BackgroundMultiple sclerosis, the most common neurological disease that causes disability in youth, does not only affect physical functions but is also associated with cognitive impairment, fatigue, depression, and anxiety and can significantly impact health-related quality of life. Since MS is generally diagnosed at a young age—a period of great significance for personal, relational, and professional development—adaptation can become highly challenging. Therefore, enhancing the competence of young people to adaptively cope with these potential challenges is of utmost importance in order to (...) promote their potentialities and talents. It has been shown that psychological interventions targeting MS patients can enhance resilience and HRQoL and that regular physical activity and social engagement can improve psychological well-being. However, literature on the development of global interventions based on the bio-psycho-social model of the disease is missing. Even less attention has been paid to interventions dedicated to young adults with MS and to the involvement of patients in the development of such programs.AimsIn collaboration with MS patients, this study aims to develop a bio-psycho-social intervention for YawMS, aiming to improve their HRQoL and to explore its feasibility, acceptability, and effects.MethodsTo tailor the intervention to the specific needs of YawMS, “patient engagement principles” will be adopted in the co-creation phase, performing a web survey and focus groups with patients and healthcare professionals. In the intervention phase, a pilot sample of 60 young adults with MS will be enrolled. The co-created intervention, composed of group sessions over a 12-week period, will cover psycho-social strategies and include physical activities. Adopting a longitudinal, pre–post evaluation design, self-report questionnaires measuring HRQoL and other bio-psycho-social features will be administered, the quantity and quality of PA will be measured, and a questionnaire developed by the authors will be used to evaluate the feasibility and acceptability of the ESPRIMO intervention. (shrink)

The different approaches of the mind-body problem a fortiori have implications on the foundations of Psychology, Psychopathology and Psychiatry, leading to many clashing theories about the determinants of "normal" human behavior, as well of the mental illnesses. These schools of research on the human mind may on a first approach be divided in two main branches: 1) the neurogenetic ones; 2) the psychogenetic ones. This paper sprang up from a lifelong pondering on its subject by its author, while working as (...) a Clinical Psychiatrist and conducting a Ph D in Philosophy. (shrink)

ABSTRACT:Psychedelics have again become a subject of widespread interest, owing to the reinvigoration of research into their traditional uses, possible medical applications, and social implications. As evidence for psychedelics' clinical potential mounts, the field has increasingly focused on searching for mechanisms to explain the effects of psychedelics and therapeutic efficacy of psychedelic-assisted therapy (PAT). This paper reviews three general frameworks that encompass several prominent models for understanding psychedelics' effects—specifically, neurobiological, psychological, and spiritual frameworks. Following our review, the implications of (...) each framework for ethics and professional competencies in the implementation of psychedelics as medicines are explored. We suggest that interdisciplinary education may be necessary to improve communication between researchers, develop models that effectively incorporate multiple levels of analysis, and facilitate collaboration between professionals with diverse backgrounds in the implementation of psychedelic medicines. We also address pitfalls associated with overemphasis on neuro-mechanisms, risks associated with instigating vulnerable states of consciousness, and hurdles associated with the integration of spiritual frameworks in medicine. Ultimately, as psychedelics push the boundaries of explanatory frameworks focused on one level of analysis, developing new and more useful models to reflect knowledge being produced in this field should be a central aim of psychedelic science going forward. (shrink)

Like elsewhere in Nigeria and Africa, the imposition of colonial rule on Batombuland and the incursion of western ideas produced profound socio-cultural, economic and political changes in the Batombu society. However, unlike several Nigerian and African peoples whose histories have received extensive scholarly attention, the history of the Batombu has attracted very little scholarly attention. Thus virtually neglected, the Batombu occupies a mere footnote position in the extant historiography of Nigeria. This is the gap this article seeks to fill. It (...) examines the impact of colonialism and western civilisation on Batombu’s political, social, economic and cultural institutions and concludes that as profound and far-reaching as these changes were some important aspects of the indigenous institutions and traditional practices of the people survived. (shrink)

Carolina Maria de Jesus, a partir de seu "Quarto de Despejo", inspira o diálogo transdisciplinar entre a psicanálise, o direito e a literatura, nos artigos reunidos neste livro. Como a obra de Carolina e o diálogo acadêmico inspirado por ela pode nos auxiliar a pensar sobre e a lutar contra o racismo? Fazendo circular e acreditando na força que a palavra tem de desconstruir as ficções psíquicas e políticas que organizam nosso pacto social. Essa é a aposta que anima (...) a pesquisa cujos primeiros resultados estão neste livro. Partimos da hipótese de que o racismo é uma construção histórico-libidinal e que pode ser desfeita. Dentre os códigos fascistas que organizam o desejo, o racismo se destaca (dentre o machismo, a homofobia, por exemplo) por tentar situar a alteridade num determinado grupo de pessoas de forma a controlá-la, subjugá-la. Esse desejo de distinção provém, em grande medida, da angústia produzida pela presença da alteridade dentro do próprio sujeito. Há algo em um livro como o de Carolina que é preciso ser destacado: trata-se de uma resposta singular a um pacto social perverso, organizado pelo racismo. É preciso pensar nos efeitos afetivos que tal resposta, endereçada como um "diário de uma favelada", produz em cada um(a) de seus (suas) leitores(as). (shrink)

This paper considers proposals for developing ‘co-productive’ medical partnerships, within the UK National Health Service (NHS), concentrating in particular on the potential problem involved in combining professional and lay conceptions of health. Much of the literature that advocates the introduction of co-productive healthcare partnerships assumes that medical professionals and patients share, or can easily come to share, a common set of beliefs about what is valuable with regard to health interventions and outcomes. However, a substantial literature documents the contestability of (...) the concept of health, particular across professional and lay divides. We suggest that this potential disagreement ought to be taken seriously, and suggest that the prospect of a co-productive NHS in which patients and professionals act in partnership is threatened by the existence of unresolved epistemic differences. We suggest that part of the solution may lie in re-framing this potential disagreement in the terms provided by Engel’s bio-psycho-social account of health, and demonstrate how support for this account can be grounded upon a critical realist foundation. What we call a ‘stratified conception of health’ reveals the potential complementarity between health beliefs which may have at first seemed to be essentially contradictory. We consider some of the practical implications this idea has for conceiving and creating co-productive medical partnerships. (shrink)

Theoretically, this essay is a psycho-social reflection on the patrimonial character of Philippine political democracy. Many scholars attest that Philippine politics is marred by oligarchic rule composed of elite families, knitted by blood and marriage, who use state resources to perpetuate themselves into public office. These officials control and exploit the economic and political landscape to rule and govern the lives of the Filipino people. Hence, I argue that the patrimonial culture is a social pathology and has (...) imbibed other names such as patron-client democracy, cacique democracy, predatory oligarchic state, and bossism. This type of social malady highlights the coercive forms of control in the Philippine political arena and, thus, expanding oligarchic power relations over and above the interest of the people. Money and power are the main causes why this social malady persists. However, more than that, I want to add that the persistence of patrimonial culture in the Philippines lies probably in what Freud calls the introjected father image, which unconsciously becomes the standard of authority. Further, I contend that, like the Oedipus rivalry, fear is a primordial element in the introjection of this authority figure which began at the nascent of the Spanish rule. Particularly, the abuses and atrocities of the colonizers over the natives created a deep-seated traumatic experience that would later fortify the immanence of a patrimonial power structure in the Philippines. Hence, a psycho-social approach could perhaps unearth these 'events' that perpetuate a patrimonial culture in our country. I believe that excavating our collective experiences could probably help us in our search for leaders who could usher us towards real liberation. (shrink)

Individuals with Acquired Brain Injury (ABI) suffer chronic impairment across cognitive, physical and psycho-social domains, and the experience of anxiety, isolation and apathy has been amplified by the COVID-19 pandemic. A qualitative evaluation was conducted of 14 individuals with ABI who had participated in series of COVID adapted group-based intervention(s) that had been designed to improve wellbeing. Eight themes were identified: Facilitating Safety, Fostering Positive Emotion, Managing and Accepting Difficult Emotions, Promoting Meaning, Finding Purpose and Accomplishment, Facilitating (...) class='Hi'>Social Ties, (Re)Connecting to Nature, and Barriers to Efficacy. Findings are discussed with respects to recent theoretical developments in positive psychology and wellbeing science and support the use of online and outdoor interventions to enhance wellbeing in individuals living with ABI during the COVID-19 pandemic. This paper makes a unique contribution to second wave positive psychology (PP2.0) through the application of recent advances in wellbeing science to an ABI population during the COVID-19 pandemic. In doing so, this paper lays the foundation for new interventions that not only reduce impairment and distress, but also create opportunities for meaning and enhanced wellbeing in people living with chronic conditions and those individuals living with ABI in particular. (shrink)

Assessing the risk-benefit ratio has always been considered key in designing clinical trials. These benefits can be diverse and may include social value and psychological benefits. When it comes to...

This study addresses the social aspect of the duty of pilgrimage through the documentation method based on sociological perspective. The aim of this paper is to determine the social gains of people through the pilgrimage. Religion is an phenomenon that people need in every aspect of their daily life. Because religion is one of the phenomenon that deeply affect the individual and society. The pilgrimage, which is one of the sociological expressions of religion, and maintains its existence in (...) the form of creed, worship and religious community, is instrumental in strengthening and consolidating the faith and feeling the feelings of brotherhood. For instance; spiritual fundamentals of integration are based on Quran by means of worships such as salaat, fasting and alms with the pilgrimage as well as the messages serving as guidance for socio-cultural integration. In accordance with this, worships, with its psychological effects, lead people to attain social aspects such as brotherhood, solidarity, protecting each other, enduring and overcoming distresses together, accomplishing societal sharing by meeting on the common ground of benefaction in the establishment and subsistence of the Islamic community. The pilgrimage, on that sense, is required to have its principal qualification once more in where the historical, social, political and economic issues of the Islamic world are discussed and solutions addressing such issues are delivered accordingly. Therefore, the pilgrimage is not expected to only affects the individuals, families, groups but also regulates the national and transnational lives of societies. (shrink)

An argument that moral functioning is immeasurably complex, mediated by biology but not determined by it. Throughout history, humanity has been seen as being in need of improvement, most pressingly in need of moral improvement. Today, in what has been called the beginnings of “the golden age of neuroscience,” laboratory findings claim to offer insights into how the brain “does” morality, even suggesting that it is possible to make people more moral by manipulating their biology. Can “moral bioenhancement”—using technological or (...) pharmaceutical means to boost the morally desirable and remove the morally problematic—bring about a morally improved humanity? In The Myth of the Moral Brain, Harris Wiseman argues that moral functioning is immeasurably complex, mediated by biology but not determined by it. Morality cannot be engineered; there is no such thing as a “moral brain.” Wiseman takes a distinctively interdisciplinary approach, drawing on insights from philosophy, biology, theology, and clinical psychology. He considers philosophical rationales for moral enhancement, and the practical realities they come up against; recent empirical work, including studies of the cognitive and behavioral effects of oxytocin, serotonin, and dopamine; and traditional moral education, in particular the influence of religious thought, belief, and practice. Arguing that morality involves many interacting elements, Wiseman proposes an integrated bio-psycho-social approach to the consideration of moral enhancement. Such an approach would show that, by virtue of their sheer numbers, social and environmental factors are more important in shaping moral functioning than the neurobiological factors with which they are interwoven. (shrink)

AIDS provides society an opportunity to expand and rationliza control over a broad range of psychological phenomena. Social control today is panoptical, involving dispersed centers and agents of surveillance and discipline throughout the whole community . The control of persons perceived as "dangerous" is effected partly through public psycho-social discourse on AIDS. This reproduces earlier encounters with frightening diseases, most notably the nineteenth-century cholera epidemic, and reveals a morally-laden ideology behind modern efforts at public hygiene.

The positive psychology landscape is changing, and its initial identity is being challenged. Moving beyond the “third wave of PP,” two roads for future research and practice in well-being studies are discerned: The first is the state of the art PP trajectory that will continue as a scientific discipline in/next to psychology. The second trajectory links to pointers described as part of the so-called third wave of PP, which will be argued as actually being the beginning of a new domain (...) of inter- or transdisciplinary well-being studies in its own right. It has a broader scope than the state of the art in PP, but is more delineated than in planetary well-being studies. It is in particular suitable to understand the complex nature of bio-psycho-social-ecological well-being, and to promote health and wellness in times of enormous challenges and changes. A unique cohering focus for this post-disciplinary well-being research domain is proposed. In both trajectories, future research will have to increase cognizance of metatheoretical assumptions, develop more encompassing theories to bridge the conceptual fragmentation in the field, and implement methodological reforms, while keeping context and the interwovenness of the various levels of the scientific text in mind. Opportunities are indicated to contribute to the discourse on the identity and development of scientific knowledge in mainstream positive psychology and the evolving post-disciplinary domain of well-being studies. (shrink)

Psychedelic-assisted Psychotherapy combines the use of psychedelic compounds, such as psilocybin, with psychotherapy. PAP has shown some promise as a novel treatment for Major Depressive Disorder, and empirical research suggests that its efficacy turns on the altered states induced by psychedelic compounds. In this paper we draw on the literature of phenomenology to explain the therapeutic potential of psychedelic experiences. Svenaeus characterises mental illness as a form of suffering that entails three distinct but related experiences of alienation or “unhomelike being-in-the-world”: (...) illness suffering, which relates to embodiment; existential suffering, which relates to self-narratives, and political suffering, which relates to social relationships. Ratcliffe further characterises the experience of MDD in phenomenological terms as a loss of pre-intentional possibility that manifests as excessive noematic feeling in the experience of embodiment, restrictive narratives in the construction of self, and disconnectedness in experience of the social world. We contend that PAP ameliorates the suffering associated with MDD by inducing and consolidating a state of broadened pre-intentional possibility—one that entails sudden, profound and enduring changes in embodiment, self-narratives, and social experience. We argue further that this phenomenological account is consistent with a bio-psycho-social model of mental health and illness, and we frame it as an argument supporting the plausibility of recent claims about treatment success. This helps to justify ongoing future empirical research in this setting. (shrink)

Chronic pain patients often miss receiving acknowledgement for the multidimensional struggles they face with their specific conditions. People suffering from chronic pain experience a type ofinvisibilitythat is also borne by other chronically ill people and their respective medical conditions. However, chronic pain patients face both passive and active exclusion from social participation in activities like family interactions or workplace inclusion. Although such aspects are discussed in the debates lead by the bio-psycho-social model of pain, there seems to (...) be a lack of a distinct interest in assessing more specifically the social aspects regarding chronic pain. As a result, the social aspects have yet to be taken into a more thorough theoretical consideration of chronic pain and to be practically implemented to help affected patients. By addressing chronic pain patients’ struggle for recognition, this paper attempts to shed light on some of these social aspects. We base this attempt on a theoretical framework that combines patients’ statements with an adaptation of Axel Honneth’s social-philosophical work onrecognition. Thus, this paper tries to make a suggestion on how the bio-psycho-social model of pain can live up to its name by helping to address more adequately some of the more neglected aspects in chronic pain patients’ suffering than has been possible to date. (shrink)

Precision medicine and molecular systems medicine (MSM) are highly utilized and successful approaches to improve understanding, diagnosis, and treatment of many diseases from bench-to-bedside. Especially in the COVID-19 pandemic, molecular techniques and biotechnological innovation have proven to be of utmost importance for rapid developments in disease diagnostics and treatment, including DNA and RNA sequencing technology, treatment with drugs and natural products and vaccine development. The COVID-19 crisis, however, has also demonstrated the need for systemic thinking and transdisciplinarity and the limits (...) of MSM: the neglect of the bio-psycho-social systemic nature of humans and their context as the object of individual therapeutic and population-oriented interventions. COVID-19 illustrates how a medical problem requires a transdisciplinary approach in epidemiology, pathology, internal medicine, public health, environmental medicine, and socio-economic modeling. Regarding the need for conceptual integration of these different kinds of knowledge we suggest the application of general system theory (GST). This approach endorses an organism-centered view on health and disease, which according to Ludwig von Bertalanffy who was the founder of GST, we call Organismal Systems Medicine (OSM). We argue that systems science offers wider applications in the field of pathology and can contribute to an integrative systems medicine by (i) integration of evidence across functional and structural differentially scaled subsystems, (ii) conceptualization of complex multilevel systems, and (iii) suggesting mechanisms and non-linear relationships underlying the observed phenomena. We underline these points with a proposal on multi-level systems pathology including neurophysiology, endocrinology, immune system, genetics, and general metabolism. An integration of these areas is necessary to understand excess mortality rates and polypharmacological treatments. In the pandemic era this multi-level systems pathology is most important to assess potential vaccines, their effectiveness, short-, and long-time adverse effects. We further argue that these conceptual frameworks are not only valid in the COVID-19 era but also important to be integrated in a medicinal curriculum. (shrink)

Small but significant gender differences in emotion expressions have been reported for adults, with women showing greater emotional expressivity, especially for positive emotions and internalizing negative emotions such as sadness. But when, developmentally, do these gender differences emerge? And what developmental and contextual factors influence their emergence? This article describes a developmental bio-psycho-social model of gender differences in emotion expression in childhood. Prior empirical research supporting the model, at least with mostly White middle-class U.S. samples of youth, is (...) presented. Limitations to the extant literature and future directions for research on gender and child emotion are suggested. (shrink)

The principles of classical and quantum holography are used to develop the theoretical basis for a non-phonemic method of detecting membership in secret social groups, such as cults, criminal gangs, drug cartels, and terrorist cells. Grounded in the basic sociological premise that every group develops a distinctive sociocultural order, the theory postulates that the primary features of a group's collective identity will be encoded, via a multilevel socio-psycho-physiological process, into the field of bio-emotional relations connecting group members. The (...) principles of classical holography (Gabor 1948) are used to describe how this information is recorded in the members' brains and communicated in interaction by a holographic-like process as a tacit signature of group affiliation —a constancy in group-related interactions. It is hypothesized that the identity signature is enfolded as a hologram in the energy spectra of vocal interactions among group members. The principles of quantum holography (Gabor 1946) are used to provide a description of the group's ongoing interactions as a dynamic process—a continuous, quantized series of snapshots (quantum holograms). Linked together, two forms of holography provide a model of how the group's collective identity evolves and is communicated over time to its members, as the group adapts to the ever-changing reality of its endogenous and exogenous circumstances. Using spectral analysis techniques, it should be possible to detect the group's identity signature in the recordings of relatively small samples of vocal interactions. In clandestine groups, the effort to remain hidden actually enhances the signal strength of the identity signature. It is predicted, therefore, that detection of unknown members can be achieved by using the spectral commonality identified in the analysis of recordings of vocal interactions among known members as a reference signature for comparison with those of the vocal spectra of suspected or potential members. (shrink)

The study examines how truth-tellers and truth-telling can be cultivated in the context of post-truth politics in the U.S. Following Foucault, it is not concerned with examining the problem of truth, with the philosophical question of how truth is determined, but with the problem of truth-tellers or truth-telling as a practical activity of self-improvement. To this end, the study traces the emergence and nature of post-truth politics in the U.S. and analyzes its relation to patterns of fascist propaganda and the (...) psychological appeal of authoritarian leaders through a psycho-social perspective. To counter the nature and ubiquity of post-truth politics, the unrelenting flow of lies, disinformation, and conspiracy theories disseminated by the far-right news and information ecosystem, the author argues that educators can help students recognize truth-tellers and become truth-tellers themselves by employing certain pedagogical strategies, informed by Foucault’s analysis of parrhesia, that can equip them to criticize and resist post-truth propaganda and demagogues. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Hildegard and HolismSuzanne M. Phillips (bio) and Monique D. Boivin (bio)Keywordsbiopsychosocial, integration, medieval, mental illnessWe appreciate the careful and enriching commentary offered by Kroll and by Radden on our paper about holistic views of mental illness in the writings of the twelfth-century abbess and healer Hildegard of Bingen. Both reviewers are well-established figures in the study of historical perspectives on mental illness, an area that we have just begun (...) to explore. We are glad for the opportunity to respond to their observations and thereby to continue the dialogue.First, we would like to clarify our purpose in preparing this paper. Nowhere do we claim that Hildegard used a biopsychosocial model of mental illness, either in addressing the needs of the particular case of Sigewiza, or more generally in her writings on illness and health. In fact, we agree with Kroll (2007, 370), when he states that Hildegard did not use a biopsychosocial model. We use the term “biopsychosocial” only three times in the paper, always by contrast with what we see in Hildegard’s writings. The present-day biopsychosocial model focuses on getting a range of perspectives on the table, encouraging the consideration of biological, psychological, and social issues when thinking about mental illness. This is a good thing, but we argue that it does not go far enough. Specifically, there has been insufficient attention to ways these perspectives might interact.How, then, might we describe Hildegard’s way of conceptualizing mental illness? In place of the label “biopsychosocial model,” Kroll suggests that Hildegard’s approach could be described as a “religious model” (p. 372). Here we disagree. By our reading, Hildegard’s description of mental illness involves religious components, certainly, but also humoral, astrological, interpersonal, community, and intrapsychic components. Radden correctly notes that we are not so much interested in the particular components as we are in their interactions. We are attracted to Hildegard’s writings because she attends to these interactions. Our students, like Kroll’s (p. 371), are curious about mind–body relationships, which represent one example of the interplay between components. Our concern is that the current biopsychosocial model often fails to satisfy our own, and our students’, interest in the nature of those interactions. Our hope is that Hildegard’s writings might help us to think more richly about the interactions.As Radden (2007, 373) points out, present-day psychiatrists and psychologists do in fact use mul-ticausal accounts of depression. And we agree that such accounts need not be reductionistic (Kroll, 371). But we also recognize that psychology and psychiatry have well-established reductionist (more specifically, materialist) habits. To borrow [End Page 377] Kroll’s phrase, the biological model threatens “to swallow all other models” (p. 371). We must guard against such reductionism, given the habits of our disciplines. As we noted, McHugh and Slavney (1998) respond to that threat by building walls between the perspectives, suggesting that we might use different perspectives when thinking about different sorts of problems. We think that there ought to be more synthetic, holistic ways of responding to that threat, and we are hopeful that Hildegard’s writings can help us to develop those.At a basic level, we see Hildegard asking different questions than people ask today. On the first page of his commentary, for example, Kroll poses the question of “which of these three modalities [bio-, psycho-, social] may be sufficient” (p. 369) in the particular medieval text. We found that the sufficiency of one modality or another does not concern Hildegard. We are not able to speak to the general point that Kroll raises, that one or another element is emphasized depending on the goal of the medieval text; we can report our experience in reading Hildegard, where we found no sense in which one or another component is privileged. Even though Hildegard operated within a thoroughly religious context, we did not find examples of her subsuming other factors under religion. Everything interacts with spiritual concerns, to be sure, but everything also interacts with the biological, and with the interpersonal, and with the astrological. Although it may seem odd to us post-Darwinian thinkers, Hildegard’s model is essentially... (shrink)

As a science and practice of intervention and control, medicine is concerned with cure and care, the promotion and protection of health, and the prevention of maladies and human suffering. This wide-ranging task is accomplished through medical practice and medical research, though no sharp boundary between them can be drawn. A widespread misconception about medicine has it that medicine is concerned with illness and disease. However, the subject of medicine is the patient, i.e., Homo patiens, but not illness or disease, (...) with the ends being directed toward the relief, prevention of human suffering, and saving human life. Accordingly, medicine needs a theory of the patient first of all. Nosology and pathology as studies of illness and disease may be viewed as elements of such a theory of the Homo patiens. Seen from this perspective, clinical research and practice are to be based on the question: What is a patient? That is, what characteristics distinguish a patient from a non-patient? The present chapter is concerned with this question. The inquiry into what a patient, i.e., Homo patiens, is, intersects with anthropology that is concerned with the question of what is a human being? This is the fundamental philosophical question of medicine because, as an experimental and diagnostic-therapeutic discipline, it undertakes momentous interventions in human life. It therefore needs an image of the human being so as to ascertain whether medical interventions are in accord with, or contravene, that image. For example, it is a legitimate question to ask whether the transplantation of animal cells, tissues, and organs into humans, i.e., xenotransplantation, or whether the designing of offspring by genetic engineering, is morally permissible. Since anthropology is basically a philosophical endeavor, medicine at its foundations turns out to intersect with philosophy. We shall consider the patient as a bio-psycho-social agent who is suffering or whose life is threatened by some occurrences inside or outside of her body, usually called diseases, pathogenic environments, etc. Our aim is to understand what these occurrences may look like and how they may be conceptualized, systematized, recognized, causally analyzed, and controlled. Thus, our discussion consists of the following five sections: 7.1 The Suffering Individual; 7.2 The Bio-Psycho-Social Agent; 7.3 Health, Illness, and Disease; 7.4 Systems of Disease; 7.5 Etiology (= Science of Clinical Causation). (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Hermeneutics, Neuroscience and PsychiatryMichael T. H. Wong, MBBS, MD, MA, MDiv, PhD, FRCPsych, FRANZCP, FHKAM (bio)Hermeneutic practice in mental health has been a theme in Philosophy, Psychiatry, & Psychology (PPP) since its very beginnings. In this essay I argue that hermeneutics, the theory and practice of interpretation, promotes therapeutic interaction between mental health professionals, patients and their family.Why does this patient present in such a way at this particular (...) point in time? The distressing symptoms are there. The changes in behavior are obvious. Impairments of functions are hurting. A mental illness clearly runs in the family. There were early losses of loved ones, physical abuse at home, bullying by peers and self-medication with drugs and alcohol. Three in four adults with a mental illness first experienced that before they turned 24. The brain goes through major reorganization during adolescence and early adulthood. If synaptic pruning went wrong, psychoses emerged. When stresses activated the hypothalamic–pituitary–adrenal axis the elevated cortisol level impacted the size and function of the hippocampus and amygdala in the genetically vulnerable; anxiety, depression, bipolar, and personality disorders developed. The patient needs a voice/language to describe all these experiences and events and the psychiatrist needs a discourse to make sense of them.Eisenberg laments the swings between "brainlessness" and "mindlessness" in psychiatry. Engel argues for a "biopsychosocial" discourse. The major challenge for psychiatry is how to organize clinical information of different nature (categories, dimensions, narratives; i.e., objective vs. subjective, personal vs. interpersonal) into a coherent and comprehensible account for us all. Mental illnesses are not only neuropsychiatric spectrum disorders but also dysfunctions of social relationship and environmental/ecological adaptation. Psychiatry as a clinical neuroscience per se lacks the semantics to address the rich interactions between the physical, psychological, social, cultural, and spiritual in the illness experience of our patients. Explanation in the diagnostic formulation (objective scientific discourse on cause and effect) and understanding in the patient narrative (subjective ordinary everyday discourse on significance and meaning) are irreducible to each other (Wong, 2018). They instead interact with one another to achieve an integrative formulation, not through merging different discourses into a single assertion/monologue but via the dialectic/dialogue of "explaining more in order to understand better," as Ricoeur puts it, and between "the whole and the parts," as Schleiermacher highlights.This "therapeutic hermeneutic circle" of "explanation vs understanding" and "the whole vs the parts" includes symptoms behavior function and life events. It correlates between bio-psychosociocultural-spiritual dimensions/perspectives and does not reduce them to any particular/single [End Page 13] stance. The whole integrates the parts and the parts enrich the whole. It explains but does not explain away. It understands through an articulation of meaning and significance. This discourse is a multilayered (bio-psycho-social-cultural-spiritual) personal narrative that formulates diagnosis and care in a correlative (linking different voices/discourses) and non-reductive (no particular voice/discourse is prejudiced against) manner that is comprehensible to us all (Wong, 2021).PPP will be an excellent forum for discussing clinical hermeneutics in the future. In this digital era of social media and virtual reality, hermeneutics has the never-ending task to tackle the unprecedented challenges to meaning illness and health posed by polarizing discourses.Michael T. H. Wong Michael T.H. Wong, MBBS, MD, MA, MDiv, PhD, FRCPsych, FRANZCP, FHKAM, is Hon Clinical Professor, Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, HKSAR, China. Michael is Chair, Section of Philosophy & Humanities in Psychiatry, World Psychiatric Association. He is an Organizational Partner & International Lead with The Collaborating Centre for Values-Based Practice in Health and Social Care, St Catherine's College Oxford. He is Advisor to the Chinese Health Foundation of Australia.ReferencesWong M. T. H. (2018). Ricoeur and the third discourse of the person: From philosophy and neuroscience to psychiatry and theology. London: Lexington Books. Google ScholarWong, M. T. H. (2021). Values, meanings, hermeneutics and mental health. In Stoyanov, D., Fulford, K. M. W. F., Stanghellini, G., Van Staden, W., & Wong, M. TH. (Eds.), International perspectives in values-based mental health practice: Case studies and commentaries (pp. 341–349... (shrink)

This paper proposes a dynamic theory of embodiment that aims to get beyond the absent moving body in embodied social theory. The first somatic revolution, inspired by Merleau Ponty, provided theories based on the feeling and experience of the body. The theory of dynamic embodiment focuses instead on the doing itself as embodied social action, in which the embodied person is fore-grounded as a complex resource for meaning making. This represents a theoretical enrichment of the earlier turn to (...) the body in social theory, which tended to separate the semiotic, as necessarily representational and/or linguistic, from the somatic as a wide range of corporeal processes and practices assumed to be separated from mind, language and/or conscious thought. We argue that overcoming this persistent Cartesianism requires a New Realist approach to the proper location of human agency as a causal power, one that promotes a bio-psycho-social concept of personhood. Part one of the paper presents a general framework for this perspective, while part two applies this paradigm ethnographically to illustrate how bringing semiosis and somatics together requires a robust conception of multi-sensory modalities. (shrink)

El trabajo presenta aspectos que permiten la conceptualización del enfoque del Derecho para el abordaje de la niñez y la adolescencia en el contexto chileno. A través del análisis de la evidencia existente en la literatura, se tratan aspectos bio-psico-sociales y legales que admiten la validación del niño como sujeto de derecho. Se hace especial hincapié en el análisis de los principios rectores de la Convención sobre los Derechos del Niño para la preparación hacia los próximos desafíos en el trabajo (...) con niños y adolescentes. This paper presents aspects that allow the conceptualization of the rights-based approach to childhood and adolescence in the Chilean context. Through the analysis of existing evidence in the literature, the bio-psycho-social and legal aspects that support the validation of children as subjects of law are dealt with. Special emphasis is given to the analysis of the guiding principles of the UNICEF´s Convention on the Rights of the Child in preparation for the forthcoming challenges in the work with children and adolescents in Chile. (shrink)

Western culture has a few traditions of representing the human body – among them mortuary art (gisants), the freak show, the culture of the relics, renaissance art and pre-modern and modern anatomy. A historical analysis in the spirit of Norbert Elias is offered with regard to body – person relationship in anatomy. Modern anatomy is characterized by separating the story of the person from the story of the body, a strategy that is incompatible with the bio-psycho-social paradigm of (...) clinical medicine. The paper discusses different aspects of the above traditions and how they might bear on this conflict and on contemporary bioethics and bedside practice. (shrink)

Cardiovascular disease is a major complication of type 2 diabetes mellitus. In addition to traditional risk factors, psychological determinants play an important role in CVD risk. This study applied Deep Neural Network to develop a CVD risk prediction model and explored the bio-psycho-social contributors to the CVD risk among patients with T2DM. From 2017 to 2020, 834 patients with T2DM were recruited from the Department of Endocrinology, Affiliated Hospital of Harbin Medical University, China. In this cross-sectional study, the (...) patients' bio-psycho-social information was collected through clinical examinations and questionnaires. The dataset was randomly split into a 75% train set and a 25% test set. DNN was implemented at the best performance on the train set and applied on the test set. The receiver operating characteristic curve analysis was used to evaluate the model performance. Of participants, 272 were diagnosed with CVD. The developed ensemble model for CVD risk achieved an area under curve score of 0.91, accuracy of 87.50%, sensitivity of 88.06%, and specificity of 87.23%. Among patients with T2DM, the top five predictors in the CVD risk model were body mass index, anxiety, depression, total cholesterol, and systolic blood pressure. In summary, machine learning models can provide an automated identification mechanism for patients at CVD risk. Integrated treatment measures should be taken in health management, including clinical care, mental health improvement, and health behavior promotion. (shrink)

This book attempts to develop a Marxist theory of the human individual. It contends that the standard description of the human as a bio-psycho-social being is fundamentally deficient as it doesn’t specify which of these attributes is the determining one. As long as this is not done, the real nature of humanity cannot be uncovered.

This study is considered as a proposal to identify some metaphysical support of the self-care for a patient suffering from a chronic disease, as an extension of the bio-psycho-social paradigm. The methodology is dominated by a phenomenological perspective, supported by a hermeneutic conceptual analysis of the care of the self in Michel Foucault, focused on the Socratico-Platonic period and pervaded by the intention of having a translation and application to self-care. Foucault pleads for an aesthetics of the self, (...) called subjectivity, in which the subject is self-constituted through the so-called technologies of the self. The care of the self comes from the resignification of the philosophy as a way of life in which the subject is objectified. The translation and the applicability of the care of the self at the idea level to self-care are identified precisely in the acquisition of some important principles of the philosophy of care of the self from the Greek Antiquity: the role of awakener of consciousness of the one who is concerned about oneself as the first moment of the metaphor of awakening from the sleep, the ēthos as a way of being, a way of behaving and a life model. The pair self-knowledge – care of oneself justifies informing the former by the latter, in which being concerned about oneself means knowing oneself. Nevertheless, knowledge means care of the self where the self is synonymous with the soul and moreover, with the divine element in man. (shrink)

This paper challenges a pervasive curricular justification for educationally acquainting young people with stories of genocide and other moral horrors from history. According to this justification, doing so favours the development of psycho-social soft skills connected with interpersonal awareness and the establishment and maintenance of positive relationships. It is argued that this justification not only renders the specific historical content incidental to the development of these skills. The educational intention of promoting such psycho-social soft skills by (...) way of studying moral horrors in history constitutes an ethically problematic instrumentalisation of the historical material itself. (shrink)

In the following pages, our specific aim is to show how Hume’s analysis of justice provides the occasion for the gradual display of some key elements of a psychosocial action theory, which lay the foundations for later social thinking. -/- RESUMEN: En lo que sigue, nuestro objetivo específico es mostrar cómo el análisis que realiza Hume de la justicia proporciona la ocasión para introducir de manera gradual elementos clave para el desarrollo de una teoría psico-social de la acción, (...) presupuesta en buena parte del pensamiento social posterior. (shrink)

This article addresses salient conceptual issues in social organisational psychology in probing change in organisational systems, e.g., culture, innovation and implementation, reflective practice and change models. Insights from chaos–complexity research in the natural sciences which underpin the dynamics of flux and change to unravel the hidden, the unexplained, the disordered will be built on to explore the phenomena of change from a social psychological perspective. The concept of nano-psychology is introduced to open up a creative debate in the (...) social psychological field on creative change which builds on the nano-insights evolving in the natural science field. (shrink)

In this paper some very fundamental attitudes we have and assumptions we make in the US about persons, what they owe and what they are owed, are scrutinized and found to be indefensibly ageist. It is argued that these assumptions and the attitudes they engender are supported by logically and ethically suspect methods and conclusions. These errors are summarized and some remedial steps by which we might better protect against such illicit and unwarranted methods and conclusions in the future are (...) suggested. (shrink)

Frailty is a complex geriatric syndrome with multifactorial associated mechanisms that need to be examined more deeply to help reverse the adverse health-related outcomes. Specific inflammatory and physical health markers have been associated with the onset of frailty, but the associations between these factors and psycho-social health outcomes seem less studied. This systematic review aimed to identify, in the same study design, the potential associations between frailty and markers of inflammation, and physical or psycho-social health. A (...) literature search was performed from inception until March 2021 using Medline, Psycinfo, and EMBASE. Three raters evaluated the articles and selected 22 studies, using inclusion and exclusion criteria. Regarding biomarkers, 95% of the included studies showed significant links between inflammation [especially the higher levels of C-reactive protein and interleukin-6 ], and frailty status. Approximately 86% of the included studies showed strong links between physical health decline, and frailty status. At most, 13 studies among the 22 included ones evaluated psycho-social variables and mixed results were observed regarding the relationships with frailty. Results are discussed in terms of questioning the medical perception of global health, centering mostly on the physical dimension. Therefore, the development of future research studies involving a more exhaustive view of frailty and global health is strongly encouraged. (shrink)

We provide empirical evidence that people who believe in dualism are more likely to be uncomfortable with Deep Brain Stimulation (DBS) and to view it as threatening to their identity, humanity, or self. It is (neurocentric) materialists—who think the mind just is the brain—that are less inclined to fear DBS or to see it as threatening. We suggest various possible reasons for this connection. The inspiration for this brief report is a target article that addresses this issue from a theoretical (...) perspective. (shrink)

In this original and compelling book, Jeffrey P. Bishop, a philosopher, ethicist, and physician, argues that something has gone sadly amiss in the care of the dying by contemporary medicine and in our social and political views of death, as shaped by our scientific successes and ongoing debates about euthanasia and the "right to die"--or to live. __The Anticipatory Corpse: Medicine, Power, and the Care of the Dying__, informed by Foucault's genealogy of medicine and power as well as by (...) a thorough grasp of current medical practices and medical ethics, argues that a view of people as machines in motion--people as, in effect, temporarily animated corpses with interchangeable parts--has become epistemologically normative for medicine. The dead body is subtly anticipated in our practices of exercising control over the suffering person, whether through technological mastery in the intensive care unit or through the impersonal, quasi-scientific assessments of psychological and spiritual "medicine." The result is a kind of nihilistic attitude toward the dying, and troubling contradictions and absurdities in our practices. Wide-ranging in its examples, from organ donation rules in the United States, to ICU medicine, to "spiritual surveys," to presidential bioethics commissions attempting to define death, and to high-profile cases such as Terri Schiavo's, __The Anticipatory Corpse__ explores the historical, political, and philosophical underpinnings of our care of the dying and, finally, the possibilities of change. A ground-breaking work in bioethics, this book will provoke thought and argument for all those engaged in medicine, philosophy, theology, and health policy. "With extraordinary philosophical sophistication as well as knowledge of modern medicine, Bishop argues that the body that shapes the work of modern medicine is a dead body. He defends this claim decisively with with urgency. I know of no book that is at once more challenging and informative as __The Anticipatory Corpse. __To say this book is the most important one written in the philosophy of medicine in the last twenty-five years would not do it justice. This book is destined to change the way we think and, hopefully, practice medicine." --_Stanley Hauerwas, Duke Divinity School _ "Jeffrey Bishop carefully builds a detailed, scholarly case that medicine is shaped by its attitudes toward death. Clinicians, ethicists, medical educators, policy makers, and administrators need to understand the fraught relationship between clinical practices and death, and __The Anticipatory Corpse __is an essential text. Bishop's use of the writings of Michel Foucault is especially provocative and significant. This book is the closest we have to a genealogy of death." --_Arthur W. Frank, University of Calgary _ "Jeffrey Bishop has produced a masterful study of how the living body has been placed within medicine's metaphysics of efficient causality and within its commitment to a totalizing control of life and death, which control has only been strengthened by medicine's taking on the mantle of a bio-psycho-socio-spiritual model. This volume's treatment of medicine's care of the dying will surely be recognized as a cardinal text in the philosophy of medicine." --_H. Tristram Engelhardt, Jr., Rice University, Baylor College of Medicine_. (shrink)

Psychiatry’s inchoate wish for a paradigm shift and the biopsychosocial model of mental illness’ critically examines the much discussed goal of a paradigm shift in psychiatric taxonomy. The chapter first highlights some illustrative calls for such a change and then sets these against the Kuhnian account of science from which the idea is taken, highlighting the connection to incommensurability. Relative to a distinction drawn from Winch, between putative sciences where the self-understanding of subjects plays no role and those where it (...) is fundamental, psychiatry falls into the latter kind. This suggests that the wish for a paradigm shift in psychiatry is either incoherent or a wish for a radical but unpredictable overhaul of a significant aspect of our self-understanding as subjects and agents. The biopsychosocial model of mental illness is thus a helpful reminder of the cost of a paradigm shift in psychiatry. (shrink)

AimsSport specialization is an actual trend in youth athletes, but it can increase injury risk. The aim was to determine the eventual correlation between sports specialization and injury risk in various sports, using a biopsychosocial approach.Methods169 sport-specialized athletes completed [; overall,, ] a self-reported questionnaire regarding sociodemographic, physical-attitudinal, injuries and psychological-attitudinal To analyze data univariate and correlate analyses were used.ResultsOf 169 athletes enrolled, 53% were single-sport specialized. In team sports a high risk of having to remain at rest for up (...) to 1 month because of overuse was observed. Males who suffered direct trauma in the team group were more exposed to that type of injury, and also the type of specialization figured significantly. In addition, interoceptive awareness correlates with injury. This study shows that, even though young athletes seem to be at a high risk of becoming injured, early team sport specialization and a high performance level cannot be considered to be the only risk factors. (shrink)

The facts and inferences exposed in this writing, and the arguments that support it, allow us to conclude that the «extension of the mind», opened during the evolutionary process, since always and today accelerated by the work of human intervention, in no case authorizes us to consider that the «extension of mind» has changed human nature, as we have always known it. Therefore, there is no justification to speak of transhumanism, as if a new man, a «transhuman», had appeared at (...) the moment of the Singularity, whose nature had undergone substantial changes in relation to the usual human nature. For this reason, we consider that we should continue speaking of an «extensive humanism». No more. (shrink)

Palliative care names as one of its central aims to prevent and relieve suffering. Following the concept of “total pain”, which was first introduced by Cicely Saunders, PC not only focuses on the physical dimension of pain but also addresses the patient’s psychological, social, and spiritual suffering. However, the goal to relieve suffering can paradoxically lead to a taboo of suffering and imply adverse consequences. Two scenarios are presented: First, PC providers sometimes might fail their own ambitions. If all (...) other means prove ineffective terminal sedation can still be applied as a last resort, though. However, it may be asked whether sedating a dying patient comes close to eliminating suffering by eliminating the sufferer and hereby resembles physician-assisted suicide, or euthanasia. As an alternative, PC providers could continue treatment, even if it so far prove unsuccessful. In that case, either futility results or the patient might even suffer from the perpetuated, albeit fruitless interventions. Second, some patients possibly prefer to endure suffering instead of being relieved from it. Hence, they want to forgo the various bio-psycho-socio-spiritual interventions. PC providers’ efforts then lead to paradoxical consequences: Feeling harassed by PC, patients could suffer even more and not less. In both scenarios, suffering is placed under a taboo and is thereby conceptualised as not being tolerable in general. However, to consider suffering essentially unbearable might promote assisted dying not only on an individual but also on a societal level insofar as unbearable suffering is considered a criterion for euthanasia or PAS. (shrink)