On the Importance of Well-being

Many among philosophers and non-philosophers would claim that well-being is important in moral theory because it is important to the individual whose well-being it is. The exact meaning of this claim, however, is in need of clarification. Having provided that, I will present a charge against it. This charge can be found in the recent work of both Joseph Raz and Thomas Scanlon. According to the latter the concept of well-being plays an unimportant role in an agent’s deliberation. As I will show, to claim this much is to undermine our initial claim; and to do that is to undermine some of the most central theories in normative ethics. I will focus on Scanlon’s discussion in particular because it affords us with two criteria for the assessment of the importance for a person of a value-concept such as well-being. I will claim that much of Scanlon’s case rests on the idea that well-being is an inclusive good, a good constituted by other things that are good in and for themselves. Then, I will put forward a case against Scanlon’s challenge by (1) showing that inclusiveness, when properly understood, does not lead to the conclusion Scanlon is led to and (2) showing that on at least the reading Scanlon prefers, his criteria are inappropriate.

Adopting Metacognitive Interpersonal Therapy to Treat Narcissistic Personality Disorder with Somatization

Narcissistic personality disorder (NPD) is characterized by an intellectualizing narrative style, poor metacognition, maladaptive interpersonal schemas, a restricted set of states of mind, impaired agency and perfectionism. Metacognitive Interpersonal therapy targets these dysfunctions with a series of formalized procedures aimed at first forming a shared formulation of functioning which patients and therapists can then use to plan change. We describe here the core NPD pathology and illustrate the therapy process of a patient with NPD and a somatization disorder. Implications for treatment of NPD are discussed together with a call for empirical testing of therapies for this severe condition.     

Exhaled breath analysis in evaluation of psychological stress: A short literature review

Physiological stress is pervasive in today's society. Its detection is normally performed through several unobtrusive methods, driving both caregivers and patients to take measures to reduce the burden of this condition on human health. Among the methods for assessing stress, exhaled breath analysis represents a non‐invasive, real‐time alternative to classic laboratory tests. Therefore, a literature review was performed to assess the presence of altered parameters, related to psychological stress, in exhaled breath. Most studies in our review measured nitric oxide (NO), whose concentration was often correlated, either positively or negatively, with psychological stress, with reasonable scientific support. Other compounds (isoprene, terpene and so on) were rarely studied and with mixed evidence. Further investigations are needed to elucidate the involvement and the pathophysiological role of NO in stress, possibly including a greater number of individuals, as sample size actually represents the main limitation of the work published to date.     

Heart rate variability and drawing impairment in hypoxemic COPD

We studied 54 patients with hypoxemic chronic obstructive pulmonary disease (COPD). The Mini Mental State Examination and the Mental Deterioration Battery were used for neuropsychological assessment. Heart rate variability (HRV) was assessed based on 24-h Holter ECG recording. Mann–Whitney test was used to compare HRV parameters of patients performing normally or abnormally on individual neuropsychological tasks. Spearman’s rho was used to investigate the correlations between HRV parameters and neuropsychological scores, indexes of health status or COPD severity. Patients with defective performance at copying drawings with landmarks (CDL) test (N = 23) had lower very low frequency (VLF) power with respect to patients with normal performance (N = 31) (24 h: median 213; interquartile range 120–282 vs. 309; 188–431 ms², p = 0.043; daytime: 202; 111–292 vs. 342; 194–397 ms², p = 0.039). The CDL score correlated with the VLF power (24 h: ρ = 0.27, p = 0.049; daytime: ρ = 0.30, p = 0.028), and the normalized low frequency/high frequency (LF/HF) ratio (24 h: ρ = 0.27, p = 0.05; daytime: ρ = 0.33, p = 0.015). Sympathetic modulation decreased for increasing severity of COPD. In conclusion, drawing impairment correlates with depressed sympathetic modulation in patients with COPD, and both might be indexes of COPD severity.     

Self-Regulatory Dysfunctions in Personality Disorders: The Role of Poor Self-Monitoring and Mindreading

To understand how persons self-regulate, we need, as Cervone, Shadel, Smith, and Fiori (2006 ) assert, to refer to personality science, with which it is possible to identify the multifarious psychological elements and processes helping or hindering action programming, overcoming difficulties, and error correction. Personality disorder research and personality science itself demonstrate that dysfunctions in two skills—self-monitoring and mindreading—worsen self-regulation and lead individuals to fail chronically to achieve goals in the social domain. Here we describe how poor self-reflection and biased mindreading impair self-regulation in personality disorders and other clinical conditions and make some suggestions about how to tackle them in psychotherapy.     

The therapeutic community in the local community: Social networks between therapeutic community and supported housing

In this paper, the authors present a model for therapeutic community programmes for those with severe and enduring mental ill health, based on social networks. These programmes have given birth to a range of therapeutic community which are, in fact, an innovative form of group psychotherapy. These new model do not depend on communal living. Some are groupings of apartments, others day units. Work schemes also feature here. And yet, as the authors outline, various components need to be present if these are to be considered genuine therapeutic communities and not just supported housing schemes. Additionally, a certain kind of training and clinical supervision is needed for the staff.     

Fostering Resilience among Couples Coparenting a Young Child with Autism: An Evaluation of Together We Are Stronger

Abstract

The purpose of this study was to evaluate a 4-week caregiver training program designed to promote resilience among couples raising a child with Autism Spectrum Disorder (ASD). Seven couples with a child between the ages of 3 and 9 completed a group-based training focused on values, communication, coparenting, and managing stress. Pre-post assessment of parenting stress, dyadic satisfaction, coparenting, life satisfaction, and hope showed that although parenting stress did not decrease, significant increases were observed in dyadic cohesion, coparenting, and hope. Implications for the development of couple-focused interventions to promote resilience among parents raising a child with ASD are discussed.     

Hallucinations and REM sleep behaviour disorder in Parkinson's disease: dream imagery intrusions and other hypotheses

REM sleep behaviour disorder (RBD) is a REM sleep-related parasomnia which may be considered a “dissociated state of wakefulness and sleep”, given that conflicting elements of REM sleep (dreaming) and of wakefulness (sustained muscle tone and movements) coexist during the episodes, leading to motor and behavioural manifestations reminiscent of an enacted dream. RBD has been reported in association with α-synucleinopathies: around a third of patients with Parkinson’s disease (PD) have full-blown RBD.Recent data indicate that PD patients with RBD are more prone to hallucinations than PD patients without this parasomnia. However it is still not clear why RBD in PD is associated with an increased prevalence of VHs.Data exist which suggest that visual hallucinations in PD may be the result of untimely intrusions of REM visual imagery into wakefulness. RBD, which is characterised by a REM sleep dissociation pattern, might be a condition that particularly favours such intrusions. However, other hypotheses may be advanced. In fact, deficits in attentional, executive, visuoperceptual and visuospatial abilities have been documented in RBD and found to occur far more frequently in PD with RBD than in PD without RBD. Neuropsychological deficits involving visual perception and attentional processes are thought to play an important role in the pathophysiology of VHs. On this basis, RBD in PD could be viewed as a contributory risk factor for VHs.     

Decisions Under Temporal AND Emotional Pressure: The Hidden Relationships Between the Unconscious,Personality, and Cognitive Styles

The existence of an unaware psychic space that influences the way we think, perceive, and decide has been known for over a century. This space, defined by Freud as the “unconscious,” contains in itself unaware psychic contents. Its sophisticated adaptive functions, implicit and unaware, allow individuals to transform an enormous amount of information into explicit behaviors, influencing their behaviors. In this article, we advance the hypothesis that there is a strong relationship between the unconscious, personality styles, and decisions under conditions of temporal and emotional pressure. The fact that an increase in the quality of a performance follows an increase in excitation, at least up to a certain threshold, clarifies the concept. Beyond this level of activation, not only are the benefits starting to diminish, but we also notice the onset of dysfunctional conditions that consist of anxiety, inner tension, difficulty in concentration, and inability to decide.