For millennia self has been conjectured to be necessary for consciousness. But scant empirical evidence has been adduced to support this hypothesis. Inconsistent explications of “self” and failure to design apt experiments have impeded progress. Advocates of phenomenological psychiatry, however, have helped explicate “self,” and employed it to explain some psychopathological symptoms. In those studies, “self” is understood in a minimalist sense, sheer “for-me-ness.” Unfortunately, explication of the “minimal self” (MS) has relied on conceptual analysis, and applications to psychopathology have (...) been hermeneutic, allowing for many degrees of interpretive latitude. The result is that MS’s current scientific status is analogous to that of the “atom,” at the time when “atom” was just beginning to undergo transformation from a philosophical to a scientific concept. Fortunately, there is now an opportunity to promote a similar transformation for “MS.” Discovery of the brain’s Default Mode Network (DMN) opened the door to neuroimaging investigations of self. Taking the DMN and other forms of intrinsic activity as a starting point, an empirical foothold can be established, one that spurs experimental research and that enables extension of research into multiple phenomena. New experimental protocols that posit “MS” can help explain phenomena hitherto not thought to be related to self, thereby hastening development of a mature science of self. In particular, targeting phenomena wherein consciousness is lost and recovered, as in some cases of Unresponsive Wakefulness Syndrome (UWS), allow for design of neuroimaging probes that enable detection of MS during non-conscious states. These probes, as well as other experimental protocols applied to NREM Sleep, General Anesthesia (GA), and the waking state, provide some evidence to suggest that not only can self and consciousness dissociate, MS might be a necessary precondition for conscious experience. Finally, these findings have implications for the science of consciousness: it has been suggested that “levels of consciousness” (LoC) is not a legitimate concept for the science of consciousness. But because we have the conceptual and methodological tools with which to refine investigations of MS, we have the means to identify a possible foundation—a bifurcation point—for consciousness, as well as the means by which to measure degrees of distance from that foundation. These neuroimaging investigations of MS position us to better assess whether LoC has a role to play in a mature science of consciousness. (shrink)

Disorders of consciousness (DoC)—that is, unresponsive wakefulness syndrome/vegetative state and minimally conscious state—are debilitating conditions for which no reliable markers of consciousness recovery have yet been identified. Evidence points to the GABAergic system being altered in DoC, making it a potential target as such a marker.

意識是如此不可捉摸又抽象的概念，「測量」意識簡直就像科幻小說情節。科學家近年來在這方面已大有進展，藉由各項腦造影技術和實驗手法，能夠分析不同意識狀態下的大腦活動型態。.

Different sort of people are interested in personal identity. Philosophers frequently ask what it takes to remain oneself. Caregivers imagine their patients’ experience. But both philosophers and caregivers think from the armchair: they can only make assumptions about what it would be like to wake up with massive bodily changes. Patients with a locked-in syndrome (LIS) suffer a full body paralysis without cognitive impairment. They can tell us what it is like. Forty-four chronic LIS patients and 20 age-matched healthy (...) medical professionals answered a 15-items questionnaire targeting: (A) global evaluation of identity, (B) body representation and (C) experienced meaning in life. In patients, selfreported identity was correlated with B and C. Patients differed with controls in C. These results suggest that the paralyzed body remains a strong component of patients’ experienced identity, that patients can adjust to objectives changes perceived as meaningful and that caregivers fail in predicting patients’ experience. (shrink)

We discuss the view that a hole is identical to the region of spacetime at which it is located. This view is more parsimonious than the view that holes are sui generis entities located at those regions surrounded by their hosts and it is more plausible than the view that there are no holes. We defend the spacetime view from several objections.

Invited Commentary On: Graziano, M. S. A., Guterstam, A., Bio, B. J., Wilterson, A. I. (2019). Toward a standard model of consciousness: Reconciling the attention schema, global workspace, higher order thought, and illusionist theories. Cognitive Neuropsychology.

Many intelligent, capable, and successful individuals believe that their success is due to luck and fear that they will someday be exposed as imposters. A puzzling feature of this phenomenon, commonly referred to as imposter syndrome, is that these same individuals treat evidence in ways that maintain their false beliefs and debilitating fears: they ignore and misattribute evidence of their own abilities, while readily accepting evidence in favour of their inadequacy. I propose a novel account of imposter syndrome (...) as an instance of self-deception, whereby biased evidence treatment is driven by the motivational benefit of negative self-appraisal. This account illuminates a number of interconnected philosophical and scientific puzzles related to the explanation, definition, and value of imposter syndrome. (shrink)

Various psychopathologies of self-awareness, such as somatoparaphrenia and thought insertion in schizophrenia, might seem to threaten the viability of the higher-order thought (HOT) theory of consciousness since it requires a HOT about one’s own mental state to accompany every conscious state. The HOT theory of consciousness says that what makes a mental state a conscious mental state is that there is a HOT to the effect that “I am in mental state M.” I have argued in previous work that a (...) HOT theorist can adequately respond to this concern with respect to somatoparaphrenia and thought insertion. There is also Cotard syndrome which is a rare neuropsychiatric disorder in which people hold the delusional belief that they are dead, do not exist, or have lost their blood or internal organs. In this paper, I argue that HOT theory has nothing to fear from it either and can consistently account for what happens in such unusual cases. I analyze Cotard syndrome in light of my previous discussion of somatoparaphrenia and thought insertion, and argue that HOT theory can provide a somewhat analogous account without the worry of inconsistency. It is crucial to recognize that there are multiple “self-concepts” and levels of HOTs which can help to provide a more nuanced explanation. With regard to the connection between consciousness and self-consciousness, it is proposed that Cotard patients are indeed capable of having some “I-thoughts” about their bodies and mental states. (shrink)

The study examines the argumentative competencies of people with Asperger syndrome (AS) and compares this with those of normal – or what are called neurotypical (NT) – subjects. To investigate how people with AS recognise, evaluate and engage in argumentation, we have adapted and applied the empirical instrument developed by van Eemeren, Garssen and Meuffels to study the conventional validity of the pragma-dialectical freedom rule (van Eemeren, Gars- sen & Meuffels 2003a; 2003b; 2005a; 2005b; van Eemeren & Meuffels, 2002). (...) Our paper begins with some background information on Asperger syndrome and how it impacts upon communication and argumentation; then it addresses the research questions and methods used; thirdly, it presents some initial findings; finally, it will conclude with some im- plications for those people with AS, for those they come into contact with and for the pragma-dialectic model in general. (shrink)

Eyal et al have recently argued that researchers should consider conducting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) human challenge studies to hasten vaccine development. We have conducted (J. L.) and overseen (L. D.) human challenge studies and agree that they can be useful in developing anti-infective agents. We also agree that adults can autonomously choose to undergo risks with no prospect of direct benefit to themselves. However, we disagree that SARS-CoV-2 challenge studies are ethically appropriate at this time, (...) for 3 reasons: (1) current scientific knowledge of SARS-CoV-2 infection is insufficient to manage risks; (2) autonomous decision making, while necessary, does not override concerns about risk; and (3) undertaking challenge studies now would imperil confidence in the research enterprise, potentially undermining the global response to the coronavirus disease 2019 (COVID-19) pandemic. (shrink)

While some of mental disorders due to emotional distress occur cross-culturally, others seem to be much more bound to particular cultures. In this paper, I propose that many of these “cultural syndromes” are culturally sanctioned responses to overwhelming negative emotions. I show how tools from cultural evolution theory can be employed for understanding how the syndromes are relatively confined to and retained within particular cultures. Finally, I argue that such an account allows for some cultural syndromes to be or become (...) mental disorders and also steers clear of some of the anti-realist trappings associated with a social constructivism of cultural syndromes. (shrink)

This chapter discusses the Ganser syndrome and gives a brief account on its clinical features. A significant number of clinicians in Europe continued accepting Ganser's basic postulates that the patients showed significant memory disorder and 'answers towards the question' within the framework of traumatic or reactive hysteria. In elderly patients, Ganser type symptoms may be indicative of the onset of dementia. Ganser syndrome raises the question of the interaction between concepts, ideology and clinical observation. The clinician must be (...) aware that a misdiagnosed case of Ganser-type hysteria may result in lawsuits, unnecessary surgical interventions, inappropriate use of minor and major tranquillizers, and social consequences that may be destabilizing for the patient and family. Positive results in the organic investigation should lead to a firm diagnosis and disconfirmation of Ganser syndrome. Persistent negative results and dramatic improvement should tend to confirm the diagnosis. (shrink)

Two main approaches can be discerned in the literature on agentive self-awareness: a top-down approach, according to which agentive self-awareness is fundamentally holistic in nature and involves the operations of a central-systems narrator, and a bottom-up approach that sees agentive self-awareness as produced by lowlevel processes grounded in the very machinery responsible for motor production and control. Neither approach is entirely satisfactory if taken in isolation; however, the question of whether their combination would yield a full account of agentive self-awareness (...) remains very much open. In this paper, I contrast two disorders affecting the control of voluntary action: the anarchic hand syndrome and utilization behavior. Although in both conditions patients fail to inhibit actions that are elicited by objects in the environment but inappropriate with respect to the wider context, these actions are experienced in radically different ways by the two groups of patients. I discuss how top-down and bottom-up processes involved in the generation of agentive self-awareness would have to be related in order to account for these differences. (shrink)

Ordinary cases of object seeing involve the visual perception of space and spatial location. But does seeing an object require such spatial perception? An empirical challenge to the idea that it does comes from reflection upon Bálint's syndrome, for some suppose that in Bálint's syndrome subjects can see objects without seeing space or spatial location. In this article, I question whether the empirical evidence available to us adequately supports this understanding of Bálint's syndrome, and explain how the (...) aforementioned empirical challenge can be resisted. (shrink)

Philosophers have recently argued that since there are people who are blind, but don't know it, and people who echolocate, but don't know it, conscious introspection is highly unreliable. I contend that a second look at Anton's syndrome, human echolocation, and ‘facial vision’ suggests otherwise. These examples do not support skepticism about the reliability of introspection.

The patient with Capgras’ syndrome claims that people very familiar to him have been replaced by impostors. I argue that this disorder is due to the destruction of a representation that the patient has of the mind of the familiar person. This creates the appearance of a familiar body and face, but without the familiar personality, beliefs, and thoughts. The posterior site of damage in Capgras’ is often reported to be the temporoparietal junction, an area that has a role (...) in the mindreading system, a connected system of cortical areas that allow us to attribute mental states to others. Just as the Capgras’ patient claims that that man is not his father, the patient with asomatognosia claims that his arm is not really his. A similar account applies here, in that a nearby brain area, the supramarginal gyrus, is damaged. This area works in concert with the temporoparietal junction and other areas to produce a large representation of a mind inside a body situated in an environment. Damage to the mind-representing part of this system (coupled with damage to executive processes in the prefrontal lobes) causes Capgras’ syndrome, whereas damage to the body-representing part of this system (also coupled with executive damage) causes asomatognosia. (shrink)

A critical review of “Gettier” cases and theoretical attempts to solve “the” "Gettier" "problem".

“Excited Delirium Syndrome” (ExDS) is a controversial diagnosis. The supposed syndrome is sometimes considered to be a potential cause of death. However, it has been argued that its sole purpose is to cover up excessive police violence because it is mainly used to explain deaths of individuals in custody. In this paper, we examine the epistemic conditions giving rise to the controversial diagnosis by discussing the relation between causal hypotheses, evidence, and data in forensic medicine. We argue that (...) the practitioners’ social context affects causal inquiry through background assumptions that enter inquiry at multiple stages. This analysis serves to better understand the wide usage of the controversial diagnosis of ExDS. (shrink)

Community forms a crux of human living. In the wake of pandemic like Covid-19 to avoid community transmission what is most required of a responsible community member is to follow physical distancing to curb the spread of the infectious disease and this may lead to a feeling of isolation and loneliness. But this essay speaks of isolation with a positive connotation. It talks of isolation as solitude as the Indian philosophy also speaks extensively about this sense of self-contemplation and reflection (...) to understand others as we need to know our own selves. The say speaks of isolation as understood in Sāṃkhya philosophy. This essay talks of isolated consciousness and the three gunas particularly of the sattvic predicaments that enables positive mental development in human beings which is much needed in these tested times as the present pandemic. (shrink)

A new approach to Nietzsche, so called Nietzeche sindrom.

The goal of the present paper is to construct a formal explication of the pluralistic ignorance explanation of the bystander effect. The social dynamics leading to inaction is presented, decomposed, and modeled using dynamic epistemic logic augmented with ‘transition rules’ able to characterize agent behavior. Three agent types are defined: First Responders who intervene given belief of accident; City Dwellers, capturing ‘apathetic urban residents’ and Hesitators, who observe others when in doubt, basing subsequent decision on social proof. It is shown (...) how groups of the latter may end in a state of pluralistic ignorance leading to inaction. Sequential models for each agent type are specified, and their results compared to empirical studies. It is concluded that only the Hesitator model produces reasonable results. (shrink)

Patients suffering from the Cotard syndrome can deny being alive, having guts, thinking or even existing. They can also complain that the world or time have ceased to exist. In this article, I argue that even though the leading neurocognitive accounts have difficulties meeting that task, we should, and we can, make sense of these bizarre delusions. To that effect, I draw on the close connection between the Cotard syndrome and a more common condition known as depersonalisation. Even (...) though they are not delusional, depersonalised patients seem to have experiences that are quite similar to those of Cotard patients. I argue that these experiences are essentially characterised by a lack of subjective character and of two other structural features of experience, which I call ‘the present character’ and ‘the actual character’. Cotard's nihilistic delusions simply consist in taking these anomalous experiences at face value. (shrink)

Epidemiological crisis during recrudescence of pandemic like COVID-19 may stir fear and anxiety leading to prejudices against people and communities, social isolation and stigma. Such behavioral change may wind up into increased hostility, chaos and unnecessary social disruptions. A qualitative exploratory approach was utilized to conduct an extensive review of secondary literature. The case-studies were gathered from academic literature like articles, opinions and perspective pieces published in journals and in grey literature like publications in humanitarian agencies and media reports. Grey (...) literature was included in the scope as the COVID-19 situation is still evolving. I discuss some of the mechanisms of stigmatization and how social connectedness and empathetic understandings can be a way out of negative stereotyping and discrimination met out to the sufferer of the communicable diseases as COVID-19. Empathetic understanding paves a way to approach a problem from the perspective of ‘we’ not limiting one only to ‘I’. The moment when we make an approach from ‘I’ to ‘We’ actually then we embark on a journey of illness to wellness. Keywords: COVID-19, pandemic, stigma, discrimination, mental health, empathy, India, Face-to-face communication, social distancing, suicide. (shrink)

This paper contrasts two relatively independent forms of human development: waking up, the process and practices of psychospiritual awakening , and growing up, the process of moving from lesser narcissistic and ethnocentric self-identities towards mature postconventional self-identities with greater degrees of inclusion, perspective-taking, caring, and compassion. Each is a unique type of growth, contemplative and transformative, with different ways of engaging and differing goals and results. The former is about transcending or deconstructing the ego and the latter about building, strengthening, (...) and diversifying the ego. Whereas the Buddhist tradition and contemplative practices aim at awakening and transcending samsara (worldly conditions) by cultivating compassion and taming the mind, the Western tradition cultivates greater degrees of care and compassion by developing a mature ego within samsara that is both social-justice and eco-justice informed. The project of transcending the ego should not be confused with growing and maturing the ego. Self-transcendence and self-development must inform each other, and both are necessary for realizing our full human potential. (shrink)

According to conventional wisdom, the split-brain syndrome puts paid to the thesis that consciousness is necessarily unified. The aim of this paper is to challenge that view. I argue both that disunity models of the split-brain are highly problematic, and that there is much to recommend a model of the split-brain—the switch model—according to which split-brain patients retain a fully unified consciousness at all times. Although the task of examining the unity of consciousness through the lens of the split-brain (...) syndrome is not a new one—such projects date back to Nagel’s seminal paper on the topic—the time is ripe for a re-evaluation of the issues. (shrink)

Kant, Wittgenstein, and Husserl all held that visual awareness of objects requires visual awareness of the space in which the objects are located. There is a lively debate in the literature on spatial perception whether this view is undermined by the results of experiments on a Balint’s syndrome patient, known as RM. I argue that neither of two recent interpretations of these results is able to explain RM’s apparent ability to experience motion. I outline some ways in which each (...) interpretation may respond to this challenge, and suggest which way of meeting the challenge is preferable. I conclude that RM retains some awareness of the larger space surrounding the objects he sees. (shrink)

How should our metaphysical commitments influence how we think of ourselves in the practical world? Hume and Buddhism share common ground in denying that there exists a metaphysically real self yet offer very different practical recommendations about how this metaphysical view ought to inform our practical identities. This paper explores the contrast between the two views. It examines the benefits and costs of embracing, and attaching to, a practical conception of the self in the absence of a metaphysical self and (...) provides a qualified defense of the Humean approach by way of considering the joys of attachment. (shrink)

One of the most compelling questions still unanswered in neuroscience is how consciousness arises. In this article, we examine visual processing, the parietal lobe, and contralateral neglect syndrome as a window into consciousness and how the brain functions as the mind and we introduce a mechanism for the processing of visual information and its role in consciousness. We propose that consciousness arises from integration of information from throughout the body and brain by the thalamus and that the thalamus reimages (...) visual and other sensory information from throughout the cortex in a default three-dimensional space in the mind. We further suggest that the thalamus generates a dynamic default three-dimensional space by integrating processed information from corticothalamic feedback loops, creating an infrastructure that may form the basis of our consciousness. Further experimental evidence is needed to examine and support this hypothesis, the role of the thalamus, and to further elucidate the mechanism of consciousness. (shrink)

A basic criticism of Perry Hendrick's "Even if the fetus is not a person, abortion is immoral: The Impairment Argument," is offered, namely that the reasons why intentionally causing fetal alcohol syndrome is wrong simply do not apply to fetuses and so the "Impairment Argument" against abortion fails.

We have all been told of the death of grand narratives. We have been told that the days of asking eternal metaphysical questions in philosophy are long since over. When Wittgenstein’s (1953/2009, p. 174) famous spade hit bedrock it reminded us that we had better stop wasting our time on lofty questions without answers. Foucault (1970) prompted us to recall Borges’story of a certain Chinese encyclopedia showing us that there are many ways of ordering the world and that each way (...) changes the rules of the game a little bit. We found that history was contingent and that hierarchies, however firmly built, would all crumble in the end. In its place were the slightly disorienting feeling following the postmodernist’s proclamation of ‘the elusiveness of meaning and knowledge’ (Kirby, 2017, p. 5). (shrink)

Impostor syndrome or Impostor phenomenon is a belief that a person thinks their success is due to luck or external factors, not their abilities. This psychological trait is present in certain groups like women. In this paper, we propose a neutrosophic trait measure to represent the psychological concept of the trait-anti trait using refined neutrosophic sets. This study analysed a group of 200 undergraduate students for impostor syndrome, perfectionism, introversion and self-esteem: after the COVID pandemic break in 2021. (...) Data labelling was carried out using these neutrosophic trait measures. Machine learning models like Support Vector Machine(SVM), K-nearest neighbour (K-NN), and random forest were used to model the data; SVM provided the best accuracy of 92.15%. (shrink)

Marion Godman makes the argument that Pathological Withdrawal Syndrome (PWS) makes the case for psychiatric disorders as a natural kind. Godman argues that we can classify kinds according to their shared ‘grounding’, but we need not know what the grounding is to know that the natural is a natural kind. However, I argue that Godman erroneously classifies PWS as its own natural kind when it is in fact a variant of depression, which is its own natural kind. Cooper highlights (...) culture-bound syndromes, which can explain the discrepancy between the different diagnosis rates for psychiatric disorders among different cultures. Taking culture-bound syndromes into account, I conclude that PWS is a type of depression that is culture-specific. (shrink)

Social cognition researchers have become increasingly interested in the ways that behavioral, physiological, and neural coupling facilitate social interaction and interpersonal understanding. We distinguish two ways of conceptualizing the role of such coupling processes in social cognition: strong and moderate interactionism. According to strong interactionism (SI), low-level coupling processes are alternatives to higher-level individual cognitive processes; the former at least sometimes render the latter superfluous. Moderate interactionism (MI) on the other hand, is an integrative approach. Its guiding assumption is that (...) higher-level cognitive processes are likely to have been shaped by the need to coordinate, modulate, and extract information from low-level coupling processes. In this paper, we present a case study on Möbius Syndrome (MS) in order to contrast SI and MI. We show how MS—a form of congenital bilateral facial paralysis—can be a fruitful source of insight for research exploring the relation between high-level cognition and low-level coupling. Lacking a capacity for facial expression, individuals with MS are deprived of a primary channel for gestural coupling. According to SI, they lack an essential enabling feature for social interaction and interpersonal understanding more generally and thus ought to exhibit severe deficits in these areas. We challenge SI’s prediction and show how MS cases offer compelling reasons for instead adopting MI’s pluralistic model of social interaction and interpersonal understanding. We conclude that investigations of coupling processes within social interaction should inform rather than marginalize or eliminate investigation of higher-level individual cognition. (shrink)

In this article, we examine phantom limb syndrome to gain insights into how the brain functions as the mind and how consciousness arises. We further explore our previously proposed consciousness model in which consciousness and body schema arise when information from throughout the body is processed by corticothalamic feedback loops and integrated by the thalamus. The parietal lobe spatially maps visual and non-visual information and the thalamus integrates and recreates this processed sensory information within a three-dimensional space termed the (...) ‘‘3D default space.’’ We propose that phantom limb syndrome and phantom limb pain arise when the afferent signaling from the amputated limb is lost but the neural circuits remain intact. In addition, integration of conflicting sensory information within the default 3D space and the loss of inhibitory afferent feedback to efferent motor activity from the amputated limb may underlie phantom limb pain. (shrink)

This article examines the various Liar paradoxes and their near kin, Grelling’s paradox and Gödel’s Incompleteness Theorem with its self-referential Gödel sentence. It finds the family of paradoxes to be generated by circular definition–whether of statements, predicates, or sentences–a manoeuvre that generates pseudo-statements afflicted with the Liar syndrome: semantic vacuity, semantic incoherence, and predicative catalepsy. Such statements, e.g., the self-referential Liar statement, are meaningless, and hence fail to say anything, a point that invalidates the reasoning on which the various (...) paradoxes rest. The seeming plausibility of the paradoxes is due to the fact that often the sentence used to make the pseudo-statement is ambiguous in that it may also be used to make a genuine statement about the pseudo-statement. Hence, if a formal system is to avoid ambiguity and consequent paradox and contradiction, it must distinguish between the two statements the sentence may be used to make. Gödel’s Theorem presents a further complication in that the self-reference involved is sentential rather than statemental. Nevertheless, on the intended interpretation of the system as a formalization of arithmetic, the self-referential Gödel sentence can only be an ambiguous statement, one that is both a pseudo-statement and its genuine double. Consequently, the conclusions commonly drawn from Gödel’s theorem must be deemed unwarranted. Arithmetic might well be formalized in a proper system that either excludes circular definition or introduces disambiguators. (shrink)

In this essay, I attempt to outline a feminist philosophical approach to the current debate concerning (allegedly) false memories of childhood sexual abuse. Bringing the voices of feminist philosophers to bear on this issue highlights the implicit and sometimes questionable epistemological, metaphysical, and ethical-political commitments of some therapists and scientists involved in these debates. It also illuminates some current debates in and about feminist philosophy.

This article examines the various Liar paradoxes and their near kin, Grelling’s paradox and Gödel’s Incompleteness Theorem with its self-referential Gödel sentence. It finds the family of paradoxes to be generated by circular definition–whether of statements, predicates, or sentences–a manoeuvre that generates the fatal disorders of the Liar syndrome: semantic vacuity, semantic incoherence, and predicative catalepsy. Afflicted statements, such as the self-referential Liar statement, fail to be genuine statements. Hence they say nothing, a point that invalidates the reasoning on (...) which the various paradoxes rest. The seeming plausibility of the paradoxes is due to the fact that the same sentence may be used to make both the pseudo-statement and a genuine statement about the pseudo-statement. Hence, if a formal system is to avoid ambiguity and consequent seeming paradox, it requires some sort of disambiguator to distinguish the two statements. Gödel’s Theorem presents a further complication in that the self-reference involved is sentential rather than statemental. Nevertheless, on the intended interpretation of the system as a formalization of arithmetic, the self-referential Gödel sentence can only be an ambiguous statement, one that is both a pseudo-statement and its genuine double. Consequently, the conclusions commonly drawn from Gödel’s theorem must be deemed unwarranted. Arithmetic might well be formalized in a proper system that either excludes circular definition or introduces disambiguators. (shrink)

In this comparative study, we examine experiential disruptions of embodiment and affectivity in Moebius Syndrome and schizophrenia. We suggest that using phenomenological resources to explore these experiences may help us better understand what it’s like to live with these conditions, and that such an understanding may have significant therapeutic value. Additionally, we suggest that this sort of phenomenologically-informed comparative analysis can shed light on the importance of embodiment and affectivity for the constitution of a sense of self and interpersonal (...) relatedness in normal conditions. (shrink)

Chronic fatigue syndrome or myalgic encephalomyelitis remains a controversial illness category. This paper surveys the state of knowledge and attitudes about this illness and proposes that epistemic concerns about the testimonial credibility of patients can be articulated using Miranda Fricker’s concept of epistemic injustice. While there is consensus within mainstream medical guidelines that there is no known cause of CFS/ME, there is continued debate about how best to conceive of CFS/ME, including disagreement about how to interpret clinical studies of (...) treatments. Against this background, robust qualitative and quantitative research from a range of countries has found that many doctors display uncertainty about whether CFS/ME is real, which may result in delays in diagnosis and treatment for patients. Strikingly, qualitative research evinces that patients with CFS/ME often experience suspicion by health professionals, and many patients vocally oppose the effectiveness, and the conceptualization, of their illness as psychologically treatable. We address the intersection of these issues and healthcare ethics, and claim that this state of affairs can be explained as a case of epistemic injustice. We find evidence that healthcare consultations are fora where patients with CFS/ME may be particularly vulnerable to epistemic injustice. We argue that the marginalization of many patients is a professional failure that may lead to further ethical and practical consequences both for progressive research into CFS/ME, and for ethical care and delivery of current treatments among individuals suffering from this debilitating illness. (shrink)

Endogenous Cushing syndrome (CS) results from hypercortisolemia caused by excess adrenocorticotropic hormone production in a pituitary adenoma or ectopic tumor, or by an adrenal tumor that directly produces excess cortisol. The diagnosis can usually be ascertained with a reasonable degree of certainty based on clinical and laboratory findings of hypercortisolism. There are patients, however, in whom the production of excess cortisol exhibits a cyclic or intermittent pattern, and, as a result, the clinical symptoms may be quite complex and varied. (...) In these patients the hypothalamic- pituitary-adrenal axis may be normal between cycles, and dexamethasone suppression testing may produce a paradoxical response. In the present article, the authors provide a definition of cyclic Cushing syndrome, review the causes and its potential pathophysiological mechanisms, and discuss the treatment options based on a review of the available literature. (DOI: 10.3171/FOC-07/09/E4). (shrink)

Hamas’s deliberate attack on October 7th against innocent civilians is absolutely wrong. Therefore, it should be universally condemned. And yet, I wonder how a universal recognition of an absolute duty of respect for human dignity can help solving the existential conflict confronting Israelis and Palestinians. Ideally, a two-state solution proposed by the international community can be seen as a reasonable and fair compromise. Nevertheless, the reality on the ground is different. Thus far the existence of one state has precluded the (...) existence of another with no end in sight to their mutually destructive violence. Their conflict demands that people who are reasonable and fair-minded try to understand it holistically and to offer an impartial assessment of this intractable conflict without relativizing the undeserved human suffering of all those involved and affected by it. (shrink)

Currently, the preferred accommodation for conscientious objection to abortion in medicine is to allow the objector to refuse to accede to the patient’s request so long as the objector refers the patient to a physician who performs abortions. The referral part of this arrangement is controversial, however. Pro-life advocates claim that referrals make objectors complicit in the performance of acts that they, the objectors, find morally offensive. McLeod argues that the referral requirement is justifiable, although not in the way that (...) people usually assume. (shrink)

Objective: This study aimed to determine the diagnostic value of median nerve cross-sectional area (MNCSA; mm2), which can be measured using ultrasonography (US), compared with electrophysiological parameters in patients with mild and moderate carpal tunnel syndrome (CTS). Methods: The study included 72 wrists of 25 patients with CTS diagnosis and 23 healthy controls. Median and ulnar sensory and motor nerve conduction study results and MNCSA values determined by US, of all subjects were recorded. Electrophysiological and US data of the (...) patient and control groups were compared, and a correlation between MNCSA and velocity and latency of sensory and motor conduction of median nerves was investigated. Moreover, Receiver operating characteristic ROC curve analysis was performed to determine the cut-off value for diagnosing CTS with MNCSA. Differences between the mean MNCSA values, median nerve sensory conduction velocity (SCV), and motor distal latency (MDL) were statistically significant between the groups. Results: Differences between the mean MNCSA values of grade 1 CTS patients with very mild CTS and those of the healthy controls were statistically significant. There was a moderate and significant negative correlation between MNCSA and SCV values and a low and significant positive correlation between MNCSA and MDL values. In addition, there was a moderate and significant positive correlation between MNCSA values and grades. A cut-off value of 10.25 mm2, which was obtained by the ROC analysis, enabled the differentiation of patients and controls with a sensitivity of 80% and specificity of 76%. Conclusion: We suggest that MNCSA, which is calculated using US, has high sensitivity and specificity values and is used as a firstline diagnostic tool with electromyography. (shrink)

Neurovascular coupling (NVC), the transient regional hyperemia following the evoked neuronal responses, is the basis of blood oxygenation level-dependent techniques and is generally adopted across physiological conditions, including the intrinsic resting state. However, the possibility of neurovascular dissociations across physiological alterations is indicated in the literature. To examine the NVC stability across sleep–wake states, we used electroencephalography (EEG) as the index of neural activity and functional magnetic resonance imaging (fMRI) as the measure of cerebrovascular response. Eight healthy adults were recruited (...) for simultaneous EEG-fMRI recordings in nocturnal sleep. We compared the cross-modality (EEG vs. fMRI) consistency of functional indices (spectral amplitude and functional connectivity) among five states of wakefulness and sleep (state effect). We also segregated the brain into three main partitions (anterior, middle and posterior) for spatial assessments (regional effect). Significant state effects were found on δ, α and fMRI indices and regional effects on the α and fMRI indices. However, the cross-state EEG changes in spectral amplitude and functional connectivity did not consistently match the changes in the fMRI indices across sleep–wake states. In spectral amplitude, the δ band peaked at the N3 stage for all brain regions, while the fMRI fluctuation amplitude peaked at the N2 stage in the central and posterior regions. In regional connectivity, the inter-hemispheric connectivity of the δ band peaked at the N3 stage for all regions, but the bilateral fMRI connectivity showed the state changes in the anterior and central regions. The cross-modality inconsistencies across sleep–wake states provided preliminary evidence that the neurovascular relationship may not change in a linear consistency during NREM sleep. Thus, caution shall be exercised when applying the NVC presumption to investigating sleep/wake transitions, even among healthy young adults. (shrink)

I propose a narrative fabrication thesis of dream reports, according to which dream reports are often not accurate representations of experiences that occur during sleep. I begin with an overview of anti-experience theses of Norman Malcolm and Daniel Dennett who reject the received view of dreams, that dreams are experiences we have during sleep which are reported upon waking. Although rejection of the first claim of the received view, that dreams are experiences that occur during sleep, is implausible, I evaluate (...) in more detail the second assumption of the received view, that dream reports are generally accurate. I then propose a “narrative fabrication” view of dreams as an alternative to the received view. Dream reports are often confabulated or fabricated because of poor memory, bizarre dream content, and cognitive deficits. It is well documented that narratives can be altered between initial rapid eye movement sleep awakenings and subsequent reports. I argue that we have reason to suspect that initial reports are prone to inaccuracy. Experiments demonstrate that subjects rationalize strange elements in narratives, leaving out supernatural or bizarre components when reporting waking memories of stories. Inaccuracies in dream reports are exacerbated by rapid memory loss and bizarre dream content. Waking memory is a process of reconstruction and blending of elements, but unlike waking memory, we cannot reality-test for dream memories. Dream experiences involve imaginative elements, and dream content cannot be verified with external evidence. Some dreams may involve wake-like higher cognitive functions, such as lucid dreams. Such dreams are more likely to elicit accurate reports than cognitively deficient dreams. However, dream reports are generally less accurate than waking reports. I then propose methods which could verify the narrative fabrication view, and argue that although the theory cannot be tested with current methods, new techniques and technologies may be able to do so in the future. -/- . (shrink)

Reinterpretation of our data concerning sleep onset, motivated by the desire to pay close attention to “intra-individual regularities,” suggests that the experience of control might be a key factor in determining the subjective sense that sleep has begun. This loss of control seems akin to what Frith and others have described as “passivity experiences,” which also occur in schizophrenia. Although clearly sleep onset is not a schizophrenic episode, this similarity might help to explain other features of sleep onset. We further (...) speculate that we could build upon the discovery of various “intra-individual regularities” to construct a model of sleep onset and other forms of sleep mentation. (shrink)

Williams Syndrome provides a striking test case for discourses on disability, because the characteristics associated with Williams Syndrome involve a combination of “abilities” and “disabilities”. For example, Williams Syndrome is associated with disabilities in mathematics and spatial cognition. However, Williams Syndrome individuals also tend to have a unique strength in their expressive language skills, and are socially outgoing and unselfconscious when meeting new people. Children with Williams are said to be typically unafraid of strangers and show (...) a greater interest in contact with adults than with their peers. This apparently keen social knowledge is a counterexample to the discussion of disability among academic philosophers, especially philosophers of the early modern period. Locke infamously used the example of disability to claim that Descartes’ arguments in favor of innate ideas were incorrect. On the contrary, Williams Syndrome may stand as an example of innate social knowledge; something that could benefit current discourse in philosophy, disability theory, and medical ethics. (shrink)

In the exploratory study reported here, we tested the efficacy of an intervention designed to train teenagers with Möbius syndrome (MS) to increase the use of alternative communication strategies (e.g., gestures) to compensate for their lack of facial expressivity. Specifically, we expected the intervention to increase the level of rapport experienced in social interactions by our participants. In addition, we aimed to identify the mechanisms responsible for any such increase in rapport. In the study, five teenagers with MS interacted (...) with three naïve participants without MS before the intervention, and with three different naïve participants without MS after the intervention. Rapport was assessed by self-report and by behavioral coders who rated videos of the interactions. Individual non-verbal behavior was assessed via behavioral coders, whereas verbal behavior was automatically extracted from the sound files. Alignment was assessed using cross recurrence quantification analysis and mixed-effects models. The results showed that observer-coded rapport was greater after the intervention, whereas self-reported rapport did not change significantly. Observer-coded gesture and expressivity increased in participants with and without MS, whereas overall linguistic alignment decreased. Fidgeting and repetitiveness of verbal behavior also decreased in both groups. In sum, the intervention may impact non-verbal and verbal behavior in participants with and without MS, increasing rapport as well as overall gesturing, while decreasing alignment. (shrink)

We argue that a phenomenological approach to social space, as well as its relation to embodiment and affectivity, is crucial for understanding how the social world shows up as social in the first place—that is, as affording different forms of sharing, connection, and relatedness. We explore this idea by considering two cases where social space is experientially disrupted: Moebius Syndrome and schizophrenia. We show how this altered sense of social space emerges from subtle disruptions of embodiment and affectivity characteristic (...) of these conditions. These disruptions are instructive, we suggest, in that they highlight the foundational role that body and affect play in organizing social space—the lived context in which we first encounter one another as social agents. (shrink)