This paper establishes a Kantian duty against screen overexposure. After defining screen exposure, I adopt a Kantian approach to its morality on the ground that Kant’s notion of duties to oneself easily captures wrongdoing in absence of harm or wrong to others. Then, I draw specifically on Kant’s ‘duties to oneself as an animal being’ to introduce a duty of self-government. This duty is based on the negative causal impact of the activities it regulates on a human being’s (...) mental and physical powers, and, ultimately, on the moral employment of these powers. After doing so, I argue that the duty against screen overexposure is an instance of the duty of self-government. Finally, I consider some objections. (shrink)

COVID-19 pandemic-related perceived risk of infection, illness fears, acute stress, emotional anxiety, exhaustion, and fatigue, psychological trauma and depressive symptoms, and sustained psychological distress can cause smartphone addiction risk and lead to technology-related cognitive, emotional, and behavioral disorders, thus impacting psychological well-being. Behavioral addiction of smartphone users can result in anxiety symptom severity, psychiatric symptoms, and depressive stress. We carried out a quantitative literature review of the Web of Science, Scopus, and ProQuest throughout June 2022, with search terms (...) including “smartphone addiction + COVID-19” + “stress,” “anxiety,” “depression,” “psychological distress,” “screen time,” and “fear.” As we analyzed only articles published between 2020 and 2022, 288 papers met the eligibility criteria. By excluding sources with similar titles, having unclear findings or unsupported by replication, or displaying inconsistent content, we selected 64, mainly empirical, sources. We used layout algorithms and bibliometric mapping as data visualization tools. Assessing the Methodological Quality of Systematic Reviews, a systematic review and literature review software, Mixed Methods Appraisal Tool, and Systematic Review Data Repository were employed as methodological quality assessment tools. As limitations, we analyzed only articles published between 2020 and 2022 in scholarly outlets indexed in the Web of Science, Scopus, and ProQuest databases. The scope of our study also does not advance the inspection of sources covering vulnerable individuals suffering from certain diseases or specific generations. Subsequent analyses should develop on smartphone use and addiction among children and adolescents. Future research should thus investigate problematic smartphone use and addiction across generations Z and Alpha. Attention should be directed to their personality traits and psychopathological symptoms. (shrink)

With the quickly rising popularity of smartphone among adolescents over the past decade, studies have begun to investigate the relationship between smartphone addiction and Eysenck's personality traits. Despite numerous studies on this topic, however, findings have been mixed and there is a lack of consensus regarding this relationship. Thus, this meta-analysis aimed to explore the relationship between smartphone addiction and Eysenck's personality traits in Chinese adolescents, as well as its possible moderators. Through literature search and screening, 33 studies (...) were included, comprising 79 independent effect sizes with a total of 17, 737 subjects. A random effects model was selected, and it was found that smartphone addiction was positively associated with psychoticism and neuroticism, but not significantly associated with extroversion. The moderating effect test showed that sex and year of study publication had significant influences on the relationship between smartphone addiction and psychoticism, and the year of study publication had a significant influence on the relationship between smartphone addiction and neuroticism. This study is the first meta-analysis on the relationship between smartphone addiction and Eysenck's personality traits among adolescents in China, and the results have helped to clarify the controversy of previous studies regarding this relationship. (shrink)

BackgroundIt is becoming increasingly apparent that the COVID-19 pandemic not only poses risks to physical health, but that it also might lead to a global mental health crisis, making the exploration of protective factors for mental well-being highly relevant. The present study seeks to investigate religious/spiritual well-being as a potential protective factor with regard to psychiatric symptom burden and addictive behavior.Materials and MethodsThe data was collected by conducting an online survey in the interim period between two national lockdowns with young (...) adults in Austria. The primary study variables were assessed through the Brief Symptom Inventory 18, the Alcohol, Smoking and Substance Involvement Screening Test and the Multidimensional Inventory for Religious/Spiritual Well-Being short version, with its sub-dimensions Hope, Forgiveness, General Religiosity, and Connectedness.ResultsWe observed HO and FO as substantial negative predictors of psychiatric symptom burden. With regard to addictive behavior, HO in particular but also GR seem to have a protective function. Furthermore, we found positive connections between CO, psychiatric symptom burden, and addictive behavior.ConclusionIn line with our assumptions, HO, FO and to a minor extent GR were confirmed as negative predictors regarding psychiatric symptom burden or addictive behavior in young adults, coping with the psychological threat of COVID-19 pandemic. These dimensions might be further considered as potential resources in clinical treatment. However, the positive prediction of mental illness parameters by increased feelings of CO could also be interpreted as an expression of exhaustion and alienation from the real world. (shrink)

This research qualitatively investigated four treatments for addiction in Brazil that use ibogaine as the main tool in the process. Ibogaine is a substance derived from an African plant, Tabernanthe iboga, traditionally used in its region of origin and which leads to intense sensations during its acute effects and also different experiences of oneself and the surrounding world in the period after its use. It’s considered a non‐typical psychedelic. We visited the clinics and interviewed professionals and patients of these (...) places. In this article, we focus on how ibogaine is used for addiction and depression treatment and how its effect is understood. There is variation in patient screening and preparation, how the ibogaine is determined, and the care practices proposed after the treatment. These variations seem to be influenced by the context where ibogaine is inserted and their practices. We identified three different contexts that influence ibogaine use in Brazil: the market of addiction treatment clinics, the Brazilian urban religious use of ayahuasca, and the medical context of ibogaine use developed by Howard Lotsof. (shrink)

Many parents worry over their children’s gaming habits, but to what extent do such worries match any detrimental effects of excessive gaming? We attempted to answer this question by comparing children of highly concerned parents with other adolescents of the same age. A cohort of parents who identified as highly concerned over their children’s video game habits were recruited for a public study in collaboration with a national television network. Using an online experimental platform in conjunction with surveys of parents’ (...) beliefs and attitudes, we compared their children to age-matched peers in an exploratory case-control study. The scores of children with highly concerned parents on tests of cognitive control and psychological wellbeing were statistically similar to controls, suggesting no selective cognitive or psychological detriments from gaming or otherwise in the cases with concerned parents. The case group, however, did spend more time gaming, and scored higher than controls on problem gaming indicators, which also correlated negatively with wellbeing. Within the case group, wellbeing effects seemed mainly to consist in issues of relaxation and sleep, and related to gaming addiction indicators of playing to forget real-world problems, and the feeling of neglecting non-gaming activities. Where most results of research staged for TV never get published, making it difficult to interpret both methods and results, this paper describes findings and participant recruitment in detail. The relationship between parental concern and children’s gaming is discussed, as is the merits and challenges of research conducted with media, such as TV programs and their recruited on-screen participants. (shrink)

Are you bored of the endless scroll of your social media feed? Do you swipe left before considering the human being whose face you just summarily rejected? Do you skim articles on your screen in search of intellectual stimulation that never arrives? If so, this book is the philosophical lifeline you have been waiting for. Offering a timely meditation on the profound effects of constant immersion in technology, also known as the Interface, Wish I Were Here draws on philosophical (...) analysis of boredom and happiness to examine the pressing issues of screen addiction and the lure of online outrage. Without moralizing, Mark Kingwell takes seriously the possibility that current conditions of life and connection are creating hollowed-out human selves, divorced from their own external world. While scrolling, swiping, and clicking suggest purposeful action, such as choosing and connecting with others, Kingwell argues that repeated flicks of the finger provide merely the shadow of meaning, by reducing us to scattered data fragments, Twitter feeds, Instagram posts, shopping preferences, and text trends captured by algorithms. Written in accessible language that references both classical philosophers and contemporary critics, Wish I Were Here turns to philosophy for a cure to the widespread unease that something is amiss in modern waking life. (shrink)

Since technology has been entering into human beings’ everyday life, individuals established a deep relationship with digital technology, thus an embodied link between people and digital instruments has been born. This is particularly evidenced by recent literature about screen time (duration of time spent by the individual in using electronic/digital media like television, smartphone, tablet or computer), it significantly influences different human beings’ dimensions: physical, psychological and neurological functions. Impact of digital technology on human beings can be considered as (...) a result of syntonic functioning in order to improve different people’s life areas (e.g., work, social or intimate relationship, learning), while the dystonic relationship is evidenced as a result of human addiction to digital technology. The present study aims to provide a cognitive and social psychology perspective on how screen time is changing our existences, defining digital technology as a gift which people should be aware of in terms of positive but even negative consequences in everyday life. (shrink)

In the Netherlands, Forensic Flexible Assertive Community Treatment is used as a specialized form of outpatient intensive treatment. This outreaching type of treatment is aimed at patients with severe and long lasting psychiatric problems that are at risk of engaging in criminal behavior. In addition, these patients often suffer from addiction and experience problems in different areas of their life. The aim of this exploratory study was to gain more insight into the characteristics of the ForFACT patient population. More (...) knowledge about these patients may enhance the effectiveness of ForFACT and therefore reduce the risk of recidivism. Data on 132 ForFACT patients were gathered by studying electronic patient records, criminal records, and by conducting semi-structured interviews with practitioners and patients. Additionally, as part of a cognitive screening, two screening instruments were conducted to gain insight into intelligence and possible mild cognitive impairments. This article gives a broad description of the ForFACT patient population, including demographic data and context variables, diagnostics, recidivism risk and offense history, and aspects related to care. Furthermore, several recommendations are given to further improve ForFACT. Based on the results it can be concluded that the ForFACT patient population shows a high degree of diversity in complex care needs and responsivity issues. Therefore, this article highlights the necessity for ForFACT to collaborate with other mental health institutions, as well as probation officers, and forensic or criminal justice institutions. Moreover, it is important to continually check the inclusion and exclusion criteria when admitting patients to ForFACT, and to examine whether ForFACT is still the most adequate care for patients or if they need to be referred. In addition, the results emphasize the importance of cognitive screening for forensic outpatients. Finally, this study zooms in on the interface between forensic psychiatric care and general mental health care. (shrink)

“An original, compelling, and provocative exploration of ethical issues in our society, with thoughtful and balanced commentary. I have not seen anything like it.” —Alan Lightman, author of Einstein’s Dreams Drawing upon the author’s two decades teaching medical ethics, as well as his work as a practicing psychiatrist, this profound and addictive little book offers up challenging ethical dilemmas and asks readers, What would you do? A daughter gets tested to see if she’s a match to donate a kidney to (...) her father. The test reveals that she is not the man’s biological daughter. Should the doctor tell the father? Or the daughter? A deaf couple prefers a deaf baby. Should they be allowed to use medical technology to ensure they have a child who can’t hear? Who should get custody of an embryo created through IVF when a couple divorces? Or, when you or a loved one is on life support, Who says you’re dead? In short, engaging scenarios, Dr. Appel takes on hot-button issues that many of us will confront: genetic screening, sexuality, privacy, doctor-patient confidentiality. He unpacks each hypothetical with a brief reflection drawing from science, philosophy, and history, explaining how others have approached these controversies in real-world cases. Who Says You’re Dead? is designed to defy easy answers and to stimulate thought and even debate among professionals and armchair ethicists alike. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:CHRISTIANITY AND VIOLENCE: A RESPONSE TO ROBERT DALY Paul Nuechterlein Emmaus Lutheran Church, Racine, Wisconsin While listening to the presentations up to now, I've found myself to be continually scrapping what I was going to say and going on to something else. The only thing I've saved so far is to begin with a sincere thanks to you, Bob Daly, for this paper. It is such an excellent start (...) on the themes ofthis conference, to cover such a broad range ofthe history and the data of Christianity on the theme of violence and institution. And yet, through that broad range ofanalysis, you also help us to focus on what I see as some very important issues, especially the one that you lifted up and emphasized againjust now, the issue ofuniversal salvation. At the risk of sounding a bit like a schoolboy with a new vocabulary word, that issue is for me an insight, to usethatLonerganian term, thatbrings togethermany things under a single view. Iknow thatthere's been abroadrange ofinterestinviolence in general, and especially as it is manifested in Christian institutions of which Tm a part. Then there has also been an interest in the issue ofuniversal salvation. I've actually already been a believer, a hoper in that for quite some time. But the way that you brought them together in this paper, that is the insight for me. It is something that I honestly will take away from this conference as being very important. You've made us see that connection and from that to raise the question: if, as Christians, we continue to imagine ourselves as possibly destined to an ultimate violence of hell as a place of eternal damnation and torture, how much has that played a part in our earthly willingness to participate in violence? Does it make it easier for us to say yes to violence here in this life, when we can imagine ourselves as possibly destined to an ultimate violence? You make that connection, you mention Paul Nuechterlein35 it as a massively central problem, and you've convinced me of it. I think its something we needto work on. We now need to find ways of lifting up that minority viewpoint of hoping for universal salvation to become once again the majority viewpoint. The question thus focuses on the strategy of how to do that. Because there's always the danger that, as we become zealous about something, we can start presenting it in a forceful and violent way. For instance, people could come away from what we're trying to convince them of, and ask themselves: "Gee, did he just say something like: 'You're going to Hell if you don't stop believing in Hell.'?" We can perhaps come across that way if we're too forceful about it. Before your remarks, I hadn't made the connection with the Vietnam War. I hadn't noticed how much that could help us toward the strategy we seek. What turned the American people against the war was seeing its violence on their TV screens, violence that didn't fit in with their imaginative view of themselves. Is there a way in which we can work that sort of strategy by replacing our imagination of ultimate violence with at least the hope of universal salvation? One of my favorite stories—itjust came to me as you were talking—is from the Lynn Brothers, Matthew and Dennis, two Catholic priests or former Catholic priests. They have a little book about the goats, from the image of Matthew 25 on the separation of the sheep from the goats. They tell a story about working with a woman who came to one of them in counseling, frightened for her son. Her son had been in all kinds of addiction problems, all kinds of trouble with the law throughout his life, and was coming to apoint where he was really bottoming out. And through all ofthat, the thing that she still worried about the most was: when he dies, is he going to go to hell? The problem, of course, was that she was still holding on to that majority vision, and I think it... (shrink)

James Bond 007 strode into the human imagination in the novel Casino Royale in 1953 and hit the movie screens with Dr. No in 1962. He has become one of the best-known personalities, real or imagined, in global history. One out of every four people in the entire world has now seen a Bond movie, and every month thousands of new readers become addicted to Ian Fleming’s original Bond stories. In James Bond and Philosophy, seventeen scholars examine hidden philosophical issues (...) in the hazardous, deceptive, glamorous world of Double-0 Seven. Is Bond a Nietzschean hero who graduates "beyond good and evil"? Does Bond paradoxically break the law in order, ultimately, to uphold it like any "stupid policeman"? What can Bond’s razor-sharp reasoning powers tell us about the scientific pursuit of truth? Does 007’s license to kill help us understand the ethics of counterterrorism? What motivates all those despicable Bond villains—could it be a Hegelian quest for recognition? (shrink)

Background: Psychopathy and substance use disorders are highly co-morbid and their co-occurrence is associated with higher severity of addictive behavior and increased risk of violent offending. Both substance use disorders and psychopathy are related to prominent impairments in emotion processing, which are also central features of alexithymia. The nature of the relationship between psychopathy and alexithymia is not well understood and has been particularly understudied among substance dependent individuals. Aims: Our goal was to evaluate the levels of psychopathy and alexithymia (...) in a relatively homogeneous sample of heroin dependent individuals and healthy controls and to examine group differences in the pattern of associations between these constructs. Methods: We examined 62 participants (31 heroin dependent individuals and 31 healthy controls) with the Psychopathy Checklist: Screening version (PCL:SV, Hart et al., 1995) and the Toronto Alexithymia Scale-20 (TAS-20, Bagby et al., 1994). Results: Heroin dependent individuals were characterized by higher levels of both psychopathy and alexithymia as compared to the control group. In addition, heroin dependent individuals with higher levels of psychopathy reported more difficulties in identifying and verbalizing emotional states. In the heroin group, alexithymia was more strongly associated with the impulsive/antisocial characteristics (impulsivity, irresponsibility, antisocial behavior) than with the interpersonal/affective features of psychopathy (grandiosity, manipulativeness, lack of empathy and remorse). Conclusions: Our findings suggest that alexithymia may be one potential mechanism linking psychopathy with opioid use disorders. The development of interventions targeting alexithymia could have significant applications in relapse prevention programs and psychotherapy of substance use disorders with concurrent psychopathy. (shrink)

This book is a vibrant investigation on a deeply human subconscious desire: the desire for omnipresence, or in a nutshell, the desire to be here, there, and everywhere at the same time. After all, why is it not enough just to be in the offline ordinariness of the here and now? To answer this question, Camila Mozzini-Alister does the crossing of two seemingly distant universes: mediation and meditation. Throughout a vigorous archaeology of the relationship between screen and mind allied (...) with an engaging first-person narrative, the author raises awareness of the risks of becoming addicted to social media and obsessed by meditation. This brings forth a vital question: what are the limits for the desire to be more than a body? (shrink)

La multiplication sur Internet des dispositifs « interactifs » interroge les enjeux et les principes des nouvelles formes de communication qui envahissent les systèmes techniques contemporains. La banalisation et la généralisation de ces agencements machiniques remettent en question les frontières traditionnelles entre l’image et le réel, le regard et l’écran, le sens et le message, le sujet et le monde, le public et le privé, le pouvoir et la captation, la présence et l’absence, le désir et le manque...The increasing number (...) of « interactive » devices on Internet addresses the question of the stakes and principles linked to the new forms of communication invading contemporary technical systems. The trivialization and extension of these tools are a challenge to the standard boundary line between images and reality, the viewer and the screen, meaning and message, the individual and the world, the public and private spheres, power and addiction, presence and absence, desire and need.. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Journal of Aesthetic Education 37.2 (2003) 73-79 [Access article in PDF] Does Film Weaken Spectator Consciousness? R.D. Boyd and S.K. Wertz The role of spectator is crucial for an actor, for there are "no actors without spectators." 1 At times the success of the actor depends upon the role taken by the spectator. Thornton Wilder's "Our Town" depends upon an active,creative, involved audience. Other artists expect their audience (...) to be passive,almost unconscious. Whether the medium of creativity is film or the printedpage, examples of both dependencies abound. The focus of this essay is ona classic piece in the literature about film. In the Theory of Film, Siegfried Kracauer provides us with a mesmerizing printed discussion of film. 2 In this essay we wish to examine his reasoning that is in a self-contained argument by analogy. Since Kracauer does not use or mention the argument thereafter, we feel that we can isolate the argument from its context and deal with it as it stands. After an extended analysis of the argument, we will relate some of the points to the literature on film. The following analogical argument is our focus. Films...tend to weaken the spectator's consciousness. Its withdrawal from the scene may be furthered by the darkness in moviehouses. Darkness automatically reduces our contacts with actuality, depriving us of many environmental data needed for adequate judgments and other mental activities. It lulls the mind....Devotees of film and its opponents alike have compared the medium to a sort of drug and have drawn attention to its stupefying effects....Doping creates dope addicts. It would seem a sound proposition that the cinema has its habitues who frequent it out of an all but physiological urge. They are not prompted by a desire to look at a specific film or to be pleasantly entertained; what they really crave is for once to be released from the grip of consciousness, lose their identity in the dark, and let sink in, [End Page 73] with their senses ready to absorb them, the images as they happen to follow each other on the screen. 3To support his main point, "Films...tend to weaken the spectator's consciousness," Kracauer develops three intermediate arguments (IA's), which support his major argument (MA). If each sentence in the above passage were numbered one through nine, with the last full sentence being broken into two sentences at the semicolon, the following schema emerges. In English the chain of reasoning is: IA-1 Some habitues of film are not prompted by a desire to look at a specific film or to be pleasantly entertained. What they really crave is release fromthe grip of consciousness, to lose their identity in the dark, and let sink in, with their senses ready to absorb them, the images as they happen to follow each other on the screen. Therefore, the cinema has its habitues who frequent it out of an all but physiological urge.IA-2 Some habitues of film frequent it out of an all but physiological urge. Doping creates dope addicts. Therefore, devotees of film and its opponents alike have compared the medium to a sort of drug and have drawn attention to its stupefying effects.IA-3 Darkness automatically reduces our contacts with actuality, depriving us of many environmental data needed for adequate judgments and other mental activities. Darkness lulls the mind. Therefore, consciousness withdrawal from the scene may be furthered by the darkness in moviehouses.MA Devotees of film and its opponents alike have compared the medium to a sort of drug and have drawn attention to its stupefying effects. Consciousness withdrawal from the scene may be furthered by the darkness in moviehouses. Therefore, films...tend to weaken the spectator's consciousness. The above chain of arguments influences us, the spectators, to embrace his main point. However, before we are lulled into accepting his reasoning, it will be helpful to examine and evaluate each link. [End Page 74]IA-1 Some habitues of film are not prompted by a desire to... (shrink)

ObjectiveA form of pathological social withdrawal which is also called hikikomori has been proved its existence in China. But the prevalence and characteristics of hikikomori in China remain unknown. Past studies had investigated the hikikomori phenomenon in three cities of China. The purpose of this study is to discover the prevalence of hikikomori in a convenient online sample in China as well as the difference in demographic characteristics and other possible traits between hikikomori sufferers and the general population.MethodsA total of (...) 1,066 youths in China completed the online questionnaire, which consisted of questions about demographics, the 25-item Hikikomori Questionnaire, the Internet Addiction Test, the Loneliness Scale, and the General Health Questionnaire. SPSS is used to evaluate the data.ResultsOf the 1,066 youths, 980 were identified as belonging to group A, 46 to group B, and 40 to group C. The hikikomori group accounted for 8.1%. The present data suggest that residence and loneliness are related to the occurrence of hikikomori. HQ-25 score of the hikikomori group was significantly higher than the comparison group. The UCLA score showed that those in the hikikomori group felt lonelier than those in the comparison. The regression model predicted hikikomori risk, the Hosmer-Lemeshow test value is 7.114 and P = 0.524 > 0.05.ConclusionThe grouping criterion in our present study is reasonable and such a grouping criterion can screen out potential populations of hikikomori. When people develop into hikikomori sufferers in the present, their social withdrawal behaviors and feeling of loneliness are both much more severe than in the past. The possible relationships between hikikomori and loneliness reflect the need to give the youths more social support, to help them connect with society. (shrink)

It is common for physicians who prescribe opioids for chronic pain to have their patients sign an opioid contract in order to receive opioid therapy. A vast majority of these contracts contain a stipulation requiring patients to submit to random drug testing which screens for both licit and illicit drugs. Physicians who prescribe opioids may be concerned about prosecution and disciplinary actions; medication abuse and misuse; and addiction. Steven Passik et al. write, “…physicians still fear the risk of abuse (...) or addiction as well as the potential legal consequences of their prescribing.”Issues surrounding OC/RDT need a closer look with a focus on enforceability and efficacy of the opioid contract; accuracy and complications of drug screens and their interpretation; and the importance of trust between patient and physician. In addition, it is vital to dispel fears with facts regarding prosecutions, nonmedical use of prescription opioids, and addiction. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:An Epidemic of Difficult PatientsKeva SouthwellAs the opioid epidemic marches on, we have all become familiar with a particular breed of "difficult patient," the intravenous drug user. Most teams try to get through these admissions with as few interactions as possible. Nurses will tell you how much they hate caring for these patients, often citing "they did this to themselves" as they experience prolonged admissions due to infections resulting (...) from Intravenous Drug Use (IVDU). Most services try to get out of admitting these patients, saying they are more appropriate with infectious disease, cardiology, or "anywhere but with me." These patients often use drugs in the hospital, threaten to leave AMA, and are dangerous, liable to assault or abuse the very staff trying to help them. The general consensus is that taking care of these patients is a dirty job … why do I have to do it?That's where I come in. It's a dirty job … and that's exactly why I do it. I run a unique service, where my preferred patients are those admitted for 6–8 weeks of IV antibiotics to treat their endocarditis. Some of these patients survive after discharge, but most don't. I know this. But it's my job to help them anyway. It just turns out that in these cases, help doesn't always look the way you think it will.In a perfect world, having a life-threatening infection would be the rock bottom these young people need to embrace a new way of life. Unfortunately, this world is far from perfect. Just as having diabetes doesn't make you stop wanting junk food, having endocarditis does not make you stop wanting drugs. In fact, it can be the opposite. [End Page 26] Drugs are often the coping tool these patients turn to. Happy? Use drugs. Sad? Use drugs. Scared? Use drugs. That's why it's hard. Addiction defies logic; it can be cunning, baffling, and powerful. Until you understand addiction, you'll never really find a way to treat these patients, let alone a way to enjoy treating them.We all have patients who change things for us. They shift our perspective, make us view our practice, our patients, and ourselves differently; patients who teach us the lessons not learned in school. I will never forget Jack, one of those "difficult patients." He taught me how to care for people who really can't be medically helped. It's a lesson that can take years to learn: You've got to let go of the outcome, and some solutions don't look the way you think they should. In this way, he helped me continue in this difficult work.I was a nearly new hospitalist, having just moved into this work from outpatient addiction care. Jack was a young man, 32 years old. He had presented to our hospital with endocarditis of the aortic and tricuspid valves secondary to IVDU. He was referred to my service when he was ineligible for valve replacement due to septic emboli in his brain and subsequent micro hemorrhage. The surgery team wanted him to recover from these events before considering surgical treatment.Jack was a big guy, over 6'2", with a weight to match. He was covered in tattoos—his back, arms, chest, and neck—not an inch was bare. His physical presence might be considered intimidating. Jack was a man of few words: he complained of very little, was often asleep during medical visits, never really left his room, and had no visitors. About four days after his arrival, nursing became concerned about illicit drug use. Despite the fact he had no orders for narcotics or other sedating meds, he was sleeping all the time. His drug screens were negative. Despite the lack of specific evidence, I was asked to take measures to ensure he was not using illicit drugs, which included placing him on a contract and ordering 1:1 observation.His fatigue was concerning, though not for drug use. A repeat ECHO showed that his aortic insufficiency was worsening. His tricuspid insufficiency was very bad from the start. His belly began to swell, followed by his... (shrink)

In technological societies where excessive screen use and internet addiction are becoming constant temptations, the valuable yet intoxicating pleasures of digital technology suggest a need to recover and repurpose temperance, a virtue emphasized by ancient and medieval philosophers. This article reconstructs this virtue for our technological age by reclaiming the most relevant features of Aristotle’s and Aquinas’s accounts and suggesting five critical revisions needed to adapt the virtue for a contemporary context. The article then draws on this critical (...) interpretation, along with empirical research analyzing the value and dangers of digital technology, to construct a normative account of digital temperance, a virtue that finds a mean between “digital insensibility,” the vice of deficiency, and “digital overindulgence,” the vice of excess. We conclude by showing how this virtue of digital temperance can help to promote human flourishing in a world saturated with tempting technology. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:When Is Enough, Enough?Megan HomsyThis was a case that stuck with many members of our transplant team for a long time. The patient was a 44-year-old Caucasian male evaluated for a liver transplant with a diagnosis of hepatitis C virus (HCV), originally diagnosed 11 years before the transplant evaluation. The patient met the criteria for the following substance use diagnoses: alcohol use disorder moderate in sustained remission, in a (...) controlled environment, opioid use disorder, severe, in sustained remission, on maintenance therapy, in a controlled environment, stimulant use disorder, amphetamine-type, severe, in early remission, in a controlled environment and stimulant use disorder, cocaine-type, severe in early remission, in a controlled environment.The patient had been living in a sober living housing program for approximately ten months prior to his transplant evaluation with me, his social worker. He had also been diagnosed with depression and bipolar disorder. He had been intermittently linked with mental health services and had participated in numerous detox and substance abuse programs over the last ten years, with varying degrees of success. He was in dual diagnosis treatment (i.e., treatment for co-occurring substance use and mental health disorders) through his Suboxone clinic and was completing toxicology screenings on a biweekly basis.After concluding the minimum three months of drug and alcohol treatment set forth by the state's Organ Transplantation Consortium, the patient graduated from his sober living program, moved in with his sister, and was listed for a liver transplant.The patient was transplanted five months after his clinic evaluation. At the time of the surgery, the patient's Suboxone was abruptly discontinued and replaced with IV Dilaudid. Within days of his transplant, the patient frequently expressed concerns about his pain. Several medical services attempted to manage the pain medications, resulting in his pain management plan being changed repeatedly and much confusion over his current medication regimen. During his liver transplant hospitalization, the RN found the patient with a needle in his arm, and after a search of the patient's hospital room, the hospital police found drug paraphernalia and illicit substances. The patient was eventually discharged to an inpatient substance abuse program, which he left before completing the program and against medical advice.During his first year post-transplant, I attempted to arrange other various treatment programs for him (most of which he did not follow through with) and to find housing for him (as he had been forced to leave his sister's home after his relapse). Eventually, the patient was incarcerated on drug-related charges. Numerous times, the patient missed completing his labs and his post-transplant appointments. He did not refill his immunosuppressant medications, and for lengthy periods of time, he was unreachable by the transplant care team, which resulted in my team members and I calling the patient's family, other providers, and the police for safety checks.In the aftermath of these issues, my colleagues and I had to reckon with the realization that we had failed the patient. As a team, our transplant center created a task force to review this case and what to do in the future to prevent such breakdowns in patient care. We created protocols for managing patients who, at the time of their transplant, are on Medication Assisted Treatment (MAT) such as Suboxone and methadone. Staff across the multidisciplinary team attended trainings regarding addiction, pain management, and best practices for MAT services. Additionally, our transplant center collaborated with our hospital's addiction treatment program for a streamlined referral process for transplant patients to addiction services.This patient's case and its sensational nature resulted in many conversations, both professional and unprofessional. Members of the social worker department became aware that personnel within transplant, though not involved in patient care, were inappropriately discussing this patient's case and engaging in unprofessional behavior. Said actions led to the termination of a member of the transplant team. I was placed in the unenviable [End Page E3] position of having to report this behavior to hospital management and legal teams to protect a vulnerable patient.The ethical challenge behind this case really stems from the transplant team attempting to balance two... (shrink)

To talk about automation and invisibility in our digitally projected world, I argue the case for the “cancelled” or lost voices of postphenomenology such as, most notably, Günther Anders. Reflecting on Nietzsche as on the role of GPS for location and for dating services like Grindr, I take up Nietzschean humanism including the fragility of his portable brass typing ball, latterly not unlike daisy wheel printer technologies and the programmed death of ink jet printers. With a casual reflection on pocket (...) robots and screen-intentionality, GPS, triangulating perambulation, and programmed addiction, I raise the necropolitical question of climate change as of technology and its scotosis. (shrink)

Putnam says that "In one way of conceiving it, realism is an empirical theory." In the present work it is maintained that, in another way of conceiving it, realism is a grammatical thesis. That is, many of the principles taken to be definitive of realism, e.g., "Truth is objective," "Truth is mind-independent," Dummett's "a thought can be true only if there is something in virtue of which it is true," are what Wittgenstein would have called "grammatical remarks." They simply call (...) attention to certain features of the grammar of truth and related concepts. Thus, e.g., it is a feature of the way we use "is true" that statements are not spoken of as true for one person and not true for another. ;The character of grammar and of grammatical remarks in general is spelled out in some detail; it is argued in particular that Wittgenstein is not intending to provide, by means of these notions, a particular account of necessary truth. He is suggesting, rather, that looking upon certain philosophical claims as grammatical is a way of "deflating" them, stripping them of their appearance of profundity. Neither can grammatical remarks imply substantive philosophical theses. This is why realism, conceived as comprising grammatical remarks, does not imply scepticism, as is often supposed, and is not itself a controversial or exciting doctrine. ;There are of course some controversial formulations of realism, versions which are not simply underwritten by grammar. Thus some philosophers have held that, because the truth conditions of a proposition are essentially independent of any evidence we may have for the proposition, truth may not be accessible at all. I believe, however, that Putnam has shown, by means of an argument which is instructively viewed as a grammatical investigation, that truth is accessible, at least to an "ideal" theory. ;Recent expressions of idealism are argued to provide helpful accounts of language use and understanding, but fail to establish that truth is nothing but warranted assertibility, or that it must in some sense "arise within us." Such a conclusion runs afoul of the grammar of truth, of which realism is shown to provide the proper account. (shrink)

The technological virtual converges with our contemporary existence in a multitude of ways, which suggests a need to interrogate the question of the virtual existentially. Merleau-Ponty’s existential phenomenological account of embodiment is invaluable in this regard because the virtual is encountered from the basis of the facticity of the embodied individual – a facticity that is closely related to perception and motor intentionality. The current article argues that these characteristics of the body-subject should be taken into consideration in order to (...) develop a clearer description of the virtual. However, beyond an embodied account that relates to early technologies, Merleau-Ponty also presents through his concept of the flesh a novel avenue for the ontological investigation of the virtual. The flesh describes the intertwining of the body-subject and the world, which is suggestive of a new account of the individual’s sensibility in relation to the virtual. An original concept is suggested to describe the existential-ontological structure of the virtual: The embodied screen. The embodied screen as neologism presents an alternative conceptualisation of the coincidence of the body-subject (who understands the world spatially) with the virtual (as non-spatial). By tracing imaginative signification and embodied habitude in terms of the virtual, this article suggests certain existential implications of the virtual for contemporary being. (shrink)

Suppose a rational agent S has some evidence E that bears on p, and on that basis makes a judgment about p. For simplicity, we’ll normally assume that she judges that p, though we’re also interested in cases where the agent makes other judgments, such as that p is probable, or that p is well-supported by the evidence. We’ll also assume, again for simplicity, that the agent knows that E is the basis for her judgment. Finally, we’ll assume that the (...) judgment is a rational one to make, though we won’t assume the agent knows this. Indeed, whether the agent can always know that she’s making a rational judgment when in fact she is will be of central importance in some of the debates that follow. (shrink)

Composed of a substantial introduction, twelve original essays produced for this volume, and a new English translation of a personal, intriguing, and little ...

Centre for Applied Philosophy and Public Ethics University of Melbourne, Parkville, 3010, Australia and.

Introduction : schizoanalysis, digital screens and new brain circuits -- Schizoid minds, delirium cinema and powers of machines of the invisible -- Illusionary perception and powers of the false -- Surveillance screens and powers of affect -- Signs of time : meta/physics of the brain-screen -- Degrees of belief : epistemology of probabilities -- Powers of creation : aesthetics of material-force -- The open archive : cinema as world-memory -- Divine in(ter)vention : micropolitics and resistance -- Logistics of perception (...) 2.0 : multiple screens as affective weapons -- Conclusion : the neuro-image : brain-screens from the future. (shrink)

Background: Screen time among adults represents a continuing and growing problem in relation to health behaviors and health outcomes. However, no instrument currently exists in the literature that quantifies the use of modern screen-based devices. The primary purpose of this study was to develop and assess the reliability of a new screen time questionnaire, an instrument designed to quantify use of multiple popular screen-based devices among the US population. -/- Methods: An 18-item screen-time questionnaire was (...) created to quantify use of commonly used screen devices (e.g. television, smartphone, tablet) across different time points during the week (e.g. weekday, weeknight, weekend). Test-retest reliability was assessed through intra-class correlation coefficients (ICCs) and standard error of measurement (SEM). The questionnaire was delivered online using Qualtrics and administered through Amazon Mechanical Turk (MTurk). -/- Results: Eighty MTurk workers completed full study participation and were included in the final analyses. All items in the screen time questionnaire showed fair to excellent relative reliability (ICCs = 0.50–0.90; all < 0.000), except for the item inquiring about the use of smartphone during an average weekend day (ICC = 0.16, p = 0.069). The SEM values were large for all screen types across the different periods under study. -/- Conclusions: Results from this study suggest this self-administered questionnaire may be used to successfully classify individuals into different categories of screen time use (e.g. high vs. low); however, it is likely that objective measures are needed to increase precision of screen time assessment. (shrink)

Addiction involves a chronic deficit in self-governance that treatment aims to restore. We draw on our interviews with addicted people to argue that addiction is, in part, a problem of self-narrative change. Over time, agents come to strongly identify with the aspects of their self-narratives that are consistently verified by others. When addiction self-narratives become established, they shape the addicted person’s experience, plans, and expectations so that pathways to recovery appear implausible and feel alien. Therefore, the agent (...) may prefer to enact her disvalued self-narrative because at least it represents who she takes herself to be. To recover, the agent needs to conduct narrative work, adjusting her existing self-narrative so that it better supports recovery-directed narrative projections. Reducing cravings, managing withdrawals, increasing self-control, and developing goals are all important for recovery but those approaches will often be in vain if the influence of self-narrative is ignored. If our analysis is correct, addiction treatment will typically be more effective if it incorporates support for self-narrative change. (shrink)

This paper attempts to reassess the educational affordances of digital screens, at a time when their educational impact has become incontournable, but is also increasingly growing suspicion. To bypass the redundancies of overly critical theoretical approaches, the paper foregrounds the subjectifying potentialities of the screen’s elusive technological ‘plasticity’. After the introduction, in which some pedagogical misgivings about the digital screen are addressed, we turn to Marie-José Mondzain’s historico-philosophical genealogy of iconoclasm. Trying to make sense of the aesthetic-political ambivalence (...) that shrouded the icon’s screenic agency within a Christian ‘economy of salvation’, and which climaxed in a politics of strictly economic equivalency, we concur with Peter Szendy that this ambivalence still haunts the icon’s contemporary heirs. By pedagogically re-reading Szendy’s alternative account of ‘iconomy’ we are subsequently led to make a case for exceeding neoliberal screening politics through an affirmation of the digital screen’s radical plasticity. Along with Yves Citton, we suggest, in our conclusion, that this post-critical affirmation calls for an ‘iconomical’ practice of care-ful experiments with the screen’s dynamic technologies. Instead of combating or adapting to its aesthetically dazzling algorithms, educational practices are required that allow these algorithmic quantities to qualitatively differentiate the uses that educands make of them. (shrink)

A dominant view of guilt and shame is that they have opposing action tendencies: guilt- prone people are more likely to avoid or overcome dysfunctional patterns of behaviour, making amends for past misdoings, whereas shame-prone people are more likely to persist in dysfunctional patterns of behaviour, avoiding responsibility for past misdoings and/or lashing out in defensive aggression. Some have suggested that addiction treatment should make use of these insights, tailoring therapy according to people’s degree of guilt-proneness versus shame-proneness. In (...) this paper, we challenge this dominant view, reviewing empirical findings from others as well as our own to question (1) whether shame and guilt can be so easily disentangled in the experience of people with addiction, and (2) whether shame and guilt have the opposing action tendencies standardly attributed to them. We recommend a shift in theoretical perspective that explains our main finding that both emotions can be either destructive or constructive for recovery, depending on how these emotions are managed. We argue such management depends in turn on a person’s quality of self-blame (retributive or ‘scaffolding’), impacting upon their attitude towards their own agency as someone with fixed and unchanging dispositions (shame and guilt destructive for recovery) or as someone capable of changing themselves (shame and guilt productive for recovery). With an eye to therapeutic intervention, we then explore how this shift in attitude towards the self can be accomplished. Specifically, we discuss empathy-driven affective and narratively-driven cognitive components of a process that allow individuals to move away from the register of retributive self-blame into a register of scaffolding ‘reproach’, thereby enabling them to manage their experiences of both shame and guilt in a more generative way. (shrink)

Simboličko ishodište za tekst predstavlja Malevičev »Crni kvadrat«, odnosno epistemološki prijelaz u teorijskom razumijevanju spomenutog umjetničkog djela: iz fenomenološko-ontološke perspektive ka psihoanalitičkoj interpretaciji istog. Putem aplikacije Lacanovog koncepta pogleda, povlačimo paralelu između simbolike Malevičevog kvadrata i primjera ekrana kroz opozicijsko sučeljavanje televizijskog i kompjutorskog ekrana. Definiranjem razlika između televizijskog i kompjutorskog ekrana reaktualiziramo i spomenuti Lacanov koncept, te ga u redefiniranoj verziji apliciramo na primjere kompjutorskog virtualnog prostora i identitet tzv. virtualnog subjekta. Tako uspostavljen problemski motiv obrađujemo i preko razmatranja (...) dihotomnog para interaktivnost/interpasivnost, sa naglaskom na modelu HCI , interakciji čovjeka i kompjutora. Paralela između umjetničkog objekta i suvremene medijske tehnologije, a sve u vezi sa subjektom koji se pita i time sebe konstituira, putokaz je prema pitanju koje predstavlja jedan od temeljnih interesa teksta, a ono glasi: o kakvom se konstruktu subjekta, odnosno formi njegova identiteta uspostavljenoj u prostoru virtualnog, zapravo radi?Symbolical starting point of the text is »Black Square« by Kazimir Malevich, or more exactly, an epistemological transition within theoretical understanding of the mentioned artwork: from a phenomenological-ontological perspective toward psychoanalytical interpretation of it. According to application of the concept of regard by Jacques Lacan, and regarding to oppositional distinction between television screen and computer screen, I am searching for a parallel between Malevich’s Square and symbolic of the screen. Process of definition of differences between television screen and computer screen is the way of re-actualization of previously mentioned Lacan’s concept, and I make an application of it on examples of computer virtual space and so-called virtually created identity. Primal theoretical problem of the text is working out through dichotomy interactivity/interpassivity with stress on the model of HCI that is interaction of human with computer. Parallel between an artwork and contemporary media technology, regarding to a human subject under self-questioned and self-created processes, leading us toward the question which is the one of main interests in the text: what is the model of self identity created within virtual space? (shrink)

Habits are the topic of a venerable history of research that extends back to antiquity, yet they were originally disregarded by the cognitive sciences. They started to become the focus of interdisciplinary research in the 1990s, but since then there has been a stalemate between those who approach habits as a kind of bodily automatism or as a kind of mindful action. This implicit mind-body dualism is ready to be overcome with the rise of interest in embodied, embedded, extended, and (...) enactive (4E) cognition. We review the enactive approach and highlight how it moves beyond the traditional stalemate by integrating both autonomy and sense-making into its theory of agency. It defines a habit as an adaptive, precarious, and self-sustaining network of neural, bodily, and interactive processes that generate dynamical sensorimotor patterns. Habits constitute a central source of normativity for the agent. We identify a potential shortcoming of this enactive account with respect to bad habits, since self-maintenance of a habit would always be intrinsically good. Nevertheless, this is only a problem if, following the mainstream perspective on habits, we treat habits as isolated modules. The enactive approach replaces this atomism with a view of habits as constituting an interdependent whole on whose overall viability the individual habits depend. Accordingly, we propose to define a bad habit as one whose expression, while positive for itself, significantly impairs a person’s well-being by overruling the expression of other situationally relevant habits. We end by considering implications of this concept of bad habit for psychological and psychiatric research, in particular with respect to addiction research. (shrink)

Addiction of the variety discussed in this chapter, is a condition that by its very nature compromises decision-making capacity across the decisional spectrum. The impairment is present not only at moments of withdrawal and intoxication, but at all stages of the active addictive cycle, as long as the pathological dispositions to overvalue addictive drugs remain entrenched and operative. In light of this entrenched and pervasive reorientation in pathological values, it seems reasonable to question the unilateral presumption of capacity for (...) cases of this sort. The reason is that there is an important, but restricted, sense in which the addicted individuals in question are not ‘responsible’ for their decisions regarding drug use. The high likelihood of relapse means that, as a clinical matter of fact, they are usually not accountable. At the same time, clinical experience also suggests that we should treat addicted individuals as if they are responsible because that empowerment is crucial to their recovery. In the end, there is probably only one safe course of action to take when faced with such a difficult situation. This is to suspend the unilateral global presumption of capacity and instead assess decision-making capacity on a case-by-case basis, with careful monitoring and encouragement. (shrink)

Research on the folk psychology of free will suggests that people believe free will is incompatible with determinism and that human decision-making cannot be exhaustively characterized by physical processes. Some suggest that certain elements of Western cultural history, especially Christianity, have helped to entrench these beliefs in the folk conceptual economy. Thus, on the basis of this explanation, one should expect to find three things: (1) a significant correlation between belief in dualism and belief in free will, (2) that people (...) with predominantly incompatibilist commitments are likely to exhibit stronger dualist beliefs than people with predominantly compatibilist commitments, and (3) people who self-identify as Christians are more likely to be dualists and incompatibilists than people who do not self-identify as Christians. We present the results of two studies (n = 378) that challenge two of these expectations. While we do find a significant correlation between belief in dualism and belief in free will, we found no significant difference in dualist tendencies between compatibilists and incompatibilists. Moreover, we found that self-identifying as Christian did not significantly predict preference for a particular metaphysical conception of free will. This calls into question assumptions about the relationship between beliefs about free will, dualism, and Christianity. (shrink)