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  Mens Sana Monographs
A Monograph Series Devoted To The Understanding Of Medicine, Mental Health, Man, Mind, Music And Their Matrix
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   2013| January-December  | Volume 11 | Issue 1  
    Online since March 21, 2013

 
 
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CONSCIOUSNESS MONOGRAPH
Towards an integrative theory of consciousness: Part 1 (Neurobiological and cognitive models)
Avinash De Sousa
January-December 2013, 11(1):100-150
DOI:10.4103/0973-1229.109335  PMID:23678241
The study of consciousness is poised today at interesting crossroads. There has been a surge of research into various neurobiological underpinnings of consciousness in the past decade. The present article looks at the theories regarding this complex phenomenon, especially the ones that neurobiology, cognitive neuroscience and cognitive psychology have to offer. We will first discuss the origin and etymology of word consciousness and its usage. Neurobiological correlates of consciousness are discussed with structures like the ascending reticular activating system, the amygdala, the cerebellum, the thalamus, the frontoparietal circuits, the prefrontal cortex and the precuneus. The cellular and microlevel theories of consciousness and cerebral activity at the neuronal level contributing to consciousness are highlighted, along with the various theories posited in this area. The role of neuronal assemblies and circuits along with firing patterns and their ramifications for the understanding of consciousness are discussed. A section on the role of anaesthesia and its links to consciousness is presented, along with details of split-brain studies in consciousness and altered states of awareness, including the vegetative states. The article finally discusses the progress cognitive psychology has made in identifying and theorising various perspectives of consciousness, perceptual awareness and conscious processing. Both recent and past researches are highlighted. The importance and salient features of each theory are discussed along with the pitfalls, if present. A need for integration of various theories to understand consciousness from a holistic perspective is stressed, to enable one to reach a theory that explains the ultimate neurobiology of consciousness.
  13,313 237 5
EDITORIALS
What makes people healthy, happy, and fulfilled in the face of current world challenges?
C Robert Cloninger
January-December 2013, 11(1):16-24
DOI:10.4103/0973-1229.109288  PMID:23678235
Recent research on the relations of personality to well-being shows that the people who are most healthy, happy and fulfilled are those who are high in all three of the character traits of self-directedness, cooperativeness, and self-transcendence as measured by the Temperament and Character Inventory. In the past, the healthy personality has often been considered to require only high self-directedness and high cooperativeness. However, now the self-centred behaviour of people who are low in self-transcendence is degrading the conditions needed for sustainable life by all human beings. Consequently, human beings need to and can develop their capacity for self-transcendence in order to maintain their individual and collective well-being.
  6,819 589 6
Neuropsychiatry: Where are we and where do we go from here?
Perminder S Sachdev, Adith Mohan
January-December 2013, 11(1):4-15
DOI:10.4103/0973-1229.109282  PMID:23678234
Introduction: Neuropsychiatry has generally been regarded as a hybrid discipline that lies in the borderland between the disciplines of psychiatry and neurology. There is much debate on its current and future identity and status as a discipline. Materials and Methods: Taking a historical perspective, the future of neuropsychiatry is placed within the context of recent developments in clinical neuroscience. Results: The authors argue that with the maturation of the discipline, it must define its own identity that is not dependent entirely upon the parent disciplines. The requirements for this are the claiming of neuropsychiatric territory, a strong training agenda, an emphasis on treatments that are uniquely neuropsychiatric, and a bold embrace of new developments in clinical neuroscience. Conclusion: The exponential growth in neuroscientific knowledge places neuropsychiatry in an excellent position to carve out a strong identity. It is imperative that the leaders of the discipline seize the moment.
  6,558 562 -
JOURNALOLOGY
Reviewer index: A new proposal of rewarding the reviewer
Sushil Ghanshyam Kachewar, Smita Balwant Sankaye
January-December 2013, 11(1):274-284
DOI:10.4103/0973-1229.109347  PMID:23678247
Science is strengthened not by research alone, but by publication of original research articles in international scientific journals that gets read by a global scientific community. Research publication is the 'heart' of a journal and the 'soul' of science - the outcome of collective efforts of authors, editors and reviewers. The publication process involves author-editor interaction for which both of them get credit once the article gets published - the author directly, the editor indirectly. However, the remote reviewer who also plays a key role in the process remains anonymous and largely unrecognised. Many potential reviewers therefore, stay away from this 'highly honorary' task. Appropriate peer review controls quality of an article and thereby ensures quality and integrity of the journal. Recognising and rewarding the role of the reviewer is therefore vital. In this article, we propose a novel idea of Reviewer Index (RI), Reviewer Index Directory (RID) and Global Reviewer Index Directory (GRID), which will strengthen science by focussing on the reviewer, as well as the author. By adopting this innovative Reviewer Centric Approach, a new breed of well-trained reviewers of high quality and sufficient quantity will be available for eternity. Moreover, RI, RID and GRID would also enable grading and ethical rewarding of reviewers.
  5,517 182 6
PSYCHIATRY, MENTAL HEALTH AND PSYCHOANALYSIS
Polypharmacy in psychiatry: A review
Sanjay Kukreja, Gurvinder Kalra, Nilesh Shah, Amresh Shrivastava
January-December 2013, 11(1):82-99
DOI:10.4103/0973-1229.104497  PMID:23678240
Psychiatric polypharmacy refers to the prescription of two or more psychiatric medications concurrently to a patient. It can be categorised as same-class, multi-class, adjunctive, augmentation and total polypharmacy. Despite advances in psychopharmacology and a better understanding of the principles of therapeutics, its practice is increasing rapidly. The prevalence of polypharmacy in psychiatry varies between 13%-90%. There are various clinical and pharmaco-economic factors associated with it. Dealing with polypharmacy requires an understanding of its associated factors. Education, guidelines and algorithms for the appropriate management of various conditions are effective ways to avoid irrational polypharmacy.
  5,214 108 4
CONSCIOUSNESS STUDIES
What affective neuroscience means for science of consciousness
Leonardo Ferreira Almada, Alfredo Pereira, Claudia Carrara-Augustenborg
January-December 2013, 11(1):253-273
DOI:10.4103/0973-1229.100409  PMID:23678246
The field of affective neuroscience has emerged from the efforts of Jaak Panksepp in the 1990s and reinforced by the work of, among others, Joseph LeDoux in the 2000s. It is based on the ideas that affective processes are supported by brain structures that appeared earlier in the phylogenetic scale (as the periaqueductal gray area), they run in parallel with cognitive processes, and can influence behaviour independently of cognitive judgements. This kind of approach contrasts with the hegemonic concept of conscious processing in cognitive neurosciences, which is based on the identification of brain circuits responsible for the processing of (cognitive) representations. Within cognitive neurosciences, the frontal lobes are assigned the role of coordinators in maintaining affective states and their emotional expressions under cognitive control. An intermediary view is the Damasio-Bechara Somatic Marker model, which puts cognition under partial somatic-affective control. We present here our efforts to make a synthesis of these views, by proposing the existence of two interacting brain circuits; the first one in charge of cognitive processes and the second mediating feelings about cognitive contents. The coupling of the two circuits promotes an endogenous feedback that supports conscious processes. Within this framework, we present the defence that detailed study of both affective and cognitive processes, their interactions, as well of their respective brain networks, is necessary for a science of consciousness.
  4,452 106 4
CONSCIOUSNESS MONOGRAPH
Towards an integrative theory of consciousness: Part 2 (An anthology of various other models)
Avinash De Sousa
January-December 2013, 11(1):151-209
DOI:10.4103/0973-1229.109341  PMID:23678242
The study of consciousness has today moved beyond neurobiology and cognitive models. In the past few years, there has been a surge of research into various newer areas. The present article looks at the non-neurobiological and non-cognitive theories regarding this complex phenomenon, especially ones that self-psychology, self-theory, artificial intelligence, quantum physics, visual cognitive science and philosophy have to offer. Self-psychology has proposed the need to understand the self and its development, and the ramifications of the self for morality and empathy, which will help us understand consciousness better. There have been inroads made from the fields of computer science, machine technology and artificial intelligence, including robotics, into understanding the consciousness of these machines and their implications for human consciousness. These areas are explored. Visual cortex and emotional theories along with their implications are discussed. The phylogeny and evolution of the phenomenon of consciousness is also highlighted, with theories on the emergence of consciousness in fetal and neonatal life. Quantum physics and its insights into the mind, along with the implications of consciousness and physics and their interface are debated. The role of neurophilosophy to understand human consciousness, the functions of such a concept, embodiment, the dark side of consciousness, future research needs and limitations of a scientific theory of consciousness complete the review. The importance and salient features of each theory are discussed along with certain pitfalls, if present. A need for the integration of various theories to understand consciousness from a holistic perspective is stressed.
  4,077 191 4
EDITORIALS
Psychiatry's catch 22, need for precision, and placing schools in perspective
Ajai R Singh
January-December 2013, 11(1):42-58
DOI:10.4103/0973-1229.109304  PMID:23678237
The catch 22 situation in psychiatry is that for precise diagnostic categories/criteria, we need precise investigative tests, and for precise investigative tests, we need precise diagnostic criteria/categories; and precision in both diagnostics and investigative tests is nonexistent at present. The effort to establish clarity often results in a fresh maze of evidence. In finding the way forward, it is tempting to abandon the scientific method, but that is not possible, since we deal with real human psychopathology, not just concepts to speculate over. Search for clear-cut definitions/diagnostic criteria in psychiatry must be relentless. There is a greater need to be ruthless and blunt in this, rather than being accommodative of diverse opinions. Investigative tests - psychological, serum, CSF, or neuroimaging - are only corroborative at present; they need to become definitive. Medicalisation appears most prominent in psychiatry; so, diagnostic proliferation and fuzziness appear inevitable. And yet, the established diagnostic entities need to forward greater and conclusive precision. Also, the need for clarity and precision must outweigh pandering to and mollifying diverse interests, moreso in the upcoming revision of diagnostic manuals. This is specially because the DSM-5, being an Association manual, may need to accommodate powerful member lobbies; and ICD-11 may similarly need to cater to diverse country lobbies. Finding precise biological correlates of psychiatric phenomena, whether through neuroimaging, molecular neurobiology and/or neurogenomics, is the right way forward. It is in the 1.5-kg structure in the cranium that all secrets of psychiatric conditions lie. Social forces, behavioural modification, psychosocial restructuring, study of intrapsychic processes, and philosophical insights are not to be discounted, but they are supplementary to the primary goal - studying and deciphering those brain processes that result in psychiatric malfunction. Experimental breakthroughs, both in psychiatric aetiology and therapeutics, will come mainly from biology and its adjunct, psychopharmacology; while supplementary and complementary breakthroughs will come from the psychosocial, cognitive and behavioural approaches; the support base will come from phenomenology, epidemiology, nosology and diagnostics; while insights and leads can hopefully come from many fields, especially the psychosocial, the behavioural, the cognitive and the philosophical. Major energies must now be marshalled towards finding biomarkers and deciphering the precise phenotype-genotype-endophenotype axis of psychiatric disorders. Energies also need to be focussed on unravelling those critical processes in the brain that tip the scale towards psychiatric disorders. At how those critical processes are set into motion by forces de novo, in utero, in the genes and their expression, by the environment's psychopathological social forces - stress, peer pressure, poverty, deprivation, alienation, malnutrition, discrimination of various types (caste, gender, race, etc.), mass conflicts (war, terror attacks, etc.), disasters (natural and man-made), religious/ideological fascism - or social institutions like marriage, family, work place, political governance, etc. Ultimately, we must decipher how the brain goes into malfunction when such varied forces impinge on it, which precise cortical areas and neuronal cellular and molecular processes are involved in such malfunction and its manifestation, as also which of these are involved when malfunction ceases and health is restored, and the psychosocial processes and institutions which aid such health restoration, as also those which promote well-being and help in primary prevention. Emphasis on the brain and its intimate neurological and molecular mechanisms will not impinge on, or nullify, importance of the 'mind,' wherein subtle and gross brain functions in the form of behaviour, thought and emotions in all their ramifications will continue to be the focus of psychological, cognitive, sociological, psychopharmacological, behavioural and philosophical research. Progress in brain research must move in tandem with progress in 'mind' research.
  3,485 74 1
Psychopharmacological practice: The DSM versus The Brain
Thomas L Schwartz
January-December 2013, 11(1):25-41
DOI:10.4103/0973-1229.109299  PMID:23678236
In 1952, the Diagnostic and Statistical Manual of Mental Disorders (DSM) system of creating, validating, studying and employing a diagnostic system in clinical psychiatric practice was introduced. There have been several updates and revisions to this manual and, regardless of its a theoretical framework, it actually does have a framework and presupposition. Essentially the DSM dictates that all psychiatric disorders are syndromes, or a collection of symptoms that commonly occur together and impair psychosocial functioning. These syndromes allow for homogenous groups of patients to be studied and psychotherapies and pharmacotherapies to be developed. This editorial will examine the DSM system with regards to its applicability to central nervous system dysfunction where psychiatric disorders are concerned. Specifically, the brain does not follow categorical, or syndromal, constructs. In fact, the psychiatric patient likely inherits several risk genes that promote abnormal proteins along several neuropathways in the brain. These abnormalities create dysfunctional neurocircuits which create individual psychiatric symptoms, but not a categorical syndrome or diagnosis. The concept that the DSM may be excellent for clinical diagnostic purposes, but less correct in its assumptions for a psychopharmacologist's treatment approaches will be discussed.
  3,244 85 2
COMMENTARIES ON THE MONOGRAPH
A Commentary on De Sousa's "Towards an Integrative Theory of Consciousness"
Alfredo Pereira
January-December 2013, 11(1):210-229
DOI:10.4103/0973-1229.104495  PMID:23678243
De Sousa's comprehensive two-part review of a diversity of contemporary approaches to the study of consciousness is highly welcome. He makes us aware of a proliferation of theoretical and empirical approaches targeting a common theme, but diverging in many ways. He skilfully accomplishes a classification of kinds of approach, identification of the main representatives, their contributions, and respective limitations. However, he does not show how the desired integration could be accomplished. Besides summarising De Sousa's efficient analytical work, I make critical comments and briefly report my contribution for the integration project.
  3,035 72 -
CONSCIOUSNESS STUDIES
The embodied embedded character of system 1 processing
Samuel de Castro Bellini-Leite
January-December 2013, 11(1):239-252
DOI:10.4103/0973-1229.109345  PMID:23678245
In the last thirty years, a relatively large group of cognitive scientists have begun characterising the mind in terms of two distinct, relatively autonomous systems. To account for paradoxes in empirical results of studies mainly on reasoning, Dual Process Theories were developed. Such Dual Process Theories generally agree that System 1 is rapid, automatic, parallel, and heuristic-based and System 2 is slow, capacity-demanding, sequential, and related to consciousness. While System 2 can still be decently understood from a traditional cognitivist approach, I will argue that it is essential for System 1 processing to be comprehended in an Embodied Embedded approach to Cognition.
  2,843 64 -
REFERENCE LIST
Total Reference List MSM 2013

January-December 2013, 11(1):304-337
  2,857 50 -
PSYCHIATRY, MENTAL HEALTH AND PSYCHOANALYSIS
Psychoanalysis and politics: Historicising subjectivity
Lynne Layton
January-December 2013, 11(1):68-81
DOI:10.4103/0973-1229.104493  PMID:23678239
In this paper, I compare three different views of the relation between subjectivity and modernity: one proposed by Elisabeth Young-Bruehl, a second by theorists of institutionalised individualisation, and a third by writers in the Foucaultian tradition of studies of the history of governmentalities. The theorists were chosen because they represent very different understandings of the relation between contemporary history and subjectivity. My purpose is to ground psychoanalytic theory about what humans need in history and so to question what it means to talk ahistorically about what humans need in order to thrive psychologically. Only in so doing can one assess the relation between psychoanalysis and progressive politics. I conclude that while psychoanalysis is a discourse of its time, it can also function as a counter-discourse and can help us understand the effects on subjectivity of a more than thirty year history in the West of repudiating dependency needs and denying interdependence.
  2,769 64 2
Reflections on psychiatry and international mental health
Helen Herrman
January-December 2013, 11(1):59-67
DOI:10.4103/0973-1229.104485  PMID:23678238
This paper reflects on the needs for close interaction between psychiatry and all partners in international mental health for the improvement of mental health and advancement of the profession, with a particular view to the relationships between mental health, development and human rights. The World Health Organisation identifies strong links between mental health status and development for individuals, communities and countries. In order to improve population mental health, countries need effective and accessible treatment, prevention, and promotion programmes. Achieving adequate support for mental health in any country requires a unified approach. Strong links between psychiatrists, community leaders and patients and families that are based on negotiation and respect, are vital for progress. When strong partnerships exist, they can contribute to community understanding and advancement of psychiatry. This is the first step towards scaling up good quality care for those living with mental illnesses, preventing illnesses in those at risk, and promoting mental health through work with other community sectors. Partnerships are needed to support education and research in psychiatry, and improvements in quality of care wherever psychiatry is practiced, including primary health and community mental health services, hospitals and private practice. There are important roles for psychiatry in building the strength of organisations that champion the advocacy and support roles of service users and family carers, and encouraging partnerships for mental health promotion in the community.
  2,512 71 2
COMMENTARIES ON THE MONOGRAPH
Conscious states: Where are they in the brain and what are their necessary ingredients?
William Hirstein
January-December 2013, 11(1):230-238
DOI:10.4103/0973-1229.109343  PMID:23678244
One of the final obstacles to understanding consciousness in physical terms concerns the question of whether conscious states can exist in posterior regions of the brain without active connections to the brain's prefrontal lobes. If they can, difficult issues concerning our knowledge of our conscious states can be resolved. This paper contains a list of types of conscious states that may meet this criterion, including states of coma, states in which subjects are absorbed in a perceptual task, states in brains with damaged prefrontal lobes, states of meditation and conscious states of some infants and animals. Recent evidence also suggests that conscious states of some autistic people may meet this criterion.
  2,421 65 -
TEMPLATE FOR MSM SUBMISSIONS
Revised Template for MSM Submissions 2013
Ajai R Singh
January-December 2013, 11(1):290-295
  1,895 42 -
PREFACE
Preface, MSM 2013
Ajai R Singh
January-December 2013, 11(1):1-3
PMID:23678233
  1,674 93 -
MSM POEMS 2013
Radiology request
Ankeet Jethwa
January-December 2013, 11(1):285-286
DOI:10.4103/0973-1229.109348  PMID:23678248
  1,372 54 -
CALL FOR PAPERS
Call for Papers for MSM 2014 Theme Monograph: Indian Concept of Mind, and Some Issues in Biological Psychiatry, Psychopharmacology, and Other Essays
Ajai Singh
January-December 2013, 11(1):296-303
  1,340 51 -
MSM POEMS 2013
Communication is key
Ankeet Jethwa
January-December 2013, 11(1):287-288
DOI:10.4103/0973-1229.109349  PMID:23678249
  1,288 41 -
INSTRUCTIONS TO CONTRIBUTORS
Instructions to Contributors

January-December 2013, 11(1):338-343
  1,016 51 -
REVIEWERS
Peer Reviewers for MSM 2013

January-December 2013, 11(1):289-289
  981 38 -
  Why MSM 
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  Call for papers... 
  Forthcoming MSM... 
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