The myth of technology in health care

Technology is believed to have liberated health care from dogmas, myths and speculations of earlier times. However, we are accused of using technology in an excessive, futile and even detrimental way, as if technology is compelling our actions. It appears to be like the monster threatening Dr. Frankenstein or like the socerer’s broom in the hand of the apprentice. That is, the same technology that should liberate us from myths, appears to be mythical. The objective of this article is to investigate the background for the re-entrance of the myth: How we encounter it and how we can explain it. The main point is that a myth of technology is normative: it relates ‘is’ and ‘ought’ and directs our actions. This becomes particularly clear in health care. Hence, if there is a myth of technology, it is an ethical issue, and should be taken seriously.     

Descartes's Regulae, mathematics, and modern psychology: "the Noblest example of all" in Light of Turing's (1936) On computable Numbers

There are surprisingly strong connections between the philosophy of mind and the philosophy of mathematics. One particular important example can be seen in the Regulae (1628) of Descartes. In "the noblest example of all," he used his new abstract understanding of numbers to demonstrate how the brain can be considered as a symbol machine and how the intellect's algebraic reasoning can be mirrored as operations on this machine. Even though his attempt failed, it is illuminating to explore it because Descartes launched 2 traditions--mechanistic philosophy of mind and abstract mathematics--that would diverge until A. Turing (1936) approached symbolic reasoning in a similar "symbol machine-existence proof" way. Descrates's and Turing's thought experiments, which mark the beginning of modern psychology and cognitive science, respectively, indicate how important the development of mathematics has been for the constitution of the science of mind.     

Metacognitions in proneness towards hallucinations and delusions

The objectives of the present study were to examine the degree of co-existence of hallucinations and delusions in the nonclinical population. In addition, we wished to investigate the role of metacognitions in hallucinations and delusions. Finally, we explored the relative roles of positive and negative metacognitive beliefs in proneness to hallucinations and delusions. Three hundred and thirty-one nonclinical participants completed instruments assessing: hallucination-proneness (Launay-Slade Hallucinations Scale; LSHS), delusion-proneness (21-item version of the Peters et al. Delusions Inventory; PDI-21) and metacognitive beliefs (Meta-Cognitions Questionnaire; MCQ). Participants were successively grouped according to their scores on the LSHS and the PDI-21. Results revealed that hallucination-proneness was positively and significantly associated with delusion-proneness. Furthermore, hallucination-prone and delusion-prone participants scored significantly higher on some sub-scales of the MCQ compared to non-prone participants. Finally, multiple regression analysis revealed that positive and negative beliefs were good predictors of proneness towards hallucinations and delusions.     

Behavioral treatment of insomnia in older adults: an open clinical trial comparing two interventions

Fifty-five insomniacs, 60 years or above, participated in a behavioral treatment program, comparing two interventions (sleep hygiene+stimulus control vs sleep hygiene+relaxation tape). Half of the subjects were randomized to a waiting-list condition prior to treatment. No significant changes were observed during the waiting-list period. During the treatment period however, the subjects improved on several sleep parameters, and treatment gains were maintained at a 6-month follow-up. The effects of treatment were greater for nocturnal measures (e.g. sleep onset latency and total sleep time) as compared to daytime measures (e.g. life satisfaction, daytime alertness) and not-targeted behavior (medication use). There were no differences in treatment effects for the two interventions.     

Day treatment of patients with personality disorders: experiences from a Norwegian treatment research network

This study sought to investigate the following research questions: Are time-limited day treatment programs for patients with personality disorder (PD) effective outside resourceful university settings, and what are the overall treatment results when the program is implemented on a larger scale? Do all categories and subtypes of PDs respond favorably to such treatment? How intensive should such day treatment programs be? All patients (n = 1,244) were consecutively admitted to eight different treatment programs in the Norwegian Network of Psychotherapeutic Day Hospitals from 1993 to 2000. Altogether, 1,010 patients were diagnosed with PD. Avoidant, borderline, not otherwise specified (NOS), and paranoid PD were the most common conditions. SCID-II and MINI were used as diagnostic instruments. Outcome measures included GAF Global Assessment of Functioning, (GAF; American Psychiatric Association, 1994), SCL-90R, CIP, Quality of Life, work functioning and parasuicidal behavior, measured at admittance, discharge and 1-year follow up. The attrition rate was 24%. The number of dropouts did not improve over time. As a group, completers with PD improved significantly on all outcome variables from admittance to discharge and improvement was maintained or increased at follow up. Treatment results were best for borderline PD, cluster C patients, PD NOS and No PD, and poorer for cluster A patients. Units with a high treatment dosage did not experience better outcomes than those with a low treatment dosage (10 hours per week). Results from the University unit were not better than those from units at local hospitals or mental health centers.     

Timed picture naming: Extended norms and validation against previous studies

Factors affecting word retrieval were compared in a timed picture-naming paradigm for 520 drawings of objects. In prior timed and untimed studies by Snodgrass and Vanderwart (1980) and Snodgrass and Yuditsky (1996), concerns were raised that participants could not reliably name large numbers of items in a single session. We show that reliable results are obtained in a single session for 520 items and validate our method against previous findings by Snodgrass and colleagues for overlapping items. For these items, comparable levels of name agreement and latency are obtained, and we replicate effects of length, frequency, both objective and subjective age of acquisition, and visual complexity on reaction time (RT) and name agreement measures. Name agreement is unaffected by order of presentation, although there is a gradual increase in RTs across the session, requiring use of multiple random orders. Current extensions of our method include cross-linguistic, bilingual, developmental, and neuropsychological studies and comparisons of action naming and object naming.     

Grandiose-Manipulative,Callous-Unemotional,and Daring-Impulsive: the Prediction of Psychopathic Traits in Adolescence and their Outcomes in Adulthood

There has been much debate about how to measure psychopathic traits in adolescence. One of the main issues is whether one should focus on callous-unemotional (CU) traits alone, or CU traits in combination with Grandiose-Manipulative (GM) and Daring-Impulsive (DI) traits. The current study first investigates the extent to which youth who are high on CU traits are also high on GM and DI traits. In addition, the study investigates if being high on both CU and GM, and high on both CU and DI, identify groups that are particularly characterized by past and future impairments. To investigate this, data from the Cambridge Study in Delinquent Development (CSDD) was analyzed. The CSDD is a prospective longitudinal study of 411 English boys spanning over 50 years. The information available at age 12–14 was coded on the Antisocial Process Screening Device (APSD). Childhood risk factors were measured at age 8–10 and later life outcomes were measured at age 32. The results indicate that being high on CU in combination with DI delineates a clinically interesting group who are characterized by high childhood risk and poorer adult life outcomes. The same applied to the high CU/high GM group, but to a lesser extent.     

Electrophysiological evidence for age effects on sensory memory processing of tonal patterns

In older adults, difficulties processing complex auditory scenes, such as speech comprehension in noisy environments, might be due to a specific impairment of temporal processing at early, automatic processing stages involving auditory sensory memory (ASM). Even though age effects on auditory temporal processing have been well-documented, there is a paucity of research on how ASM processing of more complex tone-patterns is altered by age. In the current study, age effects on ASM processing of temporal and frequency aspects of two-tone patterns were investigated using a passive listening protocol. The P1 component, the mismatch negativity (MMN) and the P3a component of event-related brain potentials (ERPs) to tone frequency and temporal pattern deviants were recorded in younger and older adults as a measure of auditory event detection, ASM processing, and attention switching, respectively. MMN was elicited with smaller amplitude to both frequency and temporal deviants in older adults. Furthermore, P3a was elicited only in the younger adults. In conclusion, the smaller MMN amplitude indicates that automatic processing of both frequency and temporal aspects of two-tone patterns is impaired in older adults. The failure to initiate an attention switch, suggested by the absence of P3a, indicates that impaired ASM processing of patterns may lead to less distractibility in older adults. Our results suggest age-related changes in ASM processing of patterns that cannot be explained by an inhibitory deficit.     

Genetic and environmental contributions to the co-occurrence of depressive personality disorder and DSM-IV personality disorders

One of the main controversies with regard to depressive personality disorder (DPD) concerns the co-occurrence with the established DSM-IV personality disorders (PDs). The main aim of this study was to examine to what extent DPD and the DSM-IV PDs share genetic and environmental risk factors, using multivariate twin modeling. The DSM-IV Structured Interview for Personality was applied to 2,794 young adult twins. Paranoid PD from Cluster A, borderline PD from Cluster B, and all three PDs from Cluster C were independently and significantly associated with DPD in multiple regression analysis. The genetic correlations between DPD and the other PDs were strong (.53-.83), while the environmental correlations were moderate (.36-.40). Close to 50% of the total variance in DPD was disorder specific. However, only 5% was due to disorder-specific genetic factors, indicating that a substantial part of the genetic vulnerability to DPD also increases the vulnerability to other PDs.