As cognitive neuroscience has advanced, the list of prospective internal, biological enhancements has steadily expanded. Education and training, as well as the use of external information‐processing devices, may be labeled as “conventional” means of cognition enhancement (CE). They are often well established and culturally accepted. By contrast, methods of enhancing cognition through “unconventional” means, such as ones involving deliberately created nootropic drugs, gene therapy, or neural implants, are nearly all to be regarded as experimental at the present (...) time. Transcranial magnetic stimulation (TMS), genetic interventions, brain‐computer interfaces and new senses are highly experimental and unlikely to be important over the next 15 years. Many of the concerns about enhancement are nonspecific to the tools used to achieve it, which means that enhancement–ethic scrutiny should also apply to nonbiological external enhancements. (shrink)

Rapid advances in cognitive neuroscience and converging technologies have led to a vigorous debate over cognitive enhancement. This book outlines the ethical and social issues, but goes on to focus on the policy dimensions, which until now have received much less attention. As the economic, social and personal stakes involved with cognitive enhancement are so high, and the advances in knowledge so swift, we are likely to see increasing demands for government involvement in cognitive (...) enhancement techniques. The book therefore places these techniques in a political context and brings the subsequent considerations and divisions to the forefront of the debate, situating their resolution within the milieu of interest group politics. The book will provide a starting point from which readers can develop a balanced policy framework for addressing such concerns. (shrink)

Purpose Prescription stimulant use as “cognitive enhancers” has been described among undergraduate college students. However, the use of prescription stimulants among future health care professionals is not well characterized. This study was designed to determine the prevalence of prescription stimulant misuse among students at an academic health sciences center. -/- Method Electronic surveys were e-mailed to 621 medical, pharmacy, and respiratory therapy students at East Tennessee State University for four consecutive weeks in fall 2011. Completing the survey was (...) voluntary and anonymous. Surveys asked about reasons for, frequency of, and side effects of nonprescription misuse of prescription stimulants. Given the sensitive material, an opportunity to win one of ten $50 gift cards was used as an incentive. -/- Results Three hundred seventy-two (59.9%) students completed the survey from three disciplines (47.6% medical, 70.5% pharmacy, and 57.6% respiratory therapy). Overall, 11.3% of responders admitted to misusing prescription stimulants. There was more misuse by respiratory therapy students, although this was not statistically significant (10.9% medicine, 9.7% pharmacy, 26.3% respiratory therapy; P = .087). Reasons for prescription stimulant misuse included to enhance alertness/ energy (65.9%), to improve academic performance (56.7%), to experiment (18.2%), and to use recreationally/get high (4.5%). -/- Conclusions Prescription stimulant misuse was prevalent among participating students, but further research is needed to describe prevalence among future health care workers more generally. The implications and consequences of such misuse require further study across professions with emphasis on investigating issues of academic dishonesty (e.g., “cognitive enhancement”), educational quality, and patient safety or health care quality. (shrink)

Pharmakologisches „cognition enhancement“ zielt auf die Verbesserung der geistigen Leistungsfähigkeit mithilfe von Präparaten, die primär als Medikamente eingesetzt werden. Der Beitrag befasst sich mit der ethischen Bewertung des Gebrauchs von Stimulanzien als „enhancer“ durch Kinder und Jugendliche. Am Beispiel von Diagnose und Behandlung der Aufmerksamkeitsdefizit-Hyperaktivitätsstörung (ADHS) werden die Schwierigkeiten der Abgrenzung von Therapie und Enhancement beschrieben und daraus auf verschiedenen Ebenen ethisch relevante Fragen bezüglich Cognition enhancement entwickelt. Diese betreffen z. B. die Wirkungen von Stimulanzien auf ein (...) sich entwickelndes System und eine mögliche grundlegende Änderung der Erziehungs- und Sozialisationssituation durch pharmakologisches Enhancement, aber auch das Problem der Normierung von Verhalten und der Einschränkung der Autonomie der Betroffenen. Die vorgestellten Überlegungen geben Anlass, Cognition enhancement durch Stimulanzien im Jugendbereich vorläufig kritisch zu beurteilen. (shrink)

Ratnayake's interesting paper challenges two claims, that cognitive distortions in depression involve epistemic issues; and that cognitive behavioral therapy can rectify those epistemic issues. We are going to discuss both claims here and offer some reasons not to underestimate the epistemic relevance of CBT. First, there may be epistemic issues underlying cognitive distortions in depression that CBT can effectively address, including blind acceptance of negative automatic thoughts and insensitivity to evidence. But, even if CBT were primarily (...) in the business of enhancing utility as opposed to validity, this would have significant, though indirect, epistemic benefits.All human agents, whether they have a... (shrink)

Students using Ritalin in preparation for their exams is a hotly debated issue, while meditating or drinking coffee before those same exams is deemed uncontroversial. However, taking Ritalin, meditating and drinking coffee or even education in general, can all be considered forms of cognitive enhancement. Although social acceptance might change in the future, it is interesting to examine the current reasons that are used to distinguish cases deemed problematic or unproblematic. Why are some forms of cognitive (...) class='Hi'>enhancement considered problematic, while others are not? In this paper, we consider cognitive enhancement as the amplification or extension of core capacities of the mind, using augmentation or improvements of our information-processing systems. We will analyse cognitive enhancement in an educational setting in order to clarify the fuzzy distinction between problematic and unproblematic forms of cognitive enhancement. We will show that the apparent distinction made by many people between problematic and unproblematic enhancement is not based on any fundamental difference between these two categories. (shrink)

This paper will philosophically extend Julian Leff’s Avatar therapy paradigm (AT) for voice-like hallucinations that was initially proposed for treatment-resistant Schizophrenia patients into the realm of gesture-enhanced embodied cognition and Virtual Reality (VR), entitled g+TA (gesture-enhanced Avatar Therapy). I propose an philosophy of technology approach of embodied rhetorics of triadic kinetic “actions” in the sense of Charles Sanders Peirce that transforms the voice hallucination incorporated by an avatar- and that can confront acousmatic voice-like hallucinations with a method of (...) gesture synchronization and dyssynchronization and gestural refusal of interaction that the player with the Avatar can resist in full embodiment. This paper therefore introduces a gesture-enhanced, extended version of Cybertherapy with Avatars that tackle multimodal bodily experience of voice-like hallucinations beyond mere visual or auditory stimulation. This is put forward theoretically in a 4E-cognition approach that expands Avatar Therapy with gestures into VR. (shrink)

A lesson from cognitive behavior therapy (CBT) is that it is possible for people to change their beliefs and attitudes in ways that enhance mood. This chapter discusses mainly how the ideas from positive psychology combined with the therapeutic methods developed in CBT might provide ways of helping individuals to enhance their mood and increase happiness. The best single perspective from which to gain an understanding of positive psychology is that of evolutionary psychology, even though it is underdeveloped (...) and contentious. Evolutionary psychology bridges the gap between individual history and the general features of the human condition that helps to explain both our capacity for happiness and some of the barriers to achieving it. The modern general evolutionary view of emotions is that they help animals in regulating their effort: how they behave at any one time and how they apportion their time and energy between different types of behavior. (shrink)

The experience of loss of agency is one of the reasons for clients to go for psychotherapy. Enhancing clients’ agency has been considered a fundamental factor for successful treatment in psychiatry and psychotherapy, yet few studies have investigated the interactional realization of how therapists do this in authentic psychotherapeutic encounters. Drawing on audio-recorded talk-in-interaction between clients and psychotherapists in cognitive behavioral therapy encounters at a mental health center in China, this paper uses the method of conversation analysis to (...) demonstrate how therapists ascribe agency positions to clients by issuing formulations of what the clients have just said. Two types of formulation were identified: affirmative formulations and challenging formulations. In the first type, the therapists highlight the positive aspect of the clients’ description of their experiences and ascribe an agentic position to the clients. In the second, the therapists challenge the clients’ implausible views and their non-agentic positioning of themselves. This study shows that the therapists’ formulation could be employed to manage the epistemic difficulties associated with claiming knowledge about the clients’ inner states and assessing their feelings. In this sense, the formulation is a robust interactional device in negotiating epistemic problems in addressing the clients’ experiences and promoting their agency in therapy. However, it is noteworthy that in the challenging formulation, therapists claim privileged access to the clients’ knowledge domain and challenge their prior epistemic status, which might run the risk of engendering clients’ resistance. (shrink)

Despite the significant contribution of cognitive-behavioral therapy to effective treatment options for specific syndromes, treatment progress has been stagnating, with response rates plateauing over the past several years. This stagnation has led clinical researchers to call for an approach that instead focuses on processes of change and the individual in their particular context. Process-based therapy is a general approach representing a model of models, grounded in evolution science, with an emphasis on idiographic methods, network models of case (...) conceptualization, and enhancing wellbeing. In this paper, we describe the theory underlying PBT and present a case study for how to apply PBT tools and principles to deliver process-informed and person-centered evidence-based treatment. In addition, we discuss lessons learned from our case and provide suggestions for future considerations when implementing PBT in clinical settings. (shrink)

BackgroundEmotional regulation is important for adolescents’ adaptive development. Preventive interventions for anxiety and depression are necessary for reducing the development of disorders later in life, and emotional regulation is a potentially relevant factor.ObjectiveWe investigated the effects of a mindfulness-based psychological education and prevention program [the Mindfulness and Awareness Program ] on the mental health of junior high school students in Japan.MethodsOur MAP primarily focused on mindfulness meditation to improve emotional regulation, thereby reducing depression and anxiety. The MAP comprised eight sessions (...) administered by a school counselor in a school setting. All participants were 12–13-year-old adolescents from nine classes in two Japanese schools. The program was provided to the intervention group, wherein students were educated on emotional expression, emotional cognition, and emotional regulation. The control group received regular school counseling services.ResultsCompared with the control group, the intervention group showed significant improvement in emotional regulation and a decrease in depression and generalized anxiety. The effect was greater at the follow-up assessment than at the immediate post-intervention assessment, and greater in female students.ConclusionOur mental health prevention program exhibited efficacy in reducing depression and anxiety and enhancing emotional regulation in early adolescence. Further, it appeared to be more effective for female adolescents. (shrink)

The ambiguity regarding whether a given intervention is perceived as enhancement or as therapy might contribute to the angst that the public expresses with respect to endorsement of enhancement. We set out to develop empirical data that explored this. We used Amazon Mechanical Turk to recruit participants from Canada and the United States. Each individual was randomly assigned to read one vignette describing the use of a pill to enhance one of 12 cognitive, affective or social (...) domains. The vignettes described a situation in which an individual was using a pill to enhance the relevant domain under one of two possible enhancement conditions, one perceived as enhancing above the norm, what most people recognize as a clear case of enhancement, whereas the other perceived as enhancing towards the norm, with the individual using the enhancement having a modest, but subclinical deficit. Participants were asked how comfortable they were with the individual using the enhancement and about the impact the enhancement might have had in the individuals’ success in life. We found that irrespective of the domain to be enhanced, participants felt significantly more comfortable with ETN than with EAN, and they regarded the enhancement intervention as contributing to greater success in life with ETN rather than EAN. These data demonstrate that the therapy enhancement distinction is morally salient to the public, and that this distinction contributes to the angst that people feel when considering the propriety of CAS enhancement. (shrink)

Sports physicians are continuously confronted with new biotechnological innovations. This applies not only to doping in sports, but to all kinds of so-called enhancement methods. One fundamental problem regarding the sports physician's self-image consists in a blurred distinction between therapeutic treatment and non-therapeutic performance enhancement. After a brief inventory of the sports physician's work environment I reject as insufficient the attempts to resolve the conflict of the sports physician by making it a classificatory problem. Followed by a critical (...) assessment of some ideas from the US President's Council on Bioethics, the formulation of ethical codes and attempts regarding a moral topography, it is argued that the sports physician's conflict cannot be resolved by the distinction between therapy and enhancement. Instead, we also have to consider the possibility that the therapy-based paradigm of medicine cannot do justice to the challenges of the continuously increasing technical manipulability of the human body and even our cognitive functions as well. At the same time we should not adhere to transhumanist ideas, because non-therapeutic interventions require clear criteria. Based on assistive technologies an alternative framework can be sketched that allows for the integration of therapeutic and non-therapeutic purposes. After a thorough definition of standards and criteria, the role of the sports physician might be defined as that of an assistant for enhancement. Yet the process of defining such an alternative framework is a societal and political task that cannot be accomplished by the sports physicians themselves. Until these questions are answered sports physicians continue to find themselves in a structural dilemma that they partially can come to terms with through personal integrity. (shrink)

Since before we can remember, humanity aims to overcome its biological limitations; such a goal has certainly played a key role in the advent of technique. However, despite the benefits that technique may bring, the people who make use of it will inevitably be under risk of harm. Even though human technical wisdom consists in attaining the best result without compromising anybody’s safety, misuses are always a possibility in the horizon. Nowadays, technology can be used for more than just improving (...) human capacities, preserving and restoring health or promoting human well-being. It also enables us to overcome human limitations and reach way beyond our "natural design". That being said, what could possibly justify the fear for these new directions of biotechnology? Should medicine and health care change their traditional goals and begin searching for artificial improvements to wellness in human nature? In this paper, I will hereby present and briefly discuss the main topics of the contemporary issue of human enhancement: the therapy-enhancement distinction, the possibility of cognitive enhancements and better physical performances, the fight against senescence, the arguments for and against human eugenics, the search for perfection, the quest of moral enhancement, the problem of public priorities, and some questions on medical ethics. Then, finally, I will want to present some realist perspectives on the subject. (shrink)

This chapter contains sections titled: What is Human Enhancement? Defining Human Enhancement The Therapy–Enhancement Distinction Human Enhancement Scenarios Untangling the Issues in Human Enhancement Restricting Human Enhancement Technologies?

BackgroundCognitive impairments are a core feature in schizophrenia and are linked to poor social functioning. Numerous studies have shown that cognitive remediation can enhance cognitive and functional abilities in patients with this pathology. The underlying mechanism of these behavioral improvements seems to be related to structural and functional changes in the brain. However, studies on neural correlates of such enhancement remain scarce.ObjectivesWe explored the neural correlates of cognitive enhancement following cognitive remediation interventions in schizophrenia (...) and the differential effect between cognitive training and other therapeutic interventions or patients’ usual care.MethodWe searched MEDLINE, PsycInfo, and ScienceDirect databases for studies on cognitive remediation therapy in schizophrenia that used neuroimaging techniques and a randomized design. Search terms included randomized controlled trial, cognitive remediation, cognitive training, rehabilitation, magnetic resonance imaging, po... (shrink)

In this paper we analyse some ethical and philosophical questions related to the development of memory enhancing drugs (MEDs) and anti-dementia drugs. The world of memory enhancement is coloured by utopian thinking and by the desire for quicker, sharper, and more reliable memories. Dementia is characterized by decline, fragility, vulnerability, a loss of the most important cognitive functions and even a loss of self. While MEDs are being developed for self-improvement, in Alzheimer’s Disease (AD) the self is being (...) lost. Despite this it is precisely those patients with AD and other forms of dementia that provide the subjects for scientific research on memory improvement. Biomedical research in the field of MEDs and anti-dementia drugs appears to provide a strong impetus for rethinking what we mean by ‘memory’, ‘enhancement’, ‘therapy’, and ‘self’. We conclude (1) that the enhancement of memory is still in its infancy, (2) that current MEDs and anti-dementia drugs are at best partially and minimally effective under specific conditions, (3) that ‘memory᾿and ‘enhancement᾿are ambiguous terms, (4) that there is no clear-cut distinction between enhancement and therapy, and (5) that the research into MEDs and anti-dementia drugs encourages a reductionistic view of the human mind and of the self. (shrink)

In this article, a practical look is taken at some of the possible enhancements for humans through the use of implants, particularly into the brain or nervous system. Some cognitive enhancements may not turn out to be practically useful, whereas others may turn out to be mere steps on the way to the construction of superhumans. The emphasis here is the focus on enhancements that take such recipients beyond the human norm rather than any implantations employed merely for (...) class='Hi'>therapy. This is divided into what we know has already been tried and tested and what remains at this time as more speculative. Five examples from the author’s own experimentation are described. Each case is looked at in detail, from the inside, to give a unique personal experience. The premise is that humans are essentially their brains and that bodies serve as interfaces between brains and the environment. The possibility of building an Interplanetary Creature, having an intelligence and possibly a consciousness of its own, is also considered. (shrink)

Cognitive enhancement refers to any technology that raises some aspect of cognition beyond the species-typical level. It is often considered distinct from and less controversial than cognitive therapy, which raises the cognition of a deficient individual to the species-typical level. The debate over CE is a result of the excitement surrounding the potential of neuroscience to one day enable us to enhance our own cognition in significant ways. Some of the aspects of cognition targeted by (...) class='Hi'>enhancement and therapeutic technologies include wakefulness, focus, memory, and executive function, or the ability to plan, organize, and complete tasks. We all regularly use cognitive enhancers without... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 11.2 (2004) 125-128 [Access article in PDF] Comparing Psychoanalytic and Cognitive-Behavioral Perspectives on Control Bruce N. Waller Keywords freedom, locus of control, psychoanalysis, self-efficacy, volition Cognitive behavioral research on locus of control and self-efficacy has produced an extensive body of empirical results that might prove useful to psychoanalytic researchers endeavoring to strengthen the empirical foundation of psychoanalytic therapy. Cognitive-behaviorists and psychoanalysts (...) share a common interest in the importance of perspectives and belief systems and their impact on individual freedom, and comparative research on therapeutic effectiveness could yield benefits for both therapeutic approaches.Locus of control and self-efficacy are central elements in cognitive-behavioral psychology, and they play an important role in cognitive-behavioral therapy. Although the psychoanalytic approach does not explicitly employ those concepts, psychoanalytic therapists are obviously concerned with problems of effective action and internal obstacles to action. Attention to these two perspectives and their overlapping interests offers potential benefits for both the cognitive-behavioral and the psychodynamic approaches to psychological research and therapy.One potential benefit is the development of useful tools for advancing empirically based research on psychoanalysis. As Lehrer (1999) states, it is advantageous to ground psychoanalysis in "firm empirical evidence whenever possible." Although there have obviously been significant positive steps in that direction (Singer 2003; Weiss 1995, 1988; Weiss and Sampson 1986), psychoanalytic researchers have recognized that one source of difficulty is in finding clearly measurable research objectives and hypotheses (Burgin 2002). Cognitive-behavioral research on locus of control and self-efficacy has produced an extensive body of research using clear measurement standards that could prove useful in the empiricist approach to psychodynamic theories. In particular, those cognitive-behavioral research findings might offer a means of extending empirical investigation of psychodynamic theory in a direction usually regarded as difficult to test empirically: the study of psychoanalytic effectiveness to "change your way of seeing" (Lieberman 1999). Shifting locus of control or efficacy expectations in specific domains (Bandura 1997) [End Page 125] would empirically confirm the effectiveness of psychoanalytic techniques. It might well be that some efficacy expectations are enhanced more effectively by psychodynamic processes than by cognitive-behavioral therapy, or that psychoanalysis is effective in enhancing some specific efficacy expectations but not others. This could potentially extend the empirical examination of psychoanalytic theory as well as provide a base of comparison with cognitive-behavioral therapy techniques.Although self-efficacy enhancement might be a fruitful empirical test for psychodynamic therapy, therapeutic intervention to modify locus of control potentially could be even more productive. Current research indicates that one's orientation toward locus of control is a relatively stable characteristic, although it can be modified (Holyrod et al. 1984; Rotter 1979; Sadow and Hopkins 1993). One reason for locus of control stability may be that the locus of control imposes a perspective on the conceptualization of all one's experiences: from a strong internal locus of control perspective I view failures and successes as largely my own doing, whereas from an external locus perspective even my most effective efforts are seen as events that were outside my control: "I guess it was just my time to do well on a math exam," rather than "My hard work for that exam really paid off." (Lieberman makes this phenomenon quite clear in his excellent discussion of transparency.) Although locus of control is not easily modified, it is important to find effective means of helping subjects to achieve such changes, because research shows that a strong internal locus of control is positively correlated with success in work, sports, studies, marriage, and psychological adjustment (Lefcourt 1981, 1992), as well as with better health care behavior and better health (Bandura 1977; Schorr and Rodin 1982; Schulz 1976; Schulz and Hanusa 1978; Wallston 1993). Those deeply enmeshed in an external locus of control enjoy less real freedom and suffer severe disadvantages.How does one effect a shift in such a basic orientation? Not easily. From a psychoanalytic approach, the key will lie in recognizing and reconceptualizing the beliefs that impede effective action. Cognitive-behaviorists are more likely to... (shrink)

The purpose of this scoping review is to investigate the value of creative arts therapies in healthy older adults. This article aims to shed light on current knowledge concerning the effectiveness of art therapies for the prevention of common age-related conditions using the definition of art therapy provided by the American Art Therapy Association, as well as Cohen’s conceptual framework for the psychological conceptualization of the relationship between the arts and health in later life. The objective is to (...) carefully capture subthreshold situations of distress, which are often not taken into account and primarily involve psychological aspects that are crucial in the multidimensional perspective of healthy aging. Twelve articles were selected and examined following an initial electronic search on 3 databases. A thematic analysis of the results identified four major themes: improving cognitive performance and proprioception; enhancing self-identity and meaningful life; reducing feelings of loneliness and depressive symptoms; and the importance of socialization. All these aspects constitute the basis for preventing psychological distress and enhancing mental well-being for healthy aging. (shrink)

Proposals to make us smarter than the greatest geniuses or to add thousands of years to our life spans seem fit only for the spam folder or trash can. And yet this is what contemporary advocates of radical enhancement offer in all seriousness. They present a variety of technologies and therapies that will expand our capacities far beyond what is currently possible for human beings. In _Humanity's End,_ Nicholas Agar argues against radical enhancement, describing its destructive consequences. Agar (...) examines the proposals of four prominent radical enhancers: Ray Kurzweil, who argues that technology will enable our escape from human biology; Aubrey de Grey, who calls for anti-aging therapies that will achieve "longevity escape velocity"; Nick Bostrom, who defends the morality and rationality of enhancement; and James Hughes, who envisions a harmonious democracy of the enhanced and the unenhanced. Agar argues that the outcomes of radical enhancement could be darker than the rosy futures described by these thinkers. The most dramatic means of enhancing our cognitive powers could in fact kill us; the radical extension of our life span could eliminate experiences of great value from our lives; and a situation in which some humans are radically enhanced and others are not could lead to tyranny of posthumans over humans. (shrink)

Proposals to make us smarter than the greatest geniuses or to add thousands of years to our life spans seem fit only for the spam folder or trash can. And yet this is what contemporary advocates of radical enhancement offer in all seriousness. They present a variety of technologies and therapies that will expand our capacities far beyond what is currently possible for human beings. In _Humanity's End,_ Nicholas Agar argues against radical enhancement, describing its destructive consequences. Agar (...) examines the proposals of four prominent radical enhancers: Ray Kurzweil, who argues that technology will enable our escape from human biology; Aubrey de Grey, who calls for anti-aging therapies that will achieve "longevity escape velocity"; Nick Bostrom, who defends the morality and rationality of enhancement; and James Hughes, who envisions a harmonious democracy of the enhanced and the unenhanced. Agar argues that the outcomes of radical enhancement could be darker than the rosy futures described by these thinkers. The most dramatic means of enhancing our cognitive powers could in fact kill us; the radical extension of our life span could eliminate experiences of great value from our lives; and a situation in which some humans are radically enhanced and others are not could lead to tyranny of posthumans over humans. (shrink)

Shoma Morita, M.D. was a Japanese psychiatrist-professor who developed a unique four stage therapy process. He challenged psychoanalysts who sanctioned an unconscious or unconsciousness that resides inside the mind. Significantly, he advanced a phenomenal connection between existentialism, Zen, Nature and the therapeutic role of serendipity. Morita is a forerunner of eco-psychology and he equalised the strength between human-to-human attachment and human-to-Nature bonds. This book chronicles Morita's theory of "peripheral consciousness", his paradoxical method, his design of a natural therapeutic setting, (...) and his progressive-four stage therapy. It explores how this therapy can be beneficial for clients outside of Japan using, for the first time, non-Japanese case studies. The author's personal material about training in Japan and subsequent practice of Morita's ecological and phenomenological therapy in Australia and the United States enhance this book. LeVine's coining of "cruelty-based trauma" generates a rich discussion on the need for therapy inclusive of ecological settings. As a medical anthropologist, clinical psychologist and genocide scholar, LeVine shows how the four progressive stages are essential to the classic method and the key importance of the first "rest" stage in outcomes for clients who have been embossed by trauma. Since cognitive science took hold in the 1970s, complex consciousness theories have lost footing in psychology and medical science. This book reinstates "consciousness" as the dynamic core of Morita therapy. The case material illustrates the use of Morita therapy for clients struggling with the aftermath of trauma and how to live creatively and responsively inside the uncertainty of existence. The never before published archival biographic notes and photos of psychoanalyst Karen Horney, Fritz Perls, Eric Fromm and other renowned scholars who took an interest in Morita in the 1950s and 60s provide a dense historical backdrop. (shrink)

Cognitive reappraisal is one of the core treatment components of cognitive behavioral therapy and is the gold standard treatment for major depressive disorders. Accumulating evidence indicates that cognitive reappraisal could function as a protective factor of cognitive vulnerability to depression. However, the neural mechanism by which CR training reduces cognitive vulnerability to depression is unclear. There is ample evidence that the prefrontal–amygdala circuit is involved in CR. This study proposes a novel cognitive bias (...) model of CR training which hypothesizes that CR training may improve the generation ability of CR with altered prefrontal–amygdala functional activation/connectivity, thus reducing negative cognitive bias and alleviating depressive symptoms. This study aims to explore whether there is abnormal CR strategy generation ability in individuals who are cognitively vulnerable to depression; test the hypothesis that CR training alleviates depressive symptoms through the mediators of cognitive bias ; explore the neural mechanism by which CR training may enhance the ability of CR strategy generation; and examine the short- and long-term effects of CR training on the reduction in depressive symptoms in individuals who are cognitively vulnerable to depression following intervention and 6 months later. The study is promising, providing theoretical and practical evidence for the early intervention of depression-vulnerable individuals. (shrink)

Cognitive enhancement (CE) covers a broad spectrum of methods, including behavioral techniques, nootropic drugs, and neuromodulation interventions. However, research on their use in children has almost exclusively been carried out in high-income countries with limited understanding of how experts working with children view their use in low- and middle- income countries (LMICs). This study examines perceptions on cognitive enhancement, their techniques, neuroethical issues about their use from an LMICs perspective.Seven Indian experts were purposively sampled for their (...) expertise in bioethics, child development and child education. In-depth interviews were conducted using a semi-structured topic guide to examine (1) understanding of CE, (2) which approaches were viewed as cognitive enhancers, (3) attitudes toward different CE techniques and (4) neuroethical issues related to CE use within the Indian context. All interviews were audio recorded and transcribed before thematic analysis.Findings indicate Indian experts view cognitive enhancement as a holistic positive impact on overall functioning and well-being, rather than improvement in specific cognitive abilities. Exogenous agents, and neuromodulation were viewed with skepticism, whereas behavioral approaches were viewed more favorably. Neuroethical concerns included equitable access to CE, limited scientific evidence and over-reliance on technology to address societal problems. This highlights the need for more contextually relevant neuroethics research in LMICs. (shrink)

Cognitive dysfunction in Alzheimer’s disease is caused by disturbances in neuronal circuits of the brain underpinned by synapse loss, neuronal dysfunction and neuronal death. Amyloid beta and tau protein cause these pathological changes and enhance neuroinflammation, which in turn modifies disease progression and severity. Vagal nerve stimulation, via activation of the locus coeruleus, results in the release of catecholamines in the hippocampus and neocortex, which can enhance synaptic plasticity and reduce inflammatory signalling. Vagal nerve stimulation has shown promise to (...) enhance cognitive ability in animal models. Research in rodents has shown that VNS can have positive effects on basal synaptic function and synaptic plasticity, tune inflammatory signalling, and limit the accumulation of amyloid plaques. Research in humans with invasive and non-invasive VNS devices has shown promise for the modulation of cognition. However, the direct stimulation of the vagus nerve afforded with the invasive procedure carries surgical risks. In contrast, non-invasive VNS has the potential to be a broadly available therapy to manage cognitive symptoms in early AD, however, the magnitude and specificity of its effects remains to be elucidated, and the non-inferiority of the effects of non-invasive VNS as compared with invasive VNS still needs to be established. Ongoing clinical trials with healthy individuals and patients with early AD will provide valuable information to clarify the potential benefits of non-invasive VNS in cognition and AD. Whether invasive or non-invasive VNS can produce a significant improvement on memory function and whether its effects can modify the progression of AD will require further investigation. (shrink)

As scientific progress approaches the point where significant human enhancements could become reality, debates arise whether such technologies should be made available. This paper evaluates the widespread concern that human enhancements will inevitably accentuate existing inequality and analyzes whether prohibition is the optimal public policy to avoid this outcome. Beyond these empirical questions, this paper considers whether the inequality objection is a sound argument against the set of enhancements most threatening to equality, i.e., cognitive enhancements. In doing so, I (...) shall argue that cognitive enhancements can be embraced wholeheartedly, for three separate reasons. However, though the inequality objection does not sufficiently support the conclusion that cognitive enhancements should be prohibited, it raises several concerns for optimal policy design that shall be addressed here. (shrink)

Cognitive enhancements in the context of converging technologies. [Annals of the New York Academy of Sciences, Vol. 1093, pp. 201-207] [with Anders Sandberg] [pdf].

The making and taking of psychotropic drugs, whether on medical prescription or as self-medication, whether marketed by pharmaceutical companies or clamoured for by an anxious population, has been an integral part of the twentieth century. In this modern era of speed, uncertainty, pleasure and anguish the boundaries between healing and enhancing the mind by chemical means have been redefined. Long before Prozac would become a household name for an ‘emotional aspirin’ did consumers embrace the idea and practice of taking psychotropics (...) not only to treat mental illness but also to make them feel better about living in a modern world. The Freudian promise that each individual can remake him- or herself in the pursuit of health and happiness was helpful in promoting and legitimizing the idea and practice of seeking wellness on prescription. We will argue that the modern consumer-driven political culture of medicine will continue to transverse the boundaries of therapy and enhancement of the mind into the largely unexplored territories of human cognition and behaviour. However exciting, this endeavour will come at the cost of further widening the problem of iatrogenic addiction in the age of happiness pills as ‘botox’ for the mind. (shrink)

Cognitive enhancement takes many and diverse forms. Various methods of cognitive enhancement have implications for the near future. At the same time, these technologies raise a range of ethical issues. For example, they interact with notions of authenticity, the good life, and the role of medicine in our lives. Present and anticipated methods for cognitive enhancement also create challenges for public policy and regulation.

Cognitive enhancement is an increasingly discussed topic and policy suggestions have been put forward. We present here empirical data of views of parents of children with and without cognitive disabilities. Analysis of the interviews revealed six primary overarching themes: meanings of health and treatment; the role of medicine; harm; the ‘good’ parent; normality and self-perception; and ability. Interestingly none of the parents used the term ethics and only one parent used the term moral twice.

In this chapter, I propose the mechanism of cognitive enhancement based on studies of cognitive-enhancing drugs and behavioral training. I argue that there are mechanistic differences between cognitive-enhancing drugs and behavioral training due to their different enhancing effects. I also suggest possible mechanisms for cognitive-enhancing drugs and behavioral training and for the synergistic effects of their simultaneous application.

There is a growing literature in neuroethics dealing with the problem of cognitive neuroenhancement for healthy adults. However, discussions on this topic have tended to focus on abstract theoretical positions while concrete policy proposals and detailed models are scarce. Furthermore, discussions tend to rely solely on data from the US, while international perspectives are mostly neglected. Therefore, there is a need for a volume that deals with cognitive enhancement comprehensively in three important ways: a) with conceptual implications (...) stemming from different points of view; b) with ethical, social and legal perspectives that would not be limited to one part of the world but reflect on the current situation in countries in Africa, Asia, Australia, Europe, North America and South America; and c) with discussions of concrete law and policy options. Contributors for the conceptual implications section will elaborate an important general issue (e.g. ethical acceptability of direct-to-consumer-marketing in case of cognitive enhancement drugs). Contributors for international perspectives section will provide a clear discussion on normative issues and cultural values, along with an analysis of empirical data on public attitudes on cognitive enhancement and/or prevalence (specific to the country in question). Contributors for law and policy section will offer a justification for the general policy type they argue for (1. prohibition, 2. discourage use, 3. laissez-faire, 4. encourage use, and 5. mandatory use) in the case of specific cognitive enhancement measure. Furthermore, they would evaluate the possible impact of a detailed regulatory model on consumption and demand, fairness in competitive settings and the social pressure to enhance. (shrink)

The prospects of enhancing cognitive or motor functions using neuroscience in otherwise healthy individuals has attracted considerable attention and interest in neuroethics (Farah et al., Nature Reviews Neuroscience 5:421–425, 2004; Glannon Journal of Medical Ethics 32:74–78, 2006). The use of stimulants is one of the areas which has propelled the discussion on the potential for neuroscience to yield cognition-enhancing products. However, we have found in our review of the literature that the paradigms used to discuss the non-medical use of (...) stimulant drugs prescribed for attention deficit/hyperactivity disorder (ADHD) vary considerably. In this brief communication, we identify three common paradigms—prescription drug abuse, cognitive enhancement, and lifestyle use of pharmaceuticals—and briefly highlight how divergences between paradigms create important “ethics blind spots”. (shrink)

Generally, the solutions based on information and communication technologies provide positive outcomes for both companies and employees. However, the process of digital transformation can be the cause of digital transformation stress, when the work demands caused by fast implementation of ICT are elevated and employees’ resources are limited. Based on the Job Demand-Resources Model we claim that DT, rapidly accelerating in the COVID-19 pandemic, can increase the level of DTS and general stress at work. To reduce these negative effects of (...) DTS, we propose the online intervention aimed to strengthen employees’ resources, such as self-efficacy. In this article we evaluate the effectiveness of the blended intervention, based on cognitive behavioral therapy and social cognitive therapy, composed of a prototyped online training and series of interactive online workshops. In a longitudinal study, we examined the change in DTS, perceived stress at work, attitudes toward DT, self-efficacy and burnout in two time points, before and after the intervention. We compared five groups of participants, three groups not qualified, and two groups qualified to intervention. Our results revealed that the designed blended intervention decreased DTS and one of the dimensions of burnout, namely disengagement. More specifically, the results showed that in the group of active participants of the blended intervention DTS significantly decreased [MT1 = 3.23, MT2 = 3.00, t = 1.96, p = 0.051], and in the group of ineligible participants DTS significantly increased [MT1 = 1.76, MT2 = 2.02, t = 4.17, p < 0.001]. This research paves way for the creation of blended online intervention which could help in addressing employee digital transformation stress before it starts having adverse effects on employee performance and well-being. (shrink)

The prospect of cognitive enhancement well beyond current human capacities raises worries that the fundamental equality in moral status of human beings could be undermined. Cognitive enhancement might create beings with moral status higher than persons. Yet, there is an expressibility problem of spelling out what the higher threshold in cognitive capacity would be like. Nicholas Agar has put forward the bold claim that we can show by means of inductive reasoning that indefinite cognitive (...) enhancement will probably mark a difference in moral status. The hope is that induction can determine the plausibility of post‐personhood existence in the absence of an account of what the higher status would be like. In this article, we argue that Agar's argument fails and, more generally, that inductive reasoning has little bearing on assessing the likelihood of post‐personhood in the absence of an account of higher status. We conclude that induction cannot bypass the expressibility problem about post‐persons. (shrink)

There are numerous ways people can improve their cognitive capacities: good nutrition and regular exercise can produce long-term improvements across many cognitive domains, whilst commonplace stimulants such as coffee temporarily boost levels of alertness and concentration. Effects like these have been well-documented in the medical literature and they raise few ethical issues. More recently, however, clinical research has shown that the off-label use of some pharmaceuticals can, under certain conditions, have modest cognition-improving effects. Substances such as methylphenidate and (...) modafinil can improve capacities such as working memory and concentration in some healthy individuals. Unlike their more mundane predecessors, these methods of “cognitive enhancement” are thought to raise a multitude of ethical issues. This paper presents the six principal ethical issues raised in relation to pharmacological cognitive enhancers —issues such as whether: the medical safety-profile of PCEs justifies restricting or permitting their elective or required use; the enhanced mind can be an “authentic” mind; individuals might be coerced into using PCEs;, there is a meaningful distinction to be made between the treatment vs. enhancement effect of the same PCE; unequal access to PCEs would have implications for distributive justice; and PCE use constitutes cheating in competitive contexts. In reviewing the six principal issues, the paper discusses how neuroscientific research might help advance the ethical debate. In particular, the paper presents new arguments about the contribution neuroscience could make to debates about justice, fairness, and cheating, ultimately concluding that neuroscientific research into “personalized enhancement” will be essential if policy is to be truly informed and ethical. We propose an “ethical agenda” for neuroscientific research into PCEs. (shrink)

This paper examines the claims in the debate on cognitive enhancement in neuroethics that society wide pressure to enhance can be expected in the near future. The author uses rational choice modeling to test these claims and proceeds with the analysis of proposed types of solutions. The discourage use, laissez-faire and prohibition types of policy are scrutinized for effectiveness, legitimacy and associated costs. Special attention is given to the moderately liberal discourage use policy (and the gate-keeper and taxation (...) approaches within this framework), as many authors presuppose that this type of policy would best serve public interest. Different more or less articulated models in the taxation approach (Tobacco regulation analogy, Coffee-shop system, Regulatory Authority for Cognitive Enhancements and Economic Disincentives Model) are analyzed from the point of view of justificatory liberalism. The author concludes that prohibition and laissez-faire types of policy would neither be effective nor justified. A moderately liberal public policy shows more promise, but not all approaches within this type of policy would be legitimate and effective. The “gate-keeper” approach and related models could not be justified whereas approach based on taxation with suitable models might be legitimate and effective. (shrink)

In an empirical study, we compared how lay people judge motivation enhancement as opposed to cognitive enhancement. We found alienation is not seen as a danger associated with either form of enhancement. Cognitive enhancement is seen as more morally wrong than motivation enhancement, and users of cognitive enhancement tend to be judged as less deserving of praise and success than users of motivation enhancement. These more negative judgments of cognitive (...) enhancement may be driven by differences in perceived fairness rather than differences in effort exerted by the user, although lay people generally see effort as necessary to deservingness of praise and success. (shrink)

Stimulant drugs, transcranial magnetic stimulation, brain-computer interfaces, and even genetic modifications are all discussed as forms of potential cognitive enhancement. Cognitive enhancement can be conceived as a benefit-seeking strategy used by healthy individuals to enhance cognitive abilities such as learning, memory, attention, or vigilance. This phenomenon is hotly debated in the public, professional, and scientific literature. Many of the statements favoring cognitive enhancement (e.g., related to greater productivity and autonomy) or opposing it (e.g., (...) related to health-risks and social expectations) rely on claims about human welfare and human flourishing. But with real-world evidence from the social and psychological sciences often missing to support (or invalidate) these claims, the debate about cognitive enhancement is stalled. In this paper, we describe a set of crucial debated questions about psychological and social aspects of cognitive enhancement (e.g., intrinsic motivation, well-being) and explain why they are of fundamental importance to address in the cognitive enhancement debate and in future research. We propose studies targeting social and psychological outcomes associated with cognitive enhancers (e.g., stigmatization, burnout, mental well-being, work motivation). We also voice a call for scientific evidence, inclusive of but not limited to biological health outcomes, to thoroughly assess the impact of enhancement. This evidence is needed to engage in empirically informed policymaking, as well as to promote the mental and physical health of users and non-users of enhancement. (shrink)

We investigated the acceptability and frequency of the use of cognitive enhancement (CE) drugs and three different types of academic misconduct (plagiarism, cheating in exams, and falsifying/fabricating data). Data from a web-based survey among German university students were used. Moral acceptability was relatively low for CE drug use and moderate for academic misconduct, while the correlation of their respective acceptability was moderately weak. Prevalence of CE drug use was lower than for academic misconduct and (very) lightly correlated with (...) the prevalence of plagiarism and fabrication/falsification. Acceptability of the investigated behaviors was associated with higher prevalence rates of each behavior. (shrink)

Cognitive enhancement is the use of drugs, biotechnological strategies or other means by healthy individuals aiming at the improvement of cognitive functions such as vigilance, concentration or memory without any medical need. In particular, the use of pharmacological substances has received considerable attention during the last few years. Currently, however, little is known concerning the use of cognitive enhancers, their effects in healthy individuals and the place and function of cognitive enhancement in everyday life. (...) The purpose of the book is to give an overview of the current research on cognitive enhancement and to provide in-depth insights into the interdisciplinary debate on cognitive enhancement. (shrink)

Cognitive enhancement may be defined as the amplification or extension of core capacities of the mind through improvement or augmentation of internal or external information processing systems. Cognition refers to the processes an organism uses to organize information. These include acquiring information (perception), selecting (attention), representing (understanding) and retaining (memory) information, and using it to guide behavior (reasoning and coordination of motor outputs). Interventions to improve cognitive function may be directed at any of these core faculties.

Objectives To understand the ethical principles guiding college students’ abstention from pharmacological cognitive enhancement, and to determine the correlates associated with endorsing different principles. Design One-stage cluster sampling was used to implement a paper-based survey among undergraduate students attending one university in the U.S. Thematic analysis was used to explore the ethical principles guiding PCE abstention. Multivariate logistic regression analyses were used to examine sociodemographic correlates associated with endorsed ethical principles. Participants Of the 499 eligible students who completed (...) the survey, 259 students had a negative attitude towards PCE, did not engage in PCE, and provided reasons for abstention. Results The thematic analysis resulted in the identification of eight themes, with respondents often endorsing more than one theme per response. The three themes most endorsed were non-malfeasance, disapproval of drugs and dosage beneficence. The sociodemographic correlates associated with endorsing each theme varied across themes. Conclusions Students abstain from PCE for a multitude of reasons, many of which are guided by ethical principles. These findings may be incorporated into future prevention programming messages. (shrink)

ObjectivesTo understand the ethical principles guiding college students’ abstention from pharmacological cognitive enhancement, and to determine the correlates associated with endorsing different principles.DesignOne-stage cluster sampling was used to implement a paper-based survey among undergraduate students attending one university in the U.S. Thematic analysis was used to explore the ethical principles guiding PCE abstention. Multivariate logistic regression analyses were used to examine sociodemographic correlates associated with endorsed ethical principles.ParticipantsOf the 499 eligible students who completed the survey, 259 students had (...) a negative attitude towards PCE, did not engage in PCE, and provided reasons for abstention.ResultsThe thematic analysis resulted in the identification of eight themes, with respondents often endorsing more than one theme per response. The three themes most endorsed were non-malfeasance, disapproval of drugs and dosage beneficence. The sociodemographic correlates associated with endorsing each theme varied across themes.ConclusionsStudents abstain from PCE for a multitude of reasons, many of which are guided by ethical principles. These findings may be incorporated into future prevention programming messages. (shrink)

This article explores the respective roles that medical and technological cognitive enhancements, on the one hand, and the moral and epistemic virtues traditionally understood, on the other, can play in enabling us to lead the good life. It will be shown that neither the virtues nor cognitive enhancements (of the kind we have access to today or in the foreseeable future) on their own are likely to enable most people to lead the good life. While the moral and (...) epistemic virtues quite plausibly are both necessary and sufficient for the good life in theory, virtue ethics is often criticised for being elitist and unachievable in practice for the vast majority. Some cognitive enhancements, on the other hand, might be necessary for the good life but are far from sufficient for such an existence. Here it will be proposed that a combination of virtue and some cognitive enhancements is preferable. (shrink)

Cognitive enhancement has an increasingly wider influence on our life. The main issue that concerns epistemologists is what its epistemological implications are. Adam Carter and Duncan Pritchard argue that cognitive enhancement improves cognitive achievement, but this view faces axiological objections. A worry exists that cognitive enhancement undermines achievements and erodes intellectual character. Crucially, two parties seem to talk past each other because the nature of cognitive enhancement and the value of (...) class='Hi'>cognitive enhancement are not clearly distinguished. To end the stand‐off between the two parties, I take insight from Gwen Bradford’s work and argue that, other things being equal, cognitive enhancement either decreases the value of cognitive achievement or undermines cognitive achievement. In the face of this threat, I further submit that we could learn to live with cognitive enhancement in an integrated way so that the lost value can be restored. (shrink)