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The epistemic paradox of mind and matter.

The attempt to posit independent mind and matter results in an unavoidable circularity. We propose to accept this circularity and then explore the steps from the various "constructs" of matter to those biological structures associated with mind. This enables us to explore the hierarchical levels of emergence that take us from the periodic table of the elements to consciousness as it develops in the evolutionary radiation. The possibility of undiscovered principles of the same epistemological status as the Pauli exclusion principle is discussed.

Biophysical Phenomena↗

Understanding other minds: linking developmental psychology and functional neuroimaging.

Evidence from developmental psychology suggests that understanding other minds constitutes a special domain of cognition with at least two components: an early-developing system for reasoning about goals, perceptions, and emotions, and a later-developing system for representing the contents of beliefs. Neuroimaging reinforces and elaborates upon this view by providing evidence that (a) domain-specific brain regions exist for representing belief contents, (b) these regions are apparently distinct from other regions engaged in reasoning about goals and actions (suggesting that the two developmental stages reflect the emergence of two distinct systems, rather than the elaboration of a single system), and (c) these regions are distinct from brain regions engaged in inhibitory control and in syntactic processing. The clear neural distinction between these processes is evidence that belief attribution is not dependent on either inhibitory control or syntax, but is subserved by a specialized neural system for theory of mind.

Brain↗

Is theory of mind in schizophrenia more strongly associated with clinical and social functioning than with neurocognitive deficits?

This paper examines the correlations between 'Theory of Mind' (ToM) and neurocognitive performance, together with clinical and social functioning, in out-patients with schizophrenic disorders. It was hypothesised that, since the ability to make inferences about the environment and about other peoples' mental states is a key ingredient of social competence, the assessment of ToM would correlate more strongly with current social functioning than with more traditional neurocognitive measures. 'Independent raters' assessed Theory of Mind, neurocognitive and clinical variables as well as community functioning in 44 subjects with schizophrenia. The neuropsychological measures were more closely associated with community functioning than with psychiatric symptoms. These associations remained evident when the effects of intelligence were controlled. Patients with a higher level of competence in making social inferences had better overall community functioning than those who showed less ability in this aspect of social cognition. In a regression model, the capacity to comprehend other people's mental states (ToM-2) was among the best predictors of global social functioning, together with recent onset of illness, good verbal fluency and low levels of negative and positive symptoms. These results are consistent with other recent findings. ToM measures of social cognition may be a useful addition to neuropsychological assessment when developing programmes for reducing clinical impairments and improving the community functioning of subjects with schizophrenic disorders. Further studies are needed to verify the value of these measures as predictors of the successful application of specific psychosocial rehabilitation strategies.

Adolescent↗

The mind-body problem from a medical perspective.

Classical philosophical ideas on the mind-body problem were interpreted in the light of contemporary theories. There are two mind-body theories that are suspect for a natural scientist, namely, parallelism and panpsychism. There are three further theories that are considered radical and not supported by current research: epiphenomenalism, central-state materialism and behaviorism. That leaves us with the two most prevalent theories, namely, interactionism and neural identity. The authors discuss the evidence for and against each theory.

Humans↗

Families of borderline patients: literal-minded parents, borderline parents, and parental protectiveness.

While borderline personality disorder is a well-established psychiatric diagnosis, less is known about family functioning and interactional patterns in subjects with the disorder. The authors describe interactional patterns in families of borderline children where one parent has a severe personality disorder and the other fails to protect the child adequately against the effects of that psychopathology. Two types of parents are described: the literal-minded parent and the borderline parent. The literal-minded parent resembles an alexithymic patient, lacking the ability to empathically understand and respond to the child's feelings and needs. The borderline parent uses the child as the target of projections and reality distortions. Therapy should mobilize the active protective functions of the healthier parent.

Adult↗

Are psychiatric educators "losing the mind"?

Psychiatry is part of medicine, and developing competence to deal with the mental life of patients is an essential part of general medical as well as psychiatric subspecialty education. As psychiatry's neurobiological data base, therapeutic armamentarium, scope of interest, and philosophical views expand and competitive pressures for time in residency training are intensified, teaching in the mental sciences and opportunities for residents to develop solid psychodynamic diagnostic and therapeutic skills are rapidly disappearing. However, brain science does not yet, and probably never will, fully explain the mind. The author urges psychiatric educators not to give up the mind or, worse yet, lose it by default.

Attitude of Health Personnel↗

Organic unity theory: the mind-body problem revisited.

The purpose of this essay is to delineate the conceptual framework for psychiatry as an integrated and integrative science that unites the mental and the physical. Four basic philosophical perspectives concerning the relationship between mind and body are introduced. The biopsychosocial model, at this time the preeminent model in medical science that addresses this relationship, is examined and found to be flawed. Mental-physical identity theory is presented as the most valid philosophical approach to understanding the relationship between mind and body. Organic unity theory is then proposed as a synthesis of the biopsychosocial model and mental-physical identity theory in which the difficulties of the biopsychosocial model are resolved. Finally, some implications of organic unity theory for psychiatry are considered. 1) The conventional dichotomy between physical (organic) and mental (functional) is linguistic/conceptual rather than inherent in nature, and all events and processes involved in the etiology, pathogenesis, symptomatic manifestation, and treatment of psychiatric disorders are simultaneously biological and psychological. 2) Neuroscience requires new conceptual models to comprehend the integrated and emergent physiological processes to which psychological phenomena correspond. 3) Introspective awareness provides data that are valid for scientific inquiry and is the most direct method of knowing psychophysical events. 4) Energy currently being expended in disputes between biological and psychological psychiatry would be more productively invested in attempting to formulate the conditions under which each approach is maximally effective.

Biological Psychiatry↗

Cyclical patterns of states of mind in psychotherapy.

OBJECTIVE: A quantitative study of shifts in states of mind was conducted to demonstrate a clinically useful mode of observation. This mode categorizes observations of a patient's mental state into well-modulated, overmodulated, undermodulated, and shimmering patterns. METHOD: The authors used reliable systems for scoring a patient's state of mind on videotapes of all sessions of her brief psychotherapy and, using separate procedures, scored the topics of discourse. These data were then examined by means of a lagged log-linear sequential analysis for patterns of shifts from one state to another and for concurrent shifts in topics. RESULTS: The findings indicated nonrandom shifts in state. Patterns of shifting from a well-modulated state to alternative states and back again were overrepresented. Such shifts were related to conflictual topics of discourse. CONCLUSIONS: Observing such shifts in mental state may help psychotherapists to formulate the contents of conflict and also to make technical interventions to stabilize optimal states for doing the work of psychotherapy.

Cognition↗

The persistence of mind-brain dualism in psychiatric reasoning about clinical scenarios.

OBJECTIVE: Despite attempts in psychiatry to adopt an integrative biopsychosocial model, social scientists have observed that psychiatrists continue to operate according to a mind-brain dichotomy in ways that are often covert and unacknowledged and suggest that the same intuitive cognitive schemas that people use to make judgments of responsibility lead to dualistic reasoning among clinicians. The goal of this study was to confirm these observations. METHOD: Self-report questionnaires were sent to the 270 psychiatrists and psychologists in the Department of Psychiatry at McGill University. In response to clinical vignettes, the participants rated the level of intentionality, controllability, responsibility, and blame attributable to the patients, as well as the importance of neurobiological, psychological, and social factors in explaining the patients' symptoms. RESULTS: A total of 136 faculty members (50.4%) responded, and 127 were included in the analysis. Factor analysis revealed a single dimension of responsibility regarding the patients' illnesses that correlated positively with ratings of psychological etiology and negatively with ratings of neurobiological etiology. Psychological and neurobiological ratings were inversely correlated. Multivariate analyses of variance supported these results. CONCLUSIONS: Mental health professionals continue to employ a mind-brain dichotomy when reasoning about clinical cases. The more a behavioral problem is seen as originating in "psychological" processes, the more a patient tends to be viewed as responsible and blameworthy for his or her symptoms; conversely, the more behaviors are attributed to neurobiological causes, the less likely patients are to be viewed as responsible and blameworthy.

Algorithms↗

Formulation of states of mind in psychotherapy.

A patient in psychotherapy may vary in his ability to understand the therapist, and to express this thoughts, as he moves from one state of mind to another. Analysis of states of mind is useful, not only in understanding these variations while the patient is in treatment, but also in helping him to understand his shifting moods in external situations.

Adult↗

Mental Darwinism and the evolution of the emotion-processing mind.

The cognitive mental module with which humans process and adapt to emotionally charged environmental or triggering events is identified as the emotion-processing mind. The current architecture of this mental module presents several anomalous features. In an effort to clarify their basis, the evolution of this module is traced for the 6,000,000-year history of hominid existence. In addition, the nature of its current adaptive resources are explored as a way of introducing mental Darwinism, the concept that the emotion-processing mind is an adaptive entity that operates according to the principles of universal Darwinism.

Biological Evolution↗

A theory of mind perspective on cognitive, affective, and intimacy deficits in child sexual offenders.

Previous work in the area of sexual offending has suggested that factors such as intimacy deficits, problems empathizing with victims, and cognitive distortions have all been associated with the genesis and maintenance of sexual abuse. While researchers have constructed theories to account for the role of these variables in sexual offending, a framework that unites their study is lacking. Recently Ward, Keenan, and Hudson have proposed that sexual offenders may suffer from a deficit in their ability to understand and attribute mental states to others. Their review of the literature on the etiology of sexual offending suggested that intimacy deficits, empathy deficits, and cognitive distortions all point to a lack of awareness of other peoples' beliefs, desires, perspectives, and needs, what is commonly referred to in the developmental literature as a theory of mind. In this paper, we expand on this argument, illustrating some of the developmental pathways by which deficits in one's theory of mind can explain the pattern of deficits exhibited by many sexual offenders.

Child↗

Beyond expectations: autism, understanding embarrassment, and the relationship with theory of mind.

The ability of high-functioning individuals with autism to understand the complex emotion of embarrassment, and how this relates to an understanding of theory of mind, was investigated. Scenarios involving embarrassing and non-embarrassing situations were presented to a group with autism and three comparison groups. Participants were required to rate the level of embarrassment felt by the protagonist and to justify their choices. The results indicated that those with autism generally gave similar ratings of embarrassment as the comparison groups, but did show significant difficulty with non-embarrassing scenarios, and in providing appropriate justifications for embarrassment. In addition, a significant relationship between scores from false belief tasks and justification scores was found, supporting the proposed link between theory of mind skills and understanding embarrassment. Participants with autism did, however, show a higher than expected understanding of this complex emotion.

Adolescent↗

Performance of children with autism spectrum disorder on advanced theory of mind tasks.

Although a number of advanced theory of mind tasks have been developed, there is sparse information on whether performance on different tasks is associated. The study examined the performance of 20 high-functioning 6- to 12-year-old children with autism spectrum disorder and 20 controls on three high-level theory of mind tasks: Strange Stories, Cartoons and the children's version of the Eyes task. The pattern of findings suggests that the three tasks may share differing, non-specific, information-processing requirements in addition to tapping any putative mentalizing ability. They may also indicate a degree of dissociation between social-cognitive and social-perceptual or affective components of the mentalizing system.

Autistic Disorder↗

Tai chi chuan: mind-body practice or exercise intervention? Studying the benefit for cancer survivors.

Tai chi chuan (TCC) has been used as a mind-body practice in Asian culture for centuries to improve wellness and reduce stress and has recently received attention by researchers as an exercise intervention. A review of the English literature on research in TCC published from 1989 to 2006 identified 20 prospective, randomized, controlled clinical trials in a number of populations, including elderly participants (7 studies), patients with cardiovascular complications (3 studies), patients with chronic disease (6 studies), and patients who might gain psychological benefit from TCC practice (2 studies). However, only the studies of TCC in the elderly and 2 studies of TCC for cardiovascular disease had adequate designs and size to allow conclusions about the efficacy of TCC. Most (11 studies) were small and provided limited information on the benefit of TCC in the settings tested. There is growing awareness that cancer survivors represent a population with multiple needs related to physical deconditioning, cardiovascular disease risk, and psychological stress. TCC as an intervention may provide benefit to cancer survivors in these multiple areas of need based on its characteristics of combining aspects of meditation and aerobic exercise. However, little research has been conducted to date to determine the benefit of TCC in this population. We propose a model to study the unique characteristics of TCC compared to physical exercise that may highlight characteristic features of this mind-body intervention in cancer survivors.

Exercise↗

Brain, mind and behaviour. Some medico-legal aspects.

The advent of new imaging techniques is broadening our understanding of the major psychiatric illnesses. The increased knowledge of brain function will have consequences for the expert medical witness who has to give evidence in court. Both the insanity defence and the defence of automatism depend on disorders of the mind. Psychiatry is now able in many cases to produce evidence that these are consequent upon disorders of the brain. In presenting evidence in court there is an apparent conflict between 'brain words' and 'mind words'.

Automatism↗

Short-term autonomic and cardiovascular effects of mindfulness body scan meditation.

BACKGROUND: Recent research suggests that the Mindfulness-Based Stress Reduction program has positive effects on health, but little is known about the immediate physiological effects of different components of the program. PURPOSE: To examine the short-term autonomic and cardiovascular effects of one of the techniques employed in mindfulness meditation training, a basic body scan meditation. METHODS: In Study 1, 32 healthy young adults (23 women, 9 men) were assigned randomly to either a meditation, progressive muscular relaxation or wait-list control group. Each participated in two laboratory sessions 4 weeks apart in which they practiced their assigned technique. In Study 2, using a within-subjects design, 30 healthy young adults (15 women, 15 men) participated in two laboratory sessions in which they practiced meditation or listened to an audiotape of a popular novel in counterbalanced order. Heart rate, cardiac respiratory sinus arrhythmia (RSA), and blood pressure were measured in both studies. Additional measures derived from impedance cardiography were obtained in Study 2. RESULTS: In both studies, participants displayed significantly greater increases in RSA while meditating than while engaging in other relaxing activities. A significant decrease in cardiac pre-ejection period was observed while participants meditated in Study 2. This suggests that simultaneous increases in cardiac parasympathetic and sympathetic activity may explain the lack of an effect on heart rate. Female participants in Study 2 exhibited a significantly larger decrease in diastolic blood pressure during meditation than the novel, whereas men had greater increases in cardiac output during meditation compared to the novel. CONCLUSIONS: The results indicate both similarities and differences in the physiological responses to body scan meditation and other relaxing activities.

Adult↗

Impact of mindfulness-based stress reduction (MBSR) on sleep, mood, stress and fatigue symptoms in cancer outpatients.

Sleep disturbance is a very common problem for cancer patients that has largely not been addressed in the clinical intervention literature. Mindfulness meditation has demonstrated clinical benefits for a variety of patient populations in other areas of functioning. This study examined the effects of an 8-week Mindfulness-Based Stress Reduction (MBSR) program on the sleep quality of a heterogeneous sample of 63 cancer patients. Overall sleep disturbance was significantly reduced (p < .001) and participants reported that their sleep quality had improved (p .001). There was also a significant reduction in stress (p < .001), mood disturbance (p = .001), and fatigue (p < .001). The associations among these changes and implications for improving quality of life of cancer patients are discussed.

Adult↗