Mental Episodes Research Articles

Reflexive awareness and reflexivity: an identity model of reflexive awareness with Korta and Perry’s reflexive-referential theory of content (RRT)

In recent years, much debate has centered on the same-order representational theory of consciousness. According to this theory, (1) conscious mental episodes are episodes of which we are aware; and (2) the awareness of an external object and the immediate, reflexive awareness of the mental episode together constitute a single episode. In this paper, I propose that the reflexive-referential theory of content developed by Korta and Perry can be used to establish the claim that reflexive awareness is numerically identical to the mental episode it represents. The advantage of this model is threefold. First, it avoids misrepresentation and vicious infinite regress. Second, it illustrates the intimate connection between a mental episode and the reflexive awareness of it. Third, it explains why consciousness is an intrinsic property.

Minds in Motion and Introspective Minds

Buddhist philosophers provide several toolkits for exploring the relationship between meditation and introspection. Drawing on some of their tools, we explore three models of mind, which offer different ways of thinking about the possibility of introspection: an entirely mindful observer, who introspectively experiences 'pure consciousness'; a thin mind, which avoids appealing to a witness or observer of mental episodes by positing a form of reflexive selfawareness; and a thicker mind, which is active, historically situated, and dependent upon an ecological and social context. We then explore practical and theoretical models of a thicker mind, which suggest that meditation is not simply a matter of representing mental episodes and then using these representations for online behavioural control. Drawing upon these models, we close by proposing that meditation should be understood as a practice of mental cultivation, which requires a more radical reconceptualization of knowing a mind.

Malcolm Arnold: The Inside Story by Anthony Meredith (review)

Reviewed by: Malcolm Arnold: The Inside Story by Anthony Meredith Ryan Ross Malcolm Arnold: The Inside Story. By Anthony Meredith. Market Harborough, Leicestershire: Book Guild, 2022. [xii, 524 p. ISBN: 9781914471490 (hardcover), £19.95.] Bibliography, plates, index. My first reaction when I learned of this book was a raised eyebrow. Here is another volume devoted to the life of Sir Malcolm Arnold (1921–2006), by my count the fourth since 1994 (see Piers Burton-Page, Philharmonic Concerto: The Life and Music of Sir Malcolm Arnold [London: Methuen, 1994]; Paul R. W. Jackson, The Life and Music of Sir Malcolm Arnold: The Brilliant and the Dark [Burlington, VT: Ashgate, 2003]; and Anthony Meredith's earlier collaboration with Paul Harris, Malcolm Arnold, Rogue Genius: The Life and Music of Britain's Most Misunderstood Composer [Norwich, Norfolk: Thames/Elkin, 2004]). Moreover, it is the second involving Meredith and similarly registers at over five hundred pages. Why the need for this latest tome? What does it offer that the others did not? The clue lies in its subtitle, "Inside Story." Now that Arnold's longtime caretaker, Anthony Day, has passed away (2019), Meredith wants to "set the record straight" about the composer's later years. He claims to advocate for Arnold's living daughter, Katherine, and the injustices she was forced to endure at the hands of those responsible for her aged father's welfare. This is a sad account, primarily concerned with the exploitation of an astonishingly talented composer whose chronic mental illness nonetheless colored his career, ruined his two marriages, hampered relationships with his children, and finally left him an enfeebled shell of his former self. Boiled down to essentials, it is a story that needed to be told. Unfortunately, Meredith's narrative is marred by questionable musical judgments, loose documentation, and especially a vindictiveness which undermines his message. The publication gives the impression of a frustrating paradox: the author seems one of a very few who are privy to his information, but he is too close to the subject for the delicacy it demands. Meredith's earlier book is a life-and-works account that, by his own description, substantially ends in 1996, with only glimpses into Arnold's later life. By contrast, the bulk of Malcolm Arnold: The Inside Story concerns itself with events following the dissolution of the composer's second marriage in 1975 and the mental episodes in the late 1970s that profoundly affected the rest of his life. Roughly the first three chapters concern earlier times (with occasional discussion of relevant music). But the heart of the book concentrates on four successive stages in Arnold's remaining years, with the last being by far the longest. They are his move to London (from Dublin) and hospitalization following psychotic episodes; his time at St. Andrew's Hospital in Northampton for further care; his stint with tavern owner Brian Charlton; and finally, the roughly two decades as Anthony Day's charge. In the latter three periods especially, Meredith focuses on a distinctive pattern: questionable choices made for Arnold's well-being by those responsible for him and their frequent failure to involve Katherine and other family members in the decision-making. Meredith brings a wealth of biographical detail to back up some incriminating questions. What were the medical treatments Arnold received at St. Andrew's? Why did the staff there allow Arnold to frequently stray from the premises and [End Page 637] eventually into the arms of the unscrupulous, inheritance-seeking Charltons? Even more pointedly, how could the Great Britain Court of Protection have sanctioned this change of custody? The reader comes away convinced that the mentally fragile Arnold did indeed suffer neglect, exploitation, and even abuse in these circumstances. With his account of the long Anthony Day era, Meredith's narrative becomes contentious. The stage is set for this in the preface, where he blames Day for the "myths and legends, fictions and fantasies" that have persistently characterized Arnold's later years (p. ix). He admits to having relied heavily on Day for information found in Malcolm Arnold, Rogue Genius, but that he became troubled by factual weaknesses and indelicacies he had taken on trust (p. x). Consequently...

Inner Speech and ‘Pure’ Thought – Do we Think in Language?

While the idea that thinking is a form of silent self-talk goes back at least to Plato, it is not immediately clear how to state this thesis precisely. The aim of the paper is to spell out the notion that we think in language by recourse to recent work on inner speech. To that end, inner speech and overt speech are briefly compared. I then propose that inner speaking be defined as a mental episode that substantially engages the speech production system; the underlying model of speech production is sketched. Next, the cognitive role of inner speaking is explored, especially its role in thinking and reasoning. The question of whether it is a way of making thoughts accessible (to whomever) or whether it is a means of thinking itself is raised. I argue that there are two reasons for assuming that, occasionally, we think in language. More specifically, I will claim that some instances of thinking are instances of inner speaking as they exploit certain properties of natural language, and that some instances of inner speaking are instances of thinking as they play a decisive role in paradigmatic cases of thinking that result from internalizing and re-using certain social-linguistic practices. Finally, the Language-of-Thought hypothesis as an alternative account is critically discussed.

Radical Empiricism, Neutral Monism, and the Elements of Mind

AbstractNeutral monism is the view that both ‘mind’ and ‘matter’ are grounded in a more fundamental form of reality that is intrinsically neither mental nor material. It has often been treated as an odd fringe theory deserving of at most a footnote in the broader philosophical debates. Yet such attitudes do a grave disservice to its sophistications and significance for late nineteenth and early twentieth-century philosophy of mind and psychology. This paper sheds light on this neglected view by situating it within broader historical monist debates about the mind and bringing attention to one of its central internal disputes regarding ‘mental chemistry’. By taking a closer look at how Ernst Mach, William James, and Bertrand Russell address the question of whether and how our mental episodes are composed of more basic elements, it highlights deep differences among their conceptions of the fundamental ‘neutral stuff’ and its relations to ‘mind’ and ‘matter’.

Ownership and First-Person Authority from a Normative Pragmatist Perspective

Abstract Mental episodes are typically associated with subjective ownership and first-person authority. My belief that an apple is red is had by me; it is mine and I’m in a privileged position to know it. Your experience of red is had by you; it is yours and you are in a privileged position to know it. The two assumptions are that mental events are had by individuals to whom they occur, and that owners are in a privileged epistemic position to fallibly report their own. This paper asks how to understand ownership and first-person authority (section 1). It argues that the two assumptions should not be accepted by default (section 2). A normative pragmatism is specified, on which mental episodes are not owned, but owed to practices of reason articulation (section 3). Finally, a positive account of ownership and first-person authority is considered (section 4).

Acute Necrotizing Encephalopathy Associated with Influenza A

ABSTRACT A severe and unusual complication found in children with influenza is an acute necrotizing encephalopathy. A 20-month-old female with no significant past medical history was admitted to our facility, presenting with a 4-day history of worsening fever, upper respiratory symptoms, new-onset altered mental status and episodes of extensor posturing. The initial concern was a dystonic reaction secondary to promethazine following a recent diagnosis of influenza A virus. A head computed tomography scan indicated concern for widespread edema, and the video EEG revealed focal slowing in the frontocentral regions with no epileptiform activity during episodes of extensor posturing. The first magnetic resonance imaging results were consistent with acute hemorrhagic encephalitis or severe anoxic brain injury for which there is a broad differential. A second MRI five days later found new areas of restricted diffusion that were consistent with acute necrotizing encephalitis.

Phenomenal contrast arguments: What they achieve

AbstractPhenomenal contrast arguments (PCAs) are normally employed as arguments showing that a certain mental feature contributes to (the phenomenal character of) experience. In this paper we examine a neglected aspect of such arguments, that is, the kind of mental episodes involved in them, and argue that this happens to be a crucial feature of the arguments. We use linguistic tools to determine the lexical aspect of verbs and verb phrases—the tests for a/telicity and for duration. We then suggest that all PCAs can show is the presence of a generic achievement‐like phenomenology, especially in the cognitive domain, which contrasts with the role that PCAs are given in the literature.

Addiction Vulnerability: Exploring Relationships Among Cigarette Smoking, Substance Misuse, and Early Psychosis

ABSTRACTObjective: Smoking rates in adolescents at risk for psychosis are significantly greater than in those who are not at risk. Recent research suggests that cigarette smoking in adolescence may be a potential marker of transition to psychosis, although the exact relationship between the two remains unclear. Our aim was to examine whether tobacco smoking is a potential marker of transition to psychosis or subsequent episodes of psychosis, independently of other substance use, or alternatively whether smoking is essentially a general marker of later mental illness episodes. Methods: This substudy was conducted as part of an audit of a specialized early psychosis community mental health service, the Psychological Assistance Service (PAS). A multilayered audit over 10 years (January 1997 to December 2007) of PAS presentations was conducted (N = 1997), which documented baseline sociodemographic and clinical characteristics and subsequent illness episodes and service usage. Among clients with baseline smoking status information (n = 421, mean age = 18.3 years), this study examined predictors of transition to or subsequent episodes of psychosis, substance misuse, and affective disorder. Results: A recent psychosis episode at baseline and receiving ongoing treatment from PAS predicted transition to or subsequent psychosis episodes; however, baseline ultra-high-risk status was not predictive. In addition, baseline smoking/substance misuse status was a significant predictor, with smokers being twice as likely to experience a subsequent episode of psychosis, even after controlling for other baseline comorbidity. Baseline smoking status also independently predicted subsequent substance misuse episodes, but not subsequent affective disorder. Among clients experiencing post-PAS comorbid substance misuse and psychosis, the majority (80.3%) reported smoking at baseline. Conclusions: Smoking status at service presentation appeared to function as a general proxy for addiction vulnerability among young help seekers and thereby as a potential marker for the development of severe mental illness (including psychosis) and associated health problems. Routine evaluations of presenting problems need to incorporate comprehensive assessments of early substance misuse and tobacco smoking. Adjunctive lifestyle interventions promoting smoking cessation, physical health, and well-being need to be offered in conjunction with conventional mental health interventions tailored to key presenting problems, recovery, and psychological strengthening.

The Complicity of Friends: How George Eliot, G. H. Lewes, and John Hughlings-Jackson Encoded Herbert Spencer's Secret

The Complicity of Friends: How George Eliot, G. H. Lewes, and John Hughlings-Jackson Encoded Herbert Spencer's Secret

Manualized Group Cognitive-Behavioral Therapy for Social Anxiety in At-Risk Mental State and First Episode Psychosis: A Pilot Study of Feasibility and Outcomes

ABSTRACTSocial anxiety has received scant attention in studies of schizophrenia and related psychoses. However, some data suggest it may be an obstacle to vocational and functional outcome. This pilot study investigated the feasibility of a group-based cognitive behavioral therapy (CBGT) to reduce social anxiety in those at risk for developing psychosis or in the early phase. Twenty-nine patients with first-episode psychosis (FEP) or at ultra high risk for developing psychosis or often referred to as at-risk mental state (ARMS) with comorbid social anxiety attended a CBGT intervention weekly for 14 weeks in 90-minute sessions. Baseline, post-treatment, and follow-up ratings of social anxiety were measured using the Social Interaction Anxiety Scale, the Social Phobia Inventory, and the Brief Social Phobia Scale. Psychotic symptoms and general psychopathology were also measured before and after the intervention. Results suggest that the proposed CBGT is feasible and beneficial for socially anxious patients at risk, or with experience of, psychosis. Participants significantly improved on three outcome measures of social anxiety after completing this intervention (all p’s < .002). Participants who completed treatment also showed a significant reduction on measures of depression and negative symptoms. Future research should examine the relative efficacy of this brief manualized CBGT intervention for the treatment of social anxiety and psychotic symptoms in a larger randomized controlled trial.

Conscious Thought and The Limits of Restrictivism

How should we characterize the nature of conscious occurrent thought? In the last few years, a rather unexplored topic has appeared in philosophy of mind: cognitive phenomenology or the phenomenal character of cognitive mental episodes. In this paper I firstly present the motivation for cognitive phenomenology views through phenomenal contrast cases, taken as a challenge for their opponents. Secondly, I explore the stance against cognitive phenomenology views proposed by Restrictivism, classifying it in two strategies, sensory restrictivism and accompanying states. On the one hand, I problematize the role of attention adopted by sensory restrictivism and I present and discuss in detail an argument that defends the limitation of sensory phenomenology so as to explain the distinction between visual and cognitive mental episodes on the basis of immediate experience. On the other hand, I address accompanying states views by discussing the empirical studies of Hurlburt et al. (2006, 2008) that defend the existence of “unsymbolized thinking”. I present how they can be construed as evidence for cognitive phenomenology views and I dispel some problems that have been raised against its acceptance. I thus conclude that cognitive phenomenology views hold up well against the restrictivist positions considered.

Thoughts, Processive Character and the Stream of Consciousness

This paper explores the relation of thought and the stream of consciousness in the light of an ontological argument raised against cognitive phenomenology views. I argue that the ontological argument relies on a notion of ‘processive character’ that does not stand up to scrutiny and therefore it is insufficient for the argument to go through. I then analyse two more views on what ‘processive character’ means and argue that the process-part account best captures the intuition behind the argument. Following this view, I reconstruct the ontological argument and argue that it succeeds in establishing that some mental episodes like judging, understanding and occurrent states of thought do not enter into the stream but fails to exclude episodes like entertaining. Contrary to what it might seem, this conclusion fits well with cognitive phenomenology views, given that, as I show, there is a way for non-processive mental episodes to be fundamentally related to processive ones, such that they cannot be excluded from the phenomenal domain. This paper sheds light on the nature of different kinds of thoughts and questions a fundamental asymmetry between the perceptual and the cognitive domain when it comes to their ontology and temporal character.

Major Mental Health Problems of Undergraduate Students in a Private University of Dhaka, Bangladesh

Introduction Mental health is a highly stigmatized topic in Bangladesh. University students are one of the susceptible groups who are experiencing mental health problems. Different studies conducted among undergraduate student in different part of South Asia revealed that they are suffering from psychological morbidity. Aim This study aims to identify the major mental health problems that students face due to academic factors. Objective To determine the proportion of undergraduate students who are facing mental health problems and to identify factors related to academic life that are associated with mental health problems. Method The study was conducted among newly admitted students who have completed one semester using cross sectional design. Simple random sampling was used to select sample. Sample size was 150. Data were collected through face to face interview using self-administered semi-structured questionnaire. Result Result of the study revealed that most of the university students commonly experienced anxiety due to academic reason. Among the respondents, 24% of the students experienced both anxiety and depressive episodes. 60% students experienced anxiety, depression and panic episodes, 12% students experienced only anxiety episodes and 4% don’t have any mental episodes. The most frequently reported pressurizing academic factors were assignment & exam workload and the obligation of getting good grade. Conclusion Undergraduate university students experienced different mental episodes at different point of time due to academic pressure.

Pharmacotherapy, Psychotherapeutic and Psychosocial Treatments Work Together Toward Recovery: a Study On Mixed Features Bipolar Disorder.

Introduction Pharmacological treatment have a key role in themanagement of Severe Mental Illness, reducing hospitalization and acute episodes, supporting and enhancing psychotherapy and recovery process. In aninstitutional pathway to remission and recovery it’s much better if thecharacteristics of chosen drugs worktogether with other kind of interventions. DSM-5 includes a new specifier 'withmixed features” for mood episodes, considering by clinicians difficult-to-treatand associated with a poorer prognosis. Objectives We evaluated, in patients admitted to our day-hospitalpsychodinamically-oriented treatment program, the impact of mixed featurestreatment on compliance and on clinicaloutcome. Methods We have included a small sample of patients withbipolar disorder based on DSM V, aged between 18 and 65. Patients are assessedby BPRS and M.I.N.I. in to analyze theimpact of different antipsychotics on specific symptomatology cluster, focusingon mixed features, and CGI and VGF toevaluate working and social functioning. Changes from baseline to 12-weeks intotal score and in partial score for symptomatology clusters was considered. Results Asenapine improved mixed features (ANOVA, p Conclusions Our treatment model, where converge psychiatrics, psychologists, physicians andrehabilitation operators, allows a drugchoice focused on symptoms assisting psychotherapeutic play and an early noticeof side effects, advancing towards recovery. Asenapine, in the treatment ofmixed features, enhances the efficacy of the program in bipolar patients.

Eye-Fixation Behavior in Major Depressive Disorder and the Influence of Pharmacological Therapy: A Microperimetric Study

Background: To evaluate retinal function and fixation stability in major depressive disorder (MDD) and the influence of antidepressant therapy, using the MP-1 microperimeter. Methods: 25 patients with MDD (57 ± 13.73 years) and 25 healthy subjects (HS) (56.41 ± 15.73 years) were enrolled. According to the Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM-IV), single (296.2) or recurrent episode (296.3) of MDD was included. Retinal sensitivity, fixation stability, and bivariate contour ellipse area (BCEA) were obtained using MP-1. Then patients were divided according to antidepressant therapy: SSRI/SNRI associated with atypical antipsychotic (group A) and SSRI/SNRI monotherapy (group B) and pharmacological washout (group C). Differences between groups were estimated using the Kruskal-Wallis test with post hoc Mann-Whitney analysis. Spearman’s rank correlation was used for comparisons. Results: Mean retinal sensitivity was significantly reduced in the MDD group than HS (P= 0.02). Six (24%) eyes had a relatively unstable fixation, and mean BCEA was larger than control group (P =0.04). The Kruskal-Wallis analysis of variance showed significant differences in log BCEA between groups (P=0.01), but no differences in mean retinal sensitivity between groups (P=0.09). Conclusion: MDD patients showed impairment in retinal sensitivity and fixation stability respect to the HS. Despite these findings, the impairment of fixation stability seems to be related to antidepressant therapy.

Focused Daydreaming and Mind-Wandering

In this paper, I describe and discuss two mental phenomena which are somewhat neglected in the philosophy of mind: focused daydreaming and mind-wandering. My aim is to show that their natures are rather distinct, despite the fact that we tend to classify both as instances of daydreaming. The first difference between the two, I argue, is that, while focused daydreaming is an instance of imaginative mental agency (i.e. mental agency with the purpose to voluntarily produce certain mental representations), mind-wandering is not—though this does not mean that mind-wandering cannot involve mental agency at all. This personal-level difference in agency and purposiveness has, furthermore, the consequence that instances of mind-wandering do not constitute unified and self-contained segments of the stream of consciousness—in stark contrast to focused daydreams. Besides, the two kinds of mental phenomena differ in whether they possess a narrative structure, and in how we may make sense of the succession of mental episodes involved.

Psychotic reactivity is triggered by social appraisals and subjective stress in daily life in persons with at-risk mental states and first episode psychosis

Identifying factors that predict the onset and severity of psychotic symptoms is essential for understanding the etiology of psychosis and developing effective interventions. We employed experience sampling methodology (ESM) to examine the association of momentary stress and interpersonal appraisals with psychotic symptoms in 29 prodromal and first-episode patients. Participants were signaled eight-times daily for one week about thoughts, feelings, and psychotic symptoms, and about momentary stress and social appraisals. As hypothesized, the experience of stress and feeling unwanted was associated with psychotic symptoms in the moment; whereas feeling close with people was associated with momentary decreases in psychotic symptoms. Time-lagged analyses indicated that stress at the preceding ESM assessment predicted symptoms at the current assessment. The study provides a unique examination of the association of environmental and individual factors in the experience of psychotic symptoms. The finding that stress in the moment precipitates psychotic symptoms supports stress sensitivity models.

Schemaspiele

AbstractThe title of “Schema Games” is certainly insinuated by Wittgenstein’s later philosophy of “Language Games” as a social practice and “life forms” and “Gepflogenheiten” (usages), social practices, action forms and mores and institutions. However, in this article Wittgenstein’s conception is extended to forms of not only language usages and actions but also any form of modeling, structuring and scheme activation in cognition and action as well as subconscious, even neuro-physiologically activated networking and modeling processes. Schemes, schematization and scheme activations as well as reactivations are decisive for any stabilization of meanings, opinions, mental episodes as well as actions, social or individual. There is no cognition or action or thinking and speaking without the activation and reactivation of schemes on different levels.Wittgenstein’s approach of a pragmatic and social practice of language games and life forms based on common and repeated usages of special cases of scheme activations and processes of interpretative constructions (interpretative constructs) may also methodologically be analyzed on different levels, even subconscious ones, to grasp or to constitute cognitive and action-like activities. Active formation and usages play a fundamental and pragmatic role, not only according to Kant under his categories but after Wittgenstein and the present methodological approach in a more flexible way - somewhat like Wittgenstein’s “language games” approach. Not only socially based speech forms and actions as well as “life forms” are dependent on active pragmatic scheme interpretations, but also already many basic processes of representing, cognizing, acting, mustering and modeling, even on subconscious neuronal levels. Any cognition and action whatsoever is scheme-dependent, produced by scheme-interpretative activity on user-oriented and a socio-pragmatic, or even institutionalized basis. Not only do language games rely on scheme activations, but they are, methodologically speaking, special cases of these forms of activation. Thus, the parallelism between “language games” and life forms in Wittgenstein’s sense and “schema games” on the basis of methodological scheme-interpretationism seems to be well-founded.

The delocalized mind. Judgements, vehicles, and persons

Drawing on various resources and requirements (as expressed by Dewey, Wittgenstein, Sellars, and Brandom), this paper proposes an externalist view of conceptual mental episodes that does not equate them, even partially, with vehicles of any sort, whether the vehicles be located in the environment or in the head. The social and pragmatic nature of the use of concepts and conceptual content makes it unnecessary and indeed impossible to locate the entities that realize conceptual mental episodes in non-personal or subpersonal contentful entities (vehicles). Persons, who engage in social practices of deontic scorekeeping (Brandom), and who are thus able to produce appropriate inferential behaviour, enact conceptual mental episodes and the basis of their supervenience.