The aims of this study were to examine the effectiveness of a range of smartphone apps for managing symptoms of anxiety and depression and to assess the utility of a single-case research design for enhancing the evidence base for this mode of treatment delivery. The study was serendipitously impacted by the COVID-19 pandemic, which allowed for effectiveness to be additionally observed in the context of significant community distress. A pilot study was initially conducted using theSuperBetter app to evaluate the proposed (...) methodology, which proved successful with the four finishing participants. In the main study, 39 participants commenced, with 29 finishing the intervention phase and completing post-intervention measures. At 6-month follow-up, a further three participants could not be contacted. This study used a digitally enhanced, multiple baseline across-individuals single-case research design. Participants were randomly assigned to the following apps:SuperBetter,Smiling Mind,MoodMission,MindShift, andDestressify. Symptomatology and life functioning were measured at five different time points: pre-baseline/screening, baseline, intervention, 3-week post-intervention, and 6-month follow-up. Detailed individual perceptions and subjective ratings of the apps were also obtained from participants following the study’s completion. Data were analyzed using visual inspection, time-series analysis, and methods of statistical and clinical significance. Positive results were observed for all apps. Overall, more favorable outcomes were achieved by younger participants, those concurrently undertaking psychotherapy and/or psychotropic medication, those with anxiety and mixed anxiety and depression rather than stand-alone depression, and those with a shorter history of mental illness. Outcomes were generally maintained at 6-month follow-up. It was concluded that a diverse range of evidence-based therapies offered via apps can be effective in managing mental health and improving life functioning even during times of significant global unrest and, like all psychotherapies, are influenced by client features. Additionally, this single-case research design is a low-cost/high value means of assessing the effectiveness of mental health apps.Clinical Trial Registration: The study is registered with the Australian and New Zealand Clinical Trials Registry, which is a primary registry in the World Health Organization Registry Network, registration number ACTRN12619001302145p. (shrink)

We sought to gain more insight into the effects of attention focus and time constraints on skill learning and performance in novices and experts by means of two complementary experiments using a table tennis paradigm. Experiment 1 showed that skill-focus conditions and slowed ball frequency disrupted the accuracy of experts, but dual-task conditions and speeded ball frequency did not. For novices, only speeded ball frequency disrupted accuracy. In Experiment 2, we extended these findings by instructing novices either explicitly or by (...) analogy . Explicitly instructed novices were less accurate in skill-focused and dual-task conditions than in single-task conditions. Following analogy instruction novices were less accurate in the skill-focused condition, but maintained accuracy under dual-task conditions. Participants in both conditions retained accuracy when ball frequency was slowed, but lost accuracy when ball frequency was speeded, suggesting that not attention, but motor dexterity, was inadequate under high temporal constraints. (shrink)

BackgroundThe present study examined the efficacy of the Michigan Model of Infant Mental Health-Home Visiting infant mental health treatment to promote the socioemotional wellbeing of infants and young children. Science illuminates the role of parental “co-regulation” of infant emotion as a pathway to young children’s capacity for self-regulation. The synchrony of parent–infant interaction begins to shape the infant’s own nascent regulatory capacities. Parents with a history of childhood adversity, such as maltreatment or witnessing family violence, and who struggle with symptoms (...) of post-traumatic stress may have greater challenges in co-regulating their infant, thus increasing the risk of their children exhibiting social and emotional problems such as anxiety, aggression, and depression. Early intervention that targets the infant–parent relationship may help buffer the effect of parental risk on child outcomes.MethodsParticipants were 58 mother–infant/toddler dyads enrolled in a longitudinal randomized control trial testing the efficacy of the relationship-based IMH-HV treatment model. Families were eligible based on child age and endorsement of at least two of four socio-demographic factors commonly endorsed in community mental health settings: elevated depression symptoms, three or more Adverse Childhood Experiences parenting stress, and/or child behavior or development concerns. This study included dyads whose children were born at the time of study enrollment and completed 12-month post-baseline follow-up visits. Parents reported on their own history of ACEs and current posttraumatic stress disorder symptoms, as well as their toddler’s socioemotional development.ResultsMaternal ACEs predicted more toddler emotional problems through their effect on maternal PTSD symptoms. Parents who received IMH-HV treatment reported more positive toddler socioemotional wellbeing at follow-up relative to the control condition. The most positive socioemotional outcomes were for toddlers of mothers with low to moderate PTSD symptoms who received IMH-HV treatment.ConclusionResults indicate the efficacy of IMH-HV services in promoting more optimal child socioemotional wellbeing even when mothers reported mild to moderate PTSD symptoms. Results also highlight the need to assess parental trauma when infants and young children present with socioemotional difficulties. (shrink)

Mrs. Duong had coronary artery disease, ischemic cardiomyopathy, and mildly altered mental status when her case was presented before an advanced heart therapy medical review board. She was accepted for left ventricular assist device placement pending additional insight into her cognitive state. Before the LVAD could be implanted, however, Mrs. Duong went into cardiogenic shock, and her heart failure team placed an intra‐aortic balloon pump in her subclavian artery. Within two weeks, Mrs. Duong became IABP dependent and deconditioned. The attending (...) deemed her as lacking capacity to make complex medical decisions, and the medical review board officially declined her for LVAD placement. The heart failure and CICU teams feel that Mrs. Duong is not being helped by the care they are giving her. They recommend terminal weaning of the IABP and initiation of comfort care. Her family disagrees, pointing to activities like continued eating and interacting with family. At an impasse after yet another family meeting, the attending for the heart failure team asks the clinical ethics consultant, “Do we have to replace the balloon pump when it fails?”. (shrink)

Soren Kierkegaard's Works of Love, a series of deliberations on the commandment to love one's neighbor, has often been condemned by critics. Here, Ferreira seeks to rehabilitate Works of Love as one of Kierkegaard's most important works. He shows that Kierkegaard's deliberations on love are highly relevant to some important themes in contemporary ethics, including impartiality, duty, equality, mutuality, reciprocity, self-love, sympathy, and sacrifice. Ferreira also argues that Works of Love bears on issues peculiar to a religious ethic, such as (...) the role of God as "middle term," and the possibility of preserving the aesthetic dimensions of love in a religious ethic of relation. (shrink)

Western democracy is now at a critical juncture. Some worry that power has been wrested from the people and placed in the hands of a small political elite. Others argue that the democratic system gives too much power to a populace that is largely ill-informed and easily swayed by demagogues. This classic study of democratic principles is thus now more relevant than ever. A renowned historian of antiquity and political philosophy, Sir M.I. Finley offers a comparative analysis of Greek (...) and modern conceptions of democracy. As he puts the ancient Greeks in dialogue with their contemporary counterparts, Finley tackles some of the most pressing issues of our day, including public apathy, partisanship, consensus politics, distrust of professional politicians, and the limits of free speech. Including three lectures that Finley delivered at Rutgers University, plus two additional essays that further illuminate his thinking, _Democracy Ancient and Modern _explores the dramatic differences between the close-knit civil society of the ancient Greeks and our own atomized mass societies. By mapping out democracy’s past and its present manifestations, this book helps us plot a course for democracy’s future. (shrink)

Background In August 2017, Chile lifted its complete ban on abortion by permitting abortion in three limited circumstances: 1) to save a woman’s life, 2) lethal fetal anomaly, and 3) rape. The new law allows regulated use of conscientious objection in abortion care, including allowing institutions to register as objectors. This study assesses medical and midwifery students’ support for CO, following legal reform. Methods From October 2017 to May 2018, we surveyed medical and midwifery students from seven universities located in (...) Santiago, Chile. Universities included 4 secular and 3 private religiously-affiliated universities; all offering medical degrees with a specialization in obstetrics and gynecology and five offering midwifery degrees. We used generalized estimating equations to identify characteristics associated with student support for CO, intentions to use CO to refuse to care for someone seeking abortion, and support for CO at the institutional level. Results 333 of the 413 eligible students who opened the survey, completed the questions on conscientious objection; 26% were seeking medical degrees with an ob-gyn specialty, 25% were seeking midwifery degrees, and 49% were seeking medical degrees and had not yet decided their specialty. While nearly all endorse requirements for conscientious objecting clinicians to inform and refer abortion-seeking patients, a minority would personally use conscientious objection to avoid caring for a patient seeking abortion. About half of religious-university students and one-fifth of secular-university students support objections at the institutional level. Conclusions Most students support the regulated use of CO which preserves patients’ access to abortion care. Religious-university student views on the use of conscientious objection in abortion care are discordant with those of their institutions which currently support institutional-level objections. (shrink)

Much has been made of the Kierkegaardian flavour of Wittgenstein's thought on religion, both with respect to its explicit allusions to Kierkegaard and its implicit appeals. Even when significant disparities between the two are noted, there remains an important core of de facto methodological agreement between them, addressing the limits of theory and the dispelling of illusion. The categories of ‘nonsense’ and ‘paradox’ are central to Wittgenstein's therapeutic enterprise, while the categories of ‘paradox’ and the ‘absurd’ are central to much (...) of Kierkegaard's attempt to dispel religious illusion. Writing of how the ‘urge to thrust against the limits of language’ yields ‘nonsense’, Wittgenstein explicitly appealed to Kierkegaard: ‘Kierkegaard, too, recognized this thrust and even described it in much the same way ’. 1 I want to consider whether Kierkegaard's category of paradox of the absurd is assimilable to Wittgenstein's view of nonsense and paradox. I shall argue that a consideration of Wittgenstein's view of paradox can highlight contrasting strands in Kierkegaard's writings on religious faith, strands which take paradox more or less strictly – in particular, it can clarify several different opinions concerning the status of religious claims. My exploration will bring to the fore some implications of the attempt to make room, in the religious employment of language, for a ‘higher understanding’ of truths which we are said to be able to grasp but cannot express. (shrink)

Soren Kierkegaard's Works of Love, a series of deliberations on the commandment to love one's neighbor, has often been condemned by critics. Here, Ferreira seeks to rehabilitate Works of Love as one of Kierkegaard's most important works. He shows that Kierkegaard's deliberations on love are highly relevant to some important themes in contemporary ethics, including impartiality, duty, equality, mutuality, reciprocity, self-love, sympathy, and sacrifice. Ferreira also argues that Works of Love bears on issues peculiar to a religious ethic, such as (...) the role of God as "middle term," and the possibility of preserving the aesthetic dimensions of love in a religious ethic of relation. (shrink)

Søren Kierkegaard and John Henry Newman have starkly opposed formulations of the relation between faith and reason. In this essay I focus on a possible convergence in their respective understandings of the transition to religious belief or faith, as embodied in metaphors they use for a qualitative transition. I explore the ways in which attention to the legitimate dimension of discontinuity highlighted by the Climacan metaphor of the ‘leap’ can illuminate Newman's use of the metaphor of a ‘polygon inscribed in (...) a circle’, as well as the ways in which Newman's metaphor can illuminate the dimension of continuity operative in the Climacan appreciation of qualitative transition. (shrink)

Early life adversity, such as child maltreatment or child poverty, engenders problems with emotional and behavioral regulation. In the quest to understand the neurobiological sequelae and mechanisms of risk, the amygdala has been of major focus. While the basic functions of this region make it a strong candidate for understanding the multiple mental health issues common after ELA, extant literature is marked by profound inconsistencies, with reports of larger, smaller, and no differences in regional volumes of this area. We believe (...) integrative models of stress neurodevelopment, grounded in “allostatic load,” will help resolve inconsistencies in the impact of ELA on the amygdala. In this review, we attempt to connect past research studies to new findings with animal models of cellular and neurotransmitter mediators of stress buffering to extreme fear generalization onto testable research and clinical concepts. Drawing on the greater impact of inescapability over unpredictability in animal models, we propose a mechanism by which ELA aggravates an exhaustive cycle of amygdala expansion and subsequent toxic-metabolic damage. We connect this neurobiological sequela to psychosocial mal/adaptation after ELA, bridging to behavioral studies of attachment, emotion processing, and social functioning. Lastly, we conclude this review by proposing a multitude of future directions in preclinical work and studies of humans that suffered ELA. (shrink)

The first comprehensive introduction to cover the entire span of Kierkegaard’s authorship. Explores how the two strands of his writing—religious discourses and pseudonymous literary creations—influenced each other Accompanies the reader chronologically through all the philosopher’s major works, and integrates his writing into his biography Employs a unique “how to” approach to help the reader discover individual texts on their own and to help them closely examine Kierkegaard’s language Presents the literary strategies employed in Kierkegaard’s work to give the reader insight (...) into subtext. (shrink)

Since the growth cone was first described a century ago by Cajal, considerable effort has been directed towards understanding the mechanisms responsible for its guidance. Traditionally, attention has focussed on the role of adhesive molecules in determining neural development. Recently, it has become apparent that inhibitory interactions may play a crucial part in axonal navigation. A common feature of inhibition seen in three model systems (peripheral nerve segmentation, retinotectal mapping and CNS/PNS segregation) is a collapse of the motile structures of (...) the growth cone. It is increasingly clear that the identification of molecular mechanisms of inhibition, as well as those of adhesion, will be of fundamental importance to understanding neural development. (shrink)

Charting the development of the British tradition of naturalism from the 17th to the 19th century, this book provides fascinating insight into a wide range of thinkers, both Catholic and Protestant, who explored the themes of proof, practice, and the role of common sense. Reappraising what these thinkers can teach us about the relations between belief, action, and skepticism, Ferreira contributes to the philosophical study of naturalist replies to skepticism, as well as to a deeper appreciation of this particular segment (...) of British intellectual history. (shrink)

Kierkegaard's "Works of Love" provocatively presses for a reconsideration of impartiality, partiality, and equality. Past readings of this text have typically (1) criticized its focus on the abstract category of "human being," ignoring its attention to distinctiveness and difference; (2) defended it from the charge of abstraction by accenting its treatment of distinctiveness and difference, playing down its assumptions about the "essentially" human; (3) acknowledged its emphases on both essence and difference, arguing that they are incompatible and irreconcilable; or (4) (...) acknowledged both emphases, assuming they are compatible without exploring or accounting for the apparent incompatibility. As a means of resolving this seeming inconsistency, I will focus on Kierkegaard's recommendation of moral blindness and its implications for moral vision, and I will argue that "Works of Love" contains resources for an understanding of impartiality that allows moral attention to concrete difference. (shrink)

This book examines the significantly similar, yet finally different, thinking of two nineteenth-century existentialist thinkers, Soren Kierkegaard and Friedrich Nietzsche. Its focus is on the different ways each envisioned a joyful acceptance of life - a concern they shared. Each strove to give a place to this acceptance in his picture of life, but their conceptions of it are far apart.

Levinas’s ethics of other‐centered service has been criticized at the theoretical level for failing to offer a conception of moral agency adequate to ground its imperative and at the practical level for encouraging self‐ hatred. Levinas’s explicit resistance to the incorporation of the phrase ”as yourself“ in the Judaeo‐Christian love command might seem to validate the critics’ complaints. The author argues, on the contrary, that Levinas does offer a strong and compelling conception of moral agency and that his ethics, properly (...) understood, does not entail self‐abnegation. Levinas’s attempt to counter excessive and manipulative self‐concern and self‐inflation by insisting on the dependent and situational position of the self has been wrongly overinterpreted as an abandonment of the self and its just claims. The author seeks to establish a more balanced understanding by focusing attention on the “ethics of welcome”, on Levinas’s distinctive conception of passivity, and on the role of the “third” in all human relations. (shrink)

The first comprehensive introduction to cover the entire span of Kierkegaard’s authorship. Explores how the two strands of his writing—religious discourses and pseudonymous literary creations—influenced each other Accompanies the reader chronologically through all the philosopher’s major works, and integrates his writing into his biography Employs a unique “how to” approach to help the reader discover individual texts on their own and to help them closely examine Kierkegaard’s language Presents the literary strategies employed in Kierkegaard’s work to give the reader insight (...) into subtext. (shrink)

How do people come to opposite causal judgments about societal problems, such as whether a public health policy reduced COVID‐19 cases? The current research tests an understudied cognitive mechanism in which people may agree about what actually happened (e.g., that a public health policy was implemented and COVID‐19 cases declined), but can be made to disagree about the counterfactual, or what would have happened otherwise (e.g., whether COVID‐19 cases would have declined naturally without intervention) via comparison cases. Across two preregistered (...) studies (total N = 480), participants reasoned about the implementation of a public policy that was followed by an immediate decline in novel virus cases. Study 1 shows that people's judgments about the causal impact of the policy could be pushed in opposite directions by emphasizing comparison cases that imply different counterfactual outcomes. Study 2 finds that people recognize they can use such information to influence others. Specifically, in service of persuading others to support or reject a public health policy, people systematically showed comparison cases implying the counterfactual outcome that aligned with their position. These findings were robust across samples of U.S. college students and politically and socioeconomically diverse U.S. adults. Together, these studies suggest that implied counterfactuals are a powerful tool that individuals can use to manufacture others’ causal judgments and warrant further investigation as a mechanism contributing to belief polarization. (shrink)

Levinas's ethics of other-centered service has been criticized at the theoretical level for failing to offer a conception of moral agency adequate to ground its imperative and at the practical level for encouraging self-hatred. Levinas's explicit resistance to the incorporation of the phrase "as yourself" in the Judaeo-Christian love command might seem to validate the critics' complaints. The author argues, on the contrary, that Levinas does offer a strong and compelling conception of moral agency and that his ethics, properly understood, (...) does not entail self-abnegation. Levinas's attempt to counter excessive and manipulative self-concern and self-inflation by insisting on the dependent and situational position of the self has been wrongly overinterpreted as an abandonment of the self and its just claims. The author seeks to establish a more balanced understanding by focusing attention on the "ethics of welcome," on Levinas's distinctive conception of passivity, and on the role of "the third" in all human relations. (shrink)

Søren Kierkegaard and John Henry Newman have starkly opposed formulations of the relation between faith and reason. In this essay I focus on a possible convergence in their respective understandings of the transition to religious belief or faith, as embodied in metaphors they use for a qualitative transition. I explore the ways in which attention to the legitimate dimension of discontinuity highlighted by the Climacan metaphor of the 'leap' can illuminate Newman 's use of the metaphor of a 'polygon inscribed (...) in a circle', as well as the ways in which Newman 's metaphor can illuminate the dimension of continuity operative in the Climacan appreciation of qualitative transition. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Hume's Natural History: Religion and "Explanation" M. JAMIE FERREIRA HUME'S BOLDLYSIMPLESTATEMENTof the genesis of religion--that "the anxious concern for happiness, the dread of future misery, the terror of death, the thirst for revenge, the appetite for food and other necessaries" led humankind to see "the first obscure traces of divinity"--is supported by appeals to what he considers plain common sense.' For example, given that at "the first origin (...) of society" (e4) our ancestors were obviously "ignorant and barbarous" (23), anxiously helpless in the face of threatening natural events--hence, obviously with neither the leisure nor the impulse nor the aptitude for serious reflection--it was obviously passionate fears and hopes, not reason, which motivated their beliefs. Given that the mind obviously "rises from inferior to superior," and that humankind obviouslyhasn't "inhabited palaces before huts and cottages or studied geometry before agriculture" (~4), polytheism obviously antedated monotheism. In the course of detailing his commonsensical account of the origin and development of religion, Hume highlights a wide variety of natural tendencies, principles, and propensities which are operative. Keith Yandell offers a recent reading of one such propensity at work in the origin of religion--namely, what Hume calls the "propensity of human nature, which leads into a system, that gives them some satisfaction" (29)--and Yandell explicitly takes it to be a propensity to an "explanatory" system.2 I want to argue in what follows that any reading of Hume's account of religion which highlights an explanatory motivation can be significantly misleading insofar as it obscures the way in which Hume's account differs markedly from other classical genetic accounts which emphasize explanation. ' The Natural History ofReligion, ed. H. E. Root (Stanford, CA, 1956), 28. Further parenthetical page references in the text will be to this work. His later formulation--"The primary religion of mankind arises chiefly from an anxious fear of future events" (65)--recalls Philo's pithy version, namely, "terror is the primary principle of religion" (Dialoguesconcerning Natural Religion, XII). ~Hume's "Inexplicable Mystery": His Views on Religion (Philadelphia, 199o), 9. Hereafter HIM. [5931 594 JOURNAL OF THE HISTORY OF PHILOSOPHY 33:4 OCTOBER 1995 In his account of the "propensity of human nature, which leads into a system, that gives them some satisfaction," Yandell admits that "no explanation is given of exactly what sort of satisfaction is in question," yet he goes on without a pause to speak of how "people accept different and various explanatory systems"; referring to a natural "propensity to understand," he concludes that "for Hume, we need not accept a religious system of explanation, but most of us in fact do so."s I suggest that Yandell's shift from "system" to "explanatory system," which is unheralded, is of crucial significance because the emphasis on explanation tends to call to a reader's mind just the sort of appeal which Hume decisively rejects. I shall argue that Hume draws our attention to and decisively excludes from his account a concept of explanation which actually does play an important role in other parallel accounts--namely, a concept which focuses on the integrity of a broad picture and an ultimate accounting; Hume points to such a concept in his references to the "frame of the universe," "final causes," and the "first rise of the visible system." Such a role might seem to elaborate Hume's appeal to common sense--after all, isn't the natural response to "unknown causes" to try to understand them, and isn't the attempt to understand them the same as looking for an "ultimate" explanation, however crude it might be at the outset? Although this might seem commonsensical to others (as we shall see), I want to argue that what Hume sees at work in the origin of religion is not a search for such an explanation, even a crude one. Rather, on Hume's view the only curiosity at work is a curiosity about how to cope: the propensity to a system is the propensity to the kind of determinacy which is expedient for control, and the only satisfaction the system provides is one in terms of a coping which is independent of truth-seeking... (shrink)