The spiritual brain: selective cortical lesions modulate human self-transcendence

A neural network for religious fundamentalism derived from patients with brain lesions

Religious fundamentalism, characterized by rigid adherence to a set of beliefs putatively revealing inerrant truths, is ubiquitous across cultures and has a global impact on society. Understanding the psychological and neurobiological processes producing religious fundamentalism may inform a variety of scientific, sociological, and cultural questions. Research indicates that brain damage can alter religious fundamentalism. However, the precise brain regions involved with these changes remain unknown. Here, we analyzed brain lesions associated with varying levels of religious fundamentalism in two large datasets from independent laboratories. Lesions associated with greater fundamentalism were connected to a specific brain network with nodes in the right orbitofrontal, dorsolateral prefrontal, and inferior parietal lobe. This fundamentalism network was strongly right hemisphere lateralized and highly reproducible across the independent datasets (r = 0.82) with cross-validations between datasets. To explore the relationship of this network to lesions previously studied by our group, we tested for similarities to twenty-one lesion-associated conditions. Lesions associated with confabulation and criminal behavior showed a similar connectivity pattern as lesions associated with greater fundamentalism. Moreover, lesions associated with poststroke pain showed a similar connectivity pattern as lesions associated with lower fundamentalism. These findings are consistent with the current understanding of hemispheric specializations for reasoning and lend insight into previously observed epidemiological associations with fundamentalism, such as cognitive rigidity and outgroup hostility.

Mindfulness-induced self-transcendence promotes universal love with consequent effects on opioid misuse

In addition to its health benefits, mindfulness has been theorized in classical contemplative frameworks to elicit self-transcendent experiences as a means of promoting universal love and compassion. Increasing feelings of love may be especially clinically relevant for the treatment of opioid misuse, in that addictive use of opioids dysregulates neurobiological processes implicated in the experience of love. Here we tested these hypotheses in a secondary analysis (n = 187) of data from a randomized clinical trial of Mindfulness-Oriented Recovery Enhancement (MORE) versus supportive psychotherapy for comorbid opioid misuse and chronic pain. At pre- and post-treatment, participants completed a measure of state self-transcendence immediately following a laboratory-based mindfulness task. Through 9-month follow-up, we assessed changes in universal love and opioid misuse. Participants also completed ecological momentary assessments of opioid craving during the 8-week study interventions and for the following month. Compared to supportive psychotherapy, participants in MORE reported significantly greater increases in mindfulness-induced self-transcendence, which mediated the effect of MORE on increased feelings of universal love. In turn, increases in universal love significantly predicted decreased opioid craving and lower odds opioid misuse through 1- and 9-month follow-ups, respectively. Findings suggest mindfulness-induced self-transcendence may promote feelings of universal love, with possible downstream benefits on reducing addictive behavior.

Spirituality in Parkinson's Disease within a Sample from the USA

Spirituality and religious beliefs are important for coping with medical conditions. The dopaminergic system is involved in reward behavior, and its dysfunction in Parkinson Disease (PD) raises questions about religiosity and spirituality in people with PD. This study examines the association between levels of spirituality and religiosity and the severity of PD motor and non-motor symptoms. The secondary aim investigates the perceived impact of PD diagnosis on spirituality and religiosity. This was a cross-sectional analysis of demographic, physical, mental, and spirituality and religiosity status in patients with PD recruited for the Health Outcomes Measurement (HOME) Study at the University of Maryland Parkinson Disease and Movement Disorders Center, Baltimore, USA. Spirituality and religiosity were assessed using the Spiritual Well-being Scale, and the World Health Organization Quality of Life Spiritual Religious and Personal Belief field-test instrument. The sample size was 85 PD patients. The mean age (standard deviation) was 65.5 (9.4) years and 67.1% were male. Higher levels of spirituality and religiosity were associated with younger age, sex (female), less education, religious affiliation (Christian), and mental health status. After adjusting for age, education, gender, race, marital status, religion, physical health, mental health, and comorbidity, only anxiety was associated with all of the spirituality/religiosity assessments. The majority of patients reported no change in their religious or spiritual beliefs following diagnosis. Greater spirituality and religiosity were associated with less anxiety. Also, younger women with PD showed higher levels of spirituality and religiosity. Longitudinal studies on more diverse populations are needed.

Monitoring the neural activity associated with praying in Sahaja Yoga meditation

BACKGROUND

Sahaja Yoga Meditation draws on many religious traditions and uses a variety of techniques including Christian prayer to reach a state known as thoughtless awareness, or mental silence. While there are many studies on the neural correlates of meditation, few studies have focused on the neural correlates of praying. Thus, the aim of our research was to study the neural activity associated with the prayer practices in Sahaja Yoga Mediation, which have not been studied before, to explore effects beyond repetitive speech or "mantra effects". Sixteen experienced Sahaja Yoga Meditation practitioners were scanned using task based functional Magnetic Resonance Imaging while performing formalised and improvised forms of praying and their equivalent secular tasks.

RESULTS

Our results showed the deactivation of bilateral thalamus during both prayers compared to secular conditions and the activation in the medial prefrontal cortex that was reduced by religious and formalised secular speech conditions but increased during improvised secular speech; similarly, frontal regions were deactivated when comparing prayers to their secular equivalents.

DISCUSSION

These results seem to depict two important factors related with praying in Sahaja Yoga Meditation merging inner concentration and social cognition. First, the perception of the surroundings mediated by the thalamus may be decreased during these prayers probably due to the establishment of inner concentration and, second, frontal deactivation effects could be related to reduced social judgement and 'mentalizing', particularly in the medial prefrontal cortex. Our findings suggest that praying by Sahaja Yoga Meditation practitioners is neurophenomenologically different from the social cognitive attempt of praying within Christian praying practices.

This is your brain on death: a comparative analysis of a near-death experience and subsequent 5-Methoxy-DMT experience

Introduction

Much research has focused on the modeling of the near-death experience (NDE) by classical and atypical psychedelics; however, to date, no study has reported on the relationship between the NDE and the experience induced by the highly potent, endogenous psychedelic drug 5-Methoxy-DMT (5MeO-DMT). This article presents a case study of an individual who is popularly documented to have had a profound near-death experience while in a coma caused by bacterial meningoencephalitis. Additionally, the individual also subsequently underwent an experience with 5MeO-DMT.

Methods

A semi-structured interview was conducted with the subject concerning his experiences with both the NDE and 5MeO-DMT. A basic thematic analysis was performed on both the original text describing the NDE as well as the interview itself, which mainly focused on the subject's experience with 5MeO-DMT. This analysis was organized to identify both the similar and different emergent themes between the two states, with a particular emphasis on the subject's perceptions of the similarities and differences between the experiences.

Results

There is a very high level of comparability between the original NDE and psychedelic experiences in general, including shared characteristics such as entering other worlds, meeting menacing or benevolent entities, experiencing synesthesia, perinatal regression, and lucid dreamlike properties. Much comparability was also identified with the 5MeO-DMT experience, in particular the major mystical experiential domains, such as ego dissolution, but especially transcendence of time and space. However, there were also a few unique themes (life review, the deceased, and the threshold) that emerged in the NDE that were not present in the 5MeO-DMT experience or other psychedelic experience studies, suggesting that these themes may be more unique to the NDE.

Discussion

Despite such similarities, the participant asserted that his NDE and psychedelic experiences were not similar enough to be attributed to endogenous psychedelics. In this study, we discussed several mechanisms that could potentially account for the NDE, including lucid dreams and perinatal regression. However, the study also explored the possibility that the unique etiology of the participant's NDE, bacterial meningoencephalitis affecting the neocortex, may have triggered similar downstream neural activity as that initiated by psychedelic agents through pyramidal neuronal activation. This hypothesis is presented with appropriate caveats and acknowledged as speculative.

Religious Experience and Clinical-EEG Aspects in Adult People with Epilepsy

Spirituality and religiosity are complex cognitive phenomena; however, the relationship between spiritual experiences and epilepsy continues to be debated. Methods. Data from the daily spiritual experience scale (DSES) were related to EEG data and clinical variables of 100 adult people with epilepsy (PWEs). DSES scores were compared to 51 normal individuals (control group [CG]), with a significance level of P < .05. Results. The total score in the DSES was 36.1 ± 14 and 37.6 ± 13.2, respectively, in the PWEs and in the CG. In the PWEs, there was a correlation between DSES and age (Pearson's correlation; -0.22; P = .027) and educational level (0.207; P = .039). PWEs with ≥one seizure/month have a lower frequency of daily spiritual experiences than those with better controlled seizures (T-test; 39.2 ± 16.2 vs 31.7 ± 7.6; P = .038). EEG epileptiform activity (EA) in the right hemisphere was associated with a higher frequency of spiritual experiences than those with left-hemisphere EA (29.8 ± 9.0 vs 38.5 ± 17.5; P = .010). Conclusion. Demographic aspects, EA in the right hemisphere, and lower seizure frequency are associated with daily spiritual experiences in epilepsy, suggesting an association between aspects of spirituality, epilepsy, and neurobiological correlates.

Stairway to Heaven: A First-Person Account of Noesis

Mystical and spiritual experiences have been reported throughout human history. Causal explanations for these range from psychopathology of mental illness, drugs such as hallucinogens, neurological disorders including temporal lobe epilepsy, and genuine mystical or spiritual awakening. There is a common core of phenomena in such experiences, as described both in historical accounts and recent research, but also evidence of cultural specificity. This article is a personal account of such an experience, which occurred in a postanesthetic state. A striking feature of the experience was noesis: a sense of revelation and complete understanding. I argue that while there must be a neural basis to these phenomena, it is difficult to reduce the subjective meaning of the experience purely to a brain dysfunction. Reconciling mechanism and meaning of such experiences remains a challenge for both neuroscience and philosophy.

Parental religiosity is associated with changes in youth functional network organization and cognitive performance in early adolescence

Parental religious beliefs and practices (religiosity) may have profound effects on youth, especially in neurodevelopmentally complex periods such as adolescence. In n = 5566 children (median age = 120.0 months; 52.1% females; 71.2% with religious affiliation) from the Adolescent Brain Cognitive Development study, relationships between parental religiosity and non-religious beliefs on family values (data on youth beliefs were not available), topological properties of youth resting-state brain networks, and executive function, inhibitory control, and cognitive flexibility were investigated. Lower caregiver education and family income were associated with stronger parental beliefs (p < 0.01). Strength of both belief types was correlated with lower efficiency, community structure, and robustness of frontoparietal control, temporoparietal, and dorsal attention networks (p < 0.05), and lower Matrix Reasoning scores. Stronger religious beliefs were negatively associated (directly and indirectly) with multiscale properties of salience and default-mode networks, and lower Flanker and Dimensional Card Sort scores, but positively associated with properties of the precuneus. Overall, these effects were small (Cohen's d ~ 0.2 to ~ 0.4). Overlapping neuromodulatory and cognitive effects of parental beliefs suggest that early adolescents may perceive religious beliefs partly as context-independent rules on expected behavior. However, religious beliefs may also differentially affect cognitive flexibility, attention, and inhibitory control and their neural substrates.

Neural Mechanisms and Psychology of Psychedelic Ego Dissolution

Neuroimaging studies of psychedelics have advanced our understanding of hierarchical brain organization and the mechanisms underlying their subjective and therapeutic effects. The primary mechanism of action of classic psychedelics is binding to serotonergic 5-HT2A receptors. Agonist activity at these receptors leads to neuromodulatory changes in synaptic efficacy that can have a profound effect on hierarchical message-passing in the brain. Here, we review the cognitive and neuroimaging evidence for the effects of psychedelics: in particular, their influence on selfhood and subject-object boundaries-known as ego dissolution-surmised to underwrite their subjective and therapeutic effects. Agonism of 5-HT2A receptors, located at the apex of the cortical hierarchy, may have a particularly powerful effect on sentience and consciousness. These effects can endure well after the pharmacological half-life, suggesting that psychedelics may have effects on neural plasticity that may play a role in their therapeutic efficacy. Psychologically, this may be accompanied by a disarming of ego resistance that increases the repertoire of perceptual hypotheses and affords alternate pathways for thought and behavior, including those that undergird selfhood. We consider the interaction between serotonergic neuromodulation and sentience through the lens of hierarchical predictive coding, which speaks to the value of psychedelics in understanding how we make sense of the world and specific predictions about effective connectivity in cortical hierarchies that can be tested using functional neuroimaging. SIGNIFICANCE STATEMENT: Classic psychedelics bind to serotonergic 5-HT2A receptors. Their agonist activity at these receptors leads to neuromodulatory changes in synaptic efficacy, resulting in a profound effect on information processing in the brain. Here, we synthesize an abundance of brain imaging research with pharmacological and psychological interpretations informed by the framework of predictive coding. Moreover, predictive coding is suggested to offer more sophisticated interpretations of neuroimaging findings by bridging the role between the 5-HT2A receptors and large-scale brain networks.

Molecular archaeology of human cognitive traits

The brains and minds of our human ancestors remain inaccessible for experimental exploration. Therefore, we reconstructed human cognitive evolution by projecting nonsynonymous/synonymous rate ratios (ω values) in mammalian phylogeny onto the anatomically modern human (AMH) brain. This atlas retraces human neurogenetic selection and allows imputation of ancestral evolution in task-related functional networks (FNs). Adaptive evolution (high ω values) is associated with excitatory neurons and synaptic function. It shifted from FNs for motor control in anthropoid ancestry (60-41 mya) to attention in ancient hominoids (26-19 mya) and hominids (19-7.4 mya). Selection in FNs for language emerged with an early hominin ancestor (7.4-1.7 mya) and was later accompanied by adaptive evolution in FNs for strategic thinking during recent (0.8 mya-present) speciation of AMHs. This pattern mirrors increasingly complex cognitive demands and suggests that co-selection for language alongside strategic thinking may have separated AMHs from their archaic Denisovan and Neanderthal relatives.

Spiritual care for the management of Parkinson's disease: Where we are and how far can we go

An increasing number of studies have investigated the neural networks and brain regions activated by different aspects of religious faith or spiritual practice. The extent to which religiousness and spirituality are dependent on the integrity of neural circuits is a question unique to neurological illnesses. Several studies have reported that neural networks and brain areas represent the various components of religious faith or spiritual activity in recent decades. In addition to research in healthy people, another strategy is to observe if neurological abnormalities caused by stroke, tumour, brain damage, or degenerative sickness are accompanied by an alteration in religiosity or spirituality. Similarly, Parkinson's disease (PD), an ailment characterized by dopaminergic neuron malfunction, has been utilized to explore the role of dopaminergic networks in the practice, experience, and maintenance of religious or spiritual beliefs. Case-control and priming studies have demonstrated a decline in spirituality and religion in people with PD due to dopaminergic degeneration. These studies could not adequately control for confounding variables and lacked methodological rigour. Using qualitative and quantitative assessments, a mixed-method approach might shed additional light on putative religious beliefs alterations in PD. In the current review paper, we discussed the recent research on the impact of PD on spiritual beliefs and spirituality.

Constant Multi-Tasking With Time Constraint to Preserve Across-Network Dynamics Throughout Awake Surgery for Low-Grade Glioma: A Necessary Step to Enable Patients Resuming an Active Life

Awake surgery for brain gliomas improves resection while minimizing morbidity. Although intraoperative mapping was originally used to preserve motor and language functions, the considerable increase of life expectancy, especially in low-grade glioma, resulted in the need to enhance patients’ long-term quality of life. If the main goal of awake surgery is to resume normal familial and socio-professional activities, preventing hemiparesis and aphasia is not sufficient: cognitive and emotional functions must be considered. To monitor higher-order functions, e.g., executive control, semantics or mentalizing, further tasks were implemented into the operating theater. Beyond this more accurate investigation of function-specific neural networks, a better exploration of the inter-system communication is required. Advances in brain connectomics led to a meta-network perspective of neural processing, which emphasizes the pivotal role of the dynamic interplay between functional circuits to allow complex and flexible, goal-directed behaviors. Constant multi-tasking with time constraint in awake patients may be proposed during intraoperative mapping, since it provides a mirror of the (dys)synchronization within and across neural networks and it improves the sensitivity of behavioral monitoring by increasing cognitive demand throughout the resection. Electrical mapping may hamper the patient to perform several tasks simultaneously whereas he/she is still capable to achieve each task in isolation. Unveiling the meta-network organization during awake mapping by using a more ecological multi-demand testing, more representative of the real-life conditions, constitutes a reliable way to tailor the surgical onco-functional balance based upon the expectations of each patient, enabling him/her to resume an active life with long-lasting projects.

A Neural Circuit for Spirituality and Religiosity Derived From Patients With Brain Lesions

BACKGROUND

Over 80% of the global population consider themselves religious, with even more identifying as spiritual, but the neural substrates of spirituality and religiosity remain unresolved.

METHODS

In two independent brain lesion datasets (N₁ = 88; N₂ = 105), we applied lesion network mapping to test whether lesion locations associated with spiritual and religious belief map to a specific human brain circuit.

RESULTS

We found that brain lesions associated with self-reported spirituality map to a brain circuit centered on the periaqueductal gray. Intersection of lesion locations with this same circuit aligned with self-reported religiosity in an independent dataset and previous reports of lesions associated with hyper-religiosity. Lesion locations causing delusions and alien limb syndrome also intersected this circuit.

CONCLUSIONS

These findings suggest that spirituality and religiosity map to a common brain circuit centered on the periaqueductal gray, a brainstem region previously implicated in fear conditioning, pain modulation, and altruistic behavior.

Alterations in Functional Connectivity Measured by Functional Magnetic Resonance Imaging and the Relationship With Heart Rate Variability in Subjects After Performing Orgasmic Meditation: An Exploratory Study

Background: We measured changes in resting brain functional connectivity, with blood oxygen level dependent (BOLD) functional magnetic resonance imaging (fMRI), associated with a creative meditation practice that is augmented by clitoral stimulation and is designed to not only achieve a spiritual experience but to help individuals manage their most intimate personal relationships. Briefly, the meditative state is attained by both the male and female participants while the male stimulates the woman’s clitoris. The goal of this practice, called orgasmic meditation (OM), according to the practitioners is not sexual, but to use the focus on clitoral stimulation to facilitate a meditative state of connectedness and calm alertness between the two participants.

Methods: fMRI was acquired on 20 pairs of subjects shortly following one of two states that were randomized in their order – during the OM practice or during a neutral condition. The practice is performed while the female is lying down on pillows with the clitoris exposed. During the practice, the male performs digital stimulation of the clitoris for 15 min. Resting BOLD image acquisition was performed at completion of the practice to assess changes in functional connectivity associated with the performance of the practice.

Results: The results demonstrated significant changes (p < 0.05) in functional connectivity associated with the OM compared to the neutral condition. For the entire group there was altered connectivity following the OM practice involving the left superior temporal lobe, the frontal lobe, anterior cingulate, and insula. In female subjects, there was altered connectivity involving the cerebellum, thalamus, inferior frontal lobe posterior parietal lobe, angular gyrus, amygdala and middle temporal gyrus, and prefrontal cortex. In males, functional connectivity changes involved the supramarginal gyrus, cerebellum, and orbitofrontal gyrus, cerebellum, parahippocampus, inferior temporal gyrus, and anterior cingulate.

Conclusion: Overall, these findings suggest a complex pattern of functional connectivity changes occurring in both members of the couple pair that result from this unique meditation practice. The changes represent a hybrid of functional connectivity findings with some similarities to meditation based practices and some with sexual stimulation and orgasm. This study has broader implications for understanding the dynamic relationship between sexuality and spirituality.

Altruism and "love of neighbor" offer neuroanatomical protection against depression

We prospectively investigate protective benefits against depression of cortical thickness across nine regions of a Ventral Frontotemporal Network (VFTN), previously associated with spiritual experience. Seventy-two participants at high and low risk for depression (Mean age 41 years; 22-63 years; 40 high risk, 32 low risk) were drawn from a three-generation, thirty-eight year study. FreeSurfer estimated cortical thickness over anatomical MRIs of the brain (Year 30) for each of the nine ROIs. Depression (MDD with SAD-L; symptoms with PHQ; Years 30 and 38) and spirituality (self-report on five phenotypes; Year 35), respectively, were associated with the weighted average of nine regions of interest. VFTN thickness was: 1) positively associated (p<0.01) with two of five spiritual phenotypes, altruism and love of neighbor, interconnectedness at a trend level, but neither commitment nor practice, 2) inversely associated with a diagnosis of MDD (SADS-L Year 30, for any MDD in the past ten years), and 3) prospectively neuroanatomically protective against depressive symptoms (PHQ-9 Year 38) for those at high familial risk.

A Multilevel Approach to Explore the Wandering Mind and Its Connections with Mindfulness and Personality

We propose an innovative approach to study Mind Wandering (MW), and we present an application of this methodology to study the effects of a Mindfulness-Oriented Meditation (MOM) training. We assessed individuals' MW through a free association task and an attentional task with thought-probes combined with a questionnaire for the phenomenological characteristic of each MW episode. We used the Temperament and Character Inventory to assess participants' personality traits and their associations with measures of MW. Our study was limited by the course of the Covid-19 pandemic and only nine healthy young individuals completed the testing sessions, which were carried out before and after the MOM training. After MOM, participants showed fewer repetitive and self-relevant thoughts and indices of better performance in the attentional task; the linguistic analysis of participants' free associations showed lower verbal productivity and a decrease in utterances that expressed anxiety/stress. Overall, we foresee that future studies could replicate our preliminary findings with larger samples and in a period without a global health emergency. This multilevel approach to the study of MW may allow researchers to gain a broader view of the phenomenon, considering its occurrence, qualitative characteristics, impact on cognitive tasks, malleability via mindfulness or other psychological interventions, and relations with personality traits.

A Neuro-Phenomenological Perspective on the Autism Phenotype

In the current paper, we present a view of autism spectrum disorder (ASD) which avoids the typical relational issues, instead drawing on philosophy, in particular Husserlian phenomenology. We begin by following the recent etiological perspectives that suggest a natural predisposition of a part of individuals with ASD towards hypersensitivity and the reduced influence of cognitive priors (i.e., event schemas). Following this perspective, these two characteristics should be considered as a sort of phenomenological a priori that, importantly, could predispose people with ASD towards a spiritual experience, not intended in its religious meaning, but as an attribute of consciousness that consists of being aware of and attentive to what is occurring in the present moment. Potential clinical implications are discussed.

The integration of sensations and mental experiences into a unified experience: A neuropsychological model for the "sense of self"

A continued weakness in the cognitive neurosciences is the lack of a model to explain the phenomenological experience of the "self." This article proposes a model that suggests that the right hemisphere association area integrates physical sensations and mental experiences into a unified experience (i.e., a "sense of self") that is best conceptualized and understood as the subjective experience of "mineness." This model presents a unifying framework for neurologic and psychiatric disorders of the self (i.e., dis-integrated sense of "mineness"), as well as a neuropsychological framework to explain several human characteristics and experiences. Research is reviewed that indicates the sense of self can be activated to serve as the neuropsychological foundation of "self-integrated" character traits such as empathy (i.e., experiencing other's thoughts/emotions as "mine"), and conversely, the inhibition of this integrative process which can serve as the foundation of "selfless" experiences such as transcendence and forgiveness. Future research and clinical applications are discussed.

The inside of me: interoceptive constraints on the concept of self in neuroscience and clinical psychology

Humans are unique in their ability to think about themselves and carry a more or less clear notion of who they are in their mind. Here we review recent evidence suggesting that the birth, maintenance, and loss of the abstract concept of 'self' is deeply tied to interoception, the sense of internal physiological signals. Interoception influences multiple facets of the self-concept, cutting across its material, social, moral, and agentive components. Overall, we argue that interoception contributes to the stability of the self-concept over time, unifying its layers and constraining the degree to which it is susceptible to external influences. Hence, the core features of the self-concept are those that correlate more with inner bodily states. We discuss the implications that this may have for theories of embodied cognition as well as for the understanding of psychiatric disorders in which the concept of self appears fragmented or loose. Finally, we formulate some empirical predictions that could be tested in future studies to shed further light on this emerging field.

Personality and behavioral changes after brain tumor resection: a lesion mapping study

BACKGROUND

Cognitive functioning is generally well preserved in patients with diffuse low-grade glioma (DLGG), even in the case of extended tumor and resection. To date, the question of personality changes in these patients has received little attention. Our aim was to investigate to what extent certain aspects of personality and behaviors could be affected by DLGG resection.

METHODS

We used self-reported personality questionnaires (NOEPI-R and TCI-R) and hetero-evaluation of executive behavioral changes in a large sample of 98 patients operated on for DLGG. To compare the patients' scores from the personality questionnaires, we recruited 47 healthy controls participants. To identify the putative neural networks associated with behavioral changes, a combination of voxel-wise and tract-wise lesion-symptom mapping was performed.

RESULTS

First, results revealed no difference between patients and controls for each subdimension of the NOEPI-R. Regarding the TCI-R, the character dimensions and three out of four temperament dimensions did not differ. Second, behavioral changes (Irritability, Hypoactivity, Anticipative disorders, and disinterest) were reported between 40 and 50% of cases. Third, some personality dimensions (as neuroticism) were strongly predictive of postoperative behavioral disorders (as hypoactivity). Lastly, specific behavioral changes were associated with selective damage to cortical (left inferior frontal gyrus, supplementary motor area, and right fusiform gyrus) and white matter (left inferior fronto-occipital and uncinate fasciculi, right cingulum) structures.

CONCLUSION

This study demonstrates that extensive lesions caused by DLGGs and their surgical resection have no or minor impact on patients' personality. However, specific personality dimensions are strongly predictive of behavioral disorders suggesting that the observed surgically related behavioral changes are modulated by the personality profile. Finally, the lesion mapping analyses indicate that damage to differential cortical or white matter structures leads to distinct patterns of behavioral abnormalities.

The Relationship Between Spirituality and the Developing Brain: A Framework for Pediatric Oncology

Development, whether motor, language, social, or spiritual, is the functional expression of complex brain processes throughout one's life span, the foundations of which are laid in childhood. The effects of cancer, chemotherapy, radiation, and surgical procedures on early brain development have been measured using neuroimaging and developmental assessment tools. We propose that spiritual development may be substantially affected in children with oncological diseases that impact underlying brain processes. By drawing connections between science, spirituality, and medicine, we can better address the spiritual needs of children as they cope with oncological diseases, by mitigating emotional, cognitive, and physical symptoms and improving outcomes.

A Review on Research and Evaluation Methods for Investigating Self-Transcendence

Self-transcendence has been characterized as a decrease in self-saliency (ego disillusionment) and increased connection, and has been growing in research interest in the past decade. Several measures have been developed and published with some degree of psychometric validity and reliability. However, to date, there has been no review systematically describing, contrasting, and evaluating the different methodological approaches toward measuring self-transcendence including questionnaires, neurological and physiological measures, and qualitative methods. To address this gap, we conducted a review to describe existing methods of measuring self-transcendence, evaluate the strengths and weaknesses of these methods, and discuss research avenues to advance assessment of self-transcendence, including recommendations for suitability of methods given research contexts.

Neural Correlates of Personalized Spiritual Experiences

Across cultures and throughout history, human beings have reported a variety of spiritual experiences and the concomitant perceived sense of union that transcends one's ordinary sense of self. Nevertheless, little is known about the underlying neural mechanisms of spiritual experiences, particularly when examined across different traditions and practices. By adapting an individualized guided-imagery task, we investigated neural correlates of personally meaningful spiritual experiences as compared with stressful and neutral-relaxing experiences. We observed in the spiritual condition, as compared with the neutral-relaxing condition, reduced activity in the left inferior parietal lobule (IPL), a result that suggests the IPL may contribute importantly to perceptual processing and self-other representations during spiritual experiences. Compared with stress cues, responses to spiritual cues showed reduced activity in the medial thalamus and caudate, regions associated with sensory and emotional processing. Overall, the study introduces a novel method for investigating brain correlates of personally meaningful spiritual experiences and suggests neural mechanisms associated with broadly defined and personally experienced spirituality.

Positive Impact of Mindfulness Meditation on Mental Health of Female Teachers during the COVID-19 Outbreak in Italy

The Covid-19 pandemic and subsequent public health measures were shown to impact negatively on people's mental health. In particular, women were reported to be at higher risk than men of developing symptoms of stress/anxiety/depression, and resilience was considered a key factor for positive mental health outcomes. In the present study, a sample of Italian female teachers (n = 66, age: 51.5 ± 7.9 years) was assessed with self-report instruments one month before and one month after the start of the Covid-19 lockdown: mindfulness skills, empathy, personality profiles, interoceptive awareness, psychological well-being, emotional distress and burnout levels were measured. Meanwhile, they received an 8-week Mindfulness-Oriented Meditation (MOM) course, through two group meetings and six individual video-lessons. Based on baseline personality profiles, analyses of variance were performed in a low-resilience (LR, n = 32) and a high-resilience (HR, n = 26) group. The LR and HR groups differed at baseline in most of the self-report measures. Pre-post MOM significant improvements were found in both groups in anxiety, depression, affective empathy, emotional exhaustion, psychological well-being, interoceptive awareness, character traits and mindfulness levels. Improvements in depression and psychological well-being were higher in the LR vs. HR group. We conclude that mindfulness-based training can effectively mitigate the psychological negative consequences of the Covid-19 outbreak, helping in particular to restore well-being in the most vulnerable individuals.

Acquisition of Ownership Illusion with Self-Disownership in Neurological Patients

The multisensory regions in frontoparietal cortices play a crucial role in the sense of body and self. Disrupting this sense may lead to a feeling of disembodiment, or more generally, a sense of disownership. Experimentally, this altered consciousness disappears during illusory own-body perceptions, increasing the intensity of perceived ownership for an external virtual limb. In many clinical conditions, particularly in individuals with a discontinuous or absent sense of bodily awareness, the brain may effortlessly create a convincing feeling of body ownership over a surrogate body or body part. The immediate visual input dominates the current bodily state and induces rapid plastic adaptation that reconfigures the dynamics of bodily representation, allowing the brain to acquire an alternative sense of body and self. Investigating strategies to deconstruct the lack of a normal sense of bodily ownership, especially after a neurological injury, may aid the selection of appropriate clinical treatment.

The assessment dimension of regulatory mode mediates the relation between frontoparietal connectivity and risk-taking: Evidence from voxel-base morphometry and functional connectivity analysis

We used voxel-based morphometry and resting-state functional magnetic resonance imaging (rs-fMRI) to investigate whether the regulatory mode orientation of assessment (the tendency of each individual to self-regulate by critically evaluating alternatives) interacts with neural systems underlying risk-taking. Across a sample of 112 participants, propensity for risk-taking (measured using the Wheel of Fortune task) was negatively correlated with assessment orientation, such that a greater tendency to critically evaluate alternatives was associated with a lower tendency for risk-taking. VBM revealed a negative correlation between assessment orientation and right inferior parietal lobe (RIPL) gray matter volume. Resting-state functional connectivity (rs-FC) between this same RIPL region and the left inferior frontal gyrus (LIFG) was positively correlated with assessment orientation in an independent sample of 41 participants. Most importantly, based on the rs-FC results, a mediation analysis indicated that assessment orientation played a completely mediating role in the relation between the functional connectivity of RIPL-LIFG and risk-taking. These results suggest that assessment orientation may affect risk-taking via the RIPL and its connectivity with LIFG. On the whole, the present study yields the insights into how the assessment dimension of regulatory mode affects risk-taking, and provides a novel account of the neural substrate of this relationship.

The Neural Basis of Religious Cognition

Religion’s neural underpinnings have long been a topic of speculation and debate, but an emerging neuroscience of religion is beginning to clarify which regions of the brain integrate moral, ritual, and supernatural religious beliefs with functionally adaptive responses. Here, we review evidence indicating that religious cognition involves a complex interplay among the brain regions underpinning cognitive control, social reasoning, social motivations, and ideological beliefs.

The relationship between individual differences in gray matter volume and religiosity and mystical experiences: A preregistered voxel-based morphometry study

The neural substrates of religious belief and experience are an intriguing though contentious topic. Here, we had the unique opportunity to establish the relation between validated measures of religiosity and gray matter volume in a large sample of participants (N = 211). In this registered report, we conducted a confirmatory voxel-based morphometry analysis to test three central hypotheses regarding the relationship between religiosity and mystical experiences and gray matter volume. The preregisterered hypotheses, analysis plan, preprocessing and analysis code and statistical brain maps are all available from online repositories. By using a region-of-interest analysis, we found no evidence that religiosity is associated with a reduced volume of the orbito-frontal cortex and changes in the structure of the bilateral inferior parietal lobes. Neither did we find support for the notion that mystical experiences are associated with a reduced volume of the hippocampus, the right middle temporal gyrus or with the inferior parietal lobes. A whole-brain analysis furthermore indicated that no structural brain differences were found in association with religiosity and mystical experiences. We believe that the search for the neural correlates of religious beliefs and experiences should therefore shift focus from studying structural brain differences to a functional and multivariate approach.

Belief in the miracles of Lourdes: A voxel-based morphometry study

BACKGROUND

It has been shown that particular religious beliefs and practices are associated with brain function and structure. The present voxel-based morphometry study investigated the correlation between the belief in the miracles of Lourdes (a major Catholic pilgrimage site) and gray matter volume in specific brain regions associated with theory of mind (ToM).

METHOD

Structural brain data from 84 women (mean age: 25 years; no current somatic illness; 80% Roman-Catholic) were correlated with self-report measures on belief in miracles, religious-spiritual well-being, and psychological problems. Selected brain regions of the ToM network included the temporoparietal junction (TPJ), hippocampus, amygdala, and medial prefrontal cortex (MPFC).

RESULTS

The belief in the miracles of Lourdes was positively correlated with general religiousness and with feelings of connectedness; there was no association with psychological problems. Belief in miracles of Lourdes correlated positively with TPJ volume and negatively with MPFC volume.

CONCLUSION

Belief in the miracles was associated with brain volume in regions involved in mentalizing and self-control.

Spiritual experiences are related to engagement of a ventral frontotemporal functional brain network: Implications for prevention and treatment of behavioral and substance addictions

BACKGROUND AND AIMS

Spirituality is an important component of 12-step programs for behavioral and substance addictions and has been linked to recovery processes. Understanding the neural correlates of spiritual experiences may help to promote efforts to enhance recovery processes in behavioral addictions. We recently used general linear model (GLM) analyses of functional magnetic resonance imaging data to examine neural correlates of spiritual experiences, with findings implicating cortical and subcortical brain regions. Although informative, the GLM-based approach does not provide insight into brain circuits that may underlie spiritual experiences.

METHODS

Spatial independent component analysis (sICA) was used to identify functional brain networks specifically linked to spiritual (vs. stressful or neutral-relaxing) conditions using a previously validated guided imagery task in 27 young adults.

RESULTS

Using sICA, engagement of a ventral frontotemporal network was identified that was engaged at the onset and conclusion of the spiritual condition in a manner distinct from engagement during the stress or neutral-relaxing conditions. Degree of engagement correlated with subjective reports of spirituality in the scanner (r = .71, p < .001) and an out-of-the-magnet measure of spirituality (r = .48, p < .018).

DISCUSSION AND CONCLUSION

The current findings suggest a distributed functional neural network associated with spiritual experiences and provide a foundation for investigating brain mechanisms underlying the role of spirituality in recovery from behavioral addictions.

Origin and evolution of human consciousness

The study of the origin and evolution of consciousness presents several problems. The first problem concerns terminology. The word consciousness comes from the Latin term conscĭentĭa that means "knowledge shared with others." However, the term consciousness also refers to several other aspects involving both its levels (sleep, coma, dreams and waking state) and contents (subjective, phenomenal and objective). A second issue is the problem of other minds, namely, the possibility to establish whether others have minds very like our own. Moreover, human consciousness has been linked to three different forms of memory: procedural/implicit, semantic and episodic. All these different aspects of consciousness will be discussed in the first part of the chapter. In the second part, we discuss different neuroscientific theories on consciousness and examine how research from developmental psychology, clinical neurology (epilepsy, coma, vegetative state and minimal state of consciousness), neuropsychology (blindsight, agnosia, neglect, split-brain and ocular rivalry), and comparative neuropsychophysiology contribute to the study of consciousness. Finally, in the last part of the chapter we discuss the distinctive features of human consciousness and in particular the ability to travel mentally through time, the phenomenon of joint intentionality, theory of mind and language.

The Downside Risk of Failing to Transcend Extraordinarily Negative Experiences: A Narrative Analysis

Introduction

American service members who survived a trauma like a prisoner of war (POW) experience and successfully rebounded afterwards present outcomes of resilience that merit further exploration. Difficulties in defining or measuring human resilience in the clinical setting have been acknowledged for some time, with a call for greater openness to lessons from other disciplines. Transcendence as an identity-enhancing experiential process of meaning-making may offer insights that complement medical and psychological care. If a person fails to make meaning of an extraordinarily negative event, he may experience anti-transcendence, or an anti-process that results in by-products that are antonymous to transcendence, like destabilization of one's sense of self or the fracturing or disintegration of connections within and beyond the self. Such outcomes may trigger a crisis of identity.

Materials and Methods

Eight memoirs of resilient American POW survivors from two time periods and the text were digitized and converted using optical character recognition software (Foxit PhantomPDF) to enable scanning for repetitious word patterns and themed searches. As passages were selected, sorted, and tagged, I designed a database in Microsoft Access to enter and query the fragments. Everyday baselines were established for each memoirist, and instances of transcendence and anti-transcendence were analyzed.

Results

While evidence was found across all memoirists for transcendence of personally relevant, extraordinarily positive and negative events, instances of failure to transcend extraordinarily negative events were found in only three of the narratives. Given that the sample consisted of resilient service members who appeared not only to rebound but also to thrive after their experience, this scarcity of failure to transcend personally relevant, extraordinarily negative events is not surprising. Types of personally relevant, extraordinarily negative events discussed included multiple instances of forced desecration of local graves to make way for construction projects by captors and breaking points after torture.

Conclusion

Transcendence as an experiential meaning-making process may utilize existential resources that enable one to make sense of personally relevant, extraordinarily positive, and negative events. If identity-relevant experiences are more powerful predictors of distress and well-being than those not relevant to one's sense of identity, then there should be greater focus on those kinds of experiences when working with service members struggling to bounce back from trauma. There are many contexts in which this can be done. Military chaplains, for example, are potentially very well suited to help service members reconnect with existential resources to help them make meaning of a traumatic event. Military psychologists can make space in their conversations discuss identity-relevant experiences. Examining written narrative can also help narrow the focus on identity-relevant experiences, both positive and negative. Written narrative about traumatic experiences as a form of self-narration carries with it an interpretive aspect that may help the person make meaning of it in way that he or she could not in a clinical setting. Although assessment of the potential therapeutic effect of written narrative was beyond the scope of the study, this might be one area to investigate.

Visual perception and spatial transformation of the body in children and adolescents with brain tumor

Representations of own and others' body play a crucial role in social interaction. While extensive knowledge has been gathered on the neuropsychological deficits affecting body representation in adult brain lesion patients, little is known on how acquired damage to a developing brain may affect this process. We tested it on pediatric brain tumor survivors, comparing the abilities of 30 children and adolescents (aged 8-16 years) surviving from a supratentorial tumor (STT) or an infratentorial tumor (ITT) in two different tasks of body representation. Thirty children with typical development (TD) served as control group. In the first task, we tested configural (body inversion effect) and holistic (composite illusion effect) processing of others' bodies. In the second task, we tested the ability to perform first-person and object-based mental spatial transformations of own body and external objects, respectively. Configural processing was spared in all patients. Conversely, ITT, but not STT patients, were impaired in the holistic processing of body stimuli. STT patients performed overall worse than both controls and ITT patients at mental spatial transformations of both own body and external objects. ITT children presented selective alteration in using the first-person transformation strategies with body stimuli. Results suggest that body-representation abilities may be heavily affected in pediatric brain tumor survivors. STTs may be associated to greater difficulties in mental visuo-spatial transformation abilities, likely reflecting damage to fronto-parietal circuits. Conversely, ITTs may be associated to specific disturbances of visual body perception abilities that require motor simulation processes, reflecting direct or indirect damage to cerebellar areas.

Classic Hallucinogens and Mystical Experiences: Phenomenology and Neural Correlates

This chapter begins with a brief review of descriptions and definitions of mystical-type experiences and the historical connection between classic hallucinogens and mystical experiences. The chapter then explores the empirical literature on experiences with classic hallucinogens in which claims about mystical or religious experiences have been made. A psychometrically validated questionnaire is described for the reliable measurement of mystical-type experiences occasioned by classic hallucinogens. Controlled laboratory studies show that under double-blind conditions that provide significant controls for expectancy bias, psilocybin can occasion complete mystical experiences in the majority of people studied. These effects are dose-dependent, specific to psilocybin compared to placebo or a psychoactive control substance, and have enduring impact on the moods, attitudes, and behaviors of participants as assessed by self-report of participants and ratings by community observers. Other studies suggest that enduring personal meaning in healthy volunteers and therapeutic outcomes in patients, including reduction and cessation of substance abuse behaviors and reduction of anxiety and depression in patients with a life-threatening cancer diagnosis, are related to the occurrence of mystical experiences during drug sessions. The final sections of the chapter draw parallels in human neuroscience research between the neural bases of experiences with classic hallucinogens and the neural bases of meditative practices for which claims of mystical-type experience are sometimes made. From these parallels, a functional neural model of mystical experience is proposed, based on changes in the default mode network of the brain that have been observed after the administration of classic hallucinogens and during meditation practices for which mystical-type claims have been made.

Contributions of Neuropsychology to the Study of Ancient Literature

The present work introduces the neuropsychological paradigm as a new approach to studying ancient literature. In the first part of the article, an epistemological framework for the proper use of neuropsychology in relation to ancient literature is presented. The article then discusses neuropsychological methods of studying different human experiences and dimensions already addressed by ancient literatures. The experiences of human encounters with gods among ancient cultures are first considered, through the contributions of Julian Jaynes and Eric R. Dodds. The concepts of right and left in the Bible, and that of soul are then discussed. Ecstatic experience in Paul of Tarsus is also presented, with a particular focus on glossolalia. Neuroscientific differences between mindful and unitive meditative practices are then described referring to ancient Buddhist literature, and finally a brief description of dreams in ancient Greek literature is proposed. Neuropsychology variously enables a more profound understanding of themes characterizing human experiences that ancient literature has already explored; these investigations prove that the collaboration of neuroscience and humanistic studies can return fruitful and interesting results.

Effect of Mindfulness Meditation on Personality and Psychological Well-being in Patients with Multiple Sclerosis

BACKGROUND

Varied evidence shows that mindfulness-oriented meditation improves individuals' mental health, positively influencing practitioners' personality profiles as well. A limited number of studies are beginning to show that this type of meditation may also be a helpful therapeutic option for persons with multiple sclerosis (MS).

METHODS

We evaluated the effects of an 8-week mindfulness-oriented meditation training on the personality profiles, anxiety and depression symptoms, and mindfulness skills of a group of patients with MS. A control group of patients with MS not enrolled in any training was also tested.

RESULTS

After mindfulness-oriented meditation training, participants in this group (n = 15) showed an increase in character traits reflecting the maturity of the self at the intrapersonal (self-directedness) and interpersonal (cooperativeness) levels. Moreover, increased mindfulness and conscientiousness and decreased trait anxiety were observed in participants after the training.

CONCLUSIONS

These data support the utility for patients with MS of therapeutic interventions based on mindfulness meditation that may lead to enhanced character and self-maturity.

Identification of COX5B as a novel biomarker in high-grade glioma patients

Background

Malignant glioma is the second leading cause of cancer-related death worldwide, and is known to exhibit a high degree of heterogeneity in its deregulation of different oncogenic pathways. The molecular subclasses of human glioma are not well known. Thus, it is crucial to identify vital oncogenic pathways in glioma with significant relationships to patient survival.

Methods

In this study, we devised a bioinformatics strategy to map patterns of oncogenic pathway activation in glioma, from the Gene Expression Omnibus (GEO). Bioinformatics analysis revealed that 749 genes were differentially expressed and classified into different glioma grades.

Results

Using gene expression signatures, we identified three oncogenic pathways (MAPK signaling pathway, Wnt signaling pathway, and ErbB signaling pathway) deregulated in the majority of human glioma. Following gene microarray analysis, the gene expression profile in the differential grade glioma was further validated by bioinformatic analyses, with coexpression network construction. Furthermore, we found that cytochrome c oxidase subunit Vb (COX5B), the terminal enzyme of the electron transport chain, was the central gene in a coexpression network that transfers electrons from reduced cytochrome c to oxygen and, in the process, generates an electrochemical gradient across the mitochondrial inner membrane. The expression level of COX5B was then detected in 87 glioma tissues as well as adjacent normal tissues using immunohistochemistry. We found that COX5B was significantly upregulated in 67 of 87 (77.0%) glioma and glioblastoma tissues, compared with adjacent tissue (p<0.01). Furthermore, statistical analysis showed the COX5B expression level was significantly associated with clinical stage and lymph node status, while there were no correlations between COX5B expression and age or tumor size.

Conclusion

These data indicate that COX5B may be implicated in glioma pathogenesis and as a biomarker for identification of the pathological grade of glioma.

The Mechanisms of Psychedelic Visionary Experiences: Hypotheses from Evolutionary Psychology

Neuropharmacological effects of psychedelics have profound cognitive, emotional, and social effects that inspired the development of cultures and religions worldwide. Findings that psychedelics objectively and reliably produce mystical experiences press the question of the neuropharmacological mechanisms by which these highly significant experiences are produced by exogenous neurotransmitter analogs. Humans have a long evolutionary relationship with psychedelics, a consequence of psychedelics' selective effects for human cognitive abilities, exemplified in the information rich visionary experiences. Objective evidence that psychedelics produce classic mystical experiences, coupled with the finding that hallucinatory experiences can be induced by many non-drug mechanisms, illustrates the need for a common model of visionary effects. Several models implicate disturbances of normal regulatory processes in the brain as the underlying mechanisms responsible for the similarities of visionary experiences produced by psychedelic and other methods for altering consciousness. Similarities in psychedelic-induced visionary experiences and those produced by practices such as meditation and hypnosis and pathological conditions such as epilepsy indicate the need for a general model explaining visionary experiences. Common mechanisms underlying diverse alterations of consciousness involve the disruption of normal functions of the prefrontal cortex and default mode network (DMN). This interruption of ordinary control mechanisms allows for the release of thalamic and other lower brain discharges that stimulate a visual information representation system and release the effects of innate cognitive functions and operators. Converging forms of evidence support the hypothesis that the source of psychedelic experiences involves the emergence of these innate cognitive processes of lower brain systems, with visionary experiences resulting from the activation of innate processes based in the mirror neuron system (MNS).

Transcranial direct current stimulation of the right temporoparietal junction impairs third-person perspective taking

Given the current debates about the precise functional role of the right temporoparietal junction (rTPJ) in egocentric and exocentric perspective taking, in the present study we manipulated activity in the rTPJ to investigate the effects on a spatial perspective-taking task. Participants engaged in a mental body transformation task, requiring them to mentally rotate their own body to the position of an avatar, while undergoing anodal, cathodal, or sham transcranial direct current stimulation (tDCS) of the rTPJ. As a control task, participants judged the laterality of a stimulus feature with respect to a fixation cross on the screen. For the first half of the experiment (only during online tDCS), a task-selective effect of tDCS was observed, reflected in slower reaction times following anodal than following cathodal and sham tDCS for the mental body transformation task, but not for the control task. The effects of tDCS were most pronounced for stimuli implying a more difficult mental body transformation. No effects of tDCS were observed during the second half of the experiment. The effects of tDCS were most pronounced for participants scoring low on aberrant perceptual beliefs and spiritual transcendence, suggesting a relation between third-person perspective taking and bodily and perceptual experiences. The finding that anodal stimulation of the rTPJ impairs third-person perspective taking indicates a key role of this region in exocentric spatial processing.

Noninvasive Brain Stimulation and Personal Identity: Ethical Considerations

As noninvasive brain stimulation (NIBS) technology advances, these methods may become increasingly capable of influencing complex networks of mental functioning. We suggest that these might include cognitive and affective processes underlying personality and belief systems, which would raise important questions concerning personal identity and autonomy. We give particular attention to the relationship between personal identity and belief, emphasizing the importance of respecting users' personal values. We posit that research participants and patients should be encouraged to take an active approach to considering the personal implications of altering their own cognition, particularly in cases of neurocognitive "enhancement." We suggest that efforts to encourage careful consideration through the informed consent process would contribute usefully to studies and treatments that use NIBS.

The Varieties of Self-Transcendent Experience

Various forms of self-loss have been described as aspects of mental illness (e.g., depersonalization disorder), but might self-loss also be related to mental health? In this integrative review and proposed organizational framework, we focus on self-transcendent experiences (STEs)—transient mental states marked by decreased self-salience and increased feelings of connectedness. We first identify common psychological constructs that contain a self-transcendent aspect, including mindfulness, flow, peak experiences, mystical-type experiences, and certain positive emotions (e.g., love, awe). We then propose psychological and neurobiological mechanisms that may mediate the effects of STEs based on a review of the extant literature from social psychology, clinical psychology, and affective neuroscience. We conclude with future directions for further empirical research on these experiences.

The Overt Behaviour Scale-Self-Report (OBS-SR) for acquired brain injury: exploratory analysis of reliability and validity

The objectives were to test the properties, via a psychometric study, of the Overt Behaviour Scale-Self-Report (OBS-SR), a version of the OBS-Adult Scale developed to provide a client perspective on challenging behaviours after acquired brain injury. Study sample 1 consisted of 37 patients with primary brain tumour (PBT) and a family-member informant. Sample 2 consisted of 34 clients with other acquired brain injury (mixed brain injury, MBI) and a service-provider informant. Participants completed the OBS-SR (at two time points), and the Awareness Questionnaire (AQ) and Mayo Portland Adaptability Inventory-III (MPAI-III) once; informants completed the OBS-Adult and AQ once only. PBT-informant dyads displayed "good" levels of agreement (ICC_2,k = .74; OBS-SR global index). Although MBI-informant dyads displayed no agreement (ICC_2,k = .22; OBS-SR global index), the sub-group (17/29) rated by clinicians as having moderate to good levels of awareness displayed "fair" agreement (ICC_2,k = .58; OBS-SR global index). Convergent/divergent validity was demonstrated by significant correlations between OBS-SR subscales and MPAI-III subscales with behavioural content (coefficients in the range .36 -.61). Scores had good reliability across one week (ICC_2,k = .69). The OBS-SR took approximately 15 minutes to complete. It was concluded that the OBS-SR demonstrated acceptable reliability and validity, providing a useful resource in understanding clients' perspectives about their behaviour.