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PubMed1996

Playing with reality: I. Theory of mind and the normal development of psychic reality.

The authors of this paper discuss changes in the child's perception of psychic reality during normal development, highlighting a major shift in the child's understanding of minds ('theory of mind') at the oedipal stage. They illustrate this transition with material from the analysis of a 4-year-old girl. They maintain that the very young child uses two forms of psychic reality, which they have called 'psychic equivalent' and 'pretend' modes, which differ primarily in the assumed relationship between internal and external realities. The integration of the dual modes into a singular reflective mode is normally completed by about the age of 4, with affect leading cognition: the child first understands that people have different feelings, then that they may have different thoughts about the same external reality. The authors describe normal psychological growth and neurotic pathology, in which the integration of these two modes of functioning has been only partly achieved.

Adult↗
PubMed1998

Functional organization of the human mind: implications for behavioral genetics research.

It is proposed that the fundamental goal of human behavior is to organize and control the social, biological, and physical environments that support reproduction and survival and that the human mind is organized as a system of social, biological, and physical modules that support attempts to seek such control. More precisely, modules are systems of motivational, emotional, cognitive, and behavioral processes that provide the interface between this fundamental goal and the environments within which this goal must be achieved. An outline of this functional systems approach to the human mind is provided and the implications of this perspective for behavioral genetics research are discussed.

Behavior↗
PubMed1998

Belief term development in children with autism, Asperger syndrome, specific language impairment, and normal development: links to theory of mind development.

This study examined the relationship between the development of theory of mind and the development of the belief terms think, know, and guess. Children with autism and Asperger syndrome, matched to children with specific language impairment and normal development, completed false belief, belief term comprehension, and belief term expression tasks. The autistic group's performance on the false belief, belief term comprehension, and belief term expression tasks was significantly poorer than that of the Asperger, language impaired, and normal groups. Across groups an association was found between false belief and belief term performance. Results support a growing body of literature demonstrating links between the development of theory of mind and communicative competence.

Autistic Disorder↗
PubMed1998

Triangulation, one's own mind and objectivity.

Some psychoanalysts now hold that an intersubjective model of the mind and of the analytic situation renders the ideas of truth, reality and objectivity obsolete. Arguing from a position of sympathy with this model, the author contends that nevertheless both a real, shared, external world and the concept of such a world are indispensable to propositional thought, and to the capacity to know one's own thoughts as thoughts, as a subjective perspective on the world. Without the idea of an objective world with which we are in touch and which we attempt to be more-or-less objective about, any so-called intersubjectivist model collapses into the one-person paradigm. The author traces a certain developmental line in twentieth-century philosophy that supports an intersubjective view, a line that shows the place of the normative ideas of truth and falsity, right and wrong, in the advent of mind; it attempts to disentangle the concept of truth from an authoritarian view that was implicit in Descartes; it points out connections, and a difference, between the view of triangulation that it argues for and the views espoused by a number of psychoanalysts. Some implications of this intersubjectivist position for psychoanalytic practice are considered; for instance: the interrelations between the analyst's third-person knowledge of her patient, and the patient's developing understanding of himself; and what the concept of unconscious fantasy presupposes.

Child↗
PubMed2026

Efficacy of Mindfulness-Based Interventions on Anxiety and Sleep Quality in Patients with Breast Cancer: A Systematic Review and Meta-Analysis.

INTRODUCTION: Patients with breast cancer commonly experience anxiety and sleep disturbance during and after treatment, and these symptoms are closely interrelated, negatively affecting the quality of life. Mindfulness-based interventions (MBIs) have been increasingly used as a nonpharmacological supportive approach. This systematic review and meta-analysis aimed to evaluate the effects of MBIs on anxiety and sleep quality in patients with breast cancer. METHODS: A systematic search of PubMed, Web of Science, Cochrane Library, CINAHL, and Embase was conducted up to May 15, 2025. Random-effects meta-analysis was used to estimate standardized mean differences (SMDs) with 95% confidence intervals (CIs). Risk of bias was assessed using the Cochrane RoB 2.0, and the certainty of evidence was evaluated with Grading of Recommendations, Assessment, Development, and Evaluation. RESULTS: Twenty-four randomized controlled trials (RCTs) including 3,212 participants were analyzed. MBIs significantly reduced anxiety compared with control groups receiving usual care, no intervention, or wait-list conditions (SMD: -0.47, 95% CI: -0.62 to -0.32), whereas no significant effect was observed for sleep quality. Subgroup analysis indicated that intervention duration accounted for 55.5% of the heterogeneity in anxiety outcomes. All studies were rated as having some concerns regarding risk of bias, primarily due to self-reported outcomes and lack of blinding. Certainty of evidence was moderate for anxiety and low for sleep quality. DISCUSSION: MBIs appear to be effective in reducing anxiety among patients with breast cancer; however, no significant effect was observed for sleep quality. All included studies were rated as having some concerns regarding risk of bias, and the limited reporting of adverse events represents a limitation of the evidence. In addition, substantial heterogeneity in sleep quality outcomes and the limited number of included RCTs restrict exploration of heterogeneity sources and limit generalizability. Further high-quality well-designed RCTs are needed to strengthen and confirm the evidence.

Female↗
PubMed2000

The millennium of mind, brain, and behavior.

Psychiatry enters the new millennium poised to answer many of its central questions. Given the complexity of the human brain and its interactions with our world, these questions are among the most difficult ever addressed by human science. How is the human brain built? How does it change over the life span? What are the precise genetic and environmental risk factors for mental illnesses? What are the pathophysiologic processes that produce the symptoms and disabilities? How do our treatments, including psychotherapy, work? What objective markers can we discover to monitor the progression of the pathogenic processes and the effects of treatment? How will we discover preventive measures and cures that will be effective in diverse populations and settings? Parallel to the pursuit of its public health agenda, psychiatry will grow closer to neuroscience, behavioral science, and neurology. In so doing, those who practice these disciplines will be better positioned to ask meaningful questions about the relationship among mind, brain, and behavior, and to finally overcome the pervasive Cartesianism that continues to incubate stigma and ignorance about mental illness.

Biological Psychiatry↗
PubMed1996

The Jamaican body's role in emotional experience and sense perception: feelings, hearts, minds, and nerves.

When Jamaicans speak of feelings, they literally mean feelings: physical sensations. Emotions, which emerge through social interaction, comprise an unmarked subset of feelings. They can affect the mind in ways that are actualized in behavior. Emotions affect other parts of the body as well, in ways that follow from an equilibrium model of health. Non-emotional feelings index bodily disequilibrium rather than causing it. An example of such is seen in nerves: a chronic feeling-complaint that comes about when the nerves, associated with perception and sensation, are weakened, and which entails visual dimness, jumpiness, and joint trouble. Although exacerbated by certain social situations, and often used in social commentary and manipulations, nerves is experienced and treated as a physical rather than a socially-based disorder. By studying the bodily dimension of nerves and other feelings we may gain insight into the ways in which the body serves as a source of culture (e.g., nerves culture) as well as into how culture influences bodily experience. We may broaden our understanding of the complex interplay between the bodily and mental dimensions of people's lives.

Attitude to Health↗
PubMedDate not supplied

Pavlov and the mind-body problem.

I. P. Pavlov claimed that the mind-body problem would ultimately be resolved by empirical methods, rather than by rational arguments. A committed monist, Pavlov was confronted by dualism in the case of an hysterical person. Under normal conditions, her body's left side was insensitive to pain, but when she was hypnotized, there was a reversal of her sensitivity to pain, with the right side becoming insensitive. Pavlov acknowledged that the divergence between stimulation and response suggested dualism, yet condemned his disciple G.P. Zelenyĭ as well as Charles S. Sherrington, for their dualistic tendencies. Pavlov's continuous adherence to monism it attributed to the influence of popular scientific books that he read during his adolescence. The books maintained that science was based upon monism. Pavlov proposed that by introducing the concept of emotions, an hysterical person's condition could be explained within the framework of his theory of higher nervous activity, thereby obviating the need to change his paradigm.

Animals↗
PubMed2006

[Mind-body medicine as a part of German integrative medicine].

Mind-body medicine (MBM) as a holistic approach to health and healing has been shaped by research into stress physiology and stress psychology, by psychoneuro(endocrino)immunology and by Antonovsky's salutogenetic paradigm. MBM seeks to acknowledge physical, psychological as well as social and spiritual aspects of human beings. MBM constitutes one of the traditions, which the emerging field of integrative medicine in Germany draws upon, others being mainstream medicine, traditional European naturopathy and non-European methods like traditional Chinese medicine. The article outlines historical aspects of MBM, gives a brief review of research evidence, and introduces clinical MBM institutes in Germany. Especially the Clinic and Chair of Complementary and Integrative Medicine, Alfried Krupp von Bohlen und Halbach Foundation at the University Duisburg-Essen has been integrating MBM into the concept of integrative medicine. Considering that a growing number of health issues arises due to maladaptive lifestyles, MBM is being identified as a development that supports a shift from increasingly expensive treatments to more cost-effective preventive approaches.

Delivery of Health Care, Integrated↗
PubMed2005

Prediction of depressive disorder following myocardial infarction data from the Myocardial INfarction and Depression-Intervention Trial (MIND-IT).

BACKGROUND: Depression following myocardial infarction (MI) is associated with complicated cardiac rehabilitation, non-compliance and poor prognosis. Whether depression following MI can be predicted from variables routinely assessed during hospitalization for MI is unknown. METHODS: Using data from the Myocardial INfarction and Depression-Intervention Trial (MIND-IT), we identified 2,177 MI patients (mean age 63 years; 23% female). Patients were randomly divided into a derivation and a validation sample. In the derivation sample, we analyzed variables potentially associated with the development of post-MI depressive disorder, which were tested in the validation sample. RESULTS: In the year following MI, 18.5% suffered from depressive disorder (ICD-10 criteria). In a multivariate model, factors associated with depression were younger age (OR 1.94; CI 1.38-2.74), hypercholesterolemia (OR 1.68; CI 1.08-2.61), the use of calcium channel blockers at discharge (OR 1.80; CI 1.20-2.71), and left ventricular ejection fraction (LVEF) (OR 4.14 for patients with LVEF <30%; CI (2.42-7.10). The derived predictors were tested in the validation sample. The final model yielded two clinical predictors, i.e., younger age and severe LV-dysfunction, which correctly predicted post-discharge depression status in 82.9% of the MI patients. The model yielded a high negative predictive value (89%). A positive depression questionnaire (BDI) during hospitalization increased the positive predictive value of 23% to 52%. CONCLUSIONS: During hospitalization for MI and using a two-step strategy with common clinical variables, i.e., younger age, severe LV-dysfunction and BDI score during hospitalization, it is possible to identify MI patients with a high risk for subsequent development of depression.

Adult↗
PubMed2005

Poor premorbid social functioning and theory of mind deficit in schizophrenia: evidence of reduced context processing?

Investigations have demonstrated deficits in theory of mind (ToM) ability in schizophrenia. Yet, the development of, and mechanisms associated with these deficits are not well understood. The present investigation examined the hypothesis that, among chronic schizophrenia patients, impaired ToM is associated with failures in context processing, greater disorganized symptoms, and poor premorbid functioning. Forty-two inpatients with schizophrenia spectrum disorders were assessed on tests of ToM, visual and linguistic context processing, executive functioning, and verbal IQ. Symptomatology and premorbid functioning were also assessed. Results revealed that more impaired ToM was associated with poorer performance on both visual and linguistic context processing measures and higher ratings of disorganization on the BRRS. ToM was also associated with poorer childhood social functioning and an earlier age of illness onset. ToM was not associated with verbal processing speed, verbal fluency, response inhibition, sequence learning, or estimated verbal IQ. A significant regression model including measures of childhood peer problems and visual and language context processing significantly predicted ToM performance and accounted for 43% of the variance. These findings suggest that, among chronic schizophrenia patients, deficits in ToM ability may be the result of context processing impairments. These impairments may be a factor in both poor social functioning during childhood and greater disorganized symptoms after illness onset.

Adult↗
PubMed2004

Biopsychosocial pain medicine and mind-brain-body science.

This article reviews how emotions, behavior, and psychiatric comorbidity influence the course and outcome of chronic pain disorders and addresses methods of identifying and managing these problems in clinical practice. Successful medical rehabilitation for patients with chronic pain requires (1) appreciating the effects of biopsychosocial factors in the onset, course, and outcomes of pain disorders; (2) understanding neurobiologic mechanisms linking mind, brain, and body in the functions of pain perception and modulation; and (3) being able to review critically and use selectively the plethora of new medications and interventional technologies that are proposed in the literature. Deficits in these skills now are recognized as hazardous to the public health so that medical school education and post residency training in pain medicine is now mandatory in some states.

Analgesia↗
PubMed2003

Abnormalities of brain function during a nonverbal theory of mind task in schizophrenia.

Theory of mind (ToM), the specific ability to attribute thoughts and feelings to oneself and others is generally impaired in schizophrenia. Previous studies demonstrated a deficit of the attribution of intentions to others among patients having formal thought disorder. During nonverbal tasks, such a function requires both the visual perception of human figures and the understanding of their intentions. These processes are considered to involve the superior temporal sulcus and the medial prefrontal cortex, respectively. Are the functional patterns of activation associated with those processes abnormal in schizophrenia? Seven schizophrenic patients on medication performed a nonverbal attribution of intentions task as well as two matched physical logic tasks, with and without human figures, while H2O15 PET-scanning was performed. Data from the patients were compared to those of eight healthy controls matched for verbal IQ and sex. The experimental design allowed dissociating the effect of the perception of human figures from that of the attribution of intentions. During attribution of intentions, significant activations in the right prefrontal cortex were detected in the control subjects. Those activations were not found in the schizophrenic group. However, in both groups, the perception of human figure elicited bilateral activation of the occipitotemporal regions and of the posterior part of the superior temporal sulcus. Schizophrenic patients performing a nonverbal attribution of intentions task have an abnormal cerebral activity.

Adult↗
PubMed2004

Theory of Mind in schizophrenia: first person vs third person perspective.

Patients suffering from schizophrenia have an impaired meta-representation also known as Theory of Mind (ToM). Moreover, the presence of delusions or other positive symptoms of schizophrenia has been correlated to poor ToM performances. Lack of insight is a common symptom of schizophrenia and can be considered a critical manifestation of impaired ToM abilities. In particular, the present study addresses the role of perspective ToM ability in schizophrenic patients. Thirty severely delusional schizophrenic patients completely lack insight when interviewed about their delusions. Seven subsequently gain insight about their mental state when perspective is shifted from the first person to third person. These data suggest that in some delusional schizophrenic patients, it may be possible to gain access to and modify their mental states.

Adult↗
PubMed2003

Qigong: harmonising the breath, the body and the mind.

Qigong is a form of exercise developed in China over millennia to prevent illness and foster physical and mental health. Despite many claims of the therapeutic effects of Qigong, the fundamental concepts and principles underlying this holistic therapy remain unfamiliar to Western populations. This article helps practitioners to understand the art of Qigong based on three main principles, harmonising the breath, the body and the mind.

Breathing Exercises↗
PubMed1997

Organic unity theory: an integrative mind-body theory for psychiatry.

The potential of psychiatry as an integrative science has been impeded by an internal schism that derives from the duality of mental and physical. Organic unity theory is proposed as a conceptual framework that brings together the terms of the mind-body duality in one coherent perspective. Organic unity theory is braided of three strands: identity, which describes the relationship between mentally described events and corresponding physically described events; continuity, which describes the linguistic-conceptual system that contains both mental and physical terms; and dialectic, which describes the relationship between the empirical way of knowing that is associated with the physical domain of the linguistic-conceptual system and the hermeneutic way of knowing that is associated with the mental domain. Each strand represents an integrative formulation that resolves an aspect of mental-physical dualism into an underlying unity. After the theory is presented, its implications for psychiatry are briefly considered.

Concept Formation↗
PubMed2002

Mind-body-environment: George Engel's psychoanalytic approach to psychosomatic medicine.

OBJECTIVE: To provide an overview of George Engel's psychoanalytic approach and contributions to psychosomatic medicine. METHODS: Engel's publications were reviewed to identify his use of psychoanalytic methods and concepts to explore and conceptualize the interrelationships among mind, body and environment in health and disease. RESULTS: Engel's contributions include an interviewing method for accessing psychological data; insights into the psychobiology of anaclitic depression; a psychosomatic theory concerning the influence of relationships and loss on susceptibility to disease; an elucidation of psychodynamic factors in the pathogenesis of chronic pain; and a longitudinal self-analytic study of anniversary reactions. CONCLUSIONS: Engel successfully bridged the disciplines of medicine, psychiatry, and psychoanalysis, and broadened the scope of psychosomatic research and clinical practice by identifying the role of interpersonal relationships throughout life in regulating mental and bodily processes.

History, 20th Century↗