Mind-brain Dualism Research Articles

Mind-Body dualism and medical student attitudes toward mental illness in Saudi Arabia.

Philosophical beliefs regarding the origin of mental illness may underlie resistance to psychiatric treatment and affect attitudes toward the mentally ill. The present study sought to: (1) identify characteristics of medical students who hold mind-brain dualism (MBD) beliefs and (2) determine relationships between MBD beliefs and perceptions of mental illnesses. This was a cross-sectional study that asked medical students questions about mind-brain beliefs and religiosity. Three fictitious vignettes (schizophrenia, antisocial personality disorder [APD], and depression) were presented and then students asked about how much participants felt the patients in these scenarios bore responsibility for their illness. A MBD score was calculated to measure MBD beliefs, and a total responsibility score (RS) was used to measure patient blameworthiness. Mediation analysis was used to examine whether MBD beliefs explained the relationship between religiosity and perceived patient responsibility for their illness, and whether this was moderated by gender. The questionnaire was completed by 106 Saudi medical students. The average RS was highest for the APD scenario and lowest for schizophrenia, whereas depression fell intermediate between those two (ANOVA F (1.82, 219.83) = 27.21, P < .001). Religiosity was positively correlated with RS, a relationship that was mediated by MBD in all three vignettes. Mind-brain dualism beliefs among medical students in Saudi Arabia were associated with greater perceptions of self-infliction, preventability, controllability, and blameworthiness for patients with mental illness, moderated by gender. Greater emphasis on the neurobiological aspects of psychiatric disorders might help to change this attitude.

How to construct neuroscience-informed psychiatric classification? Towards nomothetic networks psychiatry.

Psychiatry remains in a permanent state of crisis, which fragmented psychiatry from the field of medicine. The crisis in psychiatry is evidenced by the many different competing approaches to psychiatric illness including psychodynamic, biological, molecular, pan-omics, precision, cognitive and phenomenological psychiatry, folk psychology, mind-brain dualism, descriptive psychopathology, and postpsychiatry. The current “gold standard” Diagnostic and Statistical Manual of Mental Disorders/International Classification of Diseases taxonomies of mood disorders and schizophrenia are unreliable and preclude to employ a deductive reasoning approach. Therefore, it is not surprising that mood disorders and schizophrenia research was unable to revise the conventional classifications and did not provide more adequate therapeutic approaches. The aim of this paper is to explain the new nomothetic network psychiatry (NNP) approach, which uses machine learning methods to build data-driven causal models of mental illness by assembling risk-resilience, adverse outcome pathways (AOP), cognitome, brainome, staging, symptomatome, and phenomenome latent scores in a causal model. The latter may be trained, tested and validated with Partial Least Squares analysis. This approach not only allows to compute pathway-phenotypes or biosignatures, but also to construct reliable and replicable nomothetic networks, which are, therefore, generalizable as disease models. After integrating the validated feature vectors into a well-fitting nomothetic network, clustering analysis may be applied on the latent variable scores of the R/R, AOP, cognitome, brainome, and phenome latent vectors. This pattern recognition method may expose new (transdiagnostic) classes of patients which if cross-validated in independent samples may constitute new (transdiagnostic) nosological categories.

Mind-Brain Dualism in Psychiatry: Ethical Implications.

Psychiatric disorders are often described as disorders of the mind. Major depressive disorder (MDD), generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), and posttraumatic stress disorder (PTSD) are categorized by varying degrees of psychomotor, cognitive, affective, and volitional impairment (1). Many explain them in psychological terms without referring to an underlying neural substrate (2). This position may be traced to Freud's failed attempt to link neural mechanisms to psychodynamic concepts in his Project for a Scientific Psychology. It led him to abandon neurology in favor of psychoanalysis (3). Karl Jaspers later stated that biological and psychological investigations of the mind are like “the exploration of an unknown continent from opposite directions, where the explorers never meet because of the impenetrable country that intervenes (4).” Jaspers was not endorsing substance dualism, the theory that brain and mind are ontologically distinct material and immaterial substances (5). He was making an epistemological claim, noting that we have an incomplete understanding of the brain and mind and how they interact. Some contemporary psychiatrists seem to interpret the idea of biology and psychology coming from “opposite directions” as suggesting an epistemological and explanatory dualism between neural and mental processes. This appears to be part of an “identity crisis” in psychiatry reflecting disagreement about characterizing psychiatric disorders as disorders of the mind or brain (6). Dualism as such does not preclude mind-brain interaction. But it supports the position that mind and brain can be functionally distinct. I argue that this is not consistent with neuroscience research showing the extent to which mental and neural processes are interdependent and influence each other in maintaining mental health or causing mental illness. Dualistic thinking of the type I have described can limit therapeutic interventions for patients suffering from major psychiatric disorders.

Beyond mind–body dualism: embracing pluralism in psychiatric research—introduction to the special issue, “Psychiatry and Its Philosophy”

The special issue, “Psychiatry and Its Philosophy,” focuses on addressing the mindbrain dualism and connected problems in the clinical and scientific contexts of psychiatry. Authors in this special issue address the theoretical disagreements that are manifest in the clinical and scientific goals of psychiatry and explore the possibility of reconciling the claim that research on psychopathology needs to be scientific with the claim that it needs to address the needs of patients in the clinic. Our approach is forward looking and concerned with drawing on ideas and methods from the philosophy of science (including philosophy of cognitive science and neuroscience) and philosophy of mind to promote pluralism in psychiatry.

NATURE AND SPIRIT IN TRIPLE-ASPECT MONISM

Despite having philosophy been modernly addressed to mind rather than to brain (or to metaphysics rather than to physics), the field of neurophilosophy could represent the reoccurrence of the pretension to embrace totality. By overcoming the traditional opposition between undifferentiated monism and mind-brain dualism, Pereira Jr.’s Triple-Aspect Monism (TAM) would be more than just a conciliation or an insertion of dualism into a physicalist regard of biology. In this essay, TAM is, then, correlated to the Hegelian philosophy, in order to identify its elements as a means of reaction to mind-brain dualism, as Hegel opposed to dualism in modern philosophy. There are, thus, mainly four topics discussed in this essay that summarize the correlation between Hegelian dialectics and TAM: (1) The triadic structure of being, nothing and becoming, – also in the form of the universal, the particular and the singular – connected to the three layers of physiological, unconscious/informational and conscious processes; (2) the idea of morality and ethical life as a result from physical interactions, which include intentionality, exchange of information waves and physical-chemical-biological exchanges; (3) the forms of Aristotle incorporated in Hegel’s idea of the Absolute’s movement, which overcomes the modern opposition between nature and spirit as different entities; and (4) Hegel’s considerations of the game of forces, compatible to TAM’s contemporary scientific approach.

Prevelance and determinants of mind-brain dualism among Saudi medical students

Prevelance and determinants of mind-brain dualism among Saudi medical students

Functional dystonia and the borderland between neurology and psychiatry: New concepts.

Mind-brain dualism has dominated historical commentary on dystonia, a dichotomous approach that has left our conceptual grasp of it stubbornly incomplete. This is particularly true of functional dystonia, most diagnostically challenging of all functional movement disorders, in which the question of inherent psychogenicity remains a focus of debate. Phenomenological signs considered in isolation lack the specificity to distinguish organic and nonorganic forms, and dystonia's variability has frustrated attempts to develop objective laboratory-supported standards. Diagnostic criteria for functional dystonia that place emphasis on psychiatric symptoms perform poorly in studies of reliability, partly explained by the high frequency of psychopathology in organic dystonia. Novel approaches from the cognitive neurosciences may offer a way forward. Theory on Bayesian statistical prediction in cognitive processing is supported by sufficient experimental evidence for this model to be taken seriously as a way of reconciling contradictory notions about voluntary and unconscious motor control in functional movement disorders. In a Bayesian formulation of functional dystonia, misallocation of attention and abnormal predictive beliefs generate movements that are executed without a sense of agency. Building on this framework, there is a consensus that a biopsychosocial approach is required and that a unified philosophy of brain and mind is the best way to locate dystonia in the neurology-psychiatry borderland. At a practical level, movement disorder neurologists are best placed to differentiate organic from functional dystonia. The main role of psychiatrists is in the diagnosis and management of the primarily psychiatric disorders that often accompany dystonia. © 2016 International Parkinson and Movement Disorder Society.

Look Again: Effects of Brain Images and Mind–Brain Dualism on Lay Evaluations of Research

Brain scans have frequently been credited with uniquely seductive and persuasive qualities, leading to claims that fMRI research receives a disproportionate share of public attention and funding. It has been suggested that functional brain images are fascinating because they contradict dualist beliefs regarding the relationship between the body and the mind. Although previous research has indicated that brain images can increase judgments of an article's scientific reasoning, the hypotheses that brain scans make research appear more interesting, surprising, or worthy of funding have not been tested. Neither has the relation between the allure of brain imaging and dualism. In the following three studies, laypersons rated both fictional research descriptions and real science news articles accompanied by brain scans, bar charts, or photographs. Across 988 participants, we found little evidence of neuroimaging's seductive allure or of its relation to self-professed dualistic beliefs. These results, taken together with other recent null findings, suggest that brain images are less powerful than has been argued.

Crimes Against Minds: On Mental Manipulations, Harms and a Human Right to Mental Self-Determination

The neurosciences not only challenge assumptions about the mind’s place in the natural world but also urge us to reconsider its role in the normative world. Based on mind-brain dualism, the law affords only one-sided protection: it systematically protects bodies and brains, but only fragmentarily minds and mental states. The fundamental question, in what ways people may legitimately change mental states of others, is largely unexplored in legal thinking. With novel technologies to both intervene into minds and detect mental activity, the law should, we suggest, introduce stand alone protection for the inner sphere of persons. We shall address some metaphysical questions concerning physical and mental harm and demonstrate gaps in current doctrines, especially in regard to manipulative interferences with decision-making processes. We then outline some reasons for the law to recognize a human right to mental liberty and propose elements of a novel criminal offence proscribing severe interventions into other minds.

How Drugs can Stimulate Psychic Functions – Using Caffeine as an Example

Mind–Brain dualism is still a hotly debated issue.1,2 I am neither qualified nor inclined to outline the intricacies of these philosophical controversies. However, one aspect deserves attention by a pharmacologist: some forms of very strict dualism have problems in dealing with the fact that drugs can alter cognitive states. It also seems to me that the challenge would become even stronger if one could demonstrate not only that a drug can alter a mental state, but also provide a clear cellular mechanism of how this is brought about. This is what I will try to do in this brief essay. I will not, however, even try to consider how the effect on specific brain cells is translated into something that we perceive as mental.

Drs. Miresco and Kirmayer Reply

TO THE EDITOR: In their thought-provoking vignette-based study (1), Mark J. Miresco, M.D. and Laurence J. Kirmayer, M.D., F.R.C.P.C. report that psychologists and psychiatrists are more likely to hold individuals responsible for harmful behavior caused in part by a personality disorder than for behavior that stems in part from an antidepressant-induced manic episode. Yet because personality disorders have genetic (i.e., biological) underpinnings, the authors conclude that clinicians utilize a discredited “mind-brain dualism” and maintain an “entrenched,” misguided “dichotomy between intentional and unintentional events” (p. 914). A false mind-brain dichotomy is not the only possible explanation of the study’s findings, however. The study did not control adequately for rationality and biological causation differences. Both mania and personality disorders may have biological underpinnings, but mania usually compromises a person’s capacity for rationality considerably more than a personality disorder. It is therefore no surprise that mania was negatively correlated with responsibility. It is also not surprising that responsibility was negatively correlated with biological causation: the mania vignettes described a clearly biological cause for the clinical condition, but the source of the personality disorder was left unspecified. Thus, biological causation was made vastly more salient in the mania condition, which was already weighted toward nonresponsibility. The authors’ discussion claims that clinicians feel that people have less control over having a biologically-caused clinical condition than a psychologically-caused condition. The study results do not support this conclusion, however. The study tested perceptions of responsibility for intentional, harmful actions (causing bankruptcy, reckless sexual conduct, stabbing). Whatever one believes about persons’ control over their actions, this is not the same as one’s beliefs about control over clinical conditions. It is the “fundamental psycholegal error”(2) to suppose that biology or any other type of causation precludes blameworthiness for harmful actions if the behavior reflects choices that might be influenced by reason, including better recognition of and attention to long-term consequences. The mindbrain problem is ferociously complex. But when we ascribe responsibility for behavior, the key factor—both in morality and law—is not causation, but whether the behavior reflects a rational process that might be influenced by foreseeable outcomes and consequences. Modern societies do not punish people for having psychiatric disorders because disorders are not intentional actions that can be influenced by reason. We may hold individuals responsible for intentional actions produced in part by disorder if the individuals retain sufficient capacity for rationality to be influenced by the prospect of foreseeable harms and potential criminal sanctions. We suspect that the clinicians studied by Drs. Miresco and Kirmayer may have intuitively utilized similar ways of judging responsibility and self-control, irrespective of their views about the mind-brain problem.

Drs. Miresco and Kirmayer Reply

Back to table of contents Previous article Next article Letters to the EditorFull AccessDrs. Miresco and Kirmayer ReplyMARC J. MIRESCO, M.D.LAURENCE J. KIRMAYER M.D.,MARC J. MIRESCO, M.D.Search for more papers by this authorLAURENCE J. KIRMAYER M.D.Search for more papers by this author,Published Online:1 Nov 2006AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail To the Editor: Drs. Mossman and Morse raise several interesting and important points in their letter, and we address each of them in turn.First, they question our conclusions by suggesting that differences in the “capacity for rationality” associated with different psychiatric disorders may have determined our respondents’ judgments of responsibility, rather than assumed biological or psychological etiology. This suggestion, while intriguing and potentially fruitful as an avenue for further research, does not preclude our study’s conclusions. The simple fact that scores for biological and psychological etiology were inversely correlated across the vignettes supports the conclusion that a mind-brain dichotomy informs psychiatric clinical reasoning. Mind-brain dualism is indeed a complex phenomenon, and in our article, we acknowledge the fact that other factors besides judgments of responsibility may underlie this dichotomy. However, it was not necessary to control for all such potential factors in our experiment because there is no reason to assume that human causal reasoning processes cannot be determined by multiple factors or that various domains of causal reasoning cannot be interrelated.The commentators then argue that the vignettes of the antidepressant-induced manic episode were biased because they included a “clearly biological cause,” whereas the cause was left unspecified in the personality disorder vignettes. Although an antidepressant may trigger a manic episode, the causes of bipolar disorder remain as elusive as those of the personality disorders. Moreover, the personality disorder vignettes also described a trigger, which in those cases was an interpersonal one. There is no evidence that the effects of an interpersonal stressor are any less biological in nature than those of an antidepressant. The fact that most clinicians consider an antidepressant to be more “biological” is exactly the sort of reasoning that we sought to expose and explicate in our study.Drs. Mossman and Morse also object to our conclusions regarding our respondents’ appraisals of different clinical conditions and suspect that it may have been the actual behaviors in these vignettes (bankruptcy, stabbing the wife, contracting human immunodeficiency virus [HIV]) that led to these appraisals. However, as we reported in our article, the three behaviors in the vignettes did not account for any significant differences in the scores of biological or psychological etiology using multivariate repeated-measures analysis of variance, and although the responsibility scores did show a statistically significant difference in this test, this difference was only a slight one between the HIV-risk and wife-stabbing behaviors. In contrast, the three vignette conditions (mania, narcissistic personality disorder, heroin addiction) showed robust differences with respect to biological and psychological etiology and responsibility scores. It is based on these results that we were able to conclude that the vignette conditions, much more than the specific behaviors, determined the respondents’ attributions. Certainly, it is important to distinguish causality, responsibility, and blame in moral and legal reasoning (1) . However, everyday reasoning often conflates and confounds these dimensions or uses them for strategic purposes (2) , and it precisely this confusion that constitutes the problematic aspect of the persistent mind-brain dualism we find in clinical reasoning. Montreal, Que., Canada

A Neuroscientist–Consumer Alliance to Transform Mental Health Care

The field of mental health has long suffered from a lack of convergence of disciplines that deal with the mind, the brain, and behavior. This mind-brain dualism has been particularly detrimental for consumers and their families who daily face stigma and discrimination. The understanding of the brain and its dysfunctions has benefited from the study of the human genome and, in particular, of the mutations and variations in its code. This analysis permits a better understanding of the biological basis of mental disease and will soon inform a generation of new diagnostic tools and individualized pharmacological therapies. A biological perspective on mental illness will be complemented by the analysis of the social factors influencing people's behavior and their impact on brain biology and gene function. Neurobiology has progressed to a level for which the knowledge that is generated, even if still colored with uncertainty, could represent a catalyst for the creation of an alliance between neuroscientists and consumers. This partnership has the potential to benefit both parties but will require some concrete steps that might be outside of the usual courses of action for both consumers and scientists. It is by building collaborations based on personal contact and information sharing that a transformation of the mental health care system can occur.

Recognising and evaluating disordered mental states: a guide for neurologists

The overlap between neurology and psychiatry should be obvious, given the two disciplines’ shared concerns with disorders of the human nervous system and the effect of these disorders on such...

The metaphysical mind in its physical environment: Religious implications of neuroscience

This article introduces ideas originating from different sciences of mind and the challenge they present to religion. In spite of overcoming the mind-body dualism, it seems that the mind-brain dualism still prevails. The mind-brain relation is discussed in the light of some models. Special attention is given to supervenient theories of mind. In light of this information the article investigates how the impact of these theories on religious experience. D’Aquili and Newberg’s explanation of extraordinary religious experience is discussed. It is concluded that the phenomenon of religion and religious experience are more than mere brain functions. The place of religion and the continued importance of religion and religious experience are confirmed.

Dr. Shulman Replies

Back to table of contents Previous article Next article Letter to the EditorFull AccessDr. Shulman RepliesROBERT G. SHULMAN, PH.D., ROBERT G. SHULMANSearch for more papers by this author, PH.D., New Haven, Conn.Published Online:1 Nov 2001https://doi.org/10.1176/appi.ajp.158.11.1940AboutSectionsView EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail To the Editor: Dr. Gossart’s reaffirmation of the mind-brain linkage was, as he indicated, in agreement with my review. Psychiatrists, among others, by interpreting functional imaging experiments in terms of incremental localized activity, assume a particular model of mind-brain dualism, which breaks the linkage. The mind, in this interpretation, consists of computer-like modules that respond to specific stimuli. My article showed high rates of neuronal firing in the resting brain, which are required for purposeful brain behavior. The presence of these large, meaningful neuronal activities at rest allows for explanations in terms of subjective dynamics. If psychiatry were to use its core understanding to interpret these measurements of resting brain activity, it would be well positioned to explore mechanisms linking brain and mind. However, if we continue to use a psychology that ignores unconscious activities in order to explain functional imaging, the mind, the behavior of the brain, will remain a distant, dualistic goal. FiguresReferencesCited byDetailsCited byNone Volume 158Issue 11 November 2001Pages 1940-1940 Metrics History Published online 1 November 2001 Published in print 1 November 2001

Connectionism and psychoanalysis.

A currently interesting set of models of perception, learning, and cognition--known as connectionist or neural net systems--have contributed to changes in the way cognitive scientists view brain function. A fruitful interaction between brain models and computer models leads us to think that the brain may be less dependent on a central processor, that there may be much brain work that is self-organizing, and that mind-brain dualism may be unnecessary. This article explores the implications for psychoanalytic theory that emerge from these new models.