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Focusing on symptoms rather than diagnoses in brain dysfunction: Conscious and nonconscious expression in impulsiveness and decision-making

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Abstract

Symptoms and syndromes in neuropathology, whether expressed in conscious or nonconscious behaviour, remain imbedded in often complex diagnostic categories. Symptom-based strategies for studying brain disease states are driven by assessments of presenting symptoms, signs, assay results, neuroimages and biomarkers. In the present account, symptom-based strategies are contrasted with existing diagnostic classifications. Topics include brain areas and regional circuitry underlying decision-making and impulsiveness, and motor and learned expressions of explicit and implicit processes. In three self-report studies on young adult and adolescent healthy individuals, it was observed that linear regression analyses between positive and negative affect, self-esteem, four different types of situational motivation: intrinsic, identified regulation, extrinsic regulation and amotivation, and impulsiveness predicted significant associations between impulsiveness with negative affect and lack of motivation (i.e., amotivation) and internal locus of control, on the one hand, and non-impulsiveness with positive affect, self-esteem, and high motivation (i.e., intrinsic motivation and identified regulation), on the other. Although presymptomatic, these cognitive- affective characterizations illustrate individuals’ choice behaviour in appraisals of situations, events and proclivities essentially of distal perspective. Neuropathological expressions provide the proximal realities of symptoms and syndromes with underlying dysfunctionality of brain regions, circuits and molecular mechanisms.

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Authors and Affiliations

  1. Servicio Psiquiatrico, Hospital Universitario 12 de Octubre, 28041, Madrid

    Tomas Palomo

  2. Departments of Psychology and Psychiatry, Queen’s University, K7L 3N6, Kingston, Ontario, Canada

    Richard J. Beninger

  3. Department of Pharmacology, Quillen College of Medicine, East Tennessee State University, TN 37614, Johnson City, USA

    Richard M. Kostrzewa

  4. Department of Psychology, University of Gothenburg, Box 500, SE- 40530, Gothenburg, Sweden

    Trevor Archer

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  1. Tomas Palomo
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  2. Richard J. Beninger
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  3. Richard M. Kostrzewa
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  4. Trevor Archer
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Correspondence to Trevor Archer.

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Palomo, T., Beninger, R.J., Kostrzewa, R.M. et al. Focusing on symptoms rather than diagnoses in brain dysfunction: Conscious and nonconscious expression in impulsiveness and decision-making. neurotox res 14, 1–20 (2008). https://doi.org/10.1007/BF03033572

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  • DOI: https://doi.org/10.1007/BF03033572

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