Research exploring the needs of families of childhood cancer survivors is critical to improving the experiences of future families faced by this disease. However, there are numerous challenges in conducting research with this unique population, including a relatively high mortality rate. In recognition that research with cancer survivors is a relational activity, this article presents a series of cases of parents bereaved by childhood cancer who unintentionally received invitations to participate in survivorship research. We explore six ethical considerations, and compare (...) our experiences with that described previously. Our considerations include the sharing of confidential information with external parties to confirm past patients’ vital status and appropriate researcher responses to bereaved parents. The management of researchers’ emotional safety when working with illness populations and the fact that study invitations can elicit grief responses in non-bereaved families are discussed. To conclude, we argue for the benefits of inviting bereaved parents whose children died after treatment completion in survivorship research. Such parents’ early survivorship experiences will otherwise be systemically neglected. We argue that discussing complex cases can assist researchers to protect participants’ and researchers’ emotional well-being. We hope to contribute to the dearth of discussion about research operating procedures to address these issues. (shrink)

Major depressive disorder is a highly prevalent psychiatric disorder, and recurrent depression is associated with severe and chronic impairment. Identifying markers of risk is imperative to i...

An important application of cognitive architectures is to provide human performance models that capture psychological mechanisms in a form that can be “programmed” to predict task performance of human–machine system designs. Although many aspects of human performance have been successfully modeled in this approach, accounting for multitalker speech task performance is a novel problem. This article presents a model for performance in a two-talker task that incorporates concepts from psychoacoustics, in particular, masking effects and stream formation.

A Conversation with Claire Katz about her book, Levinas and the Crisis of Humanism.

The philosophy of patient-centred care has become widely embraced but its implementation is dependent on interrelated factors. A factor that has received limited attention is the role of policy tools. In Ontario, one method government can use to promote healthcare priorities is through health regulatory colleges, which set the standard of practice for health professionals. The degree to which government policy in support of patient-centered care has influenced the direction provided by health regulatory colleges to their members, and ultimately impacted (...) actual patient care, remains unclear. This study investigates the extent to which Ontario’s health regulatory colleges have provided explicit written guidance to members related to the importance of patient-centred care. It also explores applied and theoretical explanations that may further our understanding of why patient-centred care has not been more fully embraced. Findings reveal that guidance provided by Ontario’s health regulatory colleges varies widely. Institutional barriers and the choice of policy tools for disseminating government preferences may hinder full implementation of the principles of patient-centred care. More fully understanding the role health regulatory colleges’ play in facilitating the implementation of health policy will contribute positively to dialogue and to efforts to achieve positive health system reforms. (shrink)

While a number of valid molecular targets have been discovered for tumours over the past decade, finding an effective way of delivering therapeutic genes specifically to tumours has proved more problematic. A variety of viral and non‐viral delivery vehicles have been developed and applied in anti‐cancer gene therapies. However, these suffer from either inefficient and/or short‐lived gene transfer to target cells, instability in the bloodstream and inadequate tumour targeting. Recently, various types of non‐pathogenic obligate anaerobic and facultative anaerobic bacteria have (...) been shown to infiltrate and selectively replicate within solid tumours when delivered systemically. This has prompted the development of cancer gene therapy protocols that use such bacteria as gene delivery vehicles. Here, we review the evidence for the success of these in pre‐clinical models and clinical trials, as single modality treatments and in combination with conventional cancer therapies. BioEssays 28:84–94, 2006. © 2005 Wiley Periodicals, Inc. (shrink)

A prefrontal control system that is less mature than the limbic reward system in adolescence is thought to impede self-regulatory abilities, which could contribute to poor dietary choices and obesity. We, therefore, aimed to examine whether structural morphology of the prefrontal cortex and the amygdala are associated with dietary decisions and obesity in children and adolescents. Seventy-one individuals between the ages of 8–22 years participated in this study; each participant completed a computer-based food choice task and a T1- and T2-weighted (...) structural brain scans. Two indices of obesity were assessed, including age- and sex-specific body mass index and waist-to-height ratio. The behavioral task included rating 60 food stimuli for tastiness, healthiness, and liking. Based on each participant’s self-ratings, 100 binary food choices were then made utilizing a computer mouse. Dietary “self-control” was calculated as the proportion of trials where the individual chose the healthier food item over the total number of trials. Cortical thickness and amygdala subnuclei volumes were quantified using FreeSurfer 6.0 and CIT168 atlas, respectively. We found that WHtR was negatively associated with the thickness of bilateral superior frontal, left superior temporal, right insula, and right inferior temporal regions. We also found WHtR to be positively associated with the volume of the central nucleus region of the amygdala, after adjusting for the hemisphere, age, sex, and intracranial volumes. A similar data pattern was observed when BMIz was used. Moreover, we found that across all participants, thinner right superior frontal cortex and larger left CEN volumes predicted lower dietary self-control. These results suggest that differential development of the PFC and amygdala relate to obesity and dietary self-control. Further longitudinal studies are merited to determine causal relationships among altered PFC to amygdala neural circuitry, dietary self-control, and obesity. (shrink)

The aim of the social and behavioral sciences is to understand human behavior across a wide array of contexts. Our theories often make sweeping claims about human nature, assuming that our ancestors or offspring will be prone to the same biases and preferences. Yet we gloss over the fact that our research is often based in a single temporal context with a limited set of stimuli. Political and moral psychology are domains in which the context and stimuli are likely to (...) matter a great deal (Van Bavel, Mende-Siedlecki, Brady, & Reinero, 2016). In response to Yarkoni (see BBS issue), we delve into topics related to political and moral psychology that likely depend on features of the research. These topics include understanding differences between liberals and conservatives, when people are willing to sacrifice someone to save others, the behavior of political leaders, and the dynamics of intergroup conflict. (shrink)

Most areas of philosopher Edmund Husserl’s thought have been explored, but his views on logic, mathematics, and semantics have been largely ignored. These essays offer an alternative to discussions of the philosophy of contemporary mathematics. The book covers areas of disagreement between Husserl and Gottlob Frege, the father of analytical philosophy, and explores new perspectives seen in their work.

In the conclusion to this multi-part article I first review the discussions carried out around the six essential questions in psychiatric diagnosis – the position taken by Allen Frances on each question, the commentaries on the respective question along with Frances’ responses to the commentaries, and my own view of the multiple discussions. In this review I emphasize that the core question is the first – what is the nature of psychiatric illness – and that in some manner all further (...) questions follow from the first. Following this review I attempt to move the discussion forward, addressing the first question from the perspectives of natural kind analysis and complexity analysis. This reflection leads toward a view of psychiatric disorders – and future nosologies – as far more complex and uncertain than we have imagined. (shrink)

In our commentary we ask whether we should ultimately endeavour to find the deep causes of behaviours? Then we discuss two extensions of the proposed framework: (1) Mendelian randomisation and (2) hypothesis-free gene–environment interaction (leveraging heterogeneity in genetic associations). These complementary methods help move us towards second-generation causal knowledge, ultimately understanding mechanistic pathways and identifying more effective intervention targets.

By examining the shared neuro-cognitive correlates of curiosity and creativity, we better understand the brain basis of creativity. However, by only examining shared components, important neuro-cognitive correlates are overlooked. Here, we argue that any comprehensive brain model of creativity should consider multiple cognitive processes and, alongside the interplay between brain networks, also the neurochemistry and neural oscillations that underly creativity.

System-level change is crucial for solving society's most pressing problems. However, individual-level interventions may be useful for creating behavioral change before system-level change is in place and for increasing necessary public support for system-level solutions. Participating in individual-level solutions may increase support for system-level solutions – especially if the individual-level solutions are internalized as part of one's social identity.

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article will take up the first two questions. With the first question, invited commentators express a range of opinion regarding the nature of psychiatric disorders, loosely divided into a realist position that the diagnostic categories represent real diseases that we can accurately name and know with our perceptual abilities, a middle, nominalist position that psychiatric disorders do exist in the real world but that our diagnostic categories are constructs that may or may not accurately represent the disorders out there, and finally a purely constructivist position that the diagnostic categories are simply constructs with no evidence of psychiatric disorders in the real world. The second question again offers a range of opinion as to how we should define a mental or psychiatric disorder, including the possibility that we should not try to formulate a definition. The general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM – whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part 1 of this article took up the first two questions. Part 2 took up the second two questions. Part 3 now deals with Questions 5 & 6. Question 5 confronts the issue of utility, whether the manual design of DSM-III and IV favors clinicians or researchers, and what that means for DSM-5. Our final question, Question 6, takes up a concluding issue, whether the acknowledged problems with the earlier DSMs warrants a significant overhaul of DSM-5 and future manuals. As in Parts 1 & 2 of this article, the general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

Despite the frequency of stillbirths, the subsequent implications are overlooked and underappreciated. We present findings from comprehensive, systematic literature reviews, and new analyses of published and unpublished data, to establish the effect of stillbirth on parents, families, health-care providers, and societies worldwide. Data for direct costs of this event are sparse but suggest that a stillbirth needs more resources than a livebirth, both in the perinatal period and in additional surveillance during subsequent pregnancies. Indirect and intangible costs of stillbirth are (...) extensive and are usually met by families alone. This issue is particularly onerous for those with few resources. Negative effects, particularly on parental mental health, might be moderated by empathic attitudes of care providers and tailored interventions. The value of the baby, as well as the associated costs for parents, families, care providers, communities, and society, should be considered to prevent stillbirths and reduce associated morbidity. (shrink)

Christopher Boorse’s biostatistical theory of medical disorder claims that biological part-dysfunction (i.e., failure of an internal mechanism to perform its biological function), a factual criterion, is both necessary and sufficient for disorder. Jerome Wakefield’s harmful dysfunction analysis of medical disorder agrees that part-dysfunction is necessary but rejects the sufficiency claim, maintaining that disorder also requires that the part-dysfunction causes harm to the individual, a value criterion. In this paper, I present two considerations against the sufficiency claim. First, I analyze (...) Boorse’s central argument for the sufficiency claim, the “pathologist argument,” which takes pathologists’ intuitions about pathology as determinative of medical disorder and conclude that it begs the question and fails to support the sufficiency claim. Second, I present four counterexamples from the medical literature in which salient part-dysfunctions are considered nondisorders, including healthy disease carriers, HIV-positive status, benign mutations, and situs inversus totalis, thus falsifying the sufficiency claim and supporting the harm criterion. (shrink)

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article took up the first two questions. Part II will take up the second two questions. Question 3 deals with the question as to whether DSM-V should assume a conservative or assertive posture in making changes from DSM-IV. That question in turn breaks down into discussion of diagnoses that depend on, and aim toward, empirical, scientific validation, and diagnoses that are more value-laden and less amenable to scientific validation. Question 4 takes up the role of pragmatic consideration in a psychiatric nosology, whether the purely empirical considerations need to be tempered by considerations of practical consequence. As in Part 1 of this article, the general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

This article describes the recent reception of Giovanni Gentile and his doctrine of actualism, describing the philosopher's rehabilitation as a major Italian thinker and actualism as a provocative account of socially situated consciousness. The discussion then turns to the future of Gentile studies, focusing on ways in which the ahistorical methods of analytic philosophy might help restore actualism and its author to their proper place in the philosophical canon.

This volume addresses the intriguing issue of indirect reports from an interdisciplinary perspective. The contributors include philosophers, theoretical linguists, socio-pragmaticians, and cognitive scientists. The book is divided into four sections following the provenance of the authors. Combining the voices from leading and emerging authors in the field, it offers a detailed picture of indirect reports in the world’s languages and their significance for theoretical linguistics. Building on the previous book on indirect reports in this series, this volume adds an empirical (...) and cross-linguistic approach that covers an impressive range of languages, such as Cantonese, Japanese, Hebrew, Persian, Dutch, Spanish, Catalan, Armenian, Italian, English, Hungarian, German, Rumanian, and Basque. (shrink)

The objective of the study was to explore parental experiences of being offered participation in a previous neonatal research study involving venepuncture. The method employed was a questionnaire-based exploration of parents' attitudes in those approached to participate in a study of term and preterm immunization responses (Preterm Immunisation Study [PREMIS]). We explored experience of the initial approach, knowledge of study, venepuncture and views on research ‘in general’. In all, 59% of families responded. Highest response rates were for those participating in (...) PREMIS (87% term/69% preterm) and lowest in decliners (34% and 35%). Responding parents participating in PREMIS were well informed, positive about research and did not find the venepuncture problematic. Sixty percent of responding parents who declined PREMIS attributed their declining to the need for venepuncture. In conclusion, parents participating or declining a neonatal study involving venepuncture are different, but participating parents were well informed and seemed able to judge that participation was right for them such that in consenting families venepuncture itself is not problematic. (shrink)

In psychiatry's transformation from an asylum-based to a community-oriented profession, false positive diagnoses became a major challenge to the validity of the diagnostic system. The shift to descriptive, symptom-based operationalized diagnostic criteria of DSM-III further exacerbated this difficulty because of the contextually based nature of the distinction between normal distress and mental disorder. Through selected examples, the degree of success with which DSM-III and DSM-IV have attended to the challenge of avoiding false positive diagnoses is examined. Conceptual analysis of selected (...) criteria sets, with a focus on counterexamples to the claim that DSM criteria imply disorder, is performed. Psychiatry has so far failed to systematically confront the problem of false positives. Flaws in criteria, which can be recognized even by lay people, remain unaddressed, despite the fact that the issue is purely conceptual and is not sensitive to any new research information. (shrink)

Autonomy is a vital concept in much of modern theory, defining the Subject as capable of self-governance. Democratic theory relies on the concept of autonomy to provide justification for participatory government and the normative goal of democratic governance, which is to protect the ability of the individual to self-govern. Offering the first examination of the concept of autonomy from a postfoundationalist perspective, _The Autonomous Animal _analyzes how the ideal of self-governance has shaped everyday life. Claire E. Rasmussen begins by (...) considering the academic terrain of autonomy, then focusing on specific examples of political behavior that allow her to interrogate these theories. She demonstrates how the adolescent—a not-yet-autonomous subject—highlights how the ideal of self-governance generates practices intended to cultivate autonomy by forming the individual’s relationship to his or her body. She points up how the war on drugs rests on the perception that drug addicts are the antithesis of autonomy and thus must be regulated for their own good. Showing that the animal rights movement may challenge the distinction between human and animal, Rasmussen also examines the place of the endurance athlete in fitness culture, where self-management of the body is the exemplar of autonomous subjectivity. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:What Makes a Mental Disorder Mental?Jerome C. Wakefield (bio)Keywordsharmful dysfunction, mental disorder, intentionality, mental dysfunction, mental functioning, phenomenality, somatic disorderWhat makes a medical disorder mental rather than (exclusively) somatic or physical? Psychiatry to some extent depends for its existence as a medical specialty on the distinction between mental and somatic disorders, yet the history of this distinction presents a bewildering array of puzzling judgments, radical shifts, and seemingly (...) arbitrary distinctions. The historical observation that putative mental disorders are often reclassified as physical disorders as soon as their physiologic basis is understood further confuses matters. Moreover, recent debates about such classifications often seem to reflect desires to protect professional turf or obtain optimal reimbursement for treatment more than they do the application of a coherent conceptual distinction. No wonder that Brülde and Radovic (2006) disarmingly admit at the outset of their exploration of this question that there is a case to be made that their topic is relatively unimportant or even meaningless intellectually, a rare way to start an inquiry!Could there nonetheless be a cogent conceptual distinction lurking here? Brülde and Radovic usefully invite us to reframe the question, in effect as follows: Suppose we pay attention to professional and lay judgments as evidence but at the same time try to avoid being ensnared by the distortions resulting from turf issues and other pragmatic motives and constraints. Can we then identify some principled distinction in this domain that is worth making and that interestingly corresponds to the distinction generally made between mental disorders and strictly somatic disorders? Brülde and Radovic do not come to any confident or compelling conclusion about this.My answer, based on my harmful dysfunction analysis of disorder (Wakefield, 1992a, 1992b, 1999a, 1999b), is that a mental disorder is a harmful mental dysfunction, where a mental dysfunction is a failure of the capacity of some mental mechanism to perform a function for which it was biologically designed. I argue that, owing to a series of logical missteps, Brülde and Radovic needlessly reject this view. After some preliminary comments and clarifications, I defend the internal dysfunction approach from the objections posed by Brülde and Radovic, and then conclude by elaborating this view in some new ways. Note that Brülde and Radovic critique something they call the "internal cause view" of what makes a disorder mental, and they name others who hold that view. However, my work figures prominently in their discussion, and for expository simplicity, I will presume to simply construe their arguments as aimed at the harmful dysfunction analysis. [End Page 123]Clarifying the QuestionIt is easy to misconstrue the question "What makes a mental disorder mental" as demanding a precise account of the mental, an error to which Brülde and Radovic succumb in their repeated complaints that various writers do not present principled accounts of the mental but rely on lists of prototypical mental states or tentative guidelines to fix the reference of mental. We would need a precise definition of mental if the problem were how to classify cases in which it is ambiguous whether some phenomenon is mental or physical. We might imagine, for example, someone being genuinely puzzled as to whether inability to sleep is failure of a mental function or process. But this sort of puzzle about the boundaries of the mental is not the problem with which Brülde and Radovic are concerned; anyway, ambiguous cases may just be inherently ambiguous. The problem, which a crisp definition of mental will not resolve, is what relation mental states or mechanisms must have to a disorder to make it a mental disorder; must there be mental symptoms, or mental dysfunctions, or either one, and so on? But, even if a precise resolution of the nature of the mental is not needed, some notion of the mental domain is essential in pursuing this discussion. We can pick out the mental ostensively, by pointing to lots of examples (e.g., perception, motivation, emotion, thought, and sensation) much more confidently than we can define it in a principled way. But because Brülde and Radovic find fault in such ostensive reference fixing, let me... (shrink)

Two experiments examined similarities and differences in the effects of consciously and unconsciously perceived rewards on the active maintenance of goal-relevant information. Participants could gain high and low monetary rewards for performance on a word span task. The reward value was presented supraliminally or subliminally at different stages during the task. In Experiment 1, rewards were presented before participants processed the target words. Enhanced performance was found in response to higher rewards, regardless whether they were presented supraliminally or subliminally. In (...) Experiment 2, rewards were presented after participants processed the target words, i.e., during maintenance. Performance increased in response to relatively high rewards when they were presented subliminally, but decreased when they were presented supraliminally. We conclude that both consciously and unconsciously perceived rewards boost resources supporting the maintenance of task-relevant information. Conscious processing of rewards can, however, heavily interfere with an ongoing maintenance process and impair performance. (shrink)

The HOU-based analysis of ellipsis was shown byDalrymple et al. (1991) and Shieber et al. (1996) to correctly capture thecomplex interaction of VP-ellipsis, scope and anaphora and claimed toextend to further related phenomena. When applied to deaccenting, theanalysis makes a strong prediction, namely that all anaphors occurringin the deaccented part of a deaccented utterance are parallelanaphors, i.e., anaphors that resolve to their parallel counterpart inthe source. I argue that this prediction is supported by the data andshow that it correctly captures (...) the interaction of deaccenting withanaphora, (in)definiteness and focus. (shrink)

A filosofia com crianças, em todas as suas guisas, visa engendrar o pensamento filosófico e o raciocínio nas crianças. Muito é escrito sobre o que a participação na filosofia poderia fazer para a criança academicamente e emocionalmente. O que propomos aqui é que permitindo às crianças participar de diálogos filosóficos elas aprenderão uma abordagem que poderia dar suporte a sua participação na sociedade e que poderia envolvê-las na consideração e no arejamento de suas vistas, tomando decisões em suas interações e (...) relacionamentos com os outros. É inevitável que, vivendo com os outros, se encontrem os valores dos outros. É essencial, portanto, que as crianças aprendam como lidar com os valores dos outros mas também que elas aprendam como desenvolver os seus próprios pelo questionamento e a reflexão. Melhor que ensinar às crianças sobre os valores ou ensinar-lhes os valores que elas deveriam ter, este artigo sugere que às crianças deveriam ser proporcionadas oportunidades de explorar uma variedade de perspectivas e que elas precisam aprender a fazer isto. Além disso, no entanto, a fim de viver harmoniosamente com os outros, existem considerações sobre ética a serem encontradas. As crianças precisam aprender como lidar com política, arte, ciência, literatura e a maior variedade de problemas que a vida em sociedade inclui. De fato, as crianças precisam aprender o que é requerido para ser um cidadão. Aqui o aprendizado da criança é contextualizado no Currículo de Excelência da Escócia, no qual se espera das crianças que elas sejam capazes de “fazer escolhas e tomar decisões informadas” e de “desenvolver pontos de vista informados e éticos de problemas complexos” (Scottish Executive, 2004, p.12) como parte de sua educação para a cidadania. Se ser um cidadão envolve esses elementos, então existe um desafio para os professores no que concerne a como as crianças vão alcançar os resultados desejados. O objetivo de tal currículo é que a criança ‘aprenda para a vida’ adquirindo as competências para a vida de forma que a sociedade se beneficie. É colocado, neste artigo, que participando dos diálogos filosóficos uma pessoa é suscetível de favorecer uma apreciação dos outros e de suas perspectivas, de compreender que os valores e opiniões de alguém evoluem, que essa visão filosófica pode, de fato, funcionar para a melhora da sociedade. Contudo, o que é sugerido é que fazendo filosofia aprende-se como viver bem. (shrink)