Josh is a typical 27-year-old in a career that he enjoys and a successful marriage. Josh begins to exhibit the symptoms of a manic episode. He is soon diagnosed with bipolar disorder. While non-manic, Josh’s preferences are typical. While manic, his preferences change dramatically. He quits his job, cheats on his partner, and squanders his savings. These are behaviors that Josh, when non-manic (euthymic), would never agree to. When Josh returns to a euthymic state, he regrets these decisions. Should those (...) close to Josh have prevented him from making these decisions, or does his competence to decide persist despite his acute mania? In this paper, I examine the connections be-tween bipolar disorder and consent. I defend the view that many (although far from all) individuals with bipolar disorder are competent to consent to a wide variety of things when they are in a manic state. This means that mania should not be presumed to undermine competence in clinical settings. -/- I have several goals in this paper. I want to bring philosophy to bear on the connection between consent and bipolar disorder. Additionally, I intend this paper to contribute to the general debate about the conditions of informed consent. Bipolar disorder presents novel challenges to existing conceptions of competence to consent which require stable core of values for an agent to be competent. For example, Buchanan and Brock endorse such a view. In showing that shifting values do not undermine the competence of a person experiencing acute mania, I show that the aforementioned views of competence are false. Overall, this paper makes substantive contributions to the debate about competence to consent and presents the first sustained philosophical treatment of consent among people with bipolar disorder. (shrink)

Bipolar neutrosophic sets are the extension of neutrosophic sets and are based on the idea of positive and negative preferences of information. Projection measure is a useful apparatus for modelling real life decision making problems. In the paper, we define projection, bidirectional projection and hybrid projection measures between bipolar neutrosophic sets. Three new methods based on the proposed projection measures are developed for solving multi-attribute decision making problems. In the solution process, the ratings of performance values of the alternatives with (...) respect to the attributes are expressed in terms of bipolar neutrosophic values. We calculate projection, bidirectional projection, and hybrid projection measures between each alternative and ideal alternative with bipolar neutrosophic information. All the alternatives are ranked to identify the best alternative. Finally, a numerical example is provided to demonstrate the applicability and effectiveness of the developed methods. Comparison analysis with the existing methods in the literature in bipolar neutrosophic environment is also performed. (shrink)

The aim of this paper is to make a proposal for a new extension of the MULTIMOORA method extended to deal with bipolar fuzzy sets. Bipolar fuzzy sets are proposed as an extension of classical fuzzy sets in order to enable solving a particular class of decision-making problems. Unlike other extensions of the fuzzy set of theory, bipolar fuzzy sets introduce a positive membership function, which denotes the satisfaction degree of the element x to the property corresponding to the bipolar-valued (...) fuzzy set, and the negative membership function, which denotes the degree of the satisfaction of the element x to some implicit counter-property corresponding to the bipolar-valued fuzzy set. By using single-valued bipolar fuzzy numbers, the MULTIMOORA method can be more efficient for solving some specific problems whose solving requires assessment and prediction. The suitability of the proposed approach is presented through an example. (shrink)

In this paper, we propose a new hybrid neutrosophic multi criteria decision making (MCDM) framework that employs a collection of neutrosophic analytical network process (ANP), and order preference by similarity to ideal solution (TOPSIS) under bipolar neutrosophic numbers. The MCDM framework is applied for chief executive officer (CEO) selection in a case study at the Elsewedy Electric Group, Egypt. The proposed approach allows us to assemble individual evaluations of the decision makers and therefore perform accurate personnel selection. The outcomes of (...) the proposed method are compared with those of the related works such as weight sum model (WSM), weight product model (WPM), analytical hierarchy process (AHP), multiobjective optimization based on simple ratio analysis (MOORA) and ANP methods to prove and validate the results. (shrink)

In this paper, we define the regular and totally regular bipolar single valued neutrosophic hypergraphs, and discuss the order and size along with properties of regular and totally regular bipolar single valued neutrosophic hypergraphs. We extend work on completeness of bipolar single valued neutrosophic hypergraphs.

Any complete theory of “what we owe to each other” must be able to adequately accommodate directed or bipolar obligations, that is, those obligations that are owed to a particular individual and in virtue of which another individual stands to be wronged. Bipolar obligations receive their moral importance from their intimate connection to a particular form of recognition respect that we owe to each other: respect of another as a source of valid claims to whom in particular we owe certain (...) treatment and, at the very least, an apology if we fail to accord that treatment. While some of the most prominent accounts of interpersonal morality fail to adequately accommodate bipolar obligations, I here investigate a recent proposal that explicitly seeks to improve on these accounts—Stephen Darwall’s second-personal theory of morality. Ultimately, I object to Darwall’s theory on the grounds that his second-personal theory normatively ties bipolar obligations too closely to non-directed moral obligations or those that we are under, period. The problem for Darwall’s account is that any obligations that at first appear to be bipolar and owed to someone in particular turn out to be instances of non-directed moral obligations period that have their normative source in the representative authority of the moral community. Adequately accommodating bipolar obligations requires taking seriously a novel second-personal approach, according to which we locate the normative sources of our interpersonal obligations in the claims and demands particular persons and deliberate from what I call the pairwise or bipolar standpoint. (shrink)

Although the terms ‘poles’, ‘bipolar’, and ‘bipolarity’ do not appear in the Tractatus, it is widely held that Wittgenstein maintained his commitment to bipolarity in the Tractatus. As it is usually understood, the principle of bipolarity is that every proposition must be capable of being true and capable of being false, which rules out propositions that are necessarily true or necessarily false. Here I argue that Wittgenstein was committed to bipolarity in the Tractatus, but getting a (...) clear view of this commitment requires a different understanding of bipolarity. Properly understood, bipolarity is the view that every proposition represents two possible states of affairs, one positive and the other negative. Of course, in the case of elementary propositions, the sense of a proposition is only the positive state of affairs. There is thus an asymmetry between what a proposition represents, its true-false poles, and what it says, its sense. In this paper I show how Wittgenstein accounted for this asymmetry in Notes on Logic and I consider two ways he might have accounted for it in the Tractatus. (shrink)

Abstract:Bipolar or related disorders (BoRD) present unique practical and existential problems for people who live with them. All agents experience changes in the things they care about over time. However people living with BoRD face drastic shifts in what seems valuable to them, which upset their longitudinal values (if, indeed, any stable longitudinal values are available in the first place). Navigating these evaluative high seas presents agents living with BoRD with a distinctive existential question, not shared by those on calmer (...) waters. I draw out two contrasting ways in which someone living with BoRD might seek to support their self-determination in these circumstances, by crafting appropriate self care and support regimes. The first strategy involves managing one’s affective episodes so that they do not interrupt one’s plans and long-term agency over time. The second involves a regimen that allows one the greatest degree of freedom in adapting to changes in one’s experiences of value. What distinguishes these sorts of self-determination is the scope at which they are predicated. Although both sorts of self-determination allow an individual to rule themselves, they alter the overall shape of one’s autonomy in quite different ways. (shrink)

In this research paper, the graph of the bipolar single-valued neutrosophic set model (BSVNS) is proposed. The graphs of single valued neutrosophic set models is generalized by this graph. For the BSVNS model, several results have been proved on complete and isolated graphs. Adding, an important and suitable condition for the graphs of the BSVNS model to become an isolated graph of the BSVNS model has been demonstrated.

Bipolar soft set is formulated by two soft sets; one of them provides us the positive information and the other provides us the negative information. The philosophy of bipolarity is that human judgment is based on two sides, positive and negative, and we choose the one which is stronger. In this paper, we introduce novel belong and nonbelong relations between a bipolar soft set and an ordinary point. These relations are considered as one of the unique characteristics of bipolar (...) soft sets which are somewhat expression of the degrees of membership and nonmembership of an element. We discuss essential properties and derive the sufficient conditions of some equivalence of these relations. We also define the concept of soft mappings between two classes of bipolar soft sets and study the behaviors of an ordinary point under these soft mappings with respect to all relations introduced herein. Then, we apply bipolar soft sets to build an optimal choice application. We give an algorithm of this application and show the method for implementing this algorithm by an illustrative example. In conclusion, it can be noted that the relations defined herein give another viewpoint to explore the concepts of bipolar soft topology, in particular, soft separation axioms and soft covers. (shrink)

Cumulative Prospect Theory is the modern version of Prospect Theory and it is nowadays considered a valid alternative to the classical Expected Utility Theory. Cumulative Prospect theory implies Gain-Loss Separability, i.e., the separate evaluation of losses and gains within a mixed gamble. Recently, some authors have questioned this assumption of the theory, proposing new paradoxes where the Gain-Loss Separability is violated. We present a generalization of Cumulative Prospect Theory which does not imply Gain-Loss Separability and is able to explain the (...) cited paradoxes. On the other hand, the new model, which we call the bipolar Cumulative Prospect Theory, genuinely generalizes the original Prospect Theory of Kahneman and Tversky, preserving the main features of the theory. We present also a characterization of the bipolar Choquet Integral with respect to a bi-capacity in a discrete setting. (shrink)

The promotion of the self‐managing capacities of people has become a marker of contemporary mental health practice, yet self‐management remains a largely uncontested construct in mental health settings. This discourse analysis based upon the work of Foucault investigates self‐management practices for bipolar disorder and their action upon how a person with bipolar disorder comes to think of who they are and how they should live. Using Foucault's framework for exploring the ethical self and transcripts of interviews with people living with (...) bipolar disorder, this discourse analysis finds that the discursive practices of self‐management for bipolar disorder are prescribing a restricted regime for living based upon the quintessential neo‐liberal subject using practices that are focused upon managing an unreliable and problematic self. The article concludes with the proposition that the problem of bipolar disorder (for which self‐management is an answer) is less about the object itself and more about how we construct the nature of the self. A Māori indigenous ontology is used here as an example of an alternative discursive resource through which people make sense of the self and which allows ways of thinking about self‐management that engage with ambivalence and ambiguity rather than restriction and regulation. (shrink)

Abstract. The notion of similarity has been studied in many areas of Computer Science; in a general sense, this concept is defined to provide a measure of the semantic equivalence between two pieces of knowledge, expressing how “close” their meaning can be regarded. In this work, we study similarity as a tool useful to improve the representation of arguments, the interpretation of the relations between arguments, and the semantic evaluation associated with the arguments in the argumentative process. In this direction, (...) we present a novel mechanism to determine the similarity between two arguments based on descriptors representing particular aspects associated with these arguments. This mechanism involves a comparison process influenced by the context in which the process develops, where this context provides the relevant aspects that need to be analyzed in the application domain. Then, we use this similarity measure as a quantity to compute the result of attacks and supports in the argumentation process. These valuations, applied to a Bipolar Argumentation Frameworks, allowed us to refine the argument relations, providing the tools to establish a family of new argumentation semantics that considers the similarity between arguments as a crucial part for the argumentation process. (shrink)

This paper addresses an important yet neglected existential issue sometimes faced by persons with bipolar disorder (BD): confusion about the extent to which what one is like is influenced by BD. Although such confusion is common in psychiatric illnesses, BD raises idiosyncratic difficulties due to its intricate interactions with personality, cognition and behavior. The fluctuating mood phases of BD can generate inconsistency in one's self-experience and sense of self. One way to resolve this confusion would be to coherently account for (...) BD within one's overall self-concept. To facilitate this task, this paper introduces a heuristic taxonomy of different relationships wherein BD can be viewed in light of self-related beliefs. The relationships are as follows: (1) BD contributes to the self, (2) BD scaffolds the self, (3) BD gradually becomes part of the self and (4) BD is not part of the ‘real self’. As the individual presentation of BD varies extensively, the type of relationship one feels holds true depends on one's personal experience of managing and living with the disorder. These relationships act as an organizing framework for one's self-related beliefs about how to account for the effects of BD on personality, behavior, cognitive patterns and other self-expressions. (shrink)

Neutrosophic theory has many applications in graph theory, bipolar single valued neutrosophic graphs (BSVNGs) is the generalization of fuzzy graphs and intuitionistic fuzzy graphs, SVNGs. In this paper we introduce some types of BSVNGs, such as subdivision BSVNGs, middle BSVNGs, total BSVNGs and bipolar single valued neutrosophic line graphs (BSVNLGs), also investigate the isomorphism, co weak isomorphism and weak isomorphism properties of subdivision BSVNGs, middle BSVNGs, total BSVNGs and BSVNLGs.

Starting from a philosophical perspective, which states that the living structures are actually a combination between matter and information, this article presents the results on an analysis of the bipolar information-matter structure of the human organism, distinguishing three fundamental circuits for its survival, which demonstrates and supports this statement, as a base for further development of the informational model of consciousness to a general informational model of the human organism. For this, it was examined the Informational System of the Human (...) Body and its components from the perspective of the physics/information/neurosciences concepts, showing specific functions of each of them, highlighting the correspondence of these centers with brain support areas and with their projections in consciousness, which are: Center of Acquisition and Storing of Information (CASI) reflected in consciousness as memory, Center of Decision and Command (CDC) (decision), Info-Emotional Center (IES) (emotions), Maintenance Informational System (MIS) (personal status), Genetic Transmission System (GTS) (associativity/genetic transmission) and Info Genetic Generator (IGG) related by the body development and inherited behaviors. The Info Connection (IC), detected in consciousness as trust and confidence can explain the Near-Death Experiences (NDEs) and associated phenomena. This connection is antientropic and informational, because from the multitude of uncertain possibilities is selected a certain one, helping/supporting the survival and life. The human body appears therefore as a bipolar structure, connected to two poles: information and matter. It is argued that the survival, which is the main objective of the organism, is complied in three main ways, by means of: (i) the reactive operation for adaptation by attitude; (ii) the info-genetic integration of information by epigenetic processes and genetic transmission of information for species survival, both circuits (i) and (ii) being associated to the information pole; (iii) maintenance of the material body (defined as informed matter) and its functions, associated to the matter pole of the organism. It results therefore that the informational system of the human body is supported by seven informational circuits formed by the neuro-connections between the specific zones of the brain corresponding to the informational subsystems, the cognitive centers, the sensors, transducers and execution (motor/mobile) elements. The fundamental informational circuits assuring the survival are the reactive circuit, expressible by attitude, the epigenetic/genetic circuit, absorbing and codifying information to be transmitted to the next generations, and the metabolic circuit, connected to matter (matter pole). The presented analysis allows to extend the informational modeling of consciousness to an Informational Model of Consciousness and Organism, fully describing the composition/functions of the organism in terms of information/matter and neurosciences concept. (shrink)

The field of narrative medicine holds that personal narratives about illness have the potential to give illness meaning and to create order out of disparate facets of experience, thereby aiding a patient’s treatment and resisting universalizing medical discourse. Two narratives of bipolar disorder, Kay Redfield Jamison’s prose memoir An Unquiet Mind and Ellen Forney’s graphic memoir Marbles challenge these ideas. These writers demonstrate that one result of bipolar disorder is a rupture to their sense of identity, making straightforward and verbal (...) forms of narrative impossible. During periods of relative mood stability, reliable memories of mania or depression are equally impossible. As a result, these memoirists seek to develop sources of self-knowledge other than memory and introspection, long the foundations of personal narrative. Finally, An Unquiet Mind and Marbles return attention to questions of selfhood at a time when scholarship on memoir rejects interpretations of life stories as clear and reliable expressions of identity. (shrink)

This essay, the last in a series, focuses on the relationship between Nietzsche’s mental illness and his philosophical art. It is predicated upon my original diagnosis of his mental condition as bipolar affective disorder, which began in early adulthood and continued throughout his creative life. The kaleidoscopic mood shifts allowed him to see things from different perspectives and may have imbued his writings with passion rarely encountered in philosophical texts. At times hovering on the verge of psychosis, Nietzsche was able (...) to gain access to unconscious images and the music of language, usually inhibited by the conscious mind. He reached many of his linguistic, psychological and philosophical insights by willing suspension of the rational. None of these, however, could have been communicated had he not tamed the subterranean psychic forces with his impressive discipline and hard work. (shrink)

Keller & Miller (K&M) assert that mental disorders could not have evolved as adaptations, but they fail to make their case against the theory of the evolutionary origin of bipolar disorder that I have proposed (Sherman 2001). Such an idea may be unorthodox, but it has considerable explanatory power and heuristic value. (Published Online November 9 2006).

. According to Horgans transvaluationist approach, the robustness that characterizes vague terms is inherently incoherent. He analyzes that robustness into two conceptual poles, individualistic and collectivistic, and ascribes the incoherence to the former. However, he claims vague terms remain useful nonetheless, because the collectivistic pole can be realized with a suitable non-classical logic and can quarantine the incoherence arising out of the individualistic pole. I argue, on the contrary, that the nonclassical logic fails to resolve the difficulty and that the (...) incoherence afflicts Horgans collectivistic pole as well, consequently invalidating the entire transvaluationist approach. An alternative, coherent conception of robustness is suggested. (shrink)

Interval bipolar neutrosophic set is a significant extension of interval neutrosophic set where every element of the set comprises of three independent positive membership functions and three independent negative membership functions. In this study, we first define correlation coefficient, and weighted correlation coefficient measures of interval bipolar neutrosophic sets and prove their basic properties. Then, we develop a new multi-attribute decision making strategy based on the proposed weighted correlation coefficient measure. Finally, we solve an investment problem with interval bipolar neutrosophic (...) information and comparison is given to demonstrate the applicability and effectiveness of the proposed strategy. (shrink)

Quando Platão trata das “afecções e as formas que ela [a alma] tem na vida humana”, ele a descreve segundo um esquema tripartite, tal como aparece também na exposição dos seus gêneros na República. No Timeu, ao tomar a via mais longa para expor a natureza da alma, Platão apresenta a Ideia da alma cósmica como uma mistura de três Ideias intermediárias procedentes de um princípio bipolar. Assim como na alma do mundo, também a alma humana possui uma estrutura tripartite (...) hierarquizada segundo o mesmo princípio bipolar que governa a realidade. O artigo pretende mostrar que essas perspectivas não se contradizem, mas se completam na obra platônica. (shrink)

A substantial body of evidence suggests that autobiographical recollection and simulation of future happenings activate a shared neural network. Many of the neural regions implicated in this network are affected in patients with bipolar disorder , showing altered metabolic functioning and/or structural volume abnormalities. Studies of autobiographical recall in BD reveal overgeneralization, where autobiographical memory comprises primarily factual or repeated information as opposed to details specific in time and in place and definitive of re-experiencing. To date, no study has examined (...) whether these deficits extend to future event simulation. We examined the ability of patients with BD and controls to imagine positive, negative and neutral future events using a modified version of the Autobiographical Interview that allowed for separation of episodic and non-episodic details. Patients were selectively impaired in imagining future positive, negative, and neutral episodic details; simulation of non-episodic details was equivalent across groups. (shrink)

American and Chinese interests seem to be at one time in agreement and at another at loggerheads over issues that involve armed services, diplomacy, economics, human rights, intelligence, trade and culture. Part of what may appear to be a growing déracinement, or mutual disenchantment, arising from diverse viewpoints over infrastructure development globally but especially in sensitive developing areas such as the stand-off in the South China Sea and elsewhere along the Pacific coastline of Southeast Asia, and the Western Pacific Rim. (...) China seems to be reconstructing its ancient feudal empire, actual or imaginary, in the territory to its South, the ASEAN bloc. This article will address some issues of compatibility and conflict that unite China but that sometimes divide it from the United States and the West, then assesses what alternative strategies should be adopted or abandoned in the interests of global and regional harmony coupled with security. It urges greater cooperation and collaboration, a development of a code of conduct for state behavior in the Indo-Asia-Pacific region, together with a concerted East–West effort to maintain a stable economy for China and a sustainable trade relationship between China, Europe, and North America. (shrink)

Since the late twentieth-century shift from the liberal university to the neoliberal university (the latter distinguished by the managerial class installed to leverage and extract value from academic research, plus polish the brand of the franchise), the publications’ ecosystem for academics, foremost in the Arts and Humanities, has been altered beyond recognition. Notably, it has exponentially expanded while at the same time suffering maximum constriction in the form of what legal scholars have called the “great copyright robbery”.

This chapter highlights the complexity of the relationship between enhancement of mood and cognition on the one hand and the improvement of people's well‐being on the other. To do so, two psychiatric conditions, Asperger's syndrome and bipolar disorder, are presented in the chapter. Even though there are both negative and positive aspects to Asperger's syndrome or to bipolar disorders, taking away even these negative aspects would not necessarily promote well‐being. It might also be impossible to isolate the positive aspects of (...) these disorders. An increase in specific forms of cognition might be intrinsically connected to a decrease in specific aspects of mood. A decrease in specific aspects of mood might be intrinsically connected to an increase in creativity. Neither is necessarily linked to any changes in some general form of “well‐being.”. (shrink)

The notion of perceptual content is commonly introduced in the analysis of perception. It stems from an analogy between perception and propositional attitudes. Both kinds of mental states, it is thought, have conditions of satisfaction. I try to show that on the most plausible account of perceptual content, it does not determine the conditions under which perceptual experience is veridical. Moreover, perceptual content must be bipolar (capable of being correct and capable of being incorrect), whereas perception as a mental state (...) is not (if it is veridical, it is essentially so). This has profound consequences for the epistemological view that perception is a source of knowledge. I sktech a two-level epistemology which is consistent with this view. I conclude that the analogy between perception and propositional attitudes, from which the notion of perceptual content is born, may be more misleading than it is usually thought. (shrink)

There is a strong presumption that mental disorder injures a person's autonomy, understood as a set of capacities and as an ideal condition of agency which is worth striving for. However, recent multidimensional approaches to autonomy have revealed a greater diversity in ways of being autonomous than has previously been appreciated. This presumption, then, risks wrongly dismissing variant, neuro-atypical sorts of autonomy as non-autonomy. This is both an epistemic error, which impairs our understanding of autonomy as a phenomenon, and a (...) moral error, which withholds recognition and respect that autonomous agents are due. I argue that careful attention to the different 'shapes' of agent's autonomy reveals that there are indeed distinctive kinds of neuro-atypical autonomy that are widely mistaken for non-autonomy. This project argues for two propositions. First, that there is a kind of autonomy, with a distinctive shape and texture, available to bipolar agents. This is a variant sort of autonomy, but not a defective or deficient sort. It is the ideal of autonomy that it is worth bipolar agents striving for, given the range and intensity of experiences that they will have to confront. Whilst bipolar autonomy will look unlike more neurotypical kinds of autonomy, it continues to be owed recognition. The second proposition is that we should understand the ideal of autonomy to be both pluralist and highly context sensitive. Given the range of starting points from which agents will strive to an ideal of autonomy, there will be some variation in the ideals worth striving for. The variation in ideals will reflect the existential realities they are local to. Theory of autonomy must be adapted to recognise bipolar, and other neuro-atypical, kinds of autonomy, and to reflect this wider pluralism. These propositions will be argued for with careful attention to the experiences and agency of people living with bipolar, or related, disorders. Understanding the ways that manic or depressive episodes, and the shifts between them, alter and apply pressure to our agency will inform an account of the distinctively bipolar autonomy that can be built on top of it. (shrink)

The problem of ghostwriting in corporate-sponsored clinical trials is of concern to medicine, bioethics, and government agencies. We present a study of the ghostwritten archival report of an industry-sponsored trial comparing antidepressant treatments for bipolar depression: GlaxoSmithKline (GSK) paroxetine study 352.

Medical ghostwriting is the practice in which pharmaceutical companies engage an outside writer to draft a manuscript submitted for publication in the names of “honorary authors,” typically academic key opinion leaders. Using newly-posted documents from paroxetine litigation, we show how the use of ghostwriters and key opinion leaders contributed to the publication of a medical journal article containing manipulated outcome data to favor the proprietary medication. The article was ghostwritten and managed by SmithKline Beecham, now GlaxoSmithKline (GSK) and Scientific Therapeutics (...) Information, Inc. without acknowledging their contribution in the published article. The named authors with financial ties to GSK, had little or no direct involvement in the paroxetine 352 bipolar trial results and most had not reviewed any of the manuscript drafts. The manuscript was originally rejected by peer review; however, its ultimate acceptance to the American Journal of Psychiatry was facilitated by the journal editor who also had financial ties to GSK. Thus, GSK was able to take an under-powered and non-informative trial with negative results and present it as a positive marketing vehicle for off-label promotion of paroxetine for bipolar depression. In addition to the commercial spin of paroxetine efficacy, important protocol-designated safety data were unreported that may have shown paroxetine to produce potentially harmful adverse events. (shrink)

Background: The vascular depression hypothesis emphasizes the significance of vascular lesions in late-life depression. At present, no meta-analytic model has investigated whether a difference in hyperintensity burden compared to controls between late-life and late-onset depression is evident. By including a substantial number of studies, focusing on a meaningful outcome measure, and considering several moderating and control variables, the present meta-analysis investigates the severity of hyperintensity burden in major depressive disorder (MDD) and bipolar disorder (BD). A major focus of the present (...) meta-analysis refers to the role of age at illness onset. It is analyzed whether late-onset rather than late-life depression characterizes vascular depression. Method: In total, 68 studies were included in the meta-analysis and a multilevel random effects model was calculated using Hedges’ g as the effect size measure. Results: The severity of hyperintensity burden was significantly greater in the patient group compared to the control group. This effect was evident regarding the whole patient group (g = 0.229) as well as both depression subgroups, with a significantly greater effect in BD (g = 0.374) compared to MDD (g = 0.189). Hyperintensity burden was more pronounced in late-onset depression than in early-onset depression or late-life depression. A considerable heterogeneity between the included studies was observed, which is reflected by the large variability in effects sizes. Conclusion: In conclusion, the present meta-analysis underscores the association of hyperintensities with MDD and BD. Especially late-onset depression is associated with an increased hyperintensity burden, which is in line with the vascular depression hypothesis. The results suggest that it might be more feasible to confine the concept of vascular depression specifically to late-onset depression as opposed to late-life depression. Further research is needed to understand the causal mechanisms that might underlie the relation between hyperintensity burden and depression. (shrink)

This article explores the role of affect in the disorganized language and thought that can manifest itself in bipolar disorder. Bipolar disorder, or as it was previously known, manic-depressive illness, can produce psychotic language and thought in its more extreme forms. During the production of discourse in bipolar disorder, there is a strong correlation between the underlying affective state, i.e., depression, euthymia, hypomania, and mania, and linguistic and cognitive performance. A psycholinguistic model of the dynamics between language, thought, and affect (...) in bipolar disorder based on McNeill¿s concept of a ¿Growth Point¿ is proposed. In particular, the poetic structural phases of discourse production in bipolar disorder, which vary according to the underlying affective state, provide a phenomenological bridge between the psychotic discourse of mania and normal language production. (shrink)

In this article, we consider similarities and differences in emotion research on older adults and individuals with bipolar disorder (BD). Recent research and theory within both areas has focused on the importance of positive emotion, but the case of older adults is generally considered a case of “adaptive” positivity whereas BD is usually considered maladaptive positivity. We explore the paradox of the same phenomenon being labeled as adaptive in one group and yet maladaptive in another, with attention to commonalities and (...) distinctions between these two groups. We identify only limited areas of overlap, and suggest a refinement of models of positive emotionality in the two populations. (shrink)

W 1964 roku Herbert Marcuse postawił słynną tezę o jednowymiarowości współczesnego człowieka. Stanowi ona jedną z jego najważniejszych koncepcji teoretycznych, a także rozwinięcie tezy postawionej przez Marcusego już w 1937 roku w eseju O afirmatywnym charakterze kultury. Celem mojego artykułu jest krytyczna rewizja tej koncepcji. Z jednej strony kapitalizm kognitywny wzmocnił mechanizmy kontroli zachowań konsumenckich. Z drugiej strony społeczeństwo ponowoczesne jest jednak refleksyjne: produkcja wiedzy i samowiedzy ma w nim charakter systemowy. Połączenie tych dwóch procesów prowadzi – jak twierdzę – (...) do wytworzenia raczej dwubiegunowej niż jednowymiarowej jednostki oraz kultury. Represywna desublimacja idzie dziś w parze z refleksyjnością. W rezultacie, podmiot ponowoczesny to akratyk – człowiek systematycznie postępujący wbrew własnej woli. W drugiej części tekstu dowodzę, że dwubiegunowa struktura ponowoczesnego podmiotu tworzy warunki sprzyjające rozwojowi współczesnego populizmu. (shrink)

Discussion among individuals about a given issue often induces polarization and bipolarization effects, i.e. individuals radicalize their initial opinion towards either the same or opposite directions. Experimental psychologists have put forward Persuasive Arguments Theory as a clue for explaining polarization. PAT claims that adding novel and persuasive arguments pro or contra the debated issue is the major cause for polarization. Recent developments in abstract argumentation provide the tools for capturing these intuitions on a formal basis. Here Bipolar Argumentation Frameworks are (...) employed as a tool for encoding the information of agents in a debate relative to a given issue a. A probabilistic extension of BAF allows to encode the likelihood of the opinions pro or contra a before and after information exchange. It is shown, by a straightforward example, how these measures provide the basis to capture the intuitions of PAT. (shrink)

Group polarization occurs when an initial attitude or belief of individuals becomes more radical after group discussion. Polarization often leads subgroups towards opposite directions. Since the 1960s this effect has been observed and repeatedly confirmed in lab experiments by social psychologists. Persuasive Arguments Theory emerged as the most convincing explanation for this phenomenon. This paper is a first attempt to frame the PAT explanation more formally by means of Bipolar Argumentation Frameworks. In particular, I show that polarization may emerge in (...) a BAF by simple and rational belief updates by participants. (shrink)

Summary Background Self-binding directives instruct clinicians to overrule treatment refusal during future severe episodes of illness. These directives are promoted as having potential to increase autonomy for individuals with severe episodic mental illness. Although lived experience is central to their creation, service users’ views on self-binding directives have not been investigated substantially. This study aimed to explore whether reasons for endorsement, ambivalence, or rejection given by service users with bipolar disorder can address concerns regarding self-binding directives, decision-making capacity, and human (...) rights. Methods This study used qualitative data from an internet-based survey distributed to the mailing list of the UK charity Bipolar UK, which contained multiple closed and open questions on advance decision-making in bipolar disorder. Quantitative analysis of a closed question about self-binding directives had already demonstrated endorsement amongst a very high proportion of participants with bipolar disorder who completed the survey. We conducted thematic analysis of responses from those participants who answered a subsequent open question about reasons for their view. Research was co-produced within a multi-disciplinary team, with clinical, legal, and ethical expertise, and lived experience of bipolar disorder. Ideas and methodologies associated with all these areas of expertise were used in the analysis of these reasons and to gain insight into the thoughts of individuals with bipolar disorder about self-binding directives and associated issues. Findings Between Oct 23 and Dec 5, 2017, 932 individuals with a self-reported clinical diagnosis of bipolar disorder completed the internet survey, with 565 (154 men; 400 women; 11 transgender or other) providing free text answers to the open question. A large majority of respondents endorsed self-binding directives, nearly all describing a determinate shift to types of distorted thinking and decision-making when unwell as their key justification. Responses indicating ambivalence were dominated by logistical concerns about the drafting and implementation of self-binding directives, while those who rejected self-binding directives also cited logistical concerns, validity of their thinking when unwell, and potential contravention of human rights. Interpretation This study is, to our knowledge, the first large study of reasons why mental health service users might endorse or reject the use of self-binding directives. The findings provide empirical support for introducing self-binding directives into mental health advance decision-making practice and policy and may help to address enduring ethical concerns surrounding possible implementation of the directive while a person retains decision-making capacity. The opinions expressed here in responses given by multiple service users with bipolar disorder challenge a prominent view within international disability rights debates that involuntary treatment and recognition of impaired mental capacity constitute inherent human rights violations. Funding The Wellcome Trust . (shrink)

Objective Manic and depressive phases of bipolar disorder (BD) show opposite psychomotor symptoms. Neuronally, these may depend on altered relationships between sensorimotor network (SMN) and subcortical structures. The study aimed to investigate the functional relationships of SMN with substantia nigra (SN) and raphe nuclei (RN) via subcortical-cortical loops, and their alteration in bipolar mania and depression, as characterized by psychomotor excitation and inhibition. -/- Method In this resting-state functional magnetic resonance imaging (fMRI) study on healthy (n = 67) and BD (...) patients (n = 100), (1) functional connectivity (FC) between thalamus and SMN was calculated and correlated with FC from SN or RN to basal ganglia (BG)/thalamus in healthy; (2) using an a-priori-driven approach, thalamus-SMN FC, SN-BG/thalamus FC, and RN-BG/thalamus FC were compared between healthy and BD, focusing on manic (n = 34) and inhibited depressed (n = 21) patients. -/- Results (1) In healthy, the thalamus-SMN FC showed a quadratic correlation with SN-BG/thalamus FC and a linear negative correlation with RN-BG/thalamus FC. Accordingly, the SN-related FC appears to enable the thalamus-SMN coupling, while the RN-related FC affects it favoring anti-correlation. (2) In BD, mania showed an increase in thalamus-SMN FC toward positive values (ie, thalamus-SMN abnormal coupling) paralleled by reduction of RN-BG/thalamus FC. By contrast, inhibited depression showed a decrease in thalamus-SMN FC toward around-zero values (ie, thalamus-SMN disconnection) paralleled by reduction of SN-BG/thalamus FC (and RN-BG/thalamus FC). The results were replicated in independent HC and BD datasets. -/- Conclusions These findings suggest an abnormal relationship of SMN with neurotransmitters-related areas via subcortical-cortical loops in mania and inhibited depression, finally resulting in psychomotor alterations. (shrink)

Discussion among individuals about a given issue often induces polarization and bipolarization effects, i.e. individuals radicalize their initial opinion towards either the same or opposite directions. Experimental psychologists have put forward Persuasive Arguments Theory as a clue for explaining polarization. PAT claims that adding novel and persuasive arguments pro or contra the debated issue is the major cause for polarization. Recent developments in abstract argumentation provide the tools for capturing these intuitions on a formal basis. Here Bipolar Argumentation Frameworks are (...) employed as a tool for encoding the information of agents in a debate relative to a given issue a. A probabilistic extension of BAF allows to encode the likelihood of the opinions pro or contra a before and after information exchange. It is shown, by a straightforward example, how these measures provide the basis to capture the intuitions of PAT. (shrink)

The long history of theorizing about perception divides into two quite distinct and irreconcilable camps, one that takes sensory experience to show us external reality just as it is, and one that takes such experience to reveal our own mind. I argue that we should reject both sides of this debate, and admit that the phenomenal character of experience, as such, reveals little about the nature of the external world and even less about the mind.