The Behavioral and brain sciences
May 30, 2019
Samuel P L Veissière, Axel Constant, Maxwell J D Ramstead et al.
362 citations
A unifying account of how humans acquire shared cultural habits, norms, and expectations is developed by integrating the variational free-energy principle from theoretical neuroscience with concepts of cultural evolution and implicit learning. Humans construct social niches that provide epistemic resources called cultural affordances. Through immersive participation in patterned cultural practices, agents learn by inferring what other people expect—a process termed "thinking through other minds" (TTOM). This makes information about others' expectations the primary statistical regularity humans use to predict and organize behavior. The model aims to resolve debates in cognitive science between internalist and externalist accounts of theory of mind and between dynamical and representational views of enactivism.
Medical humanities
June 1, 2019
Laurence J Kirmayer, Ana Gómez-carrillo
104 citations
Psychosomatic explanation in medicine, psychiatry, and psychology creates a social grey zone where conflicts about agency, causality, and moral responsibility arise, reflecting deep-seated dualism in Western concepts of personhood. Illnesses viewed as psychologically mediated tend to be seen as less real or legitimate. New forms of dualism appear in philosophical attacks on Engel's biopsychosocial approach and in the NIMH's Research Domain Criteria program, which favors exclusively biological explanations. The case of resignation syndrome among refugee children in Sweden illustrates how accounting for medically unexplained symptoms raises problems of ascribing agency.
Frontiers in psychiatry
January 1, 2020
Ram P Sapkota, Alain Brunet, Laurence J Kirmayer
21 citations
In a systematic case-control study of 384 Nepalese adolescents aged 11-18 from 12 public schools, 194 students affected by mass psychogenic illness (MPI) were compared with 190 unaffected controls. MPI is understood as a dissociative phenomenon spread through social contagion among those prone to dissociation. Bivariate analyses linked caseness to childhood physical neglect and abuse, living in nuclear families, peritraumatic dissociation, dissociative tendencies, and depressive and post-traumatic stress symptoms. Hypnotizability was the strongest correlate among cognitive and personality traits. However, multivariable logistic regression found that common correlates of dissociation did not predict caseness, suggesting these factors do not adequately explain MPI. A Classification and Regression Trees analysis indicated that highly hypnotizable adolescents with high peritraumatic dissociation had a 73% probability of being a case.
Frontiers in psychology
January 1, 2024
Anya Daly, Rosa Ritunnano, Shaun Gallagher et al.
17 citations
Mental disorders involve complex alterations of the self that arise from interactions among cognitive, bodily, affective, social, narrative, cultural, and normative elements. The pattern theory of self (PTS) provides a non-reductive account consistent with embodied-enactive cognition and phenomenological psychopathology, emphasizing the multi-dimensionality of subjects and situated embodiment. This article develops the Examination of Self Patterns (ESP), a flexible methodological framework that front-loads the self-pattern into a minimally structured phenomenological interview. The ESP avoids internalist or externalist assumptions about mind and is guided by person-specific interpretations rather than diagnostic categories, offering advantages for tackling the complexity of mental health research and clinical protocols.
Transcultural psychiatry
October 1, 2022
Gabriella Gobbi, Antonio Inserra, Kyle T Greenway et al.
9 citations
Psychedelics have been used by human societies for over 3000 years, primarily in religious and healing contexts. Recent research shows promising clinical benefits for some psychiatric disorders, but applying these consciousness-altering substances outside their traditional sociocultural settings raises concerns. The therapeutic mechanisms of psychedelics depend not only on neurobiology but also on psychological, social, and spiritual processes. Therefore, physicians and psychotherapists need training to guide patients through the experience, promoting positive outcomes and addressing side effects. Psychedelic therapies may lead to a new psychiatric paradigm integrating psychopharmacological, psychotherapeutic, and cultural interventions.
Culture, medicine and psychiatry
December 1, 2014
Ram P Sapkota, Dristy Gurung, Deepa Neupane et al.
Spirit possession in a Nepali village is a multidimensional phenomenon that cannot be reduced to a psychiatric diagnosis. A mixed-method study compared women who had experienced possession with those who had not: possessed women reported higher rates of traumatic events and more symptoms of anxiety (68% vs. 18%), depression (41% vs. 19%), and PTSD (27% vs. 0%). However, qualitative interviews with possessed individuals, family members, and traditional healers showed they did not view possession as mental illness; instead, it was seen as a form of communication with spirits and an idiom of distress expressing suffering related to mental illness, violence, trauma, and oppression. Clinical efforts must consider socio-cultural context to avoid harm.