Does the philosophy of medicine exist?

There has been a great deal of discussion, in this journal and others, about obstacles hindering the evolution of the philosophy of medicine. Such discussions presuppose that there is widespread agreement about what it is that constitutes the philosophy of medicine.Despite the fact that there is, and has been for decades, a great deal of literature, teaching and professional activity carried out explicitly in the name of the philosophy of medicine, this is not enough to establish that consensus exists as to the definition of the field. And even if consensus can be obtained as to what constitutes the philosophy of medicine, this does not mean that it exists as a field.     

Resource scarcity aggravates ingroup bias: Neural mechanisms and cross-scenario validation

Previous studies examining the relationship between ingroup bias and resource scarcity have produced heterogeneous findings, possibly due to their focus on the allocation of positive resources (e.g. money). This study aims to investigate whether ingroup bias would be amplified or eliminated when perceived survival resources for counteracting negative stimuli are scarce. For this purpose, we exposed the participants and another confederate of the experimenters (ingroup/outgroup member) to a potential threat of unpleasant noise. Participants received some ‘relieving resources’ to counteract noise administration, the amount of which may or may not be enough for them and the confederate in different conditions (i.e. abundance vs. scarcity). First, a behavioural experiment demonstrated that intergroup discrimination manifested only in the scarcity condition; in contrast, the participants allocated similar amounts of resource to ingroup and outgroup members in the abundance condition, indicating a context-dependent allocation strategy. This behavioural pattern was replicated in a follow-up neuroimaging experiment, which further revealed that when contrasting scarcity with abundance, there was higher activation in the anterior cingulate cortex (ACC) as well as stronger functional connectivity of the ACC with the empathy network (including the temporoparietal junction and medial prefrontal cortex) for ingroup compared to outgroup members. We suggest that ACC activation reflects the mentalizing process toward ingroup over outgroup members in the scarcity condition. Finally, the ACC activation level significantly predicted the influence of resource scarcity on ingroup bias in hypothetical real-life situations according to a follow-up examination.     

Episodic memory effects of gamma frequency precuneus transcranial magnetic stimulation in Alzheimer's disease: A randomized multiple baseline study

Episodic memory decline is the prominent neuropsychological feature of typical Alzheimer's Disease (AD), for which current treatments have a limited clinical response. Recently, gamma entrainment therapy has been used as a non-invasive treatment in AD, providing evidence that it may have the potential to alleviate brain pathology and improve cognitive function in AD patients. At the same time, the precuneus (PC) has been recognized as a key area involved in AD related memory deficits and as a key node of the Default Mode Network. This study aimed to investigate the effectiveness of a 40 Hz Transcranial Magnetic Stimulation (TMS) intervention, delivered bilaterally to the precuneus for 10 days, in improving the patients' episodic memory performance. Secondary outcome variables investigated included general cognitive function, semantic and spatial memory, as well as attention and executive function. A concurrent multiple baseline design across five cases was employed. Four patients completed the study. Visual analysis combined with effect size indices were used to evaluate changes across phases. An increase in the average level of immediate recalled words was observed in three out of four patients. Effect size indices indicated significant improvement of attention skills in two patients. No treatment effect was observed for semantic and visual memory, or for executive function. An immediate treatment effect was observed in all patients' general cognitive function as assessed with the Alzheimer's Disease Assessment Scale (mean reduction of 5 points), which was maintained and improved further three months post-treatment. The neuropsychological evaluations indicated improved performance three months post-treatment in immediate and delayed recall, attention, phonological verbal fluency, anxiety, and neuropsychiatric symptoms. This study provides preliminary evidence for the efficacy of a novel non-pharmacological treatment using gamma-band TMS in addressing cognitive dysfunction in AD.     

场依存性与独立性认知方式对视动错觉的影响

为探讨认知方式对视动性错觉的影响,对100名男性军校学员进行了棒框测验,15名高分者和15名低分者分别作为场依存组和场独立组。每名被试随机给予一系列视动阶跃刺激(5,10,15,20,30,40,60,80,100,120度/秒),每个刺激持续20秒。记录被试视动错觉出现的潜伏期和错觉模糊量。研究结果表明:1.场依存组被试的错觉潜伏期短于场独立组,它与刺激速度呈幂函数关系,而场独立组潜伏期随刺激速度的增加呈直线下降;2.在5—120度/秒的范围内,两组被试错觉量回归成两条直线,两直线回归系数无显著性差异,而截距差别十分显著。因此,场依存性/独立性认知方式是视动错觉个体差异性的一种重要影响因素,它对军事飞行员的心理学选拔和训练有着重要的意义。     

Polanyi's Finalism

Although Michael Polanyi's model of science and his construal of the nature of the real are usually thought to be congenial to religion and although Polanyi himself says that "the stage on which we thus resume our full intellectual powers is borrowed from the Christian scheme of Fall and Redemption" (Polanyi 1958, 324), theologians have given little attention to the model of God he presents. The metaphysical and theological vision unfolded in part 4 of Personal Knowledge is a thoughtful alternative to materialist versions of neo-Darwinism and provides a platform for revisiting four long-standing controversies at the interface of science and religion: whether life and mind can be completely specified in terms of physical analysis, whether nature can be adequately understood without appeal to final causes, whether natural selection adequately explains life's diverse forms, and whether knowledge can be fully objectified. Through an exploration of Polanyi's contribution to these discussions, we undertake to show not only that his treatment of God as a cosmic field is strikingly original but also that in reinstating activity as a metaphysical category, he reconstructs our understanding of our creaturely hope and calling.     

大学生场依存性─－独立性认知方式分析

对二十一个学科专业１５２６名大学生的场依存性─－独立性认知方式进行调查所获得的新近常模资料表明：大学生场依存性─－独立性个体差异的群体分布是正态性的,其总体平均水平以《认知方式图形测验》成绩作指标为１３．７（ｓ为４．６）。在此基础上,对文献所报道的影响场依存性─－独立性发展水平的两个因素作了进一步的研究分析,发现,大学生场依存性─－独立性的性别差异非常接近显著水平;专业分化是不依赖于性别因素而导致大学生场依存性─－独立性水平显著不同的主要因素．     

A preliminary sketch of a Jungian socioanalysis – an emerging theory combining analytical psychology,complexity theories,sociological theories,socio- and psycho-analysis,group analysis and affect theories1

This paper presents a preliminary sketch of what we have termed a Jungian socioanalysis – an emerging theory combining analytical psychology, complexity theories, sociological theories, socio- and psycho-analysis, group analysis and affect theories. Our assumption is that Jungian theory and practice need to attend to and focus more on social contexts, sociality and the influence of societal developments. But also, on the other hand, that analytical psychology, primarily Jung’s theory of individuation and the transcendent function as well as the broad complexity perspective of his theory of psyche, can be extended to a ‘socio’ and not just a ‘psycho’ perspective. The paper presents five foundational assumptions for a Jungian socioanalysis, with the following headings: 1) A Jungian socioanalysis calls for a complex psychology; 2) (Un)consciousness is social and sociality has a dimension of (un)consciousness; 3) A Jungian socioanalysis explores social fields ‘from within’ by smaller groups; 4) A Jungian socioanalysis enables and is enabled by emerging metaphors and affect-imagery; 5) Socio-cultural fields have an impulse toward individuation. This is the first of two papers in the present edition of the journal – the second paper gives socio-clinical illustrations of our thesis in this paper.     

激活右腹外侧前额叶提高抑郁症患者对社会疼痛的情绪调节能力：一项TMS研究

负性人际交往经历和负性社会事件是抑郁症的重要诱导因素, 而社会功能受损是抑郁症患者的重要特征之一, 患者通常表现出对社会疼痛的情绪失调。为了提高抑郁症患者在负性社交情境中或面对负性社会事件时的情绪调节能力, 本研究采用经颅磁刺激技术(transcranial magnetic stimulation, TMS), 考察抑郁症患者在腹外侧前额叶(the ventrolateral prefrontal cortex, VLPFC)被激活后其情绪调节能力的改变。结果表明, 当右侧VLPFC被TMS激活且患者采用认知重评策略调节情绪时, 实验组患者(n = 64)比对照组患者(n = 63)在社会排斥情境下报告了更弱的负性情绪体验, 这说明激活右侧VLPFC可以有效提高患者对社会疼痛的外显性情绪调节能力。本研究是采用TMS提高抑郁症患者情绪调节能力的首次尝试, 实验发现不但支持了VLPFC与认知重评策略的因果关系, 还为临床改善抑郁症等社会功能障碍患者的情绪调节能力提供了明确的神经治疗靶点。后续研究还需探讨多疗程TMS刺激方案、改变社会疼痛的诱发方式、对比左右侧VLPFC的治疗效果、尝试使用其他的情绪调节策略, 进一步验证本研究的结论, 优化TMS治疗方案。     

背外侧前额叶对主动遗忘负性社会反馈的作用：针对抑郁症的TMS研究

抑郁症患者的负性心境可能源于其抑制功能障碍。患者在主动遗忘负性材料时无法有效调用背外侧前额叶(the dorsolateral prefrontal cortex, DLPFC)等负责抑制控制的额叶脑网络。同时, 患者对社会信息的加工比对非社会信息的加工存在更明显的认知神经障碍, 很难主动遗忘对自己不利的社会反馈信息。为了提高抑郁症患者对负性社会反馈的主动遗忘能力, 本研究采用经颅磁刺激技术(transcranial magnetic stimulation, TMS), 考察抑郁症患者在左侧(n = 32)或右侧DLPFC (n = 30)被激活后其记忆控制能力的改变。结果表明, 当患者的DLPFC被TMS激活时, 他们对社会拒绝的回忆正确率与健康对照组(n = 31)无差异, 且TMS激活右侧DLPFC还改善了患者对他人的社会态度。本研究是采用TMS提高抑郁症患者主动遗忘能力的首次尝试, 研究结果不但支持了DLPFC与记忆控制功能的因果关系, 还为临床治疗抑郁症、创伤后应激障碍、药物成瘾等患者的记忆控制缺陷提供了明确的神经靶点。     

计算模型视角下信任形成的心理和神经机制——基于信任博弈中投资者的角度

人际信任渗透在社会交互的各个方面, 是促进和维持合作的重要基石。以往研究者借助信任博弈范式, 主要探讨了人际信任的理论模型、生物基础和影响因素等方面。近年来, 研究者开始将计算模型应用于信任博弈的数据分析中, 深入挖掘人际信任行为背后的心理机制, 将计算模型与神经影像技术结合, 加深对信任行为背后脑机制的理解。目前将计算模型应用于信任博弈范式中的研究主要针对“信任是如何形成的”这一科学问题, 未来要进一步发展计算模型方法, 结合非侵入性脑刺激技术, 应用于精神疾病人群中, 以深入理解正常和异常信任形成的心理和神经机制。