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Stein DJ, Nielsen K, Hartford A, Gagné-Julien AM, Glackin S, Friston K, Maj M, Zachar P, Aftab A. Philosophy of psychiatry: theoretical advances and clinical implications. World Psychiatry 2024; 23:215-232. [PMID: 38727058 PMCID: PMC11083904 DOI: 10.1002/wps.21194] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2024] Open
Abstract
Work at the intersection of philosophy and psychiatry has an extensive and influential history, and has received increased attention recently, with the emergence of professional associations and a growing literature. In this paper, we review key advances in work on philosophy and psychiatry, and their related clinical implications. First, in understanding and categorizing mental disorder, both naturalist and normativist considerations are now viewed as important - psychiatric constructs necessitate a consideration of both facts and values. At a conceptual level, this integrative view encourages moving away from strict scientism to soft naturalism, while in clinical practice this facilitates both evidence-based and values-based mental health care. Second, in considering the nature of psychiatric science, there is now increasing emphasis on a pluralist approach, including ontological, explanatory and value pluralism. Conceptually, a pluralist approach acknowledges the multi-level causal interactions that give rise to psychopathology, while clinically it emphasizes the importance of a broad range of "difference-makers", as well as a consideration of "lived experience" in both research and practice. Third, in considering a range of questions about the brain-mind, and how both somatic and psychic factors contribute to the development and maintenance of mental disorders, conceptual and empirical work on embodied cognition provides an increasingly valuable approach. Viewing the brain-mind as embodied, embedded and enactive offers a conceptual approach to the mind-body problem that facilitates the clinical integration of advances in both cognitive-affective neuroscience and phenomenological psychopathology.
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Affiliation(s)
- Dan J Stein
- South African Medical Research Council Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Kris Nielsen
- School of Psychology, Te Herenga Waka-Victoria University of Wellington, Wellington, New Zealand
| | - Anna Hartford
- South African Medical Research Council Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Anne-Marie Gagné-Julien
- Centre for Research in Ethics, Canada Research Chair in Epistemic Injustice and Agency, Université du Québec à Montréal, Montreal, Canada
| | - Shane Glackin
- Department of Sociology, Philosophy and Anthropology, University of Exeter, Exeter, UK
| | - Karl Friston
- Wellcome Trust Centre for Neuroimaging, Institute of Neurology, University College London, London, UK
| | - Mario Maj
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Peter Zachar
- Department of Psychology, Auburn University Montgomery, Montgomery, AL, USA
| | - Awais Aftab
- Department of Psychiatry, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
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Reivan Ortiz GG, Campoverde X, Vinañzaca J, Estrada J, Yanza R, Granero R. Factors increasing the risk for food addiction in Ecuadorian students. Front Psychiatry 2024; 14:1214266. [PMID: 38234363 PMCID: PMC10792013 DOI: 10.3389/fpsyt.2023.1214266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 11/06/2023] [Indexed: 01/19/2024] Open
Abstract
Background Food addiction (FA) is a construct that has gained interest in recent years, but its relevance in the Ecuadorian population has not yet been explored. The aims of this study were to explore the differences in the psychological profile (including FA) between university students from Ecuador and to identify the underlying structure of the relationships of the FA severity level through a mediational model. Methods The sample consisted of 972 university students, women and men (mean age: 20.1 years old, SD = 2.6), recruited from four Ecuadorian regions. The assessment tools included a unidimensional scale of FA, eating-related measures, emotion regulation state, impulsivity, and psychopathology state. Path analysis modeled the direct and indirect effects explaining the FA severity level. Results The results indicated that higher psychopathological levels were associated with FA. Similarly, no differences in FA were observed between the Ecuadorian regions. The path analysis suggested that older age, female sex, and higher difficulties in emotional regulation, impulsivity, negative mood, and anxiety trigger disordered eating; subsequently, more impaired eating behavior impacted the FA level. Conclusion FA is a complex clinical entity that includes multiple components related to eating disorders (EDs) and other mental health problems. The results of this study provide empirical knowledge for designing evidence-based prevention and treatment strategies.
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Affiliation(s)
- Geovanny Genaro Reivan Ortiz
- Laboratory of Basic Psychology, Behavioral Analysis, and Programmatic Development (PAD-LAB), Catholic University of Cuenca, Cuenca, Ecuador
| | | | - Juan Vinañzaca
- Laboratory of Basic Psychology, Behavioral Analysis, and Programmatic Development (PAD-LAB), Catholic University of Cuenca, Cuenca, Ecuador
| | - Johanna Estrada
- Laboratory of Basic Psychology, Behavioral Analysis, and Programmatic Development (PAD-LAB), Catholic University of Cuenca, Cuenca, Ecuador
| | - Rafael Yanza
- Catholic University of Cuenca, Cuenca, Azuay, Ecuador
| | - Roser Granero
- Autonomous University of Barcelona, Barcelona, Spain
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García E, Arandia IR. Enactive and simondonian reflections on mental disorders. Front Psychol 2022; 13:938105. [PMID: 35992462 PMCID: PMC9382120 DOI: 10.3389/fpsyg.2022.938105] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 07/04/2022] [Indexed: 11/13/2022] Open
Abstract
As an alternative to linear and unidimensional perspectives focused mainly on either organic or psychological processes, the enactive approach to life and mind-a branch of 4-E (embodied, embedded, enactive, extended) cognitive theories-offers an integrative framework to study mental disorders that encompasses and articulates organic, sensorimotor, and intersubjective dimensions of embodiment. These three domains are deeply entangled in a non-trivial manner. A question remains on how this systemic and multi-dimensional approach may be applied to our understanding of mental disorders and symptomatic behavior. Drawing on Gilbert Simondon's philosophy of individuation (focusing particularly on the concepts of tension, metastability, and preindividual), we provide some enactive conceptual tools to better understand the dynamic, interactive, and multi-dimensional nature of human bodies in mental disorders and psychopathological symptoms. One of such tools cursiva is sense-making, a key notion that captures the relational process of generating meaning by interacting with the sociomaterial environment. The article analyzes five aspects related to sense-making: temporality, adaptivity, the multiplicity of normativities it involves, the fundamental role of tension, and its participatory character. On this basis, we draw certain implications for our understanding of mental disorders and diverse symptoms, and suggest their interpretation in terms of difficulties to transform tensions and perform individuation processes, which result in a reduction of the field of potentialities for self-individuation and sense-making.
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Affiliation(s)
- Enara García
- IAS Research group, Department of Philosophy, University of the Basque Country, San Sebastián, Spain
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Woolford FMG, Egbert MD. Goal Oriented Behavior With a Habit-Based Adaptive Sensorimotor Map Network. Front Neurorobot 2022; 16:846693. [PMID: 35619969 PMCID: PMC9127740 DOI: 10.3389/fnbot.2022.846693] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 03/28/2022] [Indexed: 11/20/2022] Open
Abstract
We present a description of an ASM-network, a new habit-based robot controller model consisting of a network of adaptive sensorimotor maps. This model draws upon recent theoretical developments in enactive cognition concerning habit and agency at the sensorimotor level. It aims to provide a platform for experimental investigation into the relationship between networked organizations of habits and cognitive behavior. It does this by combining (1) a basic mechanism of generating continuous motor activity as a function of historical sensorimotor trajectories with (2) an evaluative mechanism which reinforces or weakens those historical trajectories as a function of their support of a higher-order structure of higher-order sensorimotor coordinations. After describing the model, we then present the results of applying this model in the context of a well-known minimal cognition task involving object discrimination. In our version of this experiment, an individual robot is able to learn the task through a combination of exploration through random movements and repetition of historic trajectories which support the structure of a pre-given network of sensorimotor coordinations. The experimental results illustrate how, utilizing enactive principles, a robot can display recognizable learning behavior without explicit representational mechanisms or extraneous fitness variables. Instead, our model's behavior adapts according to the internal requirements of the action-generating mechanism itself.
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Chappell Z. The Enacted Ethics of Self-injury. TOPOI : AN INTERNATIONAL REVIEW OF PHILOSOPHY 2022; 41:383-394. [PMID: 35194278 PMCID: PMC8831164 DOI: 10.1007/s11245-022-09796-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/22/2022] [Indexed: 06/14/2023]
Abstract
Enactivism has much to offer to moral, social and political philosophy through giving a new perspective on existing ethical problems and improving our understanding of morally ambiguous behaviours. I illustrate this through the case of self-injury, a common problematic behaviour which has so far received little philosophical attention. My aim in this paper has been to use ideas from enactivism in order to explore self-injury without assuming a priori that it is morally or socially wrong under all circumstances, seeking to establish a less implicitly value-laden analysis. Enactivism can help us in making this behaviour more intelligible and contextualising it through examining the relations of individual embodied action and social practices with the help of enactivist theories of habits and affordances.
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Arandia IR, Di Paolo EA. Placebo From an Enactive Perspective. Front Psychol 2021; 12:660118. [PMID: 34149551 PMCID: PMC8206487 DOI: 10.3389/fpsyg.2021.660118] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 04/28/2021] [Indexed: 12/12/2022] Open
Abstract
Due to their complexity and variability, placebo effects remain controversial. We suggest this is also due to a set of problematic assumptions (dualism, reductionism, individualism, passivity). We critically assess current explanations and empirical evidence and propose an alternative theoretical framework-the enactive approach to life and mind-based on recent developments in embodied cognitive science. We review core enactive concepts such as autonomy, agency, and sense-making. Following these ideas, we propose a move from binary distinctions (e.g., conscious vs. non-conscious) to the more workable categories of reflective and pre-reflective activity. We introduce an ontology of individuation, following the work of Gilbert Simondon, that allow us to see placebo interventions not as originating causal chains, but as modulators and triggers in the regulation of tensions between ongoing embodied and interpersonal processes. We describe these interrelated processes involving looping effects through three intertwined dimensions of embodiment: organic, sensorimotor, and intersubjective. Finally, we defend the need to investigate therapeutic interactions in terms of participatory sense-making, going beyond the identification of individual social traits (e.g., empathy, trust) that contribute to placebo effects. We discuss resonances and differences between the enactive proposal, popular explanations such as expectations and conditioning, and other approaches based on meaning responses and phenomenological/ecological ideas.
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Affiliation(s)
- Iñigo R. Arandia
- IAS-Research Center for Life, Mind and Society, University of the Basque Country, Leioa, Spain
- ISAAC Lab, Aragón Institute of Engineering Research, University of Zaragoza, Zaragoza, Spain
| | - Ezequiel A. Di Paolo
- IAS-Research Center for Life, Mind and Society, University of the Basque Country, Leioa, Spain
- Ikerbasque-Basque Foundation for Science, Bilbao, Spain
- Center for Computational Neuroscience and Robotics, University of Sussex, Brighton, United Kingdom
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Candiotto L, Dreon R. Affective Scaffoldings as Habits: A Pragmatist Approach. Front Psychol 2021; 12:629046. [PMID: 33841258 PMCID: PMC8034264 DOI: 10.3389/fpsyg.2021.629046] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 03/03/2021] [Indexed: 11/13/2022] Open
Abstract
In this paper, we provide a pragmatist conceptualization of affective habits as relatively flexible ways of channeling affectivity. Our proposal, grounded in a conception of sensibility and habits derived from John Dewey, suggests understanding affective scaffoldings in a novel and broader sense by re-orienting the debate from objects to interactions. We claim that habits play a positive role in supporting and orienting human sensibility, allowing us to avoid any residue of dualism between internalist and externalist conceptions of affectivity. We provide pragmatist tools for understanding the environment's role in shaping our feelings, emotions, moods, and affective behaviors. However, we contend that in addition to environment, the continuous and recursive affective transaction between agent and environment (both natural and cultural) are also crucially involved. We claim that habits are transformative, which is especially evident when we consider that emotions are often the result of a crisis in habitual behavior and successively play a role in prompting changes of habits. The final upshot is a conceptualization of affective habits as pervasive tools for feelings that scaffold human conduct as well as key features in the transformation of behaviors.
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Affiliation(s)
- Laura Candiotto
- Department of Philosophy and Humanities, Institute of Philosophy, Free University of Berlin, Berlin, Germany
| | - Roberta Dreon
- Department of Philosophy and Cultural Heritage, Ca' Foscari University of Venice, Venice, Italy
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Segundo-Ortin M. Agency From a Radical Embodied Standpoint: An Ecological-Enactive Proposal. Front Psychol 2020; 11:1319. [PMID: 32670161 PMCID: PMC7332856 DOI: 10.3389/fpsyg.2020.01319] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 05/19/2020] [Indexed: 11/13/2022] Open
Abstract
Explaining agency is a significant challenge for those who are interested in the sciences of the mind, and non-representationalists are no exception to this. Even though both ecological psychologists and enactivists agree that agency is to be explained by focusing on the relation between the organism and the environment, they have approached it by focusing on different aspects of the organism-environment relation. In this paper, I offer a suggestion for a radical embodied account of agency that combines ecological psychology with recent trends in enactive cognitive science. According to this proposal, while enactivism focuses primarily on describing how our acquired sensorimotor schemes and habits mutually equilibrate, affecting our tendency to act upon some affordances instead of others, ecological psychology focuses on studying how perceptual information contributes to the actualization of the sensorimotor schemes and habits without mediating representations, inferences, and computations. The paper concludes by briefly exploring how this ecological-enactive theory of agency can account for how socio-cultural norms shape human agency.
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James MM, Loaiza JM. Coenhabiting Interpersonal Inter-Identities in Recurrent Social Interaction. Front Psychol 2020; 11:577. [PMID: 32296376 PMCID: PMC7136421 DOI: 10.3389/fpsyg.2020.00577] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 03/11/2020] [Indexed: 11/26/2022] Open
Abstract
We propose a view of identity beyond the individual in what we call interpersonal inter-identities (IIIs). Within this approach, IIIs comprise collections of entangled stabilities that emerge in recurrent social interaction and manifest for those who instantiate them as relatively invariant though ever-evolving patterns of being (or more accurately, becoming) together. Herein, we consider the processes responsible for the emergence of these IIIs from the perspective of an enactive cognitive science. Our proposal hinges primarily on the development of two related notions: enhabiting and coenhabiting. First, we introduce the notion of enhabiting, a set of processes at the individual level whereby structural interdependencies stabilize and thereafter undergird the habits, networks of habits, and personal identities through which we make sense of our experience. Articulating this position we lean on the notion of a tendency toward an optimal grip, though offering it a developmental framing, whereby iterative states of selective openness help realize relatively stable autonomous personal identities with their own norms of self-regulation. We then extend many of the notions found applicable here to an account of social coenhabiting, in particular, we introduce the notion of tending toward a co-optimal grip as central to the development of social habits, networks of habits, and ultimately IIIs. Such structures, we propose, also emerge as autonomous structures with their own norms of self-regulation. We wind down our account with some reflections on the implications of these structures outside of the interactions wherein they come into being and offer some thoughts about the complex animations of the individual embodied subjects that instantiate them.
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Affiliation(s)
- Mark M. James
- School of Computer Science, University College Dublin, Dublin, Ireland
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James MM. Bringing Forth Within: Enhabiting at the Intersection Between Enaction and Ecological Psychology. Front Psychol 2020; 11:1348. [PMID: 32922325 PMCID: PMC7457031 DOI: 10.3389/fpsyg.2020.01348] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Accepted: 05/20/2020] [Indexed: 11/13/2022] Open
Abstract
Baggs and Chemero (2018) propose that certain tensions between enaction and ecological psychology arise due different interpretations about what is meant by the "environment." In the enactive approach the emphasis is on the umwelt, which describes the environment as the "meaningful, lived surroundings of a given individual." The ecological approach, on the other hand, emphasises what they refer to as the habitat "the environment as a set of resources for a typical, or ideal, member of a species." By making this distinction, these authors claim they are able to retain the best of both the ecological and the enactive approaches. Herein I propose an account of the individuation of habits that straddles this distinction, what I call a compatabilist account. This is done in two parts. The first part teases out a host of compatibilities that exist between the enactive account as developed by Di Paolo et al. (2017) and the skilled intentionality framework as developed by Bruineberg and Rietveld (2014) and Rietveld and Kiverstein (2014). In part two these compatibilities are brought together with the that these compatibilities can be brought together with the philosophy of Gilbert Simondon to develop the notion of enhabiting. Enhabiting describes a set of ongoing processes by which an umwelt emerges from and is reproduced within the relationship between an embodied subject and their habitat. Thus, enhabiting points toward a point of intersection between enaction and ecological psychology. To enhabit is bring forth (to enact), within (to inhabit).
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Affiliation(s)
- Mark M James
- School of Computer Science, University College Dublin, Dublin, Ireland
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