The decline in autobiographical memory function in people with Alzheimer’s dementia has been argued to cause a loss of self-identity. Prior research suggests that people perceive changes in moral traits and loss of memories with a “social-moral core” as most impactful to the maintenance of identity. However, such research has so far asked people to rate from a third-person perspective, considering the extent to which hypothetical others maintain their identity in the face of various impairments. In the current study, we (...) examined the impact of perspective, comparing first- and third-person perspectives, as well as memory type. This online study asked 201 participants to consider hypothetical scenarios in which either themselves or another person experienced different types of memory failures associated with a diagnosis of AD. For each scenario, participants rated the degree to which the depicted individual remained the same person, and how impactful the impairment was. Social semantic memory failures – involving failures to recognise a loved one – were rated as most detrimental to self-continuity, and procedural memory failures the least. Averaged across all memory types, people considered their own and their partner’s self-continuity to be more resilient to memory failures than that of a parent or stranger. However, this pattern was reversed for some memory types: forgetting semantic or episodic information about close relationships was rated as more detrimental from a first-person than third-person perspective. Our findings suggest that perspective and type of memory impairment interact to impact judgements about the extent to which people maintain their identity when they experience dementia, and highlight the importance of social relationships to maintaining a sense of self. (shrink)

It has long been known that brain damage has important negative effects on one’s mental life and even eliminates one’s ability to have certain conscious experiences. It thus stands to reason that when all of one’s brain activity ceases upon death, consciousness is no longer possible and so neither is an afterlife. It seems clear that human consciousness is dependent upon functioning brains. This essay reviews some of the overall neurological evidence from brain damage studies and concludes that our argument (...) from brain damage has been vindicated by such overwhelming evidence. It also puts forth a more mature philosophical rationale against an afterlife and counters several replies to the argument. -/- 1. Philosophical Background -- 2. The Dependence of Consciousness on the Brain: Some Preliminary Evidence -- 3. Brain Damage, Lesion Studies, and the Localization of Mental Function - 3.1 Perception - 3.2 Awareness, Comprehension, and Recognition - 3.3 Memory - 3.4 Personality - 3.5 Language - 3.6 Emotion - 3.7 Decision-Making - 3.8 Social Cognition and Theory of Mind - 3.9 Moral Judgment and Empathy - 3.10 Neurological Disorders and Disease - 3.11 The Unity of Consciousness -- 4. Objections and Replies - 4.1 Souls, Minds, and Energy Fields - 4.2 The Instrument Theory - 4.3 The Embodied Soul Alone is Affected -- 5. Conclusion. (shrink)

I argue that the feeling that one is the owner of his or her mental states is not an intrinsic property of those states. Rather, it consists in a contingent relation between consciousness and its intentional objects. As such, there are (a variety of) circumstances, varying in their interpretive clarity, in which this relation can come undone. When this happens, the content of consciousness still is apprehended, but the feeling that the content “belongs to me” no longer is secured. I (...) discuss the implications of a mechanism enabling personal ownership for understanding a variety of clinical syndromes as well normal mental function. (shrink)

The Two Selves takes the position that the self is not a "thing" easily reduced to an object of scientific analysis. Rather, the self consists in a multiplicity of aspects, some of which have a neuro-cognitive basis (and thus are amenable to scientific inquiry) while other aspects are best construed as first-person subjectivity, lacking material instantiation. As a consequence of their potential immateriality, the subjective aspect of self cannot be taken as an object and therefore is not easily amenable to (...) treatment by current scientific methods. -/- Klein argues that to fully appreciate the self, its two aspects must be acknowledged, since it is only in virtue of their interaction that the self of everyday experience becomes a phenomenological reality. However, given their different metaphysical commitments (i.e., material and immaterial aspects of reality), a number of issues must be addressed. These include, but are not limited to, the possibility of interaction between metaphysically distinct aspects of reality, questions of causal closure under the physical, the principle of energy conservation. -/- After addressing these concerns, Klein presents evidence based on self-reports from case studies of individuals who suffer from a chronic or temporary loss of their sense of personal ownership of their mental states. Drawing on this evidence, he argues that personal ownership may be the factor that closes the metaphysical gap between the material and immaterial selves, linking these two disparate aspects of reality, thereby enabling us to experience a unified sense of self despite its underlying multiplicity. -/- . (shrink)

In this paper I argue that much of the confusion and mystery surrounding the concept of "self" can be traced to a failure to appreciate the distinction between the self as a collection of diverse neural components that provide us with our beliefs, memories, desires, personality, emotions, etc (the epistemological self) and the self that is best conceived as subjective, unified awareness, a point of view in the first person (ontological self). While the former can, and indeed has, been extensively (...) studied by researchers of various disciplines in the human sciences, the latter most often has been ignored -- treated more as a place holder attached to a particular predicate of interest (e.g., concept, reference, deception, esteem, image, regulation, etc). These two aspects of the self, I contend, are not reducible -- one being an object (the epistemological self) and the other a subject (the ontological self). Until we appreciate the difficulties of applying scientific methods and analysis to what cannot be reduced to an object of inquiry without stripping it of its essential aspect (its status as subject), progress on the "self", taken as a pluralistic construct, will continue to address only one part of the problems we face in understanding this most fundamental aspect of human experience. (shrink)

The discipline of knowledge translation (KT) emerged as a way of systematically understanding and addressing the challenges of applying health and medical research in practice. In light of ongoing and emerging critique of KT from the medical humanities and social sciences disciplines, KT researchers have become increasingly aware of the complexity of the translational process, particularly the significance of culture, tradition and values in how scientific evidence is understood and received, and thus increasingly receptive to pluralistic notions of knowledge. Hence, (...) there is now an emerging view of KT as a highly complex, dynamic, and integrated sociological phenomenon, which neither assumes nor creates knowledge hierarchies and neither prescribes nor privileges scientific evidence. Such a view, however, does not guarantee that scientific evidence will be applied in practice and thus poses a significant dilemma for KT regarding its status as a scientific and practice-oriented discipline, particularly within the current sociopolitical climate. Therefore, in response to the ongoing and emerging critique of KT, we argue that KT must provide scope for relevant scientific evidence to occupy an appropriate position of epistemic primacy in public discourse. Such a view is not intended to uphold the privileged status of science nor affirm the “scientific logos” per se. It is proffered as a counterbalance to powerful social, cultural, political and market forces that are able to challenge scientific evidence and promote disinformation to the detriment of democratic outcomes and the public good. (shrink)

Loss of insight is a prominent clinical manifestation of behavioral variant frontotemporal dementia , but its characteristics are poorly understood. Twelve bvFTD patients were compared with 12 Alzheimer’s disease patients on a structured insight interview of cognitive insight and emotional insight . Compared to the AD patients, the bvFTD patients were less aware and less concerned about their disorder, and they had less appreciation of its effects on themselves and on others. After corrective feedback , the bvFTD patients were just (...) as aware of their disorder as the AD patients but remained unconcerned and unappreciative of its effects. These findings suggest that lack of insight in bvFTD is not due to “anosognosia,” or impaired cognitive and executive awareness of disease, but to “frontal anosodiaphoria,” or lack of emotional concern over having bvFTD and its impact on themselves and others. (shrink)

Awareness of deficits in patients with neurological disorders may be described as a theoretical unitary phenomenon, which has been analysed reaching interesting results in the last decades. Awareness of deficits manifests itself in a continuum ranging from full awareness to total absence. In line with a neurocognitive approach, a reduction in self-awareness could be explained considering executive dysfunction associated with prefrontal cortex anatomo-functional changes. Our mini-review will focus on reduced self-awareness in neurological disorders, such as Alzheimer’s disease, behavioural Frontotemporal Dementia (...) and Acquired Brain Injuries. Results achieved thanks to an explanatory investigative approach combined with a theoretical reference model will be presented. Data suggest the key role of executive functions in supporting adequate self-awareness towards patients’ cognitive-behavioural profile and instrumental activity autonomy. The Cognitive Awareness Model seems to be one of the best theoretical model to better approach this phenomenon. (shrink)