Immigration law is exceptional enough to deserve an administrative law focus of its own. The Administrative Procedure Act (APA) does not demand uniformity in adjudication. Therefore, it may be counterintuitive to argue that any one area of administrative adjudication is exceptional. Removal adjudication is indeed exceptional because it is an extremely dysfunctional system, it operates in a double void of fewer constitutional protections and without the protections of the APA, it relies on a vast network of civil detention, and (...) it is of a different genre than the type of regulation that drove the development of the APA. The exceptionality of removal adjudication demands a review of administrative law doctrine with this exceptionality in mind. (shrink)

we have recently seen the publication of several books on the narrative and identity of Pragmatism. Perhaps this is a sign that, after the first decade of the twenty-first century, scholars of Pragmatism now have the required distance or historical perspective to be confident about the history of Pragmatism in the twentieth century. In this paper, I examine the narratives of Pragmatism in Richard Bernstein’s The Pragmatic Turn and Colin Koopman’s Pragmatism as Transition.1 In spite of their differences, these scholars (...) argue for an inclusive “big-tent” Pragmatism.2 Their view of Pragmatism in America is optimistic and reconciliatory about the past, present, and future tensions that exist between pragmatist .. (shrink)

Written for both theoretical and practical purposes, Dysfunctional Culture discusses how to understand and identify political ideologies as cultural systems. Using examples related to family morality and reproduction, this book argues that belief in individual rights as the main basis for morality is not an adequate response to the moral challenges of the future.

Made up from parents and children from a previous union or marriage, often completed by children of the new couple, the recomposed or reconstituted family is problematic under the aspect of family-specific functions, relationships and roles. Being exposed to numerous sources of conflict, it is marked by many functional difficulties, which can lead to rupture and failure. For this unit in diversity to stand the test of time, it is necessary for all the members to engage in an (...) active and flexible involvement. (shrink)

ObjectiveThe family remains one of the most important relationship systems into early adulthood and provides an important foundation for lifelong mental health. Dysfunctional family cohesion can promote adjustment problems in adolescents and might also affect adolescents’ self-concept and strategies for coping with emotional distress. To test these relationships and the underlying mechanisms, we proposed a dual mediation model describing the associations between family cohesion and internalizing and externalizing problems, mediated by shame-proneness and expressive suppression.MethodsA sample of (...) 526 German-speaking adolescents aged 14 to 18 years from Austria, Germany, and Switzerland participated in an online self-report survey encompassing questionnaires on family cohesion, shame-proneness, expressive suppression, and psychological problems. We tested a path model to examine the indirect pathways of the associations between family cohesion and internalizing and externalizing problems via shame-proneness and expressive suppression, while controlling for age, gender, and guilt-proneness.ResultsWe found a significant dual mediation of the associations between family cohesion and internalizing and externalizing problems by shame-proneness and expressive suppression. The indirect pathways were all significant, except for the indirect pathway from family cohesion to externalizing problems via shame-proneness.DiscussionOur results provide a model for the mechanisms by which disrupted family cohesion can be related to psychological problems in adolescents. Expressive suppression emerged as crucial when considering the consequences of shame-proneness in adolescents, as it was only indirectly related to externalizing problems via expressive suppression. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Feminist Studies 41, no. 2. © 2015 by Feminist Studies, Inc. 259 Chloë Taylor Female Sexual Dysfunction, Feminist Sexology, and the Psychiatry of the Normal It is really weird that doctors should be the reigning experts on sex. —Leonore Tiefer1 The first volume of Michel Foucault’s The History of Sexuality provides a compelling and influential critique of the “sciences of sex.” In this work, Foucault suggests that there is (...) little that is scientific about the disciplines of psychoanalysis, psychiatry, and sexology that emerged in the nineteenth and twentieth centuries.2 In each case, Foucault argues that the authority of science is exploited to facilitate the regulation of sexuality in a biopolitical era in which the sex life of the population has become a crucial political stake.3 Sex, according to Foucault, is managed by doctors not so much to cure health problems as to enforce social norms, and sexual science does not provide the truth of sex or make people healthy, but naturalizes the monogamous, heterosexual, nuclear family.4 1. Leonore Tiefer, Sex Is Not a Natural Act and Other Essays (Cambridge, MA: Westview Press, 2004), 180. 2. Michel Foucault, The History of Sexuality: An Introduction (New York: Vintage, 1978). 3. Michel Foucault, The History of Sexuality: 133–160. See also Michel Foucault, Psychiatric Power: Lectures at the Collège de France 1973–1974 (New York: Palgrave -MacMillan, 2006) and Michel Foucault, Abnormal: Lectures at the Collège de France 1974–1975 (New York: Picador, 2003). 4. This is not to say that for Foucault doctors do not ever cure health problems or that their intentions are not to cure health problems. However, Foucault 260 Chloë Taylor Feminism has also posed powerful critiques of the sexual sciences. As Janice Irvine notes, feminist epistemology has rejected the purported neutrality of science, especially of the sciences that claim knowledge about sex and gender.5 Feminist and queer political theorists and activists have, moreover, “underscored the hollowness of solutions based on techniques” that are favored by sexologists; teaching men skills to resist premature ejaculation or to better stimulate their wives’ clitorises are not adequate resolutions to widespread and profound dissatisfactions with sex, gender, and marriage in a heterosexist and patriarchal society.6 As Irvine writes, Feminism and lesbian/gay liberation…challenged power inequalities between men and women and questioned the very concepts of maleness and femaleness, masculinity and femininity.…They presented alternatives to tradition and to expert power and authority. Therein lay their threat to American sexology.7 Given this antagonistic relationship, combining feminism and sexology has proved controversial. The work of feminist sexologist Shere Hite in the 1970s and 1980s was critiqued by sexologists and feminists alike: sexologists complained that the 1976 Hite Report was political and thus undermined the scientific prestige of sexology, while feminists criticized Hite for aspiring to a masculine scientific authority.8 Describing the relationship between feminism and sexology, Irvine notes that “the incompatibility of their concerns—science and market, on the one hand, versus shows that what we consider “healthy” is thoroughly political and that the effect of doctors’ practices is normalizing whatever their intentions may be. For two recent Foucauldian studies of the ways that medical and sexual science function to sexually normalize individuals and populations, see Ladelle McWhorter, Bodies and Pleasures: Foucault and the Politics of Sexual Normalization (Bloomington: Indiana University Press, 1999); and Ladelle McWhorter, Racism and Sexual Oppression in Anglo-America: A Genealogy (Bloomington: Indiana University Press, 2009). 5. Janice Irvine, Disorders of Desire: Sexuality and Gender in Modern American Sexology, rev. ed. (1990; repr., Philadelphia, PA: Temple University Press, 2005), 101. 6. Ibid. 7. Ibid. 8. Ibid., 117. Chloë Taylor 261 progressive political change, on the other—led…to a contentious and emotionally charged history.”9 Drawing on both Foucauldian and feminist perspectives, this article explores a new chapter in this history, examining self-described feminist sexologists’ responses to the psychiatric diagnoses of Female Sexual Dysfunction (FSD). While psychologists had pathologized female sexuality under the label of frigidity since the nineteenth century, sexual dysfunctions were relatively marginal in the first edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), published in 1952. In the DSM-1, frigidity (like impotence) was... (shrink)

Patients with bipolar disorder may experience family dysfunction, which might result in worse psychosocial functioning through environmental and psychological factors. Research investigating the mediating role of social support, resilience and suicidal ideation on family and psychosocial functioning in BD is rare. The study aims to explore the predicting and mediating effects of social support, resilience and suicidal ideation on family and psychosocial functioning in BD patients. Two hundred forty-six patients with BD and sixty-nine healthy controls were recruited. (...) The Family Assessment Device, Functioning Assessment Short Test, Social Support Rating Scale, Connor-Davidson Resilience Scale and Beck Scale for Suicide Ideation were used to assess family functioning, psychosocial functioning, social support, resilience and suicidal ideation, respectively. Bipolar patients exhibited worse family and psychosocial functioning than healthy controls. Family functioning, social support, resilience and suicidal ideation significantly predict psychosocial functioning in the bipolar group. Social support, resilience and suicidal ideation indirectly mediate the effect of family functioning on psychosocial functioning in bipolar patients. Cross-sectional design and mixed sample including acute and remitted stages. Treatments for patients with bipolar disorder should be combined with family strategies that are formulated to improve psychosocial functioning. An emphasis should be placed on enhancing social support and resilience while paying attention to suicidal ideation. (shrink)

This study compared the family characteristics, victimization histories, and number of perpetration offenses of juvenile offenders who admitted to having had sex with animals to juvenile offenders who did not. The study found that 96% of the juveniles who had engaged in sex with nonhuman animals also admitted to sex offenses against humans and reported more offenses against humans than other sex offenders their same age and race. Those juveniles who had engaged in sex with animals were similar to (...) other sex offenders in that they also came from families with less affirming and more incendiary communication, lower attachment, less adaptability, and less positive environments. Those juveniles who had engaged in sex with animals reported victimization histories with more emotional abuse and neglect and a higher number of victimization events than other offenders. This would seem to indicate that sex with animals may be an important indicator of potential or co-occurring sex offenses against humans and may be a sign of severe family dysfunction and abuse that should be addressed in the arenas of psychological intervention, juvenile justice programs, and public policy. (shrink)

Described as a gem in Islam, intellect can lead all individual and social behaviours towards balance, appeal and godliness. Given the utmost importance of protecting intellect in this divine religion, everything from eating and drinking to reading, listening and entertainment is thus considered haram [ viz. remains prohibited] if it makes threats to the health of mind and soul. In general, narcotics and substance abuse in all forms can have crushing and all-encompassing effects, that is, inflict heavy blows on the (...) body, soul, mind, willpower and religion in a person and consequently destroy life in the family and society. The continuation of life as well as the stability and survival of this holy institution accordingly depends on many factors, including addiction tendency (AT) and sexual dysfunction (SD). It is also obvious that the balance and optimal use of sexual instinct on the accepted path of religion will be the key to the family health and strength. Altogether, the role of AT and SD on intention to divorce (ITD) in Indonesian Muslim couples ( n = 450) was investigated in 2022 in this study, wherein one partner had previously attended addiction treatment centres over the last 6 months. The study results ultimately demonstrated that AT could induce SD and consequently raise ITD among Muslim couples. Contribution: The study results confirmed the harmful impacts of AT on SD among Muslim couples, which could increase their ITD. In view of this, it was suggested to promote religious teachings in the family to benefit from their positive effects. (shrink)

The current study looked at the impact of board of director characteristics on corporate social responsibility (CSR) in the Pakistani setting. The study further added to the body of knowledge by comparing the impact of board characteristics in family versus non-family businesses in an emerging market. The study’s sample consists of 139 non-financial Pakistan Stock Exchange (PSX) listed firms from 2008 to 2019. The level of CSR among sample firms was assessed using a multidimensional financial approach. The random-effect (...) model was employed to test the study’s hypotheses. The findings support the dysfunctional view of the role of the board of directors’ in family-owned businesses. Overall, board size and CEO duality have a significant negative impact on CSR, whereas board independence has a significant positive impact. While these findings applied to both family-owned and non-family-owned businesses. It was discovered that among family-owned businesses, boards tend to look after the interests of family members, and thus are less likely to support CSR. The findings of this study will assist regulatory authorities, investors, and financial analysts in understanding CSR practices in Pakistani firms, allowing them to review the role of the board of directors in CSR among family and non-family-owned firms. (shrink)

Individuals with Parkinson’s disease and temporal lobe epilepsy have hallucinations and mild cognitive dysfunction. The objective of this work was to study dreams in PD and TLE patients using a common functional model of dream production involving the limbic and paralimbic structures.Dreams were characterised in early-stage PD and TLE patients with dream diaries classified by the Hall van de Castle system and were compared with matched controls.In PD, there were significant differences between patients’ dreams and those of controls: animals, physical (...) aggression, and a befriender were more common in patients, and aggressor and bodily misfortunes were less common. The dreams of patients with frontal dysfunction showed more aggressive features.TLE patients had lower recall than PD patients and a higher proportion of dreams involving family and familiar settings, lower proportions involving success, and a higher incidence of frontal dysfunction.The dreams of PD and TLE patients share important features. (shrink)

In the theater the fictional Dr. Kelekian’s relief that he does not have to talk to family members about his patient’s cancer treatment draws uneasy laughter from the audience. Doctors, patients, and family members alike recognize the situation, even if hearing it so baldly expressed discomfits them.Why do physicians and other health care professionals, including lawyers and bioethicists, so often view families as “trouble”? And why do families so often see medical professionals as uncaring and uncommunicative? Presumably everyone (...) wants the same goal—recovery or the best possible outcome for the patient. And yet trouble clearly exists. We do not see the problem as one of “dysfunctional families” or “callous doctors,” although there are undoubtedly many of each. (shrink)

In the theater the fictional Dr. Kelekian’s relief that he does not have to talk to family members about his patient’s cancer treatment draws uneasy laughter from the audience. Doctors, patients, and family members alike recognize the situation, even if hearing it so baldly expressed discomfits them.Why do physicians and other health care professionals, including lawyers and bioethicists, so often view families as “trouble”? And why do families so often see medical professionals as uncaring and uncommunicative? Presumably everyone (...) wants the same goal—recovery or the best possible outcome for the patient. And yet trouble clearly exists. We do not see the problem as one of “dysfunctional families” or “callous doctors,” although there are undoubtedly many of each. (shrink)

Few studies exist which look at psychological factors associated with physician sexual misconduct. In this study, we explore family dysfunction as a possible risk factor associated with physician sexual misconduct. Six hundred thirteen physicians referred to a continuing medical education (CME) course for sexual misconduct were administered the FACES-II survey, a validated and reliable measure of family dynamics. The survey was part of a self-learning activity. We collected data from February 2000 to February 2009. Participants were predominantly white, (...) middle-aged males who represented the full range of medical specialties. Their results were compared against a sample of 177 physicians. The FACES-II is a self-report test that measures family of origin (the family in which one was raised) dynamics on two dimensions (1) flexibility, ranging from too flexible (chaotic) to not flexible enough (rigid) and (2) cohesion ranging from too close (enmeshed) to not close enough (disengaged). The most common family pattern observed among physicians accused of sexual misconduct was rigid flexibility paired with disengaged cohesion, indicative of unhealthy family functioning. This pattern was significantly different than the pattern observed in the comparison group. Physicians who engage in sexual misconduct are more likely to have family of origin dysfunction. Ethics is developmental and learned in one’s family of origin. Family of origin dynamics may be one risk factor predisposing one to ethical violations. These findings have important implications for screening, education, and treatment across the medical education continuum. (shrink)

During the past few years, the IRBIT domain has emerged as an important add‐on of S‐adenosyl‐L‐homocystein hydrolase (AHCY), thereby creating the new family of AHCY‐like proteins. In this review, we discuss the currently available data on this new family of proteins. We describe the IRBIT domain as a unique part of these proteins and give an overview of its regulation via (de)phosphorylation and proteolysis. The second part of this review is focused on the potential functions of the AHCY‐like (...) proteins. We propose that the IRBIT domain serves as an anchor for targeting AHCY‐like proteins towards cytoplasmic targets. This leads to regulation of (i) intracellular Ca2+ via the inositol 1,4,5‐trisphosphate receptor (IP3R), (ii) intracellular pH via the Na+/HCO3− cotransporters (NBCs); whereas inactivation of the IRBIT domain induces (iii) nuclear translocation and regulation of AHCY activity. Dysfunction of AHCY‐like proteins will disturb these three important functions, with various biological implications. BioEssays 30:642–652, 2008. © 2008 Wiley Periodicals, Inc. (shrink)

During a controversial Weekend Update, David Spade made the following joke with an image of Eddie Murphy behind him: "Look, children, it's a falling star – make a wish." The crack came at a time when Murphy's career was hurting, and he took offense, refusing to return to the show for twenty years. Like most areas of philosophy, there are a plurality of views when it comes to familial ethics. In this chapter, the author takes this opportunity to consider some (...) of them, and to figure out what each view would say about the Spade‐Murphy family feud. Good news for the Rileys and the Combs, the two families from Dysfunctional Family Feud who can't get through a sentence without being nasty to each other, there is a view of familial ethics that might excuse their behavior. It is known as the No Special Obligations View. (shrink)

Why mediation? -- What makes bioethics mediation unique? -- Before you begin a bioethics mediation program -- The stages of bioethics mediation -- Techniques for mediating bioethics disputes -- How to write a bioethics mediation chart note -- Mediation with a competent patient : Mr. Samuels's case -- Mediation with a dysfunctional family : Mrs. Bates's case -- A complex mediation with a large and involved family : Mrs. Leonari's case -- Discharge planning for a dying patient (...) : a role-play -- An at-risk pregnancy : a role-play -- HIV and postsurgical complications in the ICU : a role-play -- Treating the dying adolescent : a role-play -- She didn't mean it : a role-play -- Don't tell mama : a role-play -- An at-risk pregnancy : a role-play transcript -- HIV and postsurgical complications in the ICU : a role-play transcript -- She didn't mean it: a role-play transcript -- Don't tell mama : a role-play transcript. (shrink)

Argues that psychotherapy's claim to be a universal scientific practice that objectively treats ahistorical illnesses is untenable. PT is a cultural product, so it both reflects and reproduces its cultural context. Because cultural context is in part composed of moral traditions embedded in political structures, PT is unavoidably a moral practice with political consequences. Implicit moralities in current practices are discussed. Philosophical hermeneutics in PT practice are offered as an alternative. In a discussion of intersecting traditions, it is suggested that (...) a hermeneutic perspective can portray the keeping of family secrets as a commitment to a particular moral code, rather than the products of a "dysfunctional family." If PT theories can be changed so that they are more historically situated, and if PT practices can be changed to use hermeneutics, then a different moral frame can be put forth. 2012 APA, all rights reserved). (shrink)

Children remain largely absent from sociolegal scholarship on sexual violence. Taking an intersectional approach to the analysis of attorneys’ strategies during child sexual assault trials, this article argues that legal narratives draw on existing gender, racial, and age stereotypes to present legally compelling evidence of credibility. This work builds on Crenshaw’s focus on women of color, emphasizing the role of structures of power and inequality in constituting the conditions of children’s experiences of adjudication. Using ethnographic observations of courtroom jury trials, (...) transcripts, and court records, three narrative themes of child credibility emerged: invisible wounds, rebellious adolescents, and dysfunctional families. Findings show how attorneys use these themes to emphasize the child’s unmarked body, imperceptible emotional responses, rebellious character, and harmful familial environments. The current study fills a gap in sexual assault research by moving beyond trial outcomes to address cultural narratives within the court that are inextricably embedded in intersectional dimensions of power and the reproduction of social status. (shrink)

In this paper, the author addresses the problem of socialisation of children with a history of disabilities and mental retardation by means of visual arts. It is important to look at the very sphere of life of these categories of children. As a rule, these children, for the most part, live in dysfunctional families, which makes it almost impossible to provide them with a form of socialization. This article focuses on the extent to which and how a programme of (...) socialisation of these children can be achieved through the medium of visual arts. At the moment there are works of modern pedagogues who have devoted their scientific researches to this problem, but there are few teachers-artists who deal with this problem. In this article the author devotes his creative attention to this issue and reflects on what means of fine arts and visual literacy can develop and guide in the right direction the socialization of children and young people with disabilities by means of fine arts. A number of scientific works devoted to this problem are seriously reviewed. The author is actively trying to draw the attention of the teaching community to the problem of prevailing social conditions, to reach an educational and cognitive level and, as a consequence, to a better product of the set task of socialization of children with special needs and disabilities in the learning process by means of subject disciplines: drawing, painting, composition, printmaking, etc. (shrink)

This paper explores the biographical and cultural sources that inspired the decision of Janusz Korczak to make his life’s vocation the education of young children from dysfunctional families. This decision emerged out of the radical version of humanism he embraced. His identification of children as the population his humanist ethos must serve, distinguishes it from other versions of humanism. The paper explores the role his sense of self and his identification with Poles, Jews, and humanity play in the composition (...) of this humanism. It identifies the hybridity of his cultural identifications as its heart. It proposes that the tensions between these identifications in general, and his non-Jewish Jewish identification that situated him as being ‘a part of’ and ‘apart from’ Polish society in particular, induced Korczak to create a universal religion of children in which religious, ethnic, or physical distinctions do not generate prejudice, intolerance, and violence. (shrink)

In this unique and exhilarating autobiography, Allan Jones – Canada’s first blind diplomat – vividly describes how an untreatable eye disease slowly decimated his visual world, most challengingly during his postings in Tokyo and New Delhi, and how he discovered and took to heart the revelatory Indian philosophy that changed his life. Advaita Vedanta, the most iconoclastic and liberating of the classical Indian philosophies, profoundly altered the author’s experience of self and world. He found that the true self, as distinct (...) from the individual ego, far exceeds the boundaries of individuality. It lies beneath sightedness or blindness and is absolutely unaffected by the latter. This welcome shift of perspective was reinforced by startling discoveries in contemporary physics, evolutionary biology, and developmental psychology that are fully consistent with Advaitic metaphysics. As for the practical applications of metaphysics, this book demonstrates step by step how Advaitic insight and practice significantly reduce physical and psychological tension. The most telling examples have to do with adjustments compelled by extreme circumstances. Thus Jones describes how he drew upon Advaitic mindfulness techniques to maintain his white cane mobility skills in the teeth of permanent spinal, nerve, and muscle pain. The arc of Beyond Vision moves from the claustrophobically personal to the openness of the transpersonal. It begins in a dysfunctional family background, breaking out into a full life encompassing an adventurous foreign service career, spiritual exploration, and an unconventional kind of marital love. (shrink)

This article employs descriptive and explorative methods concerning father absence and missional parenting. It identifies numerous ramifications caused by father absence and the failing role of men. Father absence has been a serious social issue in South Africa, which has become more tenacious in post-colonial South Africa because of economic reasons, untold fatherhood, refused fatherhood, fatherhood accountability, divorce and dissolution of households. This social issue influenced and affected both family and society dysfunction and created a vicious cycle of poverty (...) in many South African homes. This article aimed to lessen the predicament of fatherlessness by considering the role of missional parenting where the father and mother form a partnership and collaborate for the family’s progress and actualise God’s pre-eminent plan for families in South Africa. The literature review and methodology provided rich insights and considerable knowledge to help support families who do not have a father figure and men in their fatherly role. Missional parenting is gospel-centred and can be a detriment to father absence. Parents follow the example of Jesus Christ as saviour in missional parenting. Contribution: This article employed a descriptive and explorative modus operandi and explored a respective method to effectuate family disharmony in the context of South Africa. It endorses the journal’s focus on church and family in the field of Missiology and Practical Theology. A fatherless South Africa because of the social ill of father absence is a concerning issue. (shrink)

Despite recent advances in the research related to air pollution and associated adverse cardiovascular events, the combined effects of air pollution, climate change, and SARS‐CoV‐2 infection on cardiovascular health need to be researched further. This Commentary addresses their impacts on cardiovascular health in the approximately 25 million people with a severe form of inherited hypercholesterolemia, called familial hypercholesterolemia (FH). The arterial endothelium in these individuals is potentially under multiple attacks caused by particles of both endogenous and exogenous origin. Thus, they (...) have a lifelong highly elevated level of circulating low density lipoprotein (LDL) cholesterol which drives premature atherosclerosis. The high levels of LDL particles, often associated with an elevated level of circulating lipoprotein(a) particles, are both capable of inducing and maintaining endothelial dysfunction. Such pre‐existing endothelial dysfunction can be exacerbated by exposure to SARS‐CoV‐2 viral particles, by exposure to fine particulate matter generated by climate change‐associated wildfires, and by dehydration during deadly heatwaves linked to the globally rising temperatures. The external factors can severely worsen the pre‐existing endothelial dysfunction, and thereby significantly increase the risk of a cardiovascular event in the exposed FH patients. (shrink)

Agency is the human capacity to freely choose one’s thoughts, motivations and actions without undue internal or external influences; it is distinguished from decisional capacity. Four well-known conditions that can deeply affect agency are depression, demoralization, existential distress, and family dysfunction. The study reviews how they may diminish agency in persons whose circumstances may lead them to consider or request euthanasia or assisted suicide. Since agency has been a relatively neglected dimension of autonomous choice at the end of life, (...) it is argued that to respect the autonomy of individuals, it is essential to establish their agency. (shrink)

This paper provides a detailed study of fraud in practice through an empirical investigation of B.P.Sayers, a family-owned stockbroking firm that had been in existence for over 100 years and that collapsed due to the fraudulent activities of the firm's junior partner. An interpretive narrative methodology has been employed which has resulted in the development of a detailed understanding of fraud and moral breakdown in organizations, resulting from a failure of responsibility that arises from a dysfunctional work identification (...) and its moral implications. In developing this account of fraud, the conceptual framework utilized is drawn from the moral philosophical work of Emmanuel Levinas who explicated how the breakdown of social relations of responsibility results, in turn, in moral breakdown. (shrink)

In this article, I compare and evaluate R. D. Laing and A. Esterson’s account of schizophrenia as developed in Sanity, Madness and the Family, social models of disability, and accounts of extended mental disorder. These accounts claim that some putative disorders should not be thought of as reflecting biological or psychological dysfunction within the afflicted individual, but instead as external problems. In this article, I consider the grounds on which such claims might be supported. I argue that problems should (...) not be located within an individual putative patient in cases where there is some acceptable test environment in which there is no problem. A number of cases where such an argument can show that there is no internal disorder are discussed. I argue, however, that Laing and Esterson’s argument—that schizophrenia is not within diagnosed patients—does not work. The problem with their argument is that they fail to show that the diagnosed women in their study function adequately in any environment. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 11.1 (2004) 35-41 [Access article in PDF] The Rationality of Psychosis and Understanding the Deluded Matthew R. Broome Campbell's important and influential paper (Campbell 2001) has framed the debate that Bayne and Pacherie (2004) most explicitly, and Klee (2004) and Georgaca (2004) more implicitly, engage in. Campbell has offered two broad ways of thinking about explanations of delusions—the empirical and the rational. He offers some (...) criticism of the former and an endorsement of the latter. Campbell uses examples from clinical psychopathology to illustrate his argument and Bayne and Pacherie in turn employ these. Campbell discusses the eponymously named delusions of Capgras and Cotard—the former a subtype of delusional misidentification and the latter a delusion whose content is colored predominantly with nihilistic and possibly hypochondriacal themes. Campbell, Bayne and Pacherie, and Klee discuss the empirical data in relation to such delusions and as an aid to discussing the empirical model more generally. It does seem a little unfortunate that these delusions, which are less than typical, become the focus of Campbell's paper, and Bayne and Pacherie's criticism of his work. Delusions are remarkably heterogeneous; this indeed may be part of the reason why there is so much difficulty in reaching a definition as Klee discusses, and occur in a wide variety of mental and neurological illnesses. The most common delusions are those of persecution and reference (World Health Organization [WHO] 1973) and typically occur in schizophrenia. By contrast, delusional misidentification occurs most commonly in patients with dementia, delirium, and focal cognitive impairment, but can occur in other functional psychoses such as an affective or schizophrenic psychosis. The most common form of delusional misidentification is not that of either the exotic Capgras or Fregoli syndromes but delusional misidentification for place; thus, although Bayne and Pacherie's arguments against Campbell may still hold, delusional misidentification tends to occur in the context of a patient believing that they are at home or on holiday rather than in hospital and may not necessarily involve close family members or other intimate relationships. Similarly, Cotard's syndrome tends to occur in the context of a severe depressive illness with mood-congruent psychotic symptoms, typically in an elderly individual. It does not have to have the content that the deluded is dead, but can include beliefs, for example, that the world no longer exists or that their internal organs are not present. Thus, a patient with either Capgras' or Cotard's syndrome is likely to differ from patients with delusions of persecution. They would [End Page 35] have different diagnoses, probably be older, and have a greater likelihood of structural abnormalities of the brain on imaging and consequent neuropsychological dysfunction. That is not to say that patients with schizophrenia have normal cerebral anatomy and neuropsychology, but rather that the Capgras' and Cotard's patients are likely to have neurological quality to their presentation that is clinically relevant, rather than what commonly the case in schizophrenia and the other functional psychoses, where the neurological abnormalities are only currently important at the level of academic research. Empirical Models of Delusion Formation Different delusions may not have that much in common, nor may the patients who believe in them. This in turn relates to the empirical paradigm that both Campbell and Bayne and Pacherie discuss. It is true that current research, and indeed the clinical practice of cognitive behavioral therapy for psychosis, is indebted to the work of Maher and it is within his legacy which we work. This, however, is not to say that we think his initial formulation was correct. Maher's (1988, 1992) work focused attempts in explaining delusions—both to support and refute his thesis that delusions are the consequence of normal cognitive mechanisms seeking to explain an anomalous sensory experience. Such a view initially led to work demonstrating delusions in the absence of anomalous perceptions, the presence of reasoning biases in the deluded population, and the possibility that abnormal sensory experience may be consequent upon biased cognitive processes (Garety and Freeman 1999). More recent work has demonstrated the prevalence of... (shrink)

CONCERN ABOUT THE WELL-BEING OF FAMILIES HAS BEEN A CONSTANT refrain in the history of the United States. Change in family forms often has been regarded as a breakdown of the family and a harbinger of social decay. In each historical period, a family form has been identified as an ideal in contrast to which other forms of family have been found deficient, even dysfunctional. Social policies have been designed to reward "good" families and discourage (...) "bad" ones. Today, the increase in single-mother families, the high divorce rate, and the percentage of children living in poverty often are cited as evidence of the breakdown of the family and abandonment of family values because of a culture of "inordinate individualism." The Marriage Movement particularly represents this view. In this essay I first describe this approach to family values, its use of social science to support its claims, and the influence of this perspective on certain liberal Christian proposals for family ideals. I argue that family ideals assume race, gender, and economic privileges that are not available to all. By ignoring socioeconomic realities for many people, these ideals may mask and reinforce unjust inequalities. In fact, the themes and policies of the defense-of-marriage movement fit nicely with the neoliberal political economy that developed in the second half of the twentieth century. I argue that church and social policies that value families must connect the well-being of all families with a commitment to gender equality and economic justice. (shrink)

The 2012 film The Sessions tells the story of a man with polio who loses his virginity by undergoing Surrogate Partner Therapy (SPT). In light of ensuing controversy surrounding the legal and moral status of SPT, this article uses Norman Daniels’ framework of fair equality of opportunity in health to argue that SPT is a legitimate form of treatment for sexual dysfunctions and should be evaluated alongside other such treatments. I begin by showing how sexual dysfunctions constitute deviations in normal (...) species functioning. I then show that sexual capacities are a matter of fair equality of opportunity because they affect the ability to cultivate the sexual intimacy that is crucial for forming a family and often necessary for maintaining a healthy one. Recognizing that some might object to SPT as a form of prostitution, I proceed by showing how the treatment might avoid some of the objections raised against prostitution, and conclude by affirming that societies committed to fair equality of opportunity in health should work to make SPT legal and safe. (shrink)

Psychopathy is increasingly in the public eye. However, it is yet to be fully and effectively understood. Within the context of the DSM-IV, for example, it is best regarded as a complex family of disorders. The upside is that this family can be tightly related along common dimensions. Characteristic marks of psychopaths include a lack of guilt and remorse for paradigm case immoral actions, leading to the common conception of psychopathy rooted in affective dysfunctions. An adequate portrait of (...) psychopathy is much more complicated, however. Though some neural regions and corresponding functions are commonly indicated, they range across those responsible for action planning and learning, as well as emotional processes. Accordingly, a complete fine-grained map of all neural mechanisms responsible for psychopathy has not been realized, and even if it were, such a map would have limited utility outside of the context of surgical or chemical intervention. The utility of a neural-level understanding of psychopathy is further limited by the fact that it is only applicable in the clinical identification of individual subjects, and the neuro-chemical/biological correction of those subjects after they are positively identified as psychopaths. On the other hand, an information processing model of moral cognition provides for wider-ranging applications. The theoretical and practical implications for such a feasible working model of psychopathic personalities are assessed. Finally, this chapter raises the possibility of directed modification of social-environmental factors discouraging the development of psychopathic personalities in the first place, modifications which are also open to simulation and testing in terms of the same model of moral cognition. (shrink)

This volume brings together a set of conceptual, moral, and cultural concerns carefully to assess a significant public policy issue: the development and proliferation of sex robots. Critics argue, for example, that sex robots present a clear risk to real persons as well as a degradation of society. They claim that the prevalence of sex robots will increase sexual violence, immorally objectify women, encourage pedophilia, reinforce negative body image stereotypes, increase forms of sexual dysfunction, and pass on sexually transmitted disease. (...) Proponents judge robotic sexual companionship as just another step in the exploration of human erotic desire. Sex robots, and similar technology, such as virtual reality pornography and other forms of “digi-sexuality,” are appreciated as providing autonomy affirming companionship, sexual release for the lonely, and a relatively harmless outlet for sexual fantasies that avoids the use of human prostitutes and thus reduces sexual victimization. As these chapters explore, to secure normative claims about sexual activity with artificial humanoids, one will need first to understand what the meaning of the morality of sexual activity can be as well as the significance of various practices with robotic partners on such cardinal social institutions as the family and the relationship between the sexes. One will also need to consider in terms of which ranking of human goods, right-making conditions, social outcomes, or personal virtues we ought to evaluate the significance of sexual relations with robots that look like women, men and children. Without such analysis, it will be unclear whether sex robots ought to be appreciated as a social evil that will further degrade moral culture, a positive technological innovation that will help preserve human dignity, or a more or less harmless pastime. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Philosophy of Emotion in Buddhist Philosophy (and a Close Look at Remorse and Regret)Maria HeimIt is an honor to guest-edit a special issue for the Journal of Buddhist Philosophy for its inaugural issue, and even more to be invited to write a somewhat longer article than is typically the privilege of the guest editor. It was thought that something of a broader statement of the state of the (...) field in this emerging subfield of philosophy might itself be useful in situating current work and aspirations for future endeavors.That the study of emotions in Buddhist philosophy is still in its infancy is somewhat surprising given that Buddhist texts offer 2,500 years of exceedingly fine-grained analyses and reflections on experience.1 It could be that scholars have been thrown off by the word "emotion" itself, given that the English term does not map easily onto Buddhist categories. No single term in any Buddhist language does exactly what "emotion" does. Of course, "emotion" does not map precisely onto premodern Western categories of experience (affections, passions, sentiments, and so on) either, and has a notably shallow history even in European contexts, dating in something like its current usage only to the early nineteenth century (see Dixon 2003 for this history). And if "emotion" fits only awkwardly with Buddhist categories, it should occasion no surprise that many of the debates and dichotomies preoccupying Western philosophy on emotions—is emotion affective or cognitive? Physical or mental? Socially constructed or universal? Are emotions feelings? Evaluations? Motivations?—ill fit the debates and discussions that Buddhist texts offer about experience. The modern [End Page 2] Western categories and terms of the discussion may well inhibit Buddhist philosophical participation in these debates.I have found that this predicament is best met by calling into question the putative universalism of the English term and the assumption that "emotion" names a natural or ontological category. Increasingly, philosophers and neuroscientists are casting doubt on the notion that emotion is a natural kind (Rorty 2004; Griffiths 2004; Barrett 2006, 2017). That emotion is not easy to distinguish from feelings, motives, moods, and propositional attitudes, and that lists of emotions, when elaborated, seem hardly to fall into a generic family of phenomena, suggesting that its boundaries and borders are not carved in nature. This has implications for how "emotions" are to be studied in the lab, as Lisa Feldman Barrett suggests; the natural-kind view "underlies the major questions, the experimental designs, and the interpretation of empirical findings that characterize emotion research as a domain of scientific inquiry," even while the empirical evidence increasingly suggests that this view is the "result of an error of arbitrary aggregation" (Barrett 2006). For reasons piling up in the empirical literature, it is coming to look less and less likely that the English term emotion carves nature at the joints.2This situation can help us shake free of "emotion" early on, even if we may not be able to part entirely with it. A special issue on "the philosophy of emotion" gestures toward the kinds of phenomena these papers take up, even if they vary in the extent to which they find "emotion" to be analytically useful when interpreting Buddhist texts. Indeed, stepping away from assumptions of English-language universalism clears the deck for looking at very different, but no less meticulous and reflective, ways of carving up experiences of the very sort we do get in Buddhist texts. The way forward, in my view, is to permit English words like emotion, affect, and feeling to open the door to the kinds of phenomena we might want to investigate. We can at the same time resist tightly defining what these English terms mean, defending the borders around them, or closely tethering Buddhist conceptions to them. Working with Buddhist categories and meta-categories suggests ways to treat experiences that are, from the ground up, different than the modern West. These in turn can interrupt its supposed universalism and offer fresh questions and interventions.For example, Emily McRae's paper in this issue on kleśas—dysfunctional mental states—offers a Buddhist intervention for how philosophers might reconfigure and aggregate experience differently... (shrink)

The present study aims to identify contextual and psychological factors of proneness to radicalization and violent extremism operationalized through the Militant Extremist Mindset scale consisting of three distinct aspects: Proviolence, Vile World beliefs, and trust in Divine Power. A community sample of 271 high school students from Belgrade and Sandžak regions in Serbia completed: a 24-item MEM scale; contextual measures including a 6-item scale of family dysfunction and a 4-item composite measure capturing exposure to a harsh school environment and (...) peer abuse ; psychological measures including the 9-item Right-Wing Authoritarianism scale, the 5-item Social Dominance Orientation scale, and the 20-item UCLA Loneliness scale. A path analysis was conducted with contextual factors on the first and psychological factors on the second level of the model predicting the three factors of MEM. LON was positively predicted by FDys and HSE, SDO by HSE only, while RWA was positively predicted by FDys only. Contextual and psychological factors accounted for 27% of the variance in PV, 15% of the variance in VW, and 31% of the variance in DP. Obtained findings reveal a complex interplay of contextual and psychological drivers in the prediction of different aspects of RVE and build upon existing knowledge on risk factors associated with RVE. (shrink)

When Oxford published Emotion and Adaptation, the landmark 1991 book on the psychology of emotion by internationally acclaimed stress and coping expert Richard Lazarus, Contemporary Psychology welcomed it as "a brightly shining star in the galaxy of such volumes." Psychiatrists, psychologists and researchers hailed it as a masterpiece, a major breakthrough in our understanding of the emotional process and its central role in our adaptation as individuals and as a species. What was still needed, however, was a book for general (...) readers and health care practitioners that would dispel the myths still surrounding cultural beliefs about emotion and systematically explain the relevance of the new research to the emotional dramas of our everyday lives.Now, in Passion and Reason, Lazarus draws on his four decades of pioneering research to bring readers the first book to move beyond both clinical jargon and "feel-good" popular psychology to really explain, in plain, accessible language, how emotions are aroused, how they are managed, and how they critically shape our views of ourselves and the world around us. With his co-author writer Bernice Lazarus, Dr. Lazarus explores the latest findings on the short and long-term causes and effects of various emotions, including the often conflicting research on stress management and links between negative emotions and heart disease, cancer, and other aspects of physical and psychological health. Lazarus makes a strong case that contrary to common assumption, emotions are not irrational--our emotions and our analytical thought processes are inextricably linked.While not a "how-to" book, Passion and Reason does describe how readers can interpret what lies behind their own emotions and those of their families, friends, and co-workers, and how to manage them more effectively. Exploring fifteen emotions in depth, from love to jealousy, the authors show how the personal meaning we give to the events and conditions of our lives trigger such emotions as anger, anxiety, guilt, and pride. They provide fascinating vignettes to frame a "biography" of each emotion. Some are composite case histories drawn from Dr. Lazarus's long career, but most are stories of people the Lazaruses have known over the years--people whose emotional fears, conflicts, and desires mirror readers' own. The Lazaruses also offer a special chapter on the diverse strategies of coping people use in managing their emotions, and another, "When Coping Fails," on psychotherapy and its approaches to emotional stress and dysfunction, from traditional Freudian psychoanalysis to continuing research into relaxation techniques, meditation, hypnosis, and biofeedback.Packed with insight and compellingly readable, Passion and Reason will enrich all readers fascinated by our emotional lives. (shrink)

Based on genetic and biochemical advances on the molecular mechanism of circadian rhythms, a computational model for the mammalian circadian clock is used to examine the dynamical bases of circadian‐clock‐related physiological disorders in humans. Entrainment by the light–dark cycle with a phase advance or a phase delay is associated with the Familial advanced sleep phase syndrome (FASPS) or the Delayed sleep phase syndrome (DSPS), respectively. Lack of entrainment corresponding to the occurrence of quasiperiodic oscillations with or without phase jump can (...) be associated with the non‐24 h sleep–wake syndrome. In the close vicinity of the entrainment domain, the model uncovers the possibility of infradian oscillations of very long period. Perturbation in the form of chronic jet lag, as used in mice, prevents entrainment of the circadian clock and results in chaotic or quasiperiodic oscillations. It is important to clarify the conditions for entrainment and for its failure because dysfunctions of the circadian clock may lead to physiological disorders, which pertain not only to the sleep–wake cycle but also to mood and cancer. BioEssays 30:590–600, 2008. © 2008 Wiley Periodicals, Inc. (shrink)

Liang Tao and Kuang Zhao, trans. Confucian rights can be characterized as a kind of “fallback apparatus,” necessary only when preferred mechanisms—for example, familial and neighborly care or traditional courtesies—would otherwise fail to protect basic human interests. In this paper, I argue that the very existence of such rights is contingent on their ability to function as remedies for dysfunctional social relationships or failures to develop the virtues that sustain harmonious Confucian relationships. Moreover, these remedies are not, strictly speaking, (...) rights-based, for having a right consists in having the power to claim one's rights for oneself, which the classical Confucians would curtail. I conclude by noting how we might revise standard assumptions about the practice of “claiming one's rights” to make it more compatible with core Confucian principles. 梁涛 匡钊译 儒家权利可称为是一种“备用机制”（fallback apparatus），诉诸权利仅当其他首选机制，如家族与邻里的关怀或对传统礼俗的依赖等，不能有效维护人们的基本利益时才是必要的。儒家权利的存在取决于其补救功能，其需要补救的是儒家谐社会关系及相应美德中 出现的危机、过失。但儒家的补救并不完全是基于权利之上的，古典儒家不认为人民可以代表自己提出主张，也不认为民众可以直接推翻昏庸的暴君，有抵抗权的主要是汤、武等第一级的贵族。对于儒家国家来讲，从制度上认可 人民的权利主张可能是获得社会和谐最有效的手段。. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 11.4 (2004) 299-301 [Access article in PDF] The Right Not to Know: A Challenge for Accurate Self-Assessment Ruth F. Chadwick Anderson and Lux present a very interesting and thought-provoking argument for the view that accurate self-assessment is a requirement for personal autonomy. What I want to suggest is that although this may be helpful in the context with which these authors are primarily concerned, namely (...) psychiatry and brain dysfunction, it is of less value to an account of autonomy more widely construed. I want to look at a possible counterexample, taken from another area of medicine, namely genetics.Toward the end of their article Anderson and Lux consider three objections to their position. I shall not discuss them all. My concern is with the third, that inaccurate self-assessment sometimes promotes autonomy, because knowing the truth about one's weaknesses is sometimes very debilitating. It is commonly argued that "you can if you think you can" and vice versa. As they point out, there are some complex issues involved here, in that if the result of the positive thinking is the ability to do the thing in question, then how can the self-assessment be deemed to have been inaccurate in the first place? They go on, however, to say that "it is unclear that inflated self-assessments yield benefits in contexts where what is required is not just effort but competence" (290).Now it has been argued, by some, in the context of genetics, that the proper understanding of autonomy may imply a "right not to know" facts about oneself. In other words, this is not just a matter of accurate or inaccurate assessment of the relevant facts about oneself; rather, what may be involved is a deliberate decision not to have access to facts that may be relevant to that assessment. There are clearly cases in which genetic information appears to be pertinent to an accurate self-assessment, as the following example suggests. Suppose there is information "available", through genetic testing, that would affect one's chances of having children, or of having children without a particular genetic disorder, and, knowing that such information is available, a couple decides not to avail themselves of this. This is clearly an inaccurate self-assessment, but is their autonomy compromised?It might be thought that the reasons for this decision not to know could be relevant. If they have no family history of any particular genetic disorder, it could be regarded as subjectively reasonable to decline such testing as might be offered. Anderson and Lux, however, argue that whether or not a self-assessment is accurate depends on externalities. In other words, A's self-assessment is not to be assessed as accurate, or [End Page 299] not, according to what it is subjectively reasonable to believe; it has to be measured against the facts. The more that the possibilities of genetic testing increase, the more that "facts" of this nature will be available, including in the context of psychiatry.It might be objected that genetic information is not the type of information that is relevant in this context. In so far as it is predictive and probabilistic it is, arguably, different from the type of diagnostic information involved in the cases discussed by Anderson and Lux. It is not the place here, however, to discuss in general terms the thesis of "genetic exceptionalism" with regard to medical information. The important point is refusal of access to information that may be relevant to an accurate self-assessment. Historically, people have been mistaken in their self-assessment because of lack of information—for example, lack of understanding of facts about the reproduction process has led individuals automatically to blame the woman partner of a couple for infertility. And, as Anderson and Lux rightly point out, being autonomous is compatible with making mistakes, and indeed requires the freedom to make mistakes, it would look rather different if a person continued to hold this without any attempt to avail himself of the relevant—and now available—information... (shrink)

The lung allocation score system in the United States and several European countries gives more weight to risk of death without transplantation than to survival following transplantation. As a result, centers transplant sicker patients, leading to increased length of initial hospitalization. The care of patients who have accumulated functional deficits or additional organ dysfunction during their prolonged stay can be ethically complex. Disagreement occurs between the transplant team, patients and families, and non-transplant health care professionals over the burdens of ongoing (...) intensive intervention. These cases highlight important ethical issues in organ transplantation, including the nature and requirements of transplant informed consent, the limits of physician prognostication, patient autonomy and decision-making capacity following transplant, obligations to organ donors and to other potential recipients, and the impact of program metrics on individualized recipient care. We outline general ethical principles for the care of lung transplant recipients with prolonged hospitalization and give regulatory, research, and patient-centered recommendations for these cases. (shrink)

The American system of long‐term care is disorganized and expensive. Obtaining care for a loved one is a confusing and difficult journey. When it comes to paying for that care, a bit over half who receive care are supported at least partially by insurance, and those with no insurance pay entirely out of pocket. The costs are exorbitant. What makes the system function is reliance on unpaid family members, who care for their loved ones often at considerable cost to (...) themselves.As the baby boom generation ages, this creaky system will become increasingly dysfunctional, and a likely shortage of caregivers will be at the heart of the difficulties. The supply of unpaid family caregivers will become limited, as the ratio of people in the category of ages forty‐five to sixty‐four compared to those who are eighty and older shrinks from just above seven to one in 2010 to just above four to one in 2030. Paid caregivers will be needed to take up the slack, yet they are poorly paid, work under very difficult conditions, and receive little respect from the health care system. In this essay, I discuss the circumstances facing these paid home‐care workers and a possible path forward, illustrating the current problems by drawing on interviews I conducted for a book‐length study published in 2017. (shrink)

Parental substance use is a major risk factor for child development, heightening the risk of drug problems in adolescence and young adulthood, and exposing offspring to several types of traumatic event. First, prenatal drug exposure can be considered a form of trauma itself, with subtle but long-lasting sequalae at the neuro-behavioural level. Second, parents’ addiction often entails a childrearing environment characterised by poor parenting skills, disadvantaged contexts and adverse childhood experiences, leading to dysfunctional outcomes. Young adults born from/raised by (...) parents with drug problems and who develop a Substance Used Disorder (SUD) themselves might display a particularly severe condition in terms of cognitive deficits and impaired personality function. This preliminary study aims to investigate the role of early exposure to drugs as a traumatic event, capable of affecting the psychological status of young drug addicts. In particular, it intends to examine the neuropsychological functioning and personality profile of young adults with severe SUDs who were exposed to drugs early in their family context. The research involved 3 groups each consisting of 15 young adults (aged 18-24): a group of inpatients diagnosed with SUDs and exposed to drugs early, a comparison group of non-exposed inpatients and a group of non-exposed youth without SUDs. A neuropsychological battery (Esame Neuropsicologico Breve-2), an assessment procedure for personality disorders (Shedler-Westen Assessment Procedure-200) and the Symptom CheckList-90-Revised were administered. According to present preliminary results, young drug addicts exposed to drugs during their developmental age were characterised by elevated rates of neuropsychological impairments, especially at the expense of attentive and executive functions; personality disorders were also common but did not differentiate them from non-exposed young people with SUDs. Alternative multi-focused prevention and intervention programs are needed for children of drug-misusing parents, addressing executive functions and adopting a trauma-focused approach. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Hermeneutics, Neuroscience and PsychiatryMichael T. H. Wong, MBBS, MD, MA, MDiv, PhD, FRCPsych, FRANZCP, FHKAM (bio)Hermeneutic practice in mental health has been a theme in Philosophy, Psychiatry, & Psychology (PPP) since its very beginnings. In this essay I argue that hermeneutics, the theory and practice of interpretation, promotes therapeutic interaction between mental health professionals, patients and their family.Why does this patient present in such a way at this (...) particular point in time? The distressing symptoms are there. The changes in behavior are obvious. Impairments of functions are hurting. A mental illness clearly runs in the family. There were early losses of loved ones, physical abuse at home, bullying by peers and self-medication with drugs and alcohol. Three in four adults with a mental illness first experienced that before they turned 24. The brain goes through major reorganization during adolescence and early adulthood. If synaptic pruning went wrong, psychoses emerged. When stresses activated the hypothalamic–pituitary–adrenal axis the elevated cortisol level impacted the size and function of the hippocampus and amygdala in the genetically vulnerable; anxiety, depression, bipolar, and personality disorders developed. The patient needs a voice/language to describe all these experiences and events and the psychiatrist needs a discourse to make sense of them.Eisenberg laments the swings between "brainlessness" and "mindlessness" in psychiatry. Engel argues for a "biopsychosocial" discourse. The major challenge for psychiatry is how to organize clinical information of different nature (categories, dimensions, narratives; i.e., objective vs. subjective, personal vs. interpersonal) into a coherent and comprehensible account for us all. Mental illnesses are not only neuropsychiatric spectrum disorders but also dysfunctions of social relationship and environmental/ecological adaptation. Psychiatry as a clinical neuroscience per se lacks the semantics to address the rich interactions between the physical, psychological, social, cultural, and spiritual in the illness experience of our patients. Explanation in the diagnostic formulation (objective scientific discourse on cause and effect) and understanding in the patient narrative (subjective ordinary everyday discourse on significance and meaning) are irreducible to each other (Wong, 2018). They instead interact with one another to achieve an integrative formulation, not through merging different discourses into a single assertion/monologue but via the dialectic/dialogue of "explaining more in order to understand better," as Ricoeur puts it, and between "the whole and the parts," as Schleiermacher highlights.This "therapeutic hermeneutic circle" of "explanation vs understanding" and "the whole vs the parts" includes symptoms behavior function and life events. It correlates between bio-psychosociocultural-spiritual dimensions/perspectives and does not reduce them to any particular/single [End Page 13] stance. The whole integrates the parts and the parts enrich the whole. It explains but does not explain away. It understands through an articulation of meaning and significance. This discourse is a multilayered (bio-psycho-social-cultural-spiritual) personal narrative that formulates diagnosis and care in a correlative (linking different voices/discourses) and non-reductive (no particular voice/discourse is prejudiced against) manner that is comprehensible to us all (Wong, 2021).PPP will be an excellent forum for discussing clinical hermeneutics in the future. In this digital era of social media and virtual reality, hermeneutics has the never-ending task to tackle the unprecedented challenges to meaning illness and health posed by polarizing discourses.Michael T. H. Wong Michael T.H. Wong, MBBS, MD, MA, MDiv, PhD, FRCPsych, FRANZCP, FHKAM, is Hon Clinical Professor, Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, HKSAR, China. Michael is Chair, Section of Philosophy & Humanities in Psychiatry, World Psychiatric Association. He is an Organizational Partner & International Lead with The Collaborating Centre for Values-Based Practice in Health and Social Care, St Catherine's College Oxford. He is Advisor to the Chinese Health Foundation of Australia.ReferencesWong M. T. H. (2018). Ricoeur and the third discourse of the person: From philosophy and neuroscience to psychiatry and theology. London: Lexington Books. Google ScholarWong, M. T. H. (2021). Values, meanings, hermeneutics and mental health. In Stoyanov, D., Fulford, K. M. W. F., Stanghellini, G., Van Staden, W., & Wong, M. TH. (Eds.), International perspectives in values-based mental health practice: Case studies and commentaries (pp. 341–349... (shrink)

Migration is a global phenomenon growing in scope, and it can be associated with negative emotions such as sense of impending loss, fear of the unknown, and anxiety about those left at home. The objective of this exploratory study was to examine psychological distress and homesickness among Sudanese migrants in the United Arab Emirates. Participants were 1444 Sudanese migrants. The Second Version of the Dundee Relocation Inventory was used to assess homesickness, and the 28-item General Health Questionnaire was used to (...) measure psychological distress, depressive and anxiety symptoms, somatic symptoms, and social dysfunction. The results showed that older age and longer duration of residence in the UAE were associated with lower levels of homesickness, psychological distress, and depressive and anxiety symptoms. Further, homesickness was associated with higher psychological distress, somatic symptoms, and depressive and anxiety symptoms. Women and unemployed migrants had higher psychological distress, somatic symptoms, and depressive and anxiety symptoms compared with men and those employed, respectively. Being unmarried was associated with higher levels of depressive symptoms and homesickness, while those married or divorced/widowed showed lower levels of depressive symptoms and homesickness. It was concluded that there is a need to tackle unemployment among migrants in the UAE and address family reunion issues. (shrink)

The Godfather and Philosophy is comprised of twenty-eight chapters by philosophers, who reflect upon the ethical and metaphysical issues raised in The Godfather novels and movies, beginning with the 1969 novel by Mario Puzo and the 1972 movie by Francis Ford Coppola. The Godfather saga has had a profound impact on American cinema, storytelling, thinking about crime, and popular culture. Aimed at thoughtful fans of The Godfather franchise, among the questions tackled in these provocative philosophical chapters are the immigrant experience (...) in America, the relation between ethics and the law, the nature of moral corruption, private justice and vigilantism, organized crime and the American Dream, betrayal and forgiveness, religion and family values, the difficulties of breaking out of a dysfunctional way of life, and the uncertain consequences of vice laws. Joshua Heter teaches philosophy at Jefferson College, Missouri. He co-edited Punk Rock and Philosophy (2022). Richard Greene teaches philosophy at Weber State University, Utah. He wrote the definitive and highly acclaimed book, Spoiler Alert! (It's a Book about the Philosophy of Spoilers) (2019). (shrink)

The importance of male dominance in the scientific community is no strange to us all. Science, as a source of respected and influential information is a staunchly guarded male domain for millennia. What is specific for our time and place is the nervousness with which female presence is accepted. It is also the time of great changes in the axis of power, and the struggle for control is very aggressive. What is even more so in Serbia and Montenegro one of (...) the pieces of ruins of the late SFRJ, is that the dysfunction of the war and sanctions brought about more inequality than before. And science is a field of professional achievement with slow and uncertain rewards, vast investment of time, effort and funds, for a career that is beneficial more to vanity than to the bank account. Women are seen as frivolous when they devote a huge amount of work and other resources to self-improvement and personal achievement and not to the comfort of the immediate family. Osnazivanje zena i njihovo ravnopravno ucesce u drustvenom, ekonomskom politickom i kulturnom zivotu kao i eliminacija svih oblika porodicne ekonomske, politicke, obrazovne i svake druge rodne diskriminacije i nasilja nad zenama spada u milenijumske ciljeve Ujedinjenih nacija prihvacene od Evropske unije i preporucene vladama svih zemalja u formiranju njihove nacionalne strategije. (shrink)

Activities of daily living are usually defined as skills needed in typical daily self-care. Instrumental activities of daily living are more complex skills beyond basic self-care, and their measurement evaluates how individuals function in their homes, workplaces, and outdoor environments. The skills that pertain to IADLs are exposed to dysfunctions resulting from aging or illness. Reductions in those skills may begin to cause problems with independence but these problems can be solved with the help of others - for example, (...) class='Hi'>family members, social workers, and nurses. (shrink)