In this paper I discuss the role played by disturbed phenomenology in accounting for the formation and maintenance of the Capgras delusion. Whilst endorsing a two-stage model to explain the condition, I nevertheless argue that traditional accounts prioritise the role played by some form of second-stage cognitive disruption at the expense of the significant contribution made by the patient’s disturbed phenomenology, which is often reduced to such uninformative descriptions as “anomalous” or “strange”. By advocating an interactionist model, I argue (...) that the delusional belief constitutes an attempt on the part of the patient to explain his/her initially odd and somewhat disturbed phenomenal content and, moreover, that the delusion then structures the patient’s experience such that what he/she perceives is an impostor. This fact is used to explain the delusional belief’s maintenance and resistance to revision. Thus, whilst accepting that second-stage cognitive disruption has a part to play in explaining the Capgras delusion, the emphasis here is placed on the role played by the patient’s changing phenomenal content and its congruence with the delusional belief. Unlike traditional two-stage models, which posit a unidirectional progression from experience to belief, the interactionist model advocates a two-way interaction between bottom-up and top-down processes. The application of this model to other delusional beliefs is also considered. (shrink)

The patient with Capgras’ syndrome claims that people very familiar to him have been replaced by impostors. I argue that this disorder is due to the destruction of a representation that the patient has of the mind of the familiar person. This creates the appearance of a familiar body and face, but without the familiar personality, beliefs, and thoughts. The posterior site of damage in Capgras’ is often reported to be the temporoparietal junction, an area that has (...) a role in the mindreading system, a connected system of cortical areas that allow us to attribute mental states to others. Just as the Capgras’ patient claims that that man is not his father, the patient with asomatognosia claims that his arm is not really his. A similar account applies here, in that a nearby brain area, the supramarginal gyrus, is damaged. This area works in concert with the temporoparietal junction and other areas to produce a large representation of a mind inside a body situated in an environment. Damage to the mind-representing part of this system (coupled with damage to executive processes in the prefrontal lobes) causes Capgras’ syndrome, whereas damage to the body-representing part of this system (also coupled with executive damage) causes asomatognosia. (shrink)

INTRODUCTION: Delusional misidentification syndromes (DMS) are a group of psychopathological experiences occurring in psychosis, involving the misidentification of a person or place. DMS are often accompanied by hostility towards the object of delusional misidentification. This is of a particular concern in perinatal mental illness due to the potential disruption of the mother-infant bond, and risk of neglect, violence, or infanticide towards a misidentified child. This review aimed to collate all published cases of DMS in postpartum psychosis to further understand how (...) these syndromes present in perinatal mental illness. METHODS: In August 2021, an online database search was conducted using PubMed, MEDLINE, PsycINFO, CINAHL, and Embase to identify all publications reporting DMS in the perinatal period. RESULTS: Nine papers were included in the review involving 8 case reports of Capgras syndrome and one case series involving 4 cases of Fregoli syndrome. Three cases identified organic pathology, which may have contributed to the presentation. The most common subject of misidentification was the patient’s husband (n = 7), followed by their baby (n = 6), hospital staff (n = 4), other family members (n = 3), and self (n = 1). Five cases remark on the impact of perinatal illness on the maternal-infant bond, of which four result in the mother being unwilling to care for the infant as the result of their delusional beliefs. CONCLUSION: This is the first systematic review of the literature in this field. Although small in number, these cases reveal several important learning points including that DMS can occur with or without underlying organic disease. Active exploration of the nature of delusions in postpartum psychosis is required to mitigate the risk of harm to the infant and mother-infant bond. It may also uncover that these syndromes are more common in postpartum psychosis than previously realized. (shrink)

Misidentification syndromes occur commonly in neuropsychiatric practice and can be explained through aberrant integration of recollection and familiarity, in keeping with a dysfunction at the level of the attributional system in the new integrative memory model. We examine neuroimaging findings associated with Fregoli and Capgras syndromes and compare these with the proposed neural substrate of the integrative memory model supporting the core and attribution functions.

According to a common philosophical intuition, the deep nature of things is hidden from us, and the world as we know it through perception and science is, just like a dream, shadows, or a computer simulation, somehow shallow and lacking in reality. This “intuition of unreality” clashes with a strong, but perhaps more naive, intuition to the effect that the world as we know it seems perfectly real. Shadows, dreams, or informational structures appear too unreal to be identical to the (...) world as we know it! This clash between the two intuitions forms the basis of the “problem of reality.” In the late nineteenth century psychiatrists encountered patients they referred to as “metaphysician doubters” who constantly questioned the reality of the world. This essay draws on studies of these patients in order to reject, and indeed diagnose, the intuition of unreality and recent metaphysical doctrines drawing on it, such as structuralism, digitalism, and virtual realism. (shrink)

This paper examines Todd Feinberg's theory of the misidentification syndromes.

Localizing the self in the brain has been the goal of consciousness research for centuries. Recently, there has been an increase in attention to the localization of the self. Here we present data from patients suffering from a loss of self in an attempt to understand the neural correlates of consciousness. Focusing on delusional misidentification syndrome , we find that frontal regions, as well as the right hemisphere appear to play a significant role in DMS and DMS related disorders. (...) These data are placed in the context of neuroimaging findings. (shrink)

Argues for a category of “cognitive feelings”, which are representationally significant, but are not part of the content of the states they accompany. The feeling of pastness in episodic memory, of familiarity (missing in Capgras syndrome), and of motivation (that accompanies desire) are examples. The feeling of presence that accompanies normal visual states is due to such a cognitive feeling; the “two visual systems” are partially responsible for this feeling.

My central question in this paper is how delusional beliefs are related to self-deception. In section 1, I summarize my position on what self-deception is and how representative instances of it are to be explained. I turn to delusions in section 2, where I focus on the Capgras delusion, delusional jealousy (or the Othello syndrome), and the reverse Othello syndrome.

Delusional beliefs have sometimes been considered as rational inferences from abnormal experiences. We explore this idea in more detail, making the following points. Firstly, the abnormalities of cognition which initially prompt the entertaining of a delusional belief are not always conscious and since we prefer to restrict the term “experience” to consciousness we refer to “abnormal data” rather than “abnormal experience”. Secondly, we argue that in relation to many delusions (we consider eight) one can clearly identify what the abnormal cognitive (...) data are which prompted the delusion and what the neuropsychological impairment is which is responsible for the occurrence of these data; but one can equally clearly point to cases where this impairments is present but delusion is not. So the impairment is not sufficient for delusion to occur. A second cognitive impairment, one which impairs the ability to evaluate beliefs, must also be present. Thirdly (and this is the main thrust of our chapter) we consider in detail what the nature of the inference is that leads from the abnormal data to the belief. This is not deductive inference and it is not inference by enumerative induction; it is abductive inference. We offer a Bayesian account of abductive inference and apply it to the explanation of delusional belief. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 11.1 (2004) 35-41 [Access article in PDF] The Rationality of Psychosis and Understanding the Deluded Matthew R. Broome Campbell's important and influential paper (Campbell 2001) has framed the debate that Bayne and Pacherie (2004) most explicitly, and Klee (2004) and Georgaca (2004) more implicitly, engage in. Campbell has offered two broad ways of thinking about explanations of delusions—the empirical and the rational. He offers some (...) criticism of the former and an endorsement of the latter. Campbell uses examples from clinical psychopathology to illustrate his argument and Bayne and Pacherie in turn employ these. Campbell discusses the eponymously named delusions of Capgras and Cotard—the former a subtype of delusional misidentification and the latter a delusion whose content is colored predominantly with nihilistic and possibly hypochondriacal themes. Campbell, Bayne and Pacherie, and Klee discuss the empirical data in relation to such delusions and as an aid to discussing the empirical model more generally. It does seem a little unfortunate that these delusions, which are less than typical, become the focus of Campbell's paper, and Bayne and Pacherie's criticism of his work. Delusions are remarkably heterogeneous; this indeed may be part of the reason why there is so much difficulty in reaching a definition as Klee discusses, and occur in a wide variety of mental and neurological illnesses. The most common delusions are those of persecution and reference (World Health Organization [WHO] 1973) and typically occur in schizophrenia. By contrast, delusional misidentification occurs most commonly in patients with dementia, delirium, and focal cognitive impairment, but can occur in other functional psychoses such as an affective or schizophrenic psychosis. The most common form of delusional misidentification is not that of either the exotic Capgras or Fregoli syndromes but delusional misidentification for place; thus, although Bayne and Pacherie's arguments against Campbell may still hold, delusional misidentification tends to occur in the context of a patient believing that they are at home or on holiday rather than in hospital and may not necessarily involve close family members or other intimate relationships. Similarly, Cotard's syndrome tends to occur in the context of a severe depressive illness with mood-congruent psychotic symptoms, typically in an elderly individual. It does not have to have the content that the deluded is dead, but can include beliefs, for example, that the world no longer exists or that their internal organs are not present. Thus, a patient with either Capgras' or Cotard's syndrome is likely to differ from patients with delusions of persecution. They would [End Page 35] have different diagnoses, probably be older, and have a greater likelihood of structural abnormalities of the brain on imaging and consequent neuropsychological dysfunction. That is not to say that patients with schizophrenia have normal cerebral anatomy and neuropsychology, but rather that the Capgras' and Cotard's patients are likely to have neurological quality to their presentation that is clinically relevant, rather than what commonly the case in schizophrenia and the other functional psychoses, where the neurological abnormalities are only currently important at the level of academic research. Empirical Models of Delusion Formation Different delusions may not have that much in common, nor may the patients who believe in them. This in turn relates to the empirical paradigm that both Campbell and Bayne and Pacherie discuss. It is true that current research, and indeed the clinical practice of cognitive behavioral therapy for psychosis, is indebted to the work of Maher and it is within his legacy which we work. This, however, is not to say that we think his initial formulation was correct. Maher's (1988, 1992) work focused attempts in explaining delusions—both to support and refute his thesis that delusions are the consequence of normal cognitive mechanisms seeking to explain an anomalous sensory experience. Such a view initially led to work demonstrating delusions in the absence of anomalous perceptions, the presence of reasoning biases in the deluded population, and the possibility that abnormal sensory experience may be consequent upon biased cognitive processes (Garety and Freeman 1999). More recent work has demonstrated the prevalence of... (shrink)

This paper has two aims: (1) to point the way towards a novel alternative to cognitive theories of emotion, and (2) to delineate a number of different functions that the emotions play in cognition, functions that become visible from outside the framework of cognitive theories. First, I hold that the Higher Order Representational (HOR) theories of consciousness — as generally formulated — are inadequate insofar as they fail to account for selective attention. After posing this dilemma, I resolve it in (...) such a manner that the following thesis arises: the emotions play a key role in shaping selective attention. This thesis is in accord with A. Damasio’s (1994) noteworthy neuroscientific work on emotion. I then begin to formulate an alternative to cognitive theories of emotion, and I show how this new account has implications for the following issues: face recognition, two brain disorders (Capgras’ and Fregoli syndrome), the frame problem in A. I., and the research program of affective computing. (shrink)

One of the most interesting questions analysed in philosophy of language concerns the hypothesis that the referential competence – that is, the ability to link words to the objects to which they refer – is based, not only on linguistically explicit properties of that objects, but also on cognitive contents not always exhaustively definable by means of linguistic instruments. For example, experiments on neural networks suggest the possibility that perceptive properties of objects influence in an unconscious way our categorization of (...) that objects. Moreover, neuropsychological syndromes – in particular, Capgras and Fregoli syndromes – suggest that emotional contents could influence our decision to consider an entity as a member of a particular category: emotional contents could be considered, in such cases, part of the meaning of words referring to that objects. (shrink)

One of the most interesting questions analysed in philosophy of language concerns the hypothesis that the referential competence – that is, the ability to link words to the objects to which they refer – is based, not only on linguistically explicit properties of that objects, but also on cognitive contents not always exhaustively definable by means of linguistic instruments. For example, experiments on neural networks suggest the possibility that perceptive properties of objects influence in an unconscious way our categorization of (...) that objects. Moreover, neuropsychological syndromes – in particular, Capgras and Fregoli syndromes – suggest that emotional contents could influence our decision to consider an entity as a member of a particular category: emotional contents could be considered, in such cases, part of the meaning of words referring to that objects. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 9.1 (2002) 61-63 [Access article in PDF] Arguing from Neuroscience in Psychiatry James Phillips PHILIP GERRANS "A One-stage Explanation of the Cotard Delusion" provides an elegant example of the application of neuroscientific findings to known clinical phenomena in psychiatry. Gerrans argues that, in the cases of the Cotard and Capgras delusions, a one-stage explanation is sufficient to account for the clinical phenomena. That is, (...) the neuroanatomic defect and the consequent anomalous experience are sufficient to produce the delusion. According to Gerrans, we do not need to postulate that the delusion will emerge only if the anomalous experience is filtered through a faulty reasoning process (a two-stage explanation). Against the argument of Young and Leafhead (1996) that Cotard and Capgras delusions stem from the same neuroanatomic deficit and differentiate only in being processed differently—thus requiring a two-stage explanation—Gerrans argues that the respective neuroanatomic defects are in fact different, and that, therefore, the two delusional syndromes differ at the first stage and do not require the two-stage explanation suggested by Young and Leafhead.I do not have an opinion as to who is right in this disagreement, and I will devote these remarks to explaining why I do not have an opinion. In developing this explanation I will touch on what I find problematic in many discussions of neuroscience, neurocognitive models, and clinical psychiatry; I will thus use this article to highlight those problems.On the face of it, one would think that the issue raised by Gerrans should admit of a simple resolution. He argues that Capgras and Cotard delusions derive from different neural defects. Young and Leafhead, on the other hand, base their two-stage argument on the argument that the two delusions derive from the same neural defect. So which is it? Neuroscientists should be able to settle the issue and end the dispute. Gerrans remarks "that we need to look more closely at the CN [cognitive neuropsychiatric] explanation of the Capgras delusion." As he describes it, face recognition involves two components, a cognitive and an affective component, with separate neuroanatomic substrates. An individual successfully recognizes the face of a friend or acquaintance when she matches the cognitive recognition (cognitive component) with the affective tone of familiarity (second component). When there is a lesion in the neural substrate of the affective component, she may recognize the face but without the tone of familiarity. In her effort to understand her affective experience of the face as alien rather than as familiar, she may conclude that her friend has been replaced by a double. Thus we have the Capgras delusion.Let us now unpack this explanation. According to Gerrans, researchers have hypothesized [End Page 61] two anatomatically distinct pathways involved in face recognition. He writes: "Initially... these separate neuroanatomic substrates were hypothesized to lie in separate dorsal and ventral processing pathways, but the most persuasive hypothesis is that of Breen et al. that face recognition is performed in the ventral visual processing pathway, whereas covert [affective] recognition effects result from the activation of pathways connecting the ventral pathway and the limbic system. It is damage to these latter pathways that gives rise to the Capgras delusion."In other words, the explanation of Capgras delusions depends on a neurocognitive model, itself based on an unspecified base of neuroanatomic data. When Gerrans writes that "[t]he Capgras delusion arises in cases where, following a neurological accident, the pathways connecting the FRU [Face Recognition Unit] to the limbic system are damaged leaving ventral pathways and hence overt recognition unimpaired...," he means that the Capgras delusion arises in that manner if the proposed model bears any relation to the reality of the living brain and if real Capgras patients have suffered the hypothesized lesion. At this point the reader is struggling with the following questions: (1) What are the hard neuroanatomic data underpinning the neurocognitive model? (2) What is the argument for developing this model (single Face Recognition Unit with independent pathways to cognitive and affective components of face recognition) out of the hard data? (3) What is the evidence... (shrink)

Delusions are studied in two philosophical traditions: the continental or phenomenological tradition and the Anglo-American or analytic tradition. Each has its own view of delusions. Broadly stated, phenomenologists view delusions as a disturbed experience whilst most analytic researchers view them as beliefs. It is my contention that the most plausible account of delusions must ultimately incorporate valuable insights from both traditions. To illustrate the potential value of integration I provide a novel model of the Capgras delusion which describes how (...) an analytic, cognitive neuropsychological two-factor account of the Capgras delusion and the phenomenological view of delusions might be integrated. (shrink)

I defend a moderate (neither extremely conservative nor extremely liberal) view about the contents of perception. I develop an account of perceptual kinds as perceptual similarity classes, which are convex regions in similarity space. Different perceivers will enjoy different perceptual kinds. I argue that for any property P, a perceptual state of O can represent something as P only if P is coextensive with some perceptual kind for O. 'Dog' and 'chair' will be perceptual kinds for most normal people, 'blackpool (...) warbler' for the expert birdwatcher but not for the rest of us, 'dangerous', 'familiar', or 'meaning that the cat is on the mat' for none of us. (shrink)

Many intelligent, capable, and successful individuals believe that their success is due to luck and fear that they will someday be exposed as imposters. A puzzling feature of this phenomenon, commonly referred to as imposter syndrome, is that these same individuals treat evidence in ways that maintain their false beliefs and debilitating fears: they ignore and misattribute evidence of their own abilities, while readily accepting evidence in favour of their inadequacy. I propose a novel account of imposter syndrome (...) as an instance of self-deception, whereby biased evidence treatment is driven by the motivational benefit of negative self-appraisal. This account illuminates a number of interconnected philosophical and scientific puzzles related to the explanation, definition, and value of imposter syndrome. (shrink)

There is evidence indicating that the Capgras delusion is grounded in some kind of anomalous experience. According to the endorsement model, the content of the delusion is already encoded in the Capgras subject's experience, and the delusion is formed simply by endorsing that content as veridical. Elisabeth Pacherie and Sam Wilkinson have in different ways attempted to articulate a comprehensive defence of this strategy, but here I argue that the endorsement model cannot be defended along the lines envisioned (...) by either of them. I then offer a more promising way of spelling out the model, according to which the anomalous experience implicated in Capgras is metaphorical in character. (shrink)

In a recent contribution to this journal, Andrew Fenton and Sheri Alpert have argued that the so-called “extended mind hypothesis” allows us to understand why Brain Computer Interfaces (BCIs) have the potential to change the self of patients suffering from Locked-in syndrome (LIS) by extending their minds beyond their bodies. I deny that this can shed any light on the theoretical, or philosophical, underpinnings of BCIs as a tool for enabling communication with, or bodily action by, patients with LIS: (...) BCIs are not a case of cognitive extension. I argue that Fenton and Alpert’s claim to the contrary is the result of a widespread confusion about some related, but significantly different, approaches to cognition that all fall under the heading of “situated cognition.” I first provide a short taxonomy of various situated approaches to cognition, highlighting (some of) their important commonalities and differences, which should dissolve some of the confusions surrounding them. Then I show why the extended mind hypothesis is unsuitable as a model of BCI enhancements of LIS patients’ capacity to interact with their surroundings, and I argue that the situated approach with obvious bearings on the sort of questions that were driving Fenton and Alpert is not the idea that cognition is extended , but the idea that cognition is enacted. (shrink)

Various psychopathologies of self-awareness, such as somatoparaphrenia and thought insertion in schizophrenia, might seem to threaten the viability of the higher-order thought (HOT) theory of consciousness since it requires a HOT about one’s own mental state to accompany every conscious state. The HOT theory of consciousness says that what makes a mental state a conscious mental state is that there is a HOT to the effect that “I am in mental state M.” I have argued in previous work that a (...) HOT theorist can adequately respond to this concern with respect to somatoparaphrenia and thought insertion. There is also Cotard syndrome which is a rare neuropsychiatric disorder in which people hold the delusional belief that they are dead, do not exist, or have lost their blood or internal organs. In this paper, I argue that HOT theory has nothing to fear from it either and can consistently account for what happens in such unusual cases. I analyze Cotard syndrome in light of my previous discussion of somatoparaphrenia and thought insertion, and argue that HOT theory can provide a somewhat analogous account without the worry of inconsistency. It is crucial to recognize that there are multiple “self-concepts” and levels of HOTs which can help to provide a more nuanced explanation. With regard to the connection between consciousness and self-consciousness, it is proposed that Cotard patients are indeed capable of having some “I-thoughts” about their bodies and mental states. (shrink)

While some of mental disorders due to emotional distress occur cross-culturally, others seem to be much more bound to particular cultures. In this paper, I propose that many of these “cultural syndromes” are culturally sanctioned responses to overwhelming negative emotions. I show how tools from cultural evolution theory can be employed for understanding how the syndromes are relatively confined to and retained within particular cultures. Finally, I argue that such an account allows for some cultural syndromes to be or become (...) mental disorders and also steers clear of some of the anti-realist trappings associated with a social constructivism of cultural syndromes. (shrink)

Williams syndrome is a genetic disorder that, because of its unique cognitive profile, has been marshalled as evidence for the modularity of both language and social skills. But emerging evidence suggests the claims of modularity based on WS have been premature. This paper offers an examination of the recent literature on WS. It argues the literature gives little support for mental modularity. Rather than being rigidly modular, the WS brain is an extremely flexible organ that that co-opts available neural (...) resource in a highly dynamic manner to cope in the world. (shrink)

Le syndrome de Kierkegaard est un essai libre de Jean- Luc Berlet, consacré à l'un de ses penseurs de prédilection, le Danois Seren Kierkegaard (1813-1855). Ce syndrome dont il est question, tel que défini par l'auteur, pourrait être conçu comme la tension qui résulte de l'impossible choix entre l'amour de la femme et l'amour de Dieu. Kierkegaard renonça en effet à l'amour charnel de la femme au profit d'une vie ascétique consacrée à I écriture et à la réflexion (...) sur l'Amour. A plus grande échelle ce syndrome pourrait être compris comme l'abandon du temporel au profit d'un idéal spirituel Et les regrets qui en découlent. En effet, comme nombre de contemporains opérant ce type de choix, Kierkegaard connut bien des tourments. Ces affres permirent néanmoins à Kierkegaard de développer une conception de l'Amour et du Divin d'une grande originalité qu'il est bon de redécouvrir dans notre époque marquée par le consumérisme sentimental. Tout au long des quatorze chapitres qui jalonnent cet ouvrage, Jean-Luc Berlet retrace le parcours littéraire de ce philosophe danois considéré par beaucoup comme le père de l'existentialisme, brossant ici un tableau complet de son énigmatique personnalité. En outre, chaque chapitre est accompagné d'un code QR, donnant chacun actes à une vidéo en ligne où Jean - Luc Berlet approfondit son développement et fournit des clefs de lecture pour une meilleure compréhension de l'oeuvre de Kierkegaard. (shrink)

Savant syndrome and prime numbers Oliver Sacks reported that a pair of autistic twins had extraordinary number abilities and that they spontaneously generated huge prime numbers. Such abilities could contradict our understanding of human abilities. Sacks' report attracted widespread attention, and several researchers speculated theoretically. Unfortunately, most of the explanations in the literature are wrong. Here a correct explanation on prime number identification is provided. Fermat's little theorem is implemented in spreadsheet. Also, twenty years after the report, questionable aspects (...) were found in it. Extreme abilities became dubious. One possibility for the less extreme abilities is incomplete trial division. (shrink)

Language evolution resulted from changes in our biology, behavior, and culture. One source of these changes might be human self-domestication. Williams syndrome (WS) is a clinical condition with a clearly defined genetic basis and resulting in a distinctive behavioral and cognitive profile, including enhanced sociability. In this paper we show evidence that the WS phenotype can be satisfactorily construed as a hyper-domesticated human phenotype, plausibly resulting from the effect of the WS hemydeletion on selected candidates for domestication and neural (...) crest function. Specifically, we show that genes involved in animal domestication and neural crest development and function are significantly dysregulated in the blood of subjects with WS. We also discuss the consequences of this link between domestication and WS for our current understanding of language evolution. (shrink)

What is love? In this paper I argue that love is a psychological syndrome, or an enormously complex cluster of psychological attitudes and dispositions that’s accompanied by a corresponding set of symptoms that flow from it. More specifically, I argue that love is an affectionate loyalty that takes different shapes across cases and that manifests itself in some set of behavioral and emotional expressions, where this set of expressions also varies across cases. After laying down three theoretical constraints that (...) viable theories of love must satisfy, I sketch my syndrome theory of love in detail and then defend it. First, I argue that it has a strong yet defeasible claim to satisfying the three theoretical constraints. Then I defend my theory against two objections that target its extensional adequacy. I conclude that we have good grounds for being optimistic about the theory even though it calls for further development and scrutiny. (shrink)

ABSTRACT Many intelligent, capable, and successful individuals believe that their success is due to luck, and fear that they will someday be exposed as imposters. A puzzling feature of this phenomenon, commonly referred to as imposter syndrome, is that these same individuals treat evidence in ways that maintain their false beliefs and debilitating fears: they ignore and misattribute evidence of their own abilities, while readily accepting evidence in favour of their inadequacy. I propose a novel account of imposter (...) class='Hi'>syndrome as an instance of self-deception, whereby biased evidence treatment is driven by the motivational benefit of negative self-appraisal. This account illuminates a number of interconnected philosophical and scientific puzzles related to the explanation, definition, and value of imposter syndrome. (shrink)

Cockayne syndrome is a rare autosomal recessive disease characterized by a complex clinical phenotype. Most Cockayne syndrome cells are hypersensitive to killing by ultraviolet radiation. This observation has prompted a wealth of studies on the DNA repair capacity of Cockayne syndrome cells in vitro. Many studies support the notion that such cells are defective in a DNA repair mode(s) that is transcription‐dependent. However, it remains to be established that this is a primary molecular defect in Cockayne (...) class='Hi'>syndrome cells and that it explains the complex clinical phenotype associated with the disease. An alternative hypothesis is that Cockayne syndrome cells have a defect in transcription affecting the expression of certain genes, which is compatible with embryogenesis but not with normal post‐natal development. Defective transcription may impair the normal processing of DNA damage during transcription‐dependent repair.‘“Curiouser and curiouser” cried Alice.’ (Lewis Carroll, Alice's Adventures in Wonderland). (shrink)

In this important addition to the stroke literature, highly experienced clinicians set out the patterns to be expected in patients with stroke, drawing on illustrative case histories where appropriate. The book is intended as a guide to patterns and syndromes for clinicians encountering an unfamiliar presentation in a stroke patient. It will enable them to differentiate between possible locations on the basis of symptoms and signs, recognise lesion patterns found in patients with infarcts and haemorrhages in various vascular territories, and (...) refer to the clinical features associated with rare but important causes of stroke. Drawing on the experience and clinical authority of distinguished international contributors, this is a practical, highly illustrated companion and reference for students, trainees and physicians who wish to improve their skills in the accurate diagnosis of stroke syndromes, and their understanding of its clinical consequences. (shrink)

Two main approaches can be discerned in the literature on agentive self-awareness: a top-down approach, according to which agentive self-awareness is fundamentally holistic in nature and involves the operations of a central-systems narrator, and a bottom-up approach that sees agentive self-awareness as produced by lowlevel processes grounded in the very machinery responsible for motor production and control. Neither approach is entirely satisfactory if taken in isolation; however, the question of whether their combination would yield a full account of agentive self-awareness (...) remains very much open. In this paper, I contrast two disorders affecting the control of voluntary action: the anarchic hand syndrome and utilization behavior. Although in both conditions patients fail to inhibit actions that are elicited by objects in the environment but inappropriate with respect to the wider context, these actions are experienced in radically different ways by the two groups of patients. I discuss how top-down and bottom-up processes involved in the generation of agentive self-awareness would have to be related in order to account for these differences. (shrink)

As a human being possesses dual creation, certain reasons and conditions can oppose his inner and outside worlds. Giving preference one side to other, and to turn another into slavery enhance the syndrome of imbalance which inherent him in birth. To make harmony between them and their complementarities perfect the human being. This also emphasizes the necessity of parallel development of rational and irrational thinking and their complementarities. A human being is perfect in birth and he is the only (...) being who is able to understand his perfection. As it is reflected in Holy Books that the material world is a form of test, and the good and the evil return us. As it is seems that this material world is only the mean of choice in spiritual way. This choice is of the man. The man canchoose light or fire. Everybody understands his inferiority in his own and to solve it differently: it might be material things, divine love or science. What is the truth? It is the soul that defines it, if we can listen to it. (shrink)

The functions of the Bloom syndrome helicase and its orthologs are well characterized in mitotic DNA damage repair, but their roles within the context of meiotic recombination are less clear. In meiotic recombination, multiple repair pathways are used to repair meiotic DSBs, and current studies suggest that BLM may regulate the use of these pathways. Based on literature from Saccharomyces cerevisiae, Arabidopsis thaliana, Mus musculus, Drosophila melanogaster, and Caenorhabditis elegans, we present a unified model for a critical meiotic role (...) of BLM and its orthologs. In this model, BLM and its orthologs utilize helicase activity to regulate the use of various pathways in meiotic recombination by continuously disassembling recombination intermediates. This unwinding activity provides the meiotic program with a steady pool of early recombination substrates, increasing the probability for a DSB to be processed by the appropriate pathway. As a result of BLM activity, crossovers are properly placed throughout the genome, promoting proper chromosomal disjunction at the end of meiosis. This unified model can be used to further refine the complex role of BLM and its orthologs in meiotic recombination. In meiotic recombination, Blm utilizes its helicase activity to disassemble early recombination intermediates, thereby retaining a pool of recombination sites from which some can be selected to enter the Class I crossover pathway while simultaneously promoting SDSA and preventing the use of the Class II pathway. (shrink)

The study examines the argumentative competencies of people with Asperger syndrome (AS) and compares this with those of normal – or what are called neurotypical (NT) – subjects. To investigate how people with AS recognise, evaluate and engage in argumentation, we have adapted and applied the empirical instrument developed by van Eemeren, Garssen and Meuffels to study the conventional validity of the pragma-dialectical freedom rule (van Eemeren, Gars- sen & Meuffels 2003a; 2003b; 2005a; 2005b; van Eemeren & Meuffels, 2002). (...) Our paper begins with some background information on Asperger syndrome and how it impacts upon communication and argumentation; then it addresses the research questions and methods used; thirdly, it presents some initial findings; finally, it will conclude with some im- plications for those people with AS, for those they come into contact with and for the pragma-dialectic model in general. (shrink)

Embodied approaches in cognitive science hold that the body is crucial for cognition. What this claim amounts to, however, still remains unclear. This paper contributes to its clarification by confronting three ways of understanding embodiment—the sensorimotor approach, extended cognition and enactivism—with Locked-in syndrome. LIS is a case of severe global paralysis in which patients are unable to move and yet largely remain cognitively intact. We propose that LIS poses a challenge to embodied approaches to cognition requiring them to make (...) explicit the notion of embodiment they defend and its role for cognition. We argue that the sensorimotor and the extended functionalist approaches either fall short of accounting for cognition in LIS from an embodied perspective or do it too broadly by relegating the body only to a historical role. Enactivism conceives of the body as autonomous system and of cognition as sense-making. From this perspective embodiment is not equated with bodily movement but with forms of agency that do not disappear with body paralysis. Enactivism offers a clarifying perspective on embodiment and thus currently appears to be the framework in embodied cognition best suited to address the challenge posed by LIS. (shrink)

The research sought to determine the prevalence of Burnout Syndrome in health teachers at a university in north-eastern Peru. The universe was made up of 69 teachers, and 41 responded to the self-administered instrument called Maslach Burnout Inventory. The results show that 14.6% present this syndrome. The highest indicator was personal fulfillment, while depersonalization and emotional exhaustion were low. According to gender, in both it was similar. According to age group, it had a greater effect in ages between (...) 36 and 51 years. Marital status was more prevalent in singles. We conclude that the prevalence of Burnout Syndrome was low. (shrink)

This chapter discusses the Ganser syndrome and gives a brief account on its clinical features. A significant number of clinicians in Europe continued accepting Ganser's basic postulates that the patients showed significant memory disorder and 'answers towards the question' within the framework of traumatic or reactive hysteria. In elderly patients, Ganser type symptoms may be indicative of the onset of dementia. Ganser syndrome raises the question of the interaction between concepts, ideology and clinical observation. The clinician must be (...) aware that a misdiagnosed case of Ganser-type hysteria may result in lawsuits, unnecessary surgical interventions, inappropriate use of minor and major tranquillizers, and social consequences that may be destabilizing for the patient and family. Positive results in the organic investigation should lead to a firm diagnosis and disconfirmation of Ganser syndrome. Persistent negative results and dramatic improvement should tend to confirm the diagnosis. (shrink)

It has been argued that Extended Cognition (EXT), a recently much discussed framework in the philosophy of cognition, would serve as the theoretical basis to account for the impact of Brain Computer Interfaces (BCI) on the self and life of patients with Locked-in Syndrome (LIS). In this paper I will argue that this claim is unsubstantiated, EXT is not the appropriate theoretical background for understanding the role of BCI in LIS. I will critically assess what a theory of the (...) extended self would comprise and provide a list of desiderata for a theory of self that EXT fails to accommodate for. There is, however, an alternative framework in Cognitive Science, Enactivism, which entails the basis for an account of self that is able to accommodate for these desiderata. I will outline some first steps towards an Enactive approach to the self, suggesting that the self could be considered as a form of human autonomy. Understanding the self from an enactive point of view will allow to shed new light on the questions of whether and how BCIs affect or change the selves of patients with LIS. (shrink)

Eyal et al have recently argued that researchers should consider conducting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) human challenge studies to hasten vaccine development. We have conducted (J. L.) and overseen (L. D.) human challenge studies and agree that they can be useful in developing anti-infective agents. We also agree that adults can autonomously choose to undergo risks with no prospect of direct benefit to themselves. However, we disagree that SARS-CoV-2 challenge studies are ethically appropriate at this time, (...) for 3 reasons: (1) current scientific knowledge of SARS-CoV-2 infection is insufficient to manage risks; (2) autonomous decision making, while necessary, does not override concerns about risk; and (3) undertaking challenge studies now would imperil confidence in the research enterprise, potentially undermining the global response to the coronavirus disease 2019 (COVID-19) pandemic. (shrink)

Syndromic surveillance uses new ways of gathering data to identify possible disease outbreaks. Because syndromic surveillance can be implemented to detect patterns before diseases are even identified, it poses novel problems for informed consent, patient privacy and confidentiality, and risks of stigmatization. This paper analyzes these ethical issues from the viewpoint of the patient as victim and vector. It concludes by pointing out that the new International Health Regulations fail to take full account of the ethical challenges raised by syndromic (...) surveillance. (shrink)

_Not exercising as much as you should? Counting your calories in your sleep? Feeling ashamed for not being happier? You may be a victim of the wellness syndrome._ In this ground-breaking new book, Carl Cederström and André Spicer argue that the ever-present pressure to maximize our wellness has started to work against us, making us feel worse and provoking us to withdraw into ourselves. The Wellness Syndrome follows health freaks who go to extremes to find the perfect diet, (...) corporate athletes who start the day with a dance party, and the self-trackers who monitor everything, including their own toilet habits. This is a world where feeling good has become indistinguishable from being good. Visions of social change have been reduced to dreams of individual transformation, political debate has been replaced by insipid moralising, and scientific evidence has been traded for new-age delusions. A lively and humorous diagnosis of the cult of wellness, this book is an indispensable guide for everyone suspicious of our relentless quest to be happier and healthier. (shrink)

In recent times, explanations of the Capgras delusion have tended to emphasise the cognitive dysfunction that is believed to occur at the second stage of two-stage models. This is generally viewed as a response to the inadequacies of the one-stage account. Whilst accepting that some form of cognitive disruption is a necessary part of the aetiology of the Capgras delusion, I nevertheless argue that the emphasis placed on this second-stage is to the detriment of the important role played (...) by the phenomenology underlying the disorder, both in terms of the formation and maintenance of the delusional belief. This paper therefore proposes an interactionist two-stage model in which the phenomenal experience of the Capgras patient is examined, emphasised, and its relation to top-down processing discussed. (shrink)