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Scholars disagree about the plausibility of preference purification. Some see it as a familiar phenomenon. Others denounce it as conceptually incoherent, postulating that it relies on the psychologically implausible assumption of an inner rational agent. I argue that different notions of rationality can be leveraged to advance the debate: procedural rationality and structural rationality. I explicate how structural rationality, in contrast to procedural rationality, allows us to offer an account of the guiding idea behind preference purification that avoids inner rational agents. Afterward, I address two pressing challenges against preference purification that emerge under the structural rationality account.
According to the World Health Organisation goals of treatment of drug addiction are: reducing of drug use and craving, improving of health, well-being and social functioning of the affected individual, prevention of future harms by decreasing the risk of complications and relapse. Wellness means a sense of overall well-being incorporating numerous aspects of an individual’s life. These include physical, mental, emotional, intellectual, occupational, and spiritual aspects. For those who suffer from mental and substance use disorders, wellness means feeling a sense of purpose in life, being actively involved in work or play that is satisfying, finding happiness, having joyful relationships, and having a healthy body and living environment. .
We will present different dimensions of wellness and describe how to incorporate these dimensions into drug addiction treatment.
Presentation of theoretical frame and description of treatment programme at the Center for Treatment of Drug Addiction Ljubljana.
When each of wellness dimensions is balanced, it is easier to maintain recovery process and avoid the triggers of relapse.
In the context of wellness, treatment goal is to maximize the capacity of person to feel, think and act in ways that enhance his/her ability to enjoy life and deal with the challenges he/she face. Wellness lifestyle includes a balance of health habits such as adequate sleep and rest, productivity, exercise, participation in meaningful activity, nutrition, productivity, social contact, and supportive relationships.
Covid-19 does not only have repercussions on the physical level, representing a new way of life, both individually and in society. The pandemic results in invisible consequences for the population’s mental health.
This study aimed to explore the consequences of Covid-19 on mental health in Portugal with a view to understanding and promoting the well-being and happiness of the Portuguese.
The study included 111 young people and adults, aged between 18 and 58 years (M= 21.81, SD= 5.34), with 43.7% males and 52.7% females. A sociodemographic questionnaire was applied to all participants, as well as the Échelle de Mesure des Manifestations du Bien-Être Psychologique (ÈMMBEP; Massé et al., 1998 - Portuguese translation by Monteiro, Tavares & Pereira, 2012) which translates into a response scale 5-point Likert type, with five subscales, including happiness. In addition, a semistructured interview with data collection instruments was administered.
The results obtained demonstrate the negative impact of Covid-19 on the level of well-being, regardless of the participant’s gender or age.
The data presented point to the need to sensitize individuals to the risk of the pandemic in terms of mental health, thus increasing society’s awareness of the psychological effects of this new global disease. Therefore, coping mechanisms are essential to promote well-being and successfully overcome the pandemic.
Supportive, nurturing relationships facilitate good health, well-being, and life satisfaction. Intimacy is crucial for developing successful relationships as it strengthens bonds between partners through the exchange of personal details, love, and affection. Despite the importance of intimacy in developing strong relationships, the extant research often conflates affection, trust, and sexual acts with intimacy or only considers one aspect of an intimate relationship (i.e., physical or sexual touch) .
The current study aimed to clarify what elicits feelings of intimacy in men and women in order to develop a more nuanced conceptualization of intimacy for use in future research and clinical practice.
In Study 1, women and men nominated over 2,700 items that “elicited feelings of intimacy” for them. Examples of nominations included: trust, communication, touch, attraction, and sex. Trained raters condensed duplicate items and created a final list of unique nominations for use in Study 2. Study 2 identified the factor structure of the nominated items by having a new sample of participants rate the extent each item elicited intimacy for them.
Data collection is ongoing but will be completed by December 2021. Results will be updated with an addendum after data analysis.
will focus on gender differences in the factor structure of intimacy, how future research can avoid conflating this important construct with other relational aspects, and how a deeper understanding of intimacy can benefit treatment in clinical contexts and strengthen relationships more broadly.
Discovered in December 2019, COVID has affected the entire planet, through direct exposure to its virus; SARS-COV-2, or indirectly through the media, Indeed, on January 20, 2020, the World Health Organization declared COVID-19 to be “a public health emergency of international concern.” Along with other public health crises and other collective trauma (terrorism, H1N1 epidemic or SARS-COV), exposure to publicized information on this virus generates psychiatric disorders, in particular anxiety and absence of well-being.
To link exposure to information about this pandemic through social media and anxiety and lack of well-being.
Use of a questionnaire consisting of three sections, individual status and conditions, the French versions of the GAD-7 scale for anxiety (Generalized anxiety scale of 7items) and the WHO-5 (five well-being index). This questionnaire is dedicated to the general population who have not been in direct contact with the virus, but through the media.
We were able to collect 209 participants, they were essentially females with a mean age of 28yo, 17,7% had psychiatric history of anxiety and depression, the median use of social medias was 5.7 hours per day. And they were essentially getting their information about the pandemic from Instagram, Facebook, the Moroccan ministry of health’s website and electronic newspapers. 31,1% of our participants had anxiety which was above a Chinese study, and had a poor well-being.
the use of social media to get information about the pandemic had an impact on well-being and anxiety..
The present study aimed to assess the prevalence of food insecurity (FI) among college students and explore its association with indicators of mental and psychosocial health. Data were collected using a cross-sectional online survey from college students in different universities in Lebanon during the Spring 2021 semester. FI was assessed using the validated eight-item food insecurity experience scale. The mental health of college students was assessed using validated screening tools for depression, anxiety and well-being, namely the Patient Health Questionnaire (PHQ-9), the General Anxiety Disorder-7 (GAD-7) and the World Health Organization (WHO-5) index, respectively. Multiple linear regression models were conducted to assess the relationship of FI with PHQ-9, GAD-7 and WHO-5 scores. A total of 745 students completed the online survey. Approximately 39 % of students in the sample were experiencing FI of which 27·4, 8·1, and 3·5 % were experiencing mild, moderate and severe FI , respectively. Low maternal education, low household monthly income and high levels of stress were significant correlates of FI among college students (P-trend < 0·001). In addition, 22·6 and 34·4 % of students showed severe symptoms of depression and anxiety, respectively. Regression models showed that FI was associated with higher scores on PHQ-9 and GAD-7 (β = 2·45; 95 % CI [1·41, 3·49]) and (β = 1·4; 95 % CI [1·1, 2·2], respectively) and lower scores on WHO-5 (β = −4·84; 95 % CI [−8·2, −1·5]). In conclusion, a remarkable proportion of college students reported experiencing different forms of FI, which was associated with poorer mental health and well-being outcomes. Public health programmes and interventions are needed to mitigate FI and improve student health-related outcomes.
Many aspects of palliative care, such as managing (complicated) symptoms, conducting goals-of-care conversations, and repeated exposure to loss, can be stressful to clinicians. Previous research on the emotional impact of providing palliative care was mainly done in specialist settings. However, the majority of palliative care is provided by clinicians who are not specialized in palliative care, and can be supported by palliative care specialists only when needed. Therefore, this study aimed to gain insight into the emotional impact of providing palliative care on clinicians, both palliative care generalists and specialists.
A qualitative interview study among 21 clinicians (11 doctors and 10 nurses) working in hospitals, home care, or nursing homes in the Netherlands was conducted. Between February and June 2019, 13 palliative care generalists and 8 specialists were interviewed. Interviews were thematically analyzed by two researchers.
All clinicians considered the emotional impact of providing palliative care to be substantial and experienced both positive and negative aspects of providing palliative care. Several aspects of providing palliative care can support or undermine emotional stability. These so-called facilitators and barriers, such as practicing self-care and complexity of palliative care, were found at three different levels: individual, team, and organization.
Significance of results
Although clinicians experience providing palliative care as meaningful and valuable, the emotional impact is considerable. Negative and positive aspects often co-exist. Further insight into the dynamics and magnitude of the emotional impact of providing palliative care is needed in order to create a healthy working environment and develop adequate interventions.
The economic and social welfare of people living in Australia has been shaped by different sets of laws: Indigenous laws that meant individual welfare was ensured by family and kin, British laws that decreed welfare a distinct domain for managing the casualties of a hierarchical social order, and a settler colonial adaptation of the British system in which the colonial state provided the infrastructure for growth. This chapter argues that while state investment worked in positive ways for settler economies, it acted as the motor of Indigenous dispossession – though Indigenous communities maintained customary law and adapted settler welfare for their own well-being. White women were marginalised in settler economies but feminist agitation focussed on state welfare as the source of reform. The last 30 years have seen social investment in retreat, though it was revived during the Global Financial crisis and against Covid-19. The early 21st century has also witnessed the increasing dissemination of Indigenous ideas of well-being. The histories of these enduring strands provide some clarity on how we might approach what some have argued is impending automation and a ‘post-work future’.
This chapter focuses on a cluster of under-explored issues relating to children’s well-being or prudential value. I examine and reject three distinct theses relating to it in the literature on well-being, namely, that children’s lives on the whole cannot go well or poorly for them, prudentially speaking; that the prudential goods of childhood count for less than the prudential goods of adulthood towards the prudential value of an individual’s life as a whole; and that children’s prudential goods are (at least in some cases) in some way special. According to my view, children’s lives can go well or poorly for them, their prudential goods do not count for less than the prudential goods of adulthood, and their basic, non-instrumental prudential goods are not themselves special.
Old age is gendered both in concrete terms, who the old are, and in conceptual terms, how we think about old age. There are implications for justice that follow from both the practical and the theoretical link between ageing and gender. While raising more questions than it answers, this chapters explores five themes related to women’s lives, ethics, and ageing, touching on issues in normative ethics and well-being, in justice and right action, and in applied ethics. The themes include welfare and the worst off, women’s longer life span as a site of injustice, gender and the goods of old age, beauty, and the badness of death. This chapter aims to present the reader with an idea of the richness of the philosophical terrain and a sense of the range and depth of questions under the heading of women, ageing, and ethics.
What does it mean to be mentally healthy in old age? According to one account, it means to have a mind that is normal, or natural, for an elderly person. According to another, it is to enjoy the same substantive goods that characterize mental health at other ages – so that the mentally healthy ninety-year-old is just like the mentally healthy forty-year-old. Neither approach is plausible. This chapter offers an alternative “resourcist” account, which evaluates mental health in old age by asking what mental resources are most likely to help someone to live well as an elderly person. Living well involves both having good moments and of contributing to a good life story. What it means to be mentally healthy in old age then depends on what opportunities are granted by natural ageing and by social practices for elderly people to expand and conclude the stories of their lives.
In this chapter, we explore the potential of conceptualizing identity as a complex dynamic system. The chapter begins with a critical reflection on how problematic dichotomies in discussions of self and identity have created unhelpful barriers between different areas of self-related work. Exploring integrative approaches to conceptualizing self, we suggest ways in which identity can be viewed as a complex dynamic system. In particular, we focus on the characteristic of emergence and how this can accommodate the notion of a continuously dynamic, adaptive and emergent sense of self. Additionally, we argue for a greater integration of both the psychological and the social in discussions of identity. We draw parallels to developments in multilingualism and notions of translanguaging which also point to the merits of a complexity perspective. Considering the implications for research, we stress the need to capture complexity which involves the psychological and social as well as dynamics across different timescales. We illustrate our line of thinking with data extracts from a study with English-Medium Instruction (EMI) teachers working in Austria.
This chapter addresses Plato’s conception of philosophy by examining how the Apology of Socrates represents Socrates as a model lover of wisdom. This Socrates loves expertise about how to live well, and he does so in three ways: (i) by examining others to test them for this expertise and to confirm that only the gods possess it, (ii) by pursuing the expertise, nonetheless, to improve his beliefs about how to live well, and (iii) by exhorting others to examine themselves and to pursue wisdom. The chapter pays special attention to Socrates’ conceptions of knowledge, living well, and teaching, and it suggests briefly how Plato tweaks or transforms this Socratic model in other dialogues.
In Chapter 2, trends in Augmented Human Development and its dimensions are presented and compared to those of GDP per head. Then, a breakdown of AHDI gains into their dimensions’ contribution is carried out, and some explanatory hypotheses proposed. Augmented human development improved significantly in the world since 1870, especially over 1913–1980, but significant room for improvement remains. Although AHDI and real per capita GDP exhibit similar progress over the long run, their pace does not match over the different phases of its evolution. Major gains in augmented human development were achieved across the board during the economic globalisation backlash of the first half of the twentieth century. AHD progress was driven by its non-income dimensions. Life expectancy at birth was the main contributor over time, even though its main contribution took place over 1920–1970, as the epidemiological transition diffused internationally. Schooling, mostly public, stimulated by new social views and nation-building, made a steady contribution over time, while civil and political liberties led AHD gains in the last two decades of the twentieth century as authoritarian regimes gave way to the expansion of liberal democracy.
Early COVID-19 research suggests a detrimental impact of the initial lockdown on young people's mental health.
We investigated mental health among university students and young adults after the first UK lockdown and changes in symptoms over 6 months.
In total, 895 university students and 547 young adults not in higher education completed an online survey at T1 (July–September 2020). A subset of 201 university students also completed a 6 month follow-up survey at T2 (January–March 2021). Anxiety, depression, insomnia, substance misuse and suicide risk were assessed.
At T1, approximately 40%, 25% and 33% of the participants reported moderate to severe anxiety and depression and substance misuse risk, clinically significant insomnia and suicidal risk. In participants reassessed at T2, reductions were observed in anxiety and depression but not in insomnia, substance misuse or suicidality. Student and non-student participants reported similar levels of mental health symptoms. Student status was not a significant marker of mental health symptoms, except for lower substance misuse risk.
Cross-sectionally, greater symptoms across measures were consistently associated with younger age, pre-existing mental health conditions, being a carer, worse financial status, increased sleep irregularity and difficulty since lockdown. Longitudinally, T2 symptoms were consistently associated with worse financial status and increased difficulty sleeping at T1. However, these associations were attenuated when baseline mental health symptoms were adjusted for in the models.
Mental health symptoms were prevalent in a large proportion of young people after the first UK lockdown. Risk factors identified may help characterise high-risk groups for enhanced support and inform interventions.
How has human development evolved during the last 150 years of globalization and economic growth? How has human development been distributed across countries? How do developing countries compare to developed countries? Do social systems matter for wellbeing? Are there differences in the performance of developing regions over time? Employing a capabilities approach, Human Development and the Path to Freedom addresses these key questions in the context of modern economic growth and globalization from c.1870 to the present. Leandro Prados de la Escosura shows that health, access to knowledge, standards of living, and civil and political freedom can substitute for GDP per head as more accurate measures of our wellbeing.
Burnout is a major psychological and physical health-related problem for workers in all fields, but especially for those in the fast-paced and rapidly changing world of healthcare. Burnout has severe consequences for patients, including medical error, and is a leading contributing cause of depression and suicide among healthcare workers. Organizational science is just beginning to be applied in earnest to physician burnout and patient safety, and holds several potential keys to addressing these concerns. The Burned Out Physician is for two groups: healthcare workers (especially physicians) and patients. Physicians will use this book to get an accurate picture of what they are experiencing and how to change it, and patients will use this book to see what their healthcare providers are experiencing and learn how to help and/or protect themselves. The volume includes a checklist of burnout symptoms, and crucially a list of solutions as part of an active effort to solve the burnout crisis.
Paternalistic nudging and framing aim to correct flaws in deliberation by relying on the same cognitive mechanisms that create those flaws. Regarding some choices as flawed and in need of correction requires some standard of correctness. In their well-known book, Nudge, Thaler and Sunstein take the individual's own “purified” preferences to be that standard, which is inconsistent with the finding of behavioral economics that individuals do not have a stable preference ranking of alternatives, but instead construct their preferences when faced with a choice. This essay defends an alternative, readily usable standard to judge whether individuals are choosing badly and whether nudges can help them to choose better.
The COVID-19 pandemic has increased rates of psychological distress and burnout in healthcare staff. How can we understand our experiences of the pandemic? We reflect on the experiences of psychiatry trainees in two north London mental health trusts. From a psychoanalytic understanding, states of extreme anxiety can lead to a manic defence and functioning in the paranoid–schizoid position. This position is derived from object relations theory and is characterised by binary thinking, splitting, projection, defensiveness and ‘knee-jerk’ decision-making. This can affect our perceptions, responses to others, relationships and ability to function and, therefore, our clinical practice and well-being. We consider the importance of recognising these processes and of organisational containment and having space to reflect. This supports functioning in the depressive position, a state of mind where we can tolerate anxiety, address difficult realities and develop new ideas. We hope these understandings are helpful to our colleagues in all professions.
To evaluate psychological and psychosocial interventions or to decide whether it is cost-effective to reimburse specific therapies or medicines, one needs a measure of the quality of life of the persons with dementia. A large battery of specific dementia scales is available that can be used to evaluate psychological and psychosocial interventions, while cost-effectiveness is usually analysed with generic QALY-type health measures. The choice between these various measures cannot be made only on statistical or technical grounds because it has crucial ethical implications. Different measures of QoL reflect different fundamental perspectives on what makes a good life.