Treatment of urethral catheter dependence: A case study of intervention in the interdisciplinary geriatric setting

This case report describes the assessment and treatment of a 69-year-old male medical patient with urethral catheter dependence. Assessment revealed an anxiety/phobic component to the dependence and hypothesized detrusor muscle deconditioning. Retraining of the bladder and desensitization to the anxiety-provoking situation were achieved by exposure to decatheterization in the context of a supportive adult day health care setting. Interdisciplinary collaboration between nursing and psychology were associated with successful functional, social, and psychological outcomes.A psychology intern at the Portland VA Medical Center at the time the study was conducted.     

The Psychology of Dependence Between Landlord and Sharecropper in Northeastern Brazil

Contrasting beliefs and attitudes held by sharecroppers and their landlord on a fazenda in Northeastern Brazil reveal a tendency to split one another into positively and negatively idealized images. Sharecroppers who ambivalently seek patronage construct good vs. bad landlords/patrons. The landlord, defensive about envy and hostility among sharecroppers, constructs good vs. bad tenants/workers. Theory from the Kleinian school of psychoanalysis concerning envy, splitting, and idealization provides a framework for interpreting ethnographic case materials.     

A BEHAVIORAL INTERVENTION FOR IMPROVING VERBAL BEHAVIORS OF HEROIN ADDICTS IN A TREATMENT CLINIC

Positively reinforcing appropriate behaviors improved verbal behaviors of opioid-dependent patients in a buprenorphine treatment clinic. During B phases of an ABAB design, clients received stickers for engaging in appropriate verbal or nonverbal behaviors. Each sticker provided a chance of winning $25. No reinforcement was provided during the A phases. Appropriate verbal behaviors increased during reinforcement periods, and inappropriate verbal behaviors decreased.     

成瘾药物心理依赖及复发的脑机制研究

围绕学习、记忆、情绪及应激等心理因素与复发的关系,应用阿片类物质心理依赖研究条件性位置偏爱,条件性位置厌恶,Morris水迷宫量化觅药动机模型,行为及条件性行为敏感化等多种动物行为模型,从情绪相关学习、记忆在成瘾行为中的作用,不同神经核团与神经递质系统活动性的改变,应激相关因素易化的成瘾易感性,自然奖赏与成瘾药物奖赏相关记忆的比较研究等方面,对应激与记忆相关的吗啡心理依赖及复发的脑机制进行了系列研究     

Boring Infinite Descent

In formal ontology, infinite regresses are generally considered a bad sign. One debate where such regresses come into play is the debate about fundamentality. Arguments in favour of some type of fundamentalism are many, but they generally share the idea that infinite chains of ontological dependence must be ruled out. Some motivations for this view are assessed in this article, with the conclusion that such infinite chains may not always be vicious. Indeed, there may even be room for a type of fundamentalism combined with infinite descent as long as this descent is “boring,” that is, the same structure repeats ad infinitum. A start is made in the article towards a systematic account of this type of infinite descent. The philosophical prospects and scientific tenability of the account are briefly evaluated using an example from physics.     

Conceptualising Decadent Technology: A Case Study of Path Dependence in Radiotherapy

Abstract

Large-scale investments in health technologies often have limited evidence for effectiveness when first introduced. Nevertheless, professional and public discourses often present the advantages of such investments, with unknown risks, as necessary and entailing significant improvement. Such discourses are evident with the introduction of the Linac Adapted Conebeam Imager (LACI), introduced to improve the accuracy of radiotherapy treatments. From one perspective, the introduction of such technologies can be considered to be decadent since there is limited, if any, evidence of improvement of current standards and procedures, yet they are promoted as the latest and best technologies for solving societal problems. Connecting the concepts of decadence to those of path dependence, through the case of the LACI, enables the exploration of the ‘technical interrelatedness’ of technological changes. Building on the concept of path dependence, it is possible to demonstrate how introducing a closely related technology does not only become a low-risk course of action. Rather change is demanded (but not determined) as well as potential alternative systems being obscured. With decadent technologies, any future changes are not only dependent upon past introductions; but also they create a need for future changes. Such a view demonstrates how these technologies may not necessarily offer any improvements, but rather contribute to the creation of ongoing demand for unproven technologies. As a result they may encourage the introduction of increasingly complex technologies.     

基于易感人格的药物成瘾者工作记忆对执行控制功能的调节作用

为了解工作记忆在易感性人格对药物成瘾者执行控制功能和抑制性影响过程中的调节作用,采用BIS和SSS量袁以及连续操作测验（CPT）、2-back任务、威斯康星卡片分类任务（WCST）对150名药物成瘾者和100名年龄、性别及智商相匹配的非药物成瘾者实施冲动性人格、认知控制功能测试。结果发现在2-back任务正确率（工作记忆）高低不同的情况下,注意冲动性人格特质得分对执行控制功能会产生不同的影响。这说明工作记忆在冲动性人格对抑制性的影响中具有调节作用。     

Psychological treatment of hypnotic-dependent insomnia in a primarily older adult sample

Objective

This study tested cognitive behavior therapy (CBT) in hypnotic-dependent, late middle-age and older adults with insomnia.

Method

Seventy volunteers age 50 and older were randomized to CBT plus drug withdrawal, placebo biofeedback (PL) plus drug withdrawal, or drug withdrawal (MED) only. The CBT and PL groups received eight, 45 min weekly treatment sessions. The drug withdrawal protocol comprised slow tapering monitored with about six biweekly, 30 min sessions. Assessment including polysomnography (PSG), sleep diaries, hypnotic consumption, daytime functioning questionnaires, and drug screens collected at baseline, posttreatment, and 1-year follow-up.

Results

Only the CBT group showed significant sleep diary improvement, sleep onset latency significantly decreased at posttreatment. For all sleep diary measures for all groups, including MED, sleep trended to improvement from baseline to follow-up. Most PSG sleep variables did not significantly change. There were no significant between group differences in medication reduction. Compared to baseline, the three groups decreased hypnotic use at posttreatment, down 84%, and follow-up, down 66%. There was no evidence of withdrawal side-effects. Daytime functioning, including anxiety and depression, improved by posttreatment. Rigorous methodological features, including documentation of strong treatment implementation and the presence of a credible placebo, elevated the confidence due these findings.

Conclusions

Gradual drug withdrawal was associated with substantial hypnotic reduction at posttreatment and follow-up, and withdrawal side-effects were absent. When supplemented with CBT, participants accrued incremental self-reported, but not PSG, sleep benefits.     

Reference-dependent sympathy

Natural disasters and other traumatic events often draw a greater charitable response than do ongoing misfortunes, even those that may cause even more widespread misery, such as famine or malaria. Why is the response disproportionate to need? The notion of reference dependence critical to Prospect Theory (Kahneman & Tversky, 1979) maintains that self-utility, or benefit to self, is not absolute level of wealth but rather gain or loss relative to a reference point. Four studies show that sympathy (Study 1), dictator offers (Study 2), and judgments of deservingness (Study 3a) are reference-dependent: people respond greater to victims of loss than to victims of chronic conditions. This tendency goes away when people evaluate victims in comparison (Study 3b) and when evaluating affect-poor “statistical victims”, as compared to affect-rich “identifiable victims” (Study 4). Together, these results shed light on seemingly irrational patterns of humanitarian aid.