Effects of diagnostic classification systems on clinical hypothesis-generation

In this study it was determined whether (a) classification as opposed to absence of classification has an effect on the quality of clinical hypotheses (b) the DSM-III-R and the CBCL have a different effect on the quality of clinical hypotheses, and (c) the potential difference between the DSM-III-R and the CBCL is moderated by the different number of syndromes identified by these systems. To investigate these questions, an experiment was conducted in which 86 clinicians generated hypotheses for six cases. The clinicians were divided into a DSM-III-R, a CBCL, and a control group. Of the six cases, two were classified by both classification systems as one syndrome, two were classified as one syndrome by the DSM-III-R but as two syndromes by the CBCL, and two were classified as two syndromes by the DSM-III-R but as one syndrome by the CBCL. The quality of the hypotheses was determined by means of four dependent variables selected from an overview of qualitative criteria: explanatory value, redundancy, possibility of operationalization, and specificity. No differences between the CBCL and the control groups were found. The DSM group performed better than the control group regarding explanatory value and redundancy. The DSM-III-R group also scored better than the CBCL group regarding explanatory value, particularly when the number of identified syndromes was two for the CBCL and one for the DSM-III-R.     

Consider the source: One step in assessing premise acceptability

Premise acceptability is conceptually connected to presumption. To say that a premise is acceptable just when there is a presumption in its favor is to give a first approximation to this connection. A number of popular principles of presumption suggest that whether there is a presumption for a premise, belief, or claim depends on the sources which vouch for it. Sources consist of internal belief-generating mechanisms and external testimony. Alvin Plantinga's notion of warrant lays down four conditions upon a source for the belief which it generates to be warranted. We argue that there is a presumption for a premise, belief, or claim if and only if there is a presumption of warrant for that premise,belief or claim. This amounts to the thesis that there is a presumption for a belief from a challenger's point of view if and only if there is a presumption from that person's point of view that her cognitive faculties which have generated the belief have been functioning properly, in an appropriate cognitive environment, in accord with a segment of her design plan aimed at the truth, and that these faculties are reliable. In light of our argument for this thesis, we may legitimately claim that one way to determine that there is a presumption for a belief is to determine that there is a presumption of warrant for that belief, and thus that in determining whether there is a presumption for a belief or premise, we may consider the source.     

Competing interests: The need to control conflict of interests in biomedical research

Individual and institutional conflict of interests in biomedical research have becomes matters of increasing concern in recent years. In the United States, the growth in relationships — sponsored research agreements, consultancies, memberships on boards, licensing agreements, and equity ownership — between for-profit corporations and research universities and their scientists has made the problem of conflicts, particularly financial conflicts, more acute. Conflicts can interfere with or compromise important principles and obligations of researchers and their institutions, e.g., adherence to accepted research norms, duty of care to patients, and open exchange of information. Disclosure is a key component of a successful conflict policy. Commitments which conflict with a faculty member's primary obligations to teaching, research, administrative responsibilities, or patient care also need attention. Institutional conflict of interests present different problems, some of which are discussed in an analysis of an actual problem posed by two proposed clinical trials. This paper is adapted from a lecture presented to a Symposium on Scientific Integrity, Warsaw, Poland, 23 November 1995. Daniel Steiner was Vice-President and General Counsel of Harvard University (1972–92) and in that capacity became familiar with conflict of interest issues. He is currently Counsel to the Boston law firm. Ropes and Gray, and is Adjunct Lecturer in Public Policy at the John F. Kennedy School of Government. Harvard University.     

中国传统情绪疗法及其应用

系统地探讨了中国传统情绪疗法：情志相胜疗法,相反情绪疗法,激情刺激疗法,与感觉刺激有关的情绪疗法,与别人有关的情绪疗法,顺情从欲疗法,抑情顺理疗法,移情易性疗法,情志导引疗法,七情合参疗法。这些中国传统心理疗法在现代仍有实用价值。     

A case study of conflicting interests: Flemish engineers involved in environmental impact assessment

This article reports of the activities of the working group, Ethics & Engineers, of the Royal Flemish Society of Engineers. More particularly, the ethical problems that engineers face in the preparation of an environmental report are illuminated. Irrespective to which party the engineer belongs, he or she is confronted with the difficult weighting of his or her personal interest, the interests of private companies and last but not least the common good. It is argued that the implementation of a code of ethics and the introduction of courses on engineering ethics into the education of engineers would strengthen the engineer in the fulfilment of his vocation. Dirk Holemans is a bio-engineer preparing a doctoral thesis on the social responsibility of engineers, Herman Lodewyckx teaches ethics and has research interests in professional and applied ethics.     

Social desirability,perceived stress,and PACT ratings in lung transplant candidates: A preliminary investigation

Some aspect of psychosocial criteria is commonly utilized by most transplant programs in assessing candidates' acceptability for transplantation. However, regardless of the assessment methodology, information obtained in pretransplant assessments may be limited given the evaluative nature of the assessment as well as the sensitive nature of the contents. Indeed, transplant candidates may present themselves in a favorable fashion, minimizing any negative traits or psychological dysfunction which they perceive might prevent transplantation. Unfortunately, there are limited data addressing the extent to which transplant candidates may present themselves in an overly positive light. This investigation surveys the prevalence of social desirability in lung transplant candidates as well as its association with self-reports of perceived stress. Further, the relationship between social desirability and interviewer ratings of transplant candidacy is examined. Subjects included 24 patients in end-stage organ failure being evaluated for lung transplant candidacy. Subjects completed the Perceived Stress Scale and a brief version of the Marlowe-Crowne Social Desirability Scale. Additionally, subjects were interviewer-rated on the Psychosocial Assessment of Candidates for Transplantation. Results indicate social desirability is a prevalent phenomenon in lung transplant candidates, with more than half of the sample scoring at or above the 84th percentile on the social desirability measure. Further, self-reports of perceived stress are moderately and inversely associated with social desirability (r=–.55,p .01). Social desirability was unrelated to interviewer-ratings of transplant candidates acceptability (r=.13,p .56). Future research might include larger samples of subjects, other organ transplant candidates, and more detailed assessments of symptom distress.     

Freud's early metaphors and network of enterprise: Insight into a journey of scientific self-discovery

This paper examines Freud's evolving network of enterprise from 1876 to 1900 and the ensemble of metaphors which he used in the development of his theory (1888–1900). It will be shown that, in spite of Freud's obligatory change of career at age 26, there is no sharp break between Freud's early scientific work and his psychological research. Many signs of continuity between the two periods can be found. Freud's journey of scientific self-discovery only progressively led him to the frontiers of the unknown and his ultimate challenge: exploring the secrets of sexuality. Freud's avowed commitment to the study of the unconscious may have happened as late as 1899 as his metaphors celebrate an intimate fusion between the creator and his creation.     

Matching adolescents with foster mothers and fathers: An evaluation of the role of temperament

We tested the notion that better foster care adjustment would be observed when the temperaments of mothers and fathers were matched with those of adolescent foster children. We hypothesized that families in which foster parents and foster children had high (easy) scores on subscales of the Revised Dimensions of Temperament Scale (DOTS-R) would also report higher family functioning and higher foster care adjustment than parents and children from families in which one or both family members had low (difficult) scores on these scales. The hypotheses were supported when the mothers and fathers family assessments were used but rejected when the observations of the case managers and adolescents were tested. Methodological and substantive explanations for the findings are discussed and recommendation for foster care practice and continuing research are provided.     

The effects of situational performance constraints on intrinsic motivation and satisfaction: The role of perceived competence and self-determination

Situational performance constraints, task interest, and pay contingencies were manipulated in a laboratory study in order to investigate the cognitive mechanisms associated with the previously observed detrimental effects of constraints on affective task reactions. It was hypothesized that feelings of task competence and self-determination would account for both the direct and the interactive effects of constraints on motivation and satisfaction. The results of the study indicated that despite the fact that participants' performance was being constrained and they were aware of these constraints, the mere presence of the constraints alone failed to result in lower levels of satisfaction or motivation on a proofreading task. Post hoc analyses suggested that the constraints, in fact, led to negative affective task reactions when they also reduced participants' feelings of competence and self-determination. Interestingly, participants' generalized locus of control was associated with such effects. Internals tended to maintain stronger feelings of competence and self-determination than externals in the presence of constraints, thereby also maintaining greater motivation and satisfaction.     

A signal detection framework for the evaluation of probabilistic forecasts

In this paper I formulate an approach for evaluating probabilistic forecasts in terms of signal detection theory. Signal detection theory provides a powerful perspective for this type of problem, and a rich empirical background including methodological tools as well as an extensive body of research in many domains. I propose procedures which emphasize the maximization of expected utility for the decision maker who uses the forecasts. Further, I suggest approaches to obtaining indices of calibration and resolution within this framework. I also present arguments that the proposed indices will exhibit the same basic properties as do decompositions of Brier's (1950, Monthly Weather Review, 78, 1–3) mean probability score. However, the properties may be reflected in different ways, and hence, the present methods may lead to different conclusions about forecasting ability. Finally, I argue that the use of an expected utility loss function makes this approach more appropriate for practical applications as well as for theoretical research than other procedures with more arbitrary loss functions.