In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM – whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part 1 of this article took up the first two questions. Part 2 took up the second two questions. Part 3 now deals with Questions 5 & 6. Question 5 confronts the issue of utility, whether the manual design of DSM-III and IV favors clinicians or researchers, and what that means for DSM-5. Our final question, Question 6, takes up a concluding issue, whether the acknowledged problems with the earlier DSMs warrants a significant overhaul of DSM-5 and future manuals. As in Parts 1 & 2 of this article, the general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

In the conclusion to this multi-part article I first review the discussions carried out around the six essential questions in psychiatric diagnosis – the position taken by Allen Frances on each question, the commentaries on the respective question along with Frances’ responses to the commentaries, and my own view of the multiple discussions. In this review I emphasize that the core question is the first – what is the nature of psychiatric illness – and that in some manner all further (...) questions follow from the first. Following this review I attempt to move the discussion forward, addressing the first question from the perspectives of natural kind analysis and complexity analysis. This reflection leads toward a view of psychiatric disorders – and future nosologies – as far more complex and uncertain than we have imagined. (shrink)

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article will take up the first two questions. With the first question, invited commentators express a range of opinion regarding the nature of psychiatric disorders, loosely divided into a realist position that the diagnostic categories represent real diseases that we can accurately name and know with our perceptual abilities, a middle, nominalist position that psychiatric disorders do exist in the real world but that our diagnostic categories are constructs that may or may not accurately represent the disorders out there, and finally a purely constructivist position that the diagnostic categories are simply constructs with no evidence of psychiatric disorders in the real world. The second question again offers a range of opinion as to how we should define a mental or psychiatric disorder, including the possibility that we should not try to formulate a definition. The general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article took up the first two questions. Part II will take up the second two questions. Question 3 deals with the question as to whether DSM-V should assume a conservative or assertive posture in making changes from DSM-IV. That question in turn breaks down into discussion of diagnoses that depend on, and aim toward, empirical, scientific validation, and diagnoses that are more value-laden and less amenable to scientific validation. Question 4 takes up the role of pragmatic consideration in a psychiatric nosology, whether the purely empirical considerations need to be tempered by considerations of practical consequence. As in Part 1 of this article, the general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

A long-debated question in the philosophy of health, and contingent disciplines, is the extent to which wise clinical practice (“clinical wisdom”) is, or could be, compatible with empirically validated medicine (“evidence-based medicine”—EBM). Here we respond to Baum-Baicker and Sisti, who not only suggest that these two types of knowledge are divided due to their differing sources, but also that EBM can sometimes even hurt wise clinical practice. We argue that the distinction between EBM and clinical wisdom is poorly defined, unsupported (...) by the methodology employed, and ultimately incorrect; crucial differences exist, we argue, not in the source of a particular piece of clinical knowledge, but in its dependability. In light of this subtle but fundamental revision, we explain how clinical wisdom and EBM are—by necessity—complementary, rather than in conflict. We elaborate on how recognizing this relationship can have far-reaching implications for the domains of clinical practice, medical education, and health policy. (shrink)

According to embodied theories of language (ETLs), word meaning relies on sensorimotor brain areas, generally dedicated to acting and perceiving in the real world. More specifically, words denoting actions are postulated to make use of neural motor areas, while words denoting visual properties draw on the resources of visual brain areas. Therefore, there is a direct correspondence between word meaning and the experience a listener has had with a word's referent on the brain level. Behavioral and neuroimaging studies have provided (...) evidence in favor of ETLs; however, recent studies have also shown that sensorimotor information is recruited in a flexible manner during language comprehension (e.g., Raposo et al. ; Van Dam et al., ), leaving open the question as to what level of language processing sensorimotor activations contribute. In this study, we investigated the time course of modality-specific contributions (i.e., the contribution of action information) as to word processing by manipulating both (a) the linguistic and (b) the action context in which target words were presented. Our results demonstrate that processes reflecting sensorimotor information play a role early in word processing (i.e., within 200 ms of word presentation), but that they are sensitive to the linguistic context in which a word is presented. In other words, when sensorimotor information is activated, it is activated quickly; however, specific words do not reliably activate a consistent sensorimotor pattern. (shrink)

According to embodied theories of language (ETLs), word meaning relies on sensorimotor brain areas, generally dedicated to acting and perceiving in the real world. More specifically, words denoting actions are postulated to make use of neural motor areas, while words denoting visual properties draw on the resources of visual brain areas. Therefore, there is a direct correspondence between word meaning and the experience a listener has had with a word's referent on the brain level. Behavioral and neuroimaging studies have provided (...) evidence in favor of ETLs; however, recent studies have also shown that sensorimotor information is recruited in a flexible manner during language comprehension (e.g., Raposo et al. ; Van Dam et al., ), leaving open the question as to what level of language processing sensorimotor activations contribute. In this study, we investigated the time course of modality‐specific contributions (i.e., the contribution of action information) as to word processing by manipulating both (a) the linguistic and (b) the action context in which target words were presented. Our results demonstrate that processes reflecting sensorimotor information play a role early in word processing (i.e., within 200 ms of word presentation), but that they are sensitive to the linguistic context in which a word is presented. In other words, when sensorimotor information is activated, it is activated quickly; however, specific words do not reliably activate a consistent sensorimotor pattern. (shrink)

v. 1. Nicomachean ethics. Politics. The Athenian Constitution. Rhetoric. On Poetics.--v. 2. Logic.--v. 3. Physics. Metaphysics. On the soul. Short physical treaties.--v. 4. On the heavens. On generation and corruption. Meteorology. Biological treatises.

The essays in this volume apply philosophical analysis to address three kinds of questions: What are the implications of genetic science for our understanding of nature? What might it influence in our conception of human nature? What challenges does genetic science pose for specific issues of private conduct or public policy?

For many Christians, personal experiences of God provide an important ground or justification for accepting the truth of the gospel. But we are sometimes mistaken about our experiences, and followers of other religions also provide impressive testimonies to support their religious beliefs. This book explores from a philosophical and theological perspective the viability of divine encounters as support for belief in God, arguing that some religious experiences can be accepted as genuine experiences of God and can provide evidence for Christian (...) beliefs. (shrink)

Humans are experts in cooperating with each other when trying to accomplish tasks they cannot achieve alone. Recent studies of joint action have shown that when performing tasks together people strongly rely on the neurocognitive mechanisms that they also use when performing actions individually, that is, they predict the consequences of their co‐actor’s behavior through internal action simulation. Context‐sensitive action monitoring and action selection processes, however, are relatively underrated but crucial ingredients of joint action. In the present paper, we try (...) to correct the somewhat simplified view on joint action by reviewing recent studies of joint action simulation, monitoring, and selection while emphasizing the intricate interrelationships between these processes. We complement our review by defining the contours of a neurologically plausible computational framework of joint action. (shrink)

When the whole is greater than the sum of the parts--indeed, so great that the sum far transcends the parts and represents something utterly new and different--we call that phenomenon emergence. When the chemicals diffusing in the primordial waters came together to form the first living cell, that was emergence. When the activities of the neurons in the brain result in mind, that too is emergence. In The Emergence of Everything, one of the leading scientists involved in the study of (...) complexity, Harold J. Morowitz, takes us on a sweeping tour of the universe, a tour with 28 stops, each one highlighting a particularly important moment of emergence. For instance, Morowitz illuminates the emergence of the stars, the birth of the elements and of the periodic table, and the appearance of solar systems and planets. We look at the emergence of living cells, animals, vertebrates, reptiles, and mammals, leading to the great apes and the appearance of humanity. He also examines tool making, the evolution of language, the invention of agriculture and technology, and the birth of cities. And as he offers these insights into the evolutionary unfolding of our universe, our solar system, and life itself, Morowitz also seeks out the nature of God in the emergent universe, the God posited by Spinoza, Bruno, and Einstein, a God Morowitz argues we can know through a study of the laws of nature. Written by one of our wisest scientists, The Emergence of Everything offers a fascinating new way to look at the universe and the natural world, and it makes an important contribution to the dialogue between science and religion. (shrink)

In The Neoplatonic Socrates, leading scholars in classics and philosophy address this gap by examining Neoplatonic attitudes toward the Socratic method, Socratic love, Socrates's divine mission and moral example, and the much-debated issue of moral rectitude. Collectively, they demonstrate the importance of Socrates for the majority of Neoplatonists, a point that has often been questioned owing to the comparative neglect of surviving commentaries on the Alcibiades, Gorgias, Phaedo, and Phaedrus, in favor of dialogues dealing explicitly with metaphysical issues. Supplemented with (...) a contextualizing introduction and a substantial appendix detailing where evidence for Socrates can be found in the extant literature, The Neoplatonic Socrates makes a clear case for the significant place Socrates held in the education and philosophy of late antiquity. (shrink)