Outcome Trajectories for Adolescents in Residential Treatment: A Statewide Evaluation

Although residential treatment represents one of the largest and most expensive components of the mental health service system for children and adolescents, little is known about the anticipated outcomes of this service. Still less is known about the trajectory through which change occurs within these settings. We examined the clinical status of 285 adolescents over a 2-year period after placement in residential treatment by the Department of Mental Health in a western state. Using a growth modeling technique, the rate of change was determined over a set of symptoms measured by the Acuity of Psychiatric Illness—Child and Adolescent Version (CAPI). Results suggest that while adolescents tended to improve overall during the course of their stays, there was considerable variation in which symptoms improved and which did not. Two symptoms actually became reliably worse with treatment. In addition, significant variation in outcomes was demonstrated across sites, with adolescents in one site getting reliably worse during the course of residential treatment. Our findings demonstrate the utility of outcomes management and have significant implications for how residential services for children and adolescents should be managed.     

A treatment trial of an information package to help patients accept new dentures

Intolerance of dentures can be very distressing and difficult to treat. Therefore, 44 patients, having had partial or total dental clearance, completed the Brief Symptom (Psychiatric) Inventory, the Hospital Anxiety and Depression Scale and the Satisfaction with Life Scale. Allocated alternately, each patient had treatment as usual or watched a video containing information, recapitulated in a leaflet, based on the Self Regulatory Model of health beliefs explaining the experiences of wearing dentures and how to tolerate them. They were then fitted with dentures. Two and six weeks later, although both groups expressed favourable expectations of their dentures, the control group deteriorated continually on all measures, correlated with a decline in self-reported dental functioning. The video group improved on all measures except Satisfaction with Life. Therefore, our study is unique in showing that appropriate management of patients can arrest (1) clinically significant distress which can be occasioned by the replacement of teeth by dentures and (2) the development of complaints which may be seen as spurious. Experimental procedures are suggested to determine the influences which have brought this about in our study.     

Mackie on Practical Reason

I argue that John Mackie’s treatment of practical reason is both attractive and unjustly neglected. In particular, I argue that it is importantly different from, and much more plausible than, the kind of instrumentalist approach famously articulated by Bernard Williams. This matters for the interpretation of the arguments for Mackie’s most famous thesis: moral scepticism, the claim that there are no objective values. Richard Joyce has recently defended a version or variant of moral scepticism by invoking an instrumentalist theory like Williams’. I argue that this is a serious strategic mistake.

The Effect of Ad Skepticism and Celebrity Preference on Brand Attitude Change in Celebrity-Endorsed Advertising

The use of a celebrity endorser who is well recognized and favorably evaluated by the target viewers is a common strategy used by advertisers to increase the persuasiveness of an advertisement. Yet, at the same time, being skeptical of the claim being made by the celebrity endorser is the typical response of the viewers to such persuasion attempts. The present research examines how these effects potentially counterbalance each other as viewers evaluate the advertised brand in a low-involvement setting. The results show that the degree of ad skepticism and the relative allocation of attentional resources to celebrity and brand elements in advertisements determine how preference for a celebrity endorser is transferred to the advertised brand. The findings provide a more complete understanding of the psychological mechanisms by which celebrity preference influences brand attitude change than has previously been available. They indicate that ad skepticism may be the missing link in understanding the effectiveness of celebrity-endorsed advertising.     

Critical Notice: Paul Russell's The Riddle of Hume's Treatise: Skepticism,Naturalism, and Irreligion (OUP 2008)

In The Riddle of Hume's Treatise: Skepticism, Naturalism, and Irreligion (2008), Paul Russell makes a strong case for the claim that “The primary aim of Hume's series of skeptical arguments, as developed and distributed throughout the Treatise, is to discredit the doctrines and dogmas of Christian philosophy and theology with a view toward redirecting our philosophical investigations to areas of ‘common life,’ with the particular aim of advancing ‘the science of man’” (2008, 290). Understanding Hume in this way, according to Russell, sheds light on the “ultimate riddle” of the Treatise: “is it possible to reconcile Hume's (extreme) skeptical principles and conclusions with his aim to advance the ‘science of man’” (2008, 3)? Or does Hume's skepticism undermine his “secular, scientific account of the foundations of moral life in human nature” (290)? Russell's controversial thesis is that “the irreligious nature of Hume's fundamental intentions in the Treatise” is essential to solving the riddle (11). Russell makes a compelling case for Hume's irreligion as well as his atheism. Contrary to this interpretation I argue that Hume is an irreligious theist and not an atheist.