On the basis of knowledge prior to 1988, Ashbrook pointed out that whereas most men are primarily dependent on the left cerebral hemisphere (“dominant hemisphere”) for verbally related functions, women show a greater hemispheric balance in this respect. For men, he argues, their possession of a “speaking” and a “non‐speaking hemisphere” results in a positive‐negative, bipolar way of thinking that may be characterized as dualistic and dialectically hierarchical. In contrast, the greater balance of hemispheric function in women appears to promote (...) greater generalization and synthesis in their thinking.In this article I cite more recent neuroanatomical and brain imaging studies that provide further evidence of disparities in structure and function of the brains of men and women. As background for an attempt to explain these differences, I give a brief review of the triune evolution of the mammalian brain leading up to the human cerebrum. It is of major significance that the female has played a central role in mammalian evolution for more than 180 million years and that the evolutionary transition from reptilian therapsids to mammals is characterized by the develoment of (1) nursing conjoined with maternal care; (2) audiovocal communication or aiding mother‐offspring contact; and (3) play. In human beings, the infant‐carrying hypothesis suggests one means by which, over generations, certain parts of a woman's right hemisphere could undergo functional and eventual anatomical expansion. The mother‐infant communication of basic mammalian sounds with vowel and consonant components suggests a basis for the origination of speech.Finally, in an expansion of Ashbrook's original thesis, we arrive at the rovocative consideration that, unlike men, with their dialectical reasoning, women, with their more balanced brain, are provided with a trialectial ladder for climbing to achieve knowledge. In terms of quantum mechanics, the particle and wave would correspond to the substance and strength of the sides of the ladder, and the derived psychic information (which is neither matter nor energy) would compare to the rungs in between. (shrink)

Krueger & Funder (K&F) describe social psychology as overly consumed with maladaptive heuristics and biases. This characterization fails to consider multi-process models of social thought and action. Such models, especially with respect to attitudes, have outlined the situational and individual difference variables responsible for determining when thoughts and actions are relatively thoughtful versus when they are more reliant on mental shortcuts.

Mainstream social psychology focuses on how people characteristically violate norms of action through social misbehaviors such as conformity with false majority judgments, destructive obedience, and failures to help those in need. Likewise, they are seen to violate norms of reasoning through cognitive errors such as misuse of social information, self-enhancement, and an over-readiness to attribute dispositional characteristics. The causes of this negative research emphasis include the apparent informativeness of norm violation, the status of good behavior and judgment as unconfirmable null (...) hypotheses, and the allure of counter-intuitive findings. The shortcomings of this orientation include frequently erroneous imputations of error, findings of mutually contradictory errors, incoherent interpretations of error, an inability to explain the sources of behavioral or cognitive achievement, and the inhibition of generalized theory. Possible remedies include increased attention to the complete range of behavior and judgmental accomplishment, analytic reforms emphasizing effect sizes and Bayesian inference, and a theoretical paradigm able to account for both the sources of accomplishment and of error. A more balanced social psychology would yield not only a more positive view of human nature, but also an improved understanding of the bases of good behavior and accurate judgment, coherent explanations of occasional lapses, and theoretically grounded suggestions for improvement. Key Words: Bayesian inference; biases; normative models; personality; positive psychology; rationality; reasoning; social behavior; social judgment; social psychology. (shrink)

Many accounts of the historical development of neurological criteria for determination of death insufficiently distinguish between two strands of interpretation advanced by advocates of a "whole-brain" criterion. One strand focuses on the brain as the organ of integration. Another provides a far more complex and nuanced account, both of death and of a policy on the determination of death. Current criticisms of the whole-brain criterion are effective in refuting the first interpretation, but not the second, which (...) is advanced in the 2008 President's Council report on the determination of death. In this essay, I seek to further develop this second strand of interpretation. I argue that policy on determination of death aligns moral, biological, and ontological death concepts. Morally, death marks the stage when respect is no longer owed. Biologically, death concerns integrated functioning of an organism as a whole. But the biological concepts are underdetermined. The moral concerns lead to selection of strong individuality concepts rather than weak ones. They also push criteria to the "far side" of the dying process. There is a countervailing consideration associated with optimizing the number of available organs, and this pushes to the "near side" of death. Policy is governed by a conviction that it is possible to align these moral and biological death concepts, but this conviction simply lays out an agenda. There is also a prescription—integral to the dead donor rule—that lexically prioritizes the deontic concerns and that seeks to balance the countervailing tendencies by using science-based refinements to make the line between life and death more precise. After showing how these concerns have been effectively aligned in the current policy, I present a modified variant of a "division" scenario and show how an "inverse decapitation problem" leads to a conclusive refutation of the nonbrain account of death. (shrink)

The relationship between medicine and money is a delicate one that all people involved need to handle responsibly. If one becomes a physician for the mere fact of pursuing money, s/he may soon find that another profession or activity may have fulfilled such a need in a better way. While in the practice of medicine the interest of the patient is paramount, this does not suggest that the welfare of the physician should be neglected at all. It is much about (...) a balance of priorities between the legal and ethical pursuit of money and the promotion of the health of society. Physicians are not called to a life of self-denial, poverty and destitution, as others may be tempted to suggest. The service of patients and the honest reward from one's labour are not incompatible. Where conflict of interest arises, it is prudent for a physician to always remember never to harm oneself, the profession and the patient more than what can be gained. (shrink)

BackgroundThe preferable position of Deep Brain Stimulation electrodes is proposed to be located in the dorsolateral subthalamic nucleus to improve general motor performance. The optimal DBS electrode localization for the post-operative improvement of balance and gait is unknown.MethodsIn this single-center, retrospective analyses, 66 Parkinson’s disease patients were assessed pre- and post-operatively by using MDS-UPDRS, freezing of gait score, Giladi’s gait and falls questionnaire and Berg balance scale. The clinical outcome was related to the DBS electrode coordinates in x, y, (...) z plane as revealed by image-based reconstruction. Binomial generalized linear mixed models with fixed-effect variables electrode asymmetry, parkinsonian subtype, medication, age class and clinical DBS induced changes were analyzed.ResultsSubthalamic nucleus-deep brain stimulation improved all motor, balance and FoG scores in MED OFF condition, however there were heterogeneous results in MED ON condition. DBS electrode reconstructed coordinates impacted the responsiveness of axial symptoms. FoG and balance responders showed slightly more medially located STN electrode coordinates and less medio-lateral asymmetry of the electrode reconstructed coordinates across hemispheres compared to non-responders.ConclusionDeep brain stimulation electrode reconstructed coordinates, particularly electrode asymmetry on the medio-lateral axis affected the post-operative responsiveness of balance and FoG symptoms in PD patients. (shrink)

Neural complexity and brain entropy have gained greater interest in recent years. The dynamics of neural signals and their relations with information processing continue to be investigated through different measures in a variety of noteworthy studies. The BEN of spontaneous neural activity decreases during states of reduced consciousness. This evidence has been showed in primary consciousness states, such as psychedelic states, under the name of “the entropic brain hypothesis.” In this manuscript we propose an extension of this hypothesis (...) to physiological and pathological aging. We review this particular facet of the complexity of the brain, mentioning studies that have investigated BEN in primary consciousness states, and extending this view to the field of neuroaging with a focus on resting-state functional Magnetic Resonance Imaging. We first introduce historic and conceptual ideas about entropy and neural complexity, treating the mindbrain as a complex nonlinear dynamic adaptive system, in light of the free energy principle. Then, we review the studies in this field, analyzing the idea that the aim of the neurocognitive system is to maintain a dynamic state of balance between order and chaos, both in terms of dynamics of neural signals and functional connectivity. In our exploration we will review studies both on acute psychedelic states and more chronic psychotic states and traits, such as those in schizophrenia, in order to show the increase of entropy in those states. Then we extend our exploration to physiological and pathological aging, where BEN is reduced. Finally, we propose an interpretation of these results, defining a general trend of BEN in primary states and cognitive aging. (shrink)

Krueger & Funder (K&F) are right that various imbalances characterize social psychology, but I question whether they are characteristic of psychology or cognitive science as a whole. Dual-process theories, popular in the latter fields, emphasize both processing biases and the adaptiveness of human cognition in a more balanced manner.

Krueger & Funder could have gone further to sketch out a more comprehensive vision of “balanced” psychology. The triumphs and travails of other sciences provide clues about the advantages and pitfalls of pursuing such an approach. Perhaps introducing more positivity into psychology may involve asking how people can do better, not how well they do already.

Values will be central to developing a more balanced social psychology. A nonconformist account of Asch's (1956) experiments is used to illustrate the role of multiple values and to support and extend Krueger & Funder's (K&F's) claims. A balance of values, one that goes beyond accuracy and truth, and that avoids absolutism and relativism, is needed.

The public purse is responsible for funding almost all autism spectrum disorders (ASD) research in Canada (as per Canadian Institutes of Health Research [CIHR]) and for providing some of the existing services and supports for this population. In this article, we consider various reasons why Canada should be concerned to ensure a more equitable distribution of relevant public funding for ASD research than is currently the case to meet the express needs and interests of the diversity of autism stakeholders. (...) As such, we report data to show that CIHR-supported ASD research from the period of 2000–2010 demonstrates a bias focussed on the aetiology of the condition revealing a disproportionate emphasis on only two (Biomedical and Clinical) out of the four research pillars avowed by CIHR, with a comparative lack of fiscal resources committed to Health Systems and Services and Population and Public Health research. We advance certain normative and prudential reasons for funding more Health Systems and Services and Population and Public Health ASD research in Canada. In our view, this would seem to follow from CIHR’s official mandate ‘as a flexible mechanism that will continually align health research funding with changes in the manner in which health problems and opportunities are identified, understood and addressed’. (shrink)

Source preference in which equally distributed risks may be valued differently has been receiving increasing attention. Using subjects recruited in Berkeley, Fox and Tversky demonstrate a familiarity bias in source preference—betting on a less than even-chance event based on San Francisco temperature is valued more than betting on a better than even-chance event based on Istanbul temperature. Neophobia is associated with the amygdala which is GABA-rich and is known to be modulated by benzodiazepines as anxiolytic agents that enhance the (...) activity of the GABAA receptor in processing anxiety and fear. This leads to our hypothesis that familiarity bias in decision making may be explained by polymorphic variations in this receptor mediated by anxiety regulation in the amygdala. In two companion studies involving Beijing-based subjects, we examine 10 single nucleotide polymorphisms of GABRB2 and find 7 SNPs each showing negative association between familiarity bias—preference for betting on parity of Beijing temperature over Tokyo temperature—and having at least one minor allele. In an imaging genetics study of a subsample of subjects based on the SNP with the most balanced allelic distribution, we find that subjects’ familiarity bias in terms of risk aversion towards bets on the parity of the temperature of 20 Chinese cities is negatively associated with their post-scanning familiarity ratings of the cities only for those with no minor allele in this SNP. Moreover, familiarity bias is positively associated with activation in the right amygdala along with the brain’s attention networks. Overall, our findings help discriminate between ambiguity aversion and familiarity bias in source preference and supports our gene–brain–behavior hypothesis of GABAergic modulation of amygdala activation in response to familiarity towards the source of uncertainty. (shrink)

Sagvolden, Johansen, Aase, and Russell (Sagvolden et al.) examine attention-deficit/hyperactivity disorder (ADHD) at levels of analysis ranging from neurotransmitters to behavior. At the behavioral level they attribute aspects of ADHD to anomalies of delay-of-reinforcement gradients. With a normal gradient, responses followed after a long delay by a reinforcer may share in the effects of that reinforcer; with a diminished or steepened gradient they may fail to do so. Steepened gradients differentially select rapidly emitted responses (hyperactivity), and they limit the effectiveness (...) with which extended stimuli become conditioned reinforcers, so that observing behavior is less well maintained (attention deficit). Impulsiveness also follows from steepened gradients, which increase the effectiveness of smaller, more immediate consequences relative to larger, more delayed ones. Individuals who vary in the degree to which their delay gradients are steepened will show different balances between hyperactivity and attention deficit. Given the range of ADHD phenomena addressed, it may be unnecessary to appeal to additional behavioral processes such as extinction deficit. Extinction deficit is more likely a derivative of attention deficit, in that failure to attend to stimuli differentially correlated with extinction should slow its progress. The account suggests how relatively small differences in delay gradients early in development might engender behavioral interactions leading to very large differences later on. The steepened gradients presumably originate in properties of neurotransmitter function, but behavioral interventions that use consistently short delays of reinforcement to build higher-order behavioral units as a scaffolding to support complex cognitive and social skills may nonetheless be feasible. Key Words: ADHD; attention deficit; delay gradient; exponential decay; extinction deficit; hyperactivity; impulsiveness; intervention; observing responses; self-control. Footnotes1000 Jeffrey Gray was the BBS Editor for this treatment. When he accepted Sagvolden et al. for publication, he invited Catania, who was one of the reviewers of the original submission, to prepare a precommentary. Com-mentators were then invited to respond to the Sagvolden et al. article, to the Catania precommentary, or to both. (shrink)

The authors present a balanced critique of the adaptation/exaptation debate and specify some of the hard evidentiary criteria that are needed to advance our understanding of human evolution. Investigators must build more “special design” criteria into their theorizing and research. By documenting that certain traits meet these rigorous criteria, the evolutionary sciences will ultimately rest on a firmer theoretical foundation.

A balanced approach that considers human strengths and weaknesses will lead to a more flattering set of empirical findings, but will distract researchers from focusing on the mental processes that produce such findings and will diminish the practical implications of their work. Psychologists ought to be doing research that is theoretically informative and practically relevant, exactly as they are doing.

According to berkley's review, women have a higher risk of suffering from pain than men. If this is true, there should be more frequent and more intense activity both in the pain excitatory system and in the pain inhibitory system of women than of men. Consequently, it remains unclear whether the overall effect at the end is more pain or less pain in women. This conclusion fits the weak sex differences observed for experimental and clinical pain as (...) shown by BERKLEY's review of the literature. (shrink)

Nanotechnology is a swiftly developing field of technology that is believed to have the potential of great upsides and excessive downsides. In the ethical debate there has been a strong tendency to strongly focus on either the first or the latter. As a consequence ethical assessments of nanotechnology tend to radically diverge. Optimistic visionaries predict truly utopian states of affairs. Pessimistic thinkers present all manner of apocalyptic visions. Whereas the utopian views follow from one-sidedly focusing on the potential benefits of (...) nanotechnology, the apocalyptic perspectives result from giving exclusive attention to possible worst-case scenarios. These radically opposing evaluations hold the risk of conflicts and unwanted backlashes. Furthermore, many of these drastic views are based on simplified and outdated visions of a nanotechnology dominated by self-replicating assemblers and nanomachines. Hence, the present state of the ethical debate on nanotechnology calls for the development of more balanced and better-informed assessments. As a first step in this direction this contribution presents a new method of framing the ethical debate on nanotechnology. Thus, the focus of this paper is on methodology, not on normative analysis. (shrink)

There is an important hemispheric distinction in the functional organization of prefrontal cortex (PFC) that has not been fully recognized and explored. Research with split-brain patients provides considerable evidence for a left hemisphere (LH) “interpreter” that abhors indeterminacy and automatically draws inferences to complete patterns (real or imaginary). It is suggested that this “interpreter” function may be a byproduct of the linguistic capabilities of the LH. This same literature initially limited the role of the right hemisphere (RH) to little (...) more than visual organization. Recent reviews have garnered evidence for several different roles for the right PFC in reasoning, problem solving, and decision-making. We here focus on the beneficial but neglected role of indeterminacy in real-world problem solving and argue that the right PFC complements the left PFC “interpreter” by maintaining, and even enhancing indeterminacy. Successful real-world functioning is a delicate balancing act between these two systems. (shrink)

Open peer commentary on the article “Homeostats for the 21st Century? Simulating Ashby Simulating the Brain” by Stefano Franchi. Upshot: The association of heteronomy with Ashby’s work in the target article follows from a direct interpretation of the second edition of Ashby’s book Design for a Brain. However, the first edition allows for an alternative – opposite – interpretation that is compatible with autonomy and autopoiesis. Furthermore, a more balanced perspective is suggested to avoid unintentionally giving (...) the casual reader a misleading impression that the homeostat is Ashby’s ultimate position on homeostasis and that it is an adequate model of the brain. (shrink)

Human development has become particularly complex during the evolution. In this complexity, adolescence is an extremely important developmental stage. Adolescence is characterized by biological and social changes that create the prerequisites to psychopathological problems, including both substance and non-substance addictive behaviors. Central to the dynamics of the biological changes during adolescence are the synergy between sexual and neurophysiological development, which activates the motivational/emotional systems of Dominance/Submission. The latter are characterized by the interaction between the sexual hormones, the dopaminergic system and (...) the stress axis. The maturation of these motivational/emotional systems requires the integration with the phylogenetically more recent Attachment/CARE Systems, which primarily have governed the subject’s relationships until puberty. The integration of these systems is particularly complex in the human species, due to the evolution of the process of competition related to sexual selection: from a simple fight between two individuals to a struggle for the acquisition of a position in rank and the competition between groups. The latter is an important evolutionary acquisition and believed to be the variable that has most contributed to enhancing the capacity for cooperation in the human species. The interaction between competition and cooperation, and between competition and attachment, characterizes the entire human relational and emotional structure and the unending work of integration to which the BrainMind is involved. The beginning of the integration of the aforementioned motivational/emotional systems is currently identified in the prepubertal period, during the juvenile stage, with the development of the Adrenarche—the so-called Adrenal Puberty. This latter stage is characterized by a low rate of release of androgens, the hormones released by the adrenal cortex, which activate the same behaviors as those observed in the PLAY system. The Adrenarche and the PLAY system are biological and functional prerequisites of adolescence, a period devoted to learning the difficult task of integrating the phylogenetically ancient Dominance/Submission Systems with the newer Attachment/CARE Systems. These systems accompany very different adaptive goals which can easily give rise to mutual conflict and can in turn make the balance of the BrainMind precarious and vulnerable to mental suffering. (shrink)

As the pace of technological change accelerates, we are increasingly experiencing a state of information overload. Statistics show that we are interrupted every three minutes during the course of the work day. Multitasking between email, cell-phone, text messages, and four or five websites while listening to an iPod forces the brain to process more and more informaton at greater and greater speeds. And yet the human brain has hardly changed in the last 40,000 years. Are all (...) these high-tech advances overtaxing our Stone Age brains or is the constant flood of information good for us, giving our brains the daily exercise they seem to crave? In The Overflowing Brain, cognitive scientist Torkel Klingberg takes us on a journey into the limits and possibilities of the brain. He suggests that we should acknowledge and embrace our desire for information and mental challenges, but try to find a balance between demand and capacity. Klingberg explores the cognitive demands, or "complexity," of everyday life and how the brain tries to meet them. He identifies different types of attention, such as stimulus-driven and controlled attention, but focuses chiefly on "working memory," our capacity to keep information in mind for short periods of time. Dr Klingberg asserts that working memory capacity, long thought to be static and hardwired in the brain, can be improved by training, and that the increasing demands on working memory may actually have a constructive effect: as demands on the human brain increase, so does its capacity. The book ends with a discussion of the future of brain development and how we can best handle information overload in our everyday lives. Klingberg suggests how we might find a balance between demand and capacity and move from feeling overwhelmed to deeply engaged. (shrink)

Background Human brain organoids are a valuable research tool for studying brain development, physiology, and pathology. Yet, a host of potential ethical concerns are inherent in their creation. There is a growing group of bioethicists who acknowledge the moral imperative to develop brain organoid technologies and call for caution in this research. Although a relatively new technology, brain organoids and their uses are already being discussed in media literature. Media literature informs the public and policymakers but (...) has the potential for utopian or dystopian distortions. Thus, it is important to understand how this technology is portrayed to the public. Methods To investigate how brain organoids are displayed to the public, we conducted a systematic review of media literature indexed in the Nexis Uni database from 2013–2019. News and media source articles passing exclusion criteria (_n_ = 93) were scored to evaluate tone and relevant themes. Themes were validated with a pilot sample before being applied to the dataset. Thematic analysis assessed article tone, reported potential for the technology, and the scientific, social, and ethical contexts surrounding brain organoids research. Results Brain organoid publications became more frequent from 2013 to 2019. We observed increases in positively and negatively toned articles, suggesting growing polarization. While many sources discuss realistic applications of brain organoids, others suggest treatment and cures beyond the scope of the current technology. This could work to overhype the technology and disillusion patients and families by offering false hope. In the ethical narrative we observe a preoccupation with issues such as development of artificial consciousness and “humanization” of organoid-animal chimeras. Issues of regulation, ownership, and accuracy of the organoid models are rarely discussed. Conclusions Given the power that media have to inform or misinform the public, it is important this literature provides an accurate and balanced reflection of the therapeutic potential and associated ethical issues regarding brain organoid research. Our study suggests increasing polarization, coupled with misplaced and unfounded ethical concern. Given the inhibitory effects of public fear or disillusion on research funding, it is important media literature provides an accurate reflection of brain organoids. (shrink)

Despite its successes, to date Artificial Intelligence (AI) is still characterized by a number of shortcomings with regards to different application domains and goals. These limitations are arguably both conceptual (e.g., related to the underlying theoretical models, such as symbolic vs.connectionist), and operational (e.g., related to robustness and ability to generalize). Biologically inspired AI, and more specifically brain-inspired AI, promises to provide further biological aspects beyond those that are already traditionally included in AI, making it possible to assess (...) and possibly overcome some of its present shortcomings. This article examines some conceptual, technical, and ethical issues raised by the development and use of brain-inspired AI. Against this background, the paper asks whether there is anything ethically unique about brain-inspired AI. The aim of the paper is to introduce a method that has a heuristic nature and that can be applied to identify and address the ethical issues arising from brain-inspired AI (and from AI more generally). The conclusion resulting from the application of this method is that, compared to traditional AI, brain-inspired AI raises new foundational ethical issues and some new practical ethical issues, and exacerbates some of the issues raised by traditional AI. (shrink)

Researchers have wondered how the brain creates emotions since the early days of psychological science. With a surge of studies in affective neuroscience in recent decades, scientists are poised to answer this question. In this target article, we present a meta-analytic summary of the neuroimaging literature on human emotion. We compare the locationist approach (i.e., the hypothesis that discrete emotion categories consistently and specifically correspond to distinct brain regions) with the psychological constructionist approach (i.e., the hypothesis that discrete (...) emotion categories are constructed of more general brain networks not specific to those categories) to better understand the brain basis of emotion. We review both locationist and psychological constructionist hypotheses of brain–emotion correspondence and report meta-analytic findings bearing on these hypotheses. Overall, we found little evidence that discrete emotion categories can be consistently and specifically localized to distinct brain regions. Instead, we found evidence that is consistent with a psychological constructionist approach to the mind: A set of interacting brain regions commonly involved in basic psychological operations of both an emotional and non-emotional nature are active during emotion experience and perception across a range of discrete emotion categories. (shrink)

Previous research on sustainable entrepreneurship has mainly aimed to understand the antecedents of entrepreneurs’ sustainability-oriented behavior. Yet the literature lacks a more nuanced understanding of how entrepreneurs implement sustainability strategies when creating a new venture. Drawing on sustainability concepts, we first examine how entrepreneurs balance the economic, environmental, and social dimensions as part of their ventures’ strategic ambitions. We show that sustainable entrepreneurs prioritize the three sustainability dimensions and possibly reprioritize them in response to stakeholder interests. Applying a stakeholder (...) theory perspective, we theorize that how entrepreneurs balance their sustainability dimensions and goals depends on the degree of stakeholder involvement and of external expectations. Our contributions refine the growing sustainable entrepreneurship literature and call attention to the importance of including weightings and time when examining the dimensions of sustainability. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Road to Understanding and Acceptance of the Late Effects of Pediatric Brain Tumors and TreatmentJeanne CarlsonWe had little warning or time to adjust to our daughter’s diagnosis. A call from her third grade teacher reporting that Sarah seemed to be having vision problems rapidly led to eye exams, an MRI, and the discovery of a Germinoma brain tumor in the suprastellar region of Sarah’s brain. (...) We were terrified but began treatment feeling optimistic about the outlook for Sarah’s recovery. Luckily, Sarah’s treatment was relatively non–invasive and quick, chemotherapy and radiation, five months start to finish. We were thrilled to have Sarah’s treatment behind us.As any parent of a child with a life–threatening illness knows, family life is seriously disrupted by the countless doctor, lab, and hospital visits, the worry, and the financial strain that are suddenly added to the demands of everyday life. We did our best to balance our focus on both of our children as Sarah is a twin and we didn’t want her brother Will to suffer as a result of his sister’s illness. It wasn’t easy but we found a way to schedule Will’s usual play dates, baseball practice, and family time. We were all happy and relieved when Sarah’s treatment was completed, yet we would later learn that we had been incredibly naïve in two ways; we thought that our brain tumor journey was over after Sarah’s treatment was completed and we thought that we’d brought Will through the process without effect. We had a lot to learn.At the time of diagnosis we knew that Sarah’s memory and ability to express emotion had already been impacted by the tumor but we didn’t yet know what that would mean to her quality of life. We were virtually unaware however that at age nine the chemotherapy and radiation treatments that Sarah received would result in profound late effects. Following treatment Sarah successfully completed 3rd grade and even received excellent STAR test scores (California state standardized tests). In 4th grade however, Sarah’s performance began to diverge from that of her peers and she found herself struggling in school and unable to make friends. We began looking for ways to help our daughter.What followed was a five year long journey through testing, evaluations, individualized education plans (IEPs), and therapies, which, in the end, left our family needing to accept the fact that although Sarah remains intelligent and artistically talented, she suffers from a constellation of late effects that will always affect her ability to function in the world. As a result of Sarah’s tumor and treatment she struggles with Auditory Processing Disorder, word finding problems, poor executive function, inability to recognize how she feels, significant difficulty making decisions, inability to read social cues, poor memory, slow processing, an emotional age of about nine, and lots of anxiety. She is also panhypopituitary, meaning that she has no remaining pituitary function and must take replacement medications by pill and injection, has hypothalamic obesity (HO), which is primarily controlled by more medication, and Raynaud’s Disease. The HO is an ongoing challenge because if Sarah does gain weight she can’t lose it again and exercise is not an easy solution because, like many pediatric brain tumor survivors, Sarah is easily fatigued. Finally, although Sarah’s vision improved after treatment her vision loss is significant enough to prevent her from driving. We pieced together this understanding of Sarah’s challenges and disabilities slowly so it wasn’t until the end of our children’s middle school years that we finally accepted the magnitude of the damage caused by the tumor and treatment. Thereafter we changed our focus from what Sarah might achieve in life to how to support [End Page 21] her in the activities at which she still excels and how to keep her active, interested in life, and feeling good about herself.It would have been a huge gift if we had been provided with information about the possible late effects that can result from treating the brain of a 9–year–old... (shrink)

We applaud the authors' basic message. We note that the negative research emphasis is not special solely to social psychology and judgment and decision-making. We argue that the proposed integration of null hypothesis significance testing (NHST) and Bayesian analysis is promising but will ultimately succeed only if more attention is paid to proper experimental design and implementation.

For more than two thousand years, almost all doctors in the West used bloodletting to treat a great variety of diseases and conditions. In an attempt to find out why they acted thus, Dr Brain has translated the three works on bloodletting by the second-century physician Galen, which provide by far the most comprehensive account of the practice in antiquity. This is the first published version of these works in a modern language. After a brief summary of Galen's (...) medical system, the author goes on to consider the origins of Galen's ideas and methods, with particular reference to the Hippocratic writings, and the question why Galen, in common with most of the ancient physicians, believed in the efficacy of the comedy. The effects of bloodletting are considered in terms of modem physiology and medicine, and the possibility is explored that it may indeed have been beneficial in the conditions prevailing in Galen's time. (shrink)

Consideration of the adaptive problems faced by our ancestors suggests functional reasons why people exhibit some biases in social judgment more than others. We present a taxonomy consisting of six domains of central social challenges. Each is associated with somewhat different motivations, and consequently different decision-rules. These decision-rules, in turn, make some biases inherently more likely to emerge than others.

A key goal in the Olympic value system of Olympism is the all-round cultivation of the individual. According to its so-called ?fundamental principles?, Olympism is a ?philosophy of life? with ideals of ?exalting and combining in a balanced whole the qualities of body, will, and mind? and creating ?a way of life based on the joy of effort?. These goals are to be reached by blending sport with culture and education. Olympism is often criticised for idealism and lack of (...) impact in real life. At the same time Olympic ideals are intuitively appealing and have rhetorical force. The Olympic athlete stands at the very centre of the ideology. This paper examines the possibility of critical examination of Olympic ideals in terms of three different understandings of the athlete. A dualist understanding sees the athlete as divided between body and mind and with the body as a means towards the cultivation of the mind. Within this understanding Olympic ideals make little sense. A phenomenological approach attempts to overcome a dualist scheme with an understanding of the athlete as ?embodied intentionality?. This seems fertile in an examination of Olympic ideals but can be criticised for lack of contextual sensitivity. A third perspective points towards the athlete as a social construction who can be fully understood only by examining the more extensive socio-cultural context of which the athlete is a part. The contextual understanding adds critical force to Olympic analyses but seems to lack conceptual tools to examine the vision of athletes as responsible moral agents. In conclusion the complementary functions of the three perspectives are emphasised for a proper study of Olympic ideals. (shrink)

Over the past two decades, there has been a growing interest in the use of meditation to improve cognitive performance, emotional balance, and well-being. As a consequence, research into the psychological effects and neural mechanisms of meditation has been accumulating. Whether and how meditation affects decision making is not yet clear. Here, we review evidence from behavioral and neuroimaging studies and summarize the effects of meditation on social and non-social economic decision making. Research suggests that meditation modulates brain activities (...) associated with cognitive control, emotion regulation and empathy, and leads to improved non-social and social decision making. Accordingly, we propose an integrative model in which cognitive control, emotional regulation, and empathic concern mediate the effects of meditation on decision making. This model provides insights into the mechanisms by which meditation affects the decision making process. More evidence is needed to test our explanatory model and to explore the function of specific brain areas and their interactive effects on decision making during meditation training. (shrink)

Introduction Tourette Syndrome is a childhood onset disorder characterized by vocal and motor tics and often remits spontaneously during adolescence. For treatment refractory patients, Deep Brain Stimulation may be considered. Methods and Results We discuss ethical problems encountered in two adolescent TS patients treated with DBS and systematically review the literature on the topic. Following surgery one patient experienced side effects without sufficient therapeutic effects and the stimulator was turned off. After a second series of behavioural treatment, he experienced (...) a tic reduction of more than 50%. The second patient went through a period of behavioural disturbances that interfered with optimal programming, but eventually experienced a 70% tic reduction. Sixteen DBS surgeries in adolescent TS patients have been reported, none of which pays attention to ethical aspects. Discussion Specific ethical issues arise in adolescent TS patients undergoing DBS relating both to clinical practice as well as to research. Attention should be paid to selecting patients fairly, thorough examination and weighing of risks and benefits, protecting the health of children and adolescents receiving DBS, special issues concerning patient’s autonomy, and the normative impact of quality of life. In research, registration of all TS cases in a central database covering a range of standardized information will facilitate further development of DBS for this indication. Conclusion Clinical practice should be accompanied by ongoing ethical reflection, preferably covering not only theoretical thought but providing also insights in the views and perspectives of those concerned, that is patients, family members and professionals. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:A Threat to Selfhood: Moral Distress and the Psychiatric Training CultureEsther NathansonWhile many medical specialties offer to heal, or even cure, psychiatry—uniquely—places the doctor–patient relationship at the center of the therapeutic effort. Psychiatrists must possess a complex and challenging combination of broad medical knowledge, finely honed interpersonal and analytic skills and confidence in their abilities, despite limited understanding of the workings of the brain. Inpatient psychiatry in particular (...) demands a degree of strength to withstand emotional, and sometimes physical, assault from patients who may be suicidal, desperate, paranoid, aggressive or delusional. Beyond these abilities, a good psychiatrist must have robust but ‘therapeutically porous’ emotional boundaries that allow genuine empathy for the patient but, at the same time, limit internalization of the patient’s anguish as the practitioner’s own: the exquisite balance of ‘self–versus–other’ in the therapeutic encounter.Unfortunately, during my psychiatry residency in the UK, development of these intangible but essential boundaries was entirely absent from the curriculum. Early in training I struggled with my tendency to become an emotional chameleon with feelings and energies buffeted around by the prevailing emotions of each patient that walked through the door. I felt that patients expected me to offer tidy explanations for their suffering and provide answers to profound questions of meaning; to make the world a safe and understandable place. Given the complexity of mental illness and its interplay with social circumstances this was naïve and, I now realize, often unnecessary, but the weight of responsibility was unbearable. I was also completely unprepared for the intensity of human suffering I saw, and wholly unready to provide the level of interpersonal engagement required for genuine healing. My own emotional integrity felt threatened by the depth of patients’ needs, and my response—both physical and emotional—was intense and frightening.Much of my distress resulted from the profound and inevitable tension between the empathy necessary to comprehend patients’ experiences, which were often extreme and bewildering, and the need for resilience and self–protection at a time when my grasp of psychological theories and treatment practices was still rudimentary. I felt guilty that patients bore the brunt of my inexperience, and duplicitous purporting to help while burdening them with intolerable drug side–effects and stigmatizing, albeit effective, treatments such as electroconvulsive therapy (ECT). Time constraints and guidance from senior faculty encouraged expediency over treatment efficacy or durability; psychopharmacology was prioritized over the psychotherapeutic techniques and psychosocial interventions I found more effective for many patients. During the phase of our training that took place in a rambling, now defunct, asylum in the U.K, visits to the locked ward, which was reserved for patients considered a danger to others, were usually prompted by nurses’ requests for chemical restraint, the ‘pharmaceutical strait–jacket’. I was deeply uncomfortable with the role of ‘restrainer’ but had insufficient experience or seniority to propose other methods. It was only when, years later, I investigated re–training in the U.S that the senior psychiatry resident at a well–known program told me gently, ‘Oh, we assume that students will have a breakdown in their first year, so we have systems in place to help’. I’ll never forget those words; they are, to this day, the only validation of the emotional toll of my early training years.Adding to my discomfort were various ethically dubious administrative practices, the most troubling being the clinic’s unwillingness to disclose to patients that we were trainees, with little clinical experience. Senior faculty were dismissive when I asked whether my first psychotherapy patient had been told I was a trainee, indeed that I had never conducted psychotherapy before. My question was greeted with amusement and an assurance that, although she had not been told, I (not the patient, interestingly) would do fine.Due to the large number of no–shows in psychiatric outpatient clinics it was also standard practice to triple–book appointment times on the [End Page 115] assumption that one or more patients would fail to attend. Not uncommonly, more than one patient would arrive for the same appointment, leaving others to suffer agonizing waits that were often intensified by the deep discomfort... (shrink)

In philosophy, the criteria for personhood (PH) at a specific point in time (synchronic), and the necessary and sufficient conditions of personal identity (PI) over time (diachronic) are traditionally separated. Hence, the transition between both timescales of a person's life remains largely unclear. Personal habits reflect a decision-making (DM) process that binds together synchronic and diachronic timescales. Despite the fact that the actualization of habits takes place synchronically, they presuppose, for the possibility of their generation, time in a diachronic sense. (...) The acquisition of habits therefore rests upon PI over time; that is, the temporal extension of personal decisions is the necessary condition for the possible development of habits. Conceptually, habits can thus be seen as a bridge between synchronic and diachronic timescales of a person's life. In order to investigate the empirical mediation of this temporal linkage, we draw upon the neuronal mechanisms underlying DM; in particular on the distinction between internally and externally guided DM. Externally guided DM relies on external criteria at a specific point in time (synchronic); on a neural level, this has been associated with lateral frontal and parietal brain regions. In contrast, internally guided DM is based on the person's own preferences that involve a more longitudinal and thus diachronic timescale, which has been associated with the brain's intrinsic activity. Habits can be considered to reflect a balance between internally and externally guided DM, which implicates a particular temporal balance between diachronic and synchronic elements, thus linking two different timescales. Based on such evidence, we suggest a habit-based neurophilosophical approach of PH and PI by focusing on the empirically-based linkage between the synchronic and diachronic elements of habits. By doing so, we propose to link together what philosophically has been described and analyzed separately as PH and PI. (shrink)

Stoffregen & Bardy suggest that the senses are not separable. However, they have a philosophical approach rather than using direct evidence that the nervous system analyzes sensory information in a highly flexible manner.

This paper examines the culture, the dynamics and the financial underpinnings that determine how medical research is being conducted on children in the United States. Children have increasingly become the subject of experiments that offer them no potential direct benefit but expose them to risks of harm and pain. A wide range of such experiments will be examined, including a lethal heartburn drug test, the experimental insertion of a pacemaker, an invasive insulin infusion experiment, and a fenfluramine "violence prediction" experiment. (...) Emphasis, however, is given to psychoactive drug tests because of the inherent ethical and diagnostic problems involved in the absence of any objective, verifiable diagnostic tool. Effort is made to provide readers comprehensive reference sources to evidence-based reports about the serious risks these drugs pose for adults and children so that the reader may judge whether the benefits (if any) outweigh the risks for children. The first ethical issue raised by these experiments is: did the severity of illness in these children justify their exposure to short and long-term risks? The ethics of the experiments will be evaluated by referring to existing codes of medical research ethics-the Nuremberg Code, the Declaration of Helsinki, and the federal Code of Regulations. The thirteen cases presented will demonstrate that children are being used in ever more speculative experiments, often in the absence of a therapeutic intent, but a significant chance for causing harm and / or discomfort. Some of the experiments were designed to explore the mechanisms of pathology and pharmacological interventions, or the response of neurological brain receptors to chemical provocation ("challenge"). Others were designed to test the safety or efficacy of new drugs, even to test these drugs on healthy children who were hypothesized to be "at risk." Children and adolescents have been subjected to "forced dose titration" experiments that induced a spectrum of severe adverse effects, including insomnia, extreme restlessness, agitation, (akathisia) and self-injurious behavior. FDA reports show that suicide is a significant issue in psychotropic drug trials-in pediatric trials the problem is even greater. The paper aims to demonstrate how the enactment of the Better Pharmaceuticals for Children Act (incorporated into the Food and Drug Administration Modernization Act, FDAMA), set in motion a radical shift in public policy by providing huge financial incentives to pharmaceutical companies to test new or patented drugs in children. Federal policy shifted from one aimed at protecting children by setting limits on permissible research risks, to a policy aimed at broadening the inclusion of children as test subjects. It will be shown how the FDA and the Department of Health and Human Services lifted regulatory restrictions to permit research involving greater than minimal risk to be conducted on healthy children, claiming that all children are potentially "at risk" of a future condition. Children were in this way deprived of regulatory protections. An argument will be made that the approval of nontherapeutic, harmful experiments-such as exposure of toddlers to lead poison-under the current gate keeping system raises serious doubts about the sustainability of institutional review boards (IRBs) as protectors of human research subjects. Children, who are precluded from exercising the adult human's right to informed consent, are being exploited as commodities for commercial ends. It is the position of the author that nothing less than the enactment of a federal law mandating a radical overhaul of the current research review system, with independent checks and balances, will provide children the legal protections they need. Ten specific recommendations are offered to protect children from harmful experiments. (shrink)

The Convention on the Rights of Persons with Disabilities is increasingly seen as driving a paradigm shift in mental health law, particularly in relation to the understanding that it requires a shift from substituted to supported decisions. This article identifies two competing moral commitments implied by this shift, both of which appeal to the notion of autonomy. It is argued that because of these commitments the Convention is in tension with more general calls in the medical ethics literature for (...) preserving patient autonomy through support. The competing commitments within the Convention also present a particular challenge in putting the support it requires into practice. A discursive control account of freedom is used to develop some practical guidelines for navigating this new moral territory. (shrink)

Purpose: Explore public attitudes towards the trade-offs between justice and medical outcome inherent in organ allocation decisions.Background: The US Task Force on Organ Transplantation recommended that considerations of justice, autonomy and medical outcome be part of all organ allocation decisions. Justice in this context may be modeled as a function of three types of need, related to age, clinical urgency, and quality of life.Methods: A web-based survey was conducted in which respondents were asked to choose between two hypothetical patients who (...) differed in clinical urgency , age, pretransplant and post-transplant quality of life, and life expectancy.Results: A pool of 1600 people were notified via email about the survey; 623 responded. Respondents preferred giving organs to younger people up to an age difference of <15.4 years and more clinically urgent people up to a difference in urgency of <2.54 months . Priority varied with the quality of life of the worst-off patient and the relative status of the patients. If both had worse than average quality of life, respondents preferred the better-off patient. When both had better than average quality of life, they preferred the worse-off patient. In analysis according to age versus clinical urgency, the older the patient, the more urgency needed to receive priority. In quality of life versus clinical urgency, the better the control’s quality of life, the more urgency the competing patient required. The worse the patient’s post-transplant outcome, the more urgency needed to receive priority.Conclusions: It appears that clinical urgency is only one of many factors influencing attitudes about allocation decisions and that respondents may invoke different principles of fairness depending the relative clinical status of patients. (shrink)

I present evidence in favor of an overarching motivational self: a mental function that regulates expression of multiple goals. Goals often conflict with each other, and the role of a motivational self is to consciously or unconsciously prioritize pursuit of these goals. When observing inconsistency in expression of goals, it is therefore useful to consider whether the motivational self is attempting to balance between conflicting goals or if such inconsistency results from temporary self-control weakness.

A more complete and balanced theoretical framework for social psychology, as recommended in the target article, must include functional explanations of processes – moving beyond enumerations of processes and their properties. These functional explanations are at a different, but complementary, level from process descriptions. The further advancement of social psychology relies on the incorporation of such multilevel explanations.

In the last few years holography has celebrated some important anniversaries: in 2010 the 50th anniversary of the light amplification by stimulated emission of radiation (LASER) invention; in 2011 the 40th anniversary of the Nobel Prize awarded to the Hungarian scientist Dennis Gabor for inventing holography and in 2012 the 50th anniversary of the first holograms. Holography can create an accurate visual simulation, with total parallax: a replica of the real object made of light, which has the real object’s visual (...) properties but is immaterial, intangible. The holographic images are volumetric and exist in a real and measurable space, and are not based on the Renaissance perspective, which can represent the three-dimensional physical space in a bi-dimensional one. In the near future, holography-based techniques will open up new possibilities in the visualization domain, allowing new visual worlds. In the meantime, holography can be a useful technical and theoretical tool for reflecting on how our everyday mediascape works. The media can produce, reproduce and transmit bi-dimensional images on flat supports. The media system has a high degree of coherence and the images share similar morphostructural rules, and thus can be transferred from one medium to another without any fundamental information loss: bi-dimensionality and image-support coincidently appear to be the basis of this high level of translatability. Conversely, holograms cannot be displayed through the usual media without losing their peculiarity: they require new displays, new visual media and new genres of communication, even if they hybridize with the existing media. Holography stands apart from the media realm, which in part explains the difficulties of this technique in emerging and integrating into the mediascape. Holography suggests a new visual universe within a culture where visual simulation is the most effective communication system, and it lets us reflect on the need for a more comprehensive definition of ‘image’. It is easy to imagine that future images will also be holographic and that we will communicate more and more through them, in a delicate balance between presence and absence, immediacy and remoteness, materiality and immateriality, matter and energy. Holography can work as a model in science, for example in the study of brain activity in the Holonomic Brain Theory, originated by Austrian psychologist Karl Pribram and initially developed in collaboration with physicist David Bohm to explain human cognition. Holography can also be a model in physics, for example in the idea of the physicist David Bohm of an ‘implicate order’ in the universe, where global structure can be found in each small part – the universe would be a gigantic and wonderfully detailed hologram. More recently, theoretical results on black holes suggest that the idea of a holographic universe is a viable hypothesis. And in the field of quantum gravity and string theories the ‘holographic principle’ suggests that the entire universe can be considered as a two-dimensional information structure, and that the three-dimensional world we observe is but a description at a macroscopic scale and at low energies. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Clinical CommentarySim Kang, Associate ProfessorRegarding the question of whether to disclose the incidental finding or not to the 72-year-old subject, one needs to consider several issues pertaining to the elderly subject, investigator team, informed consent process, illness under examination and wider societal and cultural context. First, in terms of the subject, would keeping the incidental finding secret in the context of the informed consent be respectful of the wishes (...) of the subject? One needs to bear in mind that consent was taken with the understanding that assessments will not be further shared with the subject as the assessments were done in the research study to generate new data and were not part of clinical evaluation or treatment. In one sense, autonomy of the subject in agreeing and consenting to the study investigations must be respected and the subject is comfortable that no results of the extensive assessments (blood tests and brain scans which are performed at baseline and annually for three years prospectively) will be proffered in the course of the project. At a more personal level, it may also be that the subject prefers not to know of any incidental findings even if present, which in some cases may be related to cultural notions of abnormal findings and ill health.Second, from the standpoint of the research team, would awareness of the space-occupying lesion but not informing the subject constitute a breach of ethical principles of beneficence and non maleficence? When the subject is enrolled in a research study, it is understood that the balance between research risks and benefits should have been evaluated in favour of the latter. Although more needs to be clarified to determine the clinical significance of the lesion, there is a possibility that the lesion may be malignant which would pose [End Page 289] further challenges. If the lesion is detected early, there may be a likelihood of early intervention, including surgical or non-surgical options. If the lesion of undetermined stage at present is not treated expediently and expeditiously, is there a possibility of it progressing to a stage when delayed treatment may be less effective? In this aspect, the welfare of the subject needs to be kept in mind. Even if nondisclosure is opted, is it just to allow the subject to continue in the longitudinal study if the small intracerebral lesion turns out to be malignant or that treatment may be rendered less effective over time?Third, with regard to the informed consent procedure, does the patient fully appreciate the details and implications of the study including not sharing laboratory or neuroimaging evaluations? For the process of informed consent to be meaningful, there are three elements that need to be present, namely adequate and appropriate disclosure of details about the study, demonstration of understanding of the information presented, as well as voluntariness in participation. Pertaining to adequate disclosure, was there appropriate disclosure and discussion of some of the key aspects of the study, including prospective nature lasting three years, repeated measurements and no sharing of details of assessments? The subject needs to have an appreciation of the impact of the information beyond intellectual comprehension. Was he or she cognisant of the number of visits over the entire course of the study as well as the amount of time involved for each visit? What was the response of the subject when it was made known that additional information obtained from the study evaluations will not be revealed or disclosed?Factors that may influence the understanding in this case include older age with possible easier fatigability and shorter attention span, severity of illness with related level of cognitive impairment, educational level, and familiarity with research procedures, all of which are unclear in this case at this point. With respect to voluntariness, was there any undue coercion or influence that may compromise the respect for autonomy of the research subject? It is noteworthy that the team has painstakingly committed to retake the consent before each follow up (thrice over three years) and that the subject can withdraw from the participation in the study at any point in time. Were there factors that may affect the willingness of the subject... (shrink)

Dispositional mindfulness and emotion regulation are two psychological constructs closely interrelated, and both appear to improve with the long-term practice of mindfulness meditation. These constructs appear to be related to subcortical, prefrontal, and posterior brain areas involved in emotional processing, cognitive control, self-awareness, and mind wandering. However, no studies have yet discerned the neural basis of dispositional mindfulness that are minimally associated with emotion regulation. In the present study, we use a novel brain structural network analysis approach to (...) study the relationship between structural networks and dispositional mindfulness, measured with two different and widely used instruments [Mindfulness Attention Awareness Scale and Five Facet Mindfulness Questionnaire ], taking into account the effect of emotion regulation difficulties. We observed a number of different brain regions associated with the different scales and dimensions. The total score of FFMQ and MAAS overlap with the bilateral parahippocampal and fusiform gyri. Additionally, MAAS scores were related to the bilateral hippocampus and the FFMQ total score to the right insula and bilateral amygdala. These results indicate that, depending on the instrument used, the characteristics measured could differ and could also involve different brain systems. However, it seems that brain areas related to emotional reactivity and semantic processing are generally related to Dispositional or trait mindfulness, regardless of the instrument used. (shrink)

We argue that limiting the theory of extreme self-sacrifice to two determinants, namely, identity fusion and group threats, results in logical and conceptual difficulties. To strengthen Whitehouse's theory, we encourage a more holistic approach. In particular, we suggest that the theory include exogenous sociopolitical factors and constituents of the religious system as additional predictors of extreme self-sacrifice.

Over the last 25 years, there has been an increasing fascination with the “dark” side of leadership. The term “destructive leadership” has been used as an overarching expression to describe various “bad” leader behaviors believed to be associated with harmful consequences for followers and organizations. Yet, there is a general consensus and appreciation in the broader leadership literature that leadership represents much more than the behaviors of those in positions of influence. It is a dynamic, cocreational process between leaders, (...) followers, and environments, the product of which contributes to group and organizational outcomes. In this paper, we argue that, despite this more holistic recognition of leadership processes within the broader leadership literature, current conceptualizations and analyses of destructive leadership continue to focus too heavily on behaviors and characteristics of “bad” leaders. In our view, to achieve a more balanced understanding of destructive leadership, it is important to adopt more integrative approaches that are based in the contemporary leadership discourse and that recognize flawed or toxic leaders, susceptible followers, and conducive environments as interdependent elements of a broader destructive leadership process. To this end, we offer a critique of the destructive leadership literature, propose a broader definition of destructive leadership, and highlight gaps in our understanding of leaders, followers, and environments in contributing to destructive leadership processes. Finally, we conclude by discussing strategies for examining destructive leadership in a broader, more holistic fashion. (shrink)