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The mind and its relationship to the brain have been investigated extensively in neuroscience and philosophy. However, either way of their determination raises principal problems whose solution seem rather difficult. These problems shall be called ‘mind-problems’ (see Figure 1) and are discussed either implicitly or explicitly in the ‘philosophy of mind’. Empirically, themind is determined by neuronal states, which are supposed to characterize the brain. Neuronal states of the brain are investigated empirically and related directly to different psychological and physiological functions. Meanwhile mental states can neither be investigated empirically nor related directly to neuronal states. Unlike neuronal states,mental states are not accessible in Third-Person Perspective, whichmakes their direct empirical investigation impossible.

Rumination is defined as ‘a mode of responding to distress  that involves repetitively and passively focusing on symptoms  of distress and on the possible causes and consequences  of these symptoms’ (Nolen-Hoeksema et al., 2008). This  tendency characterizes depression (Nolen-Hoeksema et al.,  2008), and has been ascribed to deficient control processes  that cannot rid memory of negative information (Joormann,  2005). As such, a growing literature has examined the  relationship between depressive rumination and cognitive  control during demanding cognitive tasks.  However, it is likely that the most prominent display of  rumination is not when people are engaged in a task, but  when they are at rest.

Individual and species survival demand that organisms find and obtain needed resources (e.g., food and shelter) and opportunities . Such survival-relevant natural goals act as “rewards,” i.e., they are pursued with the anticipation that their consumption (or consummation) will produce desired outcomes (i.e., will “make things better”). Behaviors with rewarding goals tend to persist strongly to a conclusion and increase over time (i.e., they are positively reinforcing) (21). Internal motivational states, such as hunger, thirst, and sexual arousal, increase the incentive value of goal-related cues and of the goal objects themselves and also increase the pleasure of consumption (e.g., food tastes better when one is hungry) (22). External cues related to rewards (incentive stimuli), such as the sight or odor of food or the odor of an estrous female, can initiate or strengthen motivational states, increasing the likelihood that complex and often difficult behavioral sequences, such as foraging or hunting for food, will be brought to a successful conclusion, even in the face of obstacles.

The meta-analysis by Srisurapanont and Jarusuraisin (26) included a total of 2,861 subjects from 24 randomized, controlled trials. In the short term, naltrexone significantly decreased risk of relapse to heavy drinking (relative risk [RR] 0.64, 95% CI 0.51 to 0.82) but did not reduce the likelihood of a return to any drinking (RR 0.91, 95% CI 0.81 to 1.02). Treatment with naltrexone significantly increased adverse effects, roughly doubling the likelihood of reports of nausea and dizziness and increasing the risk of fatigue by about one-third compared with placebo. However, naltrexone treatment did not significantly affect the rate of premature discontinuation of treatment (RR 0.85, 95% CI 0.70 to 1.01).