Using Client Narratives to Identify Predictors of Outcome in Written Exposure Therapy and Cognitive Processing Therapy

Written exposure therapy (WET) is a brief, five-session treatment for posttraumatic stress disorder (PTSD) that aims to improve access to care. WET has been demonstrated to be an efficacious PTSD treatment with lower rates of dropout and noninferior PTSD symptom outcome compared to cognitive processing therapy (CPT), a 12-session, gold-standard treatment. To identify predictors of treatment outcome in both WET and CPT, the current study examined the content of participants’ written narratives. Participants were 123 adults with PTSD who were randomly assigned to receive WET (n = 61) or CPT (n = 62). The Change and Growth Experiences Scale (CHANGE) coding system was used to code all available narratives in both treatment conditions for variables hypothesized to be relevant to therapeutic change. Linear regression analyses revealed that in WET, higher average levels of accommodated (healthy, balanced) beliefs and an increase in accommodated beliefs from the first to the final impact statement predicted better PTSD symptom outcome at 12 weeks postrandomization. In CPT, higher average levels of overgeneralized and accommodated beliefs and lower levels of avoidance expressed in the narratives predicted better PTSD outcome. There were no significant predictors of outcome in analyses of change from the first to final impact statement in CPT. These findings add to research identifying predictors of change in WET and CPT by highlighting the importance of low avoidance in CPT and of trauma-related cognitions in both CPT and WET, even though WET is a brief written intervention that does not explicitly target cognitive change.     

THE WEAK ANTHROPIC PRINCIPLE AND THE DESIGN ARGUMENT

Abstract. The design argument for God's existence was critically assessed when in the growth of modern science the cognitive value of ideological categories was called into question. In recent discussions dealing with anthropic principles there has appeared a new version of the design argument, in which cosmic design is described without the use of ideological terms. The weak anthropic principle (WAP), a most critical version of all these principles, describes the fine-tuning of physical parameters necessary lo the genesis of carbon-based life. It defines no physical mechanisms of the observed coordination between physical parameters. If in a future unified physical theory such mechanisms are discovered, the weak anthropic principle should be replaced by the strong anthropic principle, which asserts the physical necessity of fine-tuning. Neither of the versions can be regarded as physically trivial unless one accepts strong assumptions of the existence of parallel universes. Consequently, a new version of the philosophical design argument can be developed on the basis of the weak anthropic principle.     

Arguing about the ethics of past actions: An analysis of a taped conversation about a taped conversation

In the face of widespread cynicism as regards the possibilities for reasoned and reasonable adjudication of ethical differences in the postmodern age, this essay proposes a dialogic, reconstructive rhetoric as a vehicle for jointly arguing about the ethics of past actions, and looks to the friendship circle as a model arena for the playing out of such a rhetoric. Analyzed by way of illustration is a conversation among four good friends about the ethics of another, surreptitiously taped, conversation between two of those friends.The author wishes to thank Barbie Zeltzer and Micheal Krippondorf, both of Temple University, fot thier comments. Abridged versions of this paper were presented at the Iowa Conference on Narrative in the Human Sciences,1990 and at the England Symposium in Narratives in the Social Sciences. Commentaries at these conferences were also very useful.     

Resolving arguments accurately

This empirical investigation examined how ordinary language users resolved disagreements over the solutions to categorical syllogisms. Forty-six participants completed puzzles in logic. After completing the puzzles, participants were then randomly paired into 23 to compare their answers and to resolve 159 disagreements. Results indicate that the most frequently used strategies for resolving disagreements centered on: (a) arguing over the merits of the position (47% of the time) and (b) appealing to past solutions as a means of addressing current disputes (28% of the time). In addition, the data revealed that the most frequently used strategy (arguing the merits of the positions) was no more effective than random choice (52% increase in correct solutions) while the strategy of appealing to past solutions significantly aided dyads in reaching correct solutions (70% increase in correct solutions).     

Critical thinking: A Socratic model

A concept of critical thinking is developed based on the Socratic method and called accordingly a Socratic model. First the features of critical thinking stressed in this model are stated and illustrated. The Socratic method is presented and interpreted, then taken to yield a model of critical thinking. The process of internalization by which the Socratic model helps us to become critical thinkers is described. Argument analysis is considered as a widely used instructional strategy adaptable for teaching critical thinking on the Socratic model. This Socratic model is advanced as one helpful way of organizing our ideas about critical thinking, helpful in unifying disparate factors and anchoring them in the humanist tradition.     

Professor Fisher on suppositions

I first support Alec Fisher's thesis that premises and conclusions in arguments can be unasserted first by arguing in its favor that only it preserves our intuition that it is at least possible that two arguments share the same premises and the same conclusion although not everything that is asserted in the one is also asserted in the other and second by answering two objections that might be raised against it. I then draw from Professor Fisher's thesis the consequence that in suppositional arguments the falsity (or unacceptability) of a supposition does not tell unfavorably in the evaluation of the argument, because the falsity (or unacceptability) of a (nonredundant) premise counts against an argument if and only if that premise is asserted. Finally, I observe that, despite the fact that they are neither expressed nor even alluded to, implicit assumptions in arguments are always asserted, unless the conclusion, but none of the explicit premisses, is unasserted. Hence, apart from an exceptional case of the kind just mentioned, the falsity (or unacceptability) of implicit assumptions always counts against an argument.I am indebted to Thomas E. Gilbert and Alec Fisher for their criticisms of an earlier draft of this paper.     

Critique of an epistemic account of fallacies

An epistemic account of fallacies is one which takes it as a necessary condition for a fallacy that it has a tendency to produce false or unwarranted beliefs. The most sophisticated form of this account occurs in an article by Robert J. Fogelin and Timothy J. Duggan (Fallacies,Argumentation 1, 1987, pp. 255–262). I criticize the Fogelin and Duggan proposal, in particular, and epistemic accounts, more generally. Though an epistemic approach is attractive, it enlarges the class of fallacies, beyond what would be permitted by traditional accounts. I also question thenecessity of fallacies leading to unwarranted beliefs. Some fallacies are fallacious due to their expected harm to argument practices. This position touches on a theme in the work of Van Eemeren and Grootendorst, though I criticize their notion of rules of argument as too broad.     

Multiple endorsers and multiple endorsements: The influence of message repetition,source congruence and involvement on brand attitudes

This paper investigates the effects of source congruence on brand attitudes in two situations: multiple brand endorsements by one celebrity and multiple celebrity endorsers of one brand. Under low involvement conditions, brand attitudes become more negative as a celebrity endorses multiple brands and more favorable with multiple endorsers. In high involvement conditions, strong source congruence overrides the negative effect of multiple brands, and the positive effect of multiple endorsers is found only with strong congruence. We interpret these results as suggestive of a frequency knowledge cue that dominates under low involvement but is non-diagnostic in high involvement scenarios.     

Perceived Barriers and Preliminary PTSD Outcomes in an Open Pilot Trial of Written Exposure Therapy With Latinx Immigrants

Latinx immigrants experience substantial disparities in mental health treatment access, particularly for posttraumatic stress disorder (PTSD). The availability of brief, flexible interventions in Spanish may assist in reducing these disparities. Written Exposure Therapy (WET) is a five-session PTSD intervention that appears as effective as longer, gold-standard interventions, but has yet to be tested among Latinx immigrants. To test the acceptability and preliminary effectiveness of WET, 20 Spanish-speaking, Latinx immigrants conducted structured interviews at pretreatment, were offered WET, and completed posttreatment structured interviews. Open thematic coding of pre- and posttreatment interview questions examined perceived barriers and benefits of WET. Quantitative components examined symptom change across PTSD (PCL-IV-C) and depression (PHQ-9). Quantitative results indicated clinically meaningful and statistically significant change in PTSD symptoms using intent-to-treat analyses (M_diff = 17.06, SD_diff = 9.97, range = 0–29, t(15) = 6.84, p < .001). Open thematic coding identified four barrier-related themes and three benefit-related themes at pretreatment. At posttreatment, three barrier-related themes and two benefit-related themes were identified. Qualitative results largely suggested that perceived barriers were common to other PTSD interventions (e.g., exposure components). Only one participant identified barriers specific to WET. Results suggested WET may reduce PTSD symptoms among Latinx immigrants. WET also appeared to be acceptable and primarily viewed as beneficial among this population. WET is a promising intervention with Latinx immigrants and warrants further testing larger trials, including testing implementation strategies that may improve access to care.     

How Is an Analytic Approach to Chinese Philosophy Possible? — An Observation from Perspective of Methodology

How to apply an analytic approach to Chinese philosophy has been a controversial issue in the field of the modern Chinese philosophy. The key to such an application is using an analytical approach. Various forms of analysis are used in modern philosophy. The term “analytic approach” refers to both conceptual and semantic analyses by which to analyze meaning and apply philosophical concepts, so as to interpret a different significance of these philosophical concepts. Beginning with the challenge of the analytic approach as applied to Chinese philosophy, it is necessary to address the line of holism and transcendental argument in terms of philosophical methodology. The former provides us with a framework of analysis of particular problems, while the latter helps us clarify the major difference between a philosophical argument and other arguments for knowledge. Chinese philosophy must greatly emphasize the importance of philosophical methodology, so as to reconstruct the framework of Chinese philosophy as it stands today.