Thoughts and feelings and things: A new psychiatric epistemology

Epistemology — the study of knowledge — is a philosophical discipline with close ties to psychiatry. When epistemologists address specific questions about how knowledge is actually realized by human beings, their philosophy must be informed by empirical studies of the sort psychiatrists now take up in a variety of forms. As this paper describes, psychiatrists can likewise improve their understanding of human psychology through a deeper appreciation of philosophical analysis in epistemology.The aim of this article is to introduce a unifying framework within which the experience from different approaches to psychiatry — (1) the conceptual schemas of cognitive psychiatry, (2) the mental structures of psychoanalytic psychiatry, (3) the categorical forms of existential psychiatry, and (4) the neural pathways of biological psychiatry — can all be applied productively to the central question of epistemology. By establishing a broad understanding of the problem of knowledge, this new view of epistemology is developed within the idiom of each psychiatric approach. In addressing themselves to a unitary problem, these diverse psychiatric approaches are themselves revealed, not as competing points of view, but as complementary views of a single subject. The result is a new epistemology that can not only bring the insights of psychiatry to philosophy, but can also contribute to the care of patients when psychiatrists bring this broader view to their clinical work.     

A study of the foundations of ethical decision making of clinical medical ethicists

A study of clinical medical ethicists was conducted to determine the various philosophical positions they hold with respect to ethical decision making in medicine and their various positions' relationship to the subjective-objective controversy in value theory. The study consisted of analyzing and interpreting data gathered from questionnaires from 52 clinical medical ethicists at 28 major health care centers in the United States. The study revealed that most clinical medical ethicists tend to be objectivists in value theory, i.e., believe that value judgments are knowledge claims capable of being true or false and therefore expressions of moral requirements and normative imperatives emanating from an external value structure or moral order in the world. In addition, the study revealed that most clinical medical ethicists are consistent in the philosophical foundations of their ethical decision making, i.e., in decision making regarding values they tend not to hold beliefs which are incompatible with other beliefs they hold about values.     

THE “WHERE IS IT?” REFLEX: AUTOSHAPING THE ORIENTING RESPONSE

The goal of this review is to compare two divergent lines of research on signal-centered behavior: the orienting reflex (OR) and autoshaping. A review of conditioning experiments in animals and humans suggests that the novelty hypothesis of the OR is no longer tenable. Only stimuli that represent biological “relevance” elicit ORs. A stimulus may be relevant a priori (i.e., unconditioned) or as a result of conditioning. Exposure to a conditioned stimulus (CS) that predicts a positive reinforcer causes the animal to orient to it throughout conditioning. Within the CS-US interval, the initial CS-directed orienting response is followed by US-directed tendencies. Experimental evidence is shown that the development and maintenance of the conditioned OR occur in a similar fashion both in response-independent (classical) and response-dependent (instrumental) paradigms. It is proposed that the conditioned OR and the signal-directed autoshaped response are identical. Signals predicting aversive events repel the subject from the source of the CS. It is suggested that the function of the CS is not only to signal the probability of US occurrence, but also to serve as a spatial cue to guide the animal in the environment.     

The second offspring of General Process Learning Theory: Overt behavior as the ambassador of the mind

Wasserman suggested in a recent book review that the study of intervening cognitive processes represents a current focus of interest in animal learning and that this has led to a revitalization of comparative psychology. An examination of the volume reviewed suggests that he may have overstated the case. Most of the authors to whom he refers expressed dissatisfaction with traditional stimulus-response associationism but few argued for the extreme (information processing) sort of cognitive approach described by Wasserman.     

Stimulus discriminability in free-operant and discrete-trial detection procedures.

Six pigeons were trained to discriminate different light intensities in four experimental procedures. Experiment 1 compared stimulus discriminability in a yes-no signal-detection task with discriminability measures obtained from two free-operant procedures. Discriminability estimates were significantly lower in the detection procedure. Experiment 2 showed this lowered discriminability to be a function of the delay between stimulus presentation and the availability of the choice-response keys in the standard detection task. In addition, reinforcement sensitivity was lowest when correct choice responses were intermittently, rather than continuously, reinforced.     

Methodological and theoretical issues in neuropsychological assessment

While there are philosophical and theoretical differences between neuropsychologists and behavior therapists, it is suggested that a significant reconciliation can be achieved in regard to assessment and treatment of the brain-damaged patient. While brain damage is often viewed as an irreversible disorder, there is evidence that substantial recovery of function can occur, particularly when adequate retraining is provided. There are practical and empirical considerations that suggest that neuropsychological tests are currently the best tools available for behavioral assessment of brain-damaged patients. However, the results of these tests can be used not only diagnostically but also to identify target behavioral deficits that may be rehabilitated through systematic retraining efforts. Such rehabilitation efforts can be optimally planned, implemented, and evaluated through an alliance between the neuropsychologist, who identifies the ability and deficit pattern, and the behavior therapist, who devises and evaluates the retraining program. It is possible that the successes of behavior therapy in numerous clinical and educational applications can be repeated in the cases of brain-damaged patients. However, such success would appear to be contingent on appreciation of the high degree of specificity often seen in neurological deficit patterns and the great complexities involved in the relationships between brain function and behavior.     

Considerations in the choice of interobserver reliability estimates

Two types of interobserver reliability values may be needed in treatment studies in which observers constitute the primary data-acquisition system: trial reliability and the reliability of the composite unit or score which is subsequently analyzed, e.g., daily or weekly session totals. Two approaches to determining interobserver reliability are described: percentage agreement and "correlational" measures of reliability. The interpretation of these estimates, factors affecting their magnitude, and the advantages and limitations of each approach are presented.     

Choice, time allocation, and response rate during stimulus generalization

Six pigeons were trained to discriminate between two noise intensities using a procedure that assessed choice, time allocation, and response rate simultaneously and independently. Responses on the left or right key (R1 or R2) were respectively correct in the presence of two different intensities, S1 and S2. After a correct response, reinforcement became available for pecks on the center key. Reinforcement density for R1¦S1 relative to R2¦S2 was varied across experimental conditions. Generalization tests followed extensive training at each condition. As a function of stimulus intensity, proportions of initial choices of R2, of time spent in R2-initiated components, and of center-key responses emitted in R2-initiated components all yielded sigmoidal gradients of similar slope, which shifted slightly in location when relative reinforcement density changed. Changeovers were maximal where initial choice proportions approximated 0.5. Gradients relating the absolute number of center-key responses to stimulus intensity were also roughly sigmoidal, but were more sensitive to changes in reinforcement density. Gradients of momentary response rate also depended on reinforcement density. During training, large but transitory shifts in choice responding occurred when reinforcement density changed, while differences in momentary response rate developed slowly, suggesting separate control of choice and response rate by the contingencies of reinforcement.     

Two simple classes of mastery scores based on the beta-binomial model

Two simple classes of mastery scores which are suitable for hand calculations are presented for beta-binomial test score distributions combined with linear and cubic referral success. The models provide a simple way to explore the consequences of selecting an arbitrary mastery score. Such assessment would be useful whenever the test user is not willing to posta priori a loss ratio, but wishes to look at the various consequences before aiming at a particular score.     

Fitting and testing carroll's weighted unfolding model for preferences

A quadratic programming algorithm is presented for fitting Carroll's weighted unfolding model for preferences to known multidimensional scale values. The algorithm can be applied directly to pairwise preferences; it permits nonnegativity constraints on subject weights; and it provides a means of testing various preference model hypotheses. While basically metric, it can be combined with Kruskal's monotone regression to fit ordinal data. Monte Carlo results show that (a) adequacy of true preference recovery depends on the number of data points and the amount of error, and (b) the proportion of data variance accounted for by the model sometimes only approximately reflects true recovery.This study is based on a doctoral dissertation submitted to the University of Illinois at Urbana-Champaign. The author wishes to thank the members of his dissertation committee—Lawrence E. Jones, Chairman, Charles Lewis, Stephen Golding, Ledyard Tucker, and Nancy Wiggins—for their helpful comments.