Psychological Causation Research Articles

Self-reported anterograde memory loss in older persons that is not validated on neuropsychological assessment: Considerations for a dissociative diagnosis

The past decade has witnessed amplified public awareness of age-related dementias. This has resulted in a dramatic rise in the number of older persons referred to memory clinics with a primary complaint of self-reported memory loss without an antecedent neurological event (e.g., stroke) who produce neuropsychological test profiles that lack evidence of such impairment. Since the latter part of the 19th century, a confusing array of changing terminology, criteria, and perceived causation have been ascribed to patients with unverified medical symptoms to implicate psychological causation. Such terms are often misperceived by laypersons as reflecting character flaws or malingering. Of import for clinical neuropsychologists, the 11th edition of the International Classification of Diseases added cognitive to symptoms eligible for a diagnosis of the modern formulation, dissociative neurological symptom disorder. One dissociative option for referrals with self-reported neurocognitive symptoms not validated on neuropsychological testing is functional memory disorder, conceived as a psychological disorder where emotional distress is plausibly related to the perceived memory loss but is of less severity than would warrant a major depressive or anxiety diagnosis. If evidence of psychological distress or behavioral impairment is not present the referral likely reflects the increased public awareness of age-related dementias interacting with the high base rate of self-perceived memory loss in the general population. In such cases, a dissociative diagnosis should be avoided as there is evidence of neither a medical nor a psychological disorder. A summary statement of not dementia or similar is likely sufficient to help the patient.

Artificial Agential Intelligence

Since artificial intelligence (AI) emerged in the mid-20th century, it has incurred many theoretical criticisms (Dreyfus, H. [1972] What Computers Can’t Do (MIT Press, New York); Dreyfus, H. [1992] What Computers Still Can’t Do (MIT Press, New York); Searle, J. [1980] Minds, brains and programs, Behav. Brain Sci. 3, 417–457; Searle, J. [1984] Minds, Brains and Sciences (Harvard University Press, Cambridge, MA); Searle, J. [1992] The Rediscovery of the Mind (MIT Press, Cambridge, MA); Fodor, J. [2002] The Mind Doesn’t Work that Way: The Scope and Limits of Computational Psychology (MIT Press, Cambridge, MA).). The technical improvements of machine learning and deep learning, though, have been continuing and many breakthroughs have occurred recently. This makes theoretical considerations urgent again: can this new wave of AI fare better than its precursors in emulating or even having human-like minds? I propose a cautious yet positive hypothesis: current AI might create human-like mind, but only if it incorporates certain conceptual rewiring: it needs to shift from a task-based to an agent-based framework, which can be dubbed “Artificial Agential Intelligence” (AAI). It comprises practical reason (McDowell, J. [1979] Virtue and reason, Monist 62(3), 331–350; McDowell, J. [1996] Mind and World (Harvard University Press, Cambridge, MA)), imaginative understanding (Campbell, J. [2020] Causation in Psychology (Harvard University Press, Cambridge, MA)), and animal knowledge (Sosa, E. [2007] A Virtue Epistemology: Apt Belief and Reflective Knowledge, volume 1 (Oxford University Press, Oxford, UK); Sosa, E. [2015] Judgment and Agency (Oxford University Press, Cambridge, MA)). Moreover, I will explore whether and in what way neuroscience-inspired AI and predictive coding (Hassabis, D., Kumaran, D., Summerfield, C., & Botvinick, M. [2017] Neuroscience-inspired artificial intelligence, Neuron 95(2), 245–258) can help carry out this project.

Plotting Memory. What Are We Made to Remember When We Read Narrative Texts?

Plotting Memory. What Are We Made to Remember When We Read Narrative Texts?

Causation in Psychology, by John Campbell

<i>Causation in Psychology</i>, by John Campbell

Prospective study of nocebo effects related to symptoms of idiopathic environmental intolerance attributed to electromagnetic fields (IEI-EMF)

The exact causes of Idiopathic Environmental Intolerance Attributed to Electromagnetic Fields (IEI-EMF, i.e., experience of somatic symptoms attributed to low-level electromagnetic fields) are still unknown. Psychological causation such as nocebo effects seem plausible. This study aimed to experimentally induce a nocebo effect for somatic symptom perception and examined whether it was reproducible after one week. We also examined whether these effects were associated with increased sympathetic activity and whether interoceptive accuracy (IAcc) moderated these relationships. Participants were recruited from the general population and instructed that electromagnetic exposure can enhance somatosensory perception. They participated twice in a cued exposure experiment with tactile stimulation and sham WiFi exposure in 50% of trials. The two sessions were scheduled one week apart (session 1: N = 65, session 2: N = 63). Before session 1, participants watched either a 6-min film on adverse health effects of EMF or a neutral film on trade of mobile phones. IAcc was assessed with the heartbeat detection paradigm. Electrodermal activity served as a measure of sympathetic activation. Evidence for a nocebo effect (i.e., increased self-reported intensity and aversiveness and electrodermal activity) during sham WiFi exposure was observed in both sessions. IAcc moderated the nocebo effect, depending on stimulus intensity. Contrary to previous findings, no difference emerged between the health-related EMF and the neutral films. Based on negative instructions, somatic perception and physiological responding can be altered. This is consistent with the assumption that IEI-EMF could be due to nocebo effects, suggesting an important role for psychological interventions.

« That was then, this is now » : introduction aux psychothérapies psychodynamiques contemporaines

AimThis paper is the translation and adaptation in French of a paper written by Jonathan Shedler, a clinical psychologist and American scholar known for his work on psychoanalytic psychotherapies. MethodShedler offers an introduction to psychoanalytic (or psychodynamic) psychotherapies, initially written for students and clinicians trained in other treatment approaches. A preliminary statement also describes the context of this writing. ResultsThe usual biases towards psychoanalysis, a description of what psychoanalysis is not, and some comments about terminology are offered in an introduction. Fundamental concepts of the psychoanalytic approach are then presented: unconscious mental life, psychological conflicts, the role of past experiences, transference, defense mechanisms, psychological causation, free association, and the importance of the clinician's personal psychotherapy. DiscussionThese notions, illustrated by several clinical examples, highlight the interest and particularities of the psychoanalytical approach in the field of psychotherapy. ConclusionThis article concludes with an epilogue in which Shedler describes his journey and his disillusionment with academic psychology in the United States due to its disconnect from the fundamental concerns of students and from clinical practice.

Is hybrid formal theory of arguments, stories and criminal evidence well suited for negative causation?

In this paper, I have two primary goals. First, I show that the causal-based story approach in A hybrid formal theory of arguments, stories and criminal evidence (or Hybrid Theory, for short) is ill suited to negative (or absence) causation. In the literature, the causal-based approach requires that hypothetical stories be causally linked to the explanandum. Many take these links to denote physical or psychological causation, or temporal precedence. However, understanding causality in those terms, as I will show, cannot capture cases of negative causation, which are of interest to the Law. In keeping with this, I also discuss some of the difficulties Hybrid Theory invites by remaining silent on the nature of the causal links. In my second aim, I sketch a way for Hybrid Theory to overcome this problem. By replacing the original, underlying causal structure with contrastive causation in the law, Hybrid Theory can represent reasoning in which the evidence that is appealed to is causally linked via negative causation to the explananda.

Clinical Practice Guidelines for the management of Dissociative disorders in children and adolescents.

Clinical Practice Guidelines for the management of Dissociative disorders in children and adolescents.

"It's That Route That Makes Us Sick": Exploring Lay Beliefs About Causes of Post-traumatic Stress Disorder Among Sub-saharan African Asylum Seekers in Germany.

Many asylum seekers have been confronted with traumatizing events, leading to high prevalence rates of post-traumatic stress disorder (PTSD). Within the diagnostic context, clinicians should take into account patients' culturally shaped presentation of symptoms. Therefore, we sought to provide insights into beliefs about causes of PTSD held by Sub-Saharan African asylum seekers living in Germany. To this aim, we used a quantitative and qualitative methodological triangulation strategy based on a vignette describing symptoms of PTSD. In the first part of the study, asylum seekers (n = 119), predominantly from Eritrea (n = 41), Somalia (n = 36), and Cameroon (n = 25), and a German comparison sample without a migration background (n = 120) completed the Revised Illness Perception Questionnaire (IPQ-R). In the second part, asylum seekers reviewed the results within eight focus group discussions (n = 26), sampled from groups of the three main countries of origin. Descriptive analyses of the first part demonstrated that asylum seekers predominantly attributed PTSD symptoms to psychological and religious causes, and rather disagreed with supernatural causes. In comparison to the German sample without a migration background, asylum seekers attributed symptoms less strongly to terrible experiences, but more strongly to religious and supernatural causes. Within the focus group discussions, six attribution categories of participants' causal beliefs were identified: (a) traumatic life experiences, (b) psychological causes, (c) social causes, (d) post-migration stressors, (e) religious causes, and (f) supernatural causes. Our findings suggest that the current Western understanding of PTSD is as relevant to migrants as to non-migrants in terms of psychological causation, but might differ regarding the religious and supernatural realm. While awareness of culture-specific belief systems of asylum seekers from Sub-Saharan Africa regarding PTSD is important, our findings do underline, at the same time, that cultural differences should not be overstated.

Interventionism and Mental Surgery

John Campbell has claimed that the interventionist account of causation must be amended if it is to be applied to causation in psychology. The problem, he argues, is that it follows from the so-called ‘surgical’ constraint that intervening on psychological states requires the suspension of the agent’s rational autonomy. In this paper, I argue that the problem Campbell identifies is in fact an instance of a wider problem for interventionism, extending beyond psychology, which I call the problem of ‘abrupt transitions’. I then defend a solution to the problem, which replaces the surgical constraint with a weaker constraint on interventions that nevertheless does all the work the surgical constraint was designed to do. I conclude by exploring some interesting consequences of this weaker constraint for causation in psychology.

Differences in illness perceptions between patients with non-epileptic seizures and functional limb weakness

ObjectivesIllness perceptions play an important role in the onset and maintenance of symptoms in functional neurological symptom disorder (conversion disorder). There has, however, been little work examining differences between subtypes of this disorder. We therefore aimed to compare illness perceptions of patients with non-epileptic seizures (NES) and those with functional weakness (FW) with matching neurological disease controls to examine their specificity. MethodsThe Illness Perception Questionnaire Revised (IPQ-R) was completed by patients with functional limb weakness, non-epileptic seizures and patients with neurological disease causing limb weakness and epilepsy in two separate case control studies. ResultsPatients with FW (n=107), NES (=40), Epilepsy (n=34) and neurological disease causing limb weakness (NDLW) (n=46) were included in the analysis. Both FW and NES patients reported a low level of personal control, understanding of their symptoms and a tendency to reject a psychological causation of their symptoms. However NES patients rejected psychological causes less strongly than FW patients (P<.01). Patients with NES were also more likely to consider their treatment to be more effective (P<.01). None of these differences appeared in a similar comparison between patients with epilepsy and patients with NDLW. ConclusionAlthough patients with NES tended, as a group, to reject psychological factors as relevant to their symptoms, they did so less strongly than patients with functional limb weakness in these cohorts. This has implications for both the way in which these symptoms are grouped together but also the way in which treatment is approached.

1184 – A case of cotard’s syndrome associated with self-starvation

Introduction In 1880 Cotard introduced the term, “delire de negation”, which referred to nihilistic delusions and has come to be known as Cotard’s syndrome. This condition is thought to be characterized by various degrees of delusional beliefs in which different aspects of existence are negated or experienced from a negative perspective. Objectives The historical concept of Cotard’s syndrome, its clinical presentation and treatment is briefly reviewed. Aims To report a case study of Cotard’s syndrome associated with self-starvation and to review the concept and clinical features of the condition. Methods A detailed clinical history was obtained from several interviews and a literature review of the theme is shortly surveyed. Results A woman of 66 years, without any psychiatric history prior 2012, developed a clinical picture of depressed mood and sudden onset of delusions of ruin, ill health, guilt and self-starvation. She believed that her esophagus and stomach were glued together, so that it was not possible for her to ingest any food. She also refused to go outside because she believed she was malodorous (she had olfactory hallucinations). The patient started experiencing these symptoms after her husband’s unexpected death, a few months prior to admission. She was treated with high doses of antidepressants and an antipsychotic. Conclusions Cotard’s syndrome in this case study is associated with depression. Attempting to understand individuals with the condition from both a phenomenological as well as biological viewpoint may eventually pave the way for clearer connections between psychological and biological causation of the syndrome.

A study in psychological mislabelling: the rise and (protracted) fall of psychogenic fibromyalgia

AbstractThis article provides a brief history of the psychogenic model of fibromyalgia from its origins in the late 1800s to its undoing a century later. Psychogenic fibromyalgia reached a high watermark in the 1930s in the anecdotal reports of a psychoanalytically-oriented Scottish disability examiner. Subsequent research, however, failed to provide convincing support for the psychogenic model, with at least four research reviews concluding there was little empirical evidence for psychological causation in fibromyalgia. By the end of the last century, psychogenic fibromyalgia was in full retreat before an advancing biomedical literature and a cognitive-behavioural coping treatment that viewed psychological distress as more consequence than cause of the disorder. Today, psychogenic fibromyalgia draws only a passing historical reference in the leading textbooks of rheumatology and psychosomatic medicine.

II-Control Variables and Mental Causation

I introduce the notion of a ‘control variable’ which gives us a way of seeing how mental causation could be an unproblematic case of causation in general, rather than being some sui generis form of causation. Psychological variables may be the control variables for a system for which there are no physical control variables, even in a deterministic physical world. That explains how there can be psychological causation without physical causation, even in a deterministic physical world.

Causality and Causation in Law, Medicine, Psychiatry, and Psychology: Progression or Regression?

In this article, I review recent developments in the areas of law, medicine, psychiatry, and psychology concerning causality and causation. I analyze the validity of the 2008 edition of the American Medical Association (AMA)’s guides to the evaluation of permanent impairment and its accompanying volume on causation. I conclude with recommendations for a synthetic approach to causality in the legal field and a more consistent model of impairment in the mental health one. The AMA’s book on medical causation needs careful revision.

Redefining (somatoform) pain disorder in ICD-10: a compromise of different interest groups in Germany

Pain is one of the most frequent reasons to visit health professionals. Many patients suffering from chronic pain conditions not only need medical treatment but also psychiatric or psychological interventions. This additional treatment need should be underlined using an ICD section F diagnosis. The current ICD-10 diagnosis of somatoform pain disorder requests psychological causation of the pain, which is frequently unclear or difficult to decide. In Germany, the different interest groups, namely of psychiatry, pain research, psychosomatic medicine and clinical psychology, met to find a consensus on how to re-classify pain disorder under section F of ICD-10. This manuscript summarizes the result. A diagnosis of pain disorder is necessary to underline the additional need of psychiatric/psychological interventions in chronic pain conditions. This diagnosis should include psychological features that are relevant for development or maintenance of chronic pain. In contrast to earlier attempts of redefining pain diagnoses, our attempt included representatives of the association for the study of pain.

Somatization, Hysteria, or Incompletely Explained Symptoms?

In this month's In Review section, all the contributors-Dr Francois Mai (1), Dr Laurence Kirmayer and colleagues (2), and I-wrestle with the seemingly intractable and endlessly interesting topic of body-mind relations. In the first review article, Dr Mai lays out the justification for a diagnostic category of somatization disorder. He recognizes that the standard monistic approach that accepts the unity of mind and body can easily be misunderstood. In particular, while we may agree that the phenomenology of a complaint such as the experience of pain cannot be split into organic and psychological components, we must nevertheless determine whenever possible how much a patient's complaint derives from identifiable or probable physical causes and how much it derives from, or is influenced by, psychosocial factors. To assess diagnosis, causes, and treatments, both types of etiologic formulation have to be qualified and also quantified, if only very broadly. As Dr Mai indicates, the notion of somatizing or somatization has a peculiar origin in the free translation of a highly questionable concept, organsprache, which we may understand as speaking or symbolizing a problem through some constituent of the body. This speculative idea deserves extra-severe questioning on its own. In the notion of somatizing, a dubious popular psychiatric thought has been blended with the practice that psychiatrists have introduced of defining a condition in terms of hard data. The tight criteria for somatization disorder were originally introduced to circumscribe a particular group of patients who could be isolated for prognostic purposes and other research (3). Although these criteria deliberately did not include all the items that had been labelled as hysteria, the original intent was soon subverted. Guze changed the label to Briquet's syndrome (4), perhaps hoping to promote its acceptance by associating it with the extensive empirical case material of Pierre Briquet (5), but the DSM-III took over the category and labelled it somatization disorder. So far so good, perhaps, although neither Briquet's syndrome nor somatization disorder quite describe what Briquet reported (6). The DSM-III maintains the understanding that somatization disorder is somehow linked with other labels related to the psychological causation of somatic symptoms. These include conversion disorder, psychogenic pain disorder, hypochondriasis, and atypical somatoform disorder, grouped under a general heading of Somatoform Disorders, which were matched with another group of conditions identified as Dissociative Disorders. Notwithstanding a serious effort in the DSM-III to treat these conditions empirically as part of an atheoretical system, several of them quickly reverted to type in medical practice, where they were seen as based on repression and emotional conflict. The criteria for somatization disorder were changed substantially in the DSM-IV. The group was also sufficiently unstable that the term psychogenic pain disorder as such was ultimately abandoned and replaced with the term pain disorder. Current evidence suggests that pain disorder is a category that should rarely, if ever, be used (7). Meanwhile, it has also been argued that the term somatizing has multiple uses and meanings that minimize its value (8). Never mind all that. Forget the theory, as the DSM-III really tried to do, and focus on the phenomena. With regard to this approach, Dr Mai has carefully outlined the criteria and uses of a category that by now corresponds to much of what psychiatrists also call medically unexplained symptoms and that has been further explored by Dr Kirmayer and colleagues (2). Many practitioners tend to diagnose somatization disorder, and likewise pain disorder, without applying the serious restrictions that are supposed to be observed. Mai, of course, does not permit such a solecism, and after refining his patient group according to the DSM-IV diagnostic criteria, which are essentially those of the ICD-10 as well, he is left with a group for whom he recommends cognitive-behavioural therapy (CBT) (1). …

Natural Law and Divine Action: The Search for an Expanded Theory of Causation

Abstract. Talk of divine action faces its greatest obstacle when it confronts natural law and efficient causation. If all valid explanations involve deterministic laws, and only microphysical causes actively trigger change, claims for divine action can serve no explanatory role. But science does not in fact require the limitation to downwardly deterministic laws and efficient causes. Evidence supports the existence of emergent systems of phenomena, which, though dependent on physical law, also display emergent causal powers not reducible to their subvenient systems. Careful study of top‐down causation in biology and of mental causation in psychology offers analogies that are helpful for making sense of the notion of divine action. Theists' ascription of a causal role to God cannot be proven from science or identified with scientific forms of causality. Nevertheless, if the emergence hypothesis is correct, theistic explanations do not need to conflict with science, and a plausible model of divine influence may even be derived from emergent causation. In this article I offer an expanded theory of causation that reduces the distance between two types of causal forces that are often held to be incommensurable.

One depression or many?

This article takes as its starting point a paper by Hugo Bleichmar presented at the 2003 Joseph Sandler Research Conference on Depression. The author argues in favour of viewing depression in a broad perspective. The Freudian prototype of “guilty depression” represents only one of many pathways leading to depressive states. Psychoanalytic understanding of depression should represent a multidimensional approach, characterised by interacting determinants, both internal and external. In clinical practice, this would imply an attitude of greater freedom and flexibility in the analyst. The paper compares the psychoanalytic account of depression with that given by the cognitive approach. It is argued that within a diverse research field, where depression is studied from different angles—as a disorder of the brain and in terms of cognitive deficits—the contribution of psychoanalysis is that depression is most usefully studied at the level of psychological causation. The psychoanalytic understanding of depressive states in terms of unconscious interpretation and meaning of experience represents a distinct contribution. Implications of viewing depression as an “illness” are discussed.

The Mental Representation of Narrative Texts as Networks: The Role of Necessity and Sufficiency in the Detection of Different Types of Causal Relations

The purpose of this study is to determine how the perceived strength of 4 types of causal relations (physical causality, motivation, psychological causation, and enablement) is affected by causal properties (i.e., necessity and sufficiency) and by distance in the text surface structure. Participants evaluated the strength of the relations between pairs of sentences extracted from narratives either without reading the narratives, or with one or two readings of the narratives. The pairs varied in necessity and sufficiency as well as in the type of causal relation and were either adjacent or nonadjacent in the text surface structure. The criteria of necessity and sufficiency were used to identify the causal inferences connecting the statements as well as to determine their strength. As predicted, causal properties and distance in the text surface structure between the cause and its consequence systematically affected the causal strengths of the relations between text statements. Also, during reading, participants detected both adjacent and nonadjacent causal relations. A 2nd reading tends to strengthen the connections for adjacent pairs only.