Under what conditions do lay people and health professionals accept a breach of doctor-patient confidentiality regarding a patient with signs of terrorist radicalization?

IntroductionConfidentiality is crucial to the establishment of a strong patient-physician relationship. However, certain situations create a dilemma for the physician who is faced with the choice of either respecting medical confidentiality or protecting others from a serious risk of violence.ObjectiveThis study aimed to observe how lay people and health professionals assessed the acceptability of breaching confidentiality when a physician is confronted to a patient showing signs of terrorist radicalization.MethodA total of 228 participants (174 from the general population and 54 health professionals) judged the acceptability of 54 scenarios which were constructed through the orthogonal combination of 4 factors frequently mentioned in the literature: presence of a “Psychiatric disorder”; “Signs of radicalization”; “Projects of violence”; “Collegiality”. Variance and cluster analyses were performed on all the raw data.ResultsResults showed that all factors influenced the judgment of participants but that “Psychiatric disorders” had a weaker impact. Five clusters were identified: “Favorable if collegiality” (n = 23); “Favorable to breach confidentiality” (n = 77); “Unfavorable to breach confidentiality” (n = 26); “Sensitive to all factors” (n = 71); “Favorable if violence” (n = 31), respectively with mean ratings of 5.87, 8.42, 3.64, 6.30 and 7.16, on an acceptability scale of 0–10.ConclusionThe importance that the great majority of participants attribute to these factors indicates that they influence their judgments in this specific context.     

Editorial

This paper is a response to William Meredith-Owen’s paper presented at the inaugural joint conference on ‘Alchemy, a bridge to Jung’s objective psyche’, for The Society of Analytical Psychology and the West Midlands Institute of Psychotherapy in autumn 2020. The paper presents a way of understanding the collective unconscious through the functioning of the core self, and thus offers a bridge which addresses the indivisibility of the personal and collective psyche/unconscious, referencing Mary Williams’ (1963) classic paper. Specifically, this is applied to Winnicott’s dream of destruction that he had after reviewing Memories, Dreams, Reflections, as well as to parts of the psyche that were dissociated due to significant early deprivation – the primary narcissistic wounds. Alchemical metaphors are shown to relate to the analytic process, which allows the primitive core self (with its identificatory, participatory, connecting nature), when integrated through relationship, to sink back into the unconscious and function as the Self.     

Embodying the psychological attitude: types of consciousness in the transformation of culture

It is time to reclaim C.G. Jung’s vision of psychology as the foundational science upon which all sciences and institutions would be based, and as the discipline, theory, and practice necessary for fostering humanity’s overall psychocultural development. Jung identified eight distinct ‘types’ of consciousness through which humankind engages its emerging psychological attitude. Jung’s view of psychological development as hingeing on the differentiation of function-attitudes provides the means for understanding not only ourselves and each other, but our society as well. This paper offers an example of such an analysis by focusing on the current conflict within American political culture. The goal is as lofty as it is necessary: the operationalization of Jung’s vision of psychology as the powerful influencer of human cultural evolution that it has the potential to be. The immediate goal is to instigate the first step toward this vision of Jung’s ‘complex psychology’ by stimulating conversations among Jungians about how they can foster that vision, leading them towards taking up roles as ‘citizen therapists’, actively involved in their communities in cultivating greater empathy and the withdrawal of projections in the interest of furthering ‘collective consciousness’.     

Les effets de la modalité sensorielle sur la perception du temps

The subjective duration of an event can be influenced by the modality of the signal demarcating that event. For example, auditory signals are often judged as of longer duration than equivalent duration visual signals. Within the framework of pacemaker-accumulator models of timing, such modality effects raise the question of whether the internal clock is modality specific or amodal. The answer to this question is quite important for the development of cognitively and neurologically realistic models of timing and time perception. Here, we argue that the internal clock has both modality specific and amodal components. Specifically, we claim there is a common amodal pacemaker, but the switch-accumulator systems are modality specific. Moreover, we also posit that long-term memory representations of duration are stored amodally.     

La mémoire à long terme des durées : fonctionnement et développement

Estimating the duration of an event often requires that we reference our own knowledge about the duration of similar events stored in long-term memory. The ability to preserve these durations in long-term memory therefore seems to serve an important function in time estimation. However, relatively few studies on this topic appear in the psychology literature. In the present article, we describe how time estimation models have treated long-term memory, and discuss relevant empirical data obtained from adults. Then, we present the results of recent experiments that examine 3- to 8-year-old children’s ability to maintain durations in memory, depending on the kind of previous experience the children have had with these durations.     

The early biopsychosocial development of boys and the origins of violence in males

We apply a biopsychosocial approach to introduce early-in-life experiences that explain a significant part of the male preponderance in the perpetration of violence. Early caregiver abuse and neglect, father absence, and exposure to family and neighborhood violence exacerbate boys’ greater risk for aggressive behavior and increase the probability of carrying out violent acts later in life. We examine the development of the psychological self and explore conditions that encourage physical aggression, focusing on the impact on the infant and toddler's emergent mental representation of self, others, and self–other relationships. Boys’ slower developmental timetable in the first years of life may enhance their vulnerability for disorganization in emergent neurobiological networks mediating organization of socioemotional relationships. Emergent attachment and activation relationship systems may differentially affect risk and resilience in boys and girls, particularly in single-parent families. Evidence has suggested that the dramatic increase in single-parent families is especially linked to corresponding increases in behavioral undercontrol, antisocial behavior, and the emergence of violence in boys.     

Look to Norway: Serving new families and infants in a multiethnic population

Despite recognition that immigrant women face significant health challenges, addressing the healthcare needs of immigrants is a source of debate in the United States. Lack of adequate healthcare for immigrants is recognized as a social justice issue, and other countries have incorporated immigrants into their healthcare services. Oslo, the fastest growing capital in Europe, is rapidly shifting to a heterogeneous society prompting organizational action and change. The New Families Program serves first-time mothers and their infants in an Oslo district serving 53% minorities from 142 countries. Anchored in salutogenic theory, the program aims to support the parent–child relationship, children's development and social adaptation, and to prevent stress-related outcomes. Formative research has informed the successful program development and implementation within the existing maternal and child healthcare service. Implications for addressing maternal and child health needs of an immigrant population are presented.     

Reproductive justice for incarcerated mothers and advocacy for their infants and young children

The United States has seen unprecedented growth in the number of incarcerated women, most of whom are mothers with minor children. Major public health concerns relate to the reproductive health of women in prisons and jails and the well-being of their infants and young children. In the current article, we use a reproductive justice framework to examine the intersection of incarceration and maternal and child health. We review (a) current research on the reproductive health of incarcerated women, (b) characteristics and experiences of pregnant incarcerated women, (c) outcomes of infants and young children with incarcerated parents, (d) implications of research findings for policy and practice, and (e) the need for increased research, public education, and advocacy. We strongly recommend that correctional policies and practices be updated to address the common misconceptions and biases as well as the unique vulnerabilities and health needs of incarcerated women and their young children.