Embodied Tools, Cognitive Tools and Brain-Computer Interfaces

In this paper I explore systematically the relationship between Brain-Computer Interfaces (BCIs) and their human users from a phenomenological and cognitive perspective. First, I functionally decompose BCI systems and develop a typology in which I categorize BCI applications with similar functional properties into three categories, those with (1) motor, (2) virtual, and (3) linguistic applications. Second, developing and building on the notions of an embodied tool and cognitive tool, I analyze whether these distinct BCI applications can be seen as bodily or cognitive extensions. Contrary to some recent philosophical claims, I will argue that, although BCI technology may have the potential to become bodily and cognitive extensions for skilled users, at this stage they are not. And while the electrodes may to a variable degree be transparent and incorporated in the body schema, the BCI system as a whole is not. Moreover, BCIs do not have a functional role characteristic for cognition and are therefore not cognitive extensions. Third, based on concepts from the distributed cognition framework, I give a number of suggestions to improve the interface design of linguistic applications, i.e. BCIs that allow its user to spell words by selecting letters on a screen. These suggestions may result in cognitive extension and would enhance the autonomy and quality of life of its users. In sum, in this paper I develop a typology, analysis and critique on the current philosophical debate on BCIs, thereby providing a richer conceptual understanding of BCI systems which allows me to offer some suggestions for improving the interface design of linguistic applications.     

Emerging Ethical Issues Related to the Use of Brain-Computer Interfaces for Patients with Total Locked-in Syndrome

New brain-computer interface and neuroimaging techniques are making differentiation less ambiguous and more accurate between unresponsive wakefulness syndrome patients and patients with higher cognitive function and awareness. As research into these areas continues to progress, new ethical issues will face physicians of patients suffering from total locked-in syndrome (total LIS), characterized by complete loss of voluntary muscle control, with retention of cognitive function and awareness detectable only with neuroimaging and brain-computer interfaces. Physicians, researchers, ethicists and hospital ethics committees should be aware of and prepared to handle ethical issues unique to these totally locked-in patients. Several thought experiments are discussed, to highlight potential ethical dilemmas surrounding surrogate decision-making, autonomy, end-of-life care, and pediatric care, which will be unique to total LIS patients. These, along with other ethical problems especially relevant to total LIS patients, merit further discussion among physicians, researchers, ethicists and hospital ethics committees, to facilitate consensus regarding these issues, and improve patient care.     

脑机接口训练对卒中后感觉障碍患者运动功能恢复的影响：1项探索性研究

目的探究脑机接口训练对存在感觉障碍的卒中患者运动功能恢复的影响。      

An Update on the Impact of Gun Control Legislation on Suicide

Objective: The authors review recent literature examining the impact of gun control legislation on suicide rates. Method: MEDLINE and PsychLIT searches on gun ownership, gun control, and psychiatric firearm-related topics from 1982 through March 1997 were examined for reports focusing on gun control legislation and suicide. Results: Suicide rates typically decreased following implementation of a variety of firearm control laws. Suicide-prone individuals seldom substitute other means or go outside legal channels for suicide weapons. Firearm restrictions may decrease the ready accessibility of firearms enough to allow the peak period of suicidality to pass. Conclusion: The findings support gun control measures as a strategy for reducing suicide rates.     

Workshop-based Training in Trauma-focused CBT: An In-depth Analysis of Impact on Provider Practices

Despite evidence that more intensive methods are more effective, many clinical settings continue to train practitioners using workshops. To more fully understand the strengths and limitations of workshops, the present investigation studied changes in practitioner behavior following a workshop in trauma-focused cognitive-behavioral therapy (TF-CBT). A chart review indicated no changes in TF-CBT use following the training, although therapists indicated that CBT was the most effective treatment for traumatized youths and was their primary approach to treating trauma. Analysis of client factors indicated weak relationships between technique use and treatment need. Implications of these findings for future training efforts are discussed. Portions of this paper were presented at the Kansas Conference in Clinical Child and Adolescent Psychology, October, 2006.     

Visual Fixation Assessment in Patients with Disorders of Consciousness Based on Brain-Computer Interface

Visual fixation is an item in the visual function subscale of the Coma Recovery Scale-Revised (CRS-R). Sometimes clinicians using the behavioral scales find it difficult to detect because of the motor impairment in patients with disorders of consciousness (DOCs). Brain-computer interface (BCI) can be used to improve clinical assessment because it directly detects the brain response to an external stimulus in the absence of behavioral expression. In this study, we designed a BCI system to assist the visual fixation assessment of DOC patients. The results from 15 patients indicated that three showed visual fixation in both CRS-R and BCI assessments and one did not show such behavior in the CRS-R assessment but achieved significant online accuracy in the BCI assessment. The results revealed that electroencephalography-based BCI can detect the brain response for visual fixation. Therefore, the proposed BCI may provide a promising method for assisting behavioral assessment using the CRS-R.     

An Exploration of the Relational Autonomy of People with Substance Use Disorders: Constraints and Limitations

International Journal of Mental Health and Addiction - The concept of relational autonomy was used to investigate how people with substance use disorders (SUDs) exercise their autonomy when using...     

An Appraisal of the Impact of the Depiction of Gambling in Society on Youth

Youth are currently growing up in a culture where gambling is legal, accessible and widely supported. Although minors are largely restricted from regulated gambling, the greater incidence of problem gambling amongst youth than adults suggests that the perception of gambling as a harmless entertainment activity is inaccurate. Gambling is widely portrayed in the media often in an inaccurate or exaggerated way that normalizes gambling and may encourage youth to participate. Wagering on sporting events is becoming intrinsically linked with these competitions and gambling-themed toys and games are widely available and targeted at children and adolescents. Gambling is often presented as providing significant social and economic benefits and the increased availability of gambling venues heightens youth’s awareness of gambling opportunities. The depiction of gambling in society requires examination with efforts made by key stakeholders to present a balanced portrayal of the odds of winning and risks associated with gambling in an effort to reduce the emergence of gambling-related problem amongst adolescents.     

An Identity Process Theory Account of the Impact of Boarding School on Sense of Self and Mental Health: an Interpretative Phenomenological Analysis

International Journal of Mental Health and Addiction - Boarding schools exist to provide education for children, but this involves the child leaving the family home and residing in an educational...     

An Evaluation of the Impact of Australia's First Community Notification Scheme

In 2012, one Australian state became the first jurisdiction in Australasia to introduce a scheme that allows information about registered sex offenders to be released to the public. This study seeks to better understand the impact of the scheme from the perspective of the police. An analysis of interviews with police officers responsible for the administration of the scheme is supplemented with an analysis of official data relevant to its implementation. The results provide little evidence that the concerns voiced by the police about the introduction of community notification have been realised. There is no consistent view that it has significantly increased the workload of the police responsible for its management, impacted adversely on offenders’ psychological well-being, led to vigilantism or resulted in offenders’ non-compliance with reporting obligations. The findings of this study may usefully inform the development of policy and practice in places that are considering introducing similar policies.     

Complete Brain-machine Interfaces and Plastic Changes in the Brain

Brain-machine interfaces (BMIs) are artificial systems that control external devices or body muscles with signals generated by the neural activities of working brains. The BMIs currently under development can be divided into 2 types,i.e.,conventional (noninvasive) BMIs and complete (invasive) BMIs. Only the latter type of BMI can ultimately be used in the future. This paper describes some recent studies on invasive BMI using monkeys as subjects and discusses the progress of and problems revealed in these studies. The focus then shifts to plastic changes in neuronal activities caused by the BMIs. When a BMI is in use,the brain inevitably changes its own functions and structures in order to operate external devices more efficiently. Therefore,basic research on BMIs inevitably involves study on neural plasticity; such research is essential for further development of neurorehabilitation and for high performance of BMIs. This paper describes 2 recent pioneering BMI studies-one involving the rat motor cortex and the other involving the monkey primary motor cortex. Both studies revealed rapid and plastic changes in neuronal function during the period the animals were learning to operate external devices with the BMIs. The fact that the neuronal changes were caused by the contingency of neuronal activity and rewards emphasizes the significance of the neural-operant paradigm for research on neuronal plasticity in BMIs. The present paper describes a neural-operant experiment involving a recently developed high-performance BMI system and reports rapid and plastic changes in firing frequency and synchrony of the hippocampal neurons in both adult and aged rats. Finally,the paper suggests that complete BMIs can be developed by neuroscience research and should be able to unmask the enigmas of the neural code,brain-body interaction,and ongoing activity in the working brain.     

An Empirical Study Examining the Impact of Gambling Advertisements on Adolescent Gambling Attitudes and Behaviors

Based upon a previous qualitative study a questionnaire ascertaining adolescents’ awareness of gambling advertisements and their impact upon their behavior was developed and administered to 1,147 youth between the ages of 12 and 19. The findings suggest that almost all youth report being exposed to advertising with many individuals indicating being bombarded with messages, especially through pop-up ads viewed on the Internet. Sixty-one percent of youth reported receiving spam gambling advertisements by e-mail and 96% had seen TV advertisements for gambling. The underlying perceived message is that winning is easy, the chance of winning is high and that gambling is an easy way to become wealthy. While most youth are dismissive of the messages and are aware of the risks associated with gambling, a large percentage of youth report that these messages prompt them to gamble. Rather than inciting non-gamblers to begin gambling, advertisements appear to serve the function of maintaining established gambling habits and were particularly problematic to youth with gambling problems. Gender and developmental trends were noted.     

Impact of Environmental Factors on Post-Stroke Disability: An Analytical Cross-Sectional Study

ObjectivesIdentify how environmental barriers and facilitators are associated with disability in stroke survivors.Materials and MethodsAn analytical, cross-sectional study was conducted involving individuals in the chronic stage of stroke. The dependent variable was disability, which was assessed using the World Health Organization Disability Assessment Schedule (WHODAS-2.0). Environmental factors (independent variable) were evaluated using the Measure of the Quality of the Environment (MQE). Multiple linear regression analysis was performed to estimate the impact of the environment on disability following a stroke.ResultsSeventy-five individuals (mean age: 54.2 + 9.8 years) were analyzed. The most frequent environmental facilitators were related to technology, social networks, and public services. The main barriers were related to the physical environment. Environmental barrier was a predictor of both overall disability [F(1.73) = 4.24; R²=0.06; β = ?0.23; t = ?2.06; p=0.04] and participation [F(1.73) = 10.45; R²=0.13; β = ?0.35; t = ?3.23; p = 0.01]. Environmental facilitators were not correlated with disability.ConclusionEnvironmental barriers explained 13% of the variation in restrictions to social participation and were also a significant predictor of overall disability. The main barriers were related to the physical environment. Identifying environmental factors related to disability in stroke victims can assist in the planning of guided therapy.     

Autonomy and the Unintended Legal Consequences of Emerging Neurotherapies

One of the ethical issues that has been raised recently regarding emerging neurotherapies is that people will be coerced explicitly or implicitly in the workplace or in schools to take cognitive enhancing drugs. This article builds on this discussion by showing how the law may pressure people to adopt emerging neurotherapies. It focuses on a range of private law doctrines that, unlike the criminal law, do not come up very often in neuroethical discussions. Three doctrines—the doctrine of mitigation, the standard of care in negligence, and child custody determinations in family law—are addressed to show how the law may pressure people to consent to treatment by offering a choice between accepting medical treatment and suffering a legal disadvantage. The doctrines considered in this article apply indirect pressure to submit to treatment, unlike court-ordered medical treatment, which applies direct pressure and is not addressed here. The outcome of this discussion is to show that there is a greater range of social pressures that may encourage the uptake of novel neurotherapies than one might initially think. Once treatments that were developed and offered with therapeutic benefits in mind become available, their existence gives rise to unintended legal consequences. This certainly does not mean we should cease developing new therapies that may be of tremendous benefit to patients, but it does raise some questions for physicians and for legal policy-makers. How should physicians, who are required by medical ethical principles to obtain valid consent to treatment, react to a patient’s reluctant consent that is driven by legal pressure? From the legal policy perspective, are our legal doctrines satisfactory or should they be changed because, for example, they unduly promote the collective interest over individual freedom to reject medical treatment or because they channel us toward economically efficient treatments to the detriment of more costly but potentially superior approaches of dealing with behavioural problems?