Familial comorbidity of bipolar disorder and multiple sclerosis: Genetic susceptibility, coexistence or causal relationship?

Our purpose in undertaking the present study was to examine the hypotheses proposed for explaining the frequent comorbidity of bipolar disorder and multiple sclerosis. One hypothesis posits that, when there is comorbidity, MS plays a causal role in psychiatric manifestations. Another suggests that both disorders have a common underlying physiological process that increases the likelihood of their co-occurrence. We examined two adult siblings with comorbidity and their relatives, including three generations of family members with psychiatric morbidity. We found an extensive multigenerational history of bipolar disorder in this family. This history would seem to support the hypothesis of a common underlying brain process (potentially genetically-based) to explain the comorbidity of BD and MS, but cannot clarify whether this comorbidity implies a relationship between the two disorders or merely reflects parallel processes of brain deterioration. We cannot, however, rule out the possibility of a subclinical MS-related process leading to the early manifestation of BD, with MS appearing much later in time, or even a third, undetermined factor, leading to familial comorbidity. Although we have insufficient information to support either hypothesis definitively, we present the familial cases as a springboard for a discussion of dilemmas related to teasing apart MS and BD comorbidity. Further observation of the clinical course of the younger family members, who have not yet shown any neurological signs, over the next few years may elucidate the current picture further.     

The impact of experiential avoidance on the relations between illness representations,pain catastrophising and pain interference in chronic pain

Objective: The aim of this study was to examine the effects of experiential avoidance (EA) on the indirect relationship of chronic pain patients’ illness representations to pain interference, through pain catastrophising

Design and main outcome measure: The sample consisted of 162 patients diagnosed with an arthritis-related or a musculoskeletal disorder. The effects of EA on the pathway between illness representations, pain catastrophising and pain interference were examined with PROCESS, a computational tool for SPSS

Results: After controlling for patient and illness-related variables and pain severity, the ‘illness representations–pain catastrophising–pain interference’ pathway was interrupted at the higher levels of EA. The reason was that, at the high levels of EA, either the relation of illness representations to pain catastrophising or the relation of pain catastrophising to pain interference was not statistically significant.

Conclusion: The findings indicate that EA is not a generalised negative response to highly aversive conditions, at least as far as the factors examined in this study are concerned. EA may rather reflect a coping reaction, the impact of which depends on its specific interactions with the other aspects of the self-regulation mechanism. At least in chronic pain, EA should become the focus of potential intervention only when its interaction with the illness-related self-regulation mechanism results in negative outcomes.     

A multilevel longitudinal study of adolescent Internet addiction: The role of obsessive–compulsive symptoms and classroom openness to experience

Internet addiction (IA) in adolescence was longitudinally examined in relation to individual obsessive–compulsive symptoms and the personality trait of openness to experience (OTE) at the classroom level. The study consists of a two-point measure of a normative sample comprising 648 Greek adolescents (retention = 363, age 16–18 years, wave 1: age = 15.75 years, SD = 0.57, males = 46.2%, females = 53.8%). IA was assessed with the IA Test (Young, K. S. [1998]. Caught in the net: How to recognize the signs of internet addiction—And a winning strategy for recovery. New York, NY: Wiley), obsessive–compulsive symptoms with the Symptom check list 90 revised (Derogatis, L. R., & Savitz, K. L. [1999]. The SCL-90-R, brief symptom inventory, and matching clinical rating scales. In M. E. Maruish (Ed.), The use of psychological testing for treatment planning and outcomes assessment (2nd ed., pp. 679–724). Mahwah, NJ: Lawrence Erlbaum Associates Publishers) and OTE with the FFFK (Asendorpf, J. D., & van Aken, M. A. G. [2003]. Validity of big five personality judgments in childhood: A 9 year longitudinal study. European Journal of Personality, 17, 1–17). A three-level hierarchical linear model investigated individual- and classroom-level effects on IA score and its changes over time. The findings revealed that IA at the initial level was associated with the obsessive–compulsive symptoms of the individual and negatively related to classroom-level OTE. However, adolescents high on obsessive–compulsive symptoms in high on OTE classrooms presented higher IA scores over time.     

Anti-Realist Interpretations of Plato: Paul Natorp

The paper considers Paul Natorp's Kantian reading of Plato's theory of ideas, as developed in his monumental work, Platos Ideenlehre, eine Einführung in den Idealismus (1903, 1921). Central to Natrop's reading are, I argue, the following two claims: (1) Plato's ideas are laws, not things; and (2) Plato's theory of ideas in the first instance a theory about the possibility and nature of thought - in particular cognitive and indeed scientific or explanatory thought - and only as a consequence is it a theory about the nature of reality. Natrop thus argues that Plato's theory of ideas is at its heart a transcendental theory, and that Plato's metaphysics is built on this basis. The paper considers these claims - and their textual basis in Plato - in some detail, and attempts an initial evaluation of their plausibility as a reading of Plato. I am on the whole sympathetic to Natorp's reading, though a proper assessment goes beyond the present paper. The wider interest of this idealist or anti-realist reading of Plato ought to be obvious, especially in view of the commonly accepted assumption these days that both Plato and Aristotle, and indeed the Greeks in general, took realism entirely for granted (see e.g. M. Burnyeat). Natorp argues that this is true of Aristotle, but quite untrue of Plato. But he is quite clear that the idealism he ascribes to Plato is not Berkeleyan or metaphysical idealism, but a certain kind of transcendental or epistemological idealism. Natorp, however, is no uncritical follower of Kant, and the version of trascendental idealism that he ascribes to Plato is, I argue, very different from Kant's.     

Critical notice

Reasons and values

Christine Korsgaard's Creating The Kingdom of Ends and The Sources of Normativity, Cambridge University Press, 1996. Pp 442. ISBN 0–521–49644–6. Price £40.     

Smart and Tensed Beliefs

The aim of this paper is to defend a prototype B-theory answer to McTaggart’s Puzzle about Time. Smart hopes to solve the issue by pointing to the “anthropocentricity” of temporal A-notions. There is one important problem: explaining Prior cases (for instance being relieved that a painful experience is over) in B-theoretic terms. First, it is argued that the problem is how to explain the nature of the subject’s tensed belief in Prior cases; the essential indexicality of the concept ‘now’. Then it is suggested that Smart could utilize Burge’s framework for dealing with de re beliefs and a way of formalizing tensed beliefs is proposed. The last section of the paper deals with the exact role of the formalized indexical element. If these three steps are worked out, we might have an explanation of the facts involved in Prior cases without mentioning any A-facts. Hence an important problem to a Smart-influenced B-theory is solved, and McTaggart’s Puzzle answered in an adequate manner.