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.     

Autonomy, Slavery, and Mill's Critique of Paternalism

Critics have charged that John Stuart Mill's discussion as of paternalism in On Liberty is internally inconsistent, noting, for example, the numerous instances in which Mill explicitly endorses examples of paternalistic coercion. Similarly, commentators have noted an apparent contradiction between Mill's political liberalism – according to which the state should be neutral among competing conceptions of the good – and Mill's condemnation of non-autonomous ways of life, such as that of a servile wife. More generally, critics have argued that while Mill professes an allegiance to utilitarianism, he actually abandons it in favor of a view that values personal autonomy as the greatest intrinsic good. This paper presents an interpretation of Mill that provides a viable and consistent treatment of paternalism, thereby refuting each of the aforementioned critiques. Mill's views, it argues, are consistently utilitarian. Moreover, the interpretation accounts for all of Mill's departures from his otherwise blanket prohibition of paternalistic legislation. In particular, it explains his most notorious example, the condemnation of voluntary contracts for slavery. The interpretation emphasizes Mill's conceptual linkage between autonomy and utility, noting his implicit use of at least three different senses of the notion of autonomy.     

Influence of chronic corticosterone and glucocorticoid receptor antagonism in the amygdala on fear conditioning

Glucocorticoid receptor activation within the basolateral amygdala (BLA) during fear conditioning may mediate enhancement in rats chronically exposed to stress levels of corticosterone. Male Sprague-Dawley rats received corticosterone (400 microg/ml) in their drinking water (days 1-21), a manipulation that was previously shown to cause hippocampal CA3 dendritic retraction. Subsequently, rats were adapted to the fear conditioning chamber (day 22), then trained (day 23), and tested for conditioned fear to context and tone (day 25). Training consisted of two tone (20s) and footshock (500 ms, 0.25 mA) pairings. In Experiment 1, muscimol (4.4 nmol/0.5 microl/side), a GABAergic agonist, was microinfused to temporarily inactivate the BLA during training. Rats given chronic corticosterone showed enhanced freezing to context, but not tone, compared to vehicle-supplemented rats. Moreover, BLA inactivation impaired contextual and tone conditioning, regardless of corticosterone treatment. In Experiment 2, RU486 (0, 0.3, and 3.0 ng/0.2 microl/side) was infused on training day to antagonize glucocorticoid receptors in the BLA. Corticosterone treatment enhanced fear conditioning to context and tone when analyzed together, but not separately. Moreover, RU486 (3.0 ng/side) selectively exacerbated freezing to context in chronic corticosterone-exposed rats only, but failed to alter tone conditioning. Serum corticosterone levels were negatively correlated with contextual, not tone, conditioning. Altogether, these suggest that chronic corticosterone influences fear conditioning differently than chronic stress as shown previously. Moreover, chronic exposure to corticosteroids alters BLA functioning in a non-linear fashion and that contextual conditioning is influenced more than tone conditioning by chronic corticosterone and BLA glucocorticoid receptor stimulation.     

Social stress in tree shrews as an animal model of depression: an example of a behavioral model of a CNS disorder

Animal models are invaluable in preclinical research on human psychopathology. Valid animal models to study the pathophysiology of depression and specific biological and behavioral responses to antidepressant drug treatments are of prime interest. In order to improve our knowledge of the causal mechanisms of stress-related disorders such as depression, we need animal models that mirror the situation seen in patients. One promising model is the chronic psychosocial stress paradigm in male tree shrews. Coexistence of two males in visual and olfactory contact leads to a stable dominant/subordinate relationship, with the subordinates showing obvious changes in behavioral, neuroendocrine, and central nervous activity that are similar to the signs and symptoms observed during episodes of depression in patients. To discover whether this model, besides its "face validity" for depression, also has "predictive validity," we treated subordinate animals with the tricyclic antidepressant clomipramine and found a time-dependent recovery of both endocrine function and normal behavior. In contrast, the anxiolytic diazepam was ineffective. Chronic psychosocial stress in male tree shrews significantly decreased hippocampal volume and the proliferation rate of the granule precursor cells in the dentate gyrus. These stress-induced changes can be prevented by treating the animals with clomipramine, tianeptine, or the selective neurokinin receptor antagonist L-760,735. In addition to its apparent face and predictive validity, the tree shrew model also has a "molecular validity" due to the degradation routes of psychotropic compounds and gene sequences of receptors are very similar to those in humans. Although further research is required to validate this model fully, it provides an adequate and interesting non-rodent experimental paradigm for preclinical research on depression.     

The course in the history of psychology: present status and future concerns

The present study provides a turn-of-the-century status report on the teaching of the history of psychology in colleges and universities in the United States. The data indicate that the course is offered regularly in most departments of psychology and is frequently required of majors; these findings are consistent with earlier research. Most instructors teach the course largely out of personal interest and self-taught expertise with their primary teaching and research commitments to other areas of psychology. Few instructors engage in publication of research and scholarship in the history of psychology, although there are 2 journals in the field that provide an outlet for scholarship. The few positions that allow for primary commitment to teaching and research in the history of psychology is a possible cause of concern for the future of the course and for its place in the education of psychologists in the 21st century.     

Cognitive mediation of intervention effects on physical exercise: Causal models for the adoption and maintenance stage

Objective: To investigate how the effects of a group-based intervention program (MoVo-LISA) on exercise behaviour were mediated by cognitive variables. Different causal models mapping the short-term (adoption) and long-term (maintenance) intervention effects were tested using path analyses.

Design: N?=?220 in-patients of a rehabilitation clinic were assigned to an usual care or intervention group (quasi-experimental design). Questionnaire-based assessment was conducted at baseline; discharge; and at six weeks, six months and 12 months post discharge.

Measures: The potential mediator variables were outcome expectations, self-efficacy, strength of goal intention (intention strength), self-concordance, action planning and barrier management.

Results: Observed intervention effects on exercise behaviour (p?<?0.05) were mediated by intention strength at the adoption and maintenance stages, by action planning only at the adoption, and by barrier management only at the maintenance stage. Self-efficacy and outcome expectations were only indirectly involved in these mediations by affecting intention strength and self-concordance.

Conclusion: This is the first study to track the cognitive mediation processes of intervention effects on exercise behaviour over a long time-period by differentiating the adoption and maintenance stages of behaviour change. The findings emphasise the importance of deconstructing intervention effects (modifiability vs. predictive power of a mediator) to develop more effective interventions.     

Exploring phenomenological interviews: questions,lessons learned and perspectives

Phenomenology and the Cognitive Sciences -     

Im Spannungsfeld von Wirkung und Nebenwirkung

Bei der Therapie der Multiplen Sklerose müssen eventuelle Nebenwirkungen gegen die erwartete Wirkung eines Medikamentes individuell abgewogen werden. Im folgenden Beitrag werden die derzeit vorhandenen MS-Therapien beschrieben und bezüglich ihrer Wirkung und m?glichen Nebenwirkungen bewertet.     

No conflict control in the absence of awareness

Introduction  

In the present study we tested whether control over the impact of potentially conflicting information depends on awareness of that conflicting information.     

Peripheral pain enhances the effects of incentive downshifts

Physical pain (induced by tissue damage) and psychological pain (induced by surprising incentive loss) share a set of common neural substrates, but little is known about their interactions. The present research studied such interactions using the formalin test to induce physical pain and consummatory successive negative contrast (cSNC) to induce psychological pain. In the formalin test, animals receive an intradermal injection of formalin (1%) in a hind paw. In cSNC, rats with free access to 32% sucrose show a sharp suppression of drinking behavior after a downshift to 4% sucrose, compared to rats that always receive 4% sucrose. In Experiment 1, formalin administration before the first and second 32-to-4% sucrose downshift trials enhanced cSNC. In Experiment 2, a similar treatment before the first downshift trial after a 16-to-4% sucrose downshift, which normally produces little or no evidence of cSNC, significantly increased cSNC. In Experiment 3, using a 32-to-4% sucrose downshift procedure similar to that of Experiment 1, no effects were observed following formalin administration immediately after Trial 11. Thus, no evidence was found that the effects of physical pain on cSNC were caused by changes in memory consolidation. The procedures used in these experiments offer a new approach to study the neural substrates of interactions between physical and psychological pain.