Patients with strokes to the Anterior Communicating Artery pose an important challenge to rehabilitation teams due to a particular mix of cognitive and behavioral impairments. These deficits often compromise engagement with rehabilitation, learning and generalization. The goal of this article is to describe the long-term presentation of a patient with an ACoA stroke as well as her rehabilitation needs and the many challenges experienced by the rehabilitation team when attempting to facilitate functional, vocational and psychosocial recovery. (...) Based on this case, and the existing literature, a neuropsychological rehabilitation framework to understand and address the specific problems and needs of this population is proposed. This framework demands rehabilitation teams to consider: the slow pattern of recovery of this population, the interaction between cognitive and behavioral impairments, the relevance of physical and social environments, the value of personal projects and the need to include psychological and relational interventions. (shrink)

In the 1970s and 1980s, a multitude of cognitive rehabilitation programs proliferated to facilitate recovery after brain injury. However only a few programs provided a framework for ameliorating disturbances in the cognitive, psychological, and interpersonal spheres of the brain-injured patient. Greatly influenced by Leonard Diller and Yehuda Ben-Yishay’s ideas and methods, George P. Prigatano began, in early 1980, a holistic neuropsychological rehabilitation program at the Presbyterian Hospital in Oklahoma City (Oklahoma). The objective of this paper is to (...) summarize the contributions of George P. Prigatano to neuropsychological rehabilitation and clinical neuropsychology during his 50th year of practice. The main body of the paper is structured in three sections. The first section briefly explains the history of neuropsychological rehabilitation in the twentieth century and the emergence of holistic neuropsychological rehabilitation programs in the 1970s. The second section describes the contributions of George P. Prigatano to neuropsychological rehabilitation and clinical neuropsychology (written by AGM). In the third section, the second author (GPP) prepared an autobiographical statement, which attempts to summarize some of the personal and professional experiences which influenced his work. George P. Prigatano’s contributions to neuropsychological rehabilitation and clinical neuropsychology are essential to understanding the therapeutic approaches currently used in the treatment of brain-injured patients. (shrink)

This volume celebrates the life achievements of Jason W. Brown, who, along with Jean Piaget, Heinz Werner, Alexander Luria and the Wurzburg school, has significantly contributed to the development of a process-based theory of brain/mind capable of challenging the currently fashionable modularist or cybernetic approaches to understanding human thought and feeling. As a paradigm, Brown's microgenetic theory is thus applicable in both brain science (where Brown was inspired by the pioneering work of Schilder and Pick) and the philosophy of mind (...) (where the influence of Bergson, Whitehead, Cassirer, and Merleau-Ponty can be seen). Essays with a range of focus as wide as Brown's expertise have been collected in such diverse areas as neuropsychology (microstructure of action, symptomatology, neuro-rehabilitation, neurolinguistics, locationism), theoretical psychology (consciousness, hypnosis, morphogenesis, personality development, psychoanalysis, Buddhist psychology, mysticism), and philosophy of mind (evolutionary epistemology, emergence/novelty/creativity, subjectivity, will and action, Whiteheadian process philosophy).". (shrink)

This volume represents a comprehensive overview of the neuropsychology of emotion and the neural mechanisms underlying emotional processing. It draws on recent studies utilizing behavioral paradigms with normal subjects, the brain lesion approach, clinical evaluations of patients with neurological and psychiatric disorders, and neuroimaging techniques. The book opens with an introduction summarizing each chapter and pointing to directions for future research. The first section is on history, the neuroanatomy and neurophysiology of emotion, and techniques that have been widely used to (...) examine emotional processing- neuropsychological assessment and neuroimaging. Theoretical perspectives on emotion are offered next, including psychological, social-cognitive, neurobiological, and neuropsychological models. A set of chapters on the neural substrates of emotion deals with a spectrum of emotional conditions: elation and mania, sadness and depression, anxiety and stress, anger and impulsivity, and apathy and flat affect. The book concludes with clinical implications, including a description of emotional deficits in neurological and psychiatric disorders. Highlighted in this section is an overview of rehabilitative treatments and brain interventions for emotional processing deficits. This authoritative volume will be an important resource and text for neuropsychologists, clinical psychologists, speech-language pathologists, neuroscientists, psychiatrists, neurologists, rehabilitation specialists, and their students and trainees. (shrink)

Vision is the main entrance for environmental input to the human brain. Even if vision is our most used sensory modality, its importance is not limited to environmental exploration. Rather it has strong links to motor competences, further extending to cognitive and social aspects of human life. These multifaceted relationships are particularly important in developmental age and become dramatically evident in presence of complex deficits originating from visual aberrancies. The present review summarizes the available neuropsychological evidence on the development (...) of visual competences, with a particular focus on the associated visuo-motor integration skills in health and disease. With the aim of supporting future research and interventional settings, the goal of the present review is to constitute a solid base to help the translation of neuropsychological hypotheses into straightforward empirical investigations and rehabilitation/training protocols. This approach will further increase the impact, ameliorate the acceptance, and ease the use and implementation of lab-derived intervention protocols in real-life situations. (shrink)

A key element of the distinction between explicit and implicit cognitive functioning is the presence or absence of conscious awareness. In this review, we consider the proposal that neuropsychological disorders can best be considered in terms of a decoupling between preserved implicit or unconscious processing and impaired explicit or conscious processing. Evidence for dissociations between implicit and explicit processes in blindsight, amnesia, object agnosia, prosopagnosia, hemi-neglect, and aphasia is examined. The implications of these findings for a) our understanding of (...) a variety of neuropsychological disorders, b) the conceptualization of normal cognitive functioning, c) the neural basis of consciousness, and d) the clinical rehabilitation of brain-injured individuals are also discussed. (shrink)

This study examined the effects of computer-assisted cognitive rehabilitation in a group of 16 brain-damaged patients. Therapeutic effectiveness was assessed by improvement on computer tasks, the results of neuropsychological tests and quality of life ratings. Participants suffered from mild to moderate attention and memory problems or aphasia. The procedure involved baseline assessment, a 15-week course of therapy conducted twice a week and posttest. Neuropsychological tests assessing attention, memory and language problems and quality of life ratings were administered (...) twice: in pre- and posttests. Twelve healthy controls were also examined twice using the same battery of neuropsychological tests. The RehaCom program and the Polish computer therapy program for aphasics called Afa-System were used for rehabilitation. The computer-assisted rehabilitation tasks were selected individually for each patient. The results showed significant improvement on computer-assisted tasks in all braindamaged subjects. However, none or very little improvement was observed on neuropsychological tests and quality of life ratings. The results of the study confirm the importance of using different types of measures to estimate the effectiveness of computer-assisted neuropsychological rehabilitation as well as the necessity of applying various kinds of therapy to improve cognitive, emotional and social functioning in brain-damaged patients. (shrink)

The chapters published in this volume developed from presentations, and their associated discussions at a conference organised by the Scottish Branch of the British Psychological Society, held at Rothesay, Isle of Bute, Scotland in September 1987. The goal of the conference was to bring together workers across a wide area of neuropsychological research to discuss recent technological advances, developments in assessment and rehabilitation, and to address theoretical issues of current interest. Thus, the chapters in this book include contributions (...) on the use of Magnetic Resonance Imaging and Single Photon Emission Computed Tomography in neuropsychological research, studies of hemi spheric specialisation and cooperation, alcoholic and Alzheimer type dementia, prosopagnosia and facial processing, the assessment, management and rehabilitation of memory problems, the assessment of premorbid intellectual status and issues in developmental neuropsychology. Many of those engaged in research and clinical practice in neuropsychology encounter a range of topic at least as wide as this in their professional lives. The opportunity for researchers and clinicians to discuss some of the key issues in the field was invaluable and we hope that readers gain as much from the material presented here as the participants did from the meeting itself. (shrink)

Biomedical interventions, such as pharmacological and neurological interventions, are increasingly being offered or considered for offer to offenders in the criminal justice system as a means of reducing recidivism and achieving offender rehabilitation through treatment. An offender’s consent to treatment may affect decisions about diversion from the criminal justice system, sentence or parole, and so hope for a preferable treatment in the criminal justice system may influence the offender’s consent. This thematic analysis of three focus group interviews conducted in (...) Canada with members of the public investigates how the public views the use of biomedical treatments within the criminal justice system, and the practice of encouraging offender consent to biomedical treatment through the hope of a reduced criminal sentence. The public focus group discussions followed a semi-structured interview guide, and were based on two hypothetical case examples involving individuals choosing whether to consent to a range of cocaine addiction or anti-libidinal treatments respectively in the hope of receiving a more lenient sentence. The discussions covered a wide range of themes, and here we present the participants’ evaluations of this type of biomedical treatment offer in light of three key theoretical sentencing objectives: the promotion of public safety, the infliction of retributive punishment, and the rehabilitation of offenders. We conclude that public safety was the predominant concern of the participants when evaluating biomedical treatment offered at the time of sentencing to offenders who had committed serious crimes. Another important observation was that the public tended to reframe and evaluate biomedical interventions in terms of retribution and punishment, rather than rehabilitation and reform. (shrink)

Dominant approaches to punishment tend to downplay the socio-emotional dimension of perpetrators. This attitude is inconsistent with the body of evidence from social and affective neuroscience and its adjacent disciplines on the crucial role of emotions and emotion-related skills coupled with positive social stimuli in promoting prosocial behavior. Through a literature review of these studies, this article explores and assesses the implications that greater consideration of emotional and social factors in sentencing and correctional practices might have for conventional punitive approaches (...) to crime. It argues that proper attention to these factors within the judgment of offending can challenge the tenets of dominant punitive ideologies and responses to crime. It further emphasizes the higher rationality and effectiveness of a paradigm of justice that aims for the social reintegration of perpetrators through a path to self-reform and change that is based on relational and inclusionary processes in the least confining environments possible to still ensure public safety. Hence, this article supports the pursuit of social rehabilitation as the ultimate goal of criminal justice. (shrink)

Impairment of spatial memory, including an inability to recall previous locations and navigate the world, is often one of the first signs of functional disability on the road to cognitive impairment. While there are many screening and diagnostic tools which attempt to measure spatial memory ability, they are often not representative of real-life situations and can therefore lack applicability. One potential solution to this problem involves the use of virtual reality, which immerses individuals in a virtually-simulated environment, allowing for scenarios (...) more representative of real-life without any of the associated risks. Here, we review the evidence surrounding the use of VR for the screening and diagnosis of spatial memory impairments, including potential limitations and how it compares to standard neuropsychological tests. We will also discuss the evidence regarding the potential use of VR in the rehabilitation of spatial memory deficits, which has not been well studied, but which could be game-changing if proven successful. (shrink)

Background: There are few standardized measures available to assess executive function in a naturalistic setting for children. The Children’s Cooking Task is a complex test that has been specifically developed to assess EF in a standardized open-ended environment. The aim of the present study was to evaluate the internal consistency, inter-rater reliability, sensitivity and specificity, and also convergent and divergent validity of the Norwegian version of CCT among children with pediatric Acquired Brain Injury and healthy controls.Methods: The present study has (...) a cross-sectional design, based on baseline data derived from a multicenter RCT. Seventy-five children with pABI from two university hospitals with parent-reported executive dysfunction and minimum of 12 months since injury/completed cancer therapy, as well as 59 HCs aged 10–17 years, were assessed with CCT using total errors as the main outcome measure. The pABI group completed tests assessing EF on the impairment level within the ICF framework, and on the participation level. In addition, they completed tests of intellectual ability, processing speed, attention, learning, and memory. Finally, overall functional outcome was evaluated for the children with pABI.Results: Acceptable internal consistency and good inter-rater reliability were found for the CCT. Children with pABI performed significantly worse on the CCT than the HCs. The CCT identified group membership, but the sensitivity and specificity were overall classified as poor. Convergent validity was demonstrated by associations between the CCT and performance-based tests assessing inhibition, cognitive flexibility, and working memory, as well as teacher-reported executive dysfunction. Divergent validity was supported by the lack of association with performance-based measures of learning and memory, attention, and verbal intellectual ability. However, there was a moderate association between the CCT and performance-based tests of processing speed. Lastly, better performance on the CCT was associated with a better functional outcome.Conclusion: Our study with a relatively large sample of children with pABI and HC’s demonstrated good psychometric properties of the CCT. CCT performance was associated with the overall level of disability and function, suggesting that CCT is related to the level of activity in everyday life and participation in society. Hence, our study suggests that the CCT has the potential to advance the assessment of EF by providing a valid analysis of real-world performance. Nevertheless, further research is needed on larger samples, focusing on predictors of task performance, and evaluating the ability of CCT to detect improvement in EF over time. The patterns of error and problem-solving strategies evaluated by the CCT could be used to inform neuropsychological rehabilitation treatmentand represent a more valid outcome measure of rehabilitation interventions. (shrink)

The relationship between philosophy and science has always been complementary. Today, while science moves increasingly fast and philosophy shows some problems in catching up with it, it is not always possible to ignore such relationships, especially in some disciplines such as philosophy of mind, cognitive science, and neuroscience. However, the methodological procedures used to analyze these data are based on principles and assumptions that require a profound dialogue between philosophy and science. Following these ideas, this work aims to raise the (...) problems that a classical connectionist theory can cause and problematize them in a cognitive framework, considering both philosophy and cognitive sciences but also the disciplines that are near to them, such as AI, computer sciences, and linguistics. For this reason, we embarked on an analysis of both the computational and theoretical problems that connectionism currently has. The second aim of this work is to advocate for collaboration between neuroscience and philosophy of mind because the promotion of deeper multidisciplinarity seems necessary in order to solve connectionism’s problems. In fact, we believe that the problems that we detected can be solved by a thorough investigation at both a theoretical and an empirical level, and they do not represent an impasse but rather a starting point from which connectionism should learn and be updated while keeping its original and profoundly convincing core. (shrink)

Motor learning can be defined as a process that leads to relatively permanent changes in motor behavior through repeated interactions with the environment. Different strategies can be adopted to achieve motor learning: movements can be overtly practiced leading to an amelioration of motor performance; alternatively, covert strategies (e.g., action observation) can promote neuroplastic changes in the motor system even in the absence of real movement execution. However, whether a training regularly alternating action observation and execution (i.e., Action Observation Training, AOT) (...) may surpass the pure motor practice (MP) and observational learning (OL) remains to be established. To address this issue, we enrolled 54 subjects requiring them to learn tying nautical knots via one out of three types of training (AOT, MP, OL) with the scope to investigate which element mostly contributes to motor learning. We evaluated the overall improvement of each group, along with the predictive role that neuropsychological indexes exert on each treatment outcome. The AOT group exhibited the highest performance improvement (42%), indicating that the regular alternation between observation and execution biases participants toward a better performance. The reiteration of this sequence provides an incremental, adjunct value that super-adds onto the efficacy of motor practice or observational learning in isolation (42% > 25% + 10%, i.e., OL + MP). These findings extend the use of the AOT from clinical and rehabilitative contexts to daily routines requiring the learning and perfectioning of new motor skills such as sports training, music, and occupational activities requiring fine motor control. (shrink)

BackgroundFunctional neurodiagnostics could allow researchers and clinicians to distinguish more accurately between the unresponsive wakefulness syndrome and the minimally conscious state. It remains unclear how it informs surrogate decision-making.ObjectiveTo explore how the next of kin of patients with disorders of consciousness interpret the results of a functional neurodiagnostics measure and how/why their interpretations influence their attitudes towards medical decisions.Methods and SampleWe conducted problem-centered interviews with seven next of kin of patients with DOC who had undergone a functional HD-EEG examination at (...) a neurological rehabilitation center in Germany. The examination included an auditory oddball paradigm and a motor imagery task to detect hidden awareness. We analyzed the interview transcripts using structuring qualitative content analysis.ResultsRegardless of the diagnostic results, all participants were optimistic of the patients’ meaningful recovery. We hypothesize, that participants deal with the results of examinations according to their belief system. Thus, an unfavorable evaluation of the patient’s state had the potential to destabilize the participant’s belief system. To re-stabilize or to prevent the destabilization of their belief system, participants used different strategies. Participants accepted a “positive” HD-EEG result since it stabilized their belief system.ConclusionWe hypothesize, that a group of next of kin of patients with DOC deals with functional neurodiagnostics results on the basis of the result’s value and their high hope that the patient will recover meaningfully. A psychological mechanism seems to moderate the impact of functional neurodiagnostics on surrogate treatment decisions. (shrink)

This volume provides, for the first time, multidisciplinary perspectives on the problem of awareness of deficits following brain injury. Such deficits may involve perception, attention, memory, language, or motor functions, and they can seriously disrupt an individual's ability to function. However, some brain-damaged patients are entirely unaware of the existence or severity of their deficits, even when they are easily noticed by others. In addressing these topics, contributors cover the entire range of neuropsychological syndromes in which problems with awareness (...) of deficit are observed: hemiplegia and hemianopia, amnesia, aphasia, traumatic head injury, dementia, and others. On the clinical side, leading researchers delineate the implications of awareness of deficits for rehabilitation and patient management, and the role of defense mechanisms such as denial. Theoretical discussions focus on the importance of awareness disturbances for better understanding such cognitive processes as attention, consciousness, and monitoring. (shrink)

The study of anosognosia has witnessed an unprecedented increase in interest over the last 20 years. This has resulted in numerous empirical investigations as well as theoretical writings on the nature of human consciousness and how disorders of the brain may influence the person's subjective awareness of a disturbed neurological or neuropsychological function. This edited text summarizes many of the advances that have taken place in the field of anosognosia. It reviews research findings on anosognosia for hemiplegia following stroke, (...) Anton's syndrome, and a variety of disorders in which impaired self-awareness is common. It also provides suggestive guidelines for the management and rehabilitation of persons who have anosognosia or impaired self-awareness. (shrink)

Riassunto: Tra i disturbi del linguaggio, il deficit di tipo pragmatico viene spesso osservato nelle persone a seguito di trauma cranio-encefalico. Nonostante sia negletta nella pratica clinica, questa componente gioca un ruolo centrale nella qualità di vita di persone con TCE. L’aspetto peculiare del deficit di tipo pragmatico è la sua natura intrinsecamente connessa sia ad altre capacità di tipo cognitivo che relazionali delle persone fin nella storia pre-morbosa. L’obiettivo di questo lavoro è proporre un punto di vista teorico che, (...) beneficiando del dialogo tra neuropsicologia e fenomenologia, possa costituire un paradigma utile per considerare in modo più sistematico il deficit di tipo pragmatico. Piuttosto che frammentarlo e ridurlo solo a una lista di singoli sintomi, esso viene analizzato come conseguenza di un’alterazione non storica dell’ ipseità, mettendolo in relazione con il concetto di “ embodiment ”. Si avanza, in conclusione, una possibile proposta di presa in carico di tale neuropsicopatologia. Parole chiave: Trauma cranio-encefalico; Pragmatica; Comunicazione; Embodiment; Fenomenologia Pragmatic disorder due to TBI: A phenomenological approach to rehabilitation –: People who suffer from traumatic brain injury are frequently affected by pragmatic disorder, among other communicative impairments. While largely neglected in terms of rehabilitation strategies, the skills impaired by PD play a fundamental role in the quality of life of people who suffer from TBI. PD uniquely impacts a person’s cognitive and interpersonal abilities, including those from their pre-morbid history. The aim of this work is to propose a theoretical framework, based on a dialogue between neuropsychology and phenomenology, that may provide a useful paradigm in approaches to rehabilitation in PD. Instead of fragmenting this disorder into a list of symptoms, we address it as a consequence of a non-historical alteration of “ ipseity” in connection with the concept of “ embodiment”. In conclusion, we suggest an intervention for this neuropsychopathology. Keywords: Traumatic Brain Injury; Pragmatics; Communication; Embodiment; Phenomenology. (shrink)

For public health professionals, traumatic brain injury and its possible protracted repercussions are a significant source of worry. In opposed to patient neurorehabilitation with developed brain abnormalities of different etiologies, neurorehabilitation of affected persons has several distinct features. The clinical repercussions of the various types of TBI injuries will be discussed in detail in this paper. During severe TBI, the medical course frequently follows a familiar first sequence of coma, accompanied by disordered awareness, followed by agitation and forgetfulness, followed by (...) return of function. Clinicians must be aware of common medical issues that might occur throughout the various stages of neurorehabilitation, for example, posttraumatic hydrocephalus, paroxysmal sympathetic hyperactivity and posttraumatic neuroendocrine disorders, at each step of the process. Furthermore, we address problems about the scheduling of various rehabilitation programs as well as the availability of current data for comprehensive rehabilitative neuropsychology techniques. (shrink)

Aggressive-sadistic personality disorder (SPD) involves derivation of pleasure from another's physical or emotional suffering, or from control and domination of others. Findings from a head-injured sample indicate that SPD traits are associated with neuropsychological deficits in executive function and language, suggesting difficulties in frontal-lobe-mediated self-regulation of aggressive and emotional impulses. Implications for rehabilitation of aggressive offenders are discussed.

Due to improvements in medicine, the figures of patients with disorders of consciousness (DoC) are increasing. Diagnostics of DoC and prognostication of rehabilitation outcome is challenging but necessary to evaluate recovery potential and to decide on treatment options. Such decisions should be made by doctors and patients’ surrogates based on medico-ethical principles. Meeting information needs and communicating effectively with caregivers as the patients´ most common surrogate-decision makers is crucial, and challenging when novel tech-nologies are introduced. This qualitative study aims (...) to explore information needs of informal DoC caregivers, how they manage the obtained information and their perceptions and experiences with caregiver-physician communication in facilities that implemented innovative neurodiagnostics studies. In 2021, we conducted semi-structured interviews with nine caregivers of clinically stable DoC patients in two rehabilitation centers in Italy and Germany. Participants were selected based on consecutive purposeful sampling. Caregivers were recruited at the facilities after written informed consent. All interviews were recorded, transcribed verbatim and translated. For analysis, we used reflexive thematic analysis according to Braun & Clarke (2006). Caregivers experienced the conversations emotionally, generally based on the value of the information provided. They reported to seek positive information, comfort and empathy with-in the communication of results of examinations. They needed detailed information to gain a deep understanding and a clear picture of their loved-one’s condition. The results suggest a mismatch between the perspectives of caregivers and the perspectives of medical profession-als, and stress the need for more elaborate approaches to the communication of results of neu-rodiagnostics studies. (shrink)

IntroductionHearing loss in adults has a pervasive impact on health and well-being. Its effects on everyday listening and communication can directly influence participation across multiple spheres of life. These impacts, however, remain poorly assessed within clinical settings. Whilst various tests and questionnaires that measure listening and communication abilities are available, there is a lack of consensus about which measures assess the factors that are most relevant to optimising auditory rehabilitation. This study aimed to map current measures used in published (...) studies to evaluate listening skills needed for oral communication in adults with hearing loss.MethodsA scoping review was conducted using systematic searches in Medline, EMBASE, Web of Science and Google Scholar to retrieve peer-reviewed articles that used one or more linguistic-based measure necessary to oral communication in adults with hearing loss. The range of measures identified and their frequency where charted in relation to auditory hierarchies, linguistic domains, health status domains, and associated neuropsychological and cognitive domains.Results9121 articles were identified and 2579 articles that reported on 6714 discrete measures were included for further analysis. The predominant linguistic-based measure reported was word or sentence identification in quiet. In contrast, discourse-based measures were used in 2.7% of the articles included. Of the included studies, 36.6% used a self-reported instrument purporting to measures of listening for communication. Consistent with previous studies, a large number of self-reported measures were identified, but 60.4% of these measures were used in only one study and 80.7% were cited five times or fewer.DiscussionCurrent measures used in published studies to assess listening abilities relevant to oral communication target a narrow set of domains. Concepts of communicative interaction have limited representation in current measurement. The lack of measurement consensus and heterogeneity amongst the assessments limit comparisons across studies. Furthermore, extracted measures rarely consider the broader linguistic, cognitive and interactive elements of communication. Consequently, existing measures may have limited clinical application if assessing the listening-related skills required for communication in daily life, as experienced by adults with hearing loss. (shrink)

Spatial neglect is a disorder of space-related behaviour. It is characterized by failure to explore the side of space contralateral to a brain lesion, or to react or respond to stimuli or subjects located on this side. Research on spatial neglect and related disorders has developed rapidly inrecent years. These advances have been made as a result of neuropsychological studies of patients with brain damage, behavioural studies of animal models, as well as through functional neurophysiological experiments and functional neuroimaging.The (...) Cognitive and Neural Bases of Spatial Neglect provides an overview of this wide-ranging field of scientific endeavour, providing a cohesive synthesis of the most recent observations and results. As well as being a fascinating clinical phenomenon, the study of spatial neglect helps us tounderstand normal mechanisms of directing and maintaining spatial attention and is relevant to the contemporary search for the cerebral correlates of conscious experience, voluntary action and the nature of personal identity itself.The book is divided into seven sections covering the anatomical and neurophysiological bases of the disorder, frameworks of neglect, perceptual and motor factors, the relation to attention, the cognitive processes involved, and strategies for rehabilitation.Chapters have been written by a team of the leading international experts in this field.This will be essential reading for neuropsychologists, neurologists, neurophysiologists, cognitive neuroscientists and psychologists. (shrink)

The new biotechnology raises expectations for modifying human behaviour through its use. This article focuses on the ethical analysis of the not so remote possibility of rehabilitating criminals by means of neurotechnological techniques. The analysis is carried out from a synthetic position of, on the one hand, the consequentialist conception of what is right and, on the other hand, the emphasis on individual liberties. As a result, firstly, the ethical appropriateness of adopting a general predisposition for allowing the neurorehabilitation of (...) prisoners only if it is safe and if they give their consent will be defended. But, at the same time, reasons will be given for requiring, in certain circumstances, the exceptional use of neurotechnology to rehabilitate severely psychopathic prisoners, even against their will, from the same ethical perspective. (shrink)

The implications for the substantivalist–relationalist controversy of Barbour and Bertotti's successful implementation of a Machian approach to dynamics are investigated. It is argued that in the context of Newtonian mechanics, the Machian framework provides a genuinely relational interpretation of dynamics and that it is more explanatory than the conventional, substantival interpretation. In a companion paper (Pooley [2002a]), the viability of the Machian framework as an interpretation of relativistic physics is explored. 1 Introduction 2 Newton versus Leibniz 3 Absolute space versus (...) an affine connection 4 Anti-relationalist arguments 5 Rehabilitating relationalism 6 Dynamics on the relative configuration space 7 Intrinsic particle dynamics 8 Conclusion. (shrink)

This chapter contains section titled: No Abstract.

When cognitive neuropsychologists make inferences about the functional architecture of the normal mind from selective cognitive impairments they generally assume that the effects of brain damage are local, that is, that the nondamaged components of the architecture continue to function as they did before the damage. This assumption follows from the view that the components of the functional architecture are modular, in the sense of being informationally encapsulated. In this target article it is argued that this “locality” assumption is probably (...) not correct in general. Inferences about the functional architecture can nevertheless be made from neuropsychological data with an alternative set of assumptions, according to which human information processing is graded, distributed, and interactive. These claims are supported by three examples of neuropsychological dissociations and a comparison of the inferences obtained from these impairments with and without the locality assumption. The three dissociations are: selective impairments in knowledge of living things, disengagment of visual attention, and overt face recognition. In all three cases, the neuropsychological phenomena lead to more plausible inferences about the normal functional architecture when the locality assumption is abandoned. Also discussed are the relations between the locality assumption in neuropsychology and broader issues, including Fodor's modularity hypothesis and the choice between top-down and bottom-up research approaches. (shrink)

Recently it has been argued that certain neuropsychological findings on the decision-making, instrumental learning, and moral understanding in psychopathic offenders offer reasons to consider them not criminally responsible, due to certain epistemic and volitional impairments. We reply to this family of arguments, that collectively we call the irresponsibility of the psychopath argument. This type of argument has a premise that describes or prescribes the deficiencies that grant or should grant partial or complete criminal exculpation. The other premise contends that (...) neuropsychological evidence shows that psychopaths have incapacitates that are sufficient to ascribe complete or partially exculpatory deficiencies. The focus of our criticism is this latter premise. We argue that it requires that psychopathy should correlate significantly with certain rational incapacities that manifest across contexts. We show that the available neuropsychological data do not support the claim that psychopaths have such general exculpatory incapacities. (shrink)

The prevalence and negative impact of brain disorders are increasing. Clinical Neuropsychology is a specialty dedicated to understanding brain-behavior relationships, applying such knowledge to the assessment of cognitive, affective, and behavioral functioning associated with brain disorders, and designing and implementing effective treatments. The need for services goes beyond neurological diseases and has increased in areas of neurodevelopmental and psychiatric conditions, among others. In Europe, a great deal of variability exists in the education and training of Clinical Neuropsychologists. Training models include (...) master’s programs, continuing education courses, doctoral programs, and/or post-doctoral specialization depending on the country, with no common framework of requirements, although patients’ needs demand equal competencies across Europe. In the past five years, the Standing Committee on Clinical Neuropsychology of the European Federation of Psychologists’ Association has conducted a series of surveys and interviews with experts in the field representing 30 European countries. The information, along with information from the existing literature, is used in presenting an overview of current and relevant topics related to policy and guidelines in the training and competencies in Clinical Neuropsychology. An option for the way forward is the EuroPsy Specialist Certificate which is currently offered in Work- and Organizational psychology and Psychotherapy. It builds upon the Basic Certificate and complements national standards without overriding them. General principles can be found that can set the basis for a common, solid, and comprehensive specialty education/training, sharpening the Neuropsychologists’ competencies across Europe. The requirements in Clinical Neuropsychology should be comparable to those for the existing specialty areas in the EuroPsy model. Despite the perceived challenges, developing a Specialist Certificate appears a step forward for the development of Clinical Neuropsychology. Recommendations are proposed towards a shared framework of competencies by the means of a common level of education/training for the professionals in Europe. Benchmarking training standards and competencies across Europe has the potential of providing protection against unqualified and ethically questionable practice, creating transparency, raising the general European standard, and promoting mobility of both Clinical Neuropsychologists and patients in Europe, for the benefit of the professional field and the population. (shrink)

This paper considers the neuropsychology of religious and spiritual experiences. This requires a review of our current understanding of brain function as well as an integrated synthesis to derive a neuropsychological model of spiritual experiences. Religious and spiritual experiences are highly complex states that likely involve many brain structures including those involved in higher order processing of sensory and cognitive input as well as those involved in the elaboration of emotions and autonomic responses. Such an analysis can help elucidate (...) the biological correlates of these experiences and provide new information regarding the function of the human brain. (shrink)

Criminal offenders are sometimes required, by the institutions of criminal justice, to undergo medical interventions intended to promote rehabilitation. Ethical debate regarding this practice has largely proceeded on the assumption that medical interventions may only permissibly be administered to criminal offenders with their consent. In this article I challenge this assumption by suggesting that committing a crime might render one morally liable to certain forms of medical intervention. I then consider whether it is possible to respond persuasively to this (...) challenge by invoking the right to bodily integrity. I argue that it is not. (shrink)

When cognitive neuropsychologists make inferences about the functional architecture of the normal mind from selective cognitive impairments they generally assume that the effects of brain damage are local, that is, that the nondamaged components of the architecture continue to function as they did before the damage. This assumption follows from the view that the components of the functional architecture are modular, in the sense of being informationally encapsulated. In this target article it is argued that this “locality” assumption is probably (...) not correct in general. Inferences about the functional architecture can nevertheless be made from neuropsychological data with an alternative set of assumptions, according to which human information processing is graded, distributed, and interactive. These claims are supported by three examples of neuropsychological dissociations and a comparison of the inferences obtained from these impairments with and without the locality assumption. The three dissociations are: selective impairments in knowledge of living things, disengagment of visual attention, and overt face recognition. In all three cases, the neuropsychological phenomena lead to more plausible inferences about the normal functional architecture when the locality assumption is abandoned. Also discussed are the relations between the locality assumption in neuropsychology and broader issues, including Fodor's modularity hypothesis and the choice between top-down and bottom-up research approaches. (shrink)

I argue that, contrary to some critics, the notion of conscious experience is a good candidate for denoting a distinct and scientifically interesting phenomenon in the brain. I base this claim mainly on an analysis of neuropsychological data concerning deficits resulting from various types of brain damage as well as some additional supporting empirical evidence. These data strongly point to the hypothesis that conscious experience expresses information that is available for global, integrated, and flexible behavior.

Recently, the practice of deciding legal cases on purely statistical evidence has been widely criticised. Many feel uncomfortable with finding someone guilty on the basis of bare probabilities, even though the chance of error might be stupendously small. This is an important issue: with the rise of DNA profiling, courts are increasingly faced with purely statistical evidence. A prominent line of argument—endorsed by Blome-Tillmann 2017; Smith 2018; and Littlejohn 2018—rejects the use of such evidence by appealing to epistemic norms that (...) apply to individual inquirers. My aim in this paper is to rehabilitate purely statistical evidence by arguing that, given the broader aims of legal systems, there are scenarios in which relying on such evidence is appropriate. Along the way I explain why popular arguments appealing to individual epistemic norms to reject legal reliance on bare statistics are unconvincing, by showing that courts and individuals face different epistemic predicaments (in short, individuals can hedge when confronted with statistical evidence, whilst legal tribunals cannot). I also correct some misconceptions about legal practice that have found their way into the recent literature. (shrink)

Criminal offenders may be offered to participate in voluntary rehabilitation programs aiming at correcting undesirable behaviour, as a condition of early release. Behavioural treatment may include direct intervention into the central nervous system (CNS). This article discusses under which circumstances voluntary rehabilitation by CNS intervention is justified. It is argued that although the context of voluntary rehabilitation is a coercive circumstance, consent may still be effective, in the sense that it can meet formal criteria for informed consent. (...) Further, for a consent to be normatively valid (“take the wronging out of the act”) under a coercive circumstance, the subject to be treated must (1) have the sovereign authority to consent, and (2) the offer-giver must be in the right normative position to make the offer. While I argue that subjects do have the sovereign authority to consent to treatment, I also argue that inappropriate offers yield invalid consents. Considerations on inappropriate offers should therefore inform which kinds of CNS intervention-based rehabilitation schemes the state may propose as part of the criminal justice system. Yet as I conclude in this paper, while there are some intrinsic constraints on voluntary rehabilitation programs, the main constraints on voluntary rehabilitation are likely to be contingent overriders. However, CNS intervention is not ruled out as such in the context of voluntary rehabilitation. (shrink)

A neuropsychological perspective on auditory verbal hallucinations links key phenomenological features of the experience, such as voice location and identity, to functionally separable pathways in normal human audition. Although this auditory processing stream framework has proven valuable for integrating research on phenomenology with cognitive and neural accounts of hallucinatory experiences, it has not yet been applied to other symptoms presumed to be closely related to AVH – such as thought insertion. In this paper, I propose that an APS framework (...) offers a useful way of thinking about the experience of TI as well as AVH, providing a common conceptual framework for both. I argue that previous self-monitoring theories struggle to account for both the differences and similarities in the characteristic features of AVH and TI, which can be readily accommodated within an APS framework. Furthermore, the APS framework can be integrated with predictive processing accounts of psychotic symptoms; makes predictions about potential sites of prediction error signals; and may offer a template for understanding a range of other symptoms beyond AVH and TI. (shrink)