Psychiatry beyond the brain: externalism, mental health, and autistic spectrum disorder

Externalist theories hold that a comprehensive understanding of mental disorder cannot be achieved unless we attend to factors that lie outside of the head: neural explanations alone will not fully capture the complex dependencies that exist between an individual’s psychiatric condition and her social, cultural, and material environment. Here, we firstly offer a taxonomy of ways in which the externalist viewpoint can be understood, and unpack its commitments concerning the nature and physical realization of mental disorder. Secondly, we apply a strongly externalist approach to the case of Autistic Spectrum Disorder, and argue that this condition can be illuminated by appeal to the hypothesis of extended cognition. We conclude by briefly considering the significance this strongly externalist approach may have for psychiatric practice and pedagogy

Managing Madness: The ethics of identifying and treating mental illness

This essay analyzes different contemporary models for defining mental illness and offers a new framework that promotes the use of normative values during the clinical diagnostic process. Although ethic centric models for identifying mental illness do currently exist, these accounts are limited. Specifically, these accounts acknowledge the relationship between mental illness labels and implied responsibility in making their argument to support a normative framework, yet do not explain what capacities are necessary for an agent to have full responsibility. Recognizing this shortcoming, this paper provides an enriched model for identifying mental illness by marrying a normative conception of psychiatric dysfunction to a differential model for assigning moral responsibility. To end this paper looks at how this model may be applied in clinical practice by working through a specific case study of Alcohol Dependence Disorder. Ultimately, I conclude that a normative conception of mental illness married to an account of responsibility is a more appropriate and comprehensive model for recognizing and treating psychiatric dysfunction in clinical practice. By carefully balancing normative and pragmatic considerations, physicians can create more effective and just therapeutic regimens that are tailored to individual patients’ circumstances and needs

Fostering Verbal and Play Interactions in Heritage Language: A Naturalistic Intervention Mediated by Siblings for Autistic Children

Research on sibling-mediated interventions (SMIs) suggests that neurotypical siblings may help bolster language and play development in autistic children (Akers et al., 2018; Celiberti & Harris, 1993; Coe et al., 1991; Glugatch & Machalicek, 2021; Oppenheim-Leaf et al., 2012; Spector & Charlop, 2018), though consideration of culturally and linguistically diverse (CALD) populations is lacking. CALD autistic children often have a heritage language, or home language, other than English that is spoken at home with family members. Evidence suggests that bilingual exposure may be advantageous for language and play of autistic children (Dalmau et al., 2011; Lim & Charlop Seung et al., 2006; Vaughn, 2013). However, studies have not yet explored the role of neurotypical siblings in delivery of heritage language during intervention. The present study examined the effects of a naturalistic intervention mediated by siblings (NIMS) across four sibling dyads. Neurotypical siblings first received training through direct instruction, modeling, and role-play with a bilingual therapist. During intervention, visual prompts were used to encourage neurotypical siblings to deliver instructions, appropriate play phrases, and questions in heritage language during play with the autistic children. Results indicated that appropriate verbalizations of autistic children, social initiations of neurotypical siblings, and interactive play of the sibling dyad increased due to the intervention. Ancillary measures revealed that all dyads reported happiness during the intervention and two dyads improved the quality of the sibling relationship. The implications of the study suggest researchers and practitioners alike should continue to explore neurotypical siblings as change agents for autistic children, particularly when delivering intervention in heritage language

Dramatistic User Experience Design: The Usability Testing of an e-Government System in A Non-Western Setting

This dissertation investigates rhetorical situatedness as a factor that culturally designates users’ motives in adopting a new technology. The application of Kenneth Burke’s dramatism extends the discussion about the situation where an interaction takes place to include acting and meaning-making in Non-Western settings as contextual and situated. This expansion is essential to reinforce the understanding of how cultural contexts impact users’ motives, specifically users from Non-Western settings, to adopt a technology. The traditional Human-Computer Interaction (HCI) research stresses mechanical and technical aspects between a user (agent) and a technology device (agency) in order to reduce user errors. This approach isolates the rhetorical situation of interaction in a computer interface, thus eliding the cultural situatedness by regarding the situation as something fixed, such as in a laboratory. Adding a cultural context provides a fuller picture of this interaction. Using a civic records online system called e-Lampid, which is administered by Surabaya City Government in Indonesia as a case study, I discover five elements of situatedness that contribute significantly to weave acting and meaning-making into a culturally informed interaction. User motives are shaped by internal and external situations that are collective, local, and both onsite and off. Dramatism is a tool for analysis and production that prioritizes cultural awareness. Dramatistic User Experience (UX) design offers analytical, comprehensive, and systematic perspectives on the design process. Dramatistic UX integrates three different approaches: usability testing, rhetorical awareness of situations, and needs analysis. The synergy of dramatism, user experience, and design thinking provides a holistic approach to construct a rhetorically grounded and culturally contingent user experience design

Korean parents' disciplinary practices and socioeconomic status : an investigation based on disciplinary domains and language functions

"The purpose of the study was to examine the culture-specific parenting processes in terms of socioeconomic status using Bronfenbrenner's PPCT model. Kohn's theory of parental values and Bernstein's sociolinguistic theory were applied to deepen the understanding of proximal processes in Korean parenting. Ten mothers of young children were selected from middle and working classes in Korea. Questionnaire and videotaped data were collected. For the survey of parental beliefs, data from 63 mothers were used. Filming was conducted for 2 hours in naturally occurring situations. Korean mothers' parental values and verbal disciplinary practices varied as a function of a social class. Middle-class mothers valued talking more and talked more than did working-class mothers. Mothers' preferences for disciplinary domains differed by the social class, supporting Kohn's thesis. Working-class mothers valued strictness in parenting and used stricter language functions than did middle-class mothers, which is consistent with Bernstein's sociolinguistic approach toward parenting."--Abstract from author supplied metadata