Family Climate and Expressed Emotion in the Course of Alcoholism

Family-based predictors of relapse were examined in 100 alcoholics who participated in a 12-week treatment program with 6-month and 18-month followups. “Expressed Emotion” (EE), or attitudes of relatives toward the alcoholic as measured by the Camberwell Family Interview, scales measuring rejection of the alcoholic by relatives, and self-reports of partner interaction were evaluated as possible predictors of abstinence. During therapy, partnership interactions showed a transient deterioration with increased temporary friction. Based on conservative criteria, the abstinence rate was 40% at 6-month followup and 30% at 18-month followup. An association with the relapse at followup could be obtained for the Patient Rejection Scale (PRS) and, using empirically derived classification rules, for the main three variables of the Camberwell Family Interview (CFI) conducted on admission: “Critical Comments,”“Emotional Overinvolvement,” and “Warmth.” A low number of Critical Comments and a high score in Warmth were associated with a lower risk of relapse; however, contrary to expectations, Emotional Overinvolvement of the significant other was associated with more abstinence. In addition, the number of Critical Comments made by relatives about the alcoholic, a major component of high EE as measured by the CFI, had a statistically significant impact on the “survival function” of abstinence, and thus contributed to the prediction of the course of alcoholism in the expected direction.     

Doing Good by Splitting Hairs? Analytic Philosophy and Applied Ethics

This article explores the connections between analytic philosophy and applied ethics — both historical and substantive. Historically speaking, applied ethics is a child of analytic philosophy. It arose as the result of two factors in the 1960s: the re‐emergence of normative ethics on the one hand, and urgent social and political challenges on the other. But is there a significant substantive link between applied ethics and analytic philosophy? I argue that applied ethics inherited important ‘analytic’ ideals such as clarity and argumentative rigour. At the same time these ideals are not the exclusive preserve of analytic philosophy and applied ethics. Moreover, they are under threat from various trends within applied ethics. In this context I rebut the allegation that the anti‐revisionist reliance on pre‐theoretical moral judgements (aka ‘intuitions’) is less rational than their revisionist dismissal. The article ends with a plea for an analytic approach within applied ethics.