The role of vital exhaustion in predicting the recurrence of vascular events: A longitudinal study

Background/objective

The aim of this study was to examine the role of vital exhaustion in predicting the recurrence of vascular events.

Setting the sales budget: An exploratory study

This article explores how the sales budget is set in a business organization. Findings from a longitudinal participant observation study revealed that the sales budget is considered of great importance to the organization as sales estimates serve as premises for planning of production and supply and new product developments. It was observed that the sales budget was based on a narrow, inner-directed perspective, almost looking away from important environmental driving forces such as competitors and customers. The findings also showed that individuals involved in the sales budgeting process behaved opportunistically, influencing the budgetary process and outcomes. Theoretical and normative implications are highlighted.     

Rhetoric and “doing philosophy”

By drawing new distinctions labelled appeal and response to replace traditional rhetorical modes of written discourse, the essay sketches a new perspective about what philosophers are doing rhetorically in doing philosophy. To think of philosophers as simply engaged in argument is an oversimplification and a distortion of what philosophers do. Crucial to doing philosophy are four activities: (1) definition and redefinition of problems and issues that form both the focus of the canonical historical literature of philosophy and what goes on in contemporary philosophy as a discipline, (2) the development and use of formal languages and technical vocabularies to abbreviate and label complexity and to disambiguate and precise distinctions necessary to deal with problems and issues, (3) the development and exploration of argumentative appeals for acceptance or refutation of answers to questions raised by the philosophical problematic, and (4) the development and exploration of explanatory responses to questions raised by the problematic. In so far as these four activities are driven and sanctioned by the current, self-defining philosophical problematic, contemporary philosophy as a body of knowledge is historical, cumulative, and marked by progress, and the doing of philosophy is fundamentally the making of written appeals and responses about its problematic.     

The social phobia and anxiety inventory: Construct validity

The Social Phobia and Anxiety Inventory (SPAI) is a new instrument composed of social phobia and agoraphobia subscales. The latter scale is used to detect social anxiety that may result from agoraphobia. The SPAI's construct validity was assessed through several procedures. First, confirmatory factor analyses were conducted to validate the existence of the two subscales. Second, exploratory factor analyses examined the underlying structure of the social phobia subscale. Third, a Q factor procedure determined if different anxiety diagnostic groups could be differentiated by their SPAI response pattern. The results confirmed the utility of the two SPAI subscales and identified a number of dimensions contained within the social phobia subscale which differed depending upon the specific subject sample. In addition, the complaints of social phobies appeared more homogeneous than those of an agoraphobic comparison group. The results are discussed in terms of construct validity and the sensitivity of the SPAI to various dimensions of social phobia fears.This study was supported in part by NIMH Grants 41852, 30915, 18269, and 16884.     

Dreaming for the World: A Jungian Study of Dreams During the COVID-19 Pandemic1

This project explores what dreams might reveal about the collective psyche’s response to the COVID-19 pandemic in its first year, before the development of vaccines. A brief survey, distributed to Jungian colleagues and organizations, and to various social media sites, invited people to submit online a dream related to the COVID-19 pandemic. Four hundred and thirty-six dreams were submitted. Forty additional Russian dreams were collected and submitted by Russian colleagues. Using qualitative research methods based on phenomenological hermeneutics, the researchers categorized and counted the range of COVID imagery. In addition, the researchers describe a range of psychic responses to the pandemic, including horror, grief, sickness, social discord, and violence, but also images of healing and transformation, increased sense of community, and spiritual renewal. Several healing nightmares are presented. Healing alchemical and anima/animus imagery is described. Twelve dreams are introduced and presented. It is concluded that the collective psyche, rooted in the Self, is a healing resource for social and cultural trauma. This project supports Beradt’s (1968) inspirational study of dreaming in Nazi Germany, as well as recent studies of COVID-related dreams and recent publications on the social nature of dreaming.     

Working with patients with disruptions in symbolic capacity1

This article focuses on understanding and working with patients who have poorly developed symbolic capacity, or for whom symbolic capacity has been disrupted due to trauma, particularly as it pertains to the use of reverie and interpretation in the analytic process. Many patients who present for Jungian analysis will initially present with deficits in symbolic functioning. This situation results in necessary limitations or modifications in utilizing traditional Jungian techniques such as dream analysis, active imagination, sand tray and other expressive art techniques. The initial phase of analytic work with these patients requires a focus on developing their symbolic capacity before traditional Jungian techniques can be utilized effectively. During the paper Jung's concept of ‘the symbolic attitude’ will be examined as well as the conceptual models of Wilfred Bion and other post-Bionians who outline theories and method for cultivating symbolic capacity and reflective functioning in patients for whom these capacities are impaired or poorly developed.     

Création de l’Échelle de Distorsions Cognitives pour adultes (EDC-A) : étude des propriétés psychométriques en population générale et association avec l’anxiété et la dépression

IntroductionCognitive distortions contribute to the maintenance of inappropriate cognitive schemas and play a role in the emergence of pathologies such as anxiety and depression. We developed the Cognitive Distortion Scale for Adults in order to identify distortions in individuals’ reasoning. The main objectives of this study were: (1) to study the psychometric properties of the Cognitive Distortion Scale for Adults, (2) to identify cognitive distortions associated with anxiety and depression in the general population.MethodThe study involved 916 participants (151 men and 765 women) aged 18 to 85-years. The participants completed the Cognitive Distortion Scale for Adults. The tool presents 42 mini scenarios with a daily life situation and a proposition concerning a cognitive distortion. Participants must give their degree of agreement (0 to 10) with this one. Seven cognitive distortions are operationalized (dichotomous reasoning, disqualification of one of the poles, arbitrary focusing, omission of the neutral, requalification in the other pole, maximization and minimization). They also completed the Hospital Anxiety and Depression Scale. Both scales were available online on the Internet. The total duration of the test was approximately 10 minutes. A group of 35 participants completed the two scale 15 days apart.ResultsThe sub-dimensions of EDC-A obtain Cronbach alphas higher than .65 and EDC-A has a coherent factor structure. The scale has good temporal stability. Anxiety is predicted by dichotomous reasoning, disqualification of one of the poles, arbitrary focusing and maximization. Depression is predicted by dichotomous reasoning, arbitrary focusing, omission of the neutral and requalification in the other pole. Anxiety and depression are associated with negative cognitive distortions in reasoning. However, depression is also associated with positive cognitive distortions. Subjects with depression produce more varied cognitive distortions than subjects with anxiety.DiscussionThe Cognitive Distortion Scale for Adults shows promising psychometric properties. Further studies will need to be conducted to confirm these results. Anxiety would be related to biased information treatment of negative information, whereas depression would be related to more comprehensive biased information treatment, both negative and positive information. Anxiety would be related to suboptimal functioning of reasoning abilities; depression would be more characterized by a structural deficit of reasoning abilities.     

Development and Evaluation of an Online Intervention for Reducing Hostile Interpretation Bias: A Randomized Controlled Trial

Hostility is a trait-level construct characterized by a generally suspicious and cynical view of other people that results in a tendency to interpret ambiguous social situations in hostile or threatening ways. Cognitive behavioral treatments for hostility have high dropout rates, which may be due to hostile beliefs interfering with treatment engagement. As such, there is a need for an alternative approach to prevent dropout and enhance engagement. The current study therefore developed and tested a 1-session, 40-minute online intervention targeting hostility. It was hypothesized that the hostility intervention would be rated as acceptable as indexed by self-report and completion rates. It was also hypothesized that the hostility intervention would be associated with greater reductions in hostility as compared to a control intervention. Finally, it was hypothesized there would be indirect effects of intervention condition on anger and aggression via changes in hostility.Undergraduates (N = 101) who reported elevated hostility and hazardous alcohol use were randomized to complete either the hostility intervention or a control condition targeting physical health habits. Results showed that individuals randomized to the hostility intervention found the intervention to be highly acceptable and all participants completed the intervention in its entirety. The hostility intervention was associated with significantly faster reductions in hostile interpretations than the control condition with medium to large effects. There were significant indirect effects of intervention condition on month one follow-up anger and aggression via changes in hostile cognitions. This proof-of-concept study provides initial evidence that a brief, single-session intervention may be a promising approach for reducing hostility and its correlates.     

Clinical interpretation: The hermeneutics of medicine

I argue that clinical medicine can best be understood not as a purified science but as a hermeneutical enterprise: that is, as involved with the interpretation of texts. The literary critic reading a novel, the judge asked to apply a law, must arrive at a coherent reading of their respective texts. Similarly, the physician interprets the text of the ill person: clinical signs and symptoms are read to ferret out their meaning, the underlying disease. However, I suggest that the hermeneutics of medicine is rendered uniquely complex by its wide variety of textual forms. I discuss four in turn: the experiential text of illness as lived out by the patient; the narrative text constituted during history-taking; the physical text of the patient's body as objectively examined; the instrumental text constructed by diagnostic technologies. I further suggest that certain flaws in modern medicine arise from its refusal of a hermeneutic self-understanding. In seeking to escape all interpretive subjectivity, medicine has threatened to expunge its primary subject — the living, experiencing patient.     

Medical hermeneutics: Where is the “text” we are interpreting?

The present paper is a commentary on an article by Drew Leder [1]. Leder identifies a series of texts in the clinical encounter, emphasizes the central role of interpretation in making sense of each of these texts, and articulates ordering principles to guide the interpretive work.The metaphor of clinical work as textual explication, however, creates the expectation that there is a text somewhere to be found. Such an expectation invites doctors and patients to search for the text and runs the risk of conceptualizing patients as more static than they are. If one is to use the textual metaphor, one must appreciate the radical extent to which the clinical encounter is a mutually produced and shifting entity. The qualities of mutuality and indeterminacy are not those one usually associates with texts. One might ultimately be better served by a different metaphor based more directly on uncertainty.