While classifications of mental disorders have existed for over one hundred years, it still remains unspecified what terms such as 'mental disorder', 'disease' and 'illness' might actually denote. While ontologies have been called in aid to address this shortfall since the GALEN project of the early 1990s, most attempts thus far have sought to provide a formal description of the structure of some pre-existing terminology or classification, rather than of the corresponding structures and processes on the side (...) of the patient. We here present a view of mental disease that is based on ontological realism and which follows the principles embodied in Basic Formal Ontology and in the application of BFO in the Ontology of General Medical Science. We analyzed statements about what counts as a mental disease provided in the research agenda for the DSM-V, and in Pies' model. The results were used to assess whether the representational units of BFO and OGMS were adequate as foundations for a formal representation of the entities in reality that these statements attempt to describe. We then analyzed the representational units specific to mental disease and provided corresponding definitions. Our key contributions lie in the identification of confusions and conflations in the existing terminology of mental disease and in providing what we believe is a framework for the sort of clear and unambiguous reference to entities on the side of the patient that is needed in order to avoid these confusions in the future. (shrink)

Mental and behavioral disorders represent a significant portion of the public health burden in all countries. The human cost of these disorders is immense, yet treatment options for sufferers are currently limited, with many patients failing to respond sufficiently to available interventions and drugs. High quality ontologies facilitate data aggregation and comparison across different disciplines, and may therefore speed up the translation of primary research into novel therapeutics. Realism-based ontologies describe entities in reality and the relationships between them in (...) such a way that – once formulated in a suitable formal language – the ontologies can be used for sophisticated automated reasoning applications. Reference ontologies can be applied across different contexts in which different, and often mutually incompatible, domain-specific vocabularies have traditionally been used. In this contribution we describe the Mental Functioning Ontology (MF) and Mental Disease Ontology (MD), two realism-based ontologies currently under development for the description of humanmental functioning and disease. We describe the structure and upper levels of the ontologies and preliminary application scenarios, and identify some open questions. (shrink)

While Quine’s linguistic behaviorism is well-known, his Kant Lectures contain one of his most detailed discussions of behaviorism in psychology and the philosophy of mind. Quine clarifies the nature of his psychological commitments by arguing for a modest view that is against ‘excessively restrictive’ variants of behaviorism while maintaining ‘a good measure of behaviorist discipline…to keep [our mental] terms under control’. In this paper, I use Quine’s Kant Lectures to reconstruct his position. I distinguish three types of behaviorism in (...) psychology and the philosophy of mind: ontological behaviorism, logical behaviorism, and epistemological behaviorism. I then consider Quine’s perspective on each of these views and argue that he does not fully accept any of them. By combining these perspectives we arrive at Quine’s surprisingly subtle view about behaviorism in psychology. (shrink)

Moralising accounts of depression include the idea that depression is a sin or the result of sin, and/or that it is the result of demonic possession which has occurred because of moral or spiritual failure. Increasingly some Christian communities, understandably concerned about the debilitating effects these views have on people with depression, have adopted secular folk psychiatry’s ‘medicalising’ campaign, emphasising that depression is an illness for which, like (so-called) physical illnesses, experients should not be held responsible. This paper argues that (...) both moralising and medicalising models of depression are intellectually and practically (pastorally and therapeutically) problematic, gesturing towards more promising emphases. (shrink)

What is it to be mentally healthy? In the ongoing movement to promote mental health, to reduce stigma, and to establish parity between mental and physical health, there is a clear enthusiasm about this concept and a recognition of its value in human life. However, it is often unclear what mental health means in all these efforts and whether there is a single concept underlying them. Sometimes, the initiatives for the sake of mental health are aimed (...) just at reducing mental illness, thus implicitly identifying mental health with the absence of diagnosable psychiatric disease. More ambitiously, there are high-profile proposals to adopt a positive definition, identifying mental health with psychic or even overall well-being. We argue against both: a definition of mental health as mere absence of mental illness is too thin, too undemanding, and too closely linked to psychiatric value judgments, while the definition in terms of well-being is too demanding and potentially oppressive. As a compromise, we sketch out a middle position. On this view, mental health is a primary good, that is, the psychological preconditions of pursuing any conception of the good life, including well-being, without being identical to well-being. (shrink)

On 11 March 2020, the World Health Organization declared a pandemic of the COVID-19 coronavirus disease that was first recognized in China in late 2019. Among the primary effects caused by the pandemic, there was the dissemination of health preventive measures such as physical distancing, travel restrictions, self-isolation, quarantines, and facility closures. This includes the global disruption of socio-economic systems including the postponement or cancellation of various public events (e.g., sporting, cultural, or religious), supply shortages and fears of the (...) same, schools and universities closure, evacuation of foreign citizens, a rise of unemployment, changes in the international aid schemes, misinformation, and incidents of discrimination toward people affected by or suspected of having the COVID-19 disease. The pandemic has brought to the fore unpreparedness in critical areas that require attention, amid prospects and challenges. Moreover, considerable reorganization efforts are required with implications for assets, resources, norms, and value systems. COVID-19 is challenging the concept of globalization and stimulating responses at the levels of local and regional socio-economic systems that lead to the mobilization of assets that have been unrecognized earlier on, such as various forms of economic capital, social capital, cultural capital, human capital, and creative capital. For example, through digital channels, local groups are forming to create schemes of support for physical and mental wellbeing. These emerging exchanges lead to various social and technological innovations by building on skills and assets that are less important in the free-market economy, such as empathy, skills for crafts, making and fixing; locally grown microgreens; and micromanufacturing. Isolation and local living are also making it much harder to ignore the civic responsibilities towards communities, meant as individuals, vulnerable groups, and local businesses. Whilst the pandemic is limiting physical participation, this challenging time is uncovering alternative ways of mutual support, which may create long-term benefits for socio-economic systems, including environmental and biodiversity protection, reduction of the air pollution, and climate action. The pandemic’s threat to public health will hopefully be overcome with implications for disruption for an extended period that we are unable to forecast at this stage. It is key to focus on studies recognizing the activities and interventions leading to the recovery of socio-economic systems after the pandemic. Reflecting and planning on how societies and economies will go back to “business as usual” requires new forms of communication and cooperation, imaginative design thinking, new styles of management, as well as new tools and forms of participation in various public policies. Many questions related to the care of the vulnerable, economic restart, and the risk of future pandemics, to mention but a few, are already occupying the academic, scientific, experts, and activist communities, who have started to imagine the “new normal.”. (shrink)

This phenomenological study aimed to determine the challenges, coping strategies, and significant insights of COVID-19 frontliners during the pandemic. The study utilized a qualitative phenomenological approach, and using purposive sampling technique, the eight (8) participants who worked as a COVID-19 frontliner in General Santos City were identified for an in-depth interview. Thematic analysis was used as a data analysis tool to interpret the data gathered. The results found that COVID-19 frontliners experienced different challenges during the pandemic, including the fear of (...) being infected with the disease, dealing with different patients, long and busy working hours, and mental health disturbance. As for their coping strategies in dealing with those challenges, the COVID-19 frontliners used their families’ support, taking care of themselves, as well as having strong faith in God. Also, valuing public health measures, the importance of self-care, and extending patience and understanding toward the patients were the significant insights shared by the COVID-19 frontliners. Moreover, understanding the impact of COVID-19 on the frontliners’ mental health can be the key to implementing plans and effective interventions to help them function more efficiently. (shrink)

Hegel reads the poet Novalis as an expression of terminal irony, a pathological case of Gemüt, where the conscious mind is alienated from reality and turns its negativity inwards on the contents of its own natural soul. The condition of self-feeling, presented in Hegel’s “Anthropology”, is a self-consumption that manifests itself somatically in the physical disease (consumption) from which Novalis dies. The poet’s literary production represents a pathological fixation that impedes the dynamic organicity of Hegelian Science. As such, Novalis’s (...) mental illness and death constitute an expression of romantic irony and an ongoing threat to Hegel’s philosophy. (shrink)

This paper explores how the diagnosis of mental disorder may affect the diagnosed subject’s self-concept by supplying an account that emphasizes the influence of autobiographical and social narratives on self-understanding. It focuses primarily on the diagnoses made according to the criteria provided by the Diagnostic Statistical Manual of Mental Disorders (DSM), and suggests that the DSM diagnosis may function as a source of narrative that affects the subject’s self-concept. Engaging in this analysis by appealing to autobiographies and memoirs (...) written by people diagnosed with mental disorder, the paper concludes that a DSM diagnosis is a double-edged sword for self- concept. On the one hand, it sets the subject’s experience in an established classificatory system which can facilitate self-understanding by providing insight into subject’s condition and guiding her personal growth, as well as treatment and recovery. In this sense, the DSM diagnosis may have positive repercussions on self-development. On the other hand, however, given the DSM’s symptom-based approach and its adoption of the Biomedical Disease model, a diagnosis may force the subject to make sense of her condition divorced from other elements in her life that may be affecting her mental- health. It may lead her frame her experience only as an irreversible imbalance. This form of self-understanding may set limits on the subject’s hopes of recovery and may create impediments to her flourishing. (shrink)

In view of the publication of the DSM-V researchers were asked to discuss the theoretical implications of the definition of mental disorders. The reasons for the use, in the DSM-III, of the term disorder instead of disease are considered. The analysis of these reasons clarifies the distinction between the general definition of disorder and its implicit, technical meaning which arises from concrete use in DSM disorders. The characteristics and limits of this technical meaning are discussed and contrasted to (...) alternative definitions, like Wakefield’s harmful/dysfunction analysis. It is shown that Wakefield’s analysis faces internal theoretical problems in addition to practical limits for its acceptance in the DSM-V. In particular, it is shown that: a) the term dysfunction is not purely factual but intrinsically normative/evaluative; b) it is difficult to clarify what dysfunctions are in the psychiatric context (the dysfunctional mechanism involved being unknown in most cases and the use of evolutionary theory being even more problematic); c) the use of conceptual analysis and commonsense intuition to define dysfunctions leaves unsatisfied empiricists; d) it is unlikely that the authors of the DSM-V will accept Wakefield’s suggestion to revise the diagnostic criteria of any single DSM disorder in accordance with his analysis, because this is an excessively extensive change and also because this would probably reduce DSM reliability. In conclusion, it is pointed up in which sense DSM mental disorders have to be conceived as constructs, and that this undermines the realistic search for a clear-cut demarcation criterion between what is disorder and what is not. (shrink)

Multiple drug resistant strains of HIV and continuing difficulties with vaccine development highlight the importance of psychologi- cal interventions which aim to in uence the psychosocial and emo- tional factors empirically demonstrated to be significant predictors of immunity, illness progression and AIDS mortality in seropositive persons. Such data have profound implications for psychological interventions designed to modify psychosocial factors predictive of enhanced risk of exposure to HIV as well as the neuroendocrine and immune mechanisms mediating the impact of such factors (...) on disease progression. Many of these factors can be construed as unconscious mental ones, and psychoanalytic self-psychology may be a useful framework for conceptualizing psychic and immune de- fence as well as bodily and self-integration in HIV infection. Al- though further prospective studies and cross-cultural validation of research are necessary, existing data suggest that psychoanalytic insights may be useful both in therapeutic interventions and evaluative research which would require an underlying epistemology of the complementarity of mind and matter. (shrink)

Introduction: The incidence of chronic low back pain (LBP) is very high in Bangladesh. There is a high prevalence of psychiatric diseases among chronic low back pain patients. But primary care physicians and specialists do not screen this association. The aims of this study were to evaluate the incidence and pattern of psychiatric diseases in chronic low back pain patients. Materials and methods: A prospective cross-sectional hospital-based study of 135 chronic low back pain patients using simple, direct, standardized questionnaire including (...) history and detailed psychiatric evaluation by a consultant psychiatrist from January to December 2014. Results: A total 69 chronic low back pain patients (51.1%) were diagnosed with psychiatric problems. Predominant group were female (65.9%), above 40 years of age (60.7%). Depression (44.9 %) and anxiety (31.9%) were the major psychiatric illness diagnosed (76.8%). Only 17.4 % patients expects complete cure. Fear of disease outcome was the commonest precipitating factor found (66.6%). With the adjuvant psychiatric management, 81.1% showed improvement clinically. Conclusion: Detecting the level of psychiatric illness among chronic low back pain patients at early stage will improve the treatment outcome. A referral system to psychiatrists by physicians needs to develop to screen the mental disorder symptoms to treat the problem. (shrink)

How do people understand the concepts of mental health and disorder? The objective of this paper is to examine the impact of several factors on people’s judgments about whether a condition constitutes a mental disorder or a healthy state. Specifically, this study examines the impact of the source of the condition, its outcome, individual valuation (i.e., the value the individual attaches to the condition), and group valuation (i.e., the value the relevant group attaches to the condition). While we (...) find that people’s health and disorder judgments are driven by perceived dysfunction, we also find that health and disorder judgments are impacted differently by these factors. Health judgements are impacted by outcome and individual valuation, and disorder judgments are impacted by condition source. These results suggest that the folk concept of mental health is positive (i.e., mental health is more than the absence of mental disorder) and normativist (i.e., value judgments play a significant role in determining whether a condition counts as healthy), while the concept of mental disorder aligns with a naturalist perspective, at least to the extent that dysfunction plays an important role in categorizing a condition as a disorder. However, our finding that people’s dysfunction judgments are influenced by individual valuation and outcomes poses a strong challenge to naturalist accounts. To provide access to our supplementary data, an appendix has been included. (shrink)

A pressing need for interrater reliability in the diagnosis of mental disorders emerged during the mid-twentieth century, prompted in part by the development of diverse new treatments. The Diagnostic and Statistical Manual of Mental Disorders (DSM), third edition answered this need by introducing operationalized diagnostic criteria that were field-tested for interrater reliability. Unfortunately, the focus on reliability came at a time when the scientific understanding of mental disorders was embryonic and could not yield valid disease definitions. (...) Based on accreting problems with the current DSM-fourth edition (DSM-IV) classification, it is apparent that validity will not be achieved simply by refining criteria for existing disorders or by the addition of new disorders. Yet DSM-IV diagnostic criteria dominate thinking about mental disorders in clinical practice, research, treatment development, and law. As a result, the modernDSMsystem, intended to create a shared language, also creates epistemic blinders that impede progress toward valid diagnoses. Insights that are beginning to emerge from psychology, neuroscience, and genetics suggest possible strategies for moving forward. (shrink)

We have begun work on two separate but related ontologies for the study of neurological diseases. The first, the Neurological Disease Ontology (ND), is intended to provide a set of controlled, logically connected classes to describe the range of neurological diseases and their associated signs and symptoms, assessments, diagnoses, and interventions that are encountered in the course of clinical practice. ND is built as an extension of the Ontology for General Medical Sciences — a high-level candidate OBO Foundry ontology (...) that provides a set of general classes that can be used to describe general aspects of medical science. ND is being built with classes utilizing both textual and axiomatized definitions that describe and formalize the relations between instances of other classes within the ontology itself as well as to external ontologies such as the Gene Ontology, Cell Ontology, Protein Ontology, and Chemical Entities of Biological Interest. In addition, references to similar or associated terms in external ontologies, vocabularies and terminologies are included when possible. Initial work on ND is focused on the areas of Alzheimer’s and other diseases associated with dementia, multiple sclerosis, and stroke and cerebrovascular disease. Extensions to additional groups of neurological diseases are planned. The second ontology, the Neuro-Psychological Testing Ontology (NPT), is intended to provide a set of classes for the annotation of neuropsychological testing data. The intention of this ontology is to allow for the integration of results from a variety of neuropsychological tests that assay similar measures of cognitive functioning. Neuro-psychological testing is an important component in developing the clinical picture used in the diagnosis of patients with a range of neurological diseases, such as Alzheimer’s disease and multiple sclerosis, and following stroke or traumatic brain injury. NPT is being developed as an extension to the Ontology for Biomedical Investigations. (shrink)

Background: The study aimed to explore the perception of mothers of adolescent girls and health service providers in urban slums toward HPV vaccination. Methodology: A cross-sectional mixed-method study in the slums of Rayer Bazaar, Kamlapur and Mohakhali was conducted. The quantitative part included a household survey of mothers (n=150) and service providers (n=30) through a semi-structured pre-tested questionnaire and qualitative interviews included in-depth interviews (IDI) with mothers (n=10) and key-informant interviews (KII) with service providers (n=10). Results: Around 96% of mothers (...) had never heard of HPV, and 98% were unaware that the virus's transmission could be halted. Only 3.3% of mothers were aware that HPV can cause cervical cancer, although, during IDI, it was seen that the majority of mothers said that cervical cancer is a communicable disease. Nearly 98% of mothers wanted their daughters to get vaccinated. Service providers had a good understanding of HPV, HPV vaccine, and cervical cancer. All service providers during KII agreed that if they had received adequate training on HPV vaccination and cervical cancer, they could have treated their patients better. Conclusion: The findings of this study have important implications for the design and advocacy of HPV immunization programs in Bangladesh. (shrink)

Climate change, pollution, and deforestation have a negative impact on global mental health. There is an environmental justice dimension to this challenge as wealthy people and high-income countries are major contributors to climate change and pollution, while poor people and low-income countries are heavily affected by the consequences. Using state-of-the art data mining, we analyzed and visualized the global research landscape on mental health, climate change, pollution and deforestation over a 15-year period. Metadata of papers were exported from (...) PubMed®, and both relevance and relatedness of terms in different time frames were computed using VOSviewer. Co-occurrence graphs were used to visualize results. The development of exemplary terms over time was plotted separately. The number of research papers on mental health and environmental challenges is growing in a linear fashion. Major topics are climate change, chemical pollution, including psychiatric medication in wastewater, and neurobiological effects. Research on specific psychiatric syndromes and diseases, particularly on their ethical and social aspects is less prominent. There is a growing body of research literature on links between mental health, climate change, pollution, and deforestation. This research provides a graphic overview to mental healthcare professionals and political stakeholders. Social and ethical aspects of the climate change-mental health link have been neglected, and more research is needed. (shrink)

Narratives structure and inform how we understand our experiences and identity, especially in instances of suffering. Suffering in mental disorder (e.g. bipolar disorder) is often uniquely distressing as it impacts capacities central to our ability to make sense of ourselves and the world—and the role of narratives in explaining and addressing these effects is well-known. For many with a mental disorder, spiritual/religious narratives shape how they understand and experience it. For most, this is because they are spiritual and/or (...) religious. For others, spiritual/religious narratives still often influence secular approaches to mental disorder, more than approaches to other disabilities (e.g. intellectual, physical) or causes of suffering (e.g. physical disease). Such narratives are often harmful, especially insofar as they ‘over-spiritualize’ mental disorder; and undercut ‘spiritual meaning-making’. Here I address the impact of spiritual/religious narratives that helpfully avoid over-spiritualizing mental disorder while enabling spiritual meaning-making about it. First, I address the role of narratives in meaning-making more generally; then, I present results from my recent empirical study testing the impact of such narratives on participants’ meaning-making about their mental disorder. I conclude by addressing implications and potential worries. (shrink)

The antipsychiatrists in the 1960's, specifically Thomas Szasz, have claimed that mental illness does not exist. This argument was based on a specific definition of physical disease that, Szasz argued, could not be applied to mental illness. Thus, by problematizing mental illness, the spotlight had turned to physical disease. Since then, philosophers of medicine have proposed definitions applying both to pathophysiological and psychopathological conditions. This paper analyzes prominent naturalist definitions which aim to provide value-free accounts (...) of pathological conditions, as well as normative accounts that propose value-laden accounts. The approaches surveyed differ not only in terms of value, but also in terms of their perspective. This perspective concerns whether the concept of health, illness or disease/disorder is emphasized. The emphasis on health or illness is holistic as it looks at the human being as a whole, while focus on disease or disorder is analytic as it considers part functions. I will here argue in favor of holism and will propose a definition of mental health based on Sartre's existential psychoanalysis of Gustave Flaubert. (shrink)

At present, psychiatric disorders are characterized descriptively, as the standard within the scientific community for communication and, to a certain extent, for diagnosis, is the DSM, now at its fifth edition. The main reasons for descriptivism are the aim of achieving reliability of diagnosis and improving communication in a situation of theoretical disagreement, and the Ignorance argument, which starts with acknowledgment of the relative failure of the project of finding biomarkers for most mental disorders. Descriptivism has also the advantage (...) of capturing the phenomenology of mental disorders, which appears to be essential for diagnosis, though not exhaustive of the nature of the disease. I argue that if we rely on the distinction between conceptions (procedures of identification) and concepts (reference-fixing representations), which was introduced in the philosophical debate on the nature of concepts, we may understand a limited but valid role for descriptive characterizations, and reply to common objections addressed by those who advocate a theoretically informed approach to nosology. (shrink)

Abstract: At present, psychiatric disorders are characterized descriptively, as the standard within the scientific community for communication and, to a cer- tain extent, for diagnosis, is the DSM, now at its fifth edition. The main rea- sons for descriptivism are the aim of achieving reliability of diagnosis and improving communication in a situation of theoretical disagreement, and the Ignorance argument, which starts with acknowledgment of the relative fail- ure of the project of finding biomarkers for most mental disorders. Descrip- (...) tivism has also the advantage of capturing the phenomenology of mental dis- orders, which appears to be essential for diagnosis, though not exhaustive of the nature of the disease. I argue that if we rely on the distinction between conceptions (procedures of identification) and concepts (reference-fixing representations), which was introduced in the philosophical debate on the nature of concepts, we may understand a limited but valid role for descrip- tive characterizations, and reply to common objections addressed by those who advocate a theoretically informed approach to nosology. (shrink)

Our philosophical understanding of mental illness is being shaped by neuroscience. However, it has the paradoxical effect of igniting two radically opposed groups of philosophical views. On one side, skepticism and denialism assume that, lacking clear biological mechanisms and etiologies for most mental illnesses, we should infer they are constructions best explained by means of social factors. This is strongly associated with medical nihilism: it considers psychiatry more harmful than benign. On the other side of the divide, naturalism (...) and reductionism are on the look for failures in the biological functioning of the organism whenever a genuine mental illness occurs. Psychiatry as currently practiced, accordingly, exhibits the gaps of an ongoing research programme; a yet to be completed neuroscience would link mental illnesses with identifiable biological mechanisms. Both sides of this divide claim to be fostered by scientific discoveries and advances in neuroscience, when taken at face value. Against this background, we argue instead for a modest view. To that end, we draw attention to some nuances in the scientific realism debate. While contending that neuroscientific theories and models aim to provide true representations of their target systems, and can justifiably claim to have attained some, we argue that our confidence should not be placed beforehand in specific features of these scientific representations. Hence, it would be unwarranted to extract morals for psychiatry from posits (or their absence) in neuroscientific explanations of mental illnesses. To illustrate our position, we examine some recent discoveries in neuroscience concerning bipolar disorder. We conclude by linking our topic to a broader issue in the philosophy of medicine: insofar as psychiatry is a biomedical specialty, its classifications of health and disease are guided by pragmatic concerns, as well as by scientific discoveries. (shrink)

The observation that a crisis of confidence regarding Psychiatry exists is a notion shared even among psychiatrists themselves. Psychiatry has a checkered history and its alliance with the pharmaceutical industry, aka Big-Pharma, continues to reinforce a need for healthy skepticism. Why? Mainly, an over-reliance on the questionable expertise and authority afforded psychiatry as the specialists of mental health. I contend that the authority of psychiatry is misplaced and too often harmful. Since the criteria required to justify and satisfy psychiatric (...) expertise is not fully established as can be substantiated by compelling reasons to rethink its authority as a reliable profession in its current form. Psychiatric expertise is not particularly scientific and this is especially dangerous in a sector that prescribes mind-altering drugs. There are a number of identified criteria that would otherwise substantiate psychiatric expertise and whilst partially existent, are nonetheless deficient. These major yet deficient aspects of psychiatric practice concern diagnostic problems – reliability and verification of diagnoses and accurate testable validity of diagnoses - mainly due to an absence of identifiable underlying biomarkers ordinarily related to disease or biological conditions. Psychiatrists often fail to distinguish between reactive-depression (reaction to external event or circumstance) and endogenous-depression (biological) resulting, in part, from incorrectly distinguishing between conditions constitutive of ‘trait’ (endogenous) and of those of ‘state’ (e.g. reactive depression; adverse effects from medication, etc.). (shrink)

Nostalgia as one of the complex emotions has been challenged over the past few decades due to its psychological and physiological functions. The present experiment investigates the effect of recalling nostalgic memories on amelioration of homeostatic and health state of people with cardiovascular disease. Method: The participants were 30 patients who were hospitalized for angiography procedure. The research was based on an experimental design with randomized and post-test groups. The instruments used included a thermometer with ° C, a checkout (...) manipulation test, a blood pressure monitor, an ice container and a manual timer, a pain intensity perception scale and Batcho’s nostalgia questionnaire. Results: The results showed that there was a significant difference between the two groups in perceived temperature, the resilience in the face of pain, and the perceived pain. The experimental group perceived higher temperature and showed greater resilience in the face of pain and also lower pain intensity was reported. There was no significant difference in blood pressure between the two groups. Conclusion: The results of this study provide significant evidence for the embodiment emotions hypothesis and positive role of Nostalgia in psychological and physiological homeostatic. Further practical implications of results and suggestions for future research were considered. (shrink)

This collection presents six case studies on the ethics of mental health research, written by scientific researchers and ethicists from around the world. We publish them here as a resource for teachers of research ethics and as a contribution to several ongoing ethical debates. Each consists of a description of a research study that was proposed or carried out and an in-depth analysis of the ethics of the study.

Jonathan Y. Tsou examines and defends positions on central issues in philosophy of psychiatry. The positions defended assume a naturalistic and realist perspective and are framed against skeptical perspectives on biological psychiatry. Issues addressed include the reality of mental disorders; mechanistic and disease explanations of abnormal behavior; definitions of mental disorder; natural and artificial kinds in psychiatry; biological essentialism and the projectability of psychiatric categories; looping effects and the stability of mental disorders; psychiatric classification; and the (...) validity of the DSM's diagnostic categories. The main argument defended by Tsou is that genuine mental disorders are biological kinds with harmful effects. This argument opposes the dogma that mental disorders are necessarily diseases that result from biological dysfunction. Tsou contends that the broader ideal of biological kinds offers a more promising and empirically ascertainable naturalistic standard for assessing the reality of mental disorders and the validity of psychiatric categories. (shrink)

Athenaeus of Attalia distinguishes two types of exercise or training (γυμνασία) that are required at each stage of life: training of the body and training of the soul. He says that training of the body includes activities like physical exercises, eating, drinking, bathing and sleep. Training of the soul, on the other hand, consists of thinking, education, and emotional regulation (in other words, 'philosophy'). The notion of 'training of the soul' and the contrast between 'bodily' and 'psychic' exercise is common (...) in the Academic and Stoic traditions Athenaeus is drawing from; however, he is the earliest extant medical author to distinguish these kinds of training and to treat them as equally important aspects of regimen. In this paper, I propose some reasons why he found this distinction useful, and I examine how he justified incorporating it into his writings on regimen, namely by attributing Plato's beliefs about regimen to Hippocrates, a strategy Galen would adopt well over a century later. (shrink)

Advances in emotion and affective science have yet to translate routinely into psychiatric research and practice. This is unfortunate since emotion and affect are fundamental components of many psychiatric conditions. Rectifying this lack of interdisciplinary integration could thus be a potential avenue for improving psychiatric diagnosis and treatment. In this contribution, we propose and discuss an ontological framework for explicitly capturing the complex interrelations between affective entities and psychiatric disorders, in order to facilitate mapping and integration between affective science and (...) psychiatric diagnostics. We build on and enhance the categorisation of emotion, affect and mood within the previously developed Emotion Ontology, and that of psychiatric disorders in the Mental Disease Ontology. This effort further draws on developments in formal ontology regarding the distinction between normal and abnormal in order to formalize the interconnections. This operational semantic framework is relevant for applications including clarifying psychiatric diagnostic categories, clinical information systems, and the integration and translation of research results across disciplines. (shrink)

We explicate and evaluate arguments both for and against the insanity defense itself, different versions of the insanity defense (M'Naghten, Model Penal Code, and Durham (or Product)), the Irresistible Impulse rule, and various reform proposals.

Mindreading is the ability to attribute mental states to other individuals. According to the Theory-Theory (TT), mindreading is based on one's possession of a Theory of Mind. On the other hand, the Simulation Theory (ST) maintains that one arrives at the attribution of a mental state by simulating it in one's own mind. In this paper, I propose a ST-TT hybrid model of the ability to attribute disgust on the basis of visual stimuli such as facial expressions, body (...) postures, etc. More precisely, while I defend Goldman's (2006) thesis that the ability to attribute disgust based on observing disgusted facial expressions stems from a mirror-based simulation process, I argue that ST is unable to account for the ability to attribute disgust based on non-facial visual stimuli; I propose, rather, that this latter ability is theory-based. My model is grounded in evidence from individuals suffering from Huntington's Disease. (shrink)

In his target article and recent interesting book about addiction and the brain, Marc Lewis claims that the prevalent medical view of addiction as a brain disease or a disorder, is mistaken. In this commentary we critically examine his arguments for this claim. We find these arguments to rest on some problematical and largely undefended assumptions about notions of disease, disorder and the demarcation between them and good health. Even if addiction does seem to differ from some typical (...) brain diseases, we believe contrary to Lewis, that there are still good reasons to maintain its classification as a mental or behavioral disorder. (shrink)

This paper challenges the common assumption that some phenotypic traits are quantitative while others are qualitative. The distinction between these two kinds of traits is widely influential in biological and biomedical research as well as in scientific education and communication. This is probably due to both historical and epistemological reasons. However, the quantitative/qualitative distinction involves a variety of simplifications on the genetic causes of phenotypic variability and on the development of complex traits. Here, I examine three cases from the life (...) sciences that show inconsistencies in the distinction: Mendelian traits, Mendelian diseases, and polygenic mental disorders. I show that these traits can be framed both quantitatively and qualitatively depending, for instance, on the methods through which they are investigated and on specific epistemic purposes. This suggests that the received view of quantitative and qualitative traits has a limited heuristic power—limited to some local contexts or to the specific methodologies adopted. Throughout the paper, I provide directions for framing phenotypes beyond the quantitative/qualitative distinction. I conclude by pointing at the necessity of developing a principled characterisation of what phenotypic traits, in general, are. (shrink)

The emergence of coronavirus disease (COVID-19) from Wuhan city of China engulfed almost the entire world and created a global pandemic. Several countries declared this pandemic as national emergency, forcing millions of people to go into lockdown. This sudden social isolation has caused enormous disruption of daily routine for the global community, especially children. To minimize the transmission of this virus all the educational institutions were closed and moved to online learning to encourage and adhere to social distancing guidelines (...) issued by the authorities from time to time. This abrupt change in the learning environment, restrictions in social interaction and other activities caused unusual situation in the development of child brain. Therefore, it is important and obligatory for the scientific community and healthcare workers to access and analyse the impact of Covid -19 pandemic on the mental health of children. The present article is a case study and was conducted in Doda of Jammu and Kashmir regarding the impact of quarantine on the children. (shrink)

Are psychiatric disorders natural kinds? This question has received a lot of attention within present-day philosophy of psychiatry, where many authors debate the ontology and nature of mental disorders. Similarly, historians of psychiatry, dating back to Foucault, have debated whether psychiatric researchers conceived of mental disorders as natural kinds or not. However, historians of psychiatry have paid little to no attention to the influence of (a) theories within logic, and (b) theories within metaphysics on psychiatric accounts of proper (...) method, and on accounts of the nature and classification of mental disorders. Historically, however, logic and metaphysics have extensively shaped methods and interpretations of classifications in the natural sciences. This paper corrects this lacuna in the history of psychiatry, and demonstrates that theories within logic and metaphysics, articulated by Christian Wolff (1679-1754), have significantly shaped the conception of medical method and (psychiatric) nosology of the influential nosologist Boissier De Sauvages (1706-1767). After treating Sauvages, I discuss the method of the influential nosologist William Cullen (1710-1790), and demonstrate the continuity between the classificatory methods of Sauvages and Cullen. I show that both Sauvages and Cullen were essentialists concerning medical diseases in general and psychiatric disorders in particular, contributing to the history of conceptions of the ontology and nature of mental disorders. (shrink)

In this chapter, I provide an overview of phenomenological approaches to psychiatric classification. My aim is to encourage and facilitate philosophical debate over the best ways to classify psychiatric disorders. First, I articulate phenomenological critiques of the dominant approach to classification and diagnosis—i.e., the operational approach employed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the International Classification of Diseases (ICD-10). Second, I describe the type or typification approach to psychiatric classification, which I distinguish into three (...) different versions: ideal types, essential types, and prototypes. I argue that despite their occasional conflation in the contemporary literature, there are important distinctions among these approaches. Third, I outline a new phenomenological-dimensional approach. I show how this approach, which starts from basic dimensions of human existence, allows us to investigate the full range of psychopathological conditions without accepting the validity of current diagnostic categories. (shrink)

In “The myth of mental illness” Thomas Szasz challenges the idea that mental illnesses are diseases in the biomedical sense. In his view they are more similar to a foreign language and for this reason they cannot be treated by means of biomedical therapies. The present article explores the semiotic implications of Szasz’s view of the hysterical symptoms as an iconic language. Following Reichenbach, Szasz distinguishes three classes of signs: indexical, iconic and symbolic. The somatic language of the (...) hysteric person would be an iconic protolanguage which is more primordial than the objective language. Nevertheless, it retains all the basic functions of the language: to transmit information, to induce mood, and to promote action. Five different but intertwined reasons for the use of such an iconic form of communication are discussed. In conclusion, the hysterical symptom speaks its proper language and our ethical commitment is primarily to empathically listen to it. (shrink)

Di masyarakat manapun, bunuh diri selalu merupakan sebuah tragedi. Meskipun ada masalah duka dan berkabung yang ditimbulkan, tragedi ini berkembang pesat di seluruh dunia. The Global Burden of Disease, sebuah penelitian global di tahun 2017 terhadap 282 penyebab kematian di 1.995 negara dan wilayah, menemukan bahwa bunuh diri merupakan penyebab kematian tertinggi pada peringkat ke-15. Diperkirakan hampir 800.000 orang meninggal dunia akibat bunuh diri setiap tahunnya, atau sekitar satu orang setiap 40 detik [1]. Banyaknya jumlah kematian akibat bunuh diri (...) telah mendorong para dokter kesehatan jiwa dan peneliti untuk menganggap kecenderungan bunuh diri sebagai penyakit. Pada tahun 2013, sebuah langkah besar telah diambil oleh tim profesional yang ada di balik edisi kelima Manual Diagnostik dan Statistik Gangguan Mental (DSM-5) [2,3]. Mereka menyarankan Suicide Behavior Disorder (SBD) atau gangguan perilaku bunuh diri sebagai sebuah “kondisi untuk studi lebih lanjut”, yang berarti bahwa SBD dapat dicantumkan sebagai suatu gangguan yang berbeda dan menerima rekomendasi pengobatan pada edisi berikutnya. Pakar berpengalaman mengembangkan lima kriteria diagnosis SBD pada Satgas dan Kelompok Kerja DSM-5 setelah melakukan tinjauan menyeluruh terhadap literatur penelitian serta diskusi dengan para ahli di bidangnya dan masyarakat umum [4],. (shrink)

According to Aristotle, the medical art aims at health, which is a virtue of the body, and does so in an unlimited way. Consequently, medicine does not determine the extent to which health should be pursued, and “mental health” falls under medicine only via pros hen predication. Because medicine is inherently oriented to its end, it produces health in accordance with its nature and disease contrary to its nature—even when disease is good for the patient. Aristotle’s politician (...) understands that this inherent orientation can be systematically distorted, and so would see the need for something like the Hippocratic Oath. (shrink)

Although neurological disease and mental illness can cause terrible human suffering, strategies for researching their causes and cures are not obvious. Invasive brain research on actual human being...

In addiction, apparently causally significant phenomena occur at a huge number of levels; addiction is affected by biomedical, neurological, pharmacological, clinical, social, and politico-legal factors, among many others. In such a complex, multifaceted field of inquiry, it seems very unlikely that all the many layers of explanation will prove amenable to any simple or straightforward, reductive analysis; if we are to unify the many different sciences of addiction while respecting their causal autonomy, then, what we are likely to need is (...) an integrative framework. In this paper, we propose the theory of “Externalist” or “4E” – for extended, embodied, embedded, and enactive – cognition, which focuses on the empirical and conceptual centrality of the wider extra-neural environment to cognitive and mental processes, as a candidate for such a framework. We begin in Section 2 by outlining how such a perspective might apply to psychiatry more generally, before turning to some of the ways it can illuminate addiction in particular: Section 3 points to a way of dissolving the classic dichotomy between the “choice model” and “disease model” in the addiction literature; Section 4 shows how 4E concepts can clarify the interplay between the addict’s brain and her environment; and Section 5 considers how these insights help to explain the success of some recovery strategies, and may help to inform the development of new ones. (shrink)

● Any given placement (e.g. Sun in Taurus; Mars in Capricorn; Mercury in the third house) is necessarily common to tens of thousands of people. Saturn in the ninth house, for example, will not behave the same or produce the same effects in the twenty or one hundred charts in which we find it there. In each case Saturn will behave in accordance with the rest of the astrographic/chart composition (as if we stayed in the same hotel in different epochs (...) or different people contracted the same disease; our stay will be different each time, according to the epoch, and each person’s symptoms will too, be different, according to their individual biochemistry; not to mention that each chart or astrography, like each genetic code or sequence, is unrepeatable). Certainly, “no planet can produce, on its own, what only the combined or concerted action of all can” (BUSTAMANTE, 2023, SPICA magazine, pp. 93-111). Hence the synergistic nature of the interpretative exercise (i.e., the whole is greater than all its parts). The fundamental component of the mathematical expression of the interpretive exercise is: astrological triangulation, the functional denomination for what we know as synthesis (WEISS, 1946; LEO, 1983, HAND, 1981). In order to demonstrate its usefulness, as well as the convenience of its mathematical expression, we have chosen two individuals (JEFFREY DAHMER, STEVEN SPIELBERG) whose astrographies do not—according to the community—explain their lives. The rest of the astrographies correspond to those of serial killers JOHN WAYNE GACY, DAVID CARPENTER, and TED BUNDY. ● We explain, by means of algebraic notations, the synthesis and the functional values that make up the synthesis. ● We take the Moon and Neptune as relevant bodies for the purpose of diagnosing or studying endocrine or neurohormonal issues, and Mars, Pluto, and Saturn as relevant planets for the purpose of inferring violence or sinister behaviour, upon the case, and quadratures or oppositions—and conjunctions—between Venus and the Moon, the Moon and Neptune, and the Sun or Venus and Neptune or Uranus as indicators of neurohormonal disorders and/or sexual deviance (APA definition) . ● We consider quadratures (90º) or oppositions (180º)—and conjunctions—between Mercury or the Moon and Saturn, or between Mars or the Moon and Saturn, Uranus, Neptune, and/or Pluto as powerful indications of violence or mental disorders, upon the case. ● We have also regarded Sagittarius as a sign as expansive and abundant as its ruler, Jupiter, according to the best of its characterisations (or as an exceptionally swift and wild sign, according to other characterisations), and the fifth region of a natal chart as one closely related to fortune in a broad sense (material and immaterial). ● Because we advocate the idea that orbs should be predicated of the planet (size, speed), not the aspect itself, the gas giants (Jupiter, Saturn, Uranus, and Neptune) and the Sun have been granted up to 10º of orb (or 12º, in the case of broad influence ). We understand aspectual relationships as angular relationships held between two or more celestial bodies placed in signs with at least one property in common (according to our molecular theory of the ecliptic, compatible with the optical theory of the aspects from the Hellenistic tradition). (shrink)

Background: In the first few months of 2020, information and news reports about the coronavirus disease (COVID-19) were rapidly published and shared on social media and social networking sites. While the field of infodemiology has studied information patterns on the Web and in social media for at least 18 years, the COVID-19 pandemic has been referred to as the first social media infodemic. However, there is limited evidence about whether and how the social media infodemic has spread panic and (...) affected the mental health of social media users. Objective: The aim of this study is to determine how social media affects self-reported mental health and the spread of panic about COVID-19 in the Kurdistan Region of Iraq. Methods: To carry out this study, an online questionnaire was prepared and conducted in Iraqi Kurdistan, and a total of 516 social media users were sampled. This study deployed a content analysis method for data analysis. Correspondingly, data were analyzed using SPSS software. Results: Participants reported that social media has a significant impact on spreading fear and panic related to the COVID-19 outbreak in Iraqi Kurdistan, with a potential negative influence on people’s mental health and psychological well-being. Facebook was the most used social media network for spreading panic about the COVID-19 outbreak in Iraq. We found a significant positive statistical correlation between self-reported social media use and the spread of panic related to COVID-19 (R=.8701). Our results showed that the majority of youths aged 18-35 years are facing psychological anxiety. Conclusions: During lockdown, people are using social media platforms to gain information about COVID-19. The nature of the impact of social media panic among people varies depending on an individual's gender, age, and level of education. Social media has played a key role in spreading anxiety about the COVID-19 outbreak in Iraqi Kurdistan. (shrink)

In some jurisdictions, the institutions of criminal justice may subject individuals who have committed crimes to preventive detention. By this, I mean detention of criminal offenders (i) who have already been punished to (or beyond) the point that no further punishment can be justified on general deterrent, retributive, restitutory, communicative or other backwardlooking grounds, (ii) for preventive purposes—that is, for the purposes of preventing the detained individual from engaging in further criminal or otherwise socially costly conduct. Preventive detention, thus understood, (...) shares many features with the quarantine measures sometimes employed in the context of infectious disease control. Both interventions involve imposing (usually severe) constraints on freedom of movement and association. Both interventions are standardly undeserved: in quarantine, the detained individual deserves no detention (or so I will, for the moment, assume), and in preventive detention, the individual has already endured any detention that can be justified by reference to desert. Both interventions are, in contrast to civil commitment under mental health legislation, normally imposed on more-or-less fully autonomous individuals. And both interventions are intended to reduce the risk that the constrained individual poses to the public. Yet despite these similarities, preventive detention and quarantine have received rather different moral report cards. (shrink)

In recent years, philosophers have identified a number of moral and psychological harms associated with the attention economy (Alysworth & Castro, 2021; Castro & Pham, 2020; Williams, 2018). Missing from many of these accounts of the attention economy, however, is what exactly attention is. As a result of this neglect of the cognitive science of attention, many of these accounts are not empirically credible. They rely on oversimplified and unsophisticated accounts of not only attention, but self- control, and addiction as (...) well. Of note are accounts of the attention economy that rely on the ‘brain disease’ rhetoric of addiction and subsequent control failures (Aylsworth & Castro, 2021; Bhargava & Velasquez, 2021), accounts that rely on a strict dichotomy of top-down vs. bottom-up attention (Williams, 2018; Aylsworth & Castro, 2021), and accounts that construe attention as a limited resource (Williams, 2018). -/- Drawing on recent work from the neuroscience and psychology of attention, I demonstrate the shortcomings of these accounts and sketch a way forward for an empirically grounded account of the attention economy. These accounts tend to uphold strict dichotomies of voluntary control (e.g., compulsion versus choice, dual-process models of self-control, and top-down versus bottom-up) that cannot account for the complexities of attentional control, mental agency, and decision-making. As such, these empirically and conceptually impoverished accounts cannot adequately address the current so-called crisis of attention. To better understand the harms associated with the attention economy, we need an empirically responsible account of the nature and function of attention and mental agency. (shrink)

The definitions and conceptualizations of health, and the management of healthcare have been challenged by the current global scenarios (e.g., new diseases, new geographical distribution of diseases, effects of climate change on health, etc.) and by the ongoing scholarship in humanities and science. In this paper we question the mainstream definition of health adopted by the WHO—‘a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’ (WHO in Preamble to the (...) constitution of the World Health Organization as adopted by the international health conference, The World Health Organization, 1948)—and its role in providing tools to understand what health is in the contemporary context. More specifically, we argue that this context requires to take into account the role of the environment both in medical theory and in the healthcare practice. To do so, we analyse WHO documents dated 1984 and 1986 which define health as ‘coping with the environment’. We develop the idea of ‘coping with the environment’, by focusing on two cardinal concepts: adaptation in public health and adaptivity in philosophy of biology. We argue that the notions of adaptation and adaptivity can be of major benefit for the characterization of health, and have practical implications. We explore some of these implications by discussing two recent case studies of adaptivity in public health, which can be valuable to further develop adaptive strategies in the current pandemic scenario: community-centred care and microbiologically healthier buildings. (shrink)

It is technically possible to clone a human being. The result of the procedure would be a human being in its own right. Given the current level of cloning technology concerning other animals there is every reason to believe that early human clones will have shorter-than-average life-spans, and will be unusually prone to disease. In addition, they would be unusually at risk of genetic defects, though they would still, probably, have lives worth living. But with experimentation and experience, seriously (...) unequal prospects between cloned and noncloned people should erode. We shall ignore arguments about cloning that focus on the potential for harm to the fetus or resultant human being, where harm is understood solely in terms of physical and mental health. Unless the resultant people would generally have lives worth living there is no positive case for cloning, or any other form of reproduction, for that matter. If the resultant beings will generally have lives worth living there is a prima facie case for allowing cloning. We imagine the case in which the resultant beings will have lives well worth living. (shrink)

Just as sadness is not always a symptom of mood disorder, irrational beliefs are not always symptoms of illness. Pathological irrational beliefs are distinguished from non-pathological ones by considering whether their existence is best explained by assuming some underlying dysfunctions. The features from which to infer the pathological nature of irrational beliefs are: un-understandability of their progression; uniqueness; coexistence with other psycho-physiological disturbances and/or concurrent decreased levels of functioning; bizarreness of content; preceding organic diseases known to be associated with irrational (...) beliefs; treatment response to medical intervention, etc. Severe irrationality is sometimes caused by normal human motivation rather than by mental or physical dysfunction. Pure forms of self-deception may satisfy the diagnostic criteria of delusional disorder, but there may be no evidence that suggests that they are caused by illness. Although those with pathological delusions do not recognize their delusions as symptomatic of illness, differentiating pathological beliefs from normal irrational beliefs is vitally important: If a belief is pathological, psychiatrists must seriously consider treating the patient against her will. If it is not pathological, conversely, involuntary treatments are prohibited because they offend her basic autonomy. (shrink)

I argue that the right to sexual satisfaction of severely physically and mentally disabled people and elderly people who suffer from neurodegenerative diseases can be fulfilled by deploying sex robots; this would enable us to satisfy the sexual needs of many who cannot provide for their own sexual satisfaction; without at the same time violating anybody’s right to sexual self-determination. I don’t offer a full-blown moral justification of deploying sex robots in such cases, as not all morally relevant concerns can (...) be addressed here; rather, I put forward a plausible way of fulfilling acute sexual needs without thereby violating anybody’s sexual rights. (shrink)

The Psychological Society of Ireland’s (PSI) response to the call from the United Nations (UN) Committee on the Rights of the Child: Draft General Comment No. 26 Calls for comment on the draft general comment on children’s rights and the environment with a special focus on climate change III. ‘Specific rights of the Convention as they relate to the environment’, B. The right to the highest attainable standard of health (art. 24), 27. … children’s current and anticipated psychosocial, emotional and (...) mental health problems and suffering caused by environmental harm. The PSI wishes to express sincere thanks to the Society’s Special Interest Group in Human Rights and Psychology, particularly Dr Michelle Cowley-Cunningham, Dr Elaine Rogers, and Ms Alexis Carey, who coordinated the following response on behalf of the Society. 1. Environmental degradation, loss of biodiversity, and climate change impact children’s human rights and present a serious threat to future generations’ enjoyment of human rights. Distressingly, 1.7 million children lose their lives annually as a result of avoidable environmental impacts, while millions more are impacted by disease, displaced from their homes and miss out on receiving education1. The PSI Special Interest Group in Human Rights and Psychology (SIGHRP) is grateful to the Committee on the Rights of the Child for this opportunity to submit a stakeholder comment in advance of the drafting of the Draft General Comment No. 26. SIGHRP is appreciative of the work of the Committee in monitoring the implementation of the Convention on the Rights of the Child (UNCRC) and welcomes the Committee's stakeholder call for ideas to aid the development of policies, both domestically and internationally, to address critical climate change issues. Specifically, SIGHRP welcomes the opportunity to comment on the connection between child and adolescent mental health and human rights obligations, and advocates for policies and initiatives to address this issue in the context of climate change. (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)