The Role of Temperament in the Etiology of Child Psychopathology

A substantial proportion of children and adolescents come to suffer from psychological disorders. This article focuses on the temperament factors that are involved in the pathogenesis of child psychopathology. It is argued that besides the reactive temperament factor of emotionality/neuroticism, the regulative process of effortful control also plays an important role in the etiology and maintenance of internalizing and externalizing problems in youths. More specifically, vulnerability to child psychopathology is determined by a temperament that is characterized by high levels of emotionality/neuroticism and low levels of effortful control. Models are hypothesized in which reactive and regulative temperament factors either have interactive or additive effects on the development of psychological disorders in children, and conceptualized in terms of a developmental psychopathology perspective. Directions for future research and clinical implications of this temperamental view on psychopathology are discussed.     

A call to restructure the drug development process: Government over-regulation and non-innovative late stage (Phase III) clinical trials are major obstacles to advances in health care

The history of drug/vaccine development has included major advances guided primarily by risk/benefit analyses concerning the innovative agent, not by evidence-based clinical trials (Phase I–IV). Because the approval for new drugs is hindered under the present process, the system requires restructuring. The Phase I/II study period should be more flexible, using the “environment of knowledge” about the new agent, plus risk/benefit assessments. Phase III, as presently constructed, does not add new adverse events data, it provides a narrower profile of drug efficacy than properly done Phase II studies, and placebo-controlled trials continue to raise unresolved ethical and social issues. Phase III studies should be abandoned for most drugs, and substituted with properly powered Phase II doseranging studies plus careful post-marketing surveillance. Phase III should be a penalty for poor drug development, not a regulatory requirement. To accomplish efficient drug development, greater cooperation between pharmaceutical companies and governments in developing clinical trials is needed rather than over-regulation. These changes will synchronize the drug development and regulatory process with the current rapid drug discovery process, reduce drug development time and cost, and improve patient care. The author is Adjunct Professor of Medicine, Weill Medical College of Cornell University, New York, New York, USA.     

Cognitive-behavioural interventions in a patient with an anxiety disorder related to diabetes

This study extends the data on the efficacy of cognitive interventions for patients with chronic medical problems and describes the case of a 37-year-old woman with an anxiety disorder related to diabetes. The effects on panic frequency, use of safety behaviour and related beliefs were investigated after the introduction of two main cognitive-behavioral interventions. The results are consistent with predictions from the cognitive model of panic. This case demonstrates the usefulness of directly challenging the 'meaning' of the feared situation in order to produce clinically significant improvements in the management of physical disease.     

Cognitive defusion and self-relevant negative thoughts: examining the impact of a ninety year old technique

Cognitive defusion techniques are designed to reduce the functions of thoughts by altering the context in which they occur, rather than the attempting to alter the form, frequency, or situational sensitivity of the thoughts themselves. Applied technologies designed to produce cognitive defusion seem to lead to reductions in the believability of negative thoughts, but defusion techniques are generally only parts of complex packages and the role of defusion techniques per se is note yet known. The present study examined the impact of a cognitive defusion technique first described by Titchener nearly 90 years ago: rapidly repeating a single word. In series of eight single-case alternating treatment designs, this defusion technique was compared to a distraction task, and to a thought control task on reductions in the discomfort and believability of self-relevant negative thoughts. The cognitive defusion technique reduced both discomfort and believability more so than the comparison approaches. Control studies showed that the effect was probably not due to demand characteristics.     

Knowing the limits of one's understanding: the development of an awareness of an illusion of explanatory depth

Adults overestimate the detail and depth of their explanatory knowledge, but through providing explanations they recognize their initial illusion of understanding. By contrast, they are much more accurate in making self-assessments for other kinds of knowledge, such as for procedures, narratives, and facts. Two studies examined this illusion of explanatory depth with 48 children each in grades K, 2, and 4, and also explored adults' ratings of the children's explanations. Children judged their understanding of mechanical devices (Study 1) and procedures (Study 2). Second and fourth graders showed a clear illusion of explanatory depth for devices, recognizing the inaccuracy of their initial impressions after providing explanations. The illusion did not occur for knowledge of procedures.     

Algebras of Intervals and a Logic of Conditional Assertions

Intervals in boolean algebras enter into the study of conditional assertions (or events) in two ways: directly, either from intuitive arguments or from Goodman, Nguyen and Walker's representation theorem, as suitable mathematical entities to bear conditional probabilities, or indirectly, via a representation theorem for the family of algebras associated with de Finetti's three-valued logic of conditional assertions/events. Further representation theorems forge a connection with rough sets. The representation theorems and an equivalent of the boolean prime ideal theorem yield an algebraic completeness theorem for the three-valued logic. This in turn leads to a Henkin-style completeness theorem. Adequacy with respect to a family of Kripke models for de Finetti's logic, ukasiewicz's three-valued logic and Priest's Logic of Paradox is demonstrated. The extension to first-order yields a short proof of adequacy for Körner's logic of inexact predicates.     

On Modal μ-Calculus and Non-Well-Founded Set Theory

A finitary characterization for non-well-founded sets with finite transitive closure is established in terms of a greatest fixpoint formula of the modal -calculus. This generalizes the standard result in the literature where a finitary modal characterization is provided only for wellfounded sets with finite transitive closure. The proof relies on the concept of automaton, leading then to new interlinks between automata theory and non-well-founded sets.     

The Suspended Aesthetic: Slavoj Žižek on Eastern European Film

Slavoj iek's writings on Krzysztof Kies´lowski and Andrej Tarkovskij represent direct challenges to the Central and Eastern European tradition of spiritual art and to dominant aesthetic concepts as such. He refuses to separate the solemn films of Kies´lowski and Tarkovskij from popular culture and stresses their import as ethical statements by their directors. Despite this ethical emphasis, iek makes an important contribution to philosophical aesthetics. He implicitly defines art as a suspension of reality which reveals time in its fragility and potentiality. Defining iek's aesthetics in terms of suspension helps to explain his partiality for Kies´lowski and Tarkovskij and bears comparison to the Russian tradition of philosophical aesthetics, in particular Aleksej Losev and Alexander Bakshy.     

Framing social information and generalized social phobia

Patients with generalized social phobia (GSP, N=33) and matched community controls (N=31) engaged in a social interaction that was constructed to go well, and then received feedback that framed social cues reflecting either the absence of negative outcomes or the presence of positive outcomes. Following feedback that framed positive social cues, the GSP group predicted they would experience more anxiety in a subsequent interaction than did non-phobic controls. In contrast, following feedback framing the absence of negative outcomes, the GSP group did not differ from controls in their anxiety predictions. The results demonstrated that framing paradigms and methods can be usefully applied to the study of cognitive processes in social phobia and indicated that research to examine how GSP patients process specific types of social information is needed.