Dementia has rapidly become a major global health crisis. As the aging population continues to increase, the burden increases commensurately on both individual and societal levels. The behavioral and psychological symptoms of dementia are a prominent clinical feature of Alzheimer’s disease and related dementias. BPSD represent a myriad of manifestations that can create significant challenges for persons living with dementia and their care providers. As such, BPSD can result in detriments to social interaction with others, resulting in harm to (...) the psychosocial health of the person with dementia. While brain deterioration can contribute to BPSD as the disease progresses, it may be confounded by language and communication difficulties associated with ADRD. Indeed, when a person with dementia cannot effectively communicate their needs, including basic needs such as hunger or toileting, nor symptoms of pain or discomfort, it may manifest as BPSD. In this way, a person with dementia may be attempting to communicate with what little resources are available to them in the form of emotional expression. Failing to recognize unmet needs compromises care and can reduce quality of life. Moreover, failing to fulfill said needs can also deteriorate communication and social bonds with loved ones and caregivers. The aim of this review is to bring the differential of unmet needs to the forefront of BPSD interpretation for both formal and informal caregivers. The overarching goal is to provide evidence to reframe the approach with which caregivers view the manifestations of BPSD to ensure quality of care for persons with dementia. Understanding that BPSD may, in fact, be attempts to communicate unmet needs in persons with dementia may facilitate clinical care decisions, promote quality of life, reduce stigma, and foster positive communications. (shrink)

The article discusses the meanings of life and value priorities of the post- Soviet society. The author argues that, at present, there are symptoms of a global ideological crisis in the world, that the West does not have its own vision of where and how to move on and has no understanding of the future. Unfortunately, most of the post-Soviet countries do not have such vision as well. In these conditions, there are mistrust, confusion, paradoxical manifestation of human consciousness. (...) The main meanings that determine our life-world are: the desire of citizens for social justice and social security, the desire to figure out and understand the basic values of modern society, how honestly and equally the authorities act toward their fellow citizens, and to what extent they reflect their interests. The meanings of life, which are the answers to the challenges of the time, are embodied in the cultural code of each nation, state. The growth points of new values, which will become the basis for the future sustainable development of a new civilization, have yet to be discovered in the systemic transformative changes of the culture. In this process, the emergence of a new system of values that governs human life is inevitable. However, modern technology brings new troubles to humans. It has provided wide opportunities for informational violence and public consciousness manipulation. Nowadays, the scenario that is implemented in Western consumer societies claims to be the dominant scenario. Meanwhile, today there is no country in the world that is a role model, there is no ideal that others would like to borrow. Most post-Soviet states failed to advance their societies to more decent levels of economic development, to meet the challenges of the modern information age, and to provide the population with new high living standards. Therefore, in conditions of growing confrontation, we should realistically understand the world and be ready to implement changes that will ensure sustainable development of the state and society without losing our national identity. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 9.3 (2002) 285-286 [Access article in PDF] Depersonalization and Feelings of Unreality:Significant Symptoms With a Variety of Meanings Kjell Modigh Evaluations and diagnostic procedures in clinical psychiatry depend mainly on how the patient communicates his or her subjective experiences and on the psychiatrist's ability to understand that message. This is critical not only for understanding and offering proper treatment, but also for developing diagnostic (...) classifications. Hence the paper by Radovic and Radovic deals with an important topic, aiming to clarify the variety of meanings of the closely related terms unreality and depersonalization. The latter occurs as a symptom in connection to some psychiatric disorder and also constitutes a separate syndromeI agree with the authors that the rather intense renewing of the diagnostic criteria is seldom balanced by corresponding ambitions to analyze and improve the distinctness of the words for the experiences and symptoms which define the diagnoses.It is indeed a difficult task to demarcate what should be included in the concepts feelings of unreality and depersonalization and even to decide whether they are synonyms or distinguishable. There is at least one clear agreement in the different diagnostic systems: psychotic, delusional experiences are excluded. The border between unreality feelings with largely intact reality-testing ability and psychotic disorders with grossly disturbed reality-testing is, however, not absolute and patients with psychotic disorders may of course experience feelings of unreality or depersonalizationThe authors present a useful scheme by which different meanings of derealization are separated and that also points out the differences between depersonalization and derealization, although they are mutually dependant. Category (a), which come closest to depersonalization, includes experiences related to the self, whereas category (c) refers to impressions that the external world is unreal. Category (b), in their scheme, refers to altered bodily sensations: "the body part of the self" (Are there any body parts of the self? Perhaps all psychoanalysts would not agree).In my view, this scheme is useful and corresponds to clinical realities. Symptoms belonging to category (a) can, for instance, occur in affective disorders of almost psychotic depth, due to a [End Page 285] pathologically changed self-esteem. Symptoms belonging to category (b)—experiences of having moved outside one's own body—mainly belong to the diagnostic category dissociative disorders and can be understood as defense reactions to earlier traumatic experiences. The self escaped from the body during repeated experiences of sexual abuse. The diagnosis of depersonalization disorder consequentlybelongs to the group of dissociative disorders. Conditions where the outer world seems unreal (category [c]) can occur when the amount of internal stimuli is increased beyond what is possible to handle and therefore the capacity to recognize the environment is limited. So is the case in severe panic anxiety. Feelings of unreality as part of grief reactions may also belong, at least partly, to category (c): when dramatic and emotionally unacceptable events occur in the environment. As the authors point out, expressions of unreality feelings during grief more often can be understood as metaphors or existential reflections. In conclusion, categories -(a) and (c) can serve to separate depersonalization experiences with different psychopathologic origin, although they are closely related.As a second step, the authors examine how the terms unreal and feels unreal can be understood. Two interpretations of unreal, "nonexistent" and "artificial," have high psychiatric relevance; a third meaning, relating to "quality," mainly has linguistic connections to the experiences on unreality and depersonalization. The word feels communicates the experience of something that appears unreal although the subject has an intact ability of reality testing.The authors propose an additional interpretation, which they describe as a quasisensory experience. They give the example that dreams with unrealistic contents in some meaning, probably related to their intensity, appear "real." A further connection to dreams is that a situation, when awake, may have dreamlike qualities because of intensity or similarities to fragments of dreams. Events that occur in an unusual sequences, for example, corresponding to ones aims and wishes ("to good to be true") perhaps have similarities to dreamlike experiences. One may... (shrink)

Every statement about language is also a statement by and about psyche. Guided by this primary assumption, and inspired by the works of Carl Jung, in _Symptom, Symbol, and the Other of Language_, Bret Alderman delves deep into the symbolic and symptomatic dimensions of a deconstructive postmodernism infatuated with semiotics and the workings of linguistic signs. This book offers an important exploration of linguistic reference and representation through a Jungian understanding of symptom and symbol, using techniques including amplification, dream interpretation, (...) and symbolic attitude. Focusing on Ferdinand de Saussure, Jacques Derrida, Michel Foucault, and Richard Rorty, Alderman examines the common belief that words and their meaning are grounded purely in language, instead envisioning a symptomatic expression of alienation and collective dissociation. Drawing upon the nascent field of ecopsychology, the modern disciplines of phenomenology and depth psychology, and the ancient knowledge of myth and animistic cosmologies, Alderman dares us to re-imagine some of the more sacrosanct concepts of the contemporary intellectual milieu informed by semiotics and the linguistic turn. Symptom, Symbol, and the Other of Language is essential reading for academics and students engaged in the study of depth psychology. However, the interdisciplinary approach of the work ensures that it will also be of great interest to those researching and studying in the areas of ethology, ecopsychology, philosophy, linguistics and mythology. (shrink)

This study examined the mediating role of meaning in life in the effect of calling on posttraumatic stress disorder and posttraumatic growth among navy soldiers of the Republic of Korea deployed to the Gulf of Aden, Somalia. Participants responded to the questionnaire survey three times at 4-month intervals. From the first, second, and third surveys, data were collected for 223, 195, and 103 respondents, respectively. Results showed that calling had a negative effect on PTSD, fully mediated by meaning (...) in life, whereas calling had a positive effect on PTG, partially mediated by meaning in life. Our findings suggest that calling acts as a positive psychological resource for maintaining the meaning in life throughout stressful events experienced during deployment, thereby reducing posttraumatic stress symptoms and promoting post-deployment psychological growth. Finally, theoretical and practical implications and the need for follow-up studies are discussed. (shrink)

Working as a peacekeeper is associated with the exposure to acute and/or catastrophic events and chronic stressors. Hence, the meager literature about peacekeepers’ wellbeing has mainly analyzed Post-Traumatic Stress Disorder (PTSD). This study aims to deep the analysis of the wellbeing of peacekeepers military. Based on the few studies on this population, we hypothesized that Italian peacekeeper military officers and enlisted men (n = 167; 103 males, 6 females, 58 missing) exhibit lower levels of internalizing symptoms (i.e., PTSD, depression, (...) general anxiety, obsessions, and somatization) as compared to a control group (n = 60; 32 males, 28 females). Moreover, we hypothesized that peacekeepers have higher levels of psychological resources (i.e., self-efficacy, self-esteem, social support) and quality of life (i.e., higher life satisfaction and lower general stress). We compared the groups by means of MANOVAs on the subscales of the Psychological Treatment Inventory (PTI; Gori et al., 2015). We found that Italian peacekeepers have lower internalizing symptoms and higher levels of self-efficacy and self-esteem than the control group; however, no statistically significant differences were observed on perceived social support. Finally, peacekeepers have a higher quality of life: scores reflect higher life satisfaction and lower distress than the control group. This study is in line with previous literature supporting the claim that Italian peacekeeper military officers have sufficient psychological resources for coping with the stressful situations implied in peacekeeping missions. Future studies should deepen the analysis of the military’s psychological characteristics by comparing war veterans and peacekeeper military. (shrink)

Through an original combination of phenomenology and psychoanalysis, Ingerslev and Legrand argue convincingly for a complex theoretical framework for making sense of bodily symptoms in psychopathology. The argument is particularly interesting because it manages to show how the theoretical efforts to arrive at a better understanding of bodily symptoms are connected closely with the ethical demand involved in the dialogical situation of therapy. The framework thus operates on two interconnected levels, on the one hand ensuring a more careful (...) clinical differentiation of bodily symptoms and, on the other, encouraging the clinician to adopt a responsive stance that allows for those symptoms to be recognized as... (shrink)

In The Crisis of the European Sciences and Transcendental Phenomenology, Husserl expands his philosophical horizon to include the question about the genuine meaning of human existence. Understanding the crisis of the European sciences as a symptom of the crisis of European philosophy and as an expression of the life-crisis of European humanity, and interpreting European science, philosophy, and humanity as representative of their global-historical counterparts, Husserl argues that the life-crisis of European humanity is reflective of the critical condition of (...) global-historical humanity. The crisis of “European” life emerges as a crisis of human existence, and Husserl’s phenomenology unfolds as a search for an answer to the question not only about the sense of the life-world but also about the meaning of human life. Thus phenomenology, as care for humanity, shares with existentialism, as a humanism in the broadest sense, the conviction that human beings live in a world not in which life makes sense, but in which they must make sense of life. Accordingly, the genuine essence of human existence is not passively “given” but actively “taken,” since it involves an entelechy that constitutes itself in an evolutionary achievement, and it is the evidentiary result of an existential struggle for meaning against annihilating forms of meaninglessness, namely, irrationalism, positivism, and skepticism. This paper examines Husserl’s hermeneutical-historical approach to the question about the meaning of human existence and suggests an understanding of phenomenology as a form of humanism, and perhaps even as a unique kind of “existentialism,” that is, an ethical philosophy that takes absolute moral responsibility for the presuppositionless application of reason to life.En La crisis e las ciencias europeas y la fenomenología trascendental, Husserl expande su horizonte filosófico a fin de incluir en él la pregunta por el auténtico sentido de la existencia humana. Al entender la crisis de las ciencias europeas como un síntoma de la crisis de la filosofía europea y como una expresión de la crisis vital de la humanidad europea, y al interpretar la ciencia, la filosofía y la humanidad europeas como representativas de sus contrapartes históricas y globales, Husserl argumenta que la crisis vital de la humanidad europea refleja la condición crítica en que se encuentra la humanidad en perspectiva histórica global. La crisis de la vida “europea” emerge como una crisis de la existencia humana, y la fenomenología de Husserl se despliega como la búsqueda de una respuesta a la cuestión no sólo del sentido del mundo de la vida, sino también del significado de la vida humana. La fe-nomenología, como cuidado de la humanidad, comparte con el existencialismo, entendido como un humanismo en el sentido más amplio, la convicción de que los seres humanos viven en un mundo en el cual no es que la vida tenga sentido sino que ellos deben dar sentido a la vida. En consonancia, la auténtica esencia de la existencia humana no está pasivamente “dada” sino que es activamente “tomada”, ya que ella envuelve una entelequia que se constituye en una realización evolutiva, y que es el resultado evidenciador de un combate existencial por el significado contra las formas de sinsentido que son aniquiladoras, a saber: irracionalismo, positivismo y escepticismo. Este ensayo examina la aproximación histórico-hermenéutica de Husserl a la cuestión del significado de la existencia humana, y sugiere una comprensión de la fenomenología como una forma de humanismo, y quizá incluso como un tipo único de existencialismo; esto es, como una filosofía ética que asume una responsabilidad moral absoluta en la aplicación sin presupuestos de la razón a la vida. (shrink)

The present paper aims to shed light on some post-oedipal moments of the Freudian-Lacanian psychoanalysis. Going beyond the stereotypical opposition between the oedipal psychoanalysis and the anti-oedipal schizoanalysis, it endeavors to reinvestigate the semiotic nature of theknotenpunktand thesinthomeby applying some Deleuzian and Bakhtinian concepts. Thus, theknotenpunktis described as a grotesque knot bringing together some heterogeneous elements. The involved disparate components establish a rhizomatic multiplicity irreducible to a common determiner. As far as thesinthomeis concerned, it is also illustrated as a grotesque (...) knot quilting the disseminated heterogeneous orders. In contrast to the dominant conception of the symptom with a complex mode of signifying (that is mainly bound to the oedipal topography), theknotenpunktand thesinthomehold a kind of hyper-formative mode of signifying. As a result, the latter may be regarded as pure formators irreducible to a meaning or a certain interpretation. Finally, the paper sets out to analyze and evaluate the relationship between thesinthomeand the foreclosure from a semiotic perspective. Accordingly, thesinthomeis explained as a reply to foreclosure which is specifically a perceptive-imperative (retroactive) contemplation (in the light of law according to the Peircean phaneroscopy) on the rhizomatic multiplicity of psychosis (the case of schizophrenia). (shrink)

Despite a wealth of findings that psychotherapy is an effective psychological intervention the principal mechanisms of psychotherapy change are still in debate. It has been suggested that all forms of psychotherapy provide a context which enables clients to transform the meaning of their experiences and symptoms in such a way as to help clients to feel better, and function more adaptively. However, psychotherapy is not the only healthcare intervention that has been associated with ‘meaning’: the reason why (...) placebo have effects has also been proposed to be a ‘meaning response’. Thus, it has been argued that the meaning of treatments has a central impact on beneficial (and by extension, negative) health-related responses. In light of the strong empirical support of a contextual understanding of psychotherapy and its effects, the aim of this conceptual analysis is to examine the role of meaning and its transformation in psychotherapy – in general – and within three different, commonly-used psychotherapy modalities. (shrink)

Background: The classical symptom specificity hypothesis (Blatt, 1974) links obsessional symptoms to autonomous interpersonal behavior. Inconsistent findings from cross-sectional group studies on symptom specificity have previously been associated with several conceptual and methodological limitations intrinsic to nomothetic research. Previous empirical case research reported ambivalences between autonomous and dependent interpersonal behavior in obsessional pathology. Aim and Method: The present ‘theory-building’ case study specifically aims at further refinement of the classical symptom specificity hypothesis by testing specific operationalizations within an empirical single (...) case design. Consensual Qualitative Research for Case studies is used to quantitatively and qualitatively describe the longitudinal, clinical interplay between obsessional symptoms and interpersonal dynamics throughout the process of a psychodynamic therapy. Interpersonal functioning is assessed by means of the Core Conflictual Relationship Theme method. The classical symptom specificity hypothesis is contrasted to an alternative hypothesis of interpersonal ambivalences as determinants of obsessional symptoms. Results: Close associations between obsessions and interpersonal dynamics are observed. Findings predominantly affirm the ambivalence hypothesis rather than the classical symptom specificity hypothesis. Psychodynamic interventions focusing on interpersonal conflicts are related to symptomatic changes. Conceptual and methodological considerations, limitations and future research indications are discussed. (shrink)

Semiotics, the theory of sign and meaning, may help physicians complement the project of interpreting signs and symptoms into diagnoses. A sign stands for something. We communicate indirectly through signs, and make sense of our world by interpreting signs into meaning. Thus, through association and inference, we transform flowers into love, Othello into jealousy, and chest pain into heart attack. Medical semiotics is part of general semiotics, which means the study of life of signs within society. With (...) special reference to a case story, elements from general semiotics, together with two theoreticians of equal importance, the Swiss linguist Ferdinand de Saussure and the American logician Charles Sanders Peirce, are presented. Two different modes of understanding clinical medicine are contrasted to illustrate the external link between what we believe or suggest, on the one hand, and the external reality on the other hand. (shrink)

BackgroundThe effects of psychological interventions on symptoms and psychology of functional dyspepsia remain unclear. We aimed to comprehensively evaluate the effects of psychological interventions on symptoms and psychology of FD.MethodsWe searched the PubMed, Cochrane Library, and Embase electronic databases for randomized controlled trials evaluating the role of psychological interventions in FD patients published before July 2021. Standardized mean differences, risk ratios and 95% confidence intervals were calculated by a random effects model. Subgroup analyses and sensitivity analyses were also (...) performed.ResultsFourteen RCTs with a total of 1,434 FD patients were included. Compared with the control group, psychological interventions were significantly more likely to symptom improvement [RR = 1.74, 95% CI, p = 0.01], relieve gastrointestinal symptoms scores at follow up [SMD = −1.06, 95% CI, p < 0.0001], relieve gastrointestinal symptoms scores at end of treatment [SMD = −0.98, 95% CI, p < 0.001], decrease anxiety [SMD = −0.8, 95% CI, p = 0.006] and depression levels [SMD = −1.11, 95% CI, p < 0.001]. The results of the subgroup analysis showed that psychotherapy was more likely to symptom improvement, relieve gastrointestinal symptoms scores and decreased depression levels compared to the control.ConclusionsPsychological interventions may be effective in alleviating the symptoms and psychology of FD, but the effect appears to be limited to psychotherapy with fewer trials for other psychological interventions. More data from high-quality RCTs are needed to confirm their use in the treatment of FD. (shrink)

BackgroundBayesian estimation with informative priors permits updating previous findings with new data, thus generating cumulative knowledge. To reduce subjectivity in the process, the present study emphasizes how to systematically weigh and specify informative priors and highlights the use of different aggregation methods using an empirical example that examined whether observed mother-adolescent positive and negative interaction behavior mediate the associations between maternal and adolescent internalizing symptoms across early to mid-adolescence in a 3-year longitudinal multi-method design.MethodsThe sample consisted of 102 mother-adolescent (...) dyads. Mothers and adolescents reported on their internalizing symptoms and their interaction behaviors were observed during a conflict task. We systematically searched for previous studies and used an expert-informed weighting system to account for their relevance. Subsequently, we aggregated the priors using three methods: linear pooling, logarithmic pooling, and fitting a normal distribution to the linear pool by means of maximum likelihood estimation. We compared the impact of the three differently specified informative priors and default priors on the prior predictive distribution, shrinkage, and the posterior estimates.ResultsThe prior predictive distributions for the three informative priors were quite similar and centered around the observed data mean. The shrinkage results showed that the logarithmic pooled priors were least affected by the data. Most posterior estimates were similar across the different priors. Some previous studies contained extremely specific information, resulting in bimodal posterior distributions for the analyses with linear pooled prior distributions. The posteriors following the fitted normal priors and default priors were very similar. Overall, we found that maternal, but not adolescent, internalizing symptoms predicted subsequent mother-adolescent interaction behavior, whereas negative interaction behavior seemed to predict subsequent internalizing symptoms. Evidence regarding mediation effects remained limited.ConclusionA systematic search for previous information and an expert-built weighting system contribute to a clear specification of power priors. How information from multiple previous studies should be included in the prior depends on theoretical considerations, and may also be affected by pragmatic considerations regarding the impact of the previous results at hand. (shrink)

In Enjoy your Symptom, Slavoj Žižek’s notion of “trauma” is critical to understanding the scope and meaning of the “symptom.” This “symptom,” conceptually, is construed through the manner in which identity, authority, and phallophany come to bear psychologically on the meaning of being. Because of this, the definition of “symptom,” when viewed in a Heideggerian way, becomes an ontical representation of that which is oriented primordially. The symptom, as we experience it, is more than just at the level (...) of its ontics, but, instead, has a primordially to it, which is only revealed through the presence of trauma. (shrink)

The notion of a ‘machinery of death’ not only underwrites abolitionist discourse but also informs what Derrida's Death Penalty refers to as an anesthesial drive that can be traced back at least as far as Guillotin. I read it here as a symptom of a more complex relation to the technological that functions across the line dividing life from death, and which is concentrated in the question of the instant that capital punishment requires. Further indications of such a relation include (...) the forms of automatic machinism that regulate, on one hand, the generalisable certainty that death occurs, and on the other, the discursive contagion that the death penalty generates. But it can be analysed most productively in the way in which the putative instantaneity of an execution reveals how life is severed from, but also perhaps tethered to death by means of a machinery of time; how that machinery of time ‘abandons’ its indifference in order to decide the moment of death by execution, and at the same time, by contriving an instant at which death takes over from life, produces the uncanny result of having life and death meet on the same knife-edge. (shrink)

The Flash Technique of Eye Movement Desensitization and Reprocessing is widely recognized for its effectiveness in reducing the effects of emotional responses associated with traumatic memories. Using a randomized-controlled trial methodology, this study attempts to establish the efficacy of the EMDR Flash Technique. This study’s sample includes volunteers who were involved in traffic accidents and were given the randomized EMDR Flash Technique and Improving Mental Health Training for Primary Care Residents Stress management module. The participants were given a socio-demographic data (...) form, the Depression-Anxiety-Stress 21 scale, the Impact of Event Scale-Revised, and the WHOQOL Quality of Life scale. Participants were evaluated using measurements taken before and after the application, as well as a one-month follow-up. The mean age of the participants was 36.20 years and 82.1% were female. The DASS-21 Anxiety, IES-R Intrusion, Avoidance, Total, and WHOQOL-BREF Psychological score improvements of the EMDR Flash Technique group were shown to be statistically significant when compared to the mhGAP group. However, no statistically significant difference in the DASS-21 Depression, Stress, Impact of Event Scale-Revised Hyperarousal WHOQOL-BREF General Health, Physical, Social Relationships, and Environment component scores was reported between the two groups. The present study’s findings clearly demonstrate that the EMDR Flash technique, when applied to persons involved in traffic accidents, is successful in improving anxiety, intrusion, avoidance, total traumatic stress, and mental quality of life symptoms for at least 1 month. We believe that these findings will improve the reliability and applicability of the EMDR Flash Technique, which was tested for the first time in a clinical randomized-controlled trial. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 10.1 (2003) 91-97 [Access article in PDF] The Ambiguities of "Meaning":A Commentary Hans S. Reinders "Death, Disability, and Dogma" by Jennifer Clegg and Richard Lansdall Welfare (2003) is a rich paper that presents an unexpected but interesting mixture of observations and perspectives on mourning, grief and bereavement in the lives of people with intellectual disabilities.In a number of ways, the notion of meaning (...) is prominent in the paper. The authors observe that recent literature on grief and bereavement because of loss of loved ones does not confirm the "stage theory of loss." Instead there is a "multiplicity of possible responses to bereavement," which is partly explained by the role of cultural diversity. Cultural diversity is particularly involved in the development of "meanings" about loss (2003, 69). However, looking into the literature on grief and bereavement among persons with intellectual disabilities, the authors found that literature "dogmatic" in that it sticks to the traditional theoretical framework of "grief work" (2003, 74). The authors offer an explanation for this "stuck discourse": The approach to grief and bereavement among people with intellectual disabilities is framed within the philosophy of normalization. This leads professionals to downplay limitations to the potential of their clients in ways that encourage the denial of disability. The meaning assigned to intellectual disabilities, this is to say, is primarily positive. This positive outlook promotes the "belief in the apparently limitless potential of the client group to develop skills and autonomy if only they are given the right help" (2003, 71). The authors read this promoting of positive meaning as a counter strategy: our culture in general does not seem to be convinced of a valued meaning of life for persons with intellectual disabilities. Therefore, the professional world of service systems adopts a strategy of "separitism" (2003, 77), which explains why approaches to phenomena like grief and bereavement are "stuck" with ideas that are inadequate. The professional community attending those with intellectual disabilities is too much a world on its own. There should be more interaction between generalists and specialists on the subject of grief and bereavement.So far the general argument of the paper. Because my own area of research is not in the fields of clinical psychology or psychiatry, it cannot be my task to comment on Clegg and Lansdall-Welfare's presentation of the research on grief and bereavement in these fields. Nonetheless, there are a few points in their review of the literature that I will briefly address, but only to prepare the way for the major topic of this commentary, which is the issue of meaning as it relates to intellectual disability.Intuitively, my sympathy would lie with social critics arguing for caution with regard to the [End Page 91] medicalization of mourning and grief (Clegg and Lansdall-Welfare 2003, 67-79). The loss of loved ones will oftentimes be a traumatic experience, but when it is, I tend to see the symptoms of distress following that experience as a sign of mental health, more than anything else. Losing a parent, sibling, or someone else who has been part of one's life, is not only missing the other person, it is missing a part of oneself. That being the case, it is only to be expected that, in some sense, life will never be again what it was. Replacing notions of recovery from a traumatic experience by notions of "adaptation and accommodation" (2003, 68) appears to me the more sensible approach.Therefore, I tend to be suspicious about notions such as "pathological grief." From a philosophical point of view, such a notion seems to betray a modernist conception of the human subject in control of its own action. Following that conception, human beings need to transform that which happens to them by means of their own action so that they have made it part of themselves. Being overcome with grief one is in an emotional state that as such is "pathological"—as Immanuel Kant had it—the main characteristic of which is its heteronomy. A person overcome by grief is controlled by passion instead... (shrink)

The aim of this article is to present a conceptual review and analysis of symptom understanding. Subjective bodily sensations occur abundantly in the normal population and dialogues about symptoms take place in a broad range of contexts, not only in the doctor’s office. Our review of symptom understanding proceeds from an initial subliminal awareness by way of attribution of meaning and subsequent management, with and without professional involvement. We introduce theoretical perspectives from phenomenology, semiotics, social interactionism, and discourse (...) analysis. Drew Leder’s phenomenological perspectives deal with how symptom perception occurs when any kind of altered balance brings forward a bodily attention. Corporeality is brought to explicit awareness and perceived as sensations. Jesper Hoffmeyer’s biosemiotic perspectives provide access to how signs are interpreted to attribute meaning to the bodily messages. Symptom management is then determined by the meaning of a symptom. Dorte E. Gannik’s concept “situational disease” explains how situations can be reviewed not just in terms of their potential to produce signs or symptoms, but also in terms of their capacity to contain symptoms. Disease is a social and relational phenomenon of containment, and regulating the situation where the symptoms originate implies adjusting containment. Discourse analysis, as presented by Jonathan Potter and Margaret Wetherell, provides a tool to notice the subtle ways in which language orders perceptions and how language constructs social interaction. Symptoms are situated in culture and context, and trends in modern everyday life modify symptom understanding continuously. Our analysis suggests that a symptom can only be understood by attention to the social context in which the symptom emerges and the dialogue through which it is negotiated. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Art as Symptom:Žižek and the Ethics of Psychoanalytic CriticismTim Dean (bio)This paper tackles a problem that is exemplified by, but not restricted to, Slavoj Žižek's work: the tendency to treat aesthetic artifacts as symptoms of the culture in which they were produced. Whether or not one employs the vocabulary and methods of psychoanalysis to do so, this approach to aesthetics has become so widespread in the humanities that (...) it qualifies as a contemporary critical norm. As a norm, it may be subject to debate and even contestation. Today it is normative to read literature, film, and other cultural texts primarily as evidence about the societies that made them—evidence that necessarily requires our hermeneutic labor in order to yield its significance. This methodological protocol remains in place whether one inhabits critical perspectives as ostensibly disparate as historicist, materialist, or psychoanalytic modes of thinking; it is also a grounding assumption of cultural studies, irrespective of how one defines that critical practice. Indeed, the issue I want to address is quite as much a Marxist problem as it is a psychoanalytic one, and therefore the way in which Žižek articulates Lacan with Marx makes his work especially fertile terrain on which to engage this matter. As Žižek reminds us in The Sublime Object of Ideology, Lacan claimed that Marx invented the symptom [SO 11]—an observation that Žižek has been keen to exploit from the very beginning of his work.Žižek's combining psychoanalysis with Marxism in novel ways has helped make Lacan more palatable to contemporary critical sensibilities by politicizing psychoanalysis, demonstrating how it offers less an account of the individual than of society and culture. In Žižek's hands psychoanalytic theory appears less vulnerable to the standard criticisms that it is ahistorical and apolitical. While a number of critiques of Žižek have reiterated these common objections, nevertheless his politicizing of psychoanalysis has been particularly important during a period that witnessed the rise of new historicism, the institutionalization of cultural studies, and the escalating importance of "the political" as a sign—perhaps the sign—of humanities professors' seriousness.1 Žižek's work has gone a long way toward making Lacan seem indispensable to cultural studies, just as Juliet Mitchell's and Jacqueline Rose's work a decade earlier made Lacan seem indispensable to theoretically rigorous feminism. At a moment when the poststructuralist variant of Lacanian theory was being displaced by historicist modes of thought, Žižek emerged on the scene to revivify psychoanalysis and make it exciting again. Thus his work's appeal has an historical basis quite apart from Žižek's own personal charisma and his remarkable productivity. It is his politicizing of psychoanalysis, as much as his [End Page 21] rendering Lacan newly accessible, that has made Žižek popular. I want to argue, however, that his style of politicizing psychoanalysis carries a significant ethical cost, one that follows partly as a consequence of Žižek's failure to work through his theoretical relation to Althusser, from whom he derives the practice of symptomatic reading while claiming to displace the latter's version of psychoanalytic Marxism. Thus I shall be arguing for a significant distinction between a political and an ethical psychoanalysis, suggesting that we have been cultivating the former at the expense of the latter.Spaghetti PsychoanalysisThe notion of the symptom is central to Žižek's thinking about politics and culture. Although in his work and in psychoanalytic theory more generally the term symptom carries a range of conceptual meanings, symptomatology remains the governing trope of Žižek's oeuvre. Following Lacan, who continued to modify the concept of the symptom throughout his career, Žižek argues that just about anything can be understood as symptomatic:[I]n the final years of Lacan's teaching we find a kind of universalization of the symptom: almost everything that is becomes in a way symptom, so that finally even woman is determined as the symptom of man. We can even say that "symptom" is Lacan's final answer to the eternal philosophical question "Why is there something instead of nothing?"—this "something" which "is... (shrink)

Over the last few years, in part due to the political impact of terrorist activities, the debate on the moral significance of torture as a useful means of obtaining information from enemy combatants has arisen with an urgency not seen in many years. Stressing the importance of exceptional cases, the defenders of torture attempt to justify its acceptance by and back its use in the judicial system of Western democracies. Yet what is at stake here are the basic moral principles—especially (...) that of human dignity-on which our political convictions rest. Admitting of exceptions would change the value of these principles: what once werefixed guidelines for acceptable action now become alterable according to specific political demands, thus making torture into a morally neutral act. The current defence of torture in the West may be a symptom of the progressive absolutization of the State. (shrink)

Emotional dysregulation, age, gender, and obesity are transdiagnostic risk factors for the development and maintenance of eating disorders. Previous studies found that patients with ED had less meaning in life than the non-clinical population, and that meaning in life acted as a buffer in the course of ED; however, to the data, there are no studies about the mediator role of meaning in life in association between the emotional dysregulation and the ED psychopathology.Objective: To analyze the mediating (...) role of meaning in life in the relationship between emotional dysregulation and the ED psychopathology in three samples with diverse risk factors for ED.Method: Sample 1, n = 153 undergraduate young women; sample 2, n = 122 participants with obesity; and sample 3, n = 292 participants with ED. Multiple mediation analysis was performed.Results: Sample 1: meaning in life showed a mediation effect between emotional dysregulation and the ED psychopathology, body satisfaction, and depression symptoms ; sample 2: meaning in life showed a mediation effect between emotional dysregulation and binge eating and purging behaviors and depression symptoms ; sample 3: meaning in life showed a mediation effect between emotional dysregulation and the ED psychopathology, body satisfaction, borderline symptoms, and hopelessness.Conclusions: These studies suggest the importance of considering meaning in life as a variable in the onset and maintenance of ED. (shrink)

The COVID-19 pandemic has subjected most of the world’s population to unprecedented situations, like national lockdowns, health hazards, social isolation and economic harm. Such a scenario calls for urgent measures not only to palliate it but also, to better cope with it. According to existential positive psychology, well-being does not simply represent a lack of stress and negative emotions but highlights their importance by incorporating an adaptive relationship with them. Thus, suffering can be mitigated by, among other factors, adopting an (...) attitude of positive reframing, maintaining hope, existential courage, life appreciation, engagement in meaningful activities, and prosociality. The conglomerate of these elements has been recently denominated as meaning-centered coping. In this study, we evaluated the protective role of this type of coping on mental health. A sample of 12,243 participants from 30 countries across all continents completed measures of Meaning-Centered Coping Scale, depression, stress, anxiety and stressful COVID-19 related conditions they experienced. Results indicated that meaning-centered coping was strongly associated with diminished symptoms of stress, anxiety, and depression. Moreover, it moderated various relationships between vulnerability factors and markers of psychological distress, especially in the case of depression. These findings call for attention to meaning-centered coping approaches in the context of hardship, such as the current COVID-19 health crisis. In these difficult times, decision-makers and health organizations may integrate these approaches into their guidelines. (shrink)

High quality monitoring of mental health and well-being over an extended period is essential to understand how communities respond to the COVID-19 pandemic and how to best tailor interventions. Multiple community threats may also have cumulative impact on mental health, so examination across several contexts is important. The objective of this study is to report on changes in mental health and well-being in response to the Australian bushfires and COVID-19 pandemic. This study utilized an Experience-Sampling-Method, using the smartphone-based mood monitoring (...) application, MoodPrism. Participants were prompted once a day to complete a brief survey inquiring about symptoms of depression and anxiety, and several well-being indices, including arousal, emotional valence, self-esteem, motivation, social connectedness, meaning and purpose, and control. Participants were N = 755 Australians who downloaded and used MoodPrism, between 2018 and 2020. Results showed that anxiety symptoms significantly increased during the COVID-19 pandemic, but not during the bushfires. This may be explained by concurrent feelings of social connectedness maintained during the bushfires but not during the pandemic. In contrast, depressive symptoms increased significantly during the bushfires, which maintained during the pandemic. Most indices of well-being decreased significantly during the bushfires, and further again during the pandemic. Study findings highlight the unique responses to the bushfire and COVID-19 crises, revealing specific areas of resilience and vulnerability. Such information can help inform the development of public health interventions or individual clinical treatment, to improve treatment approaches and preparedness for potential future community disasters. (shrink)

The arts provide openings for symbolic expression by engaging the sensory experience in the body they become a source of insight through embodied cognition and emotion, enabling meaning-making, and acting as a catalyst for change. This synthesis of sensation and enactive, embodied expression through movement and the arts is capitalized on in The BodyMind Approach®. It is integral to this biopsychosocial, innovative, unique intervention for people suffering medically unexplained symptoms applied in primary healthcare. The relevance of embodiment and (...) arts practices in TBMA are discussed in relation to the views of participants in the pursuit of self-management. If widely employed TBMA could have an enormous impact, reach, and significance for patients and global health services. This original pre-clinical trial of qualitative research reports on the perceptions of participant patients with generic MUS, a world-wide issue usually treated by either psychological therapy or physiotherapy. TBMA is not a therapy but a health education program founded upon the concept of an integration of psychological elements with physiological, bodily, and sensory experiences. Thematic analysis of qualitative data sets from open-ended questions in semi-structured interviews and a written questionnaire post intervention is presented. Five aspects which appear to be key to learning self-management were derived from analyzing the data: body with mind connections; importance of facilitation; potential benefits; preparedness for change; self-acceptance/compassion. This article advances the discourse on the nature of self-management for MUS through changing the mind-set and the relationship participants have with their bodily symptom/s through employing embodied methods and arts practices, challenging current, and solely verbal, psychological conceptual frameworks. Rigor lies in the method of data analysis using cross verification of credibility between reported findings and scrutiny by stakeholders. We conclude that facilitated TBMA groups employing embodied methods and arts practices can act as a method for developing the self-management of MUS and improving wellbeing. (shrink)

BackgroundThe high incidence of post-stroke depression during rehabilitation exerts a negative effect on the treatment and functional recovery of patients with stroke and increases the risk of mortality. It is necessary to screen PSD in the rehabilitation stage and thus provide effective intervention strategies. However, existing measurements used to assess PSD in the rehabilitation stage in patients with stroke lack specificity. This study aimed to develop a clinical measure to assess symptoms of PSD in the rehabilitation stage.MethodsThe research team (...) created the initial items through a literature review and semi-structured interviews of patients with stroke. Then, the symptom-related items were estimated by three panels: healthcare professionals, Delphi experts, and patients with stroke in the rehabilitation stage.ResultsThe literature review and semi-structured interview produced 51 symptom-related items including six domains, and the items were reduced to 47 by the healthcare professionals. The symptom-related items were further reduced to 33 items by a two-round Delphi consultation. The initiative coefficients of the two Delphi rounds were 71.4 and 100%, the expert authority coefficients were both 0.85, Kendall’s W were 0.152 and 0.408, and the coefficient of variation were 0.05–0.32 and 0.00–0.18, respectively. The item-level content validity index was 0.53–1.00, the scale-level CVI/universal agreement was 0.26, and the S-CVI/average was 0.85 for the first found Delphi consultation; the I-CVI was 0.67–1.00, the S-CVI/UA was 0.61, and the S-CVI/Ave was 0.97 for the second round Delphi consultation. All content validity indicators have been significantly improved compared with the first round. Using mean ≥ 4 and full score ≥ 0.5, combined with CV ≤ 0.16 as the item criteria, a clinical measure of PSD with 33 items and 6 dimensions was finally formed after two rounds. The patients with stroke made no further revisions after evaluation.ConclusionThe research team developed a specific tool with good content validity to assess the symptoms of PSD in the rehabilitation stage. (shrink)

A definition of virtual or virtuality is not an easy task. Both words are of recent application in Philosophy, even if the concept of virtual comes from a respectable Latin tradition. Today’s meaning brings together the notions of potentiality, latency, imaginary representations, VR, and the forms of communication in digital media. This contagious, and spontaneous synonymy fails to identify a common vein and erases memory as a central notion. In the present essay, I’ll try to explain essential features of (...) the concept of virtual, taking the investigation of memory troubles in Pierre Janet’s work as an exemplification. Pierre Janet’s work represents a rare combination of medical observation and description of symptoms of mental illnesses, therapeutic guidance in hypnosis and philosophical writing about the main psychological themes of an epoch in transition from a Metaphysics of the Soul to the modern Experimental Psychology. Pierre Janet’s intellectual evolution since the 1880s until the end of his life is dominated by the philosophical project of a theory of the psychic system supported by three basic pillars: a concept of personality, a theory of memory and a sketch of a general theory of conduct. Such complex endeavour cannot be abstracted from the initial connections with Jean-Martin Charcot’s school at La Salpêtrière which meant a turning point in the tradition of the “animal magnetism” concerning the treatment of epileptic-hysterical symptoms along with the contributions of Hyppolite Bernheim’s “Nancy School” of hypnotism. J.-M. Charcot’s or H. Bernheim’s theorising about the organic and psychological aspects of the hypnotic treatment of the hysterical symptoms was already aware of the difficulty in dealing with the extent of the dissimulation of the patients regarding the symptoms of the illness, under hypnotic suggestion, even if Charcot insisted in the identification and cataloguing of the organic expressions, such as contractures or the posture of the body in arc during the attacks. The precise location of the “great hysteria” in the organic-psychic corridor was itself a riddle. If a symptom is a special type of sign, in the case of the “great hysteria” nobody knew for sure what it stood for. The clinical symptom of the attack stood for an organic trouble with cerebral causes, a psychological interruption of the normal sensorial and muscular movements or a disguise of the female desire? Pierre Janet described many hysterical patients, somnambulism and multiple personality since his articles in La Revue Philosophique de la France et l’ Étranger, a Journal founded by the philosopher, experimental psychologist and his intellectual predecessor Théodule-Armand Ribot. The description of the case of the “great hysterical” Lucie, treated by him, is an example of a theoretical hypothesising on multiple personality and discontinuity of memories fragments. There are more cases revealing the same relation between hysteria, somnambulism, personality dissociation and “alternating memory”. Decisively inspired by and corroborating P. Janet’s ideas, S. Freud conceived also the essential of the hysterical sicknesses as disorders of memory. The theme of memory came even more to the foreground in the dissertation L’Automatisme Psychologique. Here, the strange world of somnambulism was scrutinised along with hysterical contractures and convulsions, anaesthesia, the compulsion to repetition, obsessions, “automatic writing” in hysterical patients, multiple personality and “alternating memories”. In the depicted cases memory could not be taken as a homogenous series of remembrances or as a stock of disposable information but as a variable of the depth of the personalities’ inner formation. The so-called “seconde existence” of some somnambulists referred not only unconscious representations and unconscious thoughts but complete or inceptive latent personalities provided with multiple virtual existences and multiple memories. Hypnosis was the privileged technique to access to such multiple memories ignored by the official personality. Later and after the writing of his M.D. Dissertation, Contribution à l’ Étude des Accidents Mentaux chez les Hystériques, P. Janet addressed again the themes of memory and alternating memories in a series of lectures at the Collège de France but now according to the larger framework of a general theory of conduct which included a description of the social actions participating in the narrative construction of personal memories, and the role of social memory. (shrink)

Background: Strengthening the sense of meaning in life and psychological well-being brings benefits for mental health. The group particularly vulnerable to mental problems are young adults, therefore the aim of our research was to explore how a gratitude intervention will affect the sense of meaning in life, psychological well-being, general health and perceived stress among them. The research also took into account the issue of expressing gratitude.Method: The study involved 80 young adults who were randomly assigned to the (...) experimental group that filled out the specially prepared diaries for a week or the control group. Participants completed the Meaning in Life Questionnaire, the General Health Questionnaire – 28, the Perceived Stress Scale, and the Ryff Scales of Psychological Well-Being twice.Results: In the experimental group significant increases were observed in three areas of psychological well-being: environmental mastery, relationships with others and purpose in life. The significant decrease was also noted in anxiety/insomnia and depression symptoms as well as in perceived stress. There were no differences in the level of meaning in life. There was a positive relationship between expressing gratitude and meaning in life and psychological well-being.Conclusion: Proposed gratitude intervention has the potential to enhance psychological well-being among young adults, however, it may not be effective in enhancing meaning in life. (shrink)

Deep brain stimulation of the subthalamic nucleus for the treatment of Parkinson’s disease can lead to the development of neuropsychiatric symptoms. These can include harmful changes in mood and behaviour that alienate family members and raise ethical questions about personal responsibility for actions committed under stimulation-dependent mental states. Qualitative interviews were conducted with twenty participants following subthalamic DBS at a movement disorders centre, in order to explore the meaning and significance of stimulation-related neuropsychiatric symptoms amongst a purposive (...) sample of persons with PD and their spousal caregivers. Interview transcripts underwent inductive thematic analysis. Clinical and experiential aspects of post-DBS neuropsychiatric symptoms were identified. Caregivers were highly burdened by these symptoms and both patients and caregivers felt unprepared for their consequences, despite having received information prior to DBS, desiring greater family and peer engagement prior to neurosurgery. Participants held conflicting opinions as to whether emergent symptoms were attributable to neurostimulation. Many felt that they reflected aspects of the person’s “real” or “younger” personality. Those participants who perceived a close relationship between stimulation changes and changes in mental state were more likely to view these symptoms as inauthentic and uncontrollable. Unexpected and troublesome neuropsychiatric symptoms occurred despite a pre-operative education programme that was delivered to all participants. This suggests that such symptoms are difficult to predict and manage even if best practice guidelines are followed by experienced centres. Further research aimed at predicting these complications may improve the capacity of clinicians to tailor the consent process. (shrink)

In everyday medical settings in Japan, physicians occasionally tell an elderly patient that their symptoms are “due to old age,” and there is some concern that patient care might be negatively impacted as a result. That said, as this phrase can have multiple connotations and meanings, there are certain instances in which the use of this phrase may not necessarily be indicative of ageism, or prejudice against the elderly. One of the goals in medical care is to address pain (...) and suffering that develops with age in elderly individuals, and whether or not aging is a disease is inconsequential. However, assuming that an individualized and thorough examination has been performed, there are some conditions that can be attributed only to age. Accordingly, physicians must acknowledge the merits and drawbacks of using the phrase “due to old age,” and exercise caution when using it. Both physicians and their elderly patients must share a common awareness of the incomplete and limited nature of modern medicine and its scope, and physicians must help their elderly patients accept and live with the aging phenomenon. (shrink)

BackgroundIn Parkinson's disease, the side of motor symptoms onset may influence disease progression, with a faster motor symptom progression in patients with left side lateralization. Moreover, worse neuropsychological outcomes after subthalamic nucleus deep brain stimulation have been described in patients with predominantly left-sided motor symptoms. The objective of this study was to evaluate if the body side of motor symptoms onset may predict motor outcome of bilateral STN-DBS.MethodsThis retrospective study included all consecutive PD patients treated with bilateral (...) STN-DBS at Grenoble University Hospital from 1993 to 2015. Demographic, clinical and neuroimaging data were collected before and 1 year after surgery. The predictive factors of motor outcome at one-year follow-up, measured by the percentage change in the MDS-UPDRS-III score, were evaluated through univariate and multivariate linear regression analysis.ResultsA total of 233 patients were included with one-year follow-up after surgery [143 males ; 121 right body onset; 112 left body onset; mean age at surgery, 55.31 ± 8.44 years; mean disease duration, 11.61 ± 3.87]. Multivariate linear regression analysis showed that the left side of motor symptoms onset did not predict motor outcome.ConclusionsIn this retrospective study, the body side of motor symptoms onset did not significantly influence the one-year motor outcome in a large cohort of PD patients treated with bilateral STN-DBS. (shrink)

Studies investigating differences in mental health problems between self-employed and employed workers have provided contradictory results. Many of the studies utilized scales validated for employed workers, without collecting validity evidence for making comparisons with self-employed. The aim of this study was to collect validity evidence for three different scales assessing depressive symptoms, emotional exhaustion, and sleep disturbances for employed workers, and combinators; and to test if these groups differed. We first conducted approximate measurement invariance analysis and found that all (...) scales were invariant at the scalar level. Self-employed workers had least mental health problems and employed workers had most, but differences were small. Though we found the scales invariant, we do not find them optimal for comparison of means. To be more precise in describing differences between groups, we recommend using clinical cut-offs or scales developed with the specific purpose of assessing mental health problems at work. (shrink)

The aim of this study is to examine the attitudes of people who lost their relatives due to the earthquake towards the mourning process and the role of religious rituals in combating the stressful situation caused by this loss. In the study in which the qualitative research method was adopted, a case study design was also adopted. In the study where the criterion sampling technique was used, a total of 12 participants who experienced loss due to the earthquake were included (...) in the study. The participants stated that this loss was much more severe than a normal loss due to factors such as not being able to meet for the last time, not being able to reach the lost relative and the lack of religious rituals. Accordingly, it was observed that individuals who used positive religious coping styles experienced an increase in spirituality meaning of life and showed signs of post-traumatic growth, such as positive social relationships. On the other hand, most of the individuals who adopted negative religious coping styles experienced more feelings of helplessness and meaninglessness, had more difficulty in accepting the death, withdrew from social relationships, and showed more intense symptoms of Posttraumatic Stress Disorder (PTSD). (shrink)

Higher levels of reliance on cognitive reappraisal to manage daily emotional events are commonly associated with lower levels of depressive symptoms. However, reappraisal is a cognitively demanding regulation strategy, and its efficacy may depend on how successfully an individual is able to employ it. Individual differences in the association between reappraisal use and depressive symptoms may be particularly evident during adolescence, when the cognitive skills required to implement this complex strategy are still in development. The current study sought (...) to determine whether the association between reappraisal use and subsequent depressive symptom development is contingent on perceived regulatory success when using reappraisal. At Wave 1, adolescents (n = 178, mean age = 13.92, 49.7% female) used an experience-sampling smartphone app to report on their reappraisal use and perceptions of regulatory success over the course of two weeks. Six, 12, and 18 months later, adolescents completed a self-report measure of their depressive symptoms. Results showed that a) reappraisal use was associated with both subsequent depressive symptoms and trajectories of depressive symptoms over time, b) these associations were moderated by perceptions of regulatory success. Higher levels of reappraisal use were associated with lower levels of depressive symptoms only for those who reported higher than average between-subject regulatory success when reappraisal was enacted. (shrink)

It is proposed here that the meaning of each word, w, is constituted by its ‘basic acceptance property’—a property roughly of the form, ‘Our acceptance of such‐and‐such sentences containing w explains our overall use of it’. Seven arguments in favour of this idea are developed—the principal one being that what engenders the meaning of a word will be the property that explains the symptoms of that meaning, which are the word's various uses. Objections to this position (...) are then considered, on the basis of considerations of indeterminacy, determination of reference, holism, pragmatics, propositions, ambiguity, synonymy, definition, individualism, externalism, and the relation between language and thought. (shrink)

Forced migration changes people’s lives and their sense of self-continuity fundamentally. One memory-based mechanism to protect the sense of self-continuity and psychological well-being is autobiographical meaning making, enabling individuals to explain change in personality and life by connecting personal experiences and other distant parts of life to the self and its development. Aiming to replicate and extend prior research, the current study investigated whether autobiographical meaning making has the potential to support the sense of self-continuity in refugees. We (...) therefore collected life narratives from 31 refugees that were coded for autobiographical reasoning, self-event connections, and global narrative coherence. In line with prior research, results suggest that autobiographical meaning making relates to a higher sense of self-continuity and less psychological distress. Yet, if refugees experienced many continuing postdisplacement stressors in addition to their forced displacement, autobiographical meaning making was associated with higher self-discontinuity and greater psychological distress, especially with trauma-related symptoms such as memory intrusion and hyperarousal. Altogether, results indicate that autobiographical meaning making helps to compensate the effects of extreme biographical disruptions on the sense of self-continuity, as long as the stress caused by the biographical change is not overwhelming or too protracted. (shrink)

The aim of this contribution is to trace the transformation of the meanings of certain terms as the order of the logics in which they appear is raised. By “order of the logic” we simply refer to the number of truth-values characterizing the logic, so that if the number of truth values shows symptoms of traveling to infinity we may speak of the goal as a logic of infinite order.

In recent years, researchers have tried to unpack the meaning of the term flexibility and test how different constructs of flexibility are associated with various psychopathologies. For example, it is apparent that high levels of flexibility allow individuals to adaptively cope and avoid psychopathology following traumatic events, but the precise nature of this flexibility is ambiguous. In this study we focus on two central constructs: cognitive flexibility – the ability to recognize and implement possible responses to a situation– and (...) regulatory flexibility – the ability to modulate emotional expression and experience across situations. We aim to explore the connection between cognitive and regulatory flexibility and evaluate their relative effect on PTSD symptoms. Trauma-exposed college students were assessed for cognitive and regulatory flexibility and current and lifetime PTSD symptoms. We predicted and found a relatively weak, yet significant, overlap between participants’ cognitive and regulatory flexibility. Importantly, while both cognitive and regulatory flexibility were associated with lifetime PTSD symptoms, only cognitive flexibility was associated with current PTSD symptoms. The findings illuminate the possible value of differentiating between constructs of flexibility in predicting short and long-term effects of traumatic exposure and may pave the ground for developing personalized intervention methods. (shrink)

ObjectiveTwo subregions of the dorsolateral prefrontal cortex have been identified as effective repetitive transcranial magnetic stimulation targets for the “anxiosomatic” and “dysphoric” symptoms, respectively. We aimed to develop a convenient approach to locate these targets on the scalp.Materials and methodsIn a discovery experiment, the two personalized targets were precisely identified on 24 subjects using a neuronavigation system. Then, a localized approach was developed based on individual scalp landmarks. This “landmark-based approach” was replicated and validated in an independent cohort. Reliability (...) of the approach was tested by calculating the correlation of both the inter-rater and intra-rater results. Validity was tested by comparing the mean distance between the personalized and landmark-based targets to the TMS spatial resolution. We further conducted a total of 24 sham rTMS sessions to estimate the misplacement between the coil center and target during a 10-min stimulation without neuronavigation.ResultsThe parameters of the “landmark-based approach” in the discovery experiment were replicated well in an independent cohort. Using discovery parameters, we successfully identified the symptom-specific targets in the independent cohort. Specifically, the mean distance between the personalized and landmark-based targets on the cortex was not significantly larger than 5 mm. However, the personalized and landmark-based targets distance exceeded 5 mm in more than 50% of subjects. During the 10-min sham rTMS session, the average coil misplacement was significantly larger than 5 mm.ConclusionThe “landmark-based approach” can conveniently and reliably locate the two symptom-specific targets at group level. However, the accuracy was highly varied at individual level and further improvement is needed. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Diacritics 30.4 (2000) 59-82 [Access article in PDF] Bombing and the Symptom Traumatic Earliness and the Nuclear Uncanny Paul K. Saint-Amour Many used the Japanese word bukimi, meaning weird, ghastly, or unearthly, to describe Hiroshima's uneasy combination of continued good fortune and expectation of catastrophe. People remembered saying to one another, "Will it be tomorrow or the day after tomorrow?" One man described how, each night he was (...) on air-raid watch, "I trembled with fear.... I would think, "Tonight it will be Hiroshima." These "premonitions" were partly attempts at psychic preparation, partly a form of "imagining the worst" as a magical way of warding off disaster. —Robert J. Lifton, Death in Life: Survivors of Hiroshima (1967) Robert J. Lifton's pathbreaking work on the survivors of the atomic bombing of Hiroshima focuses on the psychological aftermath of the bomb, but opens with a brief and surprising section called "Anticipation." Given the instantaneous and unprecedented devastation caused by the first atomic bomb, the anticipation of so singular an experience is just as difficult to imagine as its subsequent assimilation. In fact, the unassimilable nature of traumatic violence would seem to depend in some way upon the impossibility of its anticipation, as Lifton implies: "Neither past experience nor immediate perceptions—the two sources of prior imagination—could encompass what was about to occur." Yet Lifton also records an expectant, premonitory atmosphere in Hiroshima during the weeks before the bombing, a compound of past experience and immediate perceptions that, while inadequate to "encompass" the eventual experience of the bomb, cannot simply be dismissed as speculation that found an accidental correlate in the nuclear event. While no one in Hiroshima knew ahead of time what would occur on August 6, 1945, many had noted the city's eerie exemption from conventional bombardment and speculated as to the reasons for it. During the summer of 1945, a series of rumors circulated in Hiroshima, rumors attributing the sparing of the city, variously, to its modest military and industrial significance; to the presence of prominent foreigners there, possibly including President Truman's mother; to important American prisoners-of-war supposedly held in the city; to the number of its citizens who had emigrated to the US; to the presence of large numbers of American spies living among its citizens; to its physical appeal in the eyes of Americans who had saved the city as a site for their postwar occupation villas; and, most wishfully, to the wartime grace of a cartographic error: "We thought that perhaps the city of Hiroshima was not on the American maps" [Lifton 15-17]. 1 Other inhabitants [End Page 59] of the city feared that Hiroshima appeared all too prominently on US maps, but had been set aside for "something unusually big"—perhaps the inundation of the city by floodwaters that could be released by the bombing of a massive upstream dam. Still others spoke of a "special bomb" [PWRS 220-22; Lifton 17]. All these rumors responded to citizens' impression that their city had been in some way singled out, and the term bukimi—also meaning "ominous" or "uncanny"—spoke to the suspended question of whether Hiroshima and its inhabitants had been singled out for preservation or for annihilation.The survivors who recollected their anticipatory bukimi years after the bombing may have retrospectively amplified their memories of weird expectation, perhaps as a way of attempting to master an incommensurable and singular event by installing it within a narrative of causality, continuity, even prophecy. Nonetheless, the bukimi experienced by inhabitants of Hiroshima should not be understood as pure retrospection, nor as groundless hunch, since it arose from a series of empirical observations later revealed to have a single and coherent origin in US military strategy. By the summer of 1945, most Japanese cities whose size and military-industrial importance were similar to Hiroshima's had already been bombed with incendiaries: those who lived in Hiroshima had watched waves of American bombers fly past on their way to other targets, while the dozen or so bombs that had fallen accidentally on... (shrink)

Science as Salvation discusses the high spiritual ambitions which tend to gather round the notion of science. Officially, science claims only the modest function of establishing facts. Yet people still hope for something much grander from it--namely, the myths by which to shape and support life in an increasingly confusing age. Our faith in science is abused by some scientists whose adolescent fantasies have spilled over into their professional lives. Salvation, immortality, mastery of the universe, humans without bodies, and intelligent (...) self-reproducing computers are just some of the notions and speculations that are now found--not on the pages of science fiction--but on the pages of science itself. The danger is that these concepts are given to a myth-hungry public who turn to science now that religion has lost its ability to create myth. Science as Salvation discusses the function and meaning of such fantasies. Midgley examines the need for and the use of myth in science, and how science and religion are related. She argues that we need to develop a realistic understanding of scientific imagination and its importance. Taking them seriously as symptoms of a genuine myth-hunger, it suggests that the proper function of science may need to include wider perspectives, which would make it plain that such desperate, compensatory dramas are unnecessary. (shrink)

Objective: We aimed to analyze the characteristics and psychological mechanism of depressive symptoms in elderly patients with alcohol dependence under the COVID-19 epidemic and to observe the effect of acupuncture combined with emotional therapy of Chinese medicine treatment on depressive symptoms in elderly patients with alcohol dependence.Methods: Sixty patients were randomly divided into two groups. One group was treated by a set of emotional therapy of Chinese medicine treatment for 12 weeks. One group was treated by a set (...) of acupuncture combined with emotional therapy of Chinese medicine treatment for 12 weeks. We compared the curative effect between the control group and the treatment group, the mean alcohol consumption, the SF-36 scores before and after treatment, and the scores of Hamilton Depression Scale before and after treatment of 3, 6, and 9 weeks.Results: Based on the cognitive behavior model, the characteristics and psychological mechanism of depression in elderly patients with alcohol dependence under the COVID-19 epidemic situation were summarized. The total effective rate of the control group was 60%, and that of the treatment group was 100%. After 12 weeks of treatment, there were significant differences in PF, RF, physical pain, general health status, energy, and mental health between the treatment group and the control group. Before and after treatment, there were significant differences in PF, RF, physical pain, general health, energy, emotional function, and mental health of the treatment group. The PF, energy, and mental health of the control group were significantly different before and after treatment. There was no significant difference between the treatment group and the control group in the scores of Hamilton Depression Scale before treatment. There was significant difference between the treatment group and the control group in the scores of Hamilton Depression Scale at 3, 6, and 9 weeks after treatment.Conclusion: Attention, cognition, emotion, behavior, and physical response reinforce each other, creating a vicious cycle that reinforces and sustains the depressive symptoms of elderly alcohol dependence under the COVID-19 epidemic, and acupuncture combined with emotional therapy of Chinese medicine treatment for improving the depressive symptoms of elderly alcohol dependence during the epidemic period of COVID-19 has a brilliant therapeutic effect. (shrink)

Meaning-making plays a central role in how we deal with experiences of suffering, including those due to mental disorder. And for many, religious beliefs, experiences, and practices (hereafter, religious engagement) play a central role in informing this meaning-making. However, a crucial facet of the relationship between experiences of mental disorder and religious engagement remains underexplored—namely the potentially positive effects of mental disorder on religious engagement (e.g. experiences of bipolar disorder increasing sense of God’s presence). In what follows, I (...) will present empirical findings from two recent studies of mine which shed light on the extent to which participants experienced these positive effects, specific components of these effects, and how they fit into their understanding of their mental disorder and its relationship to their religious identity. In doing so, I will draw on and expand Tasia Scrutton’s Potentially Transformative view (2015a, 2015b, 2020) according to which mental disorders may provide opportunities for spiritual growth. My empirical results align with and help deepen an account according to which mental disorders are potentially spiritually transformative by providing further insight into such instances: specifically, which symptoms and internal and external factors are often involved, as well as which religious beliefs, experiences, and/or practices are often affected. After presenting these results and articulating their relevance for a potentially transformative view of mental disorder, I will then address some potential objections to the theoretical account as well as some limitations of the empirical work, before sketching possible promising directions for future research. (shrink)

The concept of anxiety has long held a central place in psychoanalytic theories of mind and treatment. Yet, in recent years, data from the neurosciences and from pharmacological studies have posed a compelling challenge to psychoanalytic models of anxiety. One major outcome of these studies is the realization that anxiety both organizes and disorganizes, that it can be both symptom and signal. In _Anxiety as Symptom and Signal_, editors Steven Roose and Robert Glick have brought together distinguished contributors to address (...) these different dimensions of anxiety. A section of original papers on "Anxiety as Symptom" covers evolutionary, neuroanatomical, genetic, and developmental perspectives. A complementary section on "Anxiety as Signal" focuses on the meanings and functions of anxiety in the clinical process; contributions address anxiety in its ego-psychological, intersubjective, and relational dimensions. The illuminating, readable collection will broaden clinicians' awareness of the diverse research findings that now inform our understanding of anxiety. No less importantly, it will deepen their appreciation of the richly variegated ways that anxiety can shape, and be shaped by, the clinical process. (shrink)

The concept of anxiety has long held a central place in psychoanalytic theories of mind and treatment. Yet, in recent years, data from the neurosciences and from pharmacological studies have posed a compelling challenge to psychoanalytic models of anxiety. One major outcome of these studies is the realization that anxiety both organizes and disorganizes, that it can be both symptom and signal. In _Anxiety as Symptom and Signal_, editors Steven Roose and Robert Glick have brought together distinguished contributors to address (...) these different dimensions of anxiety. A section of original papers on "Anxiety as Symptom" covers evolutionary, neuroanatomical, genetic, and developmental perspectives. A complementary section on "Anxiety as Signal" focuses on the meanings and functions of anxiety in the clinical process; contributions address anxiety in its ego-psychological, intersubjective, and relational dimensions. The illuminating, readable collection will broaden clinicians' awareness of the diverse research findings that now inform our understanding of anxiety. No less importantly, it will deepen their appreciation of the richly variegated ways that anxiety can shape, and be shaped by, the clinical process. (shrink)

Valérie Chevassus-Marchionni | : Après une étude de la notion de symptôme en psychanalyse chez Freud et chez Lacan, la paresse est envisagée précisément comme un symptôme. Mais quel peut être le sens de ce symptôme? Quelle est la nature du désir inconscient qui préside à son apparition? Après avoir considéré plusieurs causalités et élaboré quelques interprétations possibles, nous nous intéressons au cas particulier du personnage d’Oblomov dans le roman éponyme d’Ivan Gontcharov. Si la paresse d’Oblomov a un sens qu’il (...) est possible de déterminer à l’aide des outils de la psychanalyse, il est intéressant aussi de ne pas en chercher à tout prix la signification et de l’envisager davantage comme un sinthome au sens lacanien du terme : Oblomov ferait usage de sa paresse comme d’une véritable création visant à contourner son mal-être et à lui permettre de s’accommoder à sa manière des souffrances générées par son existence et sa sensibilité. En conclusion est présenté succinctement le cas de Svevo qui donne de la paresse une illustration bien différente. | : A study of the notion of symptom in psychoanalysis in Freud’s and Lacan’s work shows that laziness can be regarded exactly as a symptom. But what can be the significance of this symptom? What is the nature of the unconscious desire which presides over its appearance? Having considered several causalities and developed some possible interpretations, we’re concerned with the particular case of the character of Oblomov in Ivan Gontcharov’s eponym novel. If Oblomov’s laziness has a significance which it is possible to determine by means of the tools of psychoanalysis, it is also interesting not to look at all costs for the meaning and to envisage it more as a sinthome in the Lacanian sense of the term : Oblomov would make use of his laziness as a real creation to bypass his ill-being and to adapt, in his own way, to the sufferings generated by his existence and sensitivity. In conclusion is briefly presented the case of Svevo which gives of the laziness a very different illustration. (shrink)

Background: Although previous studies have shown an inverse relation between life meaning and eating disorder symptoms, the correlational nature of this evidence precludes causal inferences. Therefore, this study used an experimental approach to test the causal impact of life meaning on individuals' weight and shape concerns.Methods: Female students at risk for developing an eating disorder were randomly assigned to the control or the meaning condition, which involved thinking about and committing to pursue intrinsically valued life goals. (...) A color-naming interference task was used to assess the motivational salience of body-related stimuli, and self-report measures were used to assess participants' overvaluation of weight and shape.Results: The meaning manipulation was effective in activating intrinsically valued life goals. However, it did not result in lower self-reported overvaluation of weight and shape or lower color-naming interference effects of body-related stimuli, compared to the control condition. Post-hoc analyses suggested that baseline meaning in life was related to the impact of the manipulation.Conclusions: This experimental study did not provide evidence for a causal influence of life meaning on the overvaluation of weight and shape in a high-risk group. The current findings suggest that we first need to examine the relationship between life meaning and eating disorder symptoms in more detail, before implementing brief meaning manipulations in clinical practice. (shrink)

This paper seeks to demonstrate the structural difference in communication of schizophrenia and autism. For a normal adult, spontaneous communication is nothing but the transmission of phantasía (thought) by means of perceptual objects or language. This transmission is first observed in a make-believe play of child. Husserl named this function “perceptual phantasía,” and this function presupposes as its basis the “internalized affection of contact” (which functions empirically in eye contact, body contact, or voice calling me). Regarding autism, because of the (...) innate lack of affection of contact, intersubjective perceptual phantasía does not occur spontaneously. Consequently, autistics do not engage in make-believe play but in stereotyped and solipsistic play. Without the formation of perceptual phantasía, there is no differentiation between phantasía and perception. For this reason, people with Asperger's syndrome consider conversation not an immediate communication of thought but a logical transmission of concepts. Schizophrenia is characterized by a distortion in the internalized affection of contact, resulting in a disturbance of perceptual phantasía, and this later is covered by various symptoms—for example, delusion as a pathological kind of communication of thought. This delusion is based on the pathological internalized affection of contact represented by a terrifying Other. (shrink)

In the so-called reverse proportional reading :53, 1997), the truth conditions of statements of the form many/few \\ appear to make reference to the ratio of the individuals that are in the extensions of both \ and \ to the individuals that are in the extension of \. The analysis of such readings is controversial. One prominent approach assumes they are a symptom of many and few making reference to a context dependent standard of comparison. We observe that this initially (...) attractive approach systematically undergenerates, failing to capture pervasive reverse proportionality in environments that remove context dependency of the standard. Instead, we propose that reverse proportionality in such cases can arise from the underspecification of the measure function underlying the meanings of many and few. (shrink)