Addicted to neurobiology and politics

ABC Radio National’s All in the Mind has just had a special edition on the increasingly contentious debate over whether addiction is a brain disease, and does a fine job of highlighting the politics behind the interpretation of the science.

This much is agreed upon: some people inherit a greater propensity for becoming addicted to certain drugs, and taken in enough quantities, some drugs can cause long-term alterations the brain’s reward system to make non-drug pleasures less rewarding, thereby increasing future chances of drug-taking.

The controversial issue, which All the Mind tackles, is over how much this should be described as a ‘brain disease’ or a ‘psychological problem’, and this is usually where the politics kicks in.

Whenever you hear this sort of rhetoric in mental health, it’s often a reflection of a deeper argument beneath the surface – an argument over how much someone is personally responsible, or more worryingly, ‘to blame’, for their state of distress or impairment. The same often goes for the ‘genes vs environment’, ‘nature vs nurture’ debate.

There is a condition which is a great example of how thinking only in terms of ‘mind or brain’, ‘genes or environment’ is flawed for anything which involves an external trigger.

Phenylketonuria (PKU) is a single-gene disorder that results in a missing enzyme which is needed to break down phenylalanine into the building blocks of certain neurotransmitters. Without the enzyme, phenylalanine accumulates in the body, leading to problems with brain development, cognitive impairments, seizures and psychosis.

However, if people with PKU avoid phenylalanine in their diet, they have no problems at all (this is why certain foods are marked with “contains a source of phenylalanine”).

So, is PKU a genetic disorder or an environmental one? A brain disease or a psychological problem? There is no single answer. It depends how you look at it.

In a sense it’s 100% genetic, because a single gene determines whether you have the missing enzyme or not. But in another sense, it’s 100% environmental, because it’s not a problem unless you encounter phenylalanine in the environment.

Similarly, you could say it’s a brain disease, because people with PKU inherit a problem with the neurotransmitter pathway, but in another sense, it’s a psychological problem, because poor diet decision-making and vigilance can determine the likelihood of becoming sick.

What is striking is that this division into ‘brain’ and ‘mind’ is completely artificial and counter-productive. You need to understand both to see how PKU affects someone’s life.

Buy you’ll also notice how political views could favour one view or another.

If you believe in the primacy of personal responsibility, push the psychological model, because this emphasises the affected person’s actions in staying well. At one extreme, it allows us to blame people who get sick through PKU for not being vigilant enough, or wanting other people to pick up the pieces when they fail to control their diets.

If you believe in the primacy of social responsibility, push the disease model, because this emphasises the effects of factors outside an individual’s control. At the other extreme, it allows us to absolve the person of individual responsibility for the effects of their illness.

Addiction is far more complex than PKU, not least because addiction to different substances, or indeed to behaviours such as gambling, can be quite different psychologically, neurologically and socially.

However, you can see how the models used to explain each disorder are selective or can go beyond the evidence in certain instances, so preference for an explanation can be politically biased.

My advice is to be suspicious of anyone who tries to tell you a complex disorder is purely mind or purely brain, and think about what is motivating someone to explain it largely in one way.

Similarly, think of the psychological and neurobiological evidence as complementary, rather than in competition, and be prepared to accept more than one model of how something works. Each might be accurate, but just useful for different things.

This edition of AITM is an example of all of these forces at work.

Link to AITM ‘Addiction: Dis-ease over diseased brains’.

Tuna can brain tattoo, awkward acronym reminder

An unknown gent has had a brain tattooed on the top of his head, revealed by a picture of a peeled back tuna can. Actually, a few visual neuroscience things have popped up this week, so I’ve collected them here.

Omni Brain found a cartoon of what brain surgeons might be thinking during neurosurgery. If Dr Katrina Firlik’s book is anything to go by, it probably isn’t far off.

The BPS Research Digest found an eerily silent animation of deep brain stimulation.

And the ever-excellent xkcd online science comic had a great panel about the cognitive neuroscience of planning the ultimate tree house.

Also, this is your last chance to get your submission in for our awkward acronyms in cognitive science (AAICS) competition. The winner will be announced Monday and will get my spare copy of David Lodge’s Thinks.

Surprisingly absent-minded

A completely charming excerpt from the ‘People’ section of UK news magazine The Week, discussing Ben Pridmore, current British and past world memory champion:

Ben Pridomore can be surprisingly absent-minded says Adam Lusher in The Sunday Telegraph. The bespectacled accountant from Derby is Britain’s “memory champion” and a world-class mental athlete. He set a new record when he remembered 17 shuffled packs of cards in an hour.

“It was last year at the World Championships”, he recalls. “In London, somewhere in London. Erm, where was it? No it’s gone completely.”

Pridmore does remember that: “I hold all four card-remembering world records, and both binary number records. I think they are the only world records I hold at the moment, although I have quite possibly forgotten a few.

Brazilian TV gave me this wonderful cloak. They flew me to Rio just to memorise a pack of cards. Now, where did I put it…?”

His memory is, he admits, highly selective. “Yes, I have a toned hippocampus, for anything pointless like cards or long numbers. But with useful things, like names, I forget everything. Go into a room and wonder why I’m there? Happens to me all the time.”

Link to Pridmore supporting Alzheimer’s Society’s Million Memories campaign.

2007-08-17 Spike activity

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

First online mental illness support group in Hong Kong launches!

Cognitive Daily uncovers a lovely study that finds that conversational partners coordinate eye movements and nose-scratching.

Dr Petra analyses the recent research showing a link between breast implants and suicide.

The Guardian releases mp3s of the originals tapes of Susan Blackmore’s ‘conversation on consciousness’ with Daniel Dennett, Francis Crick and V.S. Ramachandran.

The New York Times beams light to alter brain function.

Flashing the cash or saving the world can both be ways of attracting a mate, reports The Economist.

More from The Economist: a short article on how the brain develops important networks during childhood and adolescence.

The Frontal Cortex picks out some interesting aspects of the Flynn Effect – the fact that IQ seems to rise from generation to generation.

Nick Bostrom’s at it again with his simulation argument: The New York Times asks whether we’re living in a computer simulation. AI to be renamed AAI.

Not cyber enough for you? The Times looks body and brain mods and labels us the ‘Blade Runner generation‘.

PsyBlog examines research on the hidden purpose of chat-up lines.

Zen and the Art of Coping With Alzheimer’s: The New York Times looks at ways of dealing with challenging behaviour in dementia.

The awkwardly named but excellent Ouroboros has been, well, excellent, recently.

10 out of 10 for the patronising headline: New Scientist reports that ‘puppy love makes teenagers lose the plot’.

The Wall Street Journal argues that too many studies use college students as participants.

Low voltage current delivered to the head can cut down alcohol craving, reports Neuromod Blog.

Time Magazine on decriminalising mental illness

Time magazine has an article on attempts to train law enforcement to prevent people with mental illness from needlessly ending up in behind bars. It includes some startling information, like the fact that more Americans receive mental health care in prisons than in hospitals.

“If you think health care in America is bad, you should look at mental health care,” says Steve Leifman, who works as a special advisor on criminal justice and mental health for the Florida Supreme Court. More Americans receive mental health treatment in prisons and jails than hospitals or treatment centers.

In fact, the country’s largest psychiatric facility isn’t even a hospital, it’s a prison ‚Äî New York City’s Rikers Island, which holds an estimated 3,000 mentally ill inmates at any given time. Fifty years ago, the U.S. had nearly 600,000 state hospital beds for people suffering from mental illness. Today, because of federal and state funding cuts, that number has dwindled to 40,000. When the government began closing state-run hospitals in the 1980s, people suffering from mental illness had nowhere to go. Without proper treatment and care, many ended up in the last place anyone wants to be.

The article starts with a telling correction of a journalistic slip, apologising for stating that one reform was inspired when a man with schizophrenia shot a policeman, when in fact, it was the policeman who shot the patient.

A 1999 US survey found that over 60% of people thought that someone with schizophrenia is ‘somewhat’ or ‘very likely’ to commit an act of interpersonal violence, when we know that people diagnosed with the condition are much more likely to be the victim of violence than the perpetrator.

It seems there are some positive developments, however, and the article describes the Miami Police’s innovative and successful methods of including people with experience of mental disorder in their training, and when dealing with distressed people they encounter.

Link to Time article ‘De-Criminalizing Mental Illness’ (via Spikol).

Discover 10 unsolved mysteries of the brain

Discover magazine has an article on ’10 unsolved mysteries of the brain’ which describes some of the biggest challenges in contemporary neuroscience.

It’s an interesting list, not least because you’ll notice that several of the problems are conceptual rather than empirical.

For example, the list includes ‘What are emotions?’, ‘What is intelligence?’ and ‘What is consciousness?’ that depend on a good philosophical analysis rather than just more data gathering.

In contrast, some of the other mysteries include things such as ‘How is information coded in neural activity?’ which is a problem of dealing with the complexity of the signals and their effect, rather than us having problems with defining any of the problem.

The fact that brain research relies as much on conceptual developments as laboratory work is one reason why philosophers are so important to cognitive science.

I like to think of them as conceptual engineers.

Link to Discover article ’10 Unsolved Mysteries Of The Brain’.

US psychologists to rebuke CIA, ban to be debated

Salon is reporting that the American Psychological Association is likely to issue a formal condemnation of many CIA interrogation tactics at its annual convention this weekend, although there may be loopholes meaning it falls short of an outright ban.

It has become clear that psychologists are playing a central role in developing and deploying CIA interrogations that a leaked report from International Committee of the Red Cross described as “tantamount to torture”.

Psychologists are important to the CIA partly because the American medical and psychiatric associations have banned their members from participation in such interrogations, citing the practices as abusive.

Views on a possible APA statement are mixed, however, with some concerned that a simple rebuke does not condemn the entire process of indefinite detention without due process and others worried that a ban will be counter-productive, as psychologists may be best placed to prevent abuse and develop humane procedures.

The APA conference has no less than eight sessions on the topic which will include military psychologists, human rights activists, psychologists who study conflict and multicultural issues, and a US Department of Defense interrogator.

However, this is only likely to be the tip-of-the-iceberg and the crucial decision will be on what gets put into the final resolution for members to vote on, with one group, led by Neil Altman, pushing for a complete moratorium on participation.

What remains unclear is whether the APA leadership, headed by APA president Sharon Stephens Brehm, will even allow a vote on Altman’s moratorium. That leadership is seen by some psychologists as too chummy with government interests and with the military in particular. Backers of the moratorium are set to meet with APA leadership before next weekend just to negotiate for the opportunity to bring their resolution up for a vote before the council.

Psychologists interviewed by Salon noted a series of potential loopholes embedded in the resolution condemning CIA tactics. A simple example is the ban on isolation and sleep deprivation, favorite tactics of the CIA. But the resolution from Brehm and the APA leadership only forbids the methods when “used in a manner that adversely affects an individual’s physical or mental health.” There will be efforts in San Francisco to plug those loopholes, and to force a vote on a moratorium.

Link to Salon article ‘Psychologists to CIA: We condemn torture’.
Link to APA Monitor on 2007 Convention Highlights.

Locked in with the bitter taste of lemon

This week’s New Scientist has a number of interesting mind and brain articles. The most striking is on locked-in syndrome, where people are completely paralysed despite having intact minds.

The article is by author Laura Spinney who wrote a novel based on locked-in syndrome called The Quick (ISBN 0007240503).

One of the challenges is to find a route for affected patients to communicate with the ‘outside world’. Sometimes eye movements are spared, which famously allowed Jean-Dominique Bauby to write the profoundly beautiful book The Diving Bell and the Butterfly (ISBN 0007139845).

She notes one case where all other routes had failed, so a rather unorthodox approach was tried with initial success, only to slip frustratingly away.

Despite the technology, communication is still a considerable challenge for these people. To operate the TTD [Thought Translation Device – converts movements into words] requires months of arduous training, and the failure rate is high. Last year, in the journal Neurology, Birbaumer and colleagues described a particularly tragic case of failure (vol 67, p 534). A 46-year-old German woman who had been diagnosed with the degenerative disease amyotrophic lateral sclerosis [ALS], also known as motor neuron disease, had made it clear that she desperately wanted to live. By the time she came to Birbaumer’s attention, she had already been locked in for a year. After trying in vain to train her to use the TTD, they decided her chances might improve if they implanted the electrodes in her brain rather than sticking them to her scalp. For this, they needed her consent, which she clearly couldn’t give. Impasse.

Then, walking past an electronics store one day, Birbaumer’s colleague Barbara Wilhelm spotted a medical device for measuring the pH of saliva, and had an idea. They trained the woman to change the acidity of her spit by imagining either the taste of lemon, or the taste of milk. She learned to push the pH one way to say “yes”, the other to say “no”. When they asked her if she agreed to them implanting the electrodes, she replied yes, repeatedly; three hours later, however, she lost control of her salivary pH. The electrodes were implanted, but she hasn’t achieved any control over her brain activity. Birbaumer is still trying to tap into other potential channels of communication, but he fears that after a certain time locked-in patients may lose the capacity to control anything voluntarily.

The issue also has a cover story on whether conscious beings could spontaneously arise from the universe, and another on the effect of breakfast on mental performance.

As New Scientist is still a little bit backward none of the articles have been made freely available (ever wondered why Scientific American gets more coverage on the net?), so you’ll need to find a copy at your local newsagent or library to have a look.

Link to table of contents.

An intimate look at couples in conflict

The New York Times has an in-depth article that tracks the course of group psychotherapy for couples with relationship problems, giving a revealing insight into what happens when couples volunteer for a group aimed at helping them understand and resolve conflict.

Group psychotherapy can take various approaches to how problems are understood but it typically relies on the idea that everyone can observe similar problems in others, each of whom can provide immediate peer feedback.

Some studies have found that couples group therapy has advantages over individual couple therapy. For example, a 2004 study found that couples in group therapy to prevent a re-occurrence of even quite serious domestic violence were more likely to be violence-free than those in individual couples therapy.

Nevertheless, it’s probably true to say that group couples therapy is quite under-researched at the present time so it’s difficult to get a completely clear picture.

There are varying approaches (not all will be like the group portrayed in the NYT article), all of which seem to be about equally effective.

One area that has significantly advanced, largely due to the work on John Gottman and his colleagues, is in understanding how patterns of communication between couples affect their relationship, and ultimately, chances of staying together.

What studies ‚Äî pioneered by John Gottman, a psychologist and emeritus professor at the University of Washington ‚Äî have rather convincingly shown are the marital patterns likely to result in divorce. In his famous “love lab,” the Family Research Laboratory, Gottman observed more than 3,000 couples during three decades of research, analyzing their discourse, including arguments, and recording their physiological responses. What he concluded is that it wasn’t whether people fought ‚Äî 69 percent of his subjects never resolved their conflicts ‚Äî but how they fought. The relatively happy couples did not escalate disagreements; they broke tension with jokes and distraction and made “repairs” after arguments. When wives raised issues gently, for example, neither partner’s heart rate exceeded 95 beats per minute and the ratio of positive to negative comments during a fight was an amazing five to one.

Link to NYT article ‘Can This Marriage Be Saved?’.
Link to Edge article and video interview with John Gottman.

Neuromatrix: neuroscience video game for kids

Neuromatrix is a soon to be released action-adventure video game for kids that aims to effortlessly teach them about the function of the brain.

It’s aimed at 10-15 year olds and, from the impressive video trailer, it seems to have a bit of a Half-Life vibe about it – a sort of 3D science-based adventure – probably without all the killing though.

Apparently, the brains of scientists from a neuroscience research centre have been attacked by nanobots, and your job is to save them from certain destruction.

The video game takes you through some of the major brain areas and as you tackle each part, you learn about the scientific method, neurons, the motor cortex, the hippocampus and amygdala.

There’s even extensive teacher’s notes online, so adults can try and keep with the kids.

As for me, I’m still waiting for the sequel to Granny’s Garden.

Link to Neuromatrix website (via Brain Waves).
Link to video trailer.

Encephalon 29 rolls into town

The 29th edition of psychology and neuroscience writing carnival has just been published on the ever erudite Memoirs of a Postgrad.

A couple of my favourites include a post on an American football team using the discredited ‘Mozart effect‘ to boost performance, and a review of a paper showing that caffeine perks you up more effectively as you get older.

This edition includes a wide range of articles, so check it out if you’re interested what’s been occupying the minds of cognitive science writers during the last fortnight.

Link to Encephalon 29.

Brain scanning the dead

A study published in Forensic Science International has examined how brain scans can be of use to forensic pathologists – clinicians who perform autopsies to better understand how someone has died, often to provide evidence for a criminal investigation.

Head injuries are unfortunately common. Serious head injuries are most commonly caused by traffic accidents in Europe and Canada, while in the USA they are most commonly caused by firearms.

These cases will typically involve a police investigation, and the usual method is for a forensic pathologist to perform an autopsy on the head and brain to establish exactly what sort of injury occurred.

One of the drawbacks of this method is that it can only be performed once. The tissue is dissected and it’s not possible to keep anything except small samples.

This can be a problem in court, because it means the pathology evidence largely rests on a single examination, done in whatever way the pathologist thought was best, and can rely on their subjective interpretation.

A brain scan might be useful in this situation as it could be independently assessed and might actually pick up some things which might otherwise be missed if the head has to be dissected to be examined.

The study, led by Dr Kathrin Yen, compared findings from a structural MRI scan, a CT scan (an older structural brain scanning technique that uses X-rays) and a post-mortem, on 57 people, the majority of whom had died from serious head injury.

The findings from the scans and the autopsies were compared to see how well they agreed with each other.

The examination of the brain scans entirely missed some signs, such as increased brain pressure, but was 100% accurate in others, such as detecting bleeds between the dura mater, the brain’s tough outer membrane, and the skull.

The researchers note that some of the poor results are likely to be because radiologists aren’t used to forensic examinations as they’re trained to examine living people.

However, the brain scans had a distinct advantage in some cases. In one instance, the brain scan better estimated the size of an internal bleed which was exaggerated during autopsy because it bled further as the brain was cut.

The brain scans also allowed 3D reconstructions which could be examined from various angles to better understand how impacts occurred or what sequence of events might have caused the damage.

The image on the left is of a heat-induced fracture in a man who died in an aeroplane crash. The scan allows the pathologist to see the relationship between the skull fractures and the bleeds in the brain from a number of angles.

The study suggests that brain scanning corpses may give important clues in a forensic investigation but that radiologists may need to be specially trained so they know what they’re looking for.

Link to abstract of scientific study.
Link to more on forensic radiology from Radiology Today.

Battles over the beginnings of language

The New York Times has a review of a new book on the evolution of language that is also a concise guide to the origin and controversies within the field.

The book is The First Word (ISBN 0670034908) by Christine Kenneally and, as the the NYT review makes clear, it tackles one of the most contentious topics in psychology.

In this field, physical evidence is scarce ‚Äî language, except in its written form, leaves no trace ‚Äî and scholarly clout depends on a capacity for ingenious inference and supposition. Christine Kenneally, a linguistics Ph.D. turned journalist, shrewdly begins “The First Word,” her account of this new science, with candid portraits of several of its most influential figures. Appropriately, the first chapter is devoted to Noam Chomsky, whose ideas have dominated linguistics since the late 1950s, and who, as Kenneally reports, has been hailed as a genius on a par with Einstein and disparaged as the leader of a “cult” with “evil side effects.”

Evolutionary psychology tends to generate mixed views among scientists as it has the (somewhat unjustified) reputation of being untestable.

It typically involves discovering a psychological attribute or innate tendency and generating theories as to why we might have it, based on an evolutionary theory of why the presence of this feature might have improved survival or increased chances of sexual reproduction.

Of course, we can’t go back in time to test the theory on early humans, but the theory might suggest the presence or link with other current attributes – something that can be tested experimentally.

However, it’s probably true to say that hypothesis tend to be a little more unconstrained by the evidence than in other fields in psychology.

We now have a slightly odd state of affairs where most psychologists think that evolutionary psychology is a bit suspect, but are quite happy to throw in a few ad-hoc sentences about the possible evolutionary function of whatever they’ve discovered in their latest research paper.

Which, of course, makes the whole thing seem a bit suspect.

The NYT review charts how the debate on the evolution of language has moved from something which was originally considered either pointless or wacky, to a field which is now relatively mainstream.

Link to NYT review of ‘The First Word’.

Superstition and madness

From the entry for ‘madness’ taken from the Cassel Dictionary of Superstitions (ISBN 0304365610):

“It is said that the mad are chosen by God and enjoy the special favour of Heaven. Accordingly, it is thought that particularly lucky throughout Europe to live in the same house as someone who is mad and historically the mad have been well cared for by their local community. Meeting such a person in the street is itself a lucky event in the folklore of fishermen, who interpret such an encounter as confirmation that the day’s catch will be a good one.”

Brain’s walking patterns specific for leg and direction

An ingenious experiment using an adapted treadmill has shown that our brain seems to store patterns for the smooth movement of our legs independently for each leg, and for each direction of walking.

The study, devised by neuroscientists Julia Choi and Dr Amy Bastian, used a split-belt treadmill – a normal treadmill for walking but where each side can be programmed with its own speed and direction.

They asked 40 volunteers to walk on the treadmill while they varied the speed and direction of each belt. They then recorded the limb movements with sensors attached to key body positions.

They found that even for unnatural walking patterns, where the two belts were going in different directions at different speeds, participants quickly adapted so that they maintained smooth graceful walking patterns.

The researchers varied these patterns so that they could separate out the adaptation needed for each limb in different directions.

After the person had adapted to the new pattern, the researchers then asked participants to walk normally.

The participants walked with a limp, showing that the brain had adjusted existing walking patterns within a matter of minutes to allow for the new style of walking, and that this new pattern was stored and still in place, even to the point of slightly disrupting normal walking.

The best demonstration of this is a short video of the results produced by the research team.

Because this could be shown to occur separately for each leg and direction, it suggests that we don’t have a single ‘rhythm generator’ (known as a central pattern generator or CPG) for walking.

This could have important implications for treating people who have walking problems caused by brain damage that affects movement in one particular limb.

Link to study abstract.
Link to video of results.
Link to write-up from Wired.

Muses, Madmen and Prophets

I’m just reading a fantastic book called Muses, Madmen and Prophets: Rethinking the History, Science, and Meaning of Auditory Hallucination (ISBN 9781594201103) – a wonderfully written book on the complex science and history of ‘hearing voices’.

Annoyingly, the book is published under the name ‘Hearing Voices’ (ISBN 041377645X) in the UK. Annoying, because its the same title as many other books, many of which are on completely different topics.

The book looks at the history of the experience, from some of the most influential ‘voice hearers’ in history, such as Socrates and Joan of Arc, to its classification by psychiatry as a key diagnostic sign of schizophrenia, to its reconsideration as part of the normal diversity of mental phenomena.

We now know that there are many more people who hear voices and never become mentally ill compared to those who become acutely impaired or distressed by the experience.

The book looks at the recent research on the neuropsychology of hallucinated voices but also takes wonderful detours into the significance of the experience for understanding notions of free will and intentionality, creativity and inspiration, and madness and the divine.

The author, ex-editor of Atlantic Monthly, brings an interesting personal angle into the work, as both his father and grandfather heard voices to differing degrees.

So far, I’ve found it poetic, wide-ranging and difficult to put down.

If you’re interested in hearing more, Smith discusses his book and investigations on Boston WBUR Radio which you can listen online.

I also just discovered that Neurophilosophy has a great post on a recent case study of a person with brain injury that affected their speech areas who heard hallucinated voices that had a speech impediment.

Link to book info.
Link to discussion on Boston WBUR radio.
Link to Neurophilosophy on ‘Hearing speech impaired voices’.