An Analogue Study of the Psychological and Psychosocial Processes Associated With Post‐concussion Symptoms

This study used an analogue design to investigate post‐concussion syndrome and the psychological and psychosocial processes associated with post‐concussion symptom (PCSx) reporting. The study examined the role of expectation in reporting of PCSx, the nature of associated psychological and psychosocial difficulties, and the “good‐old‐days” phenomenon. Forty‐five healthy participants were randomly assigned to one of two groups: (1) a control group or (2) an expectation group who were asked to perform as if they had experienced a mild traumatic brain injury. Fourteen psychiatric patients comprised the clinical group. Self‐report questionnaires assessing PCSx and psychological and psychosocial variables were administered. It was hypothesised that PCSx would be non‐specific, that the expectation group would report greater dysfunction than controls, and that the “good‐old‐days” phenomenon would cause the expectation and clinical groups to underestimate pre‐morbid PCSx. All participants reported some degree of dysfunction, and the expectation and clinical groups underestimated past PCSx. The expectation group reported more PCSx and psychological and psychosocial dysfunction than controls, resembling the clinical group. The results demonstrate that expectation can cause otherwise healthy individuals to resemble a clinical group in terms of their level of endorsement of psychological and psychosocial dysfunction.     

Jean Baker Miller,MD, Visionary Pragmatist

ABSTRACT

Jean Baker Miller’s 1976 book, Toward a New Psychology of Women, was an overnight success. It struck a deep chord in many women because it was based on listening to women’s stories. Instead of seeing women through the lens of male psychology with its emphasis on separation and autonomy, Jean suggested that relationships are central to women’s experience of themselves and the world. Traits that were typically pathologized (needing other people, attending to the messages of emotions, wanting to participate in growth fostering relationships for all involved) were revisited by Jean and her colleagues who discovered strengths where others had seen weakness. The resulting work is known as Relational-Cultural Theory (RCT) and has offered new understandings of women’s and men’s development with a special emphasis on the impact of power and marginalization on personal and collective wellbeing. Jean’s work is carried forward by members of a collaborative group with whom Jean worked for many years. RCT theorists have written and edited over 20 books, 115 works in progress, and numerous chapters and articles that continue to elaborate on Jean’s groundbreaking work. RCT is applied to both clinical and social justice settings. Jean was devoted to contributing to the creation of a more just society.     

罗夏墨迹测验中“装好”与诈病反应的研究与进展

传统观念认为罗夏测验具有投射测验的性质,因此受测者无法在其测验中故意“装好”和诈病。但相关研究发现,受测者的“装好”反应对于罗夏测验结果没有产生实质性的影响,不能改变罗夏测验的基本数据特征和结构汇总性量表;而诈病反应的研究结论不尽相同,受测者有可能造成罗夏测验变量得分的改变,伪装成相应精神病理症状。如果联合使用MMPI和罗夏测验,则可以精确地评估受测者的伪装反应。目前已有的研究存在被试取样单一、研究数量偏少、无法确定临界值等问题。罗夏测验“装好”和诈病反应研究还处于初步阶段,需要继续深入研究并建立专门的“装好”和诈病量表。     

扬弃与超越——医学人文教育的重新审视与思考

目前,医学人文教育依然存在诸多问题。通过对医学人文教育现状的审视,追根溯源,重新认识人文教育的内涵,并就认识取向、课程体系、教学模式、评价方法、专业教育与人文教育的关系等方面的障碍或弊端提出扬弃与改革措施。     

耻感与存在

本文从存在本体论维度审视耻与耻感。耻以否定性方式表达了人的内在规定性,耻感则是以否定性方式把握善。耻感形成于对善、自我及二者差距的自觉意识。耻感是一种积极的道德情感,它既是道德自律的内在根据,亦是道德义务、责任、良心的特殊存在方式。有耻无违是社会风尚清明的基本条件之一。     

UNDERSTANDING AND RESPONDING TO HUMAN EVIL: A MULTICAUSAL APPROACH

One task of religion is delivering human beings from evil within and between themselves. Defining good as well‐being or functioning well, evil as impaired functioning, and doing evil as impairing the functioning of others, this essay explores how religions in consort with other social institutions might understand and respond to evil in light of contemporary scientific knowledge. To understand evil I use a multicausal approach that includes both biological and sociocultural environmental causes. I illustrate the use of this approach by analyzing how we might understand and respond to human rage and violence.     

On the Importance of Well-being

Many among philosophers and non-philosophers would claim that well-being is important in moral theory because it is important to the individual whose well-being it is. The exact meaning of this claim, however, is in need of clarification. Having provided that, I will present a charge against it. This charge can be found in the recent work of both Joseph Raz and Thomas Scanlon. According to the latter the concept of well-being plays an unimportant role in an agent’s deliberation. As I will show, to claim this much is to undermine our initial claim; and to do that is to undermine some of the most central theories in normative ethics. I will focus on Scanlon’s discussion in particular because it affords us with two criteria for the assessment of the importance for a person of a value-concept such as well-being. I will claim that much of Scanlon’s case rests on the idea that well-being is an inclusive good, a good constituted by other things that are good in and for themselves. Then, I will put forward a case against Scanlon’s challenge by (1) showing that inclusiveness, when properly understood, does not lead to the conclusion Scanlon is led to and (2) showing that on at least the reading Scanlon prefers, his criteria are inappropriate.

Internalism and the Origin of Rational Motivation

What makes a subject's motivationrational is its originating in her practicalreasoning. I explain the appeal of this thesisabout rational motivation, and explore itsrelation to recent discussions of internalismabout reasons for action. I do so in theservice of clarifying an important meta-ethicaldebate between Humean motivational skeptics andtheir Kantian opponents. This debate is oneover whether, as this skeptic contends andKantians deny, considerations about ourmotivational capacities, together withinternalism, restrict genuine reasons foraction to merely instrumental ones. I arguethat properly adjudicating this debate requiresidentifying one particular way in which thethesis about rational motivation has beendeveloped – namely, as a part of what I term``the traditional conception' of themotivational efficacy of practical reason. Onthis conception, rational motivation consistsin choosing some course of conduct out of one'scognitive appreciation of the way its relationto one's practicable good gives one reason todo so. And I side with Kantians against theHumean motivational skeptic in part on groundsthat Kant himself – though not all Kantians –would find congenial: namely, that we shouldaccept the traditional conception.     

The persons‐in‐relation perspective: Towards a philosophy for counselling in society

This paper is the first in a planned series, which aims to articulate and synthesise the persons‐in‐relation perspective in counselling and psychotherapy, drawing together the contributions of the philosopher John Macmurray, the psychotherapist Ian Suttie and the psychoanalyst Ronald Fairbairn. The paper introduces the persons‐in‐relation perspective, derived from Macmurray's work. It outlines the historical and cultural context leading to the emergence of modernism, and the response of personalism. It summarises John Macmurray's life and philosophy, focusing on his account of knowledge, its relation to the senses and the emotions, and his view of persons, society and religion. The paper goes on to develop a hypothesis about the rise of counselling in Britain, linking it to the decline of religion, the conflict between individualism and collectivism, and the re‐emergence of the persons‐in‐relation perspective. It concludes by posing challenges for the person‐centred and psychodynamic orientations, and for counselling as a whole.