The triumph of American psychiatry: How it created the modern therapeutic state

Over the past 170 years, American psychiatry has progressively asserted its authority over a larger segment of the American population. From the mid-1800s to the end of World War II, psychiatry had authority over the asylum population, which markedly increased in the first half of the twentieth century due to the influence of eugenics, an ideology that argued the ‘mentally ill’ had to be segregated from society. After the war, American psychiatry adopted Freudian conceptions of mental disorders, which enabled it to begin treating people in the community who were ‘neurotic’ in some way, which dramatically expanded its influence in society. Then, in the 1970s, when many in American society were questioning psychiatry’s legitimacy as a branch of medicine, the American Psychiatric Association (APA) responded by adopting a disease model for diagnosing mental disorders, which it set forth in the third edition of its Diagnostic and Statistical Manual. There were no scientific discoveries that led to this new model, but soon the APA was informing the American public that mental disorders were diseases of the brain, and that psychiatric drugs helped fix those diseases, ‘like insulin for diabetes.’ The APA, in concert with pharmaceutical companies, has successfully exported this belief system to much of the developed world. In order to break free of this ‘therapeutic state,’ the public needs to understand the history of how it came to be, and see the social injury it has caused.     

Dev E-R: A computational model of early cognitive development as a creative process

This paper describes a computational model named Dev E-R (Developmental Engagement-Reflection) that, inspired by Piaget’s theory, simulates the assimilation-accommodation adaptation process. It is implemented with a new extended version of the computational model of creativity known as Engagement-Reflection. That is, this model simulates adaptation as a creative activity. We introduce here the implementation of our model on an agent that is initialized with basic reflex conducts and that through the interaction with a 3D virtual world, it is able to build new behaviors autonomously. The new acquired skills, according to Piaget’s theory, are typically observed in children that have reached the second substage of the sensorimotor period.     

Alterations in stride-to-stride variability during walking in individuals with chronic ankle instability

The aim of this study was to evaluate stride-to-stride variability of the lower extremity during walking in individuals with and without chronic ankle instability (CAI) using a nonlinear analysis. Twenty-five participants with self-reported CAI and 27 healthy control participants volunteered for this study. Participants walked on a motor-driven treadmill for 3 min at their selected speed. Lower extremity kinematics in the sagittal and frontal planes were recorded using a passive retroreflective marker motion capture system. The temporal structure of walking variability was analyzed with sample entropy (SampEn). The CAI group produced lower SampEn values in frontal-plane ankle kinematics compared to the control group (P = .04). No significant group differences were observed for SampEn values of other kinematics (P > .05). Participants with CAI demonstrated less stride-to-stride variability of the frontal plane ankle kinematics compared to healthy controls. Decreased variability of walking patterns demonstrated by participants with CAI indicates that the presence of CAI may be associated with a less adaptable sensorimotor system to environmental changes. The altered sensorimotor function associated with CAI may be targets for clinical interventions, and it is critical to explore how interventions protocols affect sensorimotor system function.     

Latent class analysis of anxiety and depressive symptoms of the Youth Self-Report in a general population sample of young adolescents

This study examined whether distinct groups of young adolescents with mainly anxiety or mainly depression could be identified in a general population sample. Latent class analysis was used on self-report ratings of DSM-IV symptoms of anxiety and depressive disorders, because it was hypothesized that these ratings provide a bigger chance to identify distinct groups than parent ratings of symptoms that are poorly associated with DSM-IV. Results from exploratory and confirmatory latent class analysis showed that only very small numbers of young adolescents had mainly anxiety or mainly depressive symptoms. Instead, a five-group model fitted the data best. These five groups contained young adolescents who either had a high, intermediate, or low probability to have comorbid symptoms of anxiety and depression. It was concluded that symptoms of DSM-IV anxiety and depressive disorders co-occur in young adolescents, and that latent class analysis on items that capture also severe symptoms like suicidal thoughts are needed to derive groups with specific comorbidity patterns in a general population sample.     

A cognitive behavioral workshop for subclinical obsessions and compulsions

The present study investigates the effectiveness of a 3-h cognitive behavioral workshop for individuals, ages 18-22, with subclinical obsessions and compulsions. It was hypothesized that, compared to individuals in an assessment-only waitlist group (n = 42), individuals assigned to the workshop group (n = 43) would experience a significant decrease in obsessive-compulsive (OC) symptomatology, comorbidity, and thought action fusion endorsement at 1-month and 5-month follow-up assessments. An additional outcome of interest was the number of incident cases of obsessive-compulsive disorder (OCD) over the course of the study. The results indicated that the workshop group reported a significantly fewer number of OC symptoms at 5-month follow-up and endorsed significantly less thought action fusion at both follow-up points. However, there were no differences between groups in severity of OC symptoms and number of comorbid diagnoses endorsed. Only one incident case of OCD was observed during the study, from a participant in the waitlist group. These results are discussed in reference to treatment of subclinical anxiety symptoms.     

Comparison of brain mechanisms underlying the processing of Chinese characters and pseudo-characters: an event-related potential study

Most Chinese characters are composed of a semantic radical on the left and a phonetic radical on the right. The semantic radical provides the semantic information; the phonetic radical provides information concerning the pronunciation of the whole character. The pseudo‐characters in the study consisted of different sub‐lexical parts of real Chinese characters and consequently they also had the semantic radical and the phonetic radical. But they were not readable and had no actual meaning. In order to investigate the spatiotemporal cortical activation patterns underlying the orthographic, phonological and semantic processing of Chinese characters, we used event‐related brain potentials (ERPs) to explore the processing of Chinese characters and pseudo‐characters when 14 healthy Chinese college students viewed the characters passively. Results showed that both Chinese characters and pseudo‐characters elicited an evident negative potential peaking around 120 ms (N120), which appeared to reflect initial orthographic distinction and evaluation. Then, Chinese pseudo‐characters elicited a more positive ERP deflection (P220) than did Chinese characters 200–250 ms after onset of the stimuli. It was similar to the recognition potential (RP) and might reflect the integration processes of phonological and semantic processing on the basis of early orthographic information. Dipole source analysis of the difference wave (pseudo‐characters minus characters) indicated that a generator localized in the left temporal‐occipital junction contributed to this effect, which was possibly related to phonological and perceptual–semantic information integration. Between 350–450 ms, a greater negativity (N360) in pseudo‐characters as compared to characters was found over midline fronto‐central scalp regions. Dipole analysis localized the generator of N360 in the right parahippocampal cortex. Therefore, the N360 might be an N400 component and reflect the higher‐level semantic activation on the basis of orthographic, phonological and perceptual–semantic processing.     

Using cumulative-recall curves to assess the extent of relational and item-specific processing

Although distinguishing between item-specific and relational information has proved to be a useful approach for understanding a variety of important memory phenomena, finding measurement tools for assessing the amount and type of information processed has proven difficult. Using the repeated-testing procedure, Burns (1993) demonstrated that item gains (the recall of items on a later test that were not recalled on earlier tests) and item losses (the forgetting of items on a later test that were recalled on earlier tests) reflected differences in amount of item-specific and relational information processed, respectively. Although several researchers have begun to use the measures with apparent success, the present research demonstrates that the accuracy of the item-gain measure is largely dependent on the rather arbitrary choice of recall-test length. We also show that a related but alternative measure, analysis of cumulative-recall curves, avoids some of the shortcomings of the item gain and loss measures. Moreover, we provide evidence for the generality of the cumulative-recall approach by demonstrating its effectiveness in mixed-list designs.     

Why they reminisce: Caregiver reports of the functions of joint reminiscence in early childhood

Theorists have long suggested that joint caregiver–child reminiscence is functional, in that it is useful, adaptive, and can be utilised to achieve a variety of goals in everyday life. In the present study we investigated caregiver reports of the functions of joint reminiscence across early childhood. Participants were 203 parents or other guardians of 2–6-year-old children. Caregivers completed the Caregiver–child Reminiscence Scale (CRS) designed to tap functions of joint reminiscence. Our results indicated that caregivers reported frequently talking about past experiences with their children. Exploratory factor analysis revealed seven functions of joint reminiscence: Emotion Regulation, Directive, Positive Emotionality, Individual Self in Relation to Others, Conversation, Cognitive Skills, and Peer Relationships. Although some of these functions map directly onto adult-like functions outlined in the theoretical literature, others are unique to the context of joint reminiscence and reflect developmental goals of the early childhood period.