The Association of American Medical Colleges and the Association of Medical School Psychologists: Finding Psychology’s Place in Academic Medicine

This paper highlights the role of the Association of Medical School Psychologists (AMSP) as a bridge between academic medicine and psychology. AMSP’s affiliation with Division 12 of the American Psychological Association is discussed, but the primary focus is AMSP’s affiliation with the Association of American Medical Colleges (AAMC) and the AAMC’s Council of Academic Societies (CAS). The history, structure, activities, and goals of AAMC and CAS are examined. AMSP’s affiliation with AAMC is important for psychologists in medical schools and academic medical centers, and for psychology in general, because AAMC is the major voice of academic medicine in the US. AAMC activities affect medical education at all levels, as well as research and health services at academic medical centers, and health care policy at the national level. AMSP’s dual affiliation with AAMC’s CAS and APA’s Society of Clinical Psychology will increase psychology’s visibility and influence in academic medical centers and enhance the two-way flow of ideas and information between academic medicine and psychology.     

The Nature and Significance of Behavioural Genetic Information

In light of the human genome project, establishing the genetic aetiology of complex human diseases has become a research priority within Western medicine. However, in addition to the identification of disease genes, numerous research projects are also being undertaken to identify genes contributing to the development of human behavioural characteristics, such as cognitive ability and criminal tendency. The permissibility of this research is obviously controversial: will society benefit from this research, or will it adversely affect our conceptions of ourselves and each other? When assessing the permissibility of this research, it is important to consider the nature and deterministic significance of behavioural genetic information. Whilst todate there has been much discussion and debate about the properties of genetic information per se and genetic determinism, this has not been applied to behavioural genetic research and its ethical implications. Therefore, this paper elucidates how behavioural genetic information can be distinguished from other types of genetic and non-genetic information and also synthesises the determinative significance of genetic factors for the development of human behavioural traits. Undertaking this analysis enables the ethical issues raised by this research to be debated in an appropriate context and indicates that separate policy considerations are warranted.

     

Cognitive-behavioural interventions in a patient with an anxiety disorder related to diabetes

This study extends the data on the efficacy of cognitive interventions for patients with chronic medical problems and describes the case of a 37-year-old woman with an anxiety disorder related to diabetes. The effects on panic frequency, use of safety behaviour and related beliefs were investigated after the introduction of two main cognitive-behavioral interventions. The results are consistent with predictions from the cognitive model of panic. This case demonstrates the usefulness of directly challenging the 'meaning' of the feared situation in order to produce clinically significant improvements in the management of physical disease.     

Given-New Ordering Effects on the Production of Scrambled Sentences in Japanese

Across many languages, speakers tend to produce sentences so that given (previously referred to) arguments are mentioned before new arguments; this is termed given-new ordering. We explored the nature of such given-new effects in Japanese using a procedure following Bock and Irwin (1980). Speakers encoded and then recalled canonical (e.g., okusan-ga otetsudaisan-ni purezento-o okutta, the housewife gave the housekeeper a present) or scrambled (okusan-ga purezento-o otetsudaisan-ni okutta) dative targets when prompted by a statement-question sequence. The prompting statement established one nonsubject argument of the dative target as given, leaving the other nonsubject argument as new. Previous mention was either with lexically identical content (e.g., otetsudaisan or purezento) or with lexically distinct but nearly synonymous content (meidosan, housemaid or okurimono, gift). Results showed that speakers produced canonical or scrambled word orders so that given arguments were mentioned before new, but especially when the previous mention of the given argument occurred with lexically identical content (replicating Bock and Irwin's English effect). These results show that the production of Japanese scrambled and canonical word orders is sensitive to given versus new status (as in English), implying that given-new ordering arises at the stage of sentence production where scrambling effects are realized.     

Shackling the shoulders of giants

This paper informally summarizes a two-day symposium held at the U.S. National Academy of Sciences in Washington, D.C., September 5–6, 2002. The issue was to what extent the progress of science and societal capacity for continued technological innovation are threatened by excessive protection of intellectual property. Excessive protection creates disadvantages not only for scientists and inventors but also for educators/students and for librarians/clientele. Speakers from a variety of disciplines and institutions agreed unanimously that scientific and technological progress is, indeed, under serious threat. Various opinions were expressed about the degree of threat, currently and prospectively, as well as what counter-measures are best suited to resist undue restrictions on creative uses of scientific and technical data and information. This summary is based entirely on the author’s notes from the symposium, and the commentary offered is his alone. My apologies to the speakers if this paper does not accurately reflect the primary intent of their presentations. The “Suggested Readings” offered at the end are not specific to the speakers’ statements but rather are offered as a general resource to aid further research. The definitive record of the symposium is planned to be available from the National Academies Press as a Proceedings publication in the summer of 2003. John Gardenier is an independent researcher, ethicist and science writer.     

The Ethics of Type 1 Diabetes Prediction and Prevention Research

There are approximately one million cases oftype 1 diabetes in the US, and the incidenceis increasing worldwide. Given that two-thirdsof cases present in childhood, it is criticalthat prediction and prevention research involvechildren. In this article, I examine whethercurrent research methodologies conform to theethical guidelines enumerated by the NationalCommission for the Protection of Human Subjectsof Biomedical and Behavioral Research, andadopted into the federal regulations thatprotect research subjects. I then offer twopolicy recommendations to help researchersdesign studies that conform to these ethicalrequirements.     

Argumentation and Evidence

This essay explores the role of informal logicand its application in the context of currentdebates regarding evidence-based medicine. This aim is achieved through a discussion ofthe goals and objectives of evidence-basedmedicine and a review of the criticisms raisedagainst evidence-based medicine. Thecontributions to informal logic by StephenToulmin and Douglas Walton are explicated andtheir relevance for evidence-based medicine isdiscussed in relation to a common clinicalscenario: hypertension management. This essayconcludes with a discussion on the relationshipbetween clinical reasoning, rationality, andevidence. It is argued that informal logic hasthe virtue of bringing explicitness to the roleof evidence in clinical reasoning, and bringssensitivity to understanding the role ofdialogical context in the need for evidence inclinical decision making.     

The ‘Medical Body’ As Philosophy's Arena

Medicine, as Byron Good argues, reconstitutes thehuman body of our daily experience as a medical body,unfamiliar outside medicine. This reconstitution can be seen intwo ways: (i) as a salutary reminder of the extent to which thereality even of the human body is constructed; and (ii) as anarena for what Stephen Toulmin distinguishes as theintersection of natural science and history, in which many ofphilosophy's traditional (and traditionally abstract) questionsare given concrete and urgent form.This paper begins by examining a number of dualities between themedical body and the body familiar in daily experience. Toulmin's epistemological analysis of clinical medicine ascombining both universal and existential knowledge is thenconsidered. Their expression, in terms of attention,respectively, to natural science and to personal history, isexplored through the epistemological contrasts between themedical body and the familiar body, noting the traditionalphilosophical questions which they in turn illustrate.     

时间记忆层次网络模型的实验检验

实验采用分类性实验材料,使被试在对词单项目加工时形成较清晰的群集,进而形成时间组块,目的在于对时间记忆层次网络进行直接检验。其中时序判断用反时间时和正确率两种反应指标,时距估计用再现和口头估计两种方法。结果发现,时间信息记忆既存在层次网络的特征,又存在线性结构的特征。