar neural and motivational processes are involved in attitudinal responses to counterattitudinal and proattitudinal commitments.     

Epistemology Without History is Blind

In the spirit of James and Dewey, I ask what one might want from a theory of knowledge. Much Anglophone epistemology is centered on questions that were once highly pertinent, but are no longer central to broader human and scientific concerns. The first sense in which epistemology without history is blind lies in the tendency of philosophers to ignore the history of philosophical problems. A second sense consists in the perennial attraction of approaches to knowledge that divorce knowing subjects from their societies and from the tradition of socially assembling a body of transmitted knowledge. When epistemology fails to use the history of inquiry as a laboratory in which methodological claims can be tested, there is a third way in which it becomes blind. Finally, lack of attention to the growth of knowledge in various domains leaves us with puzzles about the character of the knowledge we have. I illustrate this last theme by showing how reflections on the history of mathematics can expand our options for understanding mathematical knowledge.