Other Mental Disorders

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)

Many psychiatrists tell their clients that any mental disorder is ‘‘a disease, just like diabetes’’. This slogan appears to suggest that mental states and behavior that are classified ‘‘mental disorders’’ are somehow radically different from other mental states and behaviors—both when it comes to simply understanding people and when it comes to moral assessments of mental states and of actions. After all, mental illness is just like diabetes, while other human conditions are not. That sounds like a huge difference. I (...) think this suggestion is misleading. (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 discusses the developments that have occurred within the model in the past twenty years, and places it within a broader context.

In their work Gilio et al. investigate the mechanisms involved in the regulation of excitability of the cortex in epileptic subjects, and in particular their epileptogenic threshold.

Northoff's target article presents a unifying theory of the pathophysiology of catatonia, as compared to Parkinson's disease. We address two arguments in particular that do not appear justified by available evidence: (1) The physiological basis of catatonia is the breakdown of right hemisphere prefrontal-parietal cortical connectivity, and (2) Dysfunction in this system results in specific deficits in termination of action.

Dr. Northoff's comprehensive comparison of clinical symptoms and neurobiological findings in catatonia with that of Parkinson's disease through integration of various levels of investigation, from neurochemistry up to the subjective experience, is a good example of the new strategies we need to improve our understanding of psychiatric disorders. His multimodal approach, leading to the hypothesis that different pathophysiologies of transcortical “horizontal modulation” and “bottom-up/top-down” – orbitofrontal/basal ganglia – “vertical modulations,” may explain many clinical aspects of catatonia and Parkinson's disease, and (...) thereby fills an important gap in current theories of psychomotor syndromes. However, to analyze more specifically the pathophysiology of catatonia, comparison not only with Parkinson's disease, but also with schizophrenia and anxiety disorders would be helpful. As long as the pathohistological and molecular basis of catatonic syndromes is unknown, theories based mainly on functional considerations remain preliminary. (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)

How do people detect mental dysfunction? What is the influence of cultural models of dysfunction on this detection process? The detection process as such is not usually researched as it falls between the domains of cross-cultural psychiatry and anthropological ethno-psychiatry . I provide a general model for this “missing link” between behavior and cultural models, grounded in empirical evidence for intuitive psychology. Normal adult minds entertain specific intuitive expectations about mental function and behavior, and by implication they infer that specific (...) kinds of behavior are the result of underlying dysfunction. This suggests that there is a “catalogue” of possible behaviors that trigger that intuition, hence a limited catalogue of possible symptoms that feed into culturally specific folk-understandings of mental disorder. It also suggests that some mental dysfunctions, as they do not clearly violate principles of intuitive psychology, are “invisible” to folk-understandings. This perspective allows us to understand the cultural stability and spread of particular views of madness. It also suggests why certain types of mental disorder are invisible to folk-understandings. (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)

Recurrent complex visual hallucinations (RCVH) represent a form of psychosis. It may be useful to compare RCVH to another form of psychosis, catatonia. Both include a long list of medical illnesses and have been examined using several different hypotheses. Catatonia has a variety of hypotheses, including neurocircuitry, neurochemistry, and an integrated neuropsychiatric hypothesis. This hypothesis for catatonia supports Collerton et al.'s Perception and Attention Deficit model (PAD) for RCVH.

In this article, we analyze both M. J. Wainwright and E. M. Reingold's view of the process dissociation measurement models presented by A. Buchner, E. Erdfelder, and B. Vaterrodt-Plunnecke and their suggestions on that topic. This analysis reveals a number of problems in Wainwright and Reingold's approach. Some of these problems are more subtle than others, but they are nevertheless consequential. Thus, researchers working with the process dissociation procedure should be aware of these problems.

In this article, we try to clarify some of the issues raised by S. C. Draine, A. G. Greenwald, and M. R. Banaji concerning our investigation into the gender bias in fame judgments . First, we did not test the general hypothesis and did not draw the general conclusion that Drain et al. suggest we did. Second, we did not reject M. R. Banaji and A. G. Greenwald's assumptions about the familiarity of male and female names in the fame judgment (...) task, but we showed how one could have come to reject it using a widespread measurement model for the process dissociation procedure. Third, we argue that the processes which Draine et al. suggest should also be included in the measurement model we used are probably negligible, and if they are not, then the validity of the results of a number of fame judgment experiments must be called into question. In general, however, we agree with what seems to be the main message ofM. R. Banaji and A. G. Greenwald's research, namely, that social categories have to be considered whenever priming is investigated within a social domain. (shrink)

“Spousal revenge” killers murder their child apparently out of a desire to cause harm to their ex-partner, the child’s other parent. Standard explanations of these killings fail to provide an adequate solution to what I call the problem of spousal revenge filicide. This is the problem of how a killer comes to take their rage at their former partner out on their own child and how that child can be dehumanized to the point of murder. Although the dehumanization of the (...) victim is acknowledged to occur, why it occurs is not well understood. Here, I offer an hypothesis that the killer fails to represent their child as a moral subject with a mind of their own. This is due to a deficit in the killer’s capacity for person perception which is, by hypothesis, pathological. As such, the killer experiences the child as an object, rather than a person, which is of significant emotional value to the other parent. The specificity of this disorder explains why the ex-partner themselves is not targeted, and it explains how the killer is able to understand that killing the child will harm the other parent. (shrink)

Comparing the phenomenology, neurochemical pathology, and psychopharmacology of hallucinations and dreaming is limited by the available data. Evidence to date reveals no simple correspondence between the two states. Differences in the phenomenology of visual hallucinations and the visual component of dreams may reflect variations in visual context acting on the same underlying mechanism – the minimal visual input during dreaming contrasts with the more substantial perceived context in hallucinations. Variations in cholinergic, dopaminergic and serotonergic neurotransmitter function during sleep and during (...) hallucinations in Lewy body dementias, together with relevant drug effects suggest that, on the whole, different, potentially opposite, changes characterise the two states. A similar analysis of other psychotic features in Lewy body dementia and other disorders suggests that, in contrast to hallucinations, there may be more convincing parallels between dreaming and delusional states. (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.

Erratum: Volume 9, Number 4 , in the article “William James's The Fringe of Consciousness REM Mentation in Narcoleptics and Normals: Reply to Tore Nielsen,” by Roar Fosse, pages 514–515 ()On page 514, the title is incorrect as printed. The title should read “REM Mentation in Narcoleptics and Normals: Reply to Tore Nielsen.” “William James's The Fringe of Consciousness” should be a heading following this article in the Table of Contents and pertains to the articles that follow. Both the Fosse (...) reply and the heading are correct as printed in the Table of Contents in the print issue. (shrink)

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)

Epileptogenesis involves an increase in excitatory synaptic strength in the brain in a manner similar to synaptic potentiation. In the present study we investigated the mechanisms of short-term synaptic potentiation in patients with focal epilepsy by using 5 Hz repetitive transcranial magnetic stimulation (rTMS), a non invasive neurophysiological technique able to investigate the mechanisms of synaptic plasticity in humans. Ten patients with focal idiopathic cortical epilepsy were studied. 5 Hz-rTMS (10 stimuli-trains, 120% of motor threshold, RMT) was delivered over the (...) first dorsal interosseus (FDI) motor area of both (affected and unaffected) hemispheres. Changes in the motor evoked potential (MEP) size in the FDI muscle during the trains and the RMT were measured and compared between the hemispheres. 5 Hz-rTMS was also delivered in a group of healthy subjects over both hemispheres. 5 Hz-rTMS in patients elicited a reduced MEP facilitation compared to normal subjects. The reduced MEP amplitude was more evident in the affected hemisphere than in the unaffected hemisphere. RMT in the affected hemisphere was higher than in the unaffected hemisphere and in healthy subjects. Our findings showing a decreased response to 5 Hz-rTMS over the affected hemisphere, differently from the expected results suggest a reduced cortical excitability in epileptic patients. We hypothesize an altered balance between excitatory and inhibitory circuits in epileptic patients under chronic therapy. (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)

K L Kahlbaum published in 1874 the first recorded description of catatonia. Akinetic catatonia is now defined as a neuropsychiatric syndrome principally characterised by akinesia, mutism, stupor, and catalepsy. 1 Even if some advances have been made in the recognition of catatonia, in particular by the development of different rating scales, 1 the pathophysiology of this syndrome is not clearly established. A right handed 14 year old girl presented with akinetic catatonia during an episode of depression in the context of (...) a bipolar type I disorder. Her catatonic status was characterised by akinesia with brief episodic spontaneous stereotyped movements, mutism, no spontaneous oral intake, catalepsy, waxy flexibility, and stupor with brief occasional eye contacts. This corresponded to a total score of 19 on the Northoff Catatonia Scale.1 Electroencephalogram performed one day after onset of symptoms showed diffuse theta activity with sporadic diffuse delta activity. Cerebral magnetic resonance imaging was normal. Brain positron emission tomographies (PET) were obtained on a CTI-Siemens HR+ tomograph. A first PET (PET1) using (18F(- fluorodeoxyglucose (FDG) was performed on day 2 in a drug free state. Thereafter, intramuscular injection of 2 mg of lorazepam induced rapid clinical remission of the akinetic phase. Oral lorazepam was then given (3.75 mg/day) during five days. On day 8, a second PET with FDG was performed while the patient was treated by olanzapine (15 mg/day) and presented hyperactivity, logorrhoea, and disinhibition characterised by uncontrolled social interactions and physical contacts. Neuropsychological testing performed some days after remission revealed no apraxia or language disturbances but dysfunction of executive tasks manifested in the revised Wisconsin card sorting, the Tower of London, Stroop, and Trailmaking tests. Voxel based analyses comparing patient’s cerebral glucose metabolism with that of 29 right handed healthy controls (16 women and 13 men, mean age 32) were performed using Statistical Parametric Mapping (SPM99) (Wellcome Department of Cognitive Neurology, London, UK).. (shrink)

I will argue in this paper that it is possible to reconstruct the events that preceded D.P. Schreber's second nervous breakdown on the basis of chapter eight of his Memoirs of My Nervous Illness. This argument is a contribution to the debate on the etiology of Schreber's illness. It runs in parallel and in support to the studies that emphasize the role of institutional psychiatry (see Lothane) and a power crisis (e.g. Santer) in manufacturing Schreber's illness, and deemphasize Freud's and (...) Niederland's Oedipal interpretations, along the lines of Deleuze and Guattari. I will draw on the ideas of Derrida and Lacan (via Winnicott) to justify the possibility and the reconstruction of the events in the office of the presiding judge, in order to fill the gap in the factual information related to Schreber's employment in 1893. Although Schreber indicates that the cause of his illness is intimately related to his new position, he does not offer much support to this claim. Still, this study takes Schreber's claim seriously and suggests that despite the absence of a narrative of his presidency, its details come to surface in the context of his transfer to Pierson's asylum. (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. 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; to examine the literature on "socialunderstanding" mechanisms in autism, particularly those assumed to develop in the first years of life; to examine the related literature on typically developing infants and toddlers, and 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 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 - "Does the chimpanzee have a theory of mind'" - not only introduced the "falsebelief' task, but addressed a host of issues surrounding the characterization of second-order intentional systems, systems that may be interpreted as having beliefs about beliefs (or desires or intentions... (shrink)

Clinical experience suggests that adult survivors of childhood trauma arrive at their memories in a number of ways, with varying degrees of associated distress and uncertainty and, in some cases, after memory lapses of varying duration and extent. Among those patients who enter psychotherapy as a result of early abuse, three general patterns of traumatic recall are identified: relatively continuous and complete recall of childhood abuse experiences coupled with changing interpretations of these experiences, partial amnesia for abuse events, accompanied by (...) a mixture of delayed recall and delayed understanding, and delayed recall following a period of profound and pervasive amnesia. These patterns are represented by three composite clinical vignettes. Variations among them suggest that the phenomena underlying traumatic recall are continuous not dichotomous. Future research into the nature of traumatic memory should be informed by clinical observation. (shrink)

The present study was designed to explore the relationship between self-reported dissociative experiences and performance in tasks eliciting right-hemisphere processing load. Thirty-four participants performed a vigilance task in two conditions: with task-irrelevant negative-arousing pictures and task-irrelevant neutral pictures. Dissociation was assessed with the Dissociative Experience Scale. Consistent with theories positing right-hemisphere deregulation in high non-clinical dissociators, dissociative experiences correlated with greater vigilance decrement only in the negative picture condition. As both the vigilance task and negative picture processing are right lateralized, (...) this result provides support for a right-hemisphere dysfunction in high dissociators, at least in negative conditions. (shrink)

Dreaming and waking are two brain-mind states, which are characterized by shared and differentiated properties at the levels of brain and consciousness. As part of our effort to capitalize on a comparison of these two states we have applied Edelman’s distinction between primary and secondary consciousness, which we link to dreaming and waking respectively. In this paper we examine the implications of this contrastive analysis for theories of mental illness. We conclude that while dreaming is an almost perfect model of (...) organic psychosis, it is less so for schizophrenia and major affective disorder where it must serve a primarily heuristic role helping us to model hallucinations and delusions but not the diseases themselves. (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)

In this article, we focus on two issues, namely, the nature and onset of very early personal memories, especially for traumatic events, and the role of stress in long-term retention. We begin by outlining a theory of early autobiographical memory, one whose unfolding is coincident with emergence of the cognitive self. It is argued that it is not until this self emerges that personal memories will remain viable over extended periods of time. We illustrate this with 25 cases of young (...) children′s long-term retention of early traumatic events involving emergency room treatment. On the basis of both qualitative and quantitative analyses, we conclude that very young children retain limited memories for events which they commonly express behaviorally, coherent autobiographical memories are not constructed until the child develops a cognitive sense of self , autobiographical memories for traumatic events are essentially no different from those for nontraumatic events, stress is only related to long-term retention inasmuch as it is one variable that serves to make an event unique, and like nontraumatic events, traumatic memories lose peripheral details during the retention interval and retain the central components of the event. These results are discussed both in terms of their implications for theories of early autobiographical memory as well as the ways in which we might differentiate implanted memories and authentic memories for traumatic events. (shrink)

With growing concerns over children's suggestibility and how it may impact their reliability as witnesses, there is increasing interest in determining the long-term effects of induced memories. The goal of the present research was to learn whether source misattributions found by Ceci, Huffman, Smith, and Loftus caused permanent memory alterations in the subjects tested. When 22 children from the original study were reinterviewed 2 years later, they recalled 77% of all true events. However, they only consented to 13% of all (...) false events, compared to the 22% false consent rate found by Ceci et al. . Additionally, while children remained accurate in their recall of true events , they “recanted” their earlier false consents 77% of the time, after the 2-year delay. Implications of these findings for child witnesses and the legal system are discussed. (shrink)

Dementia affects millions of people throughout the world. Thinking through Dementia offers a critique of the main models used to understand dementia -the biomedical, neuropsychological, and social constructionist. It discusses clinical issues and cases, together with philosophical work that might help us to better understand and treat this illness.

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 they 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 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)