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)

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)

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)

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)

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)

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)

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)

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)

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.".

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)

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)

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)

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 comprehensive text shows how various notions of logic can be viewed as notions of universal algebra providing more advanced concepts for those who have an introductory knowledge of algebraic logic, as well as those wishing to delve into more theoretical aspects.

J. B. Schneewind's "The Invention of Autonomy" has been hailed as a major interpretation of modern moral thought. Schneewind's narrative, however, elides several serious interpretive issues, particularly in the transition from late medieval to early modern thought. This results in potentially distorted accounts of Thomas Aquinas, Hugo Grotius, and G. W. Leibniz. Since these thinkers play a crucial role in Schneewind's argument, uncertainty over their work calls into question at least some of Schneewind's larger agenda for the history of ethics.

Jurgen Habermas' construction of a critical social theory of society grounded in communicative reason is one of the very few real philosophical inventions of recent times that demands and repays extended engagement. In this elaborate and sympathetic study which places Habermas' project in the context of critical theory as a whole past and future, J. M. Bernstein argues that despite its undoubted achievements, it contributes to the very problems of ethical dislocation and meaninglessness it aims to diagnose and remedy. Bernstein (...) further argues that the precise character of the failures of Habermas' program demonstrate the necessity for a return to the first generation critical theory of Adorno. Reading across nearly the whole range of Habermas' corpus, Recovering Ethical Life traces the development of the theory of communicative reason from its inception in Knowledge and Human Interests through its elaboration in The Theory of Communicative Action and into its defense against postmodernism in The Philosophical Discourse of Modernity . In separate chapters Habermas' readings of Freud, Durkheim amd Mead, Adorno and Foucault, Castoriadis and Taylor are critically examined. The focus of Bernstein's analyses, however, is always problem centered and thematic rather than textual psychoanalytic theory as an account of self knowledge, the competing claims of ethical identity and moral reason, the place of judgment in practical reason, and the debate between philosophies of language based communities versus those oriented towards world-disclosure. Critical theory is unique among current philosophies in engaging with the problems of social injustice and nihilism by siding with an abstract moral reason that forfeits the processes of intersubjective recognition it intended to salvage. Even in the fine grain of Habermas' account of performative contradictions and the theory of discourses of application, Bernstein perceives a squandering of the resources of an ethical life in need of transfiguration. (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)

That space and time should be integrated into a single entity, spacetime, is the great insight of Einstein's special theory of relativity, and leads us to regard spacetime as a fundamental context in which to make sense of the world around us. But it is not the only one. Causality is equally important and at least as far as the special theory goes, it cannot be subsumed under a fundamentally geometrical form of explanation. In fact, the agent of propagation of (...) causal influence is electromagnetic radiation. In this examination, the authors find support for a rationalist approach to physics, never neglecting experimentation, but rejecting a simple empiricist or positivist view of science. (shrink)

In focusing on the story of Darwin's religious doubts, scholars too often overlook Darwin's positive contribution to the study of religion. J. David Pleins traces Darwin's journey in five steps. He begins with Darwin's global voyage, where his encounter with religious and cultural diversity transformed his understanding of religion. Surprisingly, Darwin wrestles with serious theological questions even as he uncovers the evolutionary layers of religion from savage roots. Next, we follow Darwin as his doubts about traditional biblical religion take root, (...) affecting his career choice and marriage to Emma Wedgwood. Pleins then examines Darwin's secret notebooks as he searches for a materialist theory of religion. Again, other surprises loom as Darwin's reading of Comte's three stages of religion's development actually predate his reading of Malthus. Pleins explores how Darwin applied his discovery to the realm of ethics by formulating an evolutionary view of the "Golden Rule" in his Descent of Man. Finally, he considers Darwin's later reflections on the religion question, as he wrestled with whether his views led to atheism, agnosticism, or a new kind of theism. The Evolving God concludes by looking at some of the current religious debates surrounding Darwin and suggests the need for a deeper appreciation for Darwin as a religious thinker. Though he grew skeptical of traditional Christian dogma, Darwin made key discoveries concerning the role and function of religion as a natural evolutionary phenomenon. (shrink)

This book takes on two main tasks. The first is to argue that anti-hedonism lies at the center of Plato's critical project in both ethics and politics. Plato sees pleasure and pain as our sole sources of empirical evidence about good and bad. But as sources of evidence they are highly fallible; contrast effects with pain intensify certain pleasures, including most pleasures related to the body and social standing. This leads us to believe that the causes of such pleasures (e.g. (...) food, drink, sex, status) are greater goods than they are, and greater goods than other, more important goods (e.g. virtue, knowledge). As a result, hedonic error produces the belief that vice, including injustice, can be prudent. Hedonic error leads to other misconceptions of virtue as well, such as that wisdom is weak and can be ruled by the passions. These cognitive distortions can only be corrected by reference to some non-hedonic standard, so hedonists reliably fall prey to them. This entire system of attitudes—hedonism and its associated misconceptions of virtue—is widely held and constitutes popular morality. Popular morality's basic source is hedonic error, but it is also transmitted and sustained in society through shame and fear of punishment. However, avoiding shame and punishment requires a sort of double-think: adherents of popular morality must accept certain views that they cannot acknowledge too clearly or too publicly. For example, they must hold that injustice can be prudent and must be willing to wrong out-groups (e.g. another city), but openly acknowledging this same view threatens in-groups (one's own city) by implying willingness to wrong some in the city to benefit a closer in-group (e.g. one's class, clique, or family). // -/- The book's second task is to tackle a seeming outlier to Plato's anti-hedonism: the _Protagoras_, where Socrates appears to defend hedonism. I argue that the _Protagoras_ actually perfectly illustrates Plato's anti-hedonism, as explained above. Protagoras and other sophists think they shape public opinion, but in fact they have internalized popular morality through shame and fear. As a result, Protagoras accepts but refuses to openly endorse three parts of popular morality: that injustice can be prudent (333c), that pleasure is the good (351c-d), and that wisdom is weak and can be ruled by the passions (352c-d). Each time, his concealed view is (aptly!) attributed to "the many". So, when Socrates appears to endorse hedonism in the _Protagoras_, he actually introduces and develops the view as part of his examination of Protagoras' covert ethical commitments. (shrink)

This article reflects a conversation between Jan G. van der Watt and Stephan Joubert. The article serves as the introduction to the Special Collection: ‘From timely exegesis to contemporary ecclesiology: Relevant hermeneutics and provocative embodiment of faith in a Corona-defined world – Festschrift for Stephan Joubert, sub-edited by Willem Oliver ’. Following a brief bio-statement as introduction, the following issues are discussed: the collection for the Jerusalem church; relevance of theology for society; social-scientific exegesis; the ancient concept of grace; Bible (...) translation in South Africa; public theology on the electronic platform; biblical examples of leadership and electronic media in religious activities and education.Contribution: This Festschrift represents current trends in biblical scholarship and ecclesial leadership. It contributes to the public discourse in church and society, especially the role of the electronic media in current Fourth Industrial Revolution. (shrink)

This chapter focuses on the question of quantitativeness – of identifying the feature that makes quantitative properties quantitative. The chapter begins with two traditional attempts at capturing what makes a property quantitative – being numerical and being determinable – and argues that neither is satisfactory. The chapter then turns to influential recent proposals which, inspired by the Representational Theory of Measurement, attempt to identify particular relations as characteristic of quantitative properties. These attempts fare better than the traditional ones, but have (...) their own limitations. It concludes with a discussion of a new recent criterion for quantitativeness, which builds on a more abstract understanding of the representational theory of measurement. (shrink)