Corporeal awareness and proprioceptive sense of the phantom

Phantom limb perception almost invariably follows limb amputation, and can be characterized by various corporeal and proprioceptive qualities. We report a study of 283 amputees, which administered a structured questionnaire to systematically determine the relative frequency and nature of various bodily aspects of phantom limb perception. These include the size, shape, posture, and telescoping of the phantom; exteroceptive sensations of itch, touch, pressure, vibration, temperature, and ‘electric’ sensations; and prosthesis embodiment. Phantom limbs were generally found to be characterized by properties that parallel those of the intact body, although with anatomically impossible configurations sometimes being perceived. We suggest that both the internal limb image and limb schemata play a significant role in the continued perception of phantom limbs.     

Immersive virtual reality as a rehabilitative technology for phantom limb experience: a protocol.

This paper describes a study protocol to investigate the use of immersive virtual reality as a treatment for amputees' phantom limb pain. This work builds upon prior research using mirror box therapy to induce vivid sensations of movement originating from the muscles and joints of amputees' phantom limbs. The present project transposes movements of amputees' anatomical limbs into movements of a virtual limb presented in the phenomenal space of their phantom limb. It is anticipated that the protocol described here will help reduce phantom limb pain.     

On the syndrome of the "spare limb": one case

We describe a case of a brain-damaged patient who had a peculiar bodily illusion which could not be labelled an hallucination but seemed somatognosically and phenomenologically similar to the phantom limb without amputation. The patient, who showed left hemiplegia, felt a third upper limb (without seeing it) which he himself defined as "spare." The spare limb was not deformed; it could be moved and controlled by the patient, and there was no sensation of pain. The patient did not show psychopathological or cognitive disorders. A possible interpretation of the phenomenon is as a "phantom movement" of the paralysed limb: the mental representation of the movement of the limb was dissociated from the bodily representation of his own limb and so was still present in his consciousness despite the paralysis.     

情感一致性及其对认知加工的影响

具身情绪观认为情感的核心功能是评价,这种评价信息会同时表征在低层感知系统和高层认知系统中,它们相互影响、互为因果。情感一致性反映的是情感具身反应（心理感受、情感相关的身体动作和表情等）与情感认知评价（情感的观念性内容,积极与消极）在效价上的耦合关系。这种关系突出的表现为效价上是否一致,情感一致促进其后的认知加工,情感不一致的作用相反。该观点在短时记忆、叙事建构、刻板印象和说服效果等领域得到了证实。未来的研究应重视情感一致性的情感意义,扩展情感一致性定义及假设,并检验情感一致性的评价本质。     

Does any aspect of mind survive brain damage that typically leads to a persistent vegetative state? Ethical considerations

Recent neuroscientific evidence brings into question the conclusion that all aspects of consciousness are gone in patients who have descended into a persistent vegetative state (PVS). Here we summarize the evidence from human brain imaging as well as neurological damage in animals and humans suggesting that some form of consciousness can survive brain damage that commonly causes PVS. We also raise the issue that neuroscientific evidence indicates that raw emotional feelings (primary-process affects) can exist without any cognitive awareness of those feelings. Likewise, the basic brain mechanisms for thirst and hunger exist in brain regions typically not damaged by PVS. If affective feelings can exist without cognitive awareness of those feelings, then it is possible that the instinctual emotional actions and pain "reflexes" often exhibited by PVS patients may indicate some level of mentality remaining in PVS patients. Indeed, it is possible such raw affective feelings are intensified when PVS patients are removed from life-supports. They may still experience a variety of primary-process affective states that could constitute forms of suffering. If so, withdrawal of life-support may violate the principle of nonmaleficence and be tantamount to inflicting inadvertent "cruel and unusual punishment" on patients whose potential distress, during the process of dying, needs to be considered in ethical decision-making about how such individuals should be treated, especially when their lives are ended by termination of life-supports. Medical wisdom may dictate the use of more rapid pharmacological forms of euthanasia that minimize distress than the de facto euthanasia of life-support termination that may lead to excruciating feelings of pure thirst and other negative affective feelings in the absence of any reflective awareness.     

Unawareness of visual and sensorimotor defects: A hypothesis

A theory is proposed to account for unawareness of blindness, hemianopsia, and hemiplegia, and for phantom limb after amputation. It is assumed that interruption of a sensory pathway at any level--from peripheral nerve to primary sensory cortex--is not associated with any immediate sensory experience that uniquely specifies the defect. Instead the sensory loss must be discovered by a process of self-observation and inference. Discovery is easy for defects that create major functional disability, such as total blindness. Hence unawareness of total blindness occurs only in association with severe intellectual impairment, precluding the required self-observation and inference. In contrast, hemianopsia is difficult to discover because several mechanisms automatically compensate the defect effectively. Thus unawareness of hemianopsia is common, even in intellectually normal individuals. Insensate fields are often the source of suggested (false) percepts, because no information from such a field specifies the absence of a sensory stimulus. The most powerful source of suggestion is sensory activity in uninvolved portions of the affected sensory field. Thus hemianopsics may perceive complete geometric forms when only incomplete forms are shown and the missing portion falls in the hemianopsic fields. Such perceptual completion also occurs in hemianesthetic hemiplegics, creating the illusion that there are normally functioning limbs on the affected side. This perceptual completion increases the difficulty of discovery of hemianesthetic hemiplegia, but the disability is still sufficiently obvious that some additional cognitive impairment is invariably present in patients with lasting unawareness of hemiplegia. Phantom limb after amputation is the product of perceptual completion without associated cognitive impairment. The patient with phantom limb is thus aware of the illusory quality of his phantom. Some insight into the neural basis of perceptual completion and of unawareness of sensory loss may derive from considering sensory systems and associative cortex as parallel-distributed processing mechanisms.     

Normal body scheme and absent phantom limb experience in amputees while dreaming

While dreaming amputees often experience a normal body image and the phantom limb may not be present. However, dreaming experiences in amputees have mainly been collected by questionnaires. We analysed the dream reports of amputated patients with phantom limb collected after awakening from REM sleep during overnight videopolysomnography (VPSG). Six amputated patients underwent overnight VPSG study. Patients were awakened during REM sleep and asked to report their dreams. Three patients were able to deliver an account of a dream. In all dreaming recalls, patients reported that the amputated limbs were intact and completely functional and they no longer experienced phantom limb sensations. Phantom limb experiences, that during wake result from a conflict between a pre-existing body scheme and the sensory information on the missing limb, were suppressed during sleep in our patients in favour of the image of an intact body accessed during dream.     

Chronic pain relief after receiving affective touch: A single case report

Affective touch is gentle slow stroking of the skin, which can reduce experimentally induced pain. Our participant, suffering from Parkinson's Disease and chronic pain, received 1 week of non-affective touch and 1 week of affective touch as part of a larger study. Interestingly, after 2 days of receiving affective touch, the participant started to feel less pain. After 7 days, the burning painful sensations fully disappeared. This suggest that affective touch may reduce chronic pain in clinical populations.     

Loss as a lifelong regenerative learning process

The predisposition to internalize death and loss of crucial attachment objects, subjectively, as a physical attack on the body, is commonly acknowledged in the field of human psychological behaviour (Freud 1915; Parkes 1972). This view is held, essentially, according to psychoanalytic principles of the functioning of the mental processes, to advance the concept of mind and body sensations as psychical consequences, or affects , of loss trauma. It does not, nevertheless, preclude wider social and cultural factors from adding to our understanding of how and why we react to loss in deeply individual ways. In the affective domain of human experience, the relationship between emotional pain and learning may not strike an immediate connection, since emotions are assumed to be subjective psychological affects of the psyche, while learning involves cognitive processes associated with developed responses to external stimuli. From a psychoanalytic perspective, however, it is possible to conceptualize the interconnecting of mind and body ‘states’ associated with pain, through the channelling and regulation of psychic tension in the ego. Importantly, the channelling of impulses into mind and body ‘ideas’ suggests a dynamic process capable of activating the human potential for emotional development and learning through the ego's capacity for adaptation to external change. We can speak, therefore, of affective learning as an integrated regenerative counterpart to emotional devel When death and major life changes are followed by corresponding feelings of loss, the human propensity to search for, and the lost object is generally viewed by therapists to be a normal part of grieving, however paradoxical the demands for integrating thoughts and irrational actions might feel. This illustrates the of a grief process that ultimately demands a degree of emotional development in enabling us to tolerate high levels of anxiety, there is disparity between the inner world of feeling and external reality. In psychodynamic grief work, the therapeutic principle of through' the deeper, inner layers of loss and mourning creates one such model for developing emotional learning and insight. It within this framework that the client can begin to understand his irrational motives, and be freed from the related feelings of alienation in his inner world.

The aim of this paper is to examine the concept of loss and learning in a wider context to include lifelong processes of and growth, which may be a cause for grief. It raises the significance of personal meaning(s) we attach to loss, links this theme to the aetiology of separation anxiety, loss and mourning from a psychoanalytic perspective.     

Aplasic phantoms and the mirror neuron system: An enactive, developmental perspective

Phantom limb experiences demonstrate an unexpected degree of fragility inherent in our self-perceptions. This is perhaps most extreme when congenitally absent limbs are experienced as phantoms. Aplasic phantoms highlight fundamental questions about the physiological bases of self-experience and the ontogeny of a physical, embodied sense of the self. Some of the most intriguing of these questions concern the role of mirror neurons in supporting the development of self–other mappings and hence the emergence of phantom experiences of congenitally absent limbs. In this paper, we will examine the hypothesis that aplasic phantom limb experience is the result of an ontogenetic interplay between body schemas and mirror neuron activity and that this interplay is founded on embedding in a social context. Phantom limb experience has been associated with the persistence of subjective experience of a part of the body after deafferentation through surgical or traumatic removal. We maintain that limited association is inconsistent with the extent to which phantom limb experience is reported by aplasic individuals.     

Incorporating Principles from Acceptance and Commitment Therapy into Cognitive-Behavioral Therapy for Insomnia: A Case Example

Although traditional cognitive behavioral treatments for insomnia have demonstrated efficacy for many individuals with primary and comorbid insomnia, not all individuals benefit from treatment and some experience a subsequent relapse of insomnia. Furthermore, many individuals experience difficulty in implementing the sleep restriction and stimulus control strategies, especially over the long-term. The current article describes ways in which principles from a newer type of behavior therapy, Acceptance and Commitment Therapy (ACT), can be integrated with traditional behavioral treatment strategies for insomnia. A major goal of ACT is to increase willingness to experience unpleasant thoughts, feelings, and physical sensations, and to promote engagement in personally-valued behaviors while non-judgmentally observing these unpleasant experiences. ACT has the potential to enhance the behavioral treatment of insomnia by fostering willingness to experience short-term discomfort (e.g., fatigue) that occurs while implementing sleep restriction and stimulus control strategies. A case example is presented to illustrate how these principles from ACT can be integrated with behavioral techniques in the treatment of insomnia.     

Emotional working memory capacity in posttraumatic stress disorder (PTSD)

Participants with a lifetime history of posttraumatic stress disorder (PTSD) and trauma-exposed controls with no PTSD history completed an emotional working memory capacity (eWMC) task. The task required them to remember lists of neutral words over short intervals while simultaneously processing sentences describing dysfunctional trauma-related thoughts (relative to neutral control sentences). The task was designed to operationalise an everyday cognitive challenge for those with mental health problems such as PTSD; namely, the ability to carry out simple, routine tasks with emotionally benign material, while at the same time tackling emotional laden intrusive thoughts and feelings. eWMC performance, indexed as the ability to remember the word lists in the context of trauma sentences, relative to neutral sentences, was poorer overall in the PTSD group compared with controls, suggestive of a particular difficulty employing working memory in emotion-related contexts in those with a history of PTSD. The possible implications for developing affective working memory training as an adjunctive treatment for PTSD are explored.     

Thoughts, Feelings and Intentions to Learn: Attitudes by Beginning Teachers Towards Aboriginal Peoples

Given that education plays a key role in the development of social attitudes, intentions to learn about other social groups is a strategic addition to cognitive and affective models of attitudes towards others. This project examined related yet discrete aspects of attitudes towards Australian Aboriginal peoples that are expressed by beginning teachers (N = 266). Cognitive aspects indicate positive and negative stereotyping of the social group. Affective aspects across situations relate positive feelings and negative feelings of guilt, worry and anger. Results suggest differential links from cognitive and affective aspects to intentions for positive and negative actions, and intentions to gain experience with others. The findings implicate broadly defined components of attitudes in situations where individuals have limited experience with people in other social groups.     

The Common Beliefs Survey-III and the Situational Self-Statement and Affective State Inventory: Test-Retest Reliability, Internal Consistency, and Further Psychometric Considerations

The Common Beliefs Survey-III (CBS-III), a factored measure of general irrational beliefs, has satisfactory convergent and discriminant validity. The Situational Self-Statement and Affective State Inventory (SSSASI), also with acceptable basic psychometric properties, assesses specific thoughts and feelings in response to vignettes describing frustrating events. Both inventories are potentially useful in assessing dimensions important to REBT, but information on test-retest reliability is needed. The CBS-III and the SSSASI were administered to 101 undergraduate students on two occasions, two or three weeks apart. Satisfactory test-retest reliability coefficients were obtained on all subscales of both inventories, but in the case of the SSSASI reliabilities were generally stronger when the same form of the test was used on both occasions (Form 1 presented the thoughts before the feelings, whereas Form 2 presented the feelings before the thoughts). Further exploration showed that responding to the thoughts before the feelings significantly attenuated scores on the feelings, but responding to the feelings before the thoughts had no effect on scores on the thoughts. This unexpected finding also held true in a previously unexamined data set obtained with a different sample of students several years earlier. Taking careful stock of one's emotional reactions before embarking on cognitive modification interventions seems essential to REBT, and it follows that asking questionnaire respondents to rate their affective states before they rate their self-statements could be desirable conceptually. These results provide empirical support for that strategy.     

Relief of phantom limb pain after EMG biofeedback-assisted relaxation : a case report

Both EEG and EMG biofeedback were used to treat severe, chronic phantom limb pain in a 54 yr-old man. Although EEG biofeedback was ineffective, EMG biofeedback-assisted relaxation of the muscles in the stump allowed the patient to greatly reduce the frequency and intensity of the pain after about 4 h of practice. Both somatic and cognitive variables may have contributed to the effectiveness of the procedure.     

Affective incoherence: when affective concepts and embodied reactions clash

In five studies, the authors examined the effects on cognitive performance of coherence and incoherence between conceptual and experiential sources of affective information. The studies crossed the priming of happy and sad concepts with affective experiences. In different experiments, these included approach or avoidance actions, happy or sad feelings, and happy or sad expressive behaviors. In all studies, coherence between affective concepts and affective experiences led to better recall of a story than did affective incoherence. The authors suggest that the experience of such experiential affective cues serves as evidence of the appropriateness of affective concepts that come to mind. The results suggest that affective coherence has epistemic benefits and that incoherence is costly in terms of cognitive performance.     

It takes two: the interpersonal nature of empathic accuracy

Although current theories suggest that affective empathy (perceivers' experience of social targets' emotions) should contribute to empathic accuracy (perceivers' ability to accurately assess targets' emotions), extant research has failed to consistently demonstrate a correspondence between them. We reasoned that prior null findings may be attributable to a failure to account for the fundamentally interpersonal nature of empathy, and tested the prediction that empathic accuracy may depend on both targets' tendency to express emotion and perceivers' tendency to empathically share that emotion. Using a continuous affect-rating paradigm, we found that perceivers' trait affective empathy was unrelated to empathic accuracy unless targets' trait expressivity was taken into account: Perceivers' trait affective empathy predicted accuracy only for expressive targets. These data suggest that perceivers' self-reported affective empathy can indeed predict their empathic accuracy, but only when targets' expressivity allows their thoughts and feelings to be read.     

Ouch! My phantom leg jumps/hurts when you stab "my" virtual hand

Pain synaesthetes experience pain in a presensitised region when observing or imagining another person in pain. We conducted an upper-limb embodiment study using a modified rubber-hand illusion in which lower-limb amputees originally participated as control subjects for the upper-limb amputees. While we found all subjects experienced topographic illusory sensations, we also serendipitously found that lower-limb amputee pain synaesthetes experienced pain or a motor response in their phantom leg when the embodied hand was threatened (e.g., with a retractable knife, mousetrap, or syringe) or submitted to high-frequency stimulation (e.g., vibration). Embodiment illusions were brought about by touching, manipulating, or threatening a rubber or real hand which was observed through a mirror so that it was superimposed upon the target hand (phantom hand for upper-limb amputees, or real hand in others). Participants included eight pain synaesthetes (six lower-limb amputees, one upper-limb amputee, and one nonamputee), and thirty-one controls (eight lower-limb amputees, twelve upper-limb amputees, and eleven nonamputees). We documented participant's subjective reports, together with quantitative measures including the Questionnaire Measure of Emotional Empathy. We found no association between pain synaesthesia and empathy scores. On the basis of related literature we suggest that pain synaesthetes likely experienced phantom-leg pain because (a) the motor system was already engaged during visual capture; (b) threatening stimuli, to which they are hyper-vigilant, triggered avoidance or 'escape' motor schemata; and (c) there could be no feedback confirming that initiated motor schemata for the phantom limb were successfully performed. Ultimately, we have further defined this new condition, synaesthesia for pain, as not only having a sensory pain component, but also a key motor component, manifesting itself in avoidance, contraction, and withdrawal 'actions'.     

Aging and qualitative characteristics of memories for perceived and imagined complex events

Older and younger adults' memory for perceived and imagined events was examined with a procedure in which everyday situations are simulated in the laboratory. Subjects perceived some situations and imagined others. Later, they were asked to rate their memory for various aspects of these situations (e.g., amount of perceptual detail, thoughts and feelings). A recall test followed the ratings. On the rating scale, for both perceived and imagined events, older subjects reported better memory for their thoughts and feelings than did younger subjects. In addition, on the recall test, older subjects produced more thoughts and feelings than did younger subjects, whereas younger subjects produced more perceptual and spatial information. These results suggest that older subjects may not inhibit personal information (e.g., thoughts and feelings), and this information may interfere with memory for other aspects of information, such as perceptual and contextual details (Hasher & Zacks, 1988).     

Interference resolution moderates the impact of rumination and reappraisal on affective experiences in daily life

Research has shown that cognitive control processes play a central role in emotion regulation. While most research has examined whether individual differences in such processes are related to the use of these strategies, a crucial next step involves examining whether such differences influence their impact on people's feelings, especially in normal daily life. The present study examined whether impairments in cognitive control (measured using an affective interference resolution task) moderate the impact of using rumination and reappraisal on affective experiences in everyday life (assessed using experience sampling methods). Multilevel analyses revealed that difficulties removing previously relevant negative information from working memory were associated with a larger increase in negative affect following rumination, and smaller increase and decrease in positive and negative affect, respectively, following reappraisal. These findings show that impaired interference resolution for negative information aggravates the deleterious effects of rumination and curbs the benefits of reappraisal in daily life.