Muchos psiquiatras se encuentran constantemente con pacientes cuyos síntomas incluyen trastornos o alteraciones de la conciencia. Infortunadamente, el significado del término conciencia es poco claro. Este artículo hace un repaso sistemático de varios significados atribuidos a dicho término, así como de diversos problemas filosóficos asociados. Asimismo, reconstruye varias teorías filosóficas y científicas de la conciencia, identificando sus ventajas y desventajas. Al final, ofrece algunas sugerencias para el uso del término conciencia en la psiquiatría.

Stanford Encyclopedia Entry on Delusions.

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

RESUMEN Muchos psiquiatras se encuentran constantemente con pacientes cuyos síntomas incluyen trastornos o alteraciones de la conciencia. Infortunadamente, el significado del término conciencia es poco claro. Este artículo hace un repaso sistemático de varios significados atribuidos a dicho término, así como de diversos problemas filosóficos asociados. Asimismo, reconstruye varias teorías filosóficas y científicas de la conciencia, identificando sus ventajas y desventajas. Al final, ofrece algunas sugerencias para el uso del término conciencia en la psiquiatría. ABSTRACT Psychiatrists often encounter patients whose (...) symptoms include disorders or impairments of consciousness. Unfortunately, the meaning of the term consciousness is not altogether clear. This article presents a systematic review of various meanings attributed to this term, as well as of diverse associated philosophical problems. Likewise, it reconstructs some philosophical and scientific theories of consciousness, identifying their advantages and disadvantages. Finally, it offers some suggestions for the use of the term consciousness in psychiatry. (shrink)