Maladapting Minds discusses a number of reasons why philosophers of psychiatry should take an interest in evolutionary explanations of mental disorders and, more generally, in evolutionary thinking. First of all, there is the nascent field of evolutionary psychiatry. Unlike other psychiatrists, evolutionary psychiatrists engage with ultimate, rather than proximate, questions about mental illnesses. Being a young and youthful new discipline, evolutionary psychiatry allows for a nice case study in the philosophy of science. Secondly, philosophers of psychiatry have engaged with evolutionary (...) theory because evolutionary considerations are often said to play a role in defining the concept of mental disorder. The basic question here is: Can the concept of mental disorder be given an objective definition, or is it rather a normative concept? Thirdly and finally, evolutionary thinking in psychiatry has often been a source of inspiration for a philosophical view on human nature. Thus evolutionary psychiatrists have suggested, for example, that man's vulnerability to mental disorders may well be one of the defining features of our species. -/- Written by leading authors in philosophy, psychiatry, biology and psychology, this volume illustrates that many debates in contemporary philosophy of psychiatry are profoundly influenced by evolutionary approaches to mental disorders. Conversely, it also reveals how philosophers can help contribute to the burgeoning field of evolutionary psychiatry. It is important reading for a wide range of readers interested in mental health care and philosophy. (shrink)
'Working Memory, Thought, and Action' is the magnum opus of one of the most influential cognitive psychologists of the past 50 years. This new volume on the model he created (with Graham Hitch) discusses the developments that have occurred within the model in the past twenty years, and places it within a broader context. -/- Working memory is a temporary storage system that underpins our capacity for coherent thought. Some 30 years ago, Baddeley and Hitch proposed a way of thinking (...) about working memory that has proved to be both valuable and influential in its application to practical problems. This book updates the theory, discussing both the evidence in its favour, and alternative approaches. In addition, it discusses the implications of the model for understanding social and emotional behaviour, concluding with an attempt to place working memory in a broader biological and philosophical context. Inside are chapters on the phonological loop, the visuo-spatial sketchpad, the central executive and the episodic buffer. There are also chapters on the relevance to working memory of studies of the recency effect, of work based on individual differences, and of neuroimaging research. -/- The broader implications of the concept of working memory are discussed in the chapters on social psychology, anxiety, depression, consciousness and on the control of action. Finally, Baddeley discusses the relevance of a concept of working memory to the classic problems of consciousness and free will. -/- This new volume from one of the pioneers in memory research will doubtless emulate the success of its predecessor, and be a major publication within the psychological literature. (shrink)
Philosophical ideas about the mind, brain, and behavior can seem theoretical and unimportant when placed alongside the urgent questions of mental distress and disorder. However, there is a need to give direction to attempts to answer these questions. On the one hand, a substantial research effort is going into the investigation of brain processes and the development of drug treatments for psychiatric disorders, and on the other, a wide range of psychotherapies is becoming available to adults and children with mental (...) health problems. These two strands reflect traditional distinctions between mind and body, and causal as opposed to meaningful explanations of behavior. In this book, which has been written for psychiatrists, psychologists, philosophers, and others in related fields, the authors propose a radical re-interpretation of these traditional distinctions. Throughout the discussions philosophical theories are brought to bear on the particular questions of the explanation of behaviors, the nature of mental causation, and eventually the origins of major disorders including depression, anxiety disorders, schizophrenia, and personality disorder. (shrink)
There is no satisfactory account for the general phenomenon of confabulation, for the following reasons: (1) confabulation occurs in a number of pathological and non-pathological conditions; (2) impairments giving rise to confabulation are likely to have different neural bases; and (3) there is no unique theory explaining the aetiology of confabulations. An epistemic approach to defining confabulation could solve all of these issues, by focusing on the surface features of the phenomenon. However, existing epistemic accounts are unable to offer sufficient (...) conditions for confabulation and tend to emphasise only its epistemic disadvantages. In this paper, we argue that a satisfactory epistemic account of confabulation should also acknowledge those features which are (potentially) epistemically advantageous. For example, confabulation may allow subjects to exercise some control over their own cognitive life which is instrumental to the construction or preservation of their sense of self. (shrink)
In English medical law, it is something of an axiom that adult competent patients have an absolute right to refuse all and any medical treatment, including potentially life-saving and life-sustaining treatment. This legal proposition, which is embedded in the doctrine of consent, has for the last few decades been regarded as the expression of the philosophical principle of personal autonomy and ethical right of self-determination. The Western ethical and legal traditions places heavy emphasis on notions of personal sovereignty reflected in (...) the strong rhetorical entrenchment of patient autonomy in judicial determinations of treatment refusal cases. In a spate of legal cases in the 1980s and 1990s judicial rhetoric .. (shrink)
Commentators agree that the Perception and Attention Deficit (PAD) model is a promising model for accounting for recurrent complex visual hallucinations (RCVH) across several disorders, though with varying detailed criticisms. Its central tenets are not modified, but further consideration of generative models of visual processing and the relationship of proto-objects and memory systems allows the PAD model to deal with variations in phenomenology. The commentaries suggest new ways to generate evidence that will test the model.
Mealey's (1995a) psychological explanation of the sociopath's antisocial activity appeals to an incomplete or nonstandard theory of mind. This is not the only possible mechanism of mental state attribution. The simulation theory of mental state ascription offers a better hope of explaining the diverse elements of sociopathy reported by Mealey.
Anxious temperament (AT) in human and non-human primates is a trait-like phenotype evident early in life that is characterized by increased behavioural and physiological reactivity to mildly threatening stimuli1–4. Studies in children demonstrate that AT is an important risk factor for the later development of anxiety disorders, depression and comorbid substance abuse5. Despite its importance as an early predictor of psychopathology, little is known about the factors that predispose vulnerable children to develop AT and the brain systems that underlie its (...) expression. To characterize the neural circuitry associated with AT and the extent to which the function of this circuit is heritable, we studied a large sample of rhesus monkeys phenotyped for AT. Using 238 young monkeys from a multigenerational single-family pedigree, we simultaneously assessed brain metabolic activity and AT while monkeys were exposed to the relevant ethological condition that elicits the phenotype. High-resolution 18F-labelled deoxyglucose positron-emission tomography (FDG–PET) was selected as the imaging modality because it provides semi-quantitative indices of absolute glucose metabolic rate, allows for simultaneous measurement of behaviour and brain activity, and has a time course suited for assessing temperament-associated sustained brain responses. Here we demonstrate that the central nucleus region of the amygdala and the anterior hippocampus are key components of the neural circuit predictive of AT. We also show significant heritability of the AT phenotype by using quantitative genetic analysis. Additionally, using voxelwise analyses, we reveal significant heritability of metabolic activity in AT-associated hippocampal regions. However, activity in the amygdala region predictive of AT is not significantly heritable. Furthermore, the heritabilities of the hippocampal and amygdala regions significantly differ from each other. Even though these structures are closely linked, the results suggest differential influences of genes and environment on how these brain regions mediate AT and the ongoing risk of developing anxiety and depression. Anxiety disorders are among the most common forms of psychopathology6, and frequently begin during childhood and adolescence. Although all children experience acute anxiety, children with AT display extreme behavioural and physiological reactivity to novel stimuli, and in the presence of strangers inhibit their locomotor activity and vocalizations3.. (shrink)
The will is one of the three pillars of the trilogy of mind that has pervaded Western thought for millennia, the other two being affectivity and cognition (Hilgard 1980). In the past century, the concept of will was imperceptibly replaced by the cognitive-oriented behavioral qualifiers “voluntary,” “goal-directed,” “purposive,” and “executive” (Tranel et al. 1994), and has lost much of its heuristic merits, which are related to the notion of “human autonomy” (Lhermitte 1986). We view catatonia as the clinical expression of (...) impairment of the brain mechanisms that promote human will. Catatonia is to the brain systems engaged in will, as coma is to the reticular ascending systems that promote sleep and wakefulness (Plum 1991). (shrink)
The following theses are defended in this paper: (1) The concept of autonomous action is centrally relevant to understanding numerous psychiatric conditions, namely, conditions that subvert autonomy; (2) The details of an analysis of autonomous action matter; a vague or rough characterization is less illuminating; (3) A promising analysis for this purpose (and generally) is a version of the "multi-tier model". After opening with five vignettes, I begin the discussion by highlighting strengths and weaknesses of contributions by other authors who (...) examine the relationship between autonomy and autonomysubverting psychiatric conditions. I then present an analysis of the concept of autonomous action, before employing this analysis in a suggestive exploration of the conditions illustrated in the vignettes. Keywords: autonomy, multi-tier model, psychiatric conditions CiteULike Connotea Del.icio.us What's this? (shrink)
Progress in psychiatry depends on accurate definitions of disorders. As long as there are no known biologic markers available that are highly specific for a particular psychiatric disorder, clinical practice as well as scientific research is forced to appeal to clinical symptoms. Currently, the nosology of obsessive-compulsive disorder is being reconsidered in view of the publication of DSM-V. Since our diagnostic entities are often simplifications of the complicated clinical profile of patients, definitions of psychiatric disorders are imprecise and always indeterminate. (...) This urges researchers and clinicians to constantly think and rethink well-established definitions that in psychiatry are at risk of being fossilised. In this paper, we offer an alternative view to the current definition of obsessive-compulsive disorder from a phenomenological perspective.TranslationThis article is translated from Dutch, originally published in [Handbook Obsessive-compulsive disorders, Damiaan Denys, Femke de Geus (Eds.), (2007). De Tijdstroom uitgeverij BV, Utrecht. ISBN13: 9789058980878.]. (shrink)
Numerous questions remain unanswered concerning the functional determinants of symbolic behavior and perspective-taking, particularly regarding the capabilities of children with autism. An alternative approach that considers these behaviors to be forms of derived relational responding allows for the design of functional intervention programs to establish such repertoires in individuals for whom they are absent.
Georg Northoff employs a comparison with Parkinson's disease in an effort to tease apart the underlying pathophysiology of psychogenic catatonia. Northoff's extensive treatment of the subject is abetted by his own research as well as the research of others. Nevertheless, a number of points concerning basal ganglia/thalamocortical processing need to be raised, some adding support to his hypothesis and others detracting from it.
In agreement with Behrendt & Young (B&Y), we considered the role of perception disturbances in schizophrenia in our first clinical approaches, using the Bender test with schizophrenic patients. Following this, we reproduced nuclear symptoms of schizophrenia in animal models, showing that perceptual disturbances, acquisition disturbances, and decrease in affective levels can be induced by glutamatergic blockade within the nucleus accumbens septi. Our results link the proposed corticostriatal dysfunction with the thalamocortical disturbances underlying perceptual problems reviewed by B&Y.
Nativists about syntactic processing have argued that linguisticprocessing, understood as the implementation of a rule-basedcomputational architecture, is spared in Williams syndrome, (WMS)subjects – and hence that it provides evidence for a geneticallyspecified language module. This argument is bolstered by treatingSpecific Language Impairments (SLI) and WMS as a developmental doubledissociation which identifies a syntax module. Neuroconstructivists haveargued that the cognitive deficits of a developmental disorder cannot beadequately distinguished using the standard gross behavioural tests ofneuropsychology and that the linguistic abilities of the (...) WMS subject canbe equally well explained by a constructivist strategy of neurallearning in the individual, with linguisitic functions implemented in anassociationist architecture. The neuroconstructivist interpretation ofWMS undermines the hypothesis of a double dissociation between SLI andWMS, leaving unresolved the question of nativism about syntax. Theapparent linguistic virtuosity of WMS subjects is an artefact ofenhanced phonological processing, a fact which is easier to demonstratevia the associationist computational model embraced byneuroconstructivism. (shrink)
A short story of an assassin and a sleeping old Fisherman: Before I explain the rationale of this anecdote, let me begin my response by saying how grateful I am to Bratton and Tomasini for engaging with me over such a thorny and unpleasant topic. Many of us have either suffered eating disorders, or have a relative or a friend who has had an eating disorder, or who has died with anorexia. I still remember giving a talk on anorexia nervosa, (...) several years ago, and at the end of the talk one senior academic was very shaken and nearly in tears. He had lost his sister with anorexia. For many of us, eating disorders are an extremely sensitive issue, and for this very reason, I feel particularly indebted when .. (shrink)
With this understanding, children are better able to anticipate the behavior of others and to attune their own behavior accordingly. In mentally retarded children with Down's syndrome, attainment of such competence is delayed, but it is generally acquired by the time they reach the mental age of 4, as measured by tests of nonverbal intelligence. Thus from a developmental perspective, attainment of the mental age of 4 appears to be of profound significance for acquisition of what we shall call psychological (...) competence : possession of the skills and resources people routinely call on in the.. (shrink)
During the paradoxical dreaming sleep stage, characterized by hallucinations and delusions, as in schizophrenia, the increased subcortical release of dopamine, the presynaptic inhibition of thalamic relay nuclei, and serotonergic disinhibition are in accordance with the model for the mechanism of hallucination-induction.
Autism is a neurodevelopmental condition characterized by difficulties in social interaction (APA, 2000). Successful social interaction relies, in part, on determining the thoughts and feelings of others, an ability commonly attributed to our faculty of folk or common-sense psychology. Because the symptoms of autism should be present by around the second birthday, it follows that the study of autism should tell us something about the early emerging mechanisms necessary for the development of an intact faculty of folk psychology. Our aims (...) in this chapter are threefold; (1) to examine the literature on "socialunderstanding" mechanisms in autism, particularly those assumed to develop in the first years of life; (2) to examine the related literature on typically developing infants and toddlers, and (3) to examine the theoretical approaches that attempt to characterize the early stages and development of this impressive skill. In doing so, we hope to help resolve some of the disagreements and sticking points that riddle the topic. In particular we will attempt to shift the focus from whether children have this or that specific mental-state concept (which they use to predict behavior of others) to a more developmentally friendly approach centered around the notion of reasons, recognizing that they may well exist before they are represented, and hence before they can be appreciated, or expressed. The peer commentary in Behavioral and Brain Sciences following Premack and Woodruff (1978) - "Does the chimpanzee have a theory of mind'" - not only introduced the "falsebelief' task (Dennett, 1978; Wimmer & Perner, 1983), but addressed a host of issues surrounding the characterization of second-order intentional systems, systems that may (or must) be interpreted as having beliefs about beliefs (or desires or intentions .... (shrink)
Multidisciplinary studies indicate that auditory hallucinations may arise from speech perception neurocircuitry without disrupted theory of mind capacities. Computer simulations of excessive pruning in speech perception neural networks provide a model for these hallucinations and demonstrate that connectivity reductions just below a “psychotogenic threshold” enhance information processing. These data suggest a process whereby vulnerability to schizophrenia is maintained in the human population despite reproductive disadvantages of this illness.
Cognitive neuropsychiatry attempts to understand psychiatric disorders as disturbances to the normal function of human cognitive organisation, and it attempts to link this functional framework to relevant brain structures and their pathology. This recent scientific discipline is the natural extension of cognitive neuroscience into the domain of psychiatry. We present two examples of recent research in cognitive neuropsychiatry: delusions of control in schizophrenia, and affective disorders. The examples demonstrate how the cognitive approach is a fruitful and necessary supplement to the (...) otherwise successful biological psychiatry paradigm, which tend to bypass the cognitive level. Philosophy concerns some of the core concepts involved in psychiatric illness, particularly concerning rationality, thought and action, reality testing, and the self. We present concrete examples that illustrate how philosophical conceptual tools can be particularly important for the construction and interpretation of the cognitive models relevant to the understanding of psychiatric illness. We conclude that cognitive neuropsychiatry is a fruitful and necessary supplement to biological psychiatry. Furthermore, cognitive neuropsychiatry itself may benefit significantly from employing philosophical conceptual tools in the interpretation and construction of its cognitive models. The cognitive and philosophical approaches may thus be further steps towards a scientific psychopathology. (shrink)
With a rapidly expanding elderly population, there has been a marked increase in the incidence of dementia, and this dreadful, debilitating illness now affects - directly or indirectly - millions of people across the world. Dementia throws up a number of particular clinical, ethical, and conceptual problems, which mostly reflect complicated evaluative decisions, for instance about diagnosis and the distinction between normal and abnormal ageing. -/- Different disciplines approach dementia in different ways - thus there are disease, cognitive neuropsychology, and (...) social constructivist models of dementia, Underlying these models and approaches, each of which is clinically useful, are various and differing conceptual committments. These models carry ethical implications concerning how we ought to treat people suffereing from dementia. -/- Thinking through Dementia offers a critique of the main models used to understand dementia-the biomedical, neuropsychological, and social constructionist. It discusses both clinical issues and cases, together with philosophical work that might help us better understand and treat this illness. Drawing on philosophical critique of models of dementia, as well as empirical data and clinical experience, the book unifies the biological, psychological, and social accounts of illness and disease. -/- Highly original and thought provoking, this book will interest psychiatrists, philosophers, psychologists, and anyone involved in the care and management of those with dementia. (shrink)
This paper builds on the insights of Jerome Bruner by underlining the central importance of narratives explaining actions in terms of reasons, arguing that by giving due attention to the central roles that narratives play in our everyday understanding of others provides a better way of explicating the nature and source of that activity than does simulation theory, theory-theory or some union of the two. However, although I promote Bruner’s basic claims about the roles narratives play in this everyday enterprise, (...) I take issue with his characterization of the nature of narrative itself. In so doing, important questions are brought to the fore about what makes our understanding of narratives possible. In line with the idea that we ought to tell a developmental story that looks to a the social arena for the source of narratives about reasons, I promote the idea that what is minimally required for becoming conversant in such everyday narratives need not be anything as sophisticated as a theory of mind or a capacity for simulation. The paper concludes using evidence concerning autism as a test case to help support this conclusion. (shrink)
The Hospital for Rehabilitation, Stavern, in Norway has treated patients with physical symptoms with no organic cause, so called conversion disorder patients, for over a decade. For four years research on the treatment has been carried out. Patients with conversion disorder seem not to fit in traditional somatic hospitals because their patienthood depends upon psychiatric diagnosis. Ironically, they appear not to belong in psychiatric hospitals because of their physical symptoms. The treatment offered these patients at hospitals for rehabilitation is adapted (...) physical activity consisting of behaviour elements such as positive reinforcement of normal function and lack of positive reinforcement at dysfunction. The pedagogical approach is seen as crucial in the successful rehabilitation of the patients. The disorder and treatment can be understood by using theories about the ecstatic body, radical behaviourism and phenomenology. When patients have problems in behaviour concerning both body and mind, it would be natural to employ both in the road to recovery. This article describes the various treatments and discusses them from phenomenological, ethical and philosophical perspectives. (shrink)
Northoff provides a compelling argument supporting a kind of “double dissociation” of Parkinson's disease and catatonia. We discuss a related form of akinetic mutism linked to mesodiencephalic injuries and suggest an alternative to the proposed “horizontal” versus “vertical” modulation distinction. Rather than a “directional” difference in patterned neuronal activity, we propose that both disorders reflect hypersynchrony within typically interdependent but segregated networks facilitated by a common thalamic gating mechanism.
The Depue & Collins model is intended to explain a normal human personality trait: extraversion. In contrast, attention-deficit/hyperactivity disorder (ADHD) is generally considered to be a type of psychopathology not found in so-called normals; however, the clinical and neurobiological research done on ADHD seems to amplify and support Depue & Collins's model.
There is a spectrum of child psychiatric and neurological disorders, in all of which a comorbidity with obsessive-compulsive disorder and ritualized behavior is very common. Therefore, they may appear as a basis for the rituals in children that cross into adolescence and adulthood. Resolving the nature of these disorders may help us to better understand “Why ritualized behavior?” (Published Online February 8 2007).
Caplan & Waters's neuropsychological evidence for two types of verbal working memory rests entirely on a very restricted definition of “syntactic complexity,” one in terms of word order. This opens the possibility that the dissociation they observe relates to the differential use of word-order strategies rather than to the structure of verbal working memory.
The question of the psychopath's responsibility for his or her wrongdoing has received considerable attention. Much of this attention has been directed toward whether psychopaths are a counterexample to motivational internalism (MI): Do they possess normal moral beliefs, which fail to motivate them? In this paper, I argue that this is a question that remains conceptually and empirically intractable, and that we ought to settle the psychopath's responsibility in some other way. I argue that recent empirical work on the moral (...) judgments of psychopaths provides us with good reason to think that they are not fully responsible agents, because their actions cannot express the kinds of ill-will toward others that grounds attributions of distinctively moral responsibility. I defend this view against objections, especially those due to an influential account of moral responsibility that holds that moral knowledge is not necessary for responsibility. (shrink)
A new diagnostic system for organic psychiatry is presented. We first define "organic psychiatry", and then give the theoretical basis for conceiving organic psychiatric disorders in terms of hypothetical psychopathogenetic processes, HPP:s. Such hypothetical disorders are not strictly identical to the clusters of symptoms in which they typically manifest themselves, since the symptoms may be concealed or modified by intervening factors in non typical circumstances and/or in the simultaneous presence of several disorders. The six basic disorders in our system are (...) Astheno Emotional Disorder (AED), Somnolence Sopor Coma Disorder (SSCD), Hallucination Coenestopathy Depersonalisation Disorder (HCDD), Confusional Disorder (CD), Emotional Motivational Blunting Disorder (EMD) and Korsakoff's Amnestic Disorder (KAD). We describe their usual etiologies, their typical symptoms and course, and some forms of interaction between them. (shrink)
To someone coming fairly fresh to this debate, Sykes’ paper is somewhat shocking. The psychogenic inference seems such an obvious fallacy, yet he shows, with detailed reference to both diagnostic practice and the literature on mental disorders, the extraordinary pervasiveness of its influence, extending even to the systematic ambiguities built into key diagnostic terms. Sykes characterizes the inference in the following terms: “If there is no known physical cause for a symptom or disorder, the cause must be psychological” (2010, 290). (...) He notes the glaring fallacy of mistaking an epistemological point (that a physical cause is not, at present, known) for an ontological one (that no such cause exists) and .. (shrink)