Machine generated contents note: -- Notes on Contributors -- Preface; R.Dallos -- Carving Nature at its Joints? DSM and the Medicalization of Everyday Life; M.Rapley, J.Moncrieff&J.Dillon -- Dualisms and the Myth of Mental Illness; P.Thomas&P.Bracken -- Making the World Go Away, and How Psychology and Psychiatry Benefit; M.Boyle -- Cultural Diversity and Racism: An Historical Perspective; S.Fernando -- The Social Context of Paranoia; D.J.Harper -- From 'Bad Character' to BPD: The Medicalization of 'Personality Disorder'; J.Bourne -- Medicalizing Masculinity; S.Timimi -- (...) Can Traumatic Events Traumatise People? Trauma, Madness and 'Psychosis'; L.Johnstone -- Children Who Witness Violence at Home; A.Vetere -- Discourses of Acceptance and Resistance: Speaking Out About Psychiatry; E.Speed -- The Personal Is the Political; J.Dillon -- 'I'm Just, You Know, Joe Bloggs': The Management of Parental Responsibility for First-Episode Psychosis; C.Coulter&M.Rapley -- The Myth of the Antidepressant: An Historical Analysis; J.Moncrieff -- Antidepressants and the Placebo Response; I.Kirsch -- Why Were Doctors so Slow to Recognise Antidepressant Discontinuation Problems?; D.Double -- Toxic Psychology; C.Newnes -- Psychotherapy: Illusion With No Future?; D.Smail -- The Psychologization of Torture; N.Patel -- What Is To Be Done?; J.Moncrieff, J.Dillon&M.Rapley -- Figure: Papers Using Term 'Antidepressant' On Medline 1957-1965 -- Index. (shrink)

Winner of the Los Angeles Times Book Prize With a new preface by the author In his most powerful and important book, renowned psychiatrist Robert Jay Lifton presents a brilliant analysis of the crucial role that German doctors played in the Nazi genocide. Now updated with a new preface, The Nazi Doctors remains the definitive work on the Nazi medical atrocities, a chilling exposé of the banality of evil at its epitome, and a sobering reminder of the darkest side (...) of human nature. (shrink)

Decision making is the physician's major activity. Every day, in doctors' offices throughout the world, patients describe their symptoms and com plaints while doctors perform examinations, order tests, and, on the basis of these data, decide what is wrong and what should be done. Although the process may appear routine-even to the physicians in volved-each step in the sequence requires skilled clinical judgment. Physicians must decide: which symptoms are important, whether any laboratory tests should be done, how the various items (...) of clinical data should be combined, and, finally, which of several treatments (including doing nothing) is indicated. Although much of the information used in clinical decision making is objective, the physician's values (a belief that pain relief is more important than potential addiction to pain-killing drugs, for example) and subjectivity are as much a part of the clinical process as the objective findings of laboratory tests. In recent years, both physicians and psychologists have come to realize that patient management decisions are not only subjective but also prob abilistic (although this is not always acknowledged overtly). When doc tors argue that an operation is fairly safe because it has a mortality rate of only 1 %, they are at least implicitly admitting that the outcome of their decision is based on probability. (shrink)

Psychological traumatisation, as we understand it today, was—in terms of the history of ideas—anticipated by various approaches which have had a lasting impact on modern psychiatry, psychotherapy, and psychosomatic medicine. On the one hand, there is the traditional concept of possession and exorcism with its impressive psychodynamics. On the other hand, there is the theory of the imagination, of an illusion in the sense of a pathogenic infection. Especially the pathological teachings of Paracelsus (sixteenth century) and Johann Baptist van Helmont (...) (seventeenth century)—the latter having advanced the former’s alchemist approach—demonstrate the extent to which demonological, parasitological, and psychological ideas were amalgamated in their ontological notion of a disease. Only the introduction of hypnotism in the middle of the nineteenth century made possible a psychological or psychodynamic understanding of psychological trauma in the modern sense. Hypnotism was striving to strictly dissociate from the magical and natural philosophical speculations of mesmerism and its theory was quite compatible with the model representations of scientific medicine. Sigmund Freud was able to tie in his ideas of hysteria and neurosis with this concept and especially to define repression of (infantile) sexuality as the cause of a culturally ineluctable psychological trauma. Finally, a brief survey of medical history is given to explore artificial trauma as a healing factor. (shrink)

Learning burnout is an important indicator that reflects an individual’s learning state. Understanding the influencing factors and mechanism of learning burnout of medical students has practical significance for improving their mental health. This study aimed to explore the mediating roles of school identity and collective self-esteem between school psychological environment and learning burnout in medical students. A total of 2,031 medical students were surveyed using the School Psychological Environment Questionnaire, School Identity Questionnaire, Collective Self-esteem Scale, and Learning (...) Burnout Scale. The results showed the following: school psychological environment had a negative effect on learning burnout among medical students, and school identity and collective self-esteem played significant mediating roles between school psychological environment and learning burnout [95% CI = ]. Specifically, there were three paths that school psychological environment and learning burnout: first, through the independent mediating role of school identity; second, through the independent mediating role of collective self-esteem; and third, through the chain mediating roles of school identity and collective self-esteem. The findings reveal that school psychological environment not only directly influences the learning burnout of medical students but also indirectly influences it through school identity and collective self-esteem. Thus, this study has some important implications for prevention and intervention of learning burnout among medical students. (shrink)

Learning burnout is a pressing issue among Chinese medical undergraduates and Postgraduates and has drawn continuous attention worldwide. Studies have found that problematic smartphone use could affect learning burnout, but more research is needed in this direction. Furthermore, few studies focused on the mediating effect of psychological capital on the relationship between problematic smartphone use and learning burnout. The present study was a cross-sectional survey that recruited 1,800 participants from a medical university in Chongqing, China. A questionnaire based (...) on the Mobile Phone Addiction Tendency Scale, Psychological Capital Questionnaire, Learning Burnout Scale, and demographic variables were administered to these students, and 1,475 provided valid responses. 771 were undergraduates and 704 were postgraduates. Hierarchical regression and the bootstrap method were used to examine the mediating effect of psychological capital. After controlling for demographic variables, problematic smartphone use positively predicted learning burnout in undergraduates and in postgraduates. The partial mediating effect of psychological capital was 0.068 in undergraduates and 0.074 in postgraduates, accounting for 20.67 and 21.64%, respectively, of the total effect of problematic smartphone use on learning burnout. All the 95% confidence intervals did not contain 0. Problematic smartphone use can directly predict learning burnout and their relationship was mediated by psychological capital in Chinese medical undergraduates and postgraduates. Strategies to alleviating problematic smartphone use and enhance psychological capital in medical undergraduates and postgraduates may provide useful suggestions for future interventions on dealing with learning burnout in Chinese medical undergraduates and postgraduates. (shrink)

When ethical decisions have to be taken in critical, complex medical situations, they often involve decisions that set the course for or against life-sustaining treatments. Therefore the decisions have far-reaching consequences for the patients, their relatives, and often for the clinical staff. Although the rich psychology literature provides evidence that reasoning may be affected by undesired influences that may undermine the quality of the decision outcome, not much attention has been given to this phenomenon in health care or ethics (...) consultation. In this paper, we aim to contribute to the sensitization of the problem of systematic reasoning biases by showing how exemplary individual and group biases can affect the quality of decision-making on an individual and group level. We are addressing clinical ethicists as well as clinicians who guide complex decision-making processes of ethical significance. Knowledge regarding exemplary group psychological biases (e.g. conformity bias), and individual biases (e.g. stereotypes), will be taken from the disciplines of social psychology and cognitive decision science and considered in the field of ethical decision-making. Finally we discuss the influence of intuitive versus analytical (systematical) reasoning on the validity of ethical decision-making. (shrink)

Euthanasia has become the subject of ethical and political debate in many countries including Mexico. Since many physicians are deeply concerned about euthanasia, due to their crucial participation in its decision and implementation, it is important to know the psychological meaning that the term ‘euthanasia’ has for them, as well as their attitudes toward this practice. This study explores psychological meaning and attitudes toward euthanasia in 546 Mexican subjects, either medical students or physicians, who were divided into three groups: (...) a) beginning students, b) advanced students, and c) physicians. We used the semantic networks technique, which analyzed the words the participants associated with the term ‘euthanasia’. Positive psychological meaning, as well as positive attitudes, prevailed among advanced students and physicians when defining euthanasia, whereas both positive and negative psychological meaning together with more ambivalent attitudes toward euthanasia predominated in beginning students. The findings are discussed in the context of a current debate on a bill proposing active euthanasia in Mexico City. (shrink)

Euthanasia has become the subject of ethical and political debate in many countries including Mexico. Since many physicians are deeply concerned about euthanasia, due to their crucial participation in its decision and implementation, it is important to know the psychological meaning that the term ‘euthanasia’ has for them, as well as their attitudes toward this practice. This study explores psychological meaning and attitudes toward euthanasia in 546 Mexican subjects, either medical students or physicians, who were divided into three groups: (...) a) beginning students, b) advanced students, and c) physicians. We used the semantic networks technique, which analyzed the words the participants associated with the term ‘euthanasia’. Positive psychological meaning, as well as positive attitudes, prevailed among advanced students and physicians when defining euthanasia, whereas both positive and negative psychological meaning together with more ambivalent attitudes toward euthanasia predominated in beginning students. The findings are discussed in the context of a current debate on a bill proposing active euthanasia in Mexico City. (shrink)

The integrated model of mental health recommends nowadays the collaboration between psychiatrists, psychotherapists and clinical psychologists. It is currently the agreed model in the managed health care system in the West and research has shown that mixing the medical model with the psychological model both in theory and practice elicits the best outcomes and guides the client towards recovery. In this paper I will challenge this view on a particular area of psychopathology, mild and moderate depression and anxiety, showing (...) that in these particular situations, 15-20 sessions of psychotherapy are sufficient and efficient for recovery and there is no further need for medicating the client, unless the client himself desires this particular type of psychiatric approach. I will also focus on a target group, pregnant women who fear toxic reactions for the fetus and don’t consider taking antidepressant and anxiolytic medication out of fear of adverse reactions. I will also explore the ethical implications of prescribing these target groups medication against their will. CBT, REBT and Existential Psychotherapy are effective options to treat both the symptoms and causes of mild and moderate anxiety and depression, whilst exercise, nutrition and mindfulness meditation can also be effective treatments. Since medications such as antidepressants have recently become the treatment of choice in United States with a 147.5% increase in antidepressant prescription rates between 1990 and 1998 and with a 10.9% decrease in the utilization of psychotherapy, my paper aims to balance this approach in the favour of psychotherapy as a first choice option. (shrink)

BackgroundIn recent years, some researchers have engaged in scientific misconduct such as fabrication, falsification, and plagiarism to achieve higher research performance. Considering their detrimental effects on individuals’ health status (e.g., patients, etc.) and extensive financial costs levied upon healthcare systems, such wrongdoings have even more salience in medical sciences. However, there has been little discussion on the possible influence of medical researchers’ existing creative performance on scientific misconduct, and the moral psychological mechanisms underlying those effects are still poorly (...) understood.MethodsWe build a moderated mediation model to test how medical researchers’ creative performance affects their scientific misconduct and explore the role of moral licensing and moral identity in this process. Based on situational experiments and projection techniques, 287 medical researchers in China participated in a survey.ResultsMedical researchers’ creative performance positively relates to scientific misconduct, and moral licensing plays a mediating role in the relationship between them. In addition, moral identity has a negative moderating effect on the mediating effect of moral licensing on creative performance and scientific misconduct.ConclusionMoral licensing plays a fully mediating role in the relationship between creative performance and scientific misconduct. And moral identity negatively moderates the indirect effect of creative performance on scientific misconduct through moral licensing. The findings provide theoretical and practical implications for the prevention of medical researchers’ scientific misconduct. (shrink)

Background: Work-related stress among healthcare professionals poses a serious economic and healthcare burden. This study aimed to investigate the prevalence of burnout as well as anxiety, depression, and stress in medical residents from different majors, and assess the effects of an online psychological intervention on the mental health status of medical residents with a high degree of burnout.Methods: We conducted an online survey that collected information on the demographics, mental health, and burnout conditions of medical residents from (...) Shengjing Hospital. The mental health condition was assessed by the Depression, Anxiety, and Stress Scale −21. Further, burnout was assessed by the Maslach Burnout Inventory. Medical residents with a total MBI score between 50 and 75 were selected to receive online psychological intervention for 3 months.Results: Two-hundred and ten medical residents completed the questionnaire, of whom, 63 residents with an MBI score between 50 and 75 received the 3-month online psychological intervention. Anesthesia residents showed the highest level of depression, anxiety, and stress, and presented with a lower sense of personal accomplishment, higher emotional exhaustion, and higher depersonalization. Furthermore, pediatric residents had the second highest DASS and MBI scores following anesthesia residents. Following the online psychological intervention, negative emotional states and burnout levels were significantly lower among anesthesia and pediatric residents. There were no differences in the level of stress and sense of personal accomplishment pre- and post-online psychological intervention among the different majors.Conclusion: Our findings revealed high levels of burnout, as well as depression, anxiety, and stress symptoms in medical residents, with marked differences among different majors. The online psychological intervention effectively improved emotional exhaustion, and depersonalization, and relieved the psychological problems such as anxiety and depression in medical residents. (shrink)

Humoralism, the view that the human body is composed of a limited number of elementary fluids, is one of the most characteristic aspects of ancient medicine. The psychological dimension of humoral theory in the ancient world has thus far received a relatively small amount of scholarly attention. Medical psychology in the ancient world can only be correctly understood by relating it to psychological thought in other fields, such as ethics and rhetoric. The concept that ties these various domains together (...) is character (êthos), which involves a view of human beings focused on clearly distinguishable psychological types that can be recognized on the basis of external signs. Psychological ideas based on humoral theory remained influential well into the early modern period. Yet, in 17th-century medicine and philosophy, humoral physiology and psychology started to lose ground to other theoretical perspectives on the mind and its relation to the body. This decline of humoralist medical psychology can be related to a broader reorientation of psychological thought in which the traditional concept of character lost its central position. Instead of the focus on types and stable character traits, a perspective emerged that was primarily concerned with individuality and transient passions. (shrink)

This article takes the following two assumptions for granted: first, that gifts influence physicians and, second, that the influences gifts have on physicians may be harmful for patients. These assumptions are common in the applied ethics literature, and they prompt an obvious practical question, namely, what is the best way to mitigate the negative effects? We examine the negative effects of gift giving in depth, considering how the influence occurs, and we assert that the ethical debate surrounding gift-giving practices must (...) be reoriented. Our main claim is that the failure of recent policies addressing gift giving can be traced to a misunderstanding of what psychological mechanisms are most likely to underpin physicians’ biased behavior as a result of interaction with the medical industry. The problem with gift giving is largely not a matter of malicious or consciously self-interested behavior, but of well-intentioned actions on the part of physicians that are nonetheless perniciously infected by the presence of the medical industry. Substantiating this claim will involve elaboration on two points. First, we will retrace the history of policies regarding gift giving between the medical profession and the medical industry and highlight how most policies assume a rationalistic view of moral agency. Reliance on this view of agency is best illustrated by past attempts to address gift giving in terms of conflicts of interest. Second, we will introduce and motivate an alternate view of moral agency emerging from recent literature in social psychology on implicit social cognition. We will show that proper consideration of implicit social cognition paints a picture of human psychology at odds with the rationalistic model assumed in discussions of COIs. With these two pieces on the table we will be able to show that, without fully appreciating the social-psychological mechanisms of implicit cognition, policy-makers are likely to overlook significant aspects of how gifts influence doctors. (shrink)

Experience and research teach us that hope, optimism and faith are crucial aspects in how a person deals with a medical situation. One ancient source of wisdom which deals with Hope – the myth of Pandora – can be interpreted in different ways, pointing to different aspects of the way hope influences the human experience. In this paper I will try to demonstrate and discuss how this pertains to medical-psychology work with patients: A short case description will be (...) brought to demonstrate the complexity of the work of hope in (difficult) medical situations. The therapeutic work in these situations will be discussed. (shrink)

BackgroundProphylactic Bilateral Salpingo-Oophorectomy reduces the risk of developing ovarian cancer. However, the psychological mechanisms that may affect post-surgery Quality of Life among patients who underwent PBSO are still largely unknown. Thus, this study aimed at exploring the direct and indirect associations of satisfaction with medical communication and cancer anxiety on post-surgery QoL among women at high risk of developing ovarian cancer.MethodFifty-nine women who underwent PBSO took part in this cross-sectional study, filling out a sociodemographic and clinical questionnaire, a battery (...) of validated psychological measures and an ad hoc developed scale for the assessment of cancer anxiety. We first examined the correlations among all variables of interest, and then tested if cancer anxiety mediated the association between satisfaction with medical communication and post-surgery psychological QoL, controlling both for time from surgery and education.ResultsPost-surgery psychological QoL was unrelated from any sociodemographic or clinical variable. Cancer anxiety had a significant direct negative effect on psychological QoL, while satisfaction with medical communication had a significant positive direct effect on it. Finally, cancer anxiety significantly mediated the association between satisfaction with medical communication and post-surgery psychological QoL.DiscussionResults suggest that post-surgery psychological QoL of patients who underwent PBSO may be increased with interventions, delivered in a genetic counselling setting, targeting quality of medical communication and cancer anxiety. (shrink)

BackgroundBoosting the individual learning passion of medical students is a novel approach to improve their academic performance. It facilitates the medical education reform, motivating both policymakers and educators to focus on the function of positive psychology in the career development of medical students. Therefore, this study aimed to assess the status of two types of learning passion; to clarify the relationship between self-esteem and two types of learning passion among Chinese medical students; to examine the mediating (...) role of psychological capital in the relationship between self-esteem and two types of learning passion, respectively; and to identify the moderating role of professional identity in the relationship between PsyCap and two types of learning passion, respectively.MethodsA cross-sectional online survey was conducted from April to June 2016 in China. A total of 1,218 valid questionnaires were collected from four medical schools.ResultsSelf-esteem significantly and positively influenced medical students’ PsyCap.ConclusionTwo types of learning passion of medical students are positively influenced by self-esteem and PsyCap. Medical students with high-level self-esteem should possess strong PsyCap, which augments their harmonious as well as obsessive learning passion. Moreover, the positive effect of medical students’ PsyCap on harmonious learning passion is more notable among those with a lower professional identity. Finally, this study argues that strengths-based interventions of self-esteem and PsyCap are a beneficial approach for future enhancing learning passion in the domain of medical education. (shrink)

For eight years Medical Psychology has been an integral part of medical pre-examination as well as of research and teaching in the Federal Republic of Germany, and a great deal of psychological knowledge is taught to the medical student under this heading. Besides mere theory the medical student is supposed to acquire behavior based on psychological findings which will be important to him in medical practice. Nevertheless, students often complain that teaching is too far from (...) reality, due to the fact that Medical Psychology is part of the first, more theoretical, period of medical eduction, even though one of the main objects of this new field is the analysis of the interaction between patient and physician. (shrink)

A close observation on the rapid change in the mind of young cohort has been made. Our Surveillance is before and after pandemic periods compels us to re-write some pre-occupied conceptions in the core of Philosophy and Psychology. We have worked on mind-body & mind-soul relationship from three angles that are Medical Science, Psychology and Philosophy. It is seen that the level of confidence is gradually diminishing among the youth due to different impetus and as a result many powerful (...) strengths are going out. Proclamation of human values in a new way must be declared so that we can save a thankful number of creative lives. Discussions have been made on thoughts, distress, medical causes of suicide or suicidal attempts, personality disorders, neuropsychology to open up a new world before the present generation. Each and every characteristics of life has positive impact and here we have tried to establish this fact. Physical and metaphysical aspects are reciprocating our lives and this should be injected in the mind of present generation and an approach can be taken to incorporate the matter in the curriculum right now. We have the intention to explain metaphysical love and its high, intelligent values proclaimed strength of mind of youth to infuse our dear world with great moral values. It may also save the earth from natural decay with their surprising discoveries. (shrink)

Three standard psychometric tests were administered to parents who volunteered their children for a randomised, double-blind placebo-controlled trial of a new asthma drug and to a control group of parents whose children were eligible for the trial but had declined the invitation. The trial took place at a children's hospital in Australia. The subjects comprised 68 parents who had volunteered their children and 42 who had not, a participation rate of 94 per cent and 70 per cent, respectively. The responses (...) of these parents to the Gordon Survey of Interpersonal Values Questionnaire, the Coopersmith Self-Esteem Inventory and the Cattell Sixteen Personality Factor Questionnaire were analysed by computer. There was a marked difference between the psychological profiles of the two groups of parents. Volunteering parents put more value on benevolence while non-volunteering parents were more concerned with power and prestige. The self-esteem of volunteering parents was much lower than that of non-volunteering parents. Finally, volunteering parents were more introverted, exhibited greater anxiety and low supergo, while non-volunteering parents appeared to have greater social confidence and emotional stability. Since an individual's values, self-esteem and personality may be important antecedents of behaviour, these findings suggest that parents who volunteer their children for clinical research are not only socially disadvantaged and emotionally vulnerable, but may also be psychologically predisposed to volunteering. Furthermore, these findings provide evidence for the existence of a psychosocial 'filter' effect of the informed consent procedure, which may be discouraging the better educated, more privileged and psychologically resilient members of society from participation as research subjects. (shrink)

Is it ethical to perform a surgery whose purpose is to make a male look like a female or a female to appear male? Is it medically appropriate? Sexual reassignment surgery (SRS) violates basic medical and ethical principles and is therefore not ethically or medically appropriate. (1) SRS mutilates a healthy, non-diseased body. To perform surgery on a healthy body involves unnecessary risks; therefore, SRS violates the principle primum non nocere, “first, do no harm.” (2) Candidates for SRS may (...) believe that they are trapped in the bodies of the wrong sex and therefore desire or, more accurately, demand SRS; however, this belief is generated by a disordered perception of self. Such a fixed, irrational belief is appropriately described as a delusion. SRS, therefore, is a “category mistake”—it offers a surgical solution for psychological problems such as a failure to accept the goodness of one’s masculinity or femininity, lack of secure attachment relationships in childhood with same-sex peers or a parent, self-rejection, untreated gender identity disorder, addiction to masturbation and fantasy, poor body image, excessive anger, and severe psychopathology in a parent. (3) SRS does not accomplish what it claims to accomplish. It does not change a person’s sex; therefore, it provides no true benefit. (4) SRS is a “permanent,” effectively unchangeable, and often unsatisfying surgical attempt to change what may be only a temporary (i.e., psychotherapeutically changeable) psychological/psychiatric condition. National Catholic Bioethics Quarterly 9.1 (Spring2009): 97–125. (shrink)

Background: With the outbreak of the coronavirus disease 2019 epidemic in China, the general public but also medical staff were confronted with psychological challenges, suffering from the highly infectious and unknown characteristics of COVID-19. In this study, we surveyed psychological symptoms including anxiety, depression, and sleep disorders in medical staff.Method: A questionnaire star/WeChat link-based survey assessing the Generalized Anxiety Disorder 7-item scale, Patient Health Questionnaire-9 depression, the Insomnia Severity Index, Social Support scales in addition to lifestyle, and income (...) level was conducted and included 8,288 medical staff from 24 provinces in China. Pearson Chi-square and Mann-Whitney U-tests were used to evaluate single risk factors and significant differences in psychological symptoms before and during the outbreak of COVID-19. Binary logistic regression analyses were conducted for the risk factors of anxiety, depression, and sleep disorder symptoms.Results: Medical staff had a high incidence of psychological symptoms, which was more prominent during the COVID-19 epidemic. Comparatively, females, nurses, first-line department, never exercised, and low income were risk factors for psychological symptoms. Social support including objective support, subjective support, support utility, and regular sports over 3 times per week were protective and manageable elements that could protect from and manage the psychological symptoms of medical staff.Conclusion: The susceptibility of psychological symptoms among medical staff should be of concern to policymakers and the public in the long-term, and the aggravation of mental health problems of medical staff could be eased by providing adequate social support during and after the COVID-19 outbreak. (shrink)