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This chapter provides an explorative analysis of self-illness ambiguity in personality disorders. Self-illness ambiguity refers to the difficulty in distinguishing one’s self from a mental disorder or diagnosis. Personality disorder diagnoses may invoke a specific type of self-illness ambiguity, for the characteristics of personality disorders (i.e., maladaptive personality traits) seem more closely related to “who one is” than to a disorder. Our analysis focuses on the concept of trait maladaptivity. We use three characteristics of trait maladaptiveness (temporality, severity, and attitude) to compare such maladaptivity in personality disorders with other cases of trait maladaptivity. Aside from some similarities, we argue that managing one’s traits in the context of personality disorders is distinct in that it may involve a distancing or disidentification with the maladaptive trait, which sometimes leads to the development of a subsidiary (or “as if”) self. In a further step, people with a personality disorder may start to experience what we call “self–self-ambiguity,” where they struggle to determine whether a particular action is part of their default or subsidiary self. Finally, we discuss how people with a personality disorder implicitly relate to their maladaptive personality traits using the concept of self-relating.
This paper introduces the concept of self-fulfilling testimonial injustice: a distinctive form of epistemic injustice whereby credibility deficits become true by shaping the very conditions that sustain them. Much of the literature on testimonial injustice has rightly emphasized cases in which credibility deficits are rooted in false beliefs, themselves underwritten by ethically bad affective investments. Yet such a focus risks obscuring a structurally significant variant: namely, those credibility deficits that are rendered true through self-fulfilling mechanisms. Drawing on insights from economics and psychology, I distinguish between motivated cognition-based and cognitive bias-based testimonial injustice, which together furnish the background conditions under which self-fulfilling testimonial injustice can take hold. I develop this account by drawing on both theoretical and experimental work on labor market discrimination, which illuminates the ways in which credibility deficits may become self-fulfillingly entrenched. Finally, I explore the distinctive harms of this form of injustice, focusing on its corrosive effects on epistemic self-confidence or self-trust and epistemic self-esteem, and suggest that its insidiousness and relative invisibility render it both difficult to detect and potentially more pervasive than has hitherto been acknowledged.
What determines the legitimacy of aspiring rulers? Questions about support of the governed are central to theories of state-building and political order. Millions worldwide live under the influence of competing armed groups, yet we know little about how people in these contexts make comparative assessments of would-be rulers. We theorize how local norms, social networks, and the provision of goods and services influence these comparative judgments. We report results from a conjoint survey experiment in Colombia among nearly 2,400 respondents across 54 municipalities contested by multiple armed groups. Armed groups that take community norms into account and those that involve local leaders in decision-making are judged less negatively. Additionally, providing services and limiting violence both reduce negative evaluations of armed groups. These findings help us understand dimensions of political legitimacy under limited statehood and the effects of governance on civilian attitudes in areas of competition.
The nutritional environment during fetal and early postnatal life has a long-term impact on growth, development, and metabolic health of the offspring, a process termed “nutritional programming.” Rodent models studying programming effects of nutritional interventions use either purified or grain-based rodent diets as background diets. However, the impact of these diets on phenotypic outcomes in these models has not been comprehensively investigated. We used a previously validated (C57BL/6J) mouse model to investigate the effects of infant milk formula (IMF) interventions on nutritional programming. Specifically, we investigated the effects of maternal diet type (i.e., grain-based vs purified) during early lactation and prior to the intervention on offspring growth, metabolic phenotype, and gut microbiota profile. Maternal exposure to purified diet led to an increased post-weaning growth velocity in the offspring and reduced adult diet-induced obesity. Further, maternal exposure to purified diet reduced the offspring gut microbiota diversity and modified its composition post-weaning. These data not only reinforce the notion that maternal nutrition significantly influences the programming of offspring vulnerability to an obesogenic diet in adulthood but emphasizes the importance of careful selection of standard background diet type when designing any preclinical study with (early life) nutritional interventions.
Findable, structured, and understandable data from health technology assessment (HTA) reports is the core of HTA policy research. Available databases with this information, such as the International Network of Agencies for Health Technology Assessment (INAHTA) database, may be incomplete and their common manual data collection is time-consuming. Automated data extraction may offer a solution by creating a standardized, real-time-updating, comprehensive, open-access HTA database.
Methods
In this research, we explore the possibilities of automated data extraction in the context of creating a standardized and comprehensive HTA policy research database. Data points were extracted from publicly available guidance reports of the National Institute for Health and Care Excellence (NICE) using different text extraction techniques such as natural language processing (NLP) and generative pre-trained transformers (GPTs). Future efforts are aiming to expand the database to other HTA bodies and link it to the European Medicines Regulatory Database (EMRD) that is also being developed.
Results
Preliminary results of our research show that it is possible to use existing text extraction techniques to extract relevant information from publicly available HTA recommendations. Scaling the system to include more HTA bodies and data points is challenging as extraction based on document structure is complicated by heterogeneity in document structure within HTA bodies and between HTA bodies. Future results will focus on finding the best data extraction approach for each data point and on validating the system.
Conclusions
Using automated data extraction to extract data from HTA reports can be a viable option for creating a comprehensive database that can be used to enhance comparative HTA policy research. Challenges remain in scaling the system to include more HTA bodies and data points. Results regarding best-performing extraction techniques and data validation of the system are expected soon.
Multilingual language control is commonly investigated using picture-naming paradigms with explicit instructions when to switch between languages. In daily life, language switching also occurs without external cues. Cued language-switching tasks usually show a switch cost (i.e., slower responses on switch than non-switch trials). Findings of switch costs in response times are mixed for voluntary language switching. This pre-registered study uses a bilingual picture-naming paradigm to compare voluntary and cued language switching in 25 highly proficient Dutch-English bilinguals using EEG. We analysed the N2 ERP component and midfrontal theta oscillations, two common electrophysiological markers of cognitive control in task and language switching. We observed significantly smaller behavioural switch costs in the voluntary task. This suggests that voluntary language switching is less effortful than switching based on external cues. However, we found no electrophysiological switch effects in either task. We discuss factors which may contribute to the inconsistency between behavioural and electrophysiological findings.
Comprehensive studies examining longitudinal predictors of dietary change during the coronavirus disease 2019 pandemic are lacking. Based on an ecological framework, this study used longitudinal data to test if individual, social and environmental factors predicted change in dietary intake during the peak of the coronavirus 2019 pandemic in Los Angeles County and examined interactions among the multilevel predictors.
Design:
We analysed two survey waves (e.g. baseline and follow-up) of the Understanding America Study, administered online to the same participants 3 months apart. The surveys assessed dietary intake and individual, social, and neighbourhood factors potentially associated with diet. Lagged multilevel regression models were used to predict change from baseline to follow-up in daily servings of fruits, vegetables and sugar-sweetened beverages.
Setting:
Data were collected in October 2020 and January 2021, during the peak of the coronavirus disease 2019 pandemic in Los Angeles County.
Participants:
903 adults representative of Los Angeles County households.
Results:
Individuals who had depression and less education or who identified as non-Hispanic Black or Hispanic reported unhealthy dietary changes over the study period. Individuals with smaller social networks, especially low-income individuals with smaller networks, also reported unhealthy dietary changes. After accounting for individual and social factors, neighbourhood factors were generally not associated with dietary change.
Conclusions:
Given poor diets are a leading cause of death in the USA, addressing ecological risk factors that put some segments of the community at risk for unhealthy dietary changes during a crisis should be a priority for health interventions and policy.
The Arabian leopard Panthera pardus nimr is categorized as Critically Endangered, with < 200 individuals estimated to remain in the wild. Historically the species ranged over an extensive area of western Saudi Arabia but, with no confirmed sightings since 2014, investigating potential continued presence and distribution is of critical conservation importance. We present the results of a comprehensive survey designed to detect any remaining Arabian leopard populations in Saudi Arabia. We conducted 14 surveys, deploying 586 camera-trap stations at 13 sites, totalling 82,075 trap-nights. Questionnaire surveys were conducted with 843 members of local communities across the Arabian leopard's historical range to assess the presence of leopards, other predators and prey species. Predator scats were collected ad hoc by field teams and we used mitochondrial DNA analysis to identify the originating species. We obtained 62,948 independent photographs of animals and people, but none were of Arabian leopards. Other carnivores appeared widespread and domestic animals were numerous, but wild prey were comparatively scarce. Three questionnaire respondents reported sightings of leopards within the previous year, but targeted camera-trap surveys in these areas did not yield evidence of leopards. Of the 143 scats sent for analysis, no DNA was conclusively identified as that of the leopard. From this extensive study, we conclude there are probably no surviving, sustainable populations of Arabian leopards in Saudi Arabia. Individual leopards might be present but were not confirmed. Any future Arabian leopard conservation in Saudi Arabia will probably require reintroduction of captive-bred leopards.
The COVID-19 pandemic increased food insufficiency: a severe form of food insecurity. Drawing on an ecological framework, we aimed to understand factors that contributed to changes in food insufficiency from April to December 2020, in a large urban population hard hit by the pandemic.
Design:
We conducted internet surveys every 2 weeks in April–December 2020, including a subset of items from the Food Insecurity Experience Scale. Longitudinal analysis identified predictors of food insufficiency, using fixed effects models.
Setting:
Los Angeles County, which has a diverse population of 10 million residents.
Participants:
A representative sample of 1535 adults in Los Angeles County who are participants in the Understanding Coronavirus in America tracking survey.
Results:
Rates of food insufficiency spiked in the first year of the pandemic, especially among participants living in poverty, in middle adulthood and with larger households. Government food assistance from the Supplemental Nutrition Assistance Program was significantly associated with reduced food insufficiency over time, while other forms of assistance such as help from family and friends or stimulus funds were not.
Conclusions:
The findings highlight that during a crisis, there is value in rapidly monitoring food insufficiency and investing in government food benefits.
People have the ability to estimate frequencies of different behaviors, beliefs, and intentions of others, allowing them to fit into their immediate social worlds, learn from, and cooperate with others. However, psychology has produced a long list of apparent biases in social cognition. We show that this apparent contradiction can be resolved by understanding how cognitive processes underlying social judgments interact with the properties of social and task environments. We describe our social sampling model that incorporates this interaction and can explain biases in people’s estimates of broader populations. We also show that asking people about their social circles produces better predictions of elections than asking about their own voting intentions, provides good description of population attributes, and helps predict people’s future voting and vaccination behavior.
Multi-stakeholder interactions have evolved at product and policy levels. There is a need to assess the current and future landscape of interactions between companies, and regulatory and HTA agencies to address challenges and identify areas for improvement.
Objectives
The aims of this study were to review the current interactions within and across regulatory and HTA agencies, and companies’ experiences in engaging in these activities; to assess the added value of interactions as well as limitations; to explore the future ecosystem for stakeholder interactions.
Method
Three separate questionnaires were developed for companies, regulators and HTA agencies, respectively, to assess their experiences and perceptions. The responses were analyzed using descriptive statistics and discussed at a multi-stakeholder workshop. Key outcomes from the surveys and workshop discussion were reported.
Results
All seven regulators and seven HTA agencies in the survey indicated that they had stakeholder interactions. More formal collaboration occurred with regulators compared with HTA agencies. All nine companies have taken early advice but indicated the need for future prioritization. Success indicators can be built at the product and therapy levels, with the added value of faster patient access. Four principles were proposed for the future ecosystem: separate remit and functions between regulators and HTA; align processes; converge evidence requirements where possible; increase transparency.
Conclusions
This research brought together regulators, HTA agencies, companies to examine how they interact with one another. We propose measures of value and make recommendations on future evolution to enable better evidence generation and improve regulatory and HTA decision-making.
Prior research on self-other differences involving risk have found that individuals make riskier decisions for others than for the self in situations where risk taking is valued. We expand this research by examining whether the direction of self-other differences reverses when risk aversion is valued, as predicted by social values theory (Stone & Allgaier, 2008). Two studies tested for self-other differences in physical safety scenarios, a domain where risk aversion is valued. In Study 1, participants read physical safety and romantic relationship scenarios and selected what they would decide for themselves, what they would decide for a friend, or what they would predict their friend would decide. In Study 2, participants read public health scenarios and either decided or predicted for themselves and for a friend. In keeping with social values theory, participants made more risk-averse decisions for others than for themselves in situations where risk aversion is valued (physical safety scenarios) but more risk-taking decisions for others than for themselves in situations where risk taking is valued (relationship scenarios). Further, we show that these self-other differences in decision making do not arise from incorrectly predicting others’ behaviors, as participants predicted that others’ decisions regarding physical safety scenarios would be either similar (Experiment 1) or more risk taking (Experiment 2) than their own decisions.
Our previous research suggests that people reporting a stronger desire to maximize obtain worse life outcomes (Bruine de Bruin et al., 2007). Here, we examine whether this finding may be explained by the decision-making styles of self-reported maximizers. Expanding on Schwartz et al. (2002), we find that self-reported maximizers are more likely to show problematic decision-making styles, as evidenced by self-reports of less behavioral coping, greater dependence on others when making decisions, more avoidance of decision making, and greater tendency to experience regret. Contrary to predictions, self-reported maximizers were more likely to report spontaneous decision making. However, the relationship between self-reported maximizing and worse life outcomes is largely unaffected by controls for measures of other decision-making styles, decision-making competence, and demographic variables.
This article introduces a “methods lab” approach to teaching undergraduates about different types of research in political science. In this approach, students are given explicit instruction on what a specific research method entails and the opportunity to practice it before conducting their own research. Methods labs can help students craft more creative research designs as well as understand the strengths and potential pitfalls associated with each method, making the subsequent process of writing a research paper or thesis easier. We provide two sample methods labs focused on conducting archival research and developing survey and interview questions. We discuss our experiences in implementing the labs in a thesis course, describe how the modular lab approach could fit into multiple types of courses, and offer suggestions for those interested in developing labs for other types of research methods.
Language switching is often associated with language competition and switching costs. However, the underlying mechanisms might differ depending on context (free versus cued naming) and modality (production or comprehension). In this study, we assessed how response-stimulus intervals (RSI) influence language-switching costs. Longer RSIs might provide more time for interference from the previous trial to decay and result in smaller switching costs. Mandarin–English bilinguals completed two dual-language production tasks (Experiment 1: cued and voluntary picture naming) and one comprehension task (Experiment 2: animacy judgement) with a short RSI and a long RSI condition. While switching costs were present in all tasks, they were only influenced by RSI length in the cued-production task, with smaller switching costs in the long RSI condition. In contrast, RSI did not influence voluntary-production or comprehension costs. This suggests that bilinguals might apply language control differently to switch languages depending on the type of switching and modality.
Social connectedness might positively influence the course of clinical symptoms in people with psychotic disorders.
Objectives
This study examines satisfaction with social connectedness (SSC) as predictor of positive and negative symptoms in people with a psychotic disorder.
Methods
Data from the Pharmacotherapy Monitoring and Outcome Survey (PHAMOUS, 2014-2019) was used from patients diagnosed with a psychotic disorder (N=2109). Items about social connectedness of the Manchester short assessment of Quality of Life (ManSA) were used to measure SSC. Linear mixed models were used to estimate the association of SSC with the Positive and Negative Syndrome Scale (PANSS) after one and two years against α=0.01. Analyses were adjusted for symptoms, time since onset, gender and age. Additionally, fluctuation of positive and negative symptom scores over time was estimated.
Results
Mean duration of illness of the sample was 18.8 years (SD 10.7) with >65% showing only small variation in positive and negative symptoms over a two to five-year time period. After adjustment for covariates, SSC showed to be negatively associated with positive symptoms after one year (β=-0.47, p<0.001, 95% CI=-0.70,-0.25) and two years (β =-0.59, p<0.001, 95% CI = -0.88,-0.30), and for negative symptoms after one year (β=-0.52, p<0.001, 95% CI = -0.77,-0.27). The prediction of negative symptoms was not significant at two years.
Conclusions
This research indicates that interventions on SSC might positively impact mental health for people with psychosis. SSC is a small and robust predictor of future levels of positive symptoms. Negative symptoms could be predicted by SSC at one year.
People with psychotic disorders receive mental healthcare services mainly for their psychiatric care needs. However, patients often experience multiple physical or social wellbeing-related care needs as well. This study aims to identify care needs, investigate their changes over time and examine their association with mental healthcare consumption and evidence-based pharmacotherapy.
Methods
This study combined annually obtained routine outcome monitoring (ROM) data with care consumption data of people with a long-term psychotic illness receiving treatment in four Dutch mental healthcare institutes between 2012 and 2016. Existing treatment algorithms were used to determine psychiatric, physical and social wellbeing-related care needs based on self-report questionnaires, semi-structured interviews and physical parameters. Care consumption was measured in hours of outpatient mental healthcare consumption per year. Generalised estimating equation models were used to calculate odds ratios of care needs and their associations with time, mental healthcare consumption and medication use.
Results
Participants (n = 2054) had on average 7.4 care needs per measurement and received 25.4 h of care per year. Physical care needs are most prevalent and persistent and people with more care needs receive more mental healthcare. Care needs for psychotic symptoms and most social wellbeing-related care needs decreased, whereas the chance of being overweight significantly increased with subsequent years of care. Several positive associations were found between care needs and mental healthcare consumption as well as positive relations between care needs and evidence-based pharmacotherapy.
Conclusions
This longitudinal study present a novel approach in identifying care needs and their association with mental healthcare consumption and pharmacotherapy. Identification of care needs in this way based on ROM can assist daily clinical practice. A recovery-oriented view and a well-coordinated collaboration between clinicians and general practitioners together with shared decisions about which care needs to treat, can improve treatment delivery. Special attention is required for improving physical health in psychosis care which, despite appropriate pharmacotherapy and increasing care consumption, remains troublesome.
Gothic media have reached unprecedented levels of commercialisation and, as a result, have begun to proliferate in new and interesting ways. From its roots in twelfth-century architecture and eighteenth-century fiction and theatre, Gothic has always been multimedia, and has always been remixed. Around the turn of the twenty-first century, however, the genre’s patchwork qualities began to take on a new intensity. What are the implications of this rapid rise in remixed Gothic, both for remix practices and for the Gothic mode? This chapter explores how remixes such as the GIF, the digitised photograph, the updating database and the social media network have all functioned in ‘monstrous’ or Gothic ways.