Clarifying boundaries of binge eating disorder and psychiatric comorbidity: a latent structure analysis

Binge eating disorder (BED) presents with substantial psychiatric comorbidity. This latent structure analysis sought to delineate boundaries of BED given its comorbidity with affective and anxiety disorders. A population-based sample of 151 women with BED, 102 women with affective or anxiety disorders, and 259 women without psychiatric disorders was assessed with clinical interviews and self-report-questionnaires. Taxometric analyses were conducted using DSM-IV criteria of BED and of affective and anxiety disorders. The results showed a taxonic structure of BED and of affective and anxiety disorders. Both taxa co-occurred at an above-chance level, but also presented independently with twice-as-large probabilities. Within the BED taxon, diagnostic co-occurrence indicated greater general psychopathology, lower social adaptation, and greater premorbid exposure to parental mood and substance disorder, but not greater eating disorder psychopathology. Eating disorder psychopathology discriminated individuals in the BED taxon from individuals in the affective and anxiety disorders taxon. Diagnostic criteria of BED were more indicative of the BED taxon than were criteria of affective and anxiety disorders. The results show that at the latent level, BED was co-occurring with, yet distinct from, affective and anxiety disorders and was not characterized by an underlying affective or anxiety disorder.     

Philosophy and Science Dialogue: Free Will

In this dialogue Derk Pereboom and Marcel Brass discuss the free will problem from the perspective of philosophy and cognitive neuroscience. First, they give their opinion on how the two disciplines contribute to the free will problem. While Pereboom is optimistic regarding the contribution of science, Brass is more pessimistic and questions the usefulness of an empirical approach to the question whether free will exists or not. Then they outline their position on the free will problem. The idea of a transcendental agent is discussed in more detail. Furthermore, it is discussed whether free will scepticism is a politically, socially, psychologically viable position. Pereboom argues that promoting the idea of free will scepticism can have a positive impact on retributive emotions and the political practice regarding retributive punishment. Brass argues that retributive emotions are deeply rooted in evolution and therefore difficult to change via high-level beliefs about free will. Finally, the future of the free will debate is discussed. Both agree that the dialogue between philosophy and psychology should be intensified. Philosophy can benefit from taking empirical research more seriously. Psychology and neuroscience can benefit from philosophy by appreciating the sophistication and conceptual clarity of the philosophical debate. Both have to find a common language and define common problems that can be tackled from both perspectives.     

The tell-tale tasks: a review of saccadic research in psychiatric patient populations

This review focuses on saccade research with adult psychiatric patients. It begins with an introduction of the various types of saccades and the tasks used to evoke them. The functional significance of the different types of eye movements is briefly discussed. Research findings regarding the saccadic performance of different adult psychiatric patient populations are discussed in detail, with particular emphasis on findings regarding error rates, response latencies, and any specific task parameters that might affect those variables. Findings regarding the symptom, neurocognitive, and neural correlates of saccadic performance and the functional significance of patients’ saccadic deficits are also discussed. We also discuss the saccadic deficits displayed by various patient groups in terms of circuitry (e.g. cortical/basal ganglia circuits) that may be implicated in the underlying pathophysiology of several of these disorders. Future directions for research in this growing area are offered.     

A Longitudinal Analysis of Psychiatric Severity upon Outcomes Among Substance Abusers Residing in Self-Help Settings

A longitudinal analysis of psychiatric severity was conducted with a national sample of recovering substance abusers living in Oxford Houses, which are self-run, self-help settings. Outcomes related to residents' psychiatric severity were examined at three follow-up intervals over one year. Over time, Oxford House residents with high versus low baseline psychiatric severity reported significantly more days using psychiatric medication, decreased outpatient psychiatric treatment, yet no significant differences for number of days abstinent and time living in an Oxford House. These findings suggest that a high level of psychiatric severity is not an impediment to residing in self-run, self-help settings such as Oxford House among persons with psychiatric comorbid substance use disorders.     

QUESTIONING SCIENTIFIC FAITH IN THE LATE NINETEENTH CENTURY

The late nineteenth century was not only a time in which religious faith was questioned in light of increasing claims of natural science. It is more accurate to see the familiar Victorian crisis of faith as but one aspect of a larger historical phenomenon, one in which the methods of both religion and science came under scrutiny. Among several examinations of the status of scientific knowledge in the waning decades of the century, the treatment of the subject by the German theologian Wilhelm Herrmann and philosopher Hans Vaihinger rejected its objective nature and denied that either scientists or theologians had access to the truth of nature. Although this stance regarding the nature of science, religion, and their relationship was limited to intellectuals in German society at the time, it foreshadowed developments in our own day in which the traditional search for truth has been problematized.     

Debunking Antipsychiatry: Laing,Law, and Largactil

The term “psychiatry” refers to two radically different ideas and practices: curing–healing “souls” and coercing–controlling persons. It is important that critics of psychiatry clarify whether they object to the former or the latter or both, and why. Because I believe coerced psychiatric relations are like coerced labor relations called “slavery,” and like coerced sexual relations called “rape,” I spent the better part of my professional life criticizing involuntary-institutional psychiatry and the insanity defense. In 1967, my effort to undermine the medical-political legitimacy of the term “mental illness” and the moral-legal legitimacy of depriving individuals of liberty by means of psychiatric rationalizations suffered a serious blow: the creation of the antipsychiatry movement. Despite their claims, “antipsychiatrists” rejected neither the idea of mental illness nor coercion practiced in the name of “treating” mental illness. Sensational claims about managing “schizophrenia” and pretentious pseudophilosophical pronouncements diverted attention from the crucial role of the psychiatrist as an agent of the state and as an adversary of the denominated patient. The legacy of the antipsychiatry movement is the creation of a catchall term used to delegitimize and dismiss critics of psychiatric fraud and force by labeling them “antipsychiatrists.”

Psychiatric Disorders in Clinical Genetics I: Addressing Family Histories of Psychiatric Illness

This is the first article of a two-part professional development series addressing genetic counseling for personal and family histories of psychiatric disorders. It is based on an Educational Breakout Session presented by the Psychiatric Special Interest Group of the National Society of Genetic Counselors at the 2006 Annual Education Conference. This article examines issues that arise in addressing family histories of psychiatric illness, while the second article in the series considers the generation and provision of individualized recurrence risks for psychiatric disorders. In this article we discuss the importance of managing uncertainty for affected individuals and their close family members who have been referred to genetics for a number of different indications. We then use four simulated cases to make recommendations about the scope and timing of discussions related to the psychiatric family history.     

The Problem of Other Minds: Wittgenstein's Phenomenological Perspective

This paper discusses Wittgenstein's take on the problem of other minds. In opposition to certain widespread views that I collect under the heading of the “No Problem Interpretation,” I argue that Wittgenstein does address some problem of other minds. However, Wittgenstein's problem is not the traditional epistemological problem of other minds; rather, it is more reminiscent of the issue of intersubjectivity as it emerges in the writings of phenomenologists such as Husserl, Merleau-Ponty, and Heidegger. This is one sense in which Wittgenstein's perspective on other minds might be called “phenomenological.” Yet there is another sense as well, in that Wittgenstein's positive views on this issue resemble the views defended by phenomenologists. The key to a proper philosophical grasp of intersubjectivity, on both views, lies in rethinking the mind. If we conceive of minds as essentially embodied we can understand how intersubjectivity is possible.     

Offspring Effects of Prenatal Alcohol Exposure from Birth to 25 Years: The Seattle Prospective Longitudinal Study

Before alcohol was generally known to cause birth defects, NIAAA in 1974 began funding a population-based Seattle study on alcohol use and pregnancy outcome. Women receiving prenatal care by mid-pregnancy were recruited (N = 1,529) and interviewed at home. Approximately 500 offspring exposed to a range of alcohol levels were examined on 11 occasions between day 1 and 25 years. Neuropsychological and neurobehavioral performance measures are correlated with prenatal alcohol dose, without substantial confounding by socio-demographic or rearing conditions, smoking, nutrition, or other drugs. Deficits in attention, arithmetic skill, spatial-visual memory, and IQ, as well as increased alcohol problems and psychiatric disorders are among offspring outcomes correlated at several ages with maternal drinking during and before pregnancy recognition. Findings are not confined to women who believed they had alcohol problems. Not all exposed offspring appear affected.