A placebo-controlled randomized trial of D-cycloserine augmentation of cue exposure therapy for smoking cessation

Recent studies underscore the importance of studying d-cycloserine (DCS) augmentation under conditions of adequate cue exposure treatment (CET) and protection from reconditioning experiences. In this randomized trial, we evaluated the efficacy of DCS for augmenting CET for smoking cessation under these conditions.

Sixty-two smokers attained at least 18 hours abstinence following 4 weeks of smoking cessation treatment and were randomly assigned to receive a single dose of DCS (n=30) or placebo (n=32) prior to each of two sessions of CET. Mechanistic outcomes were self-reported cravings and physiologic reactivity to smoking cues. The primary clinical outcome was 6-week, biochemically-verified, continuous tobacco abstinence.

DCS, relative to placebo, augmentation of CET resulted in lower self-reported craving to smoking pictorial and in vivo cues (d = 0.8 to 1.21) in a relevant subsample of participants who were reactive to cues and free from smoking-related reconditioning experiences. Select craving outcomes were correlated with smoking abstinence, and DCS augmentation was associated with a trend toward a higher continuous abstinence rate (33% vs. 13% for placebo augmentation).

DCS augmentation of CET can significantly reduce cue-induced craving, supporting the therapeutic potential of DCS augmentation when applied under appropriate conditions for adequate extinction learning.     

Personal Sovereignty and Our Moral Rights to Non‐Interference

In this article, I defend the inviolability approach to solving the paradox of deontology against a criticism raised by Michael Otsuka. The paradox of deontology revolves around the question whether it should always be permissible to infringe someone's right to non‐interference when this would serve to minimize the overall number of comparable rights infringements that occur. According to the inviolability approach, rights to non‐interference protect and give expression to our personal sovereignty, which is not advanced through the minimization of rights infringements. This seems to dissolve the paradox. Otsuka, however, contends that the proposed solution relies on too narrow an understanding of personal sovereignty. He argues that there is an enforceability dimension to personal sovereignty that would seem to undermine the inviolability approach. While I agree with Otsuka that enforceability is an important aspect of personal sovereignty, I argue that properly construed, the enforceability dimension of personal sovereignty does not undermine the inviolability approach.     

The presence of the absence in Kjell Westö’s novel: “Hägring 38”

ABSTRACT

The word ‘hägring’ (in English. ‘mirage’) can be understood in different ways: as an unrealistic hope or wish that cannot be achieved (wishful thinking); as an image in a mirror of something that is not there, but in another place, and as a sign of something that has not yet become visible, for instance, the first rays of sunlight on the horizon before the sun has risen. These meanings represent different ways in which presence and absence interplay, and are all illustrated in Kjell Westö’s impressive novel from 2013 for which he received the Nordic Literature Prize in 2014.

The action of the novel takes place during eight months in Helsinki from March to November 1938 and unravels how the past and present are woven together on a historical, societal and individual level. The present article will try to illustrate this.