After the introduction of the fifth Diagnostic and Statistical Manual of Mental Disorders, familiar voices were raised in protest. The voices stem from ideas of which, among others, and in different ways, Michel Foucault and Thomas Szasz were influential proponents: The movement was referred to as 'antipsychiatry.' This movement reacted, among other things, to the system of categorization of mental disorders. Diagnoses, in a system of classification, were thought to be vague, arbitrary, labelling, stigmatizing, and scientifically and clinically poorly validated. (...) In contemporary debates on DSM-5, similar critiques can be heard, expressed by a movement now referred to as 'critical psychiatry'... (shrink)

We may be at the brink of a Kuhnian paradigm shift when it comes to the categorical classification system of mental disorders. Reviewing more than 30 years of critical literature on the categorical classification of personality disorders, Kueger, Hopwood, Wright, and Markon conclude that the Diagnostic and Statistical Manual of Mental Disorders is "fundamentally broken". Just before, the director of the National Institute of Mental Health declared that the institute will no longer support research that is based on DSM categories.The (...) critique on the categorical system of mental disorders consists of several arguments that are briefly mentioned as they have been... (shrink)

This study investigates what professional caregivers working in nursing homes consider to be a good life for residents suffering from dementia. Ten caregivers were interviewed; special attention was paid to the way in which they deal with conflicting values. Transcripts of the interviews were analysed qualitatively according to the method of grounded theory. The results were compared with those from a similar, earlier study on ideals found in mission statements of nursing homes. The concepts that were mentioned by most interviewed (...) participants as important for a good life were ‘peace and quiet’, ‘going along with subjective experience’ and ‘no enforcement: the way the resident wants it’. A considerable overlap was found between the interviews and the mission statements; however, when compared with the mission statements, the interviews put less emphasis on individuality and on giving meaning, and more on offering residents pleasant activities. When faced with conflicting values, caregivers tend to make pragmatic and more or less intuitive decisions. Although this has its merits, it may be desirable to stimulate conscious reflection regarding conflict between different values. (shrink)

The comorbidity of personality disorders and mental disorders is commonly understood through three types of theoretical models: either a) personality disorders precede mental disorders, b) mental disorders precede personality disorders, c) mental disorders and personality disorders share common etiological grounds. Although these hypotheses differ with respect to their idea of causal direction, they all imply a latent variable perspective, in which it is assumed that either personality and mental disorders are latent variables that have certain causal relations [models a) and (...) b)]; or that, as in model c), the common etiology is in fact a latent variable that causes symptomatology of both personality and mental disorders. We aim to provide another perspective on the comorbidity between personality and mental disorders, namely a network perspective. To this end, we investigated Major Depression and Borderline Personality Disorder and hypothesized that symptoms of BPD and MD could interact with one another rather than being caused by a latent variable. To illustrate this theoretical network conceptualization of the comorbidity of BPD and MD we analyzed a cross-sectional clinical dataset of 376 patients who were asked to complete the Structured Clinical Interview for DSM-IV Axis II Disorders and the Beck Depression Inventory II. The results identify direct associations between symptoms of MD and BPD. If we take the links in this empirical network to be ‘substantive', this suggests a radical shift of our current conceptualization of the comorbidity of mental disorders and personality disorders. (shrink)

Zachar's commentary can be read as a sophisticated theoretical extension of the target article, and I am very pleased to see support for a relationalist turn in understanding mental disorders. Indeed, underlying causal properties are only an ingredient of essentialism and a more elaborate discussion of this issue brings us readily to the discourse on kinds and ontology. Zachar is an advocate for thinking of psychiatric constructs as practical kinds. This logically leads him to think that the problem with categorical (...) classification systems like the Diagnostic and Statistical Manual of Mental Disorders and the International Classification of Diseases are practical problems (lack of... (shrink)

Over the past twenty-five years, history of science has expanded into history of knowledge. Plurality has been the main message. Commonality, by contrast, is the main finding of the present study. It examines the knowledge practices of the full range of participants in cases of public inquiry—trials, tests, inspections—involving human bodies in contexts of criminal law, police, public health, marriage and family, claims to community aid, and regulation of trades. The cases come from the archives of three agencies of inquiry (...) and evaluation—a government, a university faculty, and a guild—in a variety of polities in the Holy Roman Empire between about 1500 and 1650. Participants of widely differing education, occupation, and experience—learned, artisanal, and domestic, as well as specialized versions of these—are found to have shared practices of observation, description, explanation, and argument. This finding opens the prospect of a history of shared empirical rationality, in contrast to the hegemony of difference, dialogue or transfer, and “expertise,” in how we understand knowing in modern as well as premodern Europe. (shrink)

The aim of this review is to show the fruitfulness of using images of facial expressions as experimental stimuli in order to study how neural systems support biologically relevant learning as it relates to social interactions. Here we consider facial expressions as naturally conditioned stimuli which, when presented in experimental paradigms, evoke activation in amygdala–prefrontal neural circuits that serve to decipher the predictive meaning of the expressions. Facial expressions offer a relatively innocuous strategy with which to investigate these normal variations (...) in affective information processing, as well as the promise of elucidating what role the aberrance of such processing might play in emotional disorders. (shrink)

Route memory is frequently assessed in virtual environments. These environments can be presented in a fully controlled manner and are easy to use. Yet they lack the physical involvement that participants have when navigating real environments. For some aspects of route memory this may result in reduced performance in virtual environments. We assessed route memory performance in four different environments: real, virtual, virtual with directional information (compass), and hybrid. In the hybrid environment, participants walked the route outside on an open (...) field, while all route information (i.e., path, landmarks) was shown simultaneously on a handheld tablet computer. Results indicate that performance in the real life environment was better than in the virtual conditions for tasks relying on survey knowledge, like pointing to start and end point, and map drawing. Performance in the hybrid condition however, hardly differed from real life performance. Performance in the virtual environment did not benefit from directional information. Given these findings, the hybrid condition may offer the best of both worlds: the performance level is comparable to that of real life for route memory, yet it offers full control of visual input during route learning. (shrink)

In the past decades, reductionism has dominated both research directions and funding policies in clinical psychology and psychiatry. The intense search for the biological basis of mental disorders, however, has not resulted in conclusive reductionist explanations of psychopathology. Recently, network models have been proposed as an alternative framework for the analysis of mental disorders, in which mental disorders arise from the causal interplay between symptoms. In this target article, we show that this conceptualization can help explain why reductionist approaches in (...) psychiatry and clinical psychology are on the wrong track. First, symptom networks preclude the identification of a common cause of symptomatology with a neurobiological condition; in symptom networks, there is no such common cause. Second, symptom network relations depend on the content of mental states and, as such, feature intentionality. Third, the strength of network relations is highly likely to depend partially on cultural and historical contexts as well as external mechanisms in the environment. Taken together, these properties suggest that, if mental disorders are indeed networks of causally related symptoms, reductionist accounts cannot achieve the level of success associated with reductionist disease models in modern medicine. As an alternative strategy, we propose to interpret network structures in terms of D. C. Dennett's (1987) notion ofreal patterns, and suggest that, instead of being reducible to a biological basis, mental disorders feature biological and psychological factors that are deeply intertwined in feedback loops. This suggests that neither psychological nor biological levels can claim causal or explanatory priority, and that a holistic research strategy is necessary for progress in the study of mental disorders. (shrink)

We address the commentaries on our target article in terms of four major themes. First, we note that virtually all commentators agree that mental disorders are not brain disorders in the common interpretation of these terms, and establish the consensus that explanatory reductionism is not a viable thesis. Second, we address criticisms to the effect that our article was misdirected or aimed at a straw man; we argue that this is unlikely, given the widespread communication of reductionist slogans in psychopathology (...) research and society. Third, we tackle the question of whether intentionality, extended systems, and multiple realizability are as problematic as claimed in the target article, and we present a number of nuances and extensions with respect to our article. Fourth, we discuss the question of how the network approach should incorporate biological factors, given that wholesale reductionism is an unlikely option. (shrink)

Schellings Freiheitsschrift behandelt sowohl einen modernen, positiven Begriff von Freiheit, als auch die Nacht- und Schattenseiten der Freiheit, verbunden mit dem Begriff des Bosen und der Frage der Theodizee. Die Diskussion der Freiheitstheorie wird hier auf eine erst kurzlich wieder ins Blickfeld der Metaphysik geratene spekulative Weise vertieft. Die uberarbeitete Neuauflage erschliesst Schellings Text auf dem aktuellen Stand der Forschung.".

Terminal kidney patients are faced with lower quality of life, restricted diets and higher morbidity and mortality rates while waiting for deceased donor kidney transplantation. Fortunately, living kidney donation has proven to be a better treatment alternative (e.g. in terms of waiting time and graft survival rates). We observed an inequality in the number of living kidney transplantations performed between the non-European and the European patients in our center. Such inequality has been also observed elsewhere in this field and it (...) has been suggested that this inequality relates to, among other things, attitude differences towards donation based on religious beliefs. In this qualitative research we investigated whether religion might indeed (partly) be the explanation of the inequalities in living donor kidney transplants (LDKT) among non-European patients. Fifty patients participated in focus group discussions and in-depth interviews. The interviews were conducted following the focus group method and analyzed in line with Grounded Theory. The qualitative data analyses were performed in Atlas.ti. We found that religion is not perceived as an obstacle to living donation and that religion actually promotes helping and saving the life of a person. Issues such as integrity of the body were not seen as barriers to LDKT. We observed also that there are still uncertainties and a lack of awareness about the position of religion regarding living organ donation within communities, confusion due to varying interpretations of Holy Scriptures and misconceptions regarding the process of donation. Faith leaders play an important educational role and their opinion is influential. This study has identified modifiable factors which may contribute to the ethnic disparity in our living donation program. We argue that we need to strive for more clarity and awareness regarding the stance of religion on the issue of living donation in the local community. Faith leaders could be key figures in increasing awareness and alleviating uncertainty regarding living donation and transplantation. (shrink)

This paper investigates when and how children figure out the force of modals: that possibility modals (e.g., _can_/_might_) express possibility, and necessity modals (e.g., _must_/_have to_) express necessity. Modals raise a classic subset problem: given that necessity entails possibility, what prevents learners from hypothesizing possibility meanings for necessity modals? Three solutions to such subset problems can be found in the literature: the first is for learners to rely on downward-entailing (DE) environments (Gualmini and Schwarz in J. Semant. 26(2):185–215, 2009 ); (...) the second is a bias for strong (here, necessity) meanings; the third is for learners to rely on pragmatic cues stemming from the conversational context (Dieuleveut et al. in Proceedings of the 2019 Amsterdam colloqnium, pp. 111–122, 2019a ; Rasin and Aravind in Nat. Lang. Semant. 29:339–375, 2020 ). This paper assesses the viability of each of these solutions by examining the modals used in speech to and by 2-year-old children, through a combination of corpus studies and experiments testing the guessability of modal force based on their context of use. Our results suggest that, given the way modals are used in speech to children, the first solution is not viable and the second is unnecessary. Instead, we argue that the conversational context in which modals occur is highly informative as to their force and sufficient, in principle, to sidestep the subset problem. Our child results further suggest an early mastery of possibility—but not necessity—modals and show no evidence for a necessity bias. (shrink)

FOSTER J, CHIANG F, HILLARD RC, HALL P and HEATH A. Nursing Inquiry 2010; 17: 309–316 Team process in community‐based participatory research on maternity care in the Dominican RepublicA cross‐cultural team consisting of US trained academic midwife researchers, Dominican nurses, and Dominican community leaders have partnered in this international nursing and midwifery community‐based participatory research (CBPR) project in the Dominican Republic to understand the community experience with publicly funded maternity services. The purpose of the study was to understand community perceptions (...) of maternity services. This article highlights the activities that the research team carried out during each phase of the research process, and how they established team identity, team trust, and team efficacy. This research has created a platform for new avenues for health providers and community to partner to improve maternal‐newborn care. Community‐based participatory research is one way forward to address the past and present inequities constitutive of global health disparities. (shrink)

This article traces the multiple enactments of sex in clinical practices of transgender medicine to argue against the presumed singularity of ‘transexuality’. Using autoethnography to analyse my own experience as a trans patient, I describe my clinical encounters with doctors, psychiatrists and surgeons in order to theorise sex as multiple. Following recent developments in science and technology studies (STS) that advance the work of Judith Butler on sex as performatively reproduced, I use a praxiographic approach to argue that treatment practices (...) produce particular iterations of what sex (and transexuality) ‘is’ and how these processes limit and foreclose other trans possibilities. I consider the ethical, political and material-discursive implications of treatment practices and offer a series of reflections about the effects and effectiveness of current clinical practices and the possibilities for intervening in such processes in order that, following Annemarie Mol, we might (re)make sex (and transexuality) differently. (shrink)

Patriarchal institutions govern all aspects of women's lives: their minds, their bodies, and their souls. Additionally, they govern the ways in which women are perceived by others and the ways in which women perceive themselves. (Re) Interpretations: The Shapes of Justice in Women's Experience, is a collection of essays on language, religion, war, sex trafficking, and medicine-the patriarchal structures that form the basis of western society and, thus, are in many ways inherently unjust. The essays illustrate the multitude of ways (...) that women have found to work within and without these structures to create justice. Traditional theories of justice cast it as a cardinal virtue, unbiased and impartial. The essays in this book, however, remove justice from the abstract and return it to the specific: most of the essays use personal narratives to highlight the connections all people share. The women discussed here are challenging the authority of existing patriarchal narratives by telling their versions, and, thus, calling attention to and challenging their own political and social realities. Reflecting a focus on global connectedness and interdisciplinarity, the writers of these essays aim not only to raise questions, but also to show ways in which women are creating new pathways for themselves. Only by exploring solutions will women reclaim justice. From L.A. to Zimbwabe, women have stories to tell about their experiences of justice in the inherently patriarchal institutions of Language, Religion, War, Sex Trafficking, and Medicine. This relevant and thought-provoking collection captures the trials that women across the world face and the hope they create through their courageous actions. Through both personal narrative and factual overview, these essays emphasize that as people committed to justice, women must not simply raise the questions, but they must also explore solutions in order to reclaim justice for themselves, their daughters, their sisters, and their mothers. Contributors: Yifat Bitton, Stephany Ryan Cate, Jo Scott-Coe, Susan Dewey, Carmela Epright, Carmen Faymonville, Adam Gaynor, Pauline Greenhill, Denise Handlarski, Alison Jobe, Marc J.W. de Jong, Jodie M. Lawston, Jody Lisberger, Kristy Maher, Susan Maloney, Mickias Musiyiwa, Ruben Murillo, Annemarie Profanter, Natalie Wilson, and J. Carter Wood. (shrink)

Intentional action is, in some sense, non-accidental, and one common way action theorists have attempted to explain this is with reference to control. The idea, in short, is that intentional action implicates control, and control precludes accidentality. But in virtue of what, exactly, would exercising control over an action suffice to make it non-accidental in whatever sense is required for the action to be intentional? One interesting and prima facie plausible idea that we wish to explore in this paper is (...) that control is non-accidental in virtue of requiring knowledge—either knowledge-that or knowledge-how (e.g., Beddor and Pavese 2021; cf., Setiya 2008; 2012 and Habgood-Coote 2018). We review in detail some key recent work defending such knowledge-centric theories of control, and we show that none of these accounts holds water. We conclude with some discussion about how control opposes the sort of luck intentional action excludes without doing so by requiring knowledge (that- or how). (shrink)

The strange story of the von Neumann impossibility proof is recalled, and the even stranger story of later impossibility proofs, and how the impossible was done by de Broglie and Bohm. Morals are drawn.

J. L. Ackrill; VIII*—Aristotle's Definitions of Psuche, Proceedings of the Aristotelian Society, Volume 73, Issue 1, 1 June 1973, Pages 119–134, https://doi.org.

In their thought-provoking article, Sedlakova and Trachsel (2023) defend the view that the status—both epistemic and ethical—of Conversational Artificial Intelligence (CAI) used in psychotherapy is complicated. While therapeutic CAI seems to be more than a mere tool implementing particular therapeutic techniques, it falls short of being a “digital therapist.” One of the main arguments supporting the latter claim is that even though “the interaction with CAI happens in the course of conversation… the conversation is profoundly different from a conversation with (...) a human therapist” (Sedlakova and Trachsel 2023, 8). In particular, unlike a human therapist, CAI cannot help its users gain new insight and self-understanding (Sedlakova and Trachsel 2023). We agree that currently available therapeutic CAI cannot be considered a “digital therapist,” however, we think that the issue surrounding the acquisition of new self-understanding in the interaction with therapeutic CAI is more complicated than Sedlakova and Trachsel suggest. (shrink)

Growing demand for broadly accessible mental health care, together with the rapid development of new technologies, trigger discussions about the feasibility of psychotherapeutic interventions based on interactions with Conversational Artificial Intelligence (CAI). Many authors argue that while currently available CAI can be a useful supplement for human-delivered psychotherapy, it is not yet capable of delivering fully fledged psychotherapy on its own. The goal of this paper is to investigate what are the most important obstacles on our way to developing CAI (...) systems capable of delivering psychotherapy in the future. To this end, we formulate and discuss three challenges central to this quest. Firstly, we might not be able to develop effective AI-based psychotherapy unless we deepen our understanding of what makes human-delivered psychotherapy effective. Secondly, assuming that it requires building a therapeutic relationship, it is not clear whether psychotherapy can be delivered by non-human agents. Thirdly, conducting psychotherapy might be a problem too complicated for narrow AI, i.e., AI proficient in dealing with only relatively simple and well-delineated tasks. If this is the case, we should not expect CAI to be capable of delivering fully-fledged psychotherapy until the so-called “general” or “human-like” AI is developed. While we believe that all these challenges can ultimately be overcome, we think that being mindful of them is crucial to ensure well-balanced and steady progress on our path to AI-based psychotherapy. (shrink)

This paper challenges defenders/advocates of the semantic-completeness route towards gluts to explain, in simple and plausible terms, why the ‘trivializer paradox’, framed in terms of closure relatives on theories, fails to undermine their argument.

Joseph Almog pointed out that Kripkean causal chains not only exist for names, but for all linguistic items (Almog 1984: 482). Based on this, he argues that the role of such chains is the presemantic one of assigning a linguistic meaning to the use of a name (1984: 484). This view is consistent with any number of theories about what such a linguistic meaning could be, and hence with very different views about the semantic reference of names. He concludes that (...) the causal theory is ‘rather trivial’ (1984: 487). In this paper I argue that Almog is correct to hold that the causal theory is trivial, but, contra Almog, argue that the triviality of the existence of causal chains is not a matter of such chains having a presemantic role in assigning linguistic meanings to utterances. Instead, such triviality is due to the fact that the causal theory reflects no more than a truism about the epistemology of convention acquisition. (shrink)

This paper argues, based on Lewis’ claim that communication is a coordination game (Lewis in Minnesota studies in the philosophy of science, University of Minnesota Press, Minneapolis, pp 3–35, 1975), that we can account for the communicative function of demonstratives without assuming that they semantically refer. The appeal of such a game theoretical version of the case for non-referentialism is that the communicative role of demonstratives can be accounted for without entering the cul de sac of trying to construct conventions (...) of ever-increasing complexity. Instead communication via demonstratives is explained with reference to the general, non-domain specific ability of human beings to solve games of coordination. Furthermore, there is empirical support for such a view. Judgments concerning demonstrative reference have been shown to be sensitive to judgments concerning common ground (Clark et al. in J Verb Learn Verb Behav 22:245–258, 1983), which is exactly what the non-referentialist account would predict. The game theoretical account also allows for an intuitively plausible, non-referentialist treatment of Speaks’ ‘trumping argument’ (Speaks in Philos Stud 174:709–734, 2017), as well as the Carnap/Agnew puzzle (Kaplan in Syntax Semant 9:221–43, 1970). (shrink)

According to the Feigl–Reichenbach–Salmon–Schurz pragmatic justification of induction, no predictive method is guaranteed or even likely to work for predicting the future; but if anything will work, induction will work—at least when induction is employed at the meta-level of predictive methods in light of their track records. One entertains a priori all manner of esoteric prediction methods, and is said to arrive a posteriori at the conclusion, based on the actual past, that object-level induction is optimal. Schurz’s refinements largely solve (...) the notorious short-run problem. A difficulty is noted, however, related to short-run worries but based on localized disagreement about the past, a feature characteristic of real debates (especially early modern) involving induction in intellectual history. Given the evidence about past events, _unfiltered by induction_, meta-induction might support a partly non-inductive method—especially as judged by proponents of esoteric prediction methods, who presumably believe that their methods have worked. Thus induction is justified meta-inductively in contexts where it was uncontroversial, while not obviously justified in key contexts where it has been disputed. This objection, momentarily sensed by Reichenbach regarding clairvoyance, is borne out by the Stoics’ use of meta-induction to justify both science and divination and by ancient Hebrew examples of meta-induction. Schurz’s recently introduced criteria for acceptance of testimony play a crucial role in arriving at object-level induction using meta-induction, but one might question them. Given the need for judgment in accepting testimony, it is unclear that the subjectivity of Howson’s Bayesian answer to Hume’s problem is overcome. (shrink)

Measurement realism, the view that measurement targets quantitative attributes and that not all attributes are quantitative, has come under attack both from metrologists and philosophers. In this paper, I take a close look at two influential arguments against measurement realism: the argument from obsolescence and the argument from coordination. I concede that these arguments do challenge the epistemological position traditionally taken by measurement realists, but argue that the metaphysical core of measurement realism survives the challenge posed by these arguments. This (...) metaphysical core is vital to maintaining a clear and ambitious standard for successful measurement. (shrink)

We consider the following question of Kunen: Does Con(ZFC + ∃M a transitive inner model and a non-trivial elementary embedding j: M $\longrightarrow$ V) imply Con (ZFC + ∃ a measurable cardinal)? We use core model theory to investigate consequences of the existence of such a j: M → V. We prove, amongst other things, the existence of such an embedding implies that the core model K is a model of "there exists a proper class of almost Ramsey cardinals". Conversely, (...) if On is Ramsey, then such a j, M are definable. We construe this as a negative answer to the question above. We consider further the consequences of strengthening the closure assumption on j to having various classes of fixed points. (shrink)

In both continental and analytical philosophy, social ontology has emerged as a particularly lively and increasingly sophisticated area of debate. This essay explores the potential contribution that social-ontological thinking can make to the continued development of critical theory via a critical reading of Georg Lukács and the Possibility of Critical Social Ontology – a collection of essays edited by Michael J. Thompson and published by Brill as part of the Studies in Critical Social Sciences series. The essay argues that whilst (...) social ontology as such no doubt offers a fruitful avenue for contemporary critical theory, the later philosophy of Georg Lukács represents an untenable and antiquated theoretical resource for such endeavours. The conceptual and systematic barriers to the revitalisation of the late Lukács are explored with specific reference to Lukács’ specific interpretation of the paradigm of labour and, closely related to this, his philosophy of history. (shrink)