Tuesday, 29 November 2022

Why are you talking to yourself?

Today's post is by Elmar Unnsteinsson (University College Dublin). Here Unnsteinsson asks why we talk to ourselves.



The other day I saw someone enjoying a walk while deeply engaged in conversation but I couldn’t see the other person. The ledge between us was too high. When I turned the corner I saw that the person was alone and actually talking to no one. Well, no one else I should say. It’s unremarkable that I had assumed that there was a pair of people, dancing conversational tango, but, it does raise the question why we think of conversation as, essentially, a multi-player game?

As a matter of fact, many of us thoroughly enjoy having conversations. We seek them out to achieve catharsis, form strong social bonds of trust and friendship, learn surprising new things, and obviously the list could be endless. So, it never even occurs to us to ask why we would spend our time talking to others. We couldn’t even list half of the good reasons to do so. Why is it then so surprising to us that people might get exactly the same types of enjoyment and benefit from talking to themselves? More poignantly, why is there such a strong social norm against self-talk, such that we experience shame and embarrassment when caught in the act?

In an article I recently published open access in Mind and Language, called ‘The Social Epistemology of Introspection,’ I try to show that talking to oneself and talking to others are much more alike than people have usually assumed. A little more precisely, I argue that the cognitive mechanisms, motivational profiles, and normal functions associated with each kind of action are essentially the same. 

When we introspect our own emotions or attitudes we basically tell ourselves what we feel or believe, for reasons that are similar to the reasons why we would tell such things to others. But we also rely on the normal operation of a mechanism designed for communication; roughly, the mechanism underlying our capacity to intentionally produce cognitive effects in minded creatures.

There is reason to suppose that we can derive enjoyment and benefit merely from the skillful exercise of this singular capacity; just like the poet or public speaker we can seek the pleasures of communicative acts for their own sake. And so, it should not be surprising that people might like to talk to themselves. More surprisingly, perhaps, we should also expect various epistemic or practical benefits from self-talk, which would mirror the benefits of conversing with others. So, for example, by posing a question to myself directly in a communicative act, I may unearth an answer which otherwise might remain hidden from consciousness.

This does have other, more troubling consequences, however. Any malignant purpose we are afraid others might have in talking to us, we are just as likely to have ourselves in the privacy of our own minds. Thus, social epistemology has been too focused on various doxastic or epistemic effects of informational interactions between agents, to the detriment of studying the very same effects as they manifest themselves in reasoning and cognition themselves. 

Perhaps, this is just the pernicious social norm against self-talk working its way into the work of the scientist. If we were more enlightened as a society about the potential pleasures of self-talk, we would presumably do more of it. In turn, we might also be more interested in exploring the non-pathological aspects of engaging in this – in this imagined world – common and unremarkable activity. It never occurs to us to ask why chess players would bother playing chess to themselves. And why would we not train or just enjoy the exercise one of our most cherished capacities, namely the capacity to converse?

Tuesday, 22 November 2022

MANTO: Predicting Depression

A group of researchers from the University of Ferrara, Bologna, New York, and Stockholm have developed a tool to predict the risk of developing depression in people over 55. Anyone can calculate their risk through a website. Here Martino Belvederi Murri (Ferrara) reports on the study that could mark a turning point in terms of early identification and prevention of this condition.


The prophetess Manto


According to the World Health Organization, depression is the leading cause of disability in the world. About 15% of people suffer from depression at least once in their life: the consequences can range from temporary suffering to the loss of work and social relationships, to suicide. The impact of the pandemic, isolation, the economic crisis and the population aging make depression a widespread economic and social problem, especially in late life. Unfortunately, depression often goes unrecognized or does not receive prompt treatment. This is due to several factors, such as scarcity of information, stigma, or insufficient public mental healthcare resources.

The early identification and prevention of depression is an innovative, desirable approach. Everyone can develop depression under difficult circumstances, but some people have higher risk than others. Risk factors for depression include being female, experiencing sleep disturbances, pain, or other physical symptoms, and a previous history of depression.

The Manto Depression Risk Calculator is the first tool available worldwide to provide a personalized estimate of the risk of developing depression over the next two years. It takes its name from Manto who, according to legend, was the prophetess who created the lake of the city of Mantua with her tears. To use Manto, it is sufficient to go to the site and answer some questions about symptoms of depression and some other aspects of life. 

Anonymity is guaranteed and it is not mandatory to fill in all of them, but the more answers are provided, the more accurate the estimate will be. At the end of the short questionnaire (currently in the Italian and English language) the site will produce an estimate of the individual risk score, expressed as a percentage. The calculator is intended for use by adults aged 55 or over without severe cognitive problems. 

Manto calculates the risk score processing data that derive from information on risk factors. Researchers used estimates from the scientific literature and European population data to obtain a statistical model with good discriminatory capacity. The study has just been published in the American Journal of Geriatric Psychiatry and is the product of the collaboration between Martino Belvederi Murri, from the University of Ferrara,  Luca Cattelani, Federico Chesani and Pierpaolo Palumbo, from the University of Bologna, Federico Triolo, from the Karolinska Institutet of Stockholm, and George Alexopoulos from Cornell University in New York. 


Martino Belvederi Murri presents MANTO



The project could have important positive effects for people who will use the site and could be used to develop healthcare strategies. Depression in old age has in fact significant personal and health costs. Manto can be used to identify populations at risk to target public health interventions. The researchers responsible for Manto said:

"It is a great satisfaction to make our work available. Manto is the first model of its type that can be used freely. For years, anyone could use online tools to predict the risk of developing heart disease, but no similar instrument was available for mental health, which is too important. We hope that Manto serves people and professionals in the sector, such as General Practitioners or mental health specialists. We would also like to draw attention to the issue of depression, which must be recognized without shame and can be treated at all ages. However, we will not stop here: we aim to develop newer versions of Manto, further improving personalization and precision"

One key question is what a person should do if the Manto Depression Risk Calculator says they are at high risk of depression. If Manto's "prophecy" says that the person's risk score is high (for instance, higher than 60%), there is no need to panic. Several risk factors for depression can be modified. For example, one can treat sleep disturbance or pain, exercise, engage in pleasurable or intellectually stimulating activities. Other preventive treatments and actions are also available, such as psychological, pharmacological and behavioral strategies, alone or in combination. If a person believes that are already depressed, then they need to consult their healthcare provider.


Tuesday, 15 November 2022

Temporal Asymmetries in Philosophy and Psychology

This post is by Alison Fernandes (University of Dublin). Alison works in the metaphysics and philosophy of science, with a focus on temporal asymmetries, foundations of physics and agency. Today Alison presents the edited volume Temporal Asymmetries in Philosophy and Psychology (OUP 2022).



Alison Fernandes


We have very different attitudes towards past and future events. Events looming in our futures are those we might worry about, plan for, or look forward to. Events that are already in our pasts, on the other hand, are those we might regret, contemplate, or remember fondly—but not plan for in the same way. Why is this?

 

There are, in fact, many temporal asymmetries in how we engage with the world. Most people prefer bad events to be in the past and good events to be in the future, all else being equal (Lee et al 2020). Strikingly, people assign work more compensation when it is described as taking pace in the future, compared to the past (Caruso et al 2008). There are also asymmetries in how extensively we simulate events, how strongly we feel about them (van Boven and Ashworth 2007), and how close we judge them to be (Caruso et al 2013).




 

While philosophers have long been interested in these asymmetries, traditional work in this area was interested in using these asymmetries to support a particular ‘metaphysical’ view of time—one in which the past and future were radically different, independently of our relationship to them. While psychologists were interested in giving detailed accounts of how we relate to events in time—particularly contrasting events that are close and distant—asymmetries took a back seat. Indeed, some of these asymmetries appear so fundamental that’s it’s difficult to see an empirical project of explaining them. Isn’t it obvious that future events, not having happened, are those we should care about more?

 

Christoph Hoerl, Teresa McCormack and I, working under an AHRC grant (see interview about the project with Hoerl), hosted a workshop with philosophers and psychologists with the aims of exploring psychological asymmetries—leading us to co-edit the first interdisciplinary volume on these issues, Temporal Asymmetries in Philosophy and Psychology. One of our key aims was to relate the more speculative big-picture thinking in philosophy to detailed empirical work from psychology.

 

One set of topics concerns how different asymmetries arise developmentally (explored by Lee and McCormack in their chapter), evolutionarily (Campbell) as well as how they relate to each other and to psychological mechanisms more broadly (Ramos et al, De Brigard, Greene et al, Fernandes, Hoerl and Rinaldi):
  • Are some asymmetries more basic than others? 
  • Do we already conceive of the past and future differently before we value past and future events differently? 
  • Or is our thinking about the past and future shaped by the kinds of attitudes we develop?


A second set of topics concerns the rationality of these asymmetries, explored in chapters by O’Brien, Callender, Sullivan and Hoerl. It might seem reasonable to care about future events more. But is it reasonable to assign more compensation to future wrongs versus past wrongs? Finally, there’s a set of questions about what picture of time we are left with—explored particularly by Deng but relevant throughout the volume:
  • Do we have a stable intuitive conception of time? 
  • Or are our attitudes too complex to support a single view?

By framing these questions and showcasing of up-to-date work in this area, the volume aims to provide a strong foundation for future research on psychological temporal asymmetries.

Tuesday, 8 November 2022

How Stable are Moral Judgments?

Today's post is by Paul Rehren at Utrecht University on his recent paper (co-authored with Walter Sinnott-Armstrong at Duke University) "How Stable are Moral Judgments?" (Review of Philosophy and Psychology 2022).


Paul Rehren

Psychologists and philosophers often work hand in hand to investigate many aspects of moral cognition. One issue has, however, been relatively neglected: the stability of moral judgments over time [but see, Helzer et al. 2017].

In our paper, Walter Sinnott-Armstrong and I argue that there are four main reasons for philosophers and psychologists to consider the stability of moral judgments. First, the stability of moral judgments can shed light on the role of moral values in moral judgments. Second, lay people seem to expect moral judgments to be stable in a way that contrasts with tastes. Third, philosophers also assume that their moral judgments do and should not change without reason. Finally, stability may have methodological implications for moral psychology.

Next, we report the results of a three-wave longitudinal study that probes the stability of one type of moral judgment: moral judgments about sacrificial dilemmas [see, Christensen and Gomila 2012]. In each wave (6-8 days apart), participants rated the extent to which they thought that individuals in a series of sacrificial dilemmas should or should not act. We then investigated how stable these ratings remained between the first and second wave using two different approaches. 

First, we found an overall test-retest correlation of .66. Second, we observed moderate to large proportions (M = 49%) of rating shifts (any change in rating between waves), and small to moderate proportions of rating revisions (M = 14%)—that is, the participants in question judged p in one wave, but did not judge p in the other wave.


Walter Sinnott-Armstrong

If our findings are not due to measurement error and so do shed light on a genuine feature of real-life moral judgment, then what explains the unstable moral judgments we observed? In our paper, we investigate three possible explanations, but do not find evidence for them. First, because sacrificial dilemmas are in a certain sense designed to be difficult, moral judgments about acts in these scenarios may give rise to much more instability than moral judgments about other scenarios or statements. 

However, we compared our test-retest correlations with a sampling of test-retest correlations from other instruments involving moral judgments, and sacrificial dilemmas did not stand out. Second, we did not find evidence that moral judgment changes occur because people are more confident in their moral judgments the second time around.

Third, we did not find evidence that rating changes were often due to participants changing their minds in light of reasons and reflection. We tested for this in a few different ways. Moral judgment changes between the first two waves did not tend to persist when participants judged the same dilemmas for a third time. 

Also, Actively Open-minded Thinking [Baron 1993], Need for Cognition [Cacioppo and Petty 1982] and scores on the Cognitive Reflection Test [Frederick 2005] all failed to predict whether participants changed their ratings. Last, participants who self-reported having changed their mind about at least one scenario because they thought more about the scenario or because they discussed the scenario with others accounted for only a small proportion of moral judgment changes.

We think that our findings of instability without reason may raise serious questions for moral philosophy (though of course, they do not finally settle any of these controversial issues). For example, many moral philosophers treat moral judgments about specific cases like sacrificial dilemmas as part of the “data of ethics” [Ross 2002, p. 41] when they use these judgments to choose among competing normative moral theories [e.g., Kamm 1993, Rawls 1971]. 

However, this data is unreliable when moral judgments change in the ways we observed, because incompatible moral judgments about the same act in the same circumstances cannot both be correct. Such a shifting foundation seems not to be a good place to build a moral theory if you want them to last. In addition, we also suggest that instability can create trouble for the meta-ethical theory known as intuitionism [e.g., Audi 2007, Huemer 2005], as well as for virtue theories of ethics [e.g., Aristotle, Nicomachean Ethics].

Tuesday, 1 November 2022

Subjective Experience and Meaning of Delusions in Psychosis

Today's post is by Rosa Ritunnano (University of Birmingham). Rosa is a consultant psychiatrist and PhD candidate at the Institute for Mental Health. Here she talks about a recent paper she co-authored with an interdisciplinary group of international researchers at the Universities of York, Melbourne, Warwick and Ohio State. The paper entitled “Subjective experience and meaning of delusions in psychosis: systematic review and qualitative evidence synthesis” has been published in The Lancet Psychiatry and is available Open Access.

Rosa Ritunnano

This paper is the result of a big team effort, and my hope is that it will encourage delusion and psychosis researchers across disciplines to go beyond commonplace assumptions (deeply ingrained especially within clinical psychiatry) about the nature and meaning of delusional phenomena.

The aim of this research was to gain a deeper and more nuanced understanding of delusional phenomena based on the experiential knowledge of those with lived expertise—as the necessary basis for person-centred assessment and intervention. Here, we (attempted to) remain agnostic as to the nature of delusions (beliefs or other), conceiving of them as occurrent experiential states which have a specific phenomenology—that is, we assumed that there is a characteristic what-it-is-likeness to be in a certain delusional state and that this what-it-is-likeness can be investigated on its own terms. Our research question was: how do individuals with psychosis experience and make sense of changes in their self, world and meaning during the onset and progression of delusions?

For the first time, we reviewed all the available published qualitative literature in English that explored the lived experience of delusions in help-seeking individuals with psychosis, irrespective of diagnosis and thematic content of the delusion. In order to do this rigorously, we followed a particular methodology called “meta-synthesis” or “qualitative evidence synthesis”, which is widely used in the social sciences for integrating the findings of multiple primary qualitative research studies. This required screening 2115 references and then 133 full-text reports against pre-established inclusion criteria, until 24 eligible high-quality studies were left for inclusion in the final synthesis.

These 24 papers contained first-person accounts from 373 individuals with psychosis and lived experience of delusions, who were interviewed by the authors of the primary papers on different aspects of their delusional experiences. After importing all the findings into a data management software, we analysed the text through thematic synthesis, first coding it line by line and subsequently developing descriptive and then analytic themes to answer our research question. This method enabled us to stay “close” to the original words spoken by the participants, while at the same time moving beyond a simple aggregation of data and producing new hypotheses.

Three main analytic themes were generated from the thematic synthesis: 1) A radical, affectively charged rearrangement of the lived world dominated by intense emotions; 2) Doubting, losing, and finding oneself again within delusional realities; 3) Searching for meaning, belonging, and coherence beyond mere dysfunction (see figure below). In the paper, you can find a full discussion of themes and subthemes, and examples of the participants’ quotations supporting them.


From these findings, we developed the “Emergence Model of Delusion” (figure below). This model suggests that delusions in psychosis are best understood as complex and multi-layered phenomena, emerging from a dynamical interaction between multiple processes happening at different levels of increasing organisational complexity (e.g., sub-personal, personal, inter-personal and socio-cultural). This in turns allows us to conceive of potentially dysfunctional mechanisms at one level, showing adaptive properties at a higher or lower level.


Notably, despite significant emotional and mental struggle, many participants described delusional experience as being accompanied by an enhanced sense of meaningfulness. This experience was interpreted by some in positive terms, albeit of short duration and often followed by a painful drop into depression and constant attempts at rebuilding self-trust. The role of interpersonal relationships appeared to be central in this process of building and rebuilding trust in self and others, both during and after the delusional period.

As a clinician myself, what I want to highlight here, is that all delusional experiences initiated a process of self-understanding and search for meaningfulness that appeared to clash painfully with the responses received by the participants from others (including mental health staff). These responses, mostly in line with a simple 'problem-solving' approach to remedying a dysfunction or a symptom of illness, could not help answering pressing existential questions such as “why is this happening to me?” or “what significance does it have?” For this reason, many described feeling alone and isolated.

Effective clinical care for individuals with psychosis might need adapting to match more closely, and take account of, the subjective experience and meaning of delusions as they are lived through by the person. Such an adaptation may also help redress power imbalances and enduring epistemic and hermeneutical injustices in mental health.