Le Propre et l'Etranger : le concept d'identité vécue en première personne

The aim of this study is to determinate what means the feeling of personal identity in a first person perspective and not, as it is usually considered in epistemology, in the third person perspective. It seems to us that personal identity refers both to a time-related experience of continuity and a feeling of self-recognition rooted in the mineness of all embodied experience. In a naturalistic view, we will illustrate our philosophical survey through the experimental study of two pathologies directly impacting on the feeling of one's own identity. First Alzheimer's disease threatens the time-related dimension of identity because it blows off autobiographic memory which participates to the appropriation of a past as mine. Then the locked-in syndrome causing a total loss of motor skills leads the subject to question his body-ownership. Therefore, this study offers an interdisciplinary approach of philosophical issues to propose a new conception of personal identity.L'objectif de la thèse est de déterminer, du point de vue subjectif, ce qui constitue le vécu identitaire. Conscients que la notion d'identité a été travaillée principalement du point de vue objectif en épistémologie, nous voudrions nous pencher plus avant sur l'identité telle qu'elle est vécue par le sujet. Il nous semble que ce concept prend sens pour le sujet à la fois dans le temps, comme continuité d'une présence à soi, et dans un sentiment d'appartenance ou de reconnaissance indissociable de l'expérience incarnée d'être soi. Dans une conception naturaliste de l'identité, nous illustrerons notre propos philosophique par l'étude expérimentale de deux pathologies qui affectent directement le sentiment d'identité du sujet, l'une dans le sens d'une fragmentation de son histoire qui perturbe alors l'appropriation d'un vécu comme sien propre (maladie d'Alzheimer), l'autre dans le sens d'une dépossession du corps comme outil de la volonté qui menace alors l'appropriation du corps comme corps propre (locked-in syndrome). Cette étude se situe donc d'emblée à l'intersection des philosophies du corps et des sciences cognitives contemporaines, proposant un renouveau épistémologique du concept d'identité

Mesurer le vécu identitaire subjectif

Peut-il y avoir une science du vécu identitaire ? Si la science est l’étude objective de principes généraux, le vécu identitaire subjectif peut-il être décrit, quantifié et conceptualisé en termes scientifiques ? De précédents travaux suggèrent que le vécu identitaire est associé à la qualité de vie, la dépression et le suicide (Nizzi et al., 2012). Pourtant, les professionnels de santé n’ont à ce jour aucun outil fiable à leur disposition pour évaluer le vécu identitaire de leurs patients. Développer des outils psychométriques informatifs et largement utilisables pourrait contribuer à de nouvelles perspectives théoriques, diagnostiques et cliniques pour le traitement des pathologies rencontrées fréquemment en consultation de neuropsychologie. Mon but est de développer une approche empirique du vécu identitaire, telle qu’elle soit utile au clinicien. Dans cette thèse, nous présentons trois éléments de ce programme de recherche, centré sur les démences neurodégénératives. L’Etude 1 explore l’impact du contexte culturel sur la représentation sociale de la maladie d’Alzheimer (MA). L’Etude 2 caractérise l’impact de la MA à trois stades de détérioration cognitive sur quatre marqueurs du vécu identitaire. Enfin, nous présentons le développement et la validation d’un nouvel outil neuropsychologique destiné à évaluer le vécu identitaire : les fluences verbales identitaires (Etude 3).Can there be a science of the sense of self? If science is the objective study of general principles, beyond the particularities of individuals, can the subjective sense of self ever be described, measured, and modeled in scientific terms? Prior work suggests that the patients’ subjective experience of their identity may be associated with important health outcomes, such as quality of life, depression, and suicide ideation (Nizzi et al., 2012). Yet, clinicians do not have reliable measures to assess the sense of self of their patients. Developing informative, implementable psychometric tools to assess the sense of self may provide a novel perspective on our conceptualization, diagnosis and treatment of multiple conditions frequently seen in neuropsychology consults. My aim is to develop an empirical, clinically-relevant approach to assessing the sense of self.This dissertation presents three components of this line of research. Study 1 examines the context-dependence of the ways in which Alzheimer’s disease (AD) is represented by non-specialists in two different cultural settings, Paris and Boston. Study 2 investigates how four components of the sense of self (self-knowledge, mirror self-recognition, the bodily distinction between self and other, and self- reported age) vary across three stages of AD. Building on this earlier work, Study 3 reports on the development, validation and first clinical application of a new tool to assess the sense of self, called the Verbal Self Fluency task

Le propre et l'étranger (le concept d'identité vécue en première personne)

L'objectif de la thèse est de déterminer, du point de vue subjectif, ce qui constitue le vécu identitaire. Conscients que la notion d'identité a été travaillée principalement du point de vue objectif en épistémologie, nous voudrions nous pencher plus avant sur l'identité telle qu'elle est vécue par le sujet. II nous semble que ce concept prend sens pour le sujet à la fois dans le temps, comme continuité d'une présence à soi, et dans un sentiment d'appartenance ou de reconnaissance indissociable de l'expérience incarnée d'être soi. Dans une conception naturaliste de l'identité, nous illustrerons notre propos philosophique par l'étude expérimentale de deux pathologies qui affectent directement le sentiment d'identité du sujet, l'une dans le sens d'une fragmentation de son histoire qui perturbe alors l'appropriation d'un vécu comme sien propre (maladie d' Alzheimer), l'autre dans le sens d'une dépossession du corps comme outil de la volonté qui menace alors l'appropriation du corps comme corps propre (locked-in syndrome). Cette étude se situe donc d'emblée à l'intersection des philosophies du corps et des sciences cognitives contemporaines, proposant un renouveau épistémologique du concept d'identité.PARIS1-BU Pierre Mendès-France (751132102) / SudocSudocFranceF

Attitudes towards personhood in the locked-in syndrome: from third- to first- person perspective and interpersonal significance

peer reviewedPersonhood is ascribed on others, such that someone who is recognized to be a person is bestowed with certain civils rights and the right to decision-making. A rising question is how severely brain-injured patients who regain consciousness can also regain their personhood. The case of patients with locked-in syndrome (LIS) is illustrative to this matter. Upon restoration of consciousness, patients with LIS find themselves in a state of profound demolition of their bodily functions. From the third-person perspective, it can be expected that LIS patients might experience a differential personal identity and maybe lose their status of persons. However, from the patients’ standpoint, it is uncontested that they retain their personal identity and they consider themselves as persons. We here assist this perspective by including self-reports from patients with LIS aimed at identifying the primary expectations of patients for their care by non-medical professionals. Based on these first-hand reports, we argue that personhood in LIS is progressively regained as the widening circle of others recognizes them as persons

Consciousness in the Locked-In Syndrome

peer reviewedPatients in a locked-in syndrome (LIS) are selectively de-efferented (i.e., they have no means of producing speech, limb, or face movements). Usually the anatomy of the responsible lesion in the brainstem is such that locked-in patients are left with the capacity to use vertical eye movements and blinking to communicate with the external world. The syndrome is subdivided as: (i) classical LIS, which is characterized by total immobility except for vertical eye movements or blinking; (ii) incomplete LIS, which allows remnants of voluntary motion such as head or finger movements; and (iii) total LIS, which is a complete immobility including all eye movements. In all three cases, consciousness is usually fully preserved. Eye-controlled computer-based communication and brain-computer interface technology currently allows these patients to control their environment, use a word processor coupled to a speech synthesizer and access the world wide net. Available literature raises important ethical considerations in terms of quality of life and end-of-life decisions in such challenging patients. © 2016 Elsevier Ltd All rights reserved

Posttraumatic stress disorder symptom trajectories in a 16-month COVID-19 pandemic period

In the aftermath of mass trauma, posttraumatic stress disorder (PTSD) symptoms follow prototypical trajectories of resilience, recovery, or chronic distress. The coronavirus disease 2019 (COVID-19) pandemic represented an unheralded opportunity to better understand heterogeneous trajectories of PTSD symptoms across a prolonged period of social disruption and stress. We tracked the PTSD symptoms of trauma-exposed individuals in the U.S., sought to identify population-based variability in PTSD symptom trajectories, and understand what, if any, early pandemic experiences would predict their membership in one trajectory over others. As part of a large-scale longitudinal study of U.S. residents during the pandemic, participants who reported at least one potentially traumatic event in their lifetime (N = 1206) at Wave 1 (April 2020) were included in the current study. PTSD symptoms were assessed with the PTSD Checklist for DSM-5 at four time points extending to July 2021. Latent growth mixture modeling was used to identify heterogeneous symptom trajectories. Trajectory membership was regressed on baseline demographics and experiences from the early stage of the pandemic as measured by the Epidemic-Pandemic Impacts Inventory. Four trajectories (Resilient [73%], Recurring [13.3%], Recovering [8.3%], and Chronic [5.5%] were identified. Age, trauma load, and early pandemic experiences (emotional/physical health problems and positive changes) were each significant predictors of trajectory membership. Predictors primarily differentiated the Resilient from each of the other three trajectories. Distinct PTSD symptom trajectories during the COVID-19 pandemic point to the need for targeted efforts helping those at most risk for ongoing distress

The scientific study of consciousness cannot, and should not, be morally neutral

A target question for the scientific study of consciousness is how dimensions of consciousness, such as the ability to feel pain and pleasure or reflect on one’s own experience, vary in different states and animal species. Considering the tight link between consciousness and moral status, answers to these questions have implications for law and ethics. Here we point out that given this link, the scientific community studying consciousness may face implicit pressure to carry out certain research programmes or interpret results in ways that justify current norms rather than challenge them. We show that since consciousness largely determines moral status, the use of non-human animals in the scientific study of consciousness introduces a direct conflict between scientific relevance and ethics – the more scientifically valuable an animal model is for studying consciousness, the more difficult it becomes to ethically justify compromises to its well-being for consciousness research. Lastly, in light of these considerations, we call for a discussion of the immediate ethical corollaries of the body of knowledge that has accumulated, and for a more explicit consideration of the role of ideology and ethics in the scientific study of consciousness