Psychopathology, Misc

I discuss Watsuji’s characterization of aidagara or “betweenness”. First, I develop a phenomenological reading of aidagara. I argue that the notion can help illuminate aspects of our embodied subjectivity and its interrelation with the world and others. Along the way, I also indicate how the notion can be fruitfully supplemented by different sources of empirical research. Second, I put aidagara to work in the context of psychopathology. I show how disruptions of aidagara in schizophrenia not only affirm the foundational role (...) it plays in organizing our experience of self and world in everyday life. Additionally, I suggest the notion can, in this context of application, potentially enhance our understanding of and empathy for those living with schizophrenic disorders. (shrink)

The use of philosophical phenomenology for conceptual debates in psychiatric nosology and psychopathology is beginning to be recognized. In this paper, we extend this trajectory to include Tourette Syndrome, focusing on so-called premonitory urges (PU) preceding Tourettic tics. We clarify some inconsistencies around typology in both phenomenological description and medical classification (i.e., in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, Text Revision, International Classification of Diseases, 10th edition [World Health Organization, 2004], and the scales that elicit PU). (...) We show how a less typological approach might be usefully deployed in the field, that being the dimensional approach developed by Fernandez (2019a; 2019b). We test both the typological and dimensional approaches in relation to the experience and etiological role of PU in Tourette’s syndrome. Based on our synthesis of existing studies and new information garnered through phenomenological interviews (using an approach associated with “micro-phenomenology”), we argue that the role of PU in nosology challenges both the current “operational” criteria favored by the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, Text Revision, that are focused on behaviorally observed symptoms, as well as essential and prototypical phenomenological descriptions about a given “type” of experience. (shrink)

Aphantasia is a condition characterised by a deficit of mental imagery. Since several psychopathologies are partially maintained by mental imagery, it may be illuminating to consider the condition against the background of psychological disorder. After outlining current findings and hypotheses regarding aphantasia and psychopathology, this paper suggests that some support for defining aphantasia as a lack of voluntary imagery may be found here. The paper then outlines potentially fruitful directions for future research into aphantasia in general and its relation to (...) psychopathology in particular, including rethinking use of the SUIS to measure involuntary imagery, whether aphantasia offers protection against addiction, and whether hyperphantasia is a potential risk factor for maladaptive daydreaming, among others. (shrink)

The case of Félida X and her ‘doubled personality’ served in the last quarter of the 19th century as a proving ground for a distinctively French form of psychology that bore the stamp of physiology, including the comparative term normal state. Debates around Félida’s case provided the occasion for reflection about how that term and its opposites could take their places in the emerging discursive field of psychopathology. This article centres its analysis on Eugène Azam’s 1876–77 study of Félida, and (...) the ways his framing of the case was adopted or critiqued by subsequent researchers. Azam initially deployed the label normal state in a routine manner, in contrast to his use of condition seconde to designate Félida’s other state; this pairing served, I argue, to anchor the scientific legitimacy of Félida’s extraordinary psychological manifestations. Unpacking the conceptual associations of Azam’s use of normal state, we find it marked as qualitatively distinct, temporally fixed, and most of all individualized; this without becoming normative. It was only through responses to and criticism of Azam’s study that there emerged a more generalized sense of normality against which pathological (hysteric) subjects’ comportment could be contrasted. Félida’s case itself constitutes a highly individualized reconfiguration of the concept of a normal state, while the subsequent framing of doubled mental states provides a valuable vantage point from which to consider the articulations between the language of emerging French psychology and its evolving subjects of enquiry. (shrink)

The mutual interest between embodied cognitive sciences, in particular enactivism, and phenomenological psychopathology has significantly increased in the last 15 years. Gipps's article contributes to this field of research by defining ego boundaries in an enactivist framework to explain how the distinction self-other emerges and is maintained in ordinary healthy conditions, and how it is weakened and impaired in cases of schizophrenia. Gipps's first tenet is: The ego-boundary is enacted equiprimordially with experience, that is, it...

Can affordances help in understanding psychiatric illness and psychopathological experience? In recent work on the philosophy of psychiatry and phenomenology, the answer appears to be a clear ‘yes’, but some recent worries have emerged that the affordance-concept might be “insufficiently discerning” and thus ill-suited to make sense of psychiatric illness and experience. In this paper I briefly review recent attempts to use the affordance-concept to make sense of psychopathology, as well as the worries voiced by the critics. I argue that (...) much of this criticism is, in fact, best understood as a call for more research and offer some exploratory considerations on how this research might proceed. Specifically, I argue that an improved understanding of the self-referentiality that is inherent to experiencing affordances can be useful for psychiatry. (shrink)

De Haan has provided a novel and distinctly enactivist solution to the problem of integrating the physiological, experiential, social and existential. We admire her articulation of her fourth "existential" dimension. Not only does it represent a real attempt to bridge, as she says, enactivism's explanatory gap, it is also a potentially useful construct for conceptualizing the way that self-reflexivity seems to go astray in much psychopathology. We think that pinpointing this phenomenon is something that phenomenological accounts excel at. We have, (...) however, two key reservations about her account, which we outline.To begin with, we are unsure that there is any particular scientific research program that derives from... (shrink)

In his commentary, Louis Sass points out some aspects of excentricity that are important to keep in mind when applying the notion to schizophrenia.First, it is true that the failure of the excentric position may not be equated with the naïve egocentricity of Piaget's young child—it is not a "regression" to an earlier developmental stage. On the contrary, paranoid delusion is only possible because the patients had already acquired the excentric position before, for this is what leads them to see (...) themselves "in others' eyes"—namely being observed, spied at, persecuted by them. The problem is rather that their perspective-taking is unbound, forces itself on them, and may not... (shrink)

Today the concept of 'schizophrenia' is often presented in psychiatric texts as a construct, a construct bringing together a diverse and, allegedly, independently assailable range of signs and symptoms. According to such a diagnostic scheme two patients may both be allowed to count as suffering from schizophrenia despite sharing hardly a single symptom. The validity of the concept has accordingly been contested by psychologists for its apparent lack of unity. In the absence of clear independent evidence of a unitary physiological (...) disease process underlying such diverse phenomena, a natural enough suggestion has been to... (shrink)

In "Delusion, Reality, and Intersubjectivity," Thomas Fuchs offers a superb presentation of an enactive/phenomenological approach to schizophrenic delusions—an approach that is clearly superior to the poor-reality-testing formula that has dominated thinking about delusion in psychiatry, psychoanalysis, and cognitive-behavioral theory. As he convincingly argues, two key tendencies go a long way toward accounting for the distinctive features of delusion in schizophrenia: 1) withdrawal from practical, sensori-motoric interaction with the physical environment; and 2) failure to experience reality in intersubjective terms—as a realm (...) of "participatory... (shrink)

The project of therapeutic approaches sensible to the very subjective experience of patients suffering from schizophrenia, especially those treatments most used in current practice, as pharmacological, is and must always be and unambiguously welcomed.Phenomenology is a rich and fertile tradition, born in modern academic philosophy, that along the development of psychopathology in the twentieth century inspired sophisticated theories and new conceptual tools for clinical descriptions and understanding of mental patients and disorders such as schizophrenia...

Arguing for the theoretical importance of the concept of “subject” or “self” on behalf of the “psychiatric/psycho-pathological thinking” is justified in so far as, as Costa, Bezerra Jr., and Gama say, “this is still an indispensable concept for understanding the conditions for the gestation and functioning of psychological life.” In what sense are these concepts “indispensable?”All the hints suggest them as necessary complements for neurobiological investigations to become useful for clinical employment. So, if we consider that it is possible to (...) approach mental phenomena connecting in some way their two sides to favor clinical use, the neurobiological and the psychological, we might as well suppose that any... (shrink)

In most areas of medicine, the physician's primary task is to diagnose the patient's presenting problem by correctly identifying the underlying pathology causing that problem. Diagnoses are established through a process of correlating the information obtained from an interview with the patient about his history of illness and circumstances, with additional evidence of the underlying disease derived from physical examination findings and/or the results of laboratory investigations and diagnostic imaging. In contemporary health care, various movements that call for a shift (...) in clinical care away from underlying disease pathology toward understanding people and their experience of disease are receiving growing... (shrink)

The network approach to psychopathology posits that mental disorders can be conceptualized and studied as causal systems of mutually reinforcing symptoms. This approach, first posited in 2008, has grown substantially over the past decade and is now a full-fledged area of psychiatric research. In this article, we provide an overview and critical analysis of 363 articles produced in the first decade of this research program, with a focus on key theoretical, methodological, and empirical contributions. In addition, we turn our attention (...) to the next decade of the network approach and propose critical avenues for future research in each of these domains. We argue that this program of research will be best served by working toward two overarching aims: (a) the identification of robust empirical phenomena and (b) the development of formal theories that can explain those phenomena. We recommend specific steps forward within this broad framework and argue that these steps are necessary if the network approach is to develop into a progressive program of research capable of producing a cumulative body of knowledge about how specific mental disorders operate as causal systems. (shrink)

Este não é um livro perfeito, mas é único, e se você desnatado o primeiro 400 ou assim páginas, o último 300 (de alguns 700) são uma tentativa muito boa para aplicar o que é conhecido sobre o comportamento de mudanças sociais na violência e maneiras ao longo do tempo. O tema básico é: como o nosso controle genético e limitar a mudança social? Surpreendentemente, ele não descreve a natureza da seleção de parentes (aptidão inclusiva), o que explica grande parte (...) da vida social animal e humana. Ele também (como quase todos) carece de um quadro claro para descrever a estrutura lógica da racionalidade (LSR — termo preferencial de John Searle) que eu prefiro chamar a psicologia descritiva do pensamento de ordem superior (DPHOT). Ele deveria ter dito algo sobre as muitas outras maneiras de abusar e explorar as pessoas e o planeta, uma vez que estes são agora muito mais graves para tornar outras formas de violência quase irrelevante. Estender o conceito de violência para incluir as conseqüências globais a longo prazo da replicação dos genes de alguém, e ter um entendimento da natureza de como a evolução funciona (ou seja, a seleção de parentes) fornecerá uma perspectiva muito diferente sobre a história , eventos atuais, e como as coisas são susceptíveis de ir nas próximas centenas de anos. Pode-se começar por notar que a diminuição da violência física sobre a história tem sido combinada (e tornou possível) pelo estupro constantemente crescente impiedoso do planeta (ou seja, pela destruição das pessoas do seu próprio futuro descendente's). Pinker (como a maioria das pessoas a maior parte do tempo) é muitas vezes distraído pelas superficialidades da cultura, quando é a biologia que importa. Veja meus comentários recentes de Wilson ' a conquista social da terra ' e Nowak e Highfield ' SuperCooperators ' aqui e na net para um breve resumo da vacuidade de "verdadeiro altruísmo" (seleção de grupo), e a operação de seleção de parentes e a inutilidade e superficialidade de descrever o comportamento em termos culturais. Esta é a natureza clássica/nutrir a questão ea natureza supera nutrir-infinitamente. O que realmente importa é a violência feita para a terra pelo aumento implacável da população e destruição de recursos (devido à medicina e tecnologia e supressão de conflitos por policiais e militares). Cerca de 200.000 mais pessoas por dia (outra Las Vegas a cada 10 dias, outro Los Angeles a cada mês), as 6 toneladas ou assim de solo superior indo para o mar/pessoa/ano -cerca de 1% do total do mundo desaparecendo anualmente, etc. significa que, a menos que algum milagre acontece que a biosfera e 2 a civilização vão desmoronar em grande parte durante os próximos dois séculos, e haverá fome, miséria e violência de todo tipo em uma escala escalonamento. As maneiras, as opiniões e as tendências das pessoas para cometer atos violentos não são relevantes a menos que possam fazer algo para evitar essa catástrofe, e eu não vejo como isso vai acontecer. Não há espaço para argumentos, e nenhum ponto ou (Sim, eu sou um fatalista), então eu vou fazer apenas alguns comentários como se fossem fatos. Não imagine que eu tenha uma participação pessoal na promoção de um grupo à custa de outros. Eu sou 78, não têm descendentes e não parentes próximos e não se identificam com qualquer grupo político, nacional ou religioso e consideram os que eu pertenço por padrão como tão repulsivo como todo o resto. Os pais são os piores inimigos da vida na terra e, tomando a visão ampla das coisas, as mulheres são tão violentas quanto os homens, quando se considera o fato de que a violência das mulheres (como a maior parte do que feito pelos homens) é largamente feito em câmera lenta, a uma distância no tempo e no espaço e principalmente realizado por procuração por seus descendentes e por homens. Cada vez mais, as mulheres carregam crianças, independentemente de terem um companheiro e o efeito de parar uma mulher de reprodução é, em média, muito maior do que parar um homem, uma vez que são o gargalo reprodutivo. Pode-se ter a visão de que as pessoas e seus descendentes merecem ricamente qualquer miséria que vem seu caminho e (com raras exceções) os ricos e famosos são os piores infratores. Meryl Streep ou Bill Gates ou J. K Rowling e cada um de seus filhos podem destruir 50 toneladas de solo superior cada por ano para gerações no futuro, enquanto um agricultor indiano e seu pode destruir 1 tonelada. Se alguém nega que é bom, e aos seus descendentes eu digo "bem-vindo ao inferno na terra" (Welcome To Hell On Earth) (WTHOE). A ênfase hoje em dia é sempre sobre direitos humanos, mas é claro que se a civilização é ter uma chance, as responsabilidades humanas devem substituir os direitos humanos. Ninguém recebe direitos sem ser um cidadão responsável e a primeira coisa que isto significa é a destruição ambiental do minimo. A responsabilidade mais básica não é nenhuma criança, a menos que sua sociedade lhe peça para produzi-las. Uma sociedade ou um mundo que permite que as pessoas se reproduzem aleatoriamente serão sempre exploradas por genes egoístas até que ela desmorona (ou atinge um ponto onde a vida é tão horrível que não vale a pena viver). Se a sociedade continua a manter os direitos humanos como primários, a seus descendentes pode-se dizer com confiança "WTHOE". Aqueles que desejam um quadro até à data detalhado para o comportamento humano da opinião moderna dos dois sistemas consultar meu livros Falando Macacos 3ª Ed (2019), A Estrutura Lógica da Filosofia, Psicologia, Mente e Linguagem em Ludwig Wittgenstein e John Searle 2a Ed (2019), Suicídio Pela Democracia,4aEd(2019), Entendendo as Conexões entre Ciência, Filosofia, Psicologia, Religião, Política e Economia Artigos e Análises 2006-2019 (2019), Ilusões Utópicas Suicidas no 21St século 5a Ed (2019), A Estrutura Lógica do Comportamento Humano (2019), e A Estrutura Lógica da Consciência (2019) e outras. (shrink)

The construction of the phenomenological project of psychopathology began in the 1920s. Husserl’s philosophical elaborations, which started to be drawn a few decades earlier, had a broad repercussion on the historical and cultural context of the time and was eventually incorporated into several disciplines, including psychopathology. Particularly in this field, phenomenology had a significant impact, because its epistemological foundations was a close match to the rigorous purposes of a scientific investigation of mental disorders.The phenomenological contribution has established an irrevocable and (...) unique conception of the psychiatric object. The innovation brought... (shrink)

The network approach to psychopathology is becoming increasingly popular. The motivation for this approach is to provide a replacement for the problematic common cause perspective and the associated latent variable model, where symptoms are taken to be mere effects of a common cause (the disorder itself). The idea is that the latent variable model is plausible for medical diseases, but unrealistic for mental disorders, which should rather be conceptualized as networks of directly interacting symptoms. We argue that this rationale for (...) the network approach is misguided. Latent variable (or common cause) models are not inherently problematic, and there is not even a clear boundary where network models end and latent variable (or common cause) models begin. We also argue that focusing on this contrast has led to an unrealistic view of testing and finding support for the network approach, as well as an oversimplified picture of the relationship between medical diseases and mental disorders. As an alternative, we point out more essential contrasts, such as the contrast between dynamic and static modeling approaches, that can provide a better framework for conceptualizing mental disorders. Finally, we discuss several topics and open problems that need to be addressed in order to make the network approach more concrete and to move the field of psychological network research forward. (shrink)

Technical Delusions in Schizophrenia: productivity and Limits of an AnalogyIn the debates on psychosis, the cases of "technical delusions" or "influencing machines" are regularly coming back, both in phenomenological and psychoanalytical psychiatry. As Alfred Kraus points out in the 1990s, "Even if such delusions do not represent the most frequent content in schizophrenia, they receive relatively high consideration for the diagnosis of schizophrenia". And more recently, he notes that, "It is not by chance that people with schizophrenia so often use (...) technical metaphors to explain their schizophrenic experiences", but he then concludes that they are not in fact metaphors, at least... (shrink)

I am grateful to Dien Ho and James Phillips for their comments on my article. Although they approach the topic from different perspectives, they both seem to find my account of the evolution of monoamine theories into neuroplasticity theories to be compelling. They especially seem to find my principal argument to be persuasive: Until quite recently, the use of drugs to generate and test pathophysiological hypotheses—the pharmacological bridge—has been a paramount driving force in psychiatric research.In his thoughtful commentary, Phillips is (...) right to draw attention to the role of "nonbiological" factors, which tend to be overlooked by biological psychiatry, in the etiology of depression. He... (shrink)

There is an apparent epidemic of mental illness. At the end of 2011, untreated mental disorders accounted for 13% of the total global burden of disease, and for 25.3% and 33.5% of all years lived with a disability in low-and middle-income countries, respectively. Depression affects 350 million people globally and is the leading cause of disability. One in five U.S. adults takes psychiatric medication. One study found that by age 32, 50% of people surveyed qualified for an anxiety disorder, more (...) than 40% for a mood disorder, and more than 30% for substance dependence. Another study reported that... (shrink)

My thanks go to Marcia Webb and Warren Kinghorn for their thoughtful and stimulating commentaries, one drawing attention to clinical studies of religion and depression and neuroscientific studies of determinism and free will, and the other making a case for a theological rather than philosophical argument against Christian voluntarism. In combination, the commentaries raise an important question about what a philosophical approach might valuably bring to the topics surrounding this paper, Kinghorn's by raising an explicit challenge to this end and (...) Webb's by pointing to the achievements of empirical studies in this field without the aid of philosophical engagement. Unfortunately, there is not space in this response... (shrink)

Self-knowledge is a difficult thing. Many have had the experience of knowing that a friend or partner is in a bad mood before she herself realizes it. Similarly, with mental illness it seems that a person may be sick without realizing it, or even while denying it outright. Anosognosia, the lack of awareness that one is mentally ill, is most visible in cases of dementia or brain damage, but recent insights in psychology have shown that healthy human beings too generally (...) lack accurate introspective awareness in matters of our own well-being.1 Getting this right—whether or not someone is flourishing2 psychologically—is crucial in psychiatry, and self-report cannot always be relied upon.At the same time, many have been... (shrink)

Insofar as psychiatrists and neurologists tend to the cognitive well-being of others, their work is interwoven with philosophical concerns and theoretical assumptions about the nature of the mind, its myriad functions, and the conditions governing its multiform pathologies. That the mind figures so prominently in their ordinary language attests to the wealth of insights that stands to be gained through a dialogue with philosophy. In one of the earliest efforts to taxonomize psychiatric medicine, Allgemeine Psychopathologie, Jaspers incisively remarks that "the (...) exclusion of philosophy would be disastrous for psychiatry…if any psychopathologist thinks he can disregard philosophy and leave it aside as useless he will... (shrink)

The creation of the latest version of psychiatry's 'bible' has been surrounded by a great deal of controversy. The latest revision, the DSM-5, contains several controversial diagnoses that have been the subject of much debate. One of the central criticisms of DSM-5 is that it pathologizes some behaviors that were previously considered simply problematic, or variations of normal behavior—for example, fidgetiness, noisiness, abundance of energy, shyness, anxiety, and bereavement. Diagnoses such as Binge Eating Disorder, Disruptive Mood Dysregulation Disorder...

Psychopathological delusions have a number of features that are curiously difficult to explain. Delusions are resistant to counterevidence and impervious to counterargument. Delusions are theoretically, affectively, and behaviorally circumscribed: delusional individuals often do not act on their delusions and often do not update beliefs on the basis of their delusions. Delusional individuals are occasionally able to distinguish their delusions from other beliefs, sometimes speaking of their “delusional reality.” To explain these features, I offer a model according to which, contrary to (...) appearances, delusions are not beliefs at all. Delusions are acceptances that are generated by pathologically powerful cognitive feelings. This model has implications for the way that we should think about non-pathological doxastic states and emotions. (shrink)

In “Prozac or Prosaic Diaries?”, Ginger Hoffman and Jennifer Hansen examine gendered messages in popular depression memoirs, using narrative self-constitution theory to emphasize the damaging effects such messages can have on women readers. In doing so, they bring a welcome feminist perspective to matters of mental health, as well as raising thought-provoking questions about depression memoirs, a genre that can have a far-reaching impact on public opinions about mental illness. Overall, Hoffman and Hansen do an excellent job of explaining the (...) philosophical concepts that form a basis for their arguments. This work allows even relative newcomers to philosophy to follow along, co-inspecting the... (shrink)

Over the last years, self-management has become a central value in the practice of mental health care. Patients are positioned as expertclients who are actively involved in the management of their disease. Some of the ideas that are implied in the concept of self-management may raise important and intriguing questions. For instance, in the context of psychiatry impaired agency and altered self-experience are often part of the psychopathological process itself. The capacity to manage oneself may be impeded by the very (...) problem that needs to be managed. Therefore, how should self-management be conceived in... (shrink)

It has been more than 20 years since the U.S. Supreme Court's landmark decision in Daubert v. Merrell Dow Pharmaceuticals, Inc. on the admissibility of scientific expert witness testimony in legal proceedings. It is time, perhaps, to look back at the history of Daubert decisions to determine whether it and its progeny have lived up to their collective promises to keep bad science out of the courtroom, while allowing in good, especially where the mind and brain sciences are concerned.In this (...) essay, I argue that, although the decision in Daubert describes a general test for the admissibility of scientific evidence, it has not been applied consistently to data and conclusions drawn from the behavioral sciences.... (shrink)

We are grateful to René Rosfort for his comment on our target paper Clinical Response to Bodily Symptoms in Psychopathology. Rosfort’s remarks lead us here to specify an important point which our initial proposal may have left too implicit. Within the realm of clinical practice in psychopathology, we argue that bodily manifestations can be offered an expressive space and that they can be listened to in the clinical encounter as being part of the patient’s speech whereby she, by way of (...) her bodily symptoms, addresses a demand to be attended to as a subject of communication. We detail the circumstances under which bodily manifestations may or may not be addressed to a person who is expected to respond, especially in a... (shrink)

There are different ways of responding to the absence of a shared physical causal core among the range of mental disorders currently recognized by the International Statistical Classification of Diseases and Related Health Problems and the Diagnostic and Statistical Manual of Mental Disorders. Obviously enough, some of the listed disorders are not physically explicable in principle, while others are merely likely to be biological in origin. Only a minority of disorders can be explained as the outcomes of impaired biological function, (...) and in some of those cases biological explanations capture their phenomena little more than partially. Psychiatry nevertheless is perceived as and understands itself... (shrink)

Before we respond to Tamara Browne's proposal for an external ethics advisory review panel to oversee content in the Diagnostic and Statistical Manual of Mental Disorders, we wish to introduce ourselves. One of us is a professor of bioethics, a lawyer, and a doctor of public policy, and one of us is a philosopher of psychiatry who studies psychiatric nosology, and who has done bioethics work for two congressional advisory agencies. Based on our backgrounds, we flatter ourselves that we might (...) be considered as members of the DSM ethical review panel Browne proposes. However, we realize that one of us would likely be ineligible because of a lack of experience in psychiatry, and the other would... (shrink)

Do our diagnostic terms refer? If they do not, what implications does this have for our understanding of the practice of validation in psychiatry? These are the questions raised and addressed in the main part of John Campbell’s contribution to this volume, and the ones we will focus on in our reply. While we are sympathetic to Campbell’s contentions that the Diagnostic and Statistical Manual of Mental Disorders (DSM) style of validation needs reassessment, and that causality should play a more (...) prominent role in nosological revisions, we think his picture of reference and validation is misconceived. In this short comment, we first address Campbell’s question about the reference of our diagnostic terms, before briefly sketching an alternative view of validation. (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)

Do psychopaths suffer from impairments that undermine their capacity for moral reasoning and behavior? And, if so, does that mean they are not morally responsible for their actions? The first, empirical question might seem to be rather straightforward, whereas the second, philosophical question might seem more complex and therefore more difficult to answer. In their rich and thought-provoking paper, Jalava and Griffiths target the first question. They forcefully remind us of the fact that answering empirical questions can be just as (...) complex as answering philosophical ones. Do psychopaths suffer from responsibility-relevant moral impairments? Based on the empirical data Jalava and Griffiths discuss in their... (shrink)

For more than 20 years now, the phenomenological approach to schizophrenia has developed a strong and influential hypothesis on the basic alterations of this disorder. Schizophrenia, it is claimed, is a disorder of subjectivity, and more specifically, a disorder of the minimal self. This ‘minimal self’ aims to describe the most basic or core self, which is considered to be foundational for every other kind of self. It is a form of minimal self-awareness that precedes every explicit or reflective self-awareness. (...) Based on this model, a semistructured interview has... (shrink)

Phenomenological psychopathology is a research field that aims to investigate and describe the subjective experience of mental disorders. By suspending the assumptions about etiology and causality as much as possible, and by focusing on the subjective experiences of the patient, it is supposed to offer a profound understanding of the patient’s suffering, and of the disorder in general. Clarity in the description of these experiences is, therefore, a necessity. Traditionally, phenomenological psychopathology was studied mostly by European, and particularly by German (...) and French psychiatrists, such as Karl Jaspers, Wolfgang Blankenburg, and Eugène Minkowski. Today, psychopathologists like Josef Parnas, Giovanni... (shrink)

In this brief commentary, I would like to discuss two reservations I have about the article by Bergner and Bunford. Before doing so let me make some preliminary remarks.Their hypothesis that the concept of disability unites the various mental disorder constructs that have been proposed over the centuries and across cultures is reasonable and accords well with common sense. The concept of disability does a lot of good work in helping us to understand mental disorders.With respect to the authors’ contrast (...) between the disability conception versus the behavioral conception of mental disorder, the notion that counting behaviors alone justifies diagnosing a psychiatric disorder is worth critiquing. Claiming that everyone... (shrink)

To consider power as not only the direct physical oppression of others, but as a production of authority through discursive knowledge and a claimed ‘expertise’ of the world, has been one of Foucault’s great legacies to critical work on mental health and illness. As arbiters of the ‘truth’ on what is and what is not mental pathology, I agree with Swerdfager that the privileged knowledge of the mental health professions and the consequential marginalization of other forms of knowledge on distress (...) can be better theorized through an investigation of the power/knowledge nexus. Practically, scholars and researchers can begin to address these... (shrink)

Dieser Aufsatz will zeigen, dass die Beiträge von Jakob Friedrich Fries (1773–1843) zur Psychiatrie leider (zu Unrecht) vergessen, aber überaus aktuell sind. Seine Überlegungen sowie die der Wissenschaftler, die ihm gefolgt sind, haben in den Darstellungen der Geschichte der Psychiatrie mehr Beachtung verdient.

The thesis that mental states extend beyond the skull, otherwise known as the extended mind thesis, has attracted considerable philosophical attention and support. It has also been accused of lacking practical import. At the same time, the field of psychiatry has remained largely unacquainted with ExM, tending to rely instead upon what ExM proponents would consider to be outdated models of the mind. ExM and psychiatry, therefore, have much to offer one another, but the connection between the two has remained (...) largely unexplored. Here, I consider what implications ExM may have for psychiatry and, in so doing, reveal how psychiatry may lend practical import to ExM. First, I detail the possibility of the extension of one mental state relevant to psychiatry. I augment this example by surveying other possibilities for extension in the context of psychiatric diagnoses. I then consider ways in which such extensions might alter psychiatric diagnosis and treatment. Overall, I argue that recognition of the truth of ExM could alter the diagnostic status of certain individuals by correcting both false positives and false negatives, re-conceptualize certain aspects of treatment, help us re-envision psychiatric research, and potentially increase empathy towards those individuals considered to be mentally disordered or mentally different. (shrink)

Mental disorder is an urgent and growing public health problem.1 Scientific investigation of this problem has the pragmatic goals of identifying the causes of mental disorders and developing strategies to effectively treat them. Philosophers of psychiatry have participated in the inquiry into the empirical examination of mental disorders, predominantly by debating whether psychopathology is a legitimate target of scientific inquiry and, if so, how mental disorders should be explained, predicted, and intervened on. However, as I show in this paper, these (...) philosophical discussions have mostly neglected the actual state of inquiry in psychiatry and relevant disciplines, as well as the first-person experiences... (shrink)

Pattadath and Rose, in their thoughtful responses, create room for textual dialogue by making connections and thinking about madness, lived experience, and research and knowledge production in other contexts. I am grateful for this engagement, and the opportunity to clarify my own thoughts, as well as generate new ones.Rose makes crucial points about the relative silence in many critical fields outside of Disability and Mad Studies and their “probably unknowing refusal to see madness as political”. This is often the case, (...) and can be extended to disability and chronic illness more broadly. At times, critical scholars in other fields show how the psy-disciplines are tools used to... (shrink)

Psychopathic individuals display a callous-coldhearted approach to interpersonal and affective situations and engage in impulsive and antisocial behaviors. Despite early conceptualizations suggesting that psychopathy is related to enhanced cognitive functioning, research examining executive functioning (EF) in psychopathy has yielded few such findings. It is possible that some psychopathic trait dimensions are more related to EF than others. Research using a 2-factor or 4-facet model of psychopathy highlights some dimension-specific differences in EF, but this research is limited in scope. Another complicating (...) factor in teasing apart the EF–psychopathy relationship is the tendency to use different psychopathy assessments for incarcerated versus community samples. In this study, an EF battery and multiple measures of psychopathic dimensions were administered to a sample of male prisoners (N. (shrink)

I am grateful for the insightful comments that have been furnished by Drs. Gala, Moseley, and Perring following their reading of my paper. Happily, I find myself in the position of being able to accept many of their criticisms, which identify many of the limitations of my argument as I see them. In only a few cases do I feel that their remarks are misplaced.The first concern raised by Moseley and Gala is that the paper gives the regrettable impression that (...) persons with anorexia nervosa generally have few cognitive deficits and primarily experience problems in valuing. But as is widely known, this is false: many persons with AN reason poorly and suffer perceptual distortions. I did not. (shrink)

This chapter considers two systems that are fundamental to human behavior: learning and the allocation of attention. We review the evidence to suggest that there may be deficits in these systems in a subset of children with antisocial behavior problems-those with high levels of callous-unemotional traits-and explore how altered function of these systems might contribute to the development of immoral behavior.

Psychopathy is a personality disorder characterized by callous antisocial behavior and criminal recidivism. Here we examine whether psychopathy is associated with alterations in functional connectivity in three large-scale cortical networks. Using fMRI in 142 adult male prison inmates, we computed resting-state functional connectivity using seeds from the default mode network, frontoparietal network, and cingulo-opercular network. To determine the specificity of our findings to these cortical networks, we also calculated functional connectivity using seeds from two comparison primary sensory networks: visual and (...) auditory networks. Regression analyses related network connectivity to overall psychopathy scores and to subscores for the “factors” and “facets” of psychopathy: Factor 1, interpersonal/affective traits; Factor 2, lifestyle/antisocial traits; Facet 1, interpersonal; Facet 2, affective; Facet 3, lifestyle; Facet 4, antisocial. Overall psychopathy severity was associated with reduced functional connectivity between lateral parietal cortex and dorsal anterior cingulate cortex. The two factor scores exhibited contrasting relationships with functional connectivity: Factor 1 scores were associated with reduced functional connectivity in the three cortical networks, whereas Factor 2 scores were associated with heightened connectivity in the same networks. This dissociation was evident particularly in the functional connectivity between anterior insula and dorsal anterior cingulate cortex. The facet scores also demonstrated distinct patterns of connectivity. We found no associations between psychopathy scores and functional connectivity within visual or auditory networks. These findings provide novel evidence on the neural correlates of psychopathy and suggest that connectivity between cortical association hubs, such as the dorsal anterior cingulate cortex, may be a neurobiological marker of the disorder. (shrink)