Other Mental Disorders

In some neuropsychological disorders memory distortions seemingly fill gaps in people’s knowledge about their past, where people’s self-image, history, and prospects are often enhanced. False beliefs about the past compromise both people’s capacity to construct a reliable autobiography and their trustworthiness as communicators. However, such beliefs contribute to people’s sense of competence and self-confidence, increasing psychological wellbeing. Here we consider both psychological benefits and epistemic costs, and argue that distorting the past is likely to also have epistemic benefits that cannot (...) be obtained otherwise, such as enabling people to exchange information, receive feedback, and retain key beliefs about themselves. (shrink)

Among the various human forms alluded to in the Hebrew prayer, mental retardation appears to be one of the most difficult to celebrate. It is the disability that other disabled persons do not want attributed to them. It is the disability for which prospective parents are most likely to use selective abortion (Wertz 2000). And it is the disability that prompted one of the most illustrious United States Supreme Court Justices to endorse forced sterilization, because "three generations of imbeciles are (...) enough." The mentally retarded have at times been objects of pity, compassion, or abuse by their caretakers and society at large. But they have rarely been seen as subjects, as citizens, as persons with equal entitlement to fulfillment. (shrink)

In this article we examine obsessive compulsive disorder. We examine and reject two existing models of this disorder: the Dysfunctional Belief Model and the Inference-Based Approach. Instead, we propose that the main distinctive characteristic of OCD is a hyperactive sub-personal signal of being in error, experienced by the individual as uncertainty about his or her intentional actions. This signalling interacts with the anxiety sensitivities of the individual to trigger conscious checking processes, including speculations about possible harms. We examine the implications (...) of this model for the individual's capacity to control his or her thoughts. (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.

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)

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)

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.

Machine generated contents note: -- Notes on Contributors -- Preface; R.Dallos -- Carving Nature at its Joints? DSM and the Medicalization of Everyday Life; M.Rapley, J.Moncrieff&J.Dillon -- Dualisms and the Myth of Mental Illness; P.Thomas&P.Bracken -- Making the World Go Away, and How Psychology and Psychiatry Benefit; M.Boyle -- Cultural Diversity and Racism: An Historical Perspective; S.Fernando -- The Social Context of Paranoia; D.J.Harper -- From 'Bad Character' to BPD: The Medicalization of 'Personality Disorder'; J.Bourne -- Medicalizing Masculinity; S.Timimi -- (...) Can Traumatic Events Traumatise People? Trauma, Madness and 'Psychosis'; L.Johnstone -- Children Who Witness Violence at Home; A.Vetere -- Discourses of Acceptance and Resistance: Speaking Out About Psychiatry; E.Speed -- The Personal Is the Political; J.Dillon -- 'I'm Just, You Know, Joe Bloggs': The Management of Parental Responsibility for First-Episode Psychosis; C.Coulter&M.Rapley -- The Myth of the Antidepressant: An Historical Analysis; J.Moncrieff -- Antidepressants and the Placebo Response; I.Kirsch -- Why Were Doctors so Slow to Recognise Antidepressant Discontinuation Problems?; D.Double -- Toxic Psychology; C.Newnes -- Psychotherapy: Illusion With No Future?; D.Smail -- The Psychologization of Torture; N.Patel -- What Is To Be Done?; J.Moncrieff, J.Dillon&M.Rapley -- Figure: Papers Using Term 'Antidepressant' On Medline 1957-1965 -- Index. (shrink)

Neil Levy (2007) argues that empirical data shows that psychopaths lack the moral knowledge required for moral responsibility. His account is intriguing, and it offers a promising way to think about the significance of psychopaths for work on moral responsibility. In what follows we focus on three lines of concern connected to Levy's account: his interpretation of the data, the scope of exculpation, and the significance of biological explanations for anti-social behavior.

The feuding factions of the memory wars, that is, those concerned with the validity of recovered memories versus those concerned with false memories, are unified by Erdelyi's theory of repression. Evidence shows suppression, inhibition, and retrieval blocking can have profound yet reversible effects on a memory's accessibility, and deserve as prominent a role in the recovered memory debate as evidence of false memories. Erdelyi's theory shows that both inhibitory and elaborative processes cooperate to keep unwanted memories out of consciousness.

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.

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)

From 1965, the Swedish penal law does not require accountability as a condition for criminal responsibility. Instead, severely mentally disordered offenders are sentenced to forensic psychiatric care. The process that led to the present legislation had its origins in a critique of the concept of accountability that was first launched 50 years earlier by the founding father of Swedish forensic psychiatry, Olof Kinberg. The concept severe mental disorder is part of the Criminal Code as well as the Compulsory Mental Act. (...) The medical conditions for being sentenced to forensic psychiatric care are supposed to be the same as those for being admitted to involuntary psychiatric care. What these conditions are is not regulated in any law. For the guidance of the courts and others, there is a collection of examples in the government bill drafting the legislation in question. On the basis of these examples the content of the concept of severe mental disorder is chiselled out. However, the purposes of imposing penal law sanction and admitting someone to psychiatric care are not the same, and therefore the content of the concept severe mental disorder is bound to differ accordingly. Severe mental disorder is a legal concept that masks as a psychiatric one. In its applications in penal law, the court determines its content. But for the forensic psychiatrist it is more natural to interpret the term as a medical one. This creates a tension that has led to several controversies in recent criminal cases in Sweden. The best way to alleviate the situation is to discard the concept of severe mental disorder from criminal law. This will allow for a better separation of the roles of the psychiatrist and the court. (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)

In a recent article in this journal, Schaefer et al. argue that it might be possible to enhance autonomy through the use of cognitive enhancements. In this article, I highlight an example that Schaefer et al. do not acknowledge of a way in which we already seem to be using pharmacological agents in a manner that can be understood as enhancing an agent’s autonomy. To make this argument, I begin by following other theorists in the philosophical literature in claiming that (...) impulsivity can serve to undermine an agent’s autonomy. I then explain that we are already able to reduce impulsivity through the use of pharmacological interventions, as is evidenced by the use of Methylphenidate in the treatment of ADHD. (shrink)

The diagnosis of Fetal Alcohol Spectrum Disorders is embedded in a matrix of biological, social and ethical processes, making it an important topic for crossdisciplinary social and ethical research. This article reviews different branches of research relevant to understanding how FASD is identified and defined and outlines a framework for future social and ethical research in this area. We outline the character of scientific research into FASD, epidemiological discrepancies between reported patterns of maternal alcohol consumption during pregnancy and the incidence (...) of FASD, and the social and ethical considerations that may impact on who is, and is not, diagnosed. We highlight what further research investigating FASD diagnostic processes, as well as the multi-generational impacts of FASD, is needed. Important research priorities are to: 1) enumerate the variety of stakeholders involved in seeking FASD diagnoses; 2) understand the experiences and perspectives of mothers from different backgrounds who have consumed alcohol during pregnancy and their affected children; and 3) collect health histories of maternal alcohol consumption in families to determine the effect of FASD at sub-cultural and cultural levels. (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)

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)

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)

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.

The present article undertakes a psychological reading of The Child's Conception of the World as a cultural artifact in which genetic psychology's naturalistic and positivistic assumptions reflect an Enlightenment model of science, and Piaget figures as an agent of technological rationality. A phenomenological analysis of the text reveals how Piaget's research engages in an active repression of specific dimensions of childhood experience. Young children's 'adualistic' conceptions of thought, self and language are deemed 'confused', and thereby discounted, by virtue of the (...) fact such children do not 'correctly' dichotomize experience in accord with the cultural norm of mechanistic rationality. Piaget's numerous associations of the child's 'primitive' views and the (childish) thought of the pre-Socratics are briefly explored. (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)

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)

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)

For the last thirty years, cognitive scientists have attempted to describe the cognitive architecture of typically developing human beings, using, among other sources of evidence, the dissociations that result from developmental psychopathologies such as autism spectrum disorders, Williams syndrome, and Down syndrome. Thus, in his recent defense of the massive modularity hypothesis, Steven Pinker insists on the importance of such dissociations to identify the components of the typical cognitive architecture (2005, 4; my emphasis): This kind of faculty psychology has numerous (...) advantages (...). It is supported by the existence of neurological and genetic disorders that target these faculties unevenly, such as a difficulty in recognizing faces (and facelike shapes) but not other objects, or a difficulty in reasoning about minds but not about objects or pictures. Similarly, Simon Baron-Cohen writes (1998, 335; my emphasis; see also Temple, 1997): I suggest that the study of mental retardation would profit from the application of the framework of cognitive neuropsychology (…). In cognitive neuropsychology, one key question running through the investigator’s mind is “Is this process or mechanism intact or impaired in this person?” When cognitive neuropsychology is done well, a patient’s cognitive system is examined with specific reference to a model of the normal cognitive system. And, not infrequently, evidence from the patient’s cognitive deficits leads to a revision of the model of the normal system. However, in recent years, the use of developmental psychopathologies to identify the components of the typical cognitive architecture has come under heavy fire. In a series of influential articles, neuropsychologist Annette Karmiloff-Smith has argued that findings about the pattern of impairments and preserved capacities in people with developmental psychopathologies say nothing about the cognitive architecture of.. (shrink)

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)

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 midbrain neural basis for the perceptualoscillations of binocular rivalry is suggestedon the basis of fMRI studies of rivalry andinferences from the properties of rivalry thatcannot be explained from the known propertiesof primary visual cortical (V1) neurons. Therivalry switch is proposed to activatehomologous areas of each cerebral hemispherealternately, by means of a bistable oscillatorcircuit that straddles the midline of theventral tegmentum. This bistable oscillatoroperates at the same slow rate that ischaracteristic of perceptual rivalryalternations. Whilst attempting to divert thepresent preoccupation with (...) cortical mechanismsfor rivalry, the new proposal integrates manycortical areas, in keeping with recent evidencethat binocular rivalry involves widespreadareas of the hemispheres. By linking rivalry tointerhemispheric switching mechanisms in thisway, the new proposal for the switch makes theprediction that binocular rivalry will besubject to high level influences such as moodand motivation. These predictions are beingfulfilled, with rivalry playing an increasingrole in the diagnosis and understanding if mooddisorders, schizophrenia and other psychiatricconditions. (shrink)

Rose seems to be arguing against an extreme ultra-Darwinism that probably has no adherents. He incorrectly argues that a number of psychological traits are very difficult to measure. This is not the case. Rose argues that intelligence has no biological correlates. In fact, it is correlated with brain size, EEG evoked potentials, and cerebral glucose uptake during problem solving. Data that Rose should be aware of are omitted when they do not fit the case he is trying to make.

Psychopaths are renowned for their immoral behavior. They are ideal candidates for testing the empirical plausibility of moral theories. Many think the source of their immorality is their emotional deficits. Psychopaths experience no guilt or remorse, feel no empathy, and appear to be perfectly rational. If this is true, sentimentalism is supported over rationalism. Here, I examine the nature of psychopathic practical reason and argue that it is impaired. The relevance to morality is discussed. I conclude that rationalists can explain (...) the moral deficits of psychopaths as well as sentimentalists. In the process, I identify psychological structures that underpin practical rationality. (shrink)

Aspects of Northoff's argument lend themselves to the ongoing investigation of localizing the self in the brain. Recent data from the fields of neuropsychology and cognitive neuroscience provide evidence that the right hemisphere is a candidate for localization of self. The data on catatonia further that proposition and add insight into the continuing investigation of self in the brain across sensory and motor domains.

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.

Using connectionist modelling, Thomas & Karmiloff-Smith (T&K-S) claim that developmental disorders in children are characterised by atypical trajectories and an ultimate functional architecture that is fundamentally different from normal. We argue that there is no empirical evidence for these claims in any developmental disorder and that the available evidence provides support for Residual Normality in both developmental and acquired disorders. We also refute the claim that modular accounts cannot encompass developmental trajectories in children with developmental disorders.

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.

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)

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.

Now that consciousness is thoroughly out of the way, we can focus more precisely on the kinds of things that can happen underneath. A contrast can be made between dissociation and repression. Dissociation is where a memory record or set of autobiographical memory records cannot be retrieved; repression is where there is retrieval of a record but, because of the current task specification, the contents of the record, though entering into current processing, are not allowed into consciousness. I look at (...) hypnotic amnesia and dissociative identity disorder in relation to this contrast. (shrink)

Wegner’s argument on the illusory nature of conscious will, as developed in The Illusion of Conscious Will (2002) and other publications, has had major impact. Based on empirical data, he develops a theory of apparent mental causation in order to explain the occurrence of the illusion of conscious will. Part of the evidence for his argument is derived from a specific interpretation of the phenomenon of auditory verbal hallucinations as they may occur in schizophrenia. The aim of this paper is (...) to evaluate the validity of the evidence on auditory verbal hallucinations as employed by Wegner. I conclude that auditory hallucinations do not provide solid evidence for Wegner’s theory. Moreover, the phenomena in schizophrenia provide, in fact, an argument against part of Wegner’s theory of apparent mental causation. (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.

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)

Individuals with Parkinson’s disease and temporal lobe epilepsy have hallucinations and mild cognitive dysfunction. The objective of this work was to study dreams in PD and TLE patients using a common functional model of dream production involving the limbic and paralimbic structures.Dreams were characterised in early-stage PD and TLE patients with dream diaries classified by the Hall van de Castle system and were compared with matched controls.In PD, there were significant differences between patients’ dreams and those of controls: animals, physical (...) aggression, and a befriender were more common in patients, and aggressor and bodily misfortunes were less common. The dreams of patients with frontal dysfunction showed more aggressive features.TLE patients had lower recall than PD patients and a higher proportion of dreams involving family and familiar settings, lower proportions involving success, and a higher incidence of frontal dysfunction.The dreams of PD and TLE patients share important features. (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)

To provide the three-way comparisons needed to test existing theories, we compared (1) most-stressful memories to other memories and (2) involuntary to voluntary memories (3) in 75 community dwelling adults with and 42 without a current diagnosis of posttraumatic stress disorder (PTSD). Each rated their three most-stressful, three most-positive, seven most-important and 15 word-cued autobiographical memories, and completed tests of personality and mood. Involuntary memories were then recorded and rated as they occurred for 2 weeks. Standard mechanisms of cognition and (...) affect applied to extreme events accounted for the properties of stressful memories. Involuntary memories had greater emotional intensity than voluntary memories, but were not more frequently related to traumatic events. The emotional intensity, rehearsal, and centrality to the life story of both voluntary and involuntary memories, rather than incoherence of voluntary traumatic memories and enhanced availability of involuntary traumatic memories, were the properties of autobiographical memories associated with PTSD. (shrink)