2004-02-14 Spike activity

Quick links from the past week in mind and brain news:

Cocaine use increases stroke risk in young people reports Science News. Risk of being a giant knob-end already well established.

The New York Times has an interesting piece on how musical hallucinations are giving researchers clues about the workings of the brain.

For the first time, a baby is born to a brain-dead woman kept viable on life-support to be able to give birth. Reported by the Otago Daily Times.

Brain Watch has an excellent explainer on brain death for those wanting some background.

Focussed ultrasound to stimulate the brain. The mighty Neuroskeptic has a look at this new neurostimulatory technique.

New Scientist advises us to fall for a robot to fend off heartache and explores the robot relationship subculture.

A dozen of the craziest romance-related studies ever featured on Seriously Science. Sex apparently burns 3.6 calories a minute. A minute? I barely make 30 seconds.

NHS Choices takes a level-headed look at the ‘male and female brains are different sizes’ story which has gone all shades of wibble-wibble-daft in the media.

The origins of the F-word. A brilliant post from the historians of language at So Long As It’s Words… traces it’s history. Also features John Le Fucker from 1286.

Respect is a medicine

Aeon magazine has an excellent article on how social interactions among medical team members affect clinical outcomes, patient well-being and the number of medical errors that occur.

It’s probably worth saying that the vast majority of doctors and warm and respectful people but it remains one of the last professions where teaching though humiliation is given a place to survive.

The article in Aeon looks at research on teamwork, communication style and respect and finds out that this ‘treat ‘em mean, keep ‘em keen’ attitude actually leads to higher rates of medical errors.

…many in medicine actively protect the culture of disrespect because they hold a fundamentally flawed idea: that harshness creates competence. That fear is good for doctors-in-training and, by extension, good for patients. That public shaming holds us to higher standards. Efforts to change the current climate are shot down as medicine going ‘soft’. A medical school friend told me about a chief resident who publicly yelled at a new intern for suggesting a surgical problem could be treated with drugs. The resident then justified his tirade with: ‘Yeah, yeah, I know I was harsh. But she’s gotta learn.’

Arguments such as these run counter to all the data we have on patient outcomes. Brutality doesn’t make better doctors; it just makes crankier doctors. And shame doesn’t foster improvement; it fosters more mistakes and more near-misses. We know now that clinicians working in a culture of blame and punishment report their errors less often, pointing to fear of repercussion. Meanwhile, when blame is abolished, reporting of all types of errors increases.

This, incidentally, tends to impact on certain students and trainees more than others. I still meet medical students who want to train as psychiatrists but have to suffer being humiliated in front of their peers by senior doctors when the inevitable ‘what speciality are you interested in’ question comes up.

The Aeon article is a brilliant analysis of the dynamics and interactions in medical teams and why respectful communication and a supportive teaching style is actually better medicine in terms of medical outcomes.
 

Link to Aeon magazine on interactions in medicine.

A reality of dreams

The journal Sleep has an interesting study on how people with narcolepsy can experience sometimes striking confusions between what they’ve dreamed and what’s actually happened.

Narcolepsy is a disorder of the immune system where it inappropriately attacks parts of the brain involved in sleep regulation.

The result is that affected people are not able to properly regulate sleep cycles meaning they can fall asleep unexpectedly, sometimes multiple times, during the day.

One effect of this is that the boundary between dreaming and everyday life can become a little bit blurred and a new study by sleep psychologist Erin Wamsley aimed to see how often this occurs and what happens when it does.

Some of the reports of are quite spectacular:

One man, after dreaming that a young girl had drowned in a nearby lake, asked his wife to turn on the local news in full expectation that the event would be covered. Another patient experienced sexual dreams of being unfaithful to her husband. She believed this had actually happened and felt guilty about it until she chanced to meet the ‘lover’ from her dreams and realized they had not seen each other in years, and had not been romantically involved.

Several patients dreamed that their parents, children, or pets had died, believing that this was true (one patient even made a phone call about funeral arrangements) until shocked with evidence to the contrary, when the presumed deceased suddenly reappeared. Although not all examples were this dramatic, such extreme scenarios were not uncommon.

This sometimes happens in people without narcolepsy but the difference in how often it occurs is really quite striking: 83% of patients with narcolepsy reported they had confused dreams with reality, but this only happened in 15% of the healthy controls they interviewed.

In terms of how often it happened, 95% of narcolepsy patients said it happened at least once a month and two thirds said it happened once a week. For people without the disorder, only 5% reported it had happened more than once in their life.

Although a small study, it suggests that the lives of people with narcolepsy can be surprisingly interwoven with their dreams to the point where it can at times it can be difficult to distinguish which is which.

If you want to read the study in full, there’s a pdf at the link below.
 

Link to locked study at Sleep journal (via @Neuro_Skeptic)
pdf of full text.

2004-02-07 Spike activity

Quick links from the past week in mind and brain news:

Science News has an extended piece on progress with the still-not-entirely-clear-what’s-going-on billion dollar BRAIN initiative.

There might be a little synesthesia in each of us. Nautilus looks at how our senses combine and cross.

The LA Times reports that boxing and ultimate fighting promoters are donating to a neuroscience study on the long-term effects of being repeatedly punched in the head.

The False Memory Archive. An interesting project covered by an article in The Independent.

The West Briton reports on a Cornish drug dealer who told police he didn’t know how heroin had become taped to his testicles. God bless the Westcountry.

There are ways to prevent loved ones from becoming victims of an overdose. Here are three. Important piece from Time.

The Guardian reports that the UK Government has privatised the ‘nudge unit’. Presumably by making it the default option and waiting to see if anyone opts out.

A new cognitive science news website The Psych Report launches and looks very impressive.

Discover Magazine reports that the oldest human footprints found outside of Africa have been found in Norfolk. The ‘out of Norfolk’ hypothesis soon to be published.

Heroin, addiction and free will

The death of Phillip Seymour Hoffman has sparked some strong and seemingly contradictory responses. What these reactions show is that many people find it hard to think of addiction as being anything except either a choice or a loss of free will.

The fact that addiction could involve an active choice to take drugs but still be utterly irresistible seems difficult for most people to fathom.

Let’s take some reactions from the media. Over at Time, David Sheff wrote that “it wasn’t Hoffman’s fault that he relapsed. It was the fault of a disease”. On the other hand, at Deadspin, Tim Grierson wrote that the drug taking was “thoughtless and irresponsible, leaving behind three children and a partner”.

So does addiction trap people within its claws or do drug users die from their own actions? It’s worth noting that this is a politicised debate. Those who favour a focus on social factors prefer prefer the ‘trap’ idea, those who prefer to emphasise individual responsibility like the ‘your own actions’ approach.

Those who want to tread the middle ground or aim to be diplomatic suggest it’s ‘half and half’ – but actually it’s both at the same time, and these are not, as most people believe, contradictory explanations.

To start, it’s worth thinking about how heroin has its effect at all. Heroin is metabolised to morphine which then binds to opioid receptors in the brain. It seems to be the effects in the nucleus accumbens and limbic system which are associated with the pleasure and reward associated with the drug.

But in terms of motivating actions, it is a remarkably non-specific drug and it doesn’t directly cause specific behaviours.

In fact, there is no drug that makes you hassle people in Soho for a score. There’s no drug that manipulates the neural pathways to make you take the last 40 quid out of your account to buy a bag of gear. No chemical exists that compels your hands to prepare a needle and shoot up.

You are not forced to inject heroin by your brain or by the drug. You do not become an H-zombie or a mindless smack-taking robot. You remain in control of your actions.

But that does not mean that it’s a simple ‘choice’ to do something different, as if it was like choosing one brand of soft drink over another, or like deciding between going to the cinema or staying at home.

Addiction has a massive effect on people’s choices but not so much by altering the control of actions but by changing the value and consequences of those actions.

If that’s not clear, try thinking of it like this. You probably have full mechanical control over your speech: you can talk when you want and you can stay silent when you want. Most people would say you have free will to speak or to not speak.

But try not speaking for a month and see what the consequences are. Strained relationship? Lost job maybe? Friends who ditch you? You are free to choose your actions but you are not free to choose your outcomes.

For heroin addicts, the situation is similar. As well as the pleasurable effects of taking it, not taking heroin has strong, negative and painful effects.

This is usually thought of as the effects of physical withdrawal but these are not the whole story. These are certainly important, but withdrawing from junk is like suffering a bad case of flu. Hardly something that would prevent most people from saving their lives from falling apart.

For many addicts, the physical withdrawal is painful, but it’s the emotional effects of not taking drugs that are worse.

Most smack addicts have a frightening pre-drug history of trauma, anxiety and mood disorders. Drugs can be a way of coping with those emotional problems in the short-term.

Unfortunately, in the longer-term, persistent drug use maintains the conditions that keep the problems going. Even for those few that don’t have a difficult past or unstable emotions, life quickly become difficult after regular heroin use sets in.

If you can stay high, you’ll be less affected by the consequences of both long-standing problems and your chaotic lifestyle. If you stop, you feel the full massive force of that emotional distress.

It’s vicious circle that is often set in motion by past trauma but requires a meeting with a drug and the right social circumstances. Just taking the drug until you develop tolerance and withdrawal is unlikely to addict most people.

For example, a Vietnam War study found that just under half of soldiers reported trying heroin, 1 in 5 developed full blown dependency while in Vietnam but only about 5-10% of the dependent soldiers continued using when they arrived home. Most said they gave up without any help and only a small minority had ongoing addiction problems.

In fact, some of you reading this may have been addicted to heroin and not known it. Heroin, under its medical name diamorphine, is commonly used as a painkiller after major surgery. It’s not uncommon that patients develop tolerance and go into withdrawal after they leave hospital but just put it down to ‘feeling poorly’ or ‘recovering’.

But for persistent addicts, the ‘short-term solution that maintains the long-term problem’ cycle is not the whole story and it’s important to remember the neurological effects of the drug and how it interacts with, and changes, the brain.

Addiction is associated with difficulties in resisting cravings and making flexible decisions. This is likely to be caused by a combination of genetics, earlier experience and the ongoing impact of the drug and the drug-focused lifestyle – all of which affect brain function.

A recently popular approach is the ‘disease model’ of addiction which says that the brains of those who become addicted are more susceptible to compulsive drug use because of genetic susceptibility and / or brain changes due to early experience that ‘prime’ the brain for addiction.

It’s probably true to say that the extreme version of the ‘disease model’ – which says addiction is entirely explained by these changes and is best characterised as a ‘brain disease’ – is an exaggeration of what we know about the neuroscience of addiction, but this is not to say that neuroscience is not important.

But either way, there is no clear relationship between an aspect of behaviour being best explained in neurobiological terms and not having any control over that behaviour. For example, most genuine addicts usually give up, on their own, without any assistance and don’t relapse. They still have brains, of course.

Unfortunately though, the ‘disease model’ approach is often used precisely because some think it implies addicts have less control, possibly because they feel (probably wrongly) that it is less ‘stigmatising’ to think of heroin users in this way.

Instead, we know that self-efficacy is one of the best predictors of recovery, so denying people’s role in their own decisions just undermines one of their most important tools for recovery – alongside medication, social support and other forms of therapy.

So to say an addict has ‘no choice’ over their actions is just to misunderstand addiction but to pretend these choices are like any others just misses the fact that they can sometimes be impossibly hard decisions.

Unfortunately though, people find it hard to separate any admission of addicts being able to choose their actions from blame and moral accusation.

Blaming someone for their addiction is like shaming someone for being wounded by an abusive partner. Whatever the circumstances that caused the problem, they deserve respect and treatment, and working with them to help them regain control of their circumstances and promote their own autonomy is an important and valuable way forward.

Revenge is not sweet

An interesting paper in the snappily titled International Journal of Offender Therapy and Comparative Criminology examines what we know about the psychology of revenge.

It has a fascinating section where it discusses how often people take vengeful actions and whether they actually bring any relief.

It seems that taking revenge is rare, but when it happens, it is not only remarkably unsatisfying but counter-productive in terms of dispelling the desire for retribution.

Empirical research by Crombag, Rassin, and Horselenberg (2003) showed that most people do not actually take revenge but merely have thoughts, feelings, and fantasies about it (see also Crombag, 2003). Most people become reconciled with the offender and many people decide to let bygones be bygones. Some of the people who did take revenge could not explain their reason for doing so…

It should be noted that, in the study of Crombag et al., the group of people who took revenge even after a period of time still struggled with more vengeful feelings than the people who did not take revenge. Although 58% experienced satisfaction and 16% experienced triumph, only 19% reported their vengeful feelings to be completely gone, compared with 40% of the people who did not take revenge.

A 2008 study found that one reason that people who do take revenge find it hard to move on is that taking action keeps them ruminating about the events.
 

Link to locked paper on the psychology of revenge.

2014-01-31 Spike activity

Quick links from the past week in mind and brain news:

Nautilus discusses how music hijacks our perception of time.

What the Dunning-Kruger effect is and isn’t. Good in-depth discussion of this often misunderstood effect from [citation needed].

The Atlantic has a fascinating piece on mental illness in Ancient Greece and Rome.

Should a robot decide when to kill? asks The Verge. To the bunkers, you say?

Do Deaf People Hear an Inner Voice? Fascinating discussion on The Voices Within.

The New York Times discusses recent research on how we’re genetically part Neanderthal.

Why the social construction of madness is not as simple as it seems. Excellent piece on the Discursive of Tunbrige Wells blog.

Nature releases the latest edition of the excellent NeuroPod podcast.

An article on the history of the ‘Satanic abuse’ panic of the 1980s is mysteriously taken offline by Psychiatric Times. Gary Greenberg takes up the case.

New Scientist has a oddly-titled article (mind-reading?) on genuinely interesting research looking at how the brain makes sense of phonemes.

Fantastic YouTube video of a moving sculpture that gives the illusion of a rotating head.

There probably isn’t an app for that

A man with drug-induced psychosis attempted to swallow his smartphone and the case was reported in the medical journal Internal and Emergency Medicine.

A 35 year-old man with no significant past medical history presented to the emergency department (ED) after abusing phencyclidine (PCP). Responding to command auditory hallucinations, he attempted to swallow his 4 cm × 8 cm smartphone. On arrival, he was agitated but alert, handling his secretions poorly and in moderate respiratory distress. An electronic device was clearly protruding from his oropharynx [throat]…

Emergency physicians immediately attempted to remove the device with Magill forceps, but were unsuccessful. A “trauma code” was announced bringing a surgical intensivist, an anesthesiologist, and appropriate nursing staff to the bedside, while simultaneously indicating that an operating room (OR) should be prepared… The device was successfully removed under procedural sedation without the need for surgical intervention.

Moral of the story: friends don’t let friends mix selfies and PCP.
 

Link to locked case study.

The cutting edge of brain science technologies

National Geographic has an excellent article that gives a tour of some of the latest technologies of neuroscience that are likely to be leading the way in understanding the brain over the next decade.

You can read the full article online but you need to complete a free registration first. A typical publication ploy but, in this case, it’s well worth doing.
 


 

The article is itself fascinating but is also wonderfully illustrated with photos and videos to show exactly how the new technologies allows us to see the brain at work in many different ways.

An excellent guide to the cutting edge of lab brain science.
 

Link to National Geographic article ‘Secrets of the Brain’ (free reg required).
Link to plain text copy of article – no reg required.

The hallucinated demons of intensive care

I’ve got an article in The Observer about the psychological impact of being a patient in intensive care that can include trauma, fear and intense hallucinations.

This has only been recently recognised as an issue and with mental disorders being detected in over half of post-ICU patients it has sparked a serious re-think of how ICU should be organised to minimise stress.

Some of the most spectacular experiences are intense hallucinations and delusions that can lead to intrusive and surreal flashbacks that can have effects long after the person has become medically stable.

Wade interviewed patients about the hallucinations and delusions they experienced while in intensive care. One patient reported seeing puffins jumping out of the curtains firing blood from guns, another began to believe that the nurses were being paid to kill patients and zombify them. The descriptions seem faintly amusing at a distance, but both were terrifying at the time and led to distressing intrusive memories long after the patients had realised their experiences were illusory.

Many patients don’t mention these experiences while in hospital, either through fear of sounding mad, or through an inability to speak – often because of medical breathing aids, or because of fears generated by the delusions themselves. After all, who would you talk to in a zombie factory?

One of the interesting aspects is how standard ICU care is incredibly stressful and uncomfortable experience. I quote Hugh Montgomery, a professor of intensive care medicine, who says “If you think about the sort of things used for torture you will experience most of them in intensive care”!

Anyway, more at the link below.
 

Link to ‘When intensive care is just too intense’ in The Observer.

2014-01-17 Spike activity

Quick links from the past week in mind and brain news:

Wired magazine has an excellent profile of artificial intelligence bossman Geoff Hinton.

Is it time we stopped ‘sectioning‘ people? Thought-provoking piece on the excellent Psychiatry SHO blog.

The New York Times has an insightful piece on what the ‘marshmallow study’ really tells us about self-control.

Tough love for fMRI. Interesting piece on fixing the problems with fMRI research on the Neurochambers blog.

Nature discusses why ‘irrational’ choices can be rational. Are you reading moustache haters?

Caffeine’s little memory jolt garners a lot of excitement. A fascinating discussion on caffeine and memory boosts from Scicurious newly located blog.

Science News reports on how the brain weighs more when you think harder due to increase blood flow.

An artist made a life-sized skull made of compressed cocaine and it got posted to BoingBoing. Can’t wait for the Viagra sculpture.

Live Science reports on a new study finding that people can register an image in 13 milliseconds.

Cannabis and memory loss: dude, where’s my CBD? Interesting The Guardian piece argues that legalisation may have a knock on effect of making cannabis with higher levels of beneficial CBD more widely available.

What’s the evidence on using rational argument to change people’s minds?

Contributoria is an experiment in community funded, collaborative journalism. What that means is that you can propose an article you’d like to write, and back proposals by others that you’d like to see written. There’s an article I’d like to write: What’s the evidence on using rational argument to change people’s minds?. Here’s something from the proposal:

Is it true that “you can’t tell anybody anything”? From pub arguments to ideology-driven party political disputes it can sometimes seem like people have their minds all made up, that there’s no point trying to persuade anybody of anything. Popular psychology books reinforce the idea that we’re emotional, irrational creatures (Dan Ariely “Predictably irrational”, David McRaney “You Are Not So Smart”). This piece will be 2000 words on the evidence from psychological science about persuasion by rational argument.

If the proposal is backed it will give me a chance to look at the evidence on things like the , on whether political extremism is supported by an illusion of explanatory depth (and how that can be corrected), and on how we treat all those social psychology priming experiments which suggest that our opinions on things can be pushed about by irrelevant factors such as the weight of a clipboard we’re holding.

All you need to do to back proposals, currently, is sign up for the site. You can see all current proposals here. Written articles are Creative Commons licensed.

Back the proposal: What’s the evidence on using rational argument to change people’s minds?

Full disclosure: I’ll be paid by Contributoria if the proposal is backed

Update: Backed! That was quick! Much thanks mindhacks.com readers! I’d better get reading and writing now…

Parental advisory: teenage kicks in progress

New York Magazine has an excellent piece on whether adolescence is really a time of turmoil for young people or whether it is actually the parents that find their kids’ teenage years the most challenging.

The article is a brilliant alternative take on adolescence and looks into a range of studies on how teens develop and how it affects the changing parent-teen relationship.

Laurence Steinberg, a psychologist at Temple University and one of the country’s foremost authorities on puberty, thinks there’s a strong case to be made for this idea. “It doesn’t seem to me like adolescence is a difficult time for the kids,” he says. “Most adolescents seem to be going through life in a very pleasant haze.” Which isn’t to say that most adolescents don’t suffer occasionally, or that some don’t struggle terribly. They do. But they also go through other intense experiences: crushes, flirtations with risk, experiments with personal identity. It’s the parents who are left to absorb these changes and to adjust as their children pull away from them. “It’s when I talk to the parents that I notice something,” says Steinberg. “If you look at the narrative, it’s ‘My teenager who’s driving me crazy.’ ”

In the 2014 edition of his best-known textbook, Adolescence, Steinberg debunks the myth of the querulous teen with even more vigor. “The hormonal changes of puberty,” he writes, “have only a modest direct effect on adolescent behavior; rebellion during adolescence is atypical, not normal.”

A fascinating and very well-written piece.
 

Link to NYMag article ‘The Collateral Damage of a Teenager’

Ghost psychiatry

The Australian Journal of Parapsychology has an article about post-traumatic stress disorder in people who have been murdered.

I suspect diagnosing mental disorder in those who have passed onto another plane of existence isn’t the easiest form of mental health assessment but it seems this gentleman is determined to give it a go.

Psychological phenomena in dead people: Post- traumatic stress disorder in murdered people and its consequences to public health

Australian Journal of Parapsychology, Volume 13 Issue 1 (Jun 2013)

Wasney de Almeida Ferreira

The aims of this paper are to narrate and analyze some psychological phenomena that I have perceived in dead people, including evidence of post-traumatic stress disorder (PTSD) in murdered people. The methodology adopted was “projection of consciousness” (i.e., a non-ordinary state of consciousness), which allowed me to observe, interact, and interview dead people directly as a social psychologist. This investigation was based on Cartesian skepticism, which allowed me a more critical analysis of my experiences during projection of consciousness. There is strong evidence that a dead person: (i) continues living, thinking, behaving after death as if he/she still has his/her body because consciousness continues in an embodied state as ‘postmortem embodied experiences’; (ii) may not realize for a considerable time that he/she is already dead since consciousness continues to be embodied after death (i.e., ‘postmortem perturbation’ – the duration of this perturbation can vary from person to person, in principle according to the type of death, and the level of conformation), and (iii) does not like to talk, remember, and/or explain things related to his/her own death because there is evidence that many events related to death are repressed in his/her unconscious (‘postmortem cognitive repression’). In addition, there is evidence that dying can be very traumatic to consciousness, especially to the murdered, and PTSD may even develop.

It is worth noting that the concept of post-mortem PTSD was largely invented by Big Parlour as a way of selling seances, when what spirits really need is someone to help them understand their experiences.
 

Link to abstract for article (via @WiringTheBrain)

Put your hands up and move away from the therapy

An editorial in Molecular Psychiatry has been titled “Launching the War on Mental Illness” – which, considering the effects of war on mental health, must surely win a prize for the most inappropriate metaphor in psychiatry.

But it also contains a curious Freudian slip. Five times in the article, the project is described as the ‘War on Mental Health’, which is another thing entirely.

…how can we then proceed to successfully launch a ‘War on Mental Health’? Our vision for that is summarized in Figure 3 and Table 1.

Sadly, Figure 3 and Table 1 don’t contain a description of a world with continuous traffic jams, rude waiters and teenagers constantly playing R&B through their mobile phone speakers.
 

Link to Launching the ‘War on Mental Illness’ (thanks @1boringyoungman)

2014-01-10 Spike activity

Quick links from the past week in mind and brain news:

Not-So-Sweet Home: The Persistence of Domestic Violence. Important piece from Nautilus.

The Lancet discusses whether, once again, psychiatry is being used for political repression in Russia.

Are we too keen to turn crime into a mental health issues? asks Spiked Online.

Nature has an excellent piece on the new generation of influential ‘deep learning‘ AI algorithms.

What’s it like to hear voices that aren’t there? Interesting review of the common features of hallucinated voices from the BPS Research Digest.

The New York Times has an amazing piece by a man losing his memory who eloquently describes the experience.

Keyboard dyspraxia: do neuropsychological syndromes need updating in light of modern life? asks the Cortex Unfolded blog.

An antipsychotic drug may banish hallucinations and delusions by prompting neurons to churn out proteins that reshape the cells report Science News.

Neuroskeptic continues the excellent coverage on fMRI with The Reliability of fMRI Revisited.

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