Should DBS for Psychiatric Disorders be Considered a Form of Psychosurgery? Ethical and Legal Considerations

Deep brain stimulation (DBS), a surgical procedure involving the implantation of electrodes in the brain, has rekindled the medical community’s interest in psychosurgery. Whereas many researchers argue DBS is substantially different from psychosurgery, we argue psychiatric DBS—though a much more precise and refined treatment than its predecessors—is nevertheless a form of psychosurgery, which raises both old and new ethical and legal concerns that have not been given proper attention. Learning from the ethical and regulatory failures of older forms of psychosurgery can help shed light on how to address the regulatory gaps that exist currently in DBS research. To show why it is important to address the current regulatory gaps within psychiatric DBS, we draw on the motivations underlying the regulation of earlier forms of psychosurgery in the US. We begin by providing a brief history of psychosurgery and electrical brain stimulation in the US. Against this backdrop, we introduce psychiatric DBS, exploring current research and ongoing clinical trials. We then draw out the ethical and regulatory similarities between earlier forms of psychosurgery and psychiatric DBS. As we will show, the factors that motivated strict regulation of earlier psychosurgical procedures mirror concerns with psychiatric DBS today. We offer three recommendations for psychiatric DBS regulation, which echo earlier motivations for regulating psychosurgery, along with new considerations that reflect the novel technologies used in DBS.     

Risky prospects and risk aversion tendencies: does competition in the classroom depend on grading practices and knowledge of peer-status?

When students are faced with the decision of whether to assist a peer, they should be sensitive to the potential risks associated with doing so. Two factors associated with risky helping behaviour in the classroom are: (1) the grading practices that are used, and (2) knowledge of a peer’s relative status. Normative (“curved”) grading creates a situation in which peer-interactions are potentially competitive, but it is only those interactions with peers of a similar status that carry the potential for assistance to be costly to oneself. In two studies, we created hypothetical scenarios in which the grading practices (normative or absolute) and peer-status proximity (proximate, distant, or unknown) were manipulated, and asked participants to report their willingness to cooperate with a peer by sharing their notes from an important lecture. We found that when normative grading was used, individuals were less willing to assist a peer when they knew that the peer’s status was proximate to their own. There was also less cooperation when peer status was unknown, under normative grading, which is consistent with a risk-aversion tendency.     

Personality Assessment: A Competency–Capability Perspective

This article begins by reviewing the proficiency of personality assessment in the context of the competencies movement, which has dominated health service psychology in recent years. It examines the value of including a capability framework for advancing this proficiency and enhancing the quality of personality assessments, including Therapeutic Assessment (Finn &; Tonsager, 1997 Finn, S. E., &; Tonsager, M. E. (1997). Information-gathering and therapeutic models of assessment: Complementary paradigms. Psychological Assessment, 9, 374–385. doi:10.1037//1040-3590.9.4.374[Crossref], [Web of Science ®] , [Google Scholar]), that include a personality assessment component. This hybrid competency–capability framework is used to set the stage for the conduct of personality assessments in a variety of contexts and for the optimal training of personality assessment. Future directions are offered in terms of ways psychologists can strengthen their social contract with the public and offer a broader array of personality assessments in more diverse contexts and by individuals who are both competent and capable.     

High self‐monitors modulate their responses as a function of relevant social roles

We reasoned that high self‐monitors' responses may be influenced by the characteristic traits and behaviors associated with social roles. Results across four studies confirmed expectations. The findings from Experiments 1, 2, and 3 demonstrated that exposure to a particular role (e.g., nurse) led high self‐monitors to respond in a manner consistent with the relevant role. Results from Experiment 4 showed that the effect found in the first three experiments was attenuated when the behavioral guidance of the particular role was reduced. Low self‐monitors' responses were not influenced by exposure to the role. Showing that high self‐monitors use information embedded in a social role to tailor their behavior provides a novel finding that has heretofore been absent from the literature.     

Asymmetric cultural effects on perceptual expertise underlie an own-race bias for voices

The own-race bias in memory for faces has been a rich source of empirical work on the mechanisms of person perception. This effect is thought to arise because the face-perception system differentially encodes the relevant structural dimensions of features and their configuration based on experiences with different groups of faces. However, the effects of sociocultural experiences on person perception abilities in other identity-conveying modalities like audition have not been explored. Investigating an own-race bias in the auditory domain provides a unique opportunity for studying whether person identification is a modality-independent construct and how it is sensitive to asymmetric cultural experiences. Here we show that an own-race bias in talker identification arises from asymmetric experience with different spoken dialects. When listeners categorized voices by race (White or Black), a subset of the Black voices were categorized as sounding White, while the opposite case was unattested. Acoustic analyses indicated listeners’ perceptions about race were consistent with differences in specific phonetic and phonological features. In a subsequent person-identification experiment, the Black voices initially categorized as sounding White elicited an own-race bias from White listeners, but not from Black listeners. These effects are inconsistent with person-perception models that strictly analogize faces and voices based on recognition from only structural features. Our results demonstrate that asymmetric exposure to spoken dialect, independent from talkers’ physical characteristics, affects auditory perceptual expertise for talker identification. Person perception thus additionally relies on socioculturally-acquired dynamic information, which may be represented by different mechanisms in different sensory modalities.     

Bifactor models and rotations: exploring the extent to which multidimensional data yield univocal scale scores

The application of psychological measures often results in item response data that arguably are consistent with both unidimensional (a single common factor) and multidimensional latent structures (typically caused by parcels of items that tap similar content domains). As such, structural ambiguity leads to seemingly endless "confirmatory" factor analytic studies in which the research question is whether scale scores can be interpreted as reflecting variation on a single trait. An alternative to the more commonly observed unidimensional, correlated traits, or second-order representations of a measure's latent structure is a bifactor model. Bifactor structures, however, are not well understood in the personality assessment community and thus rarely are applied. To address this, herein we (a) describe issues that arise in conceptualizing and modeling multidimensionality, (b) describe exploratory (including Schmid-Leiman [Schmid & Leiman, 1957] and target bifactor rotations) and confirmatory bifactor modeling, (c) differentiate between bifactor and second-order models, and (d) suggest contexts where bifactor analysis is particularly valuable (e.g., for evaluating the plausibility of subscales, determining the extent to which scores reflect a single variable even when the data are multidimensional, and evaluating the feasibility of applying a unidimensional item response theory (IRT) measurement model). We emphasize that the determination of dimensionality is a related but distinct question from either determining the extent to which scores reflect a single individual difference variable or determining the effect of multidimensionality on IRT item parameter estimates. Indeed, we suggest that in many contexts, multidimensional data can yield interpretable scale scores and be appropriately fitted to unidimensional IRT models.     

Why Leibniz thinks Descartes was wrong and the Scholastics were right

The bundle theory is a theory about the internal constitution of individuals. It asserts that individuals are entirely composed of universals. Typically, bundle theorists augment their theory with a constitutional approach to individuation entailing the thesis ‘identity of constituents is a sufficient ground for numerical identity’ (CIT). But then the bundle theory runs afoul of Black’s duplication case—a world containing two indiscernible spheres. Here I propose and defend a new version of the bundle theory that denies ‘CIT’, and which instead conjoins it with a structural diversity thesis, according to which being separated by distance is a sufficient ground for numerical diversity. This version accommodates Black’s world as well as the three-spheres world—a world containing three indiscernible spheres, arranged as the vertices of an equilateral triangle. In this paper, I also criticize Rodriguez-Pereyra’s alternative attempt to defend the bundle theory against Black’s case and the case of the three-spheres world.