Philosophy of medicine: should it be teleologically or socially construed?

This response to Kevin Wildes's article in the previous issue of the Kennedy Institute of Ethics Journal addresses several major points of disagreement between Pellegrino and Wildes regarding the nature and scope of a philosophy of medicine, in particular how it is derived and by what method of philosophical enquiry it is best pursued.     

Comparison of Single Unit Responses to Tone, Light, and Compound Conditioned Stimuli during Rabbit Classical Eyeblink Conditioning

Unit recordings and lesion studies have implicated the cerebellum as an essential site for the acquisition and maintenance of the conditioned eyeblink response. The current study looked at the neural characteristics of conditioned stimulus (CS) processing in the interpositus nucleus of the cerebellum after training New Zealand white rabbits (Oryctolagus cuniculus) in one of two conditioning paradigms: (a) compound conditioning (CMP), a compound CS consisting of light and tone paired with an air puff unconditioned stimulus (US); or (b) stimulus compounding (ALT), alternating blocks of tone CS and light CS trials paired with the air puff US. Single unit responses were recorded during five sessions after the animals had reached an asymptotic level of responding. Animals were tested for behavioral and neural responses to CS alone trials that included tone alone, light alone, and compound tone-light trials. For the CMP group, the compound CS elicited 80 to 90% conditioned eyeblink responses (CRs), whereas the individual tone and light CSs elicited only 40 to 50% CRs. For the ALT group, all three CSs (tone, light, and compound) elicited very high levels of responding of at least 80% CRs. For the CMP group, there were roughly equal numbers of cells responding to all of the CSs. This includes cells that responded exclusively to one, and only one, of the three stimuli and also those cells that responded to combinations of two or more. Cells from the ALT group were far more likely to respond exclusively to only one of the CSs. Both the behavioral and physiological results suggest that the compound tone-light stimulus was processed as a distinct stimulus, separate from the component tone and light. These results are discussed in the context of multisensory processing.     

Response perseveration in psychopathic women.

Recent attempts to validate the Psychopathy Checklist-Revised (PCL-R) as a measure of psychopathy in female offenders have been limited by a failure to examine laboratory correlates of the syndrome. We assessed 112 incarcerated women by using the PCL-R and examined their performance on a card perseveration task that has been used to demonstrate response perseveration in psychopathic men. Contrary to prediction, psychopathic women did not perseverate responding when the PCL-R was used either dimensionally or categorically. The authors discuss the implications of the results for the PCL-R and for female psychopathy more generally.     

Parkinsonian Patients Reduce Their Stroke Size with Increased Processing Demands

Parkinson's disease (PD) patients often show reductions in writing size (micrographia) as the length of the text they produce increases. The cause for these reductions in stroke size are not well understood. Reductions in stroke size could be associated with either concurrent processing demands that result from the coordination and control of fingers, wrist, and arm during writing and the processing of future words or increased extension of the wrist joint as the execution of the writing progresses to the right across the page, resulting in increased stiffness in the pen-limb system. Parkinson's patients and elderly controls wrote phrases of different lengths with target patterns in various serial positions. When the number of words to be written increased, PD patients reduced their stroke size of the initial target pattern, while the elderly controls did not reduce their stroke size. There was no systematic change in stroke size of the second pattern as function of serial position. This result suggests that PD patients reduce the size of their handwriting strokes when concurrent processing load increases.     

Beyond the gambling paradigm: internal controllability in decision-making.

Much research within decision-making has used the standard gambling paradigm, where decision outcomes depend only on chance. Many real life decisions, however, imply personal control over decision outcomes. This paper addressed the question of how internal controllability influences decision-making. Internal controllability is assumed (i) to enhance unrealistic optimism and (ii) to result in a better cost:benefit ratio. Both tendencies support each other and predict an enhanced attractiveness for internal and controllable choice options. Participants read a scenario and made a decision afterwards. Results supported the prediction: decision-makers take the option they can personally control. This finding widens the narrow perspective inherent in much previous research based on the gambling paradigm.     

Unified psychology.

The authors describe an approach to psychology they refer to as unified psychology, which is the multiparadigmatic, multidisciplinary, and integrated study of psychological phenomena through converging operations. In this article, they unpack this definition and explore some of its implications. First, they review some previous efforts to conceive of a unified psychology and consider objections to such an undertaking. Second, they discuss the importance of converging operations for psychology. Third, they consider the need for multidisciplinary and integrated study of psychological phenomena that focuses on the phenomena rather than on particular lines of disciplinary inquiry. Fourth, they ponder the problem of investigators' becoming locked into a single paradigm with its attendant set of presuppositions about psychological theory and research. Fifth, they outline some possible objections to their proposal and respond to them. Finally, they discuss some implications of their views.     

Discrimination Reversal Conditioning of an Eyeblink Response is Impaired by NMDA Receptor Blockade

In the present study we examined the effects of the specific NMDA receptor antagonist CPP on discrimination reversal learning in rabbits. We report two primary findings. First, the institution of NMDA receptor blockade had no effect on a learned discrimination. Second, after stimulus reversal, CPP treatment impaired acquisition of the discrimination reversal. This impairment manifested itself early in training as a retardation in acquisition of a CR to the new CS+ and late in training as an inability to suppress responsiveness to the new CS-. Given the comparability of the present results with previously published results for phenytoin-treated rabbits, we suggest that the effects of phenytoin on learning in this paradigm is at least in part mediated by its effects on NMDA receptors. We further suggest that these findings emphasize the need to better define the role of NMDA receptor activation and hippocampally-mediated circuits in a variety of associative learning paradigms.     

Representational momentum and Michotte's (1946/1963) "launching effect" paradigm

In A. Michotte's (1946/1963) launching effect, a moving launcher contacts a stationary target, and then the launcher becomes stationary and the target begins to move. In this experiment, observers viewed modifications of a launching effect display, and displacement in memory for the location of targets was measured. Forward displacement of targets in launching effect displays was decreased relative to that of targets (a) that were presented in isolation and either moved at a constant fast or slow velocity or decelerated or (b) that moved in a direction orthogonal to previous motion of the launcher. Possible explanations involving a deceleration of motion or landmark attraction effects were ruled out. Displacement patterns were consistent with naive impetus theory and the hypothesis that observers believed impetus from the launcher was imparted to the target and then dissipated.     

Semantic priming in Alzheimer's dementia: evidence for dissociation of automatic and attentional processes

The nature of the semantic memory deficit in dementia of the Alzheimer's type (DAT) was investigated in a semantic priming task which was designed to assess both automatic and attention-induced priming effects. Ten DAT patients and 10 age-matched control subjects completed a word naming semantic priming task in which both relatedness proportion (RP) and stimulus-onset asynchrony (SOA) were varied. A clear dissociation between automatic and attentional priming effects in both groups was demonstrated; however, the DAT subjects' pattern of priming deviated significantly from that of the normal controls. The DAT patients failed to produce any priming under conditions which encouraged automatic semantic processing and produced facilitation only when the RP was high. In addition, the DAT group produced hyperpriming, with significantly larger facilitation effects than the control group. These results suggest an impairment of automatic spreading activation in DAT and have implications for theories of semantic memory impairment in DAT as well as models of normal priming.