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The neurobiology of functional neurological disorders characterised by impaired awareness 2023 Milano et al

Discussion in 'Other psychosomatic news and research' started by Andy, Apr 4, 2023.

  1. Andy

    Andy Committee Member

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    Location:
    Hampshire, UK
    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.

    Open access, https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1122865/full
     
  2. Andy

    Andy Committee Member

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    21,810
    Location:
    Hampshire, UK
    "Everyone knows what attention is and no one knows what attention is

    Over the course of time and across different disciplines, attention has been addressed and presented with many definitions (246, 247). Interestingly, it has been defined as the process that enhances representation of some kinds of information and inhibits others (248), thus privileging the former over the latter for further processing. It has long been hypothesised that « dissociative » disorders, and FIAD, in particular, involve biased attention, we researched the sources that cited original search articles to find (249255). For example, experimental participants scoring high for dissociation on a self-report scale showed reduced attention to somatosensory stimulation after they watched a trauma-related film (162, 256260). As we will describe below, predictive coding theory formulates attention as an implicit prediction about the value of sensory input. In other words, patients may gate out awareness of input, analogous to collateral discharges normally suppressing (predictably uninformative) blurring during visual saccades. Thus, predictive coding theory both emphasises and helps operationalise the role of attention in FIAD."

    Ref 251 is Naviaux's "dauer" paper, Metabolic features of chronic fatigue syndrome 2016 Naviaux et al, which is used here to support "biased attention"....
     
  3. rvallee

    rvallee Senior Member (Voting Rights)

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    Canada
    If you can't manipulate the patient with a BS narrative, you should try manipulating the patient with a different BS narrative. What they propose is just as manipulative, it's always admitted that the "theory" is only invented to manipulate the patients, to fool them into thinking it is scientifically valid, so clearly they see nothing wrong with mass abusing a complete and unaccountable power differential. They seem to think nothing of a coercive, manipulative model based on lying and think it can form a collaborative process with this. Absurd, zero respect for the patient as a person, as worthy of the same respect they expect for themselves.

    More than anything, they keep showing they learned nothing other than manipulating people, then covering up the mass manipulation with more pseudoscientific BS that is always derivative of every other manipulative BS before that. If you simply removed the coercive manipulative process, none of this would work. If patients' objections were recorded, this couldn't be sustained. They cannot possibly not understand that the only reason this stuff is around is simply because they can shove it down our throats. They even keep admitting that their theories are fake, and no one cares.

    As to why they think they can, somehow, separate attention from cognitive issues, I have no words. Well, there is a word for this: perfidy. They have false pretenses and hidden motivations, but they abuse their credentials to bring people in, openly manipulating and not even ashamed of admitting it among themselves. Revolting.

    It may not have a new hat, but it has a sticker that says "New hat!":

    [​IMG]
     
  4. Hutan

    Hutan Moderator Staff Member

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    Location:
    Aotearoa New Zealand
    alktipping, Peter Trewhitt and Trish like this.

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