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Respect, often known as gratitude, is a sense of admiration for another person. Philosophers have characterized respect in a variety of ways, including modes of action, treatment, gratitude, attention, reasons, attitudes, respect, principles, moral virtues, and epistemic virtues. 1). This is one of the Global Brain Health Institute's (GBHI) basic values, which strives to protect the world's aging population against dangers to brain health. These qualities are abbreviated "A FORCE" and stand for dependability, fairness, openness, respect, courage, and empathy [1]. These two values are linked.

For any activity to be reliable, it must have a solid foundation. This measure may advocate for procedural fairness and emphasizes the importance of transparency, fairness, and openness. This underpins the need for evidence-based change, which cannot occur without respect, which encourages appreciation and embraces variety. This, however, necessitates the willingness to take risks. Finally, the ability to feel the feelings of others as if they were your own is fundamental to community-focused transformation. These values can be used as a guide when making claims to reduce the impact of dementia. Applying this values-based approach to brain health has the potential to transform millions of people around the world.

The neurobiology of respect

Respect holds a central position across numerous fields such as biomedicine, ethology, philosophy, and ethics. Its unique quality lies in its dual nature as both a verb and a noun, simultaneously triggering action and emotion within human conduct. Respect embodies a positive social sentiment linked to profound admiration. As Kant proposes (3) when acknowledging commendable conduct in another individual, "Behave in a manner that treats humanity, whether it's in your own self or in anyone else, never merely as a method but always concurrently as an objective." This pertains to the intrinsic value that molds our identity and connections with others.

The complexity of this value can be traced back evolutionarily through dominance hierarchies seen in animal societies, including our closest ancestors, the great apes . Related concepts, such as respect for ownership, are lost in young children and only found in children with object-subject conceptualization and theory of mind . In an exploratory study, the concept of ownership was observed to evoke respect in 4-year-old children in over 85% of the conducted trials. This phenomenon displayed similar trends across various societies among children aged 4 to 7 years. Among younger children lacking fully developed object-subject conceptualization abilities, the recognition of ownership and the corresponding respect might waver. The foundation for respect could be linked to the advancement of theory of mind, the maturation of empathetic processes, and the establishment of social hierarchies [2-5]. These aspects might be interconnected with the development of the social brain and the prefrontal cortex. Additionally, multiple research endeavors have consistently pinpointed specific brain regions contributing to social dominance, encompassing the amygdala, hippocampus, striatum, intraparietal sulcus, and the prefrontal cortex. These neural networks collectively shape the intricate pathways governing the social brain, emotional responses, and reward systems.

When one experiences a sense of disrespect, the amygdala, a component of the brain responsible for processing intense emotions, becomes activated. This occurs irrespective of whether the individual exhibiting the behavior perceives their actions as completely respectful; the brain interprets it as a potential threat. In contrast to the support garnered within a social setting, the amygdala also influences the importance of emotions prior to evaluating the significance of the action taken. Alongside this neural structure, the hypothalamus plays a role in governing self-preservation instincts and triggering the fight-flight-freeze response. This rapid response initiates in the peri aqueduct grey area and swiftly transmits signals to the hypothalamus in under a second. The hypothalamus plays a pivotal role in regulating autonomic functions, stress responses, body temperature, and other vital physiological processes.

When one is respected, hormones such as oxytocin and serotonin are released in the creation of bounding; in contrast, when one is disrespected, hormones such as adrenaline, cortisol, and norepinephrine are released . Nonetheless, further research is need to elucidate completely the neurobiology behind values and respect.

Neuroanatomical localization of respect

Where does the concept of respect reside within the brain? When we admire remarkable conduct, positive social emotions usually emerge as a manifestation of respect. This process relies on semantic memory. The storage of social semantic information takes place in a brain region known as the anterior temporal lobe (ATL). The activity in the ATL is influenced by the conceptual aspects of semantic knowledge, as it involves evaluating exceptional behavior and the individual as a complete entity. The act of showing respect triggers activity in the ATL. Conversely, admiration is linked to a person's exemplary behavior. In their study, Nakatani et al observed that appraisal ratings for a person’s behavior were higher in admiration-related vignettes. In respectrelated vignettes, however, those for the person were higher. The intensities of admiration and respect differentially modulated brain activity in a part of the left ATL [6]. Other significant areas include the medial, orbitofrontal, temporal, and cingulate cortex, which are related to understanding and predicting other people’s feelings, ideas, and behaviors, representing the theory of mind. This process can potentially alter social interactions by mediating respect behaviors, social needs, emotional reactions, and normative expectations.

The final verdict

“The girl expressed regret for making false accusations. The villagers questioned the King, ‘Why did not he refute this at the outset?’ The King said, ‘What difference would it have made? The child must belong to someone. People would have relished defaming one more individual if they had the opportunity.’ If the King had been concerned about their condemnation, he would also have been concerned about their respect. He had become indifferent to people’s behaviors by dropping the idea of good and bad because the thinking makes it so.”The absence of differentiation between positive and negative aspects becomes evident in the behaviors of real-world professionals due to the dehumanizing effects within the medical field. Nevertheless, the incorporation of "A FORCE" concepts into general practice has the potential to reintroduce a sense of humanity towards patients [7,8]. The movement of positive psychology and positive psychiatry, rooted in humanism, could facilitate this transformation through constructive interventions that center on wholeheartedly respecting a patient's optimism, wisdom, and kindness. From our perspective, the principles of positive psychology and psychiatry need to be integrated into the educational curricula of future practitioners, emphasizing the cultivation of often-neglected soft skills in clinical practice. For example, a humanistic approach grounded in values could enhance brain health outcomes, even though further research is required to substantiate and globalize these practices for a broader impact on overall healthcare. Moreover, these approaches need to be extended even more in society, for example, through regional and global initiatives that impulse multi-level brain health-directed policy agendas, focus to augment sustainability of democratic societies through brain capital, equity, mental health and resilience , which not only goes in line with “A FORCE” concepts, but also promotes brain health, altruistic behaviors and democracy .

Conclusion

To wrap up, the fusion of cognitive and social neuroscience with innovative approaches stands as a captivating frontier in the realm of social cognitive neuroscience. While many investigations have pinpointed neurobiological indicators linked to values, this alone falls short. Subsequent research should strive to delve into the neurobiological underpinnings of values in a broader context, encompassing aspects like respect. This entails a thorough examination of distinct neural networks linked to these values. Moreover, deciphering the relevance of these networks in clinical applications will advance our grasp of how social elements exert influence on mental well-being.

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