Manic exhilaration

car_speed_tracers.jpgThere’s a wonderful piece in yesterday’s British Medical Journal by Raquel Duarte, a fourth year medical student at Edinburgh University, on the sheer exhilaration of being with a manic patient.

She describes the first time she interviewed a manic patient during her attachment to a psychiatric ward.

…my patient sat down in the family room of the inpatient ward, and I proceeded to obtain a full, detailed psychiatric history‚Äîor rather, I tried to. The truth is, she just talked‚Äîabout everything from art, to politics, to literature. Because of my complete inability to direct the interview, I let her carry on. “Been here almost three hours already… Damn, shouldn’t have giggled at the SHO. Never mind, I’ll just have to come back again tomorrow.” Resigned to the fact that I’d have to meet this patient many times before I could get all the relevant facts, I relaxed and was surprised to find myself enjoying all the irrelevant bits of the conversation.

We both laughed and chuckled like a couple of schoolgirls, me and this 65 year old woman, as I got caught up in her contagious joy and boundless energy. Amid deliberations on Monet and reflections on the situation in the Middle East, she told me about her experience of terrible confusion that somehow, like in a dream, makes perfect sense. I heard about her tragic losses and deep despair, about the havoc this disease can wreck on a family and about how her faith had sustained her throughout. “Mania… psychosis… depression.” She didn’t just give me a history of bipolar illness, she told me a story and took me on a journey to discover a person struggling with a disease but who, in spite of or perhaps because of it, was a whole and wonderful human being.

Unfortunately, the whole piece is not freely available available online, but for those who can access the BMJ, you can read it here.

2006-07-28 Spike activity

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


Research in PLoS Biology reports that functional connections in the brain transform experience into memory.

Some researchers still not disclosing their conflict of interest in key studies, reports AADT Blog.

BBC Radio 4 programme Leading Edge discusses body clock genes and mind reading machines.

Metapsychology has an in-depth review of Nancy Andreasan’s book on the neuroscience of genius (via 3Q).

New autism study shows differences in brain structure.

Seed Magazine reports that brain scanning research that suggests that we can process social outsiders as less than human.

Researchers identify what are possibly the first neurons in the development of the human cortex.

Nature Reviews Neuroscience has an in-depth article on molecular and genetic approaches to brain asymmetry and handedness.

The Psychiatric Times explores the link between conduct problems in adolescence and personality disorders in adulthood.

Nature vs nurture via neuroscience


For those of who you particularly enjoyed the Prospect article on the interaction between environment and genetics in promoting certain mental states and behaviours, Nature Reviews Neuroscience has an in-depth review article on how neuroscience is helping understand this complex process.

If you haven’t got time to get down and dirty with a full-on review article though, Brain Ethics has a fantastic summary that captures the main points.

Link to full text of Nature Reviews Neuroscience article.
Link to Brain Ethics article.

Reflected glory

new_hair_mirror.jpgThere have been some critical commentaries recently that suggest that the hype over mirror neurons has become unbearable and a backlash is about to begin.

Mirror neurons are cells in the brain that are active both when a person is performing an action, or when they see someone else perform an action, and have been hypothesised to be involved in perceiving and comprehending others’ actions.

Worryingly, this system has been proposed as the basis of everything from empathy to appreciation of art, with very little supporting evidence.

Both Mixing Memory and Neurotopia have sceptical commentaries on mirror neurons and doubt whether they have been consistently demonstrated in humans in anything other than correlational brain scanning experiments.

This is probably a little unfair, as evidence for ‘mirror neurons’ in humans has been found using subdural (brain surface) electrodes, transcranial magnetic stimulation, fMRI, magnetoencephalography, EEG and when studying patients with action production and recognition problems after brain injury.

That’s quite a lot of converging evidence for the existence of an equivalent human system.

What is a little misleading is that the original studies measured the responses of single neurons in monkeys, whereby the human studies have all been using techniques that measured activation from a group of neurons.

This, and the fact that the recognition and generation of actions also relies on other brain areas, has led some to use the more accurate term ‘mirror system’ in preference to ‘mirror neuron’.

What most of the recent articles seem to be criticising, however, is that the concept is being used as a convenient ‘just so’ story for explaining almost any sort of complex human behaviour, usually by people with a fairly poor grasp of the existing evidence.

It’s easy to see why the idea is attractive. A system that is both involved in producing our own movements and becomes active when we see others moving leads some to infer (perhaps falsely) that we encode others’ behaviour into our brains in quite a direct way.

Even worse, in some retellings of the story, behaviour can include almost anything you care to think of.

As noted by Frontal Cortex, this concept, although flawed, is easy to grasp and user-friendly, making almost anyone an instant ‘expert’ on how the brain supports human interaction.

The reality will probably turn out to have too many qualifications to allow the media obsession with mirror neurons to continue forever, but in the mean time, don’t get put off by the hype.

The findings are fascinating and the mirror system will surely play an important role in our future understanding of human neuropsychology, even if this won’t exactly match how the media portrays it the moment.

Link to Mixing Memory article.
Link to Neurotopia article.

The intelligent environment

school_student.jpgContinuing our IQ theme, the New York Times has a fascinating article on the contributions of genetics and environment to IQ and argues that the effect of the environment becomes much more crucial for those from low-income backgrounds.

[Psychologist Eric Turkheimer] has a reputation as a methodologist’s methodologist. In combing through the research, he noticed that the twins being studied had middle-class backgrounds. The explanation was simple – poor people don’t volunteer for research projects – but he wondered whether this omission mattered.

Together with several colleagues, Turkheimer searched for data on twins from a wider range of families. He found what he needed in a sample from the 1970’s of more than 50,000 American infants, many from poor families, who had taken I.Q. tests at age 7. In a widely-discussed 2003 article [pdf], he found that, as anticipated, virtually all the variation in I.Q. scores for twins in the sample with wealthy parents can be attributed to genetics. The big surprise is among the poorest families. Contrary to what you might expect, for those children, the I.Q.’s of identical twins vary just as much as the I.Q.’s of fraternal twins. The impact of growing up impoverished overwhelms these children’s genetic capacities. In other words, home life is the critical factor for youngsters at the bottom of the economic barrel. “If you have a chaotic environment, kids’ genetic potential doesn’t have a chance to be expressed,” Turkheimer explains. “Well-off families can provide the mental stimulation needed for genes to build the brain circuitry for intelligence.”

This interaction between economic background and mental functioning has now been replicated in a number of studies looking at everything from mental illness to criminal behaviour (e.g. see Christian’s previous post).

It seems that the simple summing of genetic and environmental effects is no longer a valid way of understanding how we develop, as the duration, quality and frequency of different life experiences seem to have unique influences on the expression of our inherited traits.

Link to New York Times article ‘After the Bell Curve.
pdf of Turkheimer’s paper.

Born to be bad?

criminal personality.jpgThe latest issue of Prospect magazine features a fresh in-depth analysis of whether there is such a thing as a criminal personality. The author David Rose of the Observer notes that contemporary politicans have tended to focus on the social causes of criminality – think of Blair’s ‘tough on the causes of crime’ speech. But he points to new research showing that genetic factors are also key, in particular he highlights research by Terrie Moffitt and colleagues at the Institute of Psychiatry, including a study showing that whether childhood maltreatment leads to later increased risk of criminality depends in part on the variant of the MAOA gene that a person has. The gene codes for the enzyme monoamine oxidase A, and is involved in the regulation of neurotransmitter levels. A person with a low activity variant of this gene who is maltreated is far more likely to develop antisocial behaviour.

Link to Prospect article (open access).
Link to the Dunedin Study.

Happiness is an impossible dream

adam_phillips_guardian_pic.jpgPsychoanalyst Adam Phillips is interviewed in The Guardian about the paradox of chasing happiness and the negative effects of emotional idealism.

Phillips argues that trying to eliminate all sources of stress in your life is a pointless exercise and we should become better at tolerating difficult situations if we are to be become fully content.

I tell Phillips that at my workstation books with the word happiness in the title arrive unbidden by the hour. They include: Daniel Gilbert’s Stumbling on Happiness, Richard Schoch’s The Secrets of Happiness, Darrin McMahon’s The Pursuit of Happiness, Richard Layard’s Happiness: Lessons from a New Science and Jonathan Haidt’s The Happiness Hypothesis. Do you read these books? “I’ve looked at them. They seem to me to be the problem rather than the solution.”

Phillips also gives his take on the current focus on CBT as the psychological therapy of choice and the use of psychoanalysis as a long-term therapy for people with socially turbulent modern lives.

Link to article ‘Happiness is always a delusion’.