Vulnerability of Individuals With Mental Disorders to Epistemic Injustice in Both Clinical and Social Domains

Many individuals who have mental disorders often report negative experiences of a distinctively epistemic sort, such as not being listened to, not being taken seriously, or not being considered credible because of their psychiatric conditions. In an attempt to articulate and interpret these reports we present Fricker’s concepts of epistemic injustice (Fricker, 2007, p. 1) and then focus on testimonial injustice and hermeneutic injustice as it applies to individuals with mental disorders. The clinical impact of these concepts on quality of care is discussed. Within the clinical domain, we contrast epistemic injustice with epistemic privilege and authority. We then argue that testimonial and hermeneutic injustices also affect individuals with mental disorders not only when communicating with their caregivers but also in the social context as they attempt to reintegrate into the general society and assume responsibilities as productive citizens. Following the trend of the movement of mental health care to the community, the testimonies of people with mental disorders should not be restricted to issues involving their own personal mental states.     

Safety Behavior After Extinction Triggers a Return of Threat Expectancy

Safety behavior is involved in the maintenance of anxiety disorders, presumably because it prevents the violation of negative expectancies. Recent research showed that safety behavior is resistant to fear extinction. This fear conditioning study investigated whether safety behavior after fear extinction triggers a return of fear in healthy participants. Participants learned that two stimuli (A and C) were followed by an aversive loud noise (“threat”), and one stimulus (B) was not. Participants then learned to use safety behavior that prevented the loud noise. Next, A and C were no longer followed by the loud noise, which typically led to extinction of threat expectancy. Safety behavior then became available again for C, but not for A and B. All participants used safety behavior on these C trials. In a final test phase, A, B, and C were presented once without the availability to use safety behavior. At each stimulus presentation, participants rated threat expectancy by indicating to what extent they expected that the loud noise would follow. Compared with the last extinction trial, threat expectancy increased for C in the test phase, whereas it did not increase for A and B. Hence, safety behavior after the extinction of classically conditioned fear caused a partial return of fear. The findings suggest that safety behavior may be involved in relapse after exposure-based therapy for anxiety disorders.     

Protecting Women from the Negative Effects of Body Dissatisfaction: The Role of Differentiation of Self

ABSTRACT

Body dissatisfaction is a prevalent and concerning issue among college age women. Due to its strong association with eating pathology, identification of moderating variables is a crucial line of inquiry. The present study investigated the ability for an intrapersonal differentiation-of-self variable (“I” position) to attenuate the impact of body dissatisfaction on anorexia and bulimia symptoms among college women participants. Study findings indicated that an “I” position moderated the body dissatisfaction-bulimia relationship and the body dissatisfaction-anorexia relationship. These findings signified the protective influence of a high “I” position for women with high levels of body dissatisfaction. Research and therapeutic implications are discussed.     

Équivalence de la version en français pour le Canada et de la version originale états-unienne de l’Adult Self-Report

The aim of the present study was to evaluate the equivalence of the French-Canadian version of the Adult Self-Report (ASR; Achenbach & Rescorla, 2003) to its original English (USA) version. Both the original English version and the newly translated French-Canadian version were administered to 251 bilingual students from four Canadian provinces (Manitoba, New-Brunswick, Ontario, and Quebec), with a one to two weeks interval. Correlations varying from 0.72 to 0.87 indicated a high degree of correspondence between the scales of the two versions. Cohen's d calculated using Morris and DeShon's (2002) formula for within-subjects designs indicate that differences between mean scores varied from near-zero (d = 0.01) to small (d = 0.19), and suggest that they are not clinically significant. Ordinal alpha coefficients for the scales of the French-Canadian version varied from 0.66 to 0.96 but are inferior to those of the English version in seven of the eleven scales. Globally, results indicate that the equivalence of the French-Canadian version to the original English version of the ASR is sufficient to recommend its use.     

A dissociation between selective attention and conscious awareness in the representation of temporal order information

Previous electrophysiological studies have shown that attentional selection processes are highly sensitive to the temporal order of task-relevant visual events. When two successively presented colour-defined target stimuli are separated by a stimulus onset asynchrony (SOA) of only 10 ms, the onset latencies of N2pc components to these stimuli (which reflect their attentional selection) precisely match their objective temporal separation. We tested whether such small onset differences are accessible to conscious awareness by instructing participants to report the category (letter or digit) of the first of two target-colour items that were separated by an SOA of 10, 20, or 30 ms. Performance was at chance level for the 10 ms SOA, demonstrating that temporal order information which is available to attentional control processes cannot be utilized for conscious temporal order judgments. These results provide new evidence that selective attention and conscious awareness are functionally separable, and support the hypothesis that attention and awareness operate at different stages of cognitive processing.     

Hypnotizing Libet: Readiness potentials with non-conscious volition

The readiness potential (RP) is one of the most controversial topics in neuroscience and philosophy due to its perceived relevance to the role of conscious willing in action. Libet and colleagues reported that RP onset precedes both volitional movement and conscious awareness of willing that movement, suggesting that the experience of conscious will may not cause volitional movement (Libet, Gleason, Wright, & Pearl, 1983). Rather, they suggested that the RP indexes unconscious processes that may actually cause both volitional movement and the accompanying conscious feeling of will (Libet et al., 1983; pg. 640). Here, we demonstrate that volitional movement can occur without an accompanying feeling of will. We additionally show that the neural processes indexed by RPs are insufficient to cause the experience of conscious willing. Specifically, RPs still occur when subjects make self-timed, endogenously-initiated movements due to a post-hypnotic suggestion, without a conscious feeling of having willed those movements.     

Balancing awareness: Vestibular signals modulate visual consciousness in the absence of awareness

The processing of visual and vestibular information is crucial for perceiving self-motion. Visual cues, such as optic flow, have been shown to induce and alter vestibular percepts, yet the role of vestibular information in shaping visual awareness remains unclear. Here we investigated if vestibular signals influence the access to awareness of invisible visual signals. Using natural vestibular stimulation (passive yaw rotations) on a vestibular self-motion platform, and optic flow masked through continuous flash suppression (CFS) we tested if congruent visual–vestibular information would break interocular suppression more rapidly than incongruent information. We found that when the unseen optic flow was congruent with the vestibular signals perceptual suppression as quantified with the CFS paradigm was broken more rapidly than when it was incongruent. We argue that vestibular signals impact the formation of visual awareness through enhanced access to awareness for congruent multisensory stimulation.