We may be at the brink of a Kuhnian paradigm shift when it comes to the categorical classification system of mental disorders. Reviewing more than 30 years of critical literature on the categorical classification of personality disorders, Kueger, Hopwood, Wright, and Markon conclude that the Diagnostic and Statistical Manual of Mental Disorders is "fundamentally broken". Just before, the director of the National Institute of Mental Health declared that the institute will no longer support research that is based on DSM categories.The (...) critique on the categorical system of mental disorders consists of several arguments that are briefly mentioned as they have been... (shrink)

Over the past twenty-five years, history of science has expanded into history of knowledge. Plurality has been the main message. Commonality, by contrast, is the main finding of the present study. It examines the knowledge practices of the full range of participants in cases of public inquiry—trials, tests, inspections—involving human bodies in contexts of criminal law, police, public health, marriage and family, claims to community aid, and regulation of trades. The cases come from the archives of three agencies of inquiry (...) and evaluation—a government, a university faculty, and a guild—in a variety of polities in the Holy Roman Empire between about 1500 and 1650. Participants of widely differing education, occupation, and experience—learned, artisanal, and domestic, as well as specialized versions of these—are found to have shared practices of observation, description, explanation, and argument. This finding opens the prospect of a history of shared empirical rationality, in contrast to the hegemony of difference, dialogue or transfer, and “expertise,” in how we understand knowing in modern as well as premodern Europe. (shrink)

The comorbidity of personality disorders and mental disorders is commonly understood through three types of theoretical models: either a) personality disorders precede mental disorders, b) mental disorders precede personality disorders, c) mental disorders and personality disorders share common etiological grounds. Although these hypotheses differ with respect to their idea of causal direction, they all imply a latent variable perspective, in which it is assumed that either personality and mental disorders are latent variables that have certain causal relations [models a) and (...) b)]; or that, as in model c), the common etiology is in fact a latent variable that causes symptomatology of both personality and mental disorders. We aim to provide another perspective on the comorbidity between personality and mental disorders, namely a network perspective. To this end, we investigated Major Depression and Borderline Personality Disorder and hypothesized that symptoms of BPD and MD could interact with one another rather than being caused by a latent variable. To illustrate this theoretical network conceptualization of the comorbidity of BPD and MD we analyzed a cross-sectional clinical dataset of 376 patients who were asked to complete the Structured Clinical Interview for DSM-IV Axis II Disorders and the Beck Depression Inventory II. The results identify direct associations between symptoms of MD and BPD. If we take the links in this empirical network to be ‘substantive', this suggests a radical shift of our current conceptualization of the comorbidity of mental disorders and personality disorders. (shrink)

Zachar's commentary can be read as a sophisticated theoretical extension of the target article, and I am very pleased to see support for a relationalist turn in understanding mental disorders. Indeed, underlying causal properties are only an ingredient of essentialism and a more elaborate discussion of this issue brings us readily to the discourse on kinds and ontology. Zachar is an advocate for thinking of psychiatric constructs as practical kinds. This logically leads him to think that the problem with categorical (...) classification systems like the Diagnostic and Statistical Manual of Mental Disorders and the International Classification of Diseases are practical problems (lack of... (shrink)

After the introduction of the fifth Diagnostic and Statistical Manual of Mental Disorders, familiar voices were raised in protest. The voices stem from ideas of which, among others, and in different ways, Michel Foucault and Thomas Szasz were influential proponents: The movement was referred to as 'antipsychiatry.' This movement reacted, among other things, to the system of categorization of mental disorders. Diagnoses, in a system of classification, were thought to be vague, arbitrary, labelling, stigmatizing, and scientifically and clinically poorly validated. (...) In contemporary debates on DSM-5, similar critiques can be heard, expressed by a movement now referred to as 'critical psychiatry'... (shrink)

This study investigates what professional caregivers working in nursing homes consider to be a good life for residents suffering from dementia. Ten caregivers were interviewed; special attention was paid to the way in which they deal with conflicting values. Transcripts of the interviews were analysed qualitatively according to the method of grounded theory. The results were compared with those from a similar, earlier study on ideals found in mission statements of nursing homes. The concepts that were mentioned by most interviewed (...) participants as important for a good life were ‘peace and quiet’, ‘going along with subjective experience’ and ‘no enforcement: the way the resident wants it’. A considerable overlap was found between the interviews and the mission statements; however, when compared with the mission statements, the interviews put less emphasis on individuality and on giving meaning, and more on offering residents pleasant activities. When faced with conflicting values, caregivers tend to make pragmatic and more or less intuitive decisions. Although this has its merits, it may be desirable to stimulate conscious reflection regarding conflict between different values. (shrink)

The aim of this review is to show the fruitfulness of using images of facial expressions as experimental stimuli in order to study how neural systems support biologically relevant learning as it relates to social interactions. Here we consider facial expressions as naturally conditioned stimuli which, when presented in experimental paradigms, evoke activation in amygdala–prefrontal neural circuits that serve to decipher the predictive meaning of the expressions. Facial expressions offer a relatively innocuous strategy with which to investigate these normal variations (...) in affective information processing, as well as the promise of elucidating what role the aberrance of such processing might play in emotional disorders. (shrink)

In the past decades, reductionism has dominated both research directions and funding policies in clinical psychology and psychiatry. The intense search for the biological basis of mental disorders, however, has not resulted in conclusive reductionist explanations of psychopathology. Recently, network models have been proposed as an alternative framework for the analysis of mental disorders, in which mental disorders arise from the causal interplay between symptoms. In this target article, we show that this conceptualization can help explain why reductionist approaches in (...) psychiatry and clinical psychology are on the wrong track. First, symptom networks preclude the identification of a common cause of symptomatology with a neurobiological condition; in symptom networks, there is no such common cause. Second, symptom network relations depend on the content of mental states and, as such, feature intentionality. Third, the strength of network relations is highly likely to depend partially on cultural and historical contexts as well as external mechanisms in the environment. Taken together, these properties suggest that, if mental disorders are indeed networks of causally related symptoms, reductionist accounts cannot achieve the level of success associated with reductionist disease models in modern medicine. As an alternative strategy, we propose to interpret network structures in terms of D. C. Dennett's (1987) notion ofreal patterns, and suggest that, instead of being reducible to a biological basis, mental disorders feature biological and psychological factors that are deeply intertwined in feedback loops. This suggests that neither psychological nor biological levels can claim causal or explanatory priority, and that a holistic research strategy is necessary for progress in the study of mental disorders. (shrink)

Terminal kidney patients are faced with lower quality of life, restricted diets and higher morbidity and mortality rates while waiting for deceased donor kidney transplantation. Fortunately, living kidney donation has proven to be a better treatment alternative (e.g. in terms of waiting time and graft survival rates). We observed an inequality in the number of living kidney transplantations performed between the non-European and the European patients in our center. Such inequality has been also observed elsewhere in this field and it (...) has been suggested that this inequality relates to, among other things, attitude differences towards donation based on religious beliefs. In this qualitative research we investigated whether religion might indeed (partly) be the explanation of the inequalities in living donor kidney transplants (LDKT) among non-European patients. Fifty patients participated in focus group discussions and in-depth interviews. The interviews were conducted following the focus group method and analyzed in line with Grounded Theory. The qualitative data analyses were performed in Atlas.ti. We found that religion is not perceived as an obstacle to living donation and that religion actually promotes helping and saving the life of a person. Issues such as integrity of the body were not seen as barriers to LDKT. We observed also that there are still uncertainties and a lack of awareness about the position of religion regarding living organ donation within communities, confusion due to varying interpretations of Holy Scriptures and misconceptions regarding the process of donation. Faith leaders play an important educational role and their opinion is influential. This study has identified modifiable factors which may contribute to the ethnic disparity in our living donation program. We argue that we need to strive for more clarity and awareness regarding the stance of religion on the issue of living donation in the local community. Faith leaders could be key figures in increasing awareness and alleviating uncertainty regarding living donation and transplantation. (shrink)

We address the commentaries on our target article in terms of four major themes. First, we note that virtually all commentators agree that mental disorders are not brain disorders in the common interpretation of these terms, and establish the consensus that explanatory reductionism is not a viable thesis. Second, we address criticisms to the effect that our article was misdirected or aimed at a straw man; we argue that this is unlikely, given the widespread communication of reductionist slogans in psychopathology (...) research and society. Third, we tackle the question of whether intentionality, extended systems, and multiple realizability are as problematic as claimed in the target article, and we present a number of nuances and extensions with respect to our article. Fourth, we discuss the question of how the network approach should incorporate biological factors, given that wholesale reductionism is an unlikely option. (shrink)

Schellings Freiheitsschrift behandelt sowohl einen modernen, positiven Begriff von Freiheit, als auch die Nacht- und Schattenseiten der Freiheit, verbunden mit dem Begriff des Bosen und der Frage der Theodizee. Die Diskussion der Freiheitstheorie wird hier auf eine erst kurzlich wieder ins Blickfeld der Metaphysik geratene spekulative Weise vertieft. Die uberarbeitete Neuauflage erschliesst Schellings Text auf dem aktuellen Stand der Forschung.".

This paper investigates when and how children figure out the force of modals: that possibility modals (e.g., _can_/_might_) express possibility, and necessity modals (e.g., _must_/_have to_) express necessity. Modals raise a classic subset problem: given that necessity entails possibility, what prevents learners from hypothesizing possibility meanings for necessity modals? Three solutions to such subset problems can be found in the literature: the first is for learners to rely on downward-entailing (DE) environments (Gualmini and Schwarz in J. Semant. 26(2):185–215, 2009 ); (...) the second is a bias for strong (here, necessity) meanings; the third is for learners to rely on pragmatic cues stemming from the conversational context (Dieuleveut et al. in Proceedings of the 2019 Amsterdam colloqnium, pp. 111–122, 2019a ; Rasin and Aravind in Nat. Lang. Semant. 29:339–375, 2020 ). This paper assesses the viability of each of these solutions by examining the modals used in speech to and by 2-year-old children, through a combination of corpus studies and experiments testing the guessability of modal force based on their context of use. Our results suggest that, given the way modals are used in speech to children, the first solution is not viable and the second is unnecessary. Instead, we argue that the conversational context in which modals occur is highly informative as to their force and sufficient, in principle, to sidestep the subset problem. Our child results further suggest an early mastery of possibility—but not necessity—modals and show no evidence for a necessity bias. (shrink)

FOSTER J, CHIANG F, HILLARD RC, HALL P and HEATH A. Nursing Inquiry 2010; 17: 309–316 Team process in community‐based participatory research on maternity care in the Dominican RepublicA cross‐cultural team consisting of US trained academic midwife researchers, Dominican nurses, and Dominican community leaders have partnered in this international nursing and midwifery community‐based participatory research (CBPR) project in the Dominican Republic to understand the community experience with publicly funded maternity services. The purpose of the study was to understand community perceptions (...) of maternity services. This article highlights the activities that the research team carried out during each phase of the research process, and how they established team identity, team trust, and team efficacy. This research has created a platform for new avenues for health providers and community to partner to improve maternal‐newborn care. Community‐based participatory research is one way forward to address the past and present inequities constitutive of global health disparities. (shrink)

This article traces the multiple enactments of sex in clinical practices of transgender medicine to argue against the presumed singularity of ‘transexuality’. Using autoethnography to analyse my own experience as a trans patient, I describe my clinical encounters with doctors, psychiatrists and surgeons in order to theorise sex as multiple. Following recent developments in science and technology studies (STS) that advance the work of Judith Butler on sex as performatively reproduced, I use a praxiographic approach to argue that treatment practices (...) produce particular iterations of what sex (and transexuality) ‘is’ and how these processes limit and foreclose other trans possibilities. I consider the ethical, political and material-discursive implications of treatment practices and offer a series of reflections about the effects and effectiveness of current clinical practices and the possibilities for intervening in such processes in order that, following Annemarie Mol, we might (re)make sex (and transexuality) differently. (shrink)

Controversy swept the U.K. in January of 2000 over public disclosure of the fact that a Scottish surgeon named Robert Smith had amputated the limbs of two able-bodied individuals who reportedly suffered from a condition known as apotemnophilia. The patients, both of whom had sought and consented to the surgery, claimed they had desperately desired for years to live as amputees and had been unable, despite considerable efforts, to reconcile themselves psychologically to living with the bodies with which they were (...) born. Both surgeries were successful, and both patients, who had undergone psychiatric evaluation prior to the amputations, subsequently reported having no regrets. In the wake of a wave of sensationalistic stories in the media, the hospital at which the surgeries had been performed, the Falkirk and District Royal Infirmary, banned any future surgeries of the kind. Outraged local politicians promptly announced their intention to pass laws banning the procedure outright. One member of Scottish Parliament declared the surgery obscene and asserted that the whole thing is repugnant and legislation needs to be brought in now to outlaw this. (shrink)

Controversy swept the U.K. in January of 2000 over public disclosure of the fact that a Scottish surgeon named Robert Smith had amputated the limbs of two able-bodied individuals who reportedly suffered from a condition known as apotemnophilia. The patients, both of whom had sought and consented to the surgery, claimed they had desperately desired for years to live as amputees and had been unable, despite considerable efforts, to reconcile themselves psychologically to living with the bodies with which they were (...) born. Both surgeries were successful, and both patients, who had undergone psychiatric evaluation prior to the amputations, subsequently reported having no regrets. In the wake of a wave of sensationalistic stories in the media, the hospital at which the surgeries had been performed, the Falkirk and District Royal Infirmary, banned any future surgeries of the kind. Outraged local politicians promptly announced their intention to pass laws banning the procedure outright. One member of Scottish Parliament declared the surgery obscene and asserted that the whole thing is repugnant and legislation needs to be brought in now to outlaw this. (shrink)

In part 1 of Enquiry 12, Hume presents a skeptical argument against belief in external existence. The argument involves a perceptual relativity argument that seems to conclude straightaway the double existence of objects and perceptions, where objects cause and resemble perceptions. In Treatise 1.4.2, Hume claimed that the belief in double existence arises from imaginative invention, not reasoning about perceptual relativity. I dissolve this tension by distinguishing the effects of natural instinct and showing that some ofthese effects supplement the Enquiry’s (...) perceptual relativity argument. The Enquiry’s skeptical argument thus reveals the fundamental involvement of natural instinct in any belief in external existence. (shrink)

Recent studies of scientific interaction based on agent-based models suggest that a crucial factor conducive to efficient inquiry is what Zollman has dubbed ‘transient diversity’. It signifies a process in which a community engages in parallel exploration of rivaling theories lasting sufficiently long for the community to identify the best theory and to converge on it. But what exactly generates transient diversity? And is transient diversity a decisive factor when it comes to the efficiency of inquiry? In this paper we (...) examine the impact of different conditions on the efficiency of inquiry, as well as the relation between diversity and efficiency. This includes certain diversity-generating mechanisms previously proposed in the literature, as well as some factors that have so far been neglected. This study is obtained via an argumentation-based ABM. Our results suggest that cautious decision-making does not always have a significant impact on the efficiency of inquiry while different evaluations underlying theory-choice and different social networks do. Moreover, we find a correlation between diversity and a successful performance of agents only under specific conditions, which indicates that transient diversity is sometimes not the primary factor responsible for efficiency. Altogether, when comparing our results to those obtained by structurally different ABMs based on Zollman’s work, the impact of specific factors on efficiency of inquiry, as well as the role of transient diversity in achieving efficiency, appear to be highly dependent on the underlying model. (shrink)

Recent studies of scientific interaction based on agent-based models suggest that a crucial factor conducive to efficient inquiry is what Zollman has dubbed ‘transient diversity’. It signifies a process in which a community engages in parallel exploration of rivaling theories lasting sufficiently long for the community to identify the best theory and to converge on it. But what exactly generates transient diversity? And is transient diversity a decisive factor when it comes to the efficiency of inquiry? In this paper we (...) examine the impact of different conditions on the efficiency of inquiry, as well as the relation between diversity and efficiency. This includes certain diversity-generating mechanisms previously proposed in the literature, as well as some factors that have so far been neglected. This study is obtained via an argumentation-based ABM. Our results suggest that cautious decision-making does not always have a significant impact on the efficiency of inquiry while different evaluations underlying theory-choice and different social networks do. Moreover, we find a correlation between diversity and a successful performance of agents only under specific conditions, which indicates that transient diversity is sometimes not the primary factor responsible for efficiency. Altogether, when comparing our results to those obtained by structurally different ABMs based on Zollman’s work, the impact of specific factors on efficiency of inquiry, as well as the role of transient diversity in achieving efficiency, appear to be highly dependent on the underlying model. (shrink)

In this paper we introduce hypersequent-based frameworks for the modelling of defeasible reasoning by means of logic-based argumentation and the induced entailment relations. These structures are an extension of sequent-based argumentation frameworks, in which arguments and the attack relations among them are expressed not only by Gentzen-style sequents, but by more general expressions, called hypersequents. This generalization allows us to overcome some of the known weaknesses of logical argumentation frameworks and to prove several desirable properties of the entailments that are (...) induced by the extended frameworks. It also allows us to incorporate as the deductive base of our formalism some well-known logics, which lack cut-free sequent calculi, and so are not adequate for standard sequent-based argumentation. We show that hypersequent-based argumentation yields robust defeasible variants of these logics, with many desirable properties. (shrink)

Traditionally, self-control is conceptualized in terms of internal processes such as willpower or motivational mechanisms. These processes supposedly explain how agents manage to exercise self-control or, in other words, how they act on the basis of their best judgment in the face of conflicting motivation. Against the mainstream view that self-control is a mechanism or set of mechanisms realized in the brain, several authors have recently argued for the inclusion of situated factors in our understanding of self-control. In this paper, (...) we review such recent attempts from the perspective of situated accounts of cognition and argue that even though these accounts integrate situational features, they ultimately still rely on an orthodox, neurocentric view of self-control. Instead, we will argue that in order to develop a really situated account it is necessary to radically rethink what self-control is. Building on recent work on extended skill, we will develop an outline of a really situated account of self-control. (shrink)

RÉSUMÉ : Dans le Traité 1.4.4, Hume a présenté au nom des philosophes modernes un argument causal qui démontre que nos impressions des qualités secondaires ne ressemblent pas aux qualités des objets eux-mêmes. Les prédécesseurs de Hume n’ont pourtant pas employé d’argument causal, mais l’argument des qualités contraires. Je soutiens que la présentation qu’en a fait Hume n’est pas simplement à mettre au compte d’une différence stylistique «gratuite» mais est une correction importante dans la foulée de ses propres découvertes philosophiques.

What is man? “The feather of an angel was brought and tied to a donkey's tail that the donkey perhaps might turn into an angel”.Thus writes the greatest of all Persian-writing mystical poets of Islam, Maulânâ Jalâladdân Rûmî (1207-1273) in his conversations, Fîhi mâ fîhi, when pointing to the mystery of man's existence : man is able to attain a rank superior to that of the angels (who have no free will and are eternally good) provided he develops his God-given (...) faculties of reason and love; but he can sink lower than a beast if he neglects his spiritual powers and falls a prey to sensual pleasures and crimes owing to the misuse of his rational faculties. (shrink)

In the Name of the One who has no Name,He who appears before you, how ever you call Him!How does Islamic theology and Koran exegesis, some of whose representatives set out to find the most modern developments, such as the atomic bomb, in the Koran, deal with the latest interpretations of quantum physics, of Heisenberg's uncertainty relation, and with the question of whether the sub-atomic world is made up of waves or particles? How does a theologian react to the notion (...) that parts of the atom influence each other and that the observer himself plays a role in the shaping of future events? Are these discoveries compatible with the traditional idea of a God who knows all; are they compatible with the various terms for fate: qadar, qada, or qismat? (shrink)