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.     

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.     

重大传染病感染患者的道德创伤隐患研究

重大传染病疫情背景下,病原体的不断变异、疫苗保护效力的不确定性以及诸多后遗症会导致疫情难以控制,并且造成一个数量极其庞大的特殊弱势群体—感染患者。在感染患者从疑似患病到康复的期间,影响他人工作生活、恶化疫情防控形势、感染他人、亲友的抛弃、传染病污名化、医疗资源分配不均以及社会的歧视与排挤等潜在的道德创伤源会对其内心原本的道德体系产生巨大的冲击,甚至改变其原有的道德认知并击溃其积极的道德情感,从而产生道德创伤。在此基础上,感染患者会因此产生一系列社会问题、信任问题、精神问题、生存问题以及诸多消极观念。

     

Reconsidering the path for neural and physiological methods in consumer psychology

Recent decades have witnessed a burst of neuroscience research investigating mental and physiological processes central to consumer behavior, including sensory perception, memory, and decision making. Nonetheless, few publications that include neural and physiological measures, or develop conceptual frameworks around neuroscience principles, have been published in consumer psychology. It is clear that “consumer neuroscience” has thus far not lived up to its promises in the marketing literature. We suggest three main reasons for this. First, neural and other biological markers are often mistaken to be identical to the overlaying psychological constructs in traditional consumer psychology work. Second, somewhat surprisingly, there has been an overly narrow utilization of neural data. Most previous work focused on linking existing behavioral phenomena or psychological constructs central to consumer research to neural correlates using brain imaging techniques while ignoring other methods. We argue that much can be gained from improved integration of physiological measures and through them, different levels of analysis. Third, there remain significant structural hurdles to the broad adoption of neural and physiological measures for consumer researchers. We outline how addressing these three components can translate to a more holistic understanding of the consumer via both broader and deeper consumer insights.     

Who's afraid of the Wolfe couple: the interlocking traumatic scene

Fulfilling intimate relationships require a constant emotional and psychological struggle to disentangle strangleholds created by the interpenetration of unresolved complexes stemming from previous disappointing relational experiences. These complexes may manifest as an encrypted pattern of engagement that each partner brings to the marriage, like a 'malignant dowry'. The dowry box, once opened, releases its nefarious contents to create an extremely complex and entangled drama I call the 'interlocking traumatic scene'. Partners unconsciously entrap each other to play a part in such a scene with double (sometimes multiple) roles for each antagonist. The imaginal space between the two characters can be seen as a projection screen, upon which are superimposed two separate shadow plays, one on each side of the screen. A third play, which is a co-created product of these two individual traumatic scenes, can also be observed. Three plays are performed simultaneously. The defensive systems that the two individuals bring to the equation dovetail together, but the actual interlocking mechanism itself deadlocks in such a way that it seems to have its own malignant presence, a 'malevolent third' (after Ogden 1994). I outline therapeutic interventions using the metaphor of the therapist as 'anti-director' and I introduce my concept of the conjoint selected fact (after Bion 1963 after Poincaré 1952).     

The Role of Maternal Acceptance in the Relation Between Community Violence Exposure and Child Functioning

Children in the United States are exposed to considerable community violence that has been linked to child functioning. However, not all those exposed, experience negative outcomes. Recent research has focused on factors that “buffer” or protect children from negative consequences of violence exposure. The purpose of this investigation was to examine the potential buffering or moderating role of maternal acceptance in the relationship between community violence exposure and internalizing and externalizing problems. Subjects were 268 urban African American first graders. Community violence exposure was significantly related to symptoms of post-traumatic stress, but did not correlate with either internalizing or externalizing problems for all children, after control for demographics, maternal mental health, and general life stress. However, children's perceptions of maternal acceptance moderated the relationship between violence exposure and internalizing and externalizing problems which included being withdrawn, anxious-depressed, and demonstrating delinquent behavior. Children with the lowest levels of self-reported maternal acceptance were most impacted by community violence. In this sample of urban first graders, low levels of maternal acceptance placed children at greater risk for adverse outcomes associated with community violence exposure compared to moderate and high levels of maternal acceptance.     

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.     

Modeling and estimating recall processing capacity: Sensitivity and diagnostic utility in application to mild cognitive impairment

We investigate the potential for using latency-based measures of retrieval processing capacity to assess changes in performance specific to individuals with mild cognitive impairment (MCI), a reliable precursor state to Alzheimer’s Disease. Use of these capacity measures is motivated in part by exploration of the effects of atrophy on a computational model of a basic hippocampal circuit. We use this model to suggest that capacity may be a more sensitive indicator of the underlying atrophy than speed of processing, and test this hypothesis by adapting a standard behavioral measure of memory (the free and cued selective reminding test, FCSRT) to allow for the collection of cued recall latencies. Participants were drawn from five groups: college-aged, middle-aged, healthy elderly, those with a diagnosis of MCI, and a sample of MCI control participants. The measure of capacity is shown to offer increased classificatory sensitivity relative to the standard behavioral measures, and is also shown to be the behavioral measure that correlated most strongly with hippocampal volume.