Working with Bangladeshi young women

The author describes once-weekly psychoanalytically informed work in a child mental health setting with young Bangladeshi women making the transition to adulthood. She argues that the prevalent notion of 'culture conflict' used to account for patterns of emotional disturbance and self-harm in these young women is reductionist and represents a denial of severe family dysfunction and individual psychic pain. She shows how, despite cultural differences, psychoanalytically informed thinking can provide a basis for understanding these young women's experience and facilitate their emotional growth. However, faced with complex unconscious processes, the worker has to remain alert to her countertransference in order not to be drawn into an unhelpful collusion or denial of reality. Organizational defences may also operate to protect staff and their institutions from awareness of such high levels of emotional distress, which therefore remain hidden. The author is grateful to the two young women who consented to publication in the hope that it might help others. Details have been changed to protect their anonymity.     

Cognitive and motor deficits in older adults with HIV infection: Comparison with normal ageing and Parkinson’s disease

Despite the life-extending success of antiretroviral pharmacotherapy in HIV infection (HIV), the prevalence of mild cognitive impairment in HIV remains high. Near-normal life expectancy invokes an emerging role for age–infection interaction and a potential synergy between immunosenescence and HIV-related health factors, increasing risk of cognitive and motor impairment associated with degradation in corticostriatal circuits. These neural systems are also compromised in Parkinson’s disease (PD), which could help model the cognitive deficit pattern in HIV. This cross-sectional study examined three groups, age 45–79 years: 42 HIV, 41 PD, and 37 control (CTRL) participants, tested at Stanford University Medical School and SRI International. Neuropsychological tests assessed executive function (EF), information processing speed (IPS), episodic memory (MEM), visuospatial processing (VSP), and upper motor (MOT) speed and dexterity. The HIV and PD deficit profiles were similar for EF, MEM, and VSP. Although only the PD group was impaired on MOT compared with CTRL, MOT scores were related to cognitive scores in HIV but not PD. Performance was not related to depressive symptoms, socioeconomic status, or CD4⁺ T-cell counts. The overlap of HIV-PD cognitive deficits implicates frontostriatal disruption in both conditions. The motor-cognitive score relation in HIV provides further support for the hypothesis that these processes share similar underlying mechanisms in HIV infection possibly expressed with or exacerbated by ageing.     

Justice,Virtue, and Power in Democratic Conflict

The question of how to respond to the deep political divides in the United States today has resulted in the emergence of two camps. On one side are those who argue that the cultivation of civic virtues like civility will lead to more respectful interpersonal relationships through which consensus and mutual understanding can be built. On the other are those who argue that our commitment to justice is primary and may require uncivil behavior to disrupt and change unjust structural relationships. In Healthy Conflict in Contemporary American Society, Jason Springs helps to bridge the divide between these two positions. Because he takes a relational approach that centers both interpersonal and structural relationships, Springs makes both mutual respect and just structures central to his conception of healthy conflict. Taking relationality seriously thus helps to overcome this impasse, but it also raises significant questions about the impact of asymmetrical relationships on citizens’ responsibilities to engage in healthy conflict.     

Pure Time Preference: Reply to Johansson and Rosenqvist

Johansson and Rosenqvist reject our argument for the rational permissibility of pure time preferences (PTP). Johansson and Rosenqvist's main objection is that where two options, X and Y, have equal intrinsic value, there will be a reason to be indifferent between X and Y, and therefore a reason to not hold a PTP for X or Y. In this reply, we argue that if two options have equal intrinsic value, it does not follow that you have a reason to be indifferent. Rather, the two equally large intrinsic values cancel each other out, like two equal weights on kitchen scales.     

Tradition,Authority, and Immanent Critique in Comparative Ethics

Drawing on resources from pragmatist thought allows religious ethicists to take account of the central role traditions play in the formation and development of moral concepts without thereby espousing moral relativism or becoming traditionalists. After giving an account of this understanding of the concept of tradition, I examine the ways in which understandings of tradition play out in two contemporary examples of tradition‐based ethics: works in comparative ethics of war by James Turner Johnson and John Kelsay. I argue that a pragmatist approach to tradition‐based ethics allows for a nuanced and flexible understanding of moral traditions, and one that holds great promise for international consensus‐building around shared ethical norms for the use of armed force.