The myth of the control of suffering

Is it true that the suffering associated with chronic illness can be controlled in all but a few intractable cases? The bio-ethical literature gives the impression that suffering is primarily pain and that a competent physician should be able to control suffering. This perception jibes neither with my forty years of clinical experience nor with suffering as depicted in novels. Using Kenaz' novel,The Way to the Cats as a starting point, I argue that, with regard to suffering and illness, fiction is closer to reality than professional literature, and suffering is far more than pain. I content that the control of suffering is a modern myth. This argument applies equally well to the control of non-insulin dependent diabetes. Patient selection, duration of follow-up, remembering what we want to remember, bias, self-fulfilled prophecy, and asking the wrong questions are offered as partial explanation for the gap between perception and reality. The complexity of suffering and the elusiveness of its control should be honestly recognized.     

Action Understanding in the Superior Temporal Sulcus Region

ABSTRACT— The posterior superior temporal sulcus (STS) region plays an important role in the perception of social acts, although its full role has not been completely clarified. This functional magnetic resonance imaging experiment examined activity in the STS region as participants viewed actions that were congruent or incongruent with intentions established by a previous emotional context. Participants viewed an actress express either a positive or a negative emotion toward one of two objects and then subsequently pick up one of them. If the object that was picked up had received positive regard, or if the object that was not picked up had received negative regard, the action was congruent; otherwise, the action was incongruent. Activity in the right posterior STS region was sensitive to the congruency between the action and the actress's emotional expression (i.e., STS activity was greater on incongruent than on congruent trials). These findings suggest that the posterior STS represents not only biological motion, but also how another person's motion is related to his or her intentions.     

Causal learning is collaborative: Examining explanation and exploration in social contexts

Causal learning in childhood is a dynamic and collaborative process of explanation and exploration within complex physical and social environments. Understanding how children learn causal knowledge requires examining how they update beliefs about the world given novel information and studying the processes by which children learn in collaboration with caregivers, educators, and peers. The objective of this article is to review evidence for how children learn causal knowledge by explaining and exploring in collaboration with others. We review three examples of causal learning in social contexts, which elucidate how interaction with others influences causal learning. First, we consider children’s explanation-seeking behaviors in the form of “why” questions. Second, we examine parents’ elaboration of meaning about causal relations. Finally, we consider parents’ interactive styles with children during free play, which constrains how children explore. We propose that the best way to understand children’s causal learning in social context is to combine results from laboratory and natural interactive informal learning environments.     

How fantasy benefits young children's understanding of pretense

Sobel and Lillard (2001) demonstrated that 4-year-olds' understanding of the role that the mind plays in pretending improved when children were asked questions in a fantasy context. The present study investigated whether this fantasy effect was motivated by children recognizing that fantasy contains violations of real-world causal structure. In Experiment 1, 4-year-olds were shown a fantasy character engaged in ordinary actions or actions that violated causal knowledge. Children were more likely to say that a troll doll who was acting like but ignorant of the character was not pretending to be that character when read the violation story. Experiment 2 suggested that this difference was not caused by a greater interest in the violation story. Experiment 3 demonstrated a similar difference for characters engaged in social and functional violations that were possible in the real world. These data are consistent with the hypothesis that preschoolers use actions and appearance more than mental states to make judgments about pretense, but that those judgments can be influenced by the context in which the questions are presented.     

Roles of salience and strategy in conjunction search

In some cases, the search for a conjunction target proceeds through the smaller group of elements in a display, whereas in others, search is limited to those elements that share a particular feature with the target. In 6 experiments, participants searched for a conjunction target among displays consisting of various proportions of 2 distractor types. Smaller-group search was more prevalent than target-feature search with denser displays and with features that were highly discriminable. Explicit instructions to limit search to a specific feature affected performance only when the discriminability of the guiding feature was much greater than the other target feature. Together, these experiments show that bottom-up factors have more influence in guiding conjunction searches than previously thought.     

Tell Me a Story: How Children's Developing Domain Knowledge Affects Their Story Construction

Young children distinguish between the physical and biological domains of knowledge. The current study examines how this distinction is expressed in a story construction task. Three- and 4-year-olds were shown pairs of pictures, one that depicted a normal event and one that depicted an event that violated either physical or biological causal structure. Children were asked to choose which picture to include in a story. Three-year-olds generally showed no systematic patterns of responses when constructing their stories. Four-year-olds, in contrast, made more normal than violation choices overall, and their stories were relatively consistent with regard to the fictional world's internal coherence. When 4-year-olds did include violation events in their stories, those violations tended to be of physical rather than biological causality. These data suggest that a general understanding of impossible events is underpinned by causal domain knowledge.     

Children’s causal inferences from indirect evidence: Backwards blocking and Bayesian reasoning in preschoolers

Previous research suggests that children can infer causal relations from patterns of events. However, what appear to be cases of causal inference may simply reduce to children recognizing relevant associations among events, and responding based on those associations. To examine this claim, in Experiments 1 and 2, children were introduced to a “blicket detector,” a machine that lit up and played music when certain objects were placed upon it. Children observed patterns of contingency between objects and the machine’s activation that required them to use indirect evidence to make causal inferences. Critically, associative models either made no predictions, or made incorrect predictions about these inferences. In general, children were able to make these inferences, but some developmental differences between 3- and 4-year-olds were found. We suggest that children’s causal inferences are not based on recognizing associations, but rather that children develop a mechanism for Bayesian structure learning. Experiment 3 explicitly tests a prediction of this account. Children were asked to make an inference about ambiguous data based on the base rate of certain events occurring. Four-year-olds, but not 3-year-olds were able to make this inference.