126 research outputs found
Dialogue entre les humanitaires français et anglo-saxons
Ce livre est l’édition anglaise du livre publié en français en 2006 et intitulé Critique de la raison humanitaire. Le titre français invite le lecteur à une analyse critique de l’humanitaire, ce qui signifie réfléchir à ce que l’on peut comprendre de l’action humanitaire et considérer les limites de cette analyse. Ce livre utilise une approche unique pour stimuler et informer le lecteur dans sa propre analyse : juxtaposer des textes traitant des organisations humanitaires écrits par des auteu..
Dialogue entre les humanitaires français et anglo-saxons
Ce livre est l’édition anglaise du livre publié en français en 2006 et intitulé Critique de la raison humanitaire. Le titre français invite le lecteur à une analyse critique de l’humanitaire, ce qui signifie réfléchir à ce que l’on peut comprendre de l’action humanitaire et considérer les limites de cette analyse. Ce livre utilise une approche unique pour stimuler et informer le lecteur dans sa propre analyse : juxtaposer des textes traitant des organisations humanitaires écrits par des auteu..
The neurobiology of functional neurological disorders characterised by impaired awareness
We review the neurobiology of Functional Neurological Disorders (FND), i.e., neurological disorders not explained by currently identifiable histopathological processes, in order to focus on those characterised by impaired awareness (functionally impaired awareness disorders, FIAD), and especially, on the paradigmatic case of Resignation Syndrome (RS). We thus provide an improved more integrated theory of FIAD, able to guide both research priorities and the diagnostic formulation of FIAD. We systematically address the diverse spectrum of clinical presentations of FND with impaired awareness, and offer a new framework for understanding FIAD. We find that unraveling the historical development of neurobiological theory of FIAD is of paramount importance for its current understanding. Then, we integrate contemporary clinical material in order to contextualise the neurobiology of FIAD within social, cultural, and psychological perspectives. We thus review neuro-computational insights in FND in general, to arrive at a more coherent account of FIAD. FIAD may be based on maladaptive predictive coding, shaped by stress, attention, uncertainty, and, ultimately, neurally encoded beliefs and their updates. We also critically appraise arguments in support of and against such Bayesian models. Finally, we discuss implications of our theoretical account and provide pointers towards an improved clinical diagnostic formulation of FIAD. We suggest directions for future research towards a more unified theory on which future interventions and management strategies could be based, as effective treatments and clinical trial evidence remain limited
Group psychotherapy format guided self-help for patients with FNSD awaiting inpatient multidisciplinary treatment: A pilot study
Background:
We describe our experience of developing Guided Self Help for patients with Functional Neurological Symptom Disorder as group therapy, delivered remotely, via Zoom.
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Aims:
The aims of the current study are (a) to describe how the original Queen Square Guided Self-Help (QGSH) was adapted for group therapy, and (b) to present a service evaluation of the first 8 months of running QGSH therapy groups remotely.
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Methods:
We carried out a review after 8 months, from 11 May 2021 until 31 January 2022.
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Results:
A total of 16 patients were treated in three groups. Assessing our outcomes in terms of Yalom's framework for group psychotherapy, we found that the group provided 10/11 of Yalom's therapeutic factors. Patient satisfaction was high.
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Discussion:
We outline for plans for further devaluation and development, including the development of a stand-alone group.
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Conclusion:
The group therapy format is a promising addition to our service
Active inference, evidence accumulation, and the urn task
Deciding how much evidence to accumulate before making a decision is a problem we and other animals often face, but one that is not completely understood. This issue is particularly important because a tendency to sample less information (often known as reflection impulsivity) is a feature in several psychopathologies, such as psychosis. A formal understanding of information sampling may therefore clarify the computational anatomy of psychopathology. In this theoretical letter, we consider evidence accumulation in terms of active (Bayesian) inference using a generic model of Markov decision processes. Here, agents are equipped with beliefs about their own behavior--in this case, that they will make informed decisions. Normative decision making is then modeled using variational Bayes to minimize surprise about choice outcomes. Under this scheme, different facets of belief updating map naturally onto the functional anatomy of the brain (at least at a heuristic level). Of particular interest is the key role played by the expected precision of beliefs about control, which we have previously suggested may be encoded by dopaminergic neurons in the midbrain. We show that manipulating expected precision strongly affects how much information an agent characteristically samples, and thus provides a possible link between impulsivity and dopaminergic dysfunction. Our study therefore represents a step toward understanding evidence accumulation in terms of neurobiologically plausible Bayesian inference and may cast light on why this process is disordered in psychopathology
Predictors of risky foraging behaviour in healthy young people
During adolescence and early adulthood, learning when to avoid threats and when to pursue rewards becomes crucial. Using a risky foraging task, we investigated individual differences in this dynamic across 781 individuals aged 14-24 years who were split into a hypothesis-generating discovery sample and a hold-out confirmation sample. Sex was the most important predictor of cautious behaviour and performance. Males earned one standard deviation (or 20%) more reward than females, collected more reward when there was little to lose and reduced foraging to the same level as females when potential losses became high. Other independent predictors of cautiousness and performance were self-reported daringness, IQ and self-reported cognitive complexity. We found no evidence for an impact of age or maturation. Thus, maleness, a high IQ or self-reported cognitive complexity, and self-reported daringness predicted greater success in risky foraging, possibly due to better exploitation of low-risk opportunities in high-risk environments
Reflection impulsivity in binge drinking: behavioural and volumetric correlates.
The degree to which an individual accumulates evidence prior to making a decision, also known as reflection impulsivity, can be affected in psychiatric disorders. Here, we study decisional impulsivity in binge drinkers, a group at elevated risk for developing alcohol use disorders, comparing two tasks assessing reflection impulsivity and a delay discounting task, hypothesizing impairments in both subtypes of impulsivity. We also assess volumetric correlates of reflection impulsivity focusing on regions previously implicated in functional magnetic resonance imaging studies. Sixty binge drinkers and healthy volunteers were tested using two different information-gathering paradigms: the beads task and the Information Sampling Task (IST). The beads task was analysed using a behavioural approach and a Bayesian model of decision making. Delay discounting was assessed using the Monetary Choice Questionnaire. Regression analyses of primary outcomes were conducted with voxel-based morphometry analyses. Binge drinkers sought less evidence prior to decision in the beads task compared with healthy volunteers in both the behavioural and computational modelling analysis. There were no group differences in the IST or delay discounting task. Greater impulsivity as indexed by lower evidence accumulation in the beads task was associated with smaller dorsolateral prefrontal cortex and inferior parietal volumes. In contrast, greater impulsivity as indexed by lower evidence accumulation in the IST was associated with greater dorsal cingulate and precuneus volumes. Binge drinking is characterized by impaired reflection impulsivity suggesting a deficit in deciding on the basis of future outcomes that are more difficult to represent. These findings emphasize the role of possible therapeutic interventions targeting decision-making deficits.The study was supported by theWellcome Trust grant to VV (093705/10/Z) and to NA Harrison. PB is supported by the Portuguese Foundation for Science and Technology (individual fellowship to PB: SFRH/BD/33889/ 2009). YW is supported by the Fyssen Fondation. MM is supported by the Welcome Trust and the Biomedical Research Centre.Wewould also like to thank theWolfson Brain Imaging Center staff for their expertise with collecting the imaging data and all the participants for their involvement in this study. The Behavioural and Clinical Neuroscience Institute is supported by the Wellcome Trust and Medical Research Council.This is the final published version. It first appeared from Wiley via http://dx.doi.org/10.1111/adb.1222
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