The joy of sexology

The Charlie Rose Show had a recent discussion on the science of sex, and the video of the programme is available to view online. It’s a fascinating discussion, largely focusing on biology and neuroscience, but as Dr Petra Boyton notes it’s quite a narrow consideration in some respects.

For me, simply seeing a discussion of sex research in the still remarkably prudish American media is a huge step.

I suspect their achingly academic approach to the subject reflects the need to be seen to be serious, but it’s also interesting that the Charlie Rose show is sponsored by Pfizer, the makers of Viagra, which may also account for the almost unrelenting focus on biology.

Petra Boynton suggests areas which weren’t tackled by the programme, and highlights that there’s much more to sex research than measuring the mechanisms of our bodies.

It’s well worth watching, but definitely with some of the context in mind.

One of the best programmes on sexuality I have seen on TV was The Truth About Female Desire, which was a collaboration with the Kinsey Institute and involved several women taking part in a number of scientific experiments on female sexuality.

Unfortunately, it doesn’t seem to be available on public servers, but I’ll post on Mind Hacks if ever I find a reliable torrent.

Link to Charlie Rose discussion on Human Sexuality.
Link to Petra Boynton on the programme.

Brave old world: the future of cognitive enhancement

The British Medical Association has just released a report on the ethics of using medical technology to increase cognitive function and optimise the brain. Although the report looks to possible futures, many of them are already upon us.

The report is an interesting sign that cognitive enhancement, using largely physical interventions such as drugs and implants, is now a topic important enough to trouble the UK’s professional medical association.

Many of the ethical concerns centre around a potential future where brain enhancing interventions are largely available to the wealthy, leading to a ‘brain gap’ where the less well off will have relatively poorer mental functioning because they can’t access the same cognitive benefits.

However, this is exactly the situation we already have.

Probably the single best cognitive enhancer available to the human race at the moment is a balanced diet and healthy lifestyle.

Poor health goes hand in hand with poverty, meaning those who have less money are likely to have brains that don’t function at their optimum because of increased stress, poor nutrition and increased susceptibility to damage and disease.

Martha Farah’s research group has been specifically researching the links between the neuropsychological development of children and poverty, and have found that children from poorer social groups have markedly poorer mental and neurological functioning.

It is possible that a drug or implant will be discovered in the future that will extend our abilities by an order of magnitude, but more likely the improvement will be much more modest. For example, an improvement of 10% would be considered to be clinically important.

So while it’s essential to consider the ethical implications of how specific cognitive technologies will affect us, the inequality-driven ‘brain gap’ is already here.

One ethical issue less commonly debated is whether we are justified in spending billions developing high-tech cognitive enhancers for a relatively small section of the population rather than support the widespread improvement in nutrition and lifestyle which we know has a strong, reliable and life-long effect.

Link to BMA report ‘Boosting your brainpower: Ethical aspects of cognitive enhancements’.

2007-11-23 Spike activity

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

Glamour model Daisy Thompson-Lake has a forthcoming paper on synaesthesia in the British Journal of Psychology.

Cognitive Daily looks at whether selfishness or competition is the strongest influence on behaviour.

How does physical stress and illness affect mental states and psychopathology? ABC All in the Mind investigates.

PsyBlog examines recent research on achieving sustainable happiness.

Hollywood actor Forest Whittaker hails the pioneering brain surgeon that saved his mother’s life.

ABC Radio National’s Ockham’s Razor looks at the infamous case of Sir Roy Meadow and the debates over the existence of ‘Munchhausen’s syndrome by proxy’.

The New York Times has an article on South Korean boot camps to cure children of non-existent internet addiction.

Denial and public belief. ABC News covers research showing that highlighting false reports may actually make them more widely believed.

The BPS Research Digest looks at research on why sexism towards females in the workplace has a negative effect on males too.

Interesting post on Action Potential shock! The under-performing Nature blog has two great articles on the genetic control of intelligence and innate social evaluation in children.

The last of the neuromercials?

One of the most interesting things about the recent election brain scan nonsense is not that it got to the front page of The New York Times, as that’s happened several times before, but that the slap down from the scientific community has been remarkably strong and public.

The media is obsessed by neuroscience but in a very odd way. This means that sometimes complete nonsense gets published, like on this occasion, or the focus is on the least important thing.

For example, there have been many reports during the last few days about a study on people with migraines.

Almost all the headlines are variants of the ‘Migraine Sufferers Have Different Brains’ line. This just isn’t news. We know migraine sufferers have different brains because they have migraines and its a brain difference. It’s like reporting that ‘taller people have different heights’.

What the study actually found was that the somatosensory cortex, an area of the brain that is involved with representing body sensation, is thicker in people with migraines. Most interestingly, this was most pronounced in the section of this brain area that maps to the head and neck.

It was a correlational study, so it’s impossible to say whether these differences cause, or are caused by, migraine, but it’s a fascinating finding. Isn’t this so this much more interesting than repeating the obvious?

The media love stories about the brain because they often sound like explanations even when they’re nothing more than descriptions.

This is why nonsense like the ‘election brain scans’ gets media attention. In this case, it wasn’t even as if the ideas were distorted in the retelling, it was clearly nonsense from beginning to end. But because it had all the trappings of science, it made headlines.

This time, however, the size of the backlash from the scientific has been unprecedented.

It got plenty of negative attention in the blogs, but it also inspired a list of leading neuroscientists to write to the NYT to criticise it, it got featured in The Guardian’s ‘Bad Science’ column and has just been roundly condemned in the editorial from this week’s Nature.

If brain scans could really predict how people will react when they encounter advertising, you’d think that FKF Research would use it on their own material.

Ironically, for a company that supposedly specialises in neuromarketing, they just got themselves some incredibly bad press.

Link to Nature editorial.

Sad, mad or dangerous to diagnose?

The New York Review of Books has a wonderful article that ostensibly reviews three books about mental illness but is also a powerful summary of some of the most important criticisms of modern psychiatry.

One of the key points of debate is the extent to which distressing yet common mental states such as shyness or feeling low are being classified as mental illnesses such as social phobia or depression.

This is currently a hot topic. The British Medical Journal hosted a recent debate on whether depression is overdiagnosed with Ian Hickie arguing that it needs to be recognised more widely to stop people missing out on lifesaving treatment and Gordon Parker arguing that normal sadness is being excessively labelled as a medical disorder.

Drug companies have an obvious interest in getting more people diagnosed, but less obviously, although equally as pervasive, is their interest in pushing for new diagnoses.

On the level of the individual patient, medicalising a problem often shifts people’s thinking so they feel less empowered to make a difference to their lives – it becomes an illness to be dealt with by medical experts.

In the US, however, where insurance payments are often only guaranteed when a medical diagnosis is made, people might only be able to get relief from their mental distress if their problem is medicalised.

Unlike in socialised health systems, insurance-based healthcare can pressure professionals not to help people with non-specific or difficult to diagnose problems, meaning the existing categories are often stretched to allow such people to be treated.

Treatment has traditionally been medication, which means drug companies have a strong financial incentive to push for the changes to the classification of mental illness and promote theories which best support their treatments.

In contrast, cognitive behavioural therapy, a type of psychological therapy, is known to be as effective as drugs (the most effective treatment is both medication and therapy), and is better at preventing relapse.

However, because it isn’t a ‘product’, there is no corporate marketing machine behind it, meaning it is typically under-recognised and under-used.

The ‘promotion’ of psychological therapies is left to mental health charities (such as the recent We Need to Talk campaign) which pales in comparison to the billions spent by drug companies.

So, the extent to which mental and emotional distress should be treated as a medical disorder effects everything from the personal to the political.

The New York Review of Books article does a fantastic job of covering how these processes work, both at the medical and corporate level, and how they impact on our individual health care.

Link to article ‘Talking Back to Prozac’ (via MeFi).

Personality to prevent teen drinking

A study that successfully used personality-tailored training to reduce teen drinking is shortly to appear in the Journal of Child Psychology and Psychiatry. It’s interesting because it’s one of a few studies that have found that the psychology of personality is useful for solving clinical problems.

Your average person on the street probably thinks that clinical psychologists spend a lot of time trying to ‘work out’ people’s personalities as a necessary part of treating them.

Of course, this is something that happens as the psychologist meets and talks to the patient, but considering that a great deal of research in psychology is focused on understanding personality, the findings and techniques barely make a scratch on clinical work.

This is largely because using psychological measures to find out whether someone is introverted, extroverted, conscientious, or any other of the so-called ‘big five‘ personality traits, have been found to be of little use in helping treat or prevent mental disorders or behavioural problems.

Compared to reliably assessing someone’s mood, anxiety, risk of self-harm, cognitive abilities or reasoning style, personality is rarely essential for clinical decision-making.

However, one related aspect of personality, similar to the ‘Openness to Experience’ in the ‘big five’ model, has been found to relate to substance misuse.

It’s called ‘sensation seeking’ and it’s been linked to risky behaviour, including binge-drinking and risky sexual encounters.

In this study, led by psychologist Dr Patricia Conrod, the research team assessed the personality of over 350 teenagers and specifically tailored a programme to focus on common differences between high and low sensation-seekers.

The programme had an educational component, a motivational part and a section that taught the kids skills how to solve problems, manage their thoughts and moods, and pick out common cognitive errors when reasoning about drinking.

It turned out that it was particularly effective in reducing binge-drinking in the high-sensation seekers, the most risky group.

As well as developing a useful way of reducing problem alcohol use in teenagers, it’s also interesting to see that a personality measure can be genuinely useful in the prevention of problems.

Clinical psychology is traditionally focused on trying to help with problems after they’ve happened, rather than before, which is perhaps why personality is not so useful. It’s just too subtle when something serious like mental illness affects the mind and brain.

Nevertheless, it’s possible that personality will be key in preventive programmes, where this more subtle approach has much more of an effect when the person is not trying to manage a mental crisis.

Link to abstract of study.

It’s not denial, it’s filtered acceptance

The New York Times has a brief but interesting article on the psychology of denial, which according to the piece has got a bad rap. It’s actually a useful and necessary process in many types of relationship.

Yet recent studies from fields as diverse as psychology and anthropology suggest that the ability to look the other way, while potentially destructive, is also critically important to forming and nourishing close relationships. The psychological tricks that people use to ignore a festering problem in their own households are the same ones that they need to live with everyday human dishonesty and betrayal, their own and others’. And it is these highly evolved abilities, research suggests, that provide the foundation for that most disarming of all human invitations, forgiveness.

In this emerging view, social scientists see denial on a broader spectrum — from benign inattention to passive acknowledgment to full-blown, willful blindness — on the part of couples, social groups and organizations, as well as individuals. Seeing denial in this way, some scientists argue, helps clarify when it is wise to manage a difficult person or personal situation, and when it threatens to become a kind of infectious silent trance that can make hypocrites of otherwise forthright people.

The article also discusses a number of experiments where participants ‘cheat’ on certain aspects, but which demonstrate that we seem to manage not only how much we admit to others about the deception, but we also our own awareness of what we’re doing (mostly unconsciously it seems).

Link to NYT article ‘Denial Makes the World Go Round’.

BBC AIl in the Mind on Tasers, film and Anthony Clare

BBC Radio 4 has just kicked off a new series of All in the Mind with a programme on tasers and their use on people with mental illness, the psychoanalytic film festival and a tribute to the late great Irish psychiatrist Anthony Clare.

Not to be confused with the Australian radio show of the same name, All in the Mind takes a look at whether police are properly trained to detect mental illness in light of preliminary evidence that they may be using Tasers on people with psychiatric disorders more than other people.

The show also talks to some of the participants in the recent European Psychoanalytic Film Festival and traces the intertwined history of film and psychoanalysis.

Finally, the show broadcasts a tribute to Irish psychiatrist Anthony Clare, who, as we reported recently, passed away at the end of October. Among many other things, he was famous as a past presenter of the programme.

Link to first of the BBC All in the Mind new series.

Psychopharmacologist’s song

Well, it doesn’t get much stranger than this. OmniBrain has discovered an animation created by Prof Stephen Stahl, researcher and author of numerous academic papers and books on the neuroscience of psychoactive drugs, where he sings about his love of psychopharmacology.

If that’s not weird enough for you, it’s to the tune of a Gilbert and Sullivan operetta song and he’s dressed as a 19th century Naval officer.

I would describe more of it, but you really need to see it to fully appreciate it in all its glory.

I’m sure no-one needs to remind a professor of psychopharmacology of the maxim “don’t get high on your own supply”, so I repeat it here purely for our collective reflection.

Link to embedded video of the Psychopharmacologist’s Song.

The ethical psychiatrist

ABC Radio National’s The Philosopher’s Zone had a fascinating discussion recently on the ethics of psychiatry, tackling some of the challenges of this unique medical speciality.

Perhaps the most obvious aspect of psychiatry which distinguishes it from other medical specialities is that it more commonly involves treating people against their will.

The laws on involuntary treatment vary, but most include the principle that someone who is judged to have their lost their insight into their own condition because of mental illness, is at risk to themselves or others, and who refuses voluntary treatment can be treated against their will.

Of course, this relies on a huge amount of other assumptions, such as the ability to distinguish between normal and abnormal mental states, and an idea of what constitutes insight.

It also relies on a presumption that psychiatrists can distinguish between potentially foolish but reasoned refusal of treatment, and a refusal driven by pathological thinking.

The programme tackles many of these issues and discusses how these decisions are affected by cultural norms and political influence, as well as how they fit in with the wider ethical approach of medicine.

Link to the Philosopher’s Zone on the ethics of psychiatry.

Cerebral blood sweets

It looks like a pipette full of cerebral blood, but actually it’s a fun and harmless candy product for children. Bless!

But if you’re concerned that this might be a bit too disturbing for your sweet-toothed young ones, another product by the same company will do nothing to dispell your worries.

Because they also makes a plastic brain from which you can squeeze the liquified neural mush straight into your mouth.

After which, the gummy brains and chocolate brains just seem a bit passé really.

Link to disturbing brain candy.

Reflections on the brain of an idiot

I’ve just discovered that the Journal of Anatomy and Physiology have all their past issues freely available online all the way back to 1867. I came across a curious article entitled ‘Description of the Brain of an Idiot’ in the 1871 issue and it made me think about how names for brain disorders have been rejected and changed throughout history.

Back in 1871, the term ‘idiot’ was a proper medical term. It referred to someone we would now describe as having learning disabilities or intellectual impairment.

As the word became used as an everyday form of abuse, it left the realms of medicine because it was deemed inappropriate, and has been replaced by seemingly more appropriate terms. There is a long history of this process and it continues to this day.

For example, wildly abnormal or problematic sexual behaviours used to be called sexual deviancy. ‘Sexual deviancy’ described something beyond the presumed normal range, but it was thought to be inappropriate because it branded people as outsiders.

Now we use the term ‘paraphillia’ which means, well, exactly the same – someone who has desires outside the norm – but because it’s Greek, everyone is much happier.

It’s also interesting when the terminology differs between countries. In America, ‘mentally retarded’ is a common description in medicine, but in Europe it’s considered an outdated insult – similar to the previously official words imbecile and idiot.

However, it’s always struck me as a little curious why our words for intellectual disabilities have changed so much throughout history, but the word for epilepsy (despite there being many commonly used nicknames) has been maintained since the time of Ancient Greece.

Presumably, there’s something about the Greek language which just makes us feel better about our difficulties.

Link to 1871 article ‘Description of the Brain of an Idiot’.

A pain in the neck, mind, brain and society

Technology Review has an article that looks at recent work on the neuroscience of chronic pain. While understanding the problem in terms of neurobiology is essential, understanding the psychology and social influences on pain is equally important.

Chronic pain is an interesting condition because it can continue even when the original tissue damage has healed.

The article talks about chronic pain purely in terms of its neurobiology, but there is now a great deal of evidence that we can explain how pain is maintained through social and psychological explanations.

This is remarkably hard for some people to take on board, as there is still the attitude that explaining something in psychological terms somehow implies the pain isn’t “real” or is somehow a figment of their imagination.

As he recounted in a recent article for the British Medical Journal, Ben Goldacre came across exactly this when he recently discussed the psychosocial aspects of pain on the radio and got a number of outraged listeners contact the programme to say they were offended by the implication that their suffering was imaginary.

This is exactly the opposite of what the standard scientific approach aims to do though. It accepts that pain is experienced, but attempts to work out the biological, psychological and social factors that can increase or decrease pain.

One of the most important findings in the last few decades is that psychological and social factors have a huge influence.

A recent review article, published in Psychological Bulletin [pdf], examined all of the factors and recounted some fascinating studies that have found that people’s beliefs about pain have a huge impact both on how unpleasant they rate the pain to be, and on how disabled they are in everyday life.

This is just a sample from the huge amount of research done on the psychology of pain:

Appraisal and beliefs about pain can have a strong impact on an individual’s affective and behavioral response to pain. If a pain signal is interpreted as harmful (threat appraisal) and is believed to be associated with actual or potential tissue damage, it may be perceived as more intense and unpleasant and may evoke more escape or avoidance behavior. For instance, pain associated with cancer is rated as more unpleasant than labor pain, even when the intensity is rated as equivalent (Price, Harkins, & Baker, 1987). Similarly, Smith, Gracely, and Safer (1998) demonstrated that cancer patients, who attributed pain sensations after physiotherapy directly to cancer, reported more intense pain than patients who attributed this pain to other causes… These studies demonstrate the important role of people’s interpretations regarding the meaning of pain.

Pain appraisal and pain beliefs are also prominent determinants of adjustment to chronic pain (Jensen, Romano, Turner, Good, & Wald, 1999; Turner, Jensen, & Romano, 2000). The following pain beliefs have been identified as particularly maladaptive in dealing with pain: Pain is a signal of damage, activity should be avoided when one has pain, pain leads to disability, pain is uncontrollable, and pain is a permanent condition (Jensen, Turner, Romano, & Lawler, 1994; Turner et al., 2000). The belief that pain is a signal of damage and the belief that activity should be avoided in order to recover from pain appear to be widespread (Balderson, Lin, & Von Korff, 2004; Ihlebaek & Eriksen, 2003).

Because of the importance of our beliefs about pain on the experience of pain itself, we know that psychological therapy can lead to significant improvement.

A key 1999 study [pdf] gathered evidence from all the relevant clinical trials to date and found that cognitive behaviour therapy was a useful and powerful treatment.

Although we typically associate pain with physical damage to the body, thinking only in terms of physical damage is counter-productive. We also need to tackle the psychology and neuroscience of pain both to fully understand it and to help people affected by it.

Link to TechReview article on the neuroscience of chronic pain.
Link to Ben Goldacre on the challenges of communicating psychosocial factors.
pdf of scientific article on psychology and neuroscience of pain.
pdf of scientific article on effectiveness of CBT for pain.

2007-11-16 Spike activity

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

NPR has a radio programme exploring the significance of dreams and nightmares.

The first version of chocolate is discovered to be 500 years older than previously thought

The Washington Post has an article on ways of optimising your brain function.

An artificial speech implant is looked at by Neurophilosophy.

The Neurocritic rounds up the group smack-down to the nonsense election brain scanning ‘study’ we reported on earlier.

Japan suffers an average of 90 suicides a day, spurring the government into action, according to a report by The Times.

The New York Times has an article by an economist doing the maths on the process of dating and dating success.

Men talk more than women overall, but not in all circumstances, according to a new study covered by Science Daily.

A forthcoming science series called Curious has launched their website with video clips of some interesting neuroscience stuff.

BBC Radio 4’s Case Notes has a special on chronic fatigue syndrome.

BBC News report on more evidence that a healthy diet cuts Alzheimer’s risk.

PLoS One has an interesting paper on how gene expression in the human hippocampus differs in cocaine users compared to others.

Dr Petra analyses the Sex Addiction Screening Test and discovers it’s not been validated despite being widely used.

Teaching children philosophy brings persistent, long-term cognitive benefits, according to a study reported by the BPS Research Digest.

Does stress turn your hair grey?

Scientific American has a short article which examines whether there’s any truth to the common theory that stress makes your hair go grey. It’s turns out there’s some circumstantial evidence that stress may have an effect, but no definite causal link has been found.

Apparently, the gradual loss of melanocyte stem cells, ones that are key for hair colouring, lead to the loss of pigment.

Does stress accelerate this demise of the melanocyte population? “It is not so simple,” Fisher says, noting that the process of graying is a multivariable equation. Stress hormones may impact the survival and / or activity of melanocytes, but no clear link has been found between stress and gray hair. Suspicions ‚Äî and hypotheses ‚Äî abound, however.

“Graying could be a result of chronic free radical damage,” says Ralf Paus, professor of dermatology at the University Hospital Schleswig-Holstein in L√ºbeck, Germany. Stress hormones produced either systemically or locally (by cells in the follicle) could produce inflammation that drives the production of free radicals ‚Äî unstable molecules that damage cells ‚Äî and “it is possible that these free radicals could influence melanin production or induce bleaching of melanin,” Paus says.

“There is evidence that local expression of stress hormones mediate the signals instructing melanocytes to deliver melanin to keratinocytes,” notes Jennifer Lin, a dermatologist who conducts molecular biology research at the Dana-Farber / Harvard Cancer Center in Boston. “Conceivably, if that signal is disrupted, melanin will not deliver pigment to your hair.”

And general practice physicians have observed accelerated graying among patients under stress, says Tyler Cymet, head of family medicine at Sinai Hospital in Baltimore, who conducted a small retrospective study on hair graying among patients at Sinai. “We’ve seen that people who are stressed two to three years report that they turn gray sooner,” he says.

Link to SciAm article ‘Fact or Fiction?: Stress Causes Gray Hair’ (via 3Q).

Uh-oh, little girl, psychotic reaction

It’s an age old story. Boy meets girl, boys loses girl, boy suffers psychotic reaction, boy forms band to sing about his experience on live TV.

I feel depressed, I feel so bad
‘Cause you’re the best girl that I ever had
I can’t get your love, I can’t get a fraction
Uh-oh, little girl, psychotic reaction

The group is Count Five singing ‘Psychotic Reaction’ and as well as being a 1960s rock n’ roll classic, it also helpfully informs us that depression is one of the most common signs of impending relapse in psychosis.

In fact, the song preceded Herz and Melville’s pioneering study, the first to report this association in the scientific literature, by at least 15 years.

Did the two psychosis researchers lead an earlier life as garage band pioneers? I think we should be told.

Link to Count Five singing ‘Psychotic Reaction’ (actually very good).
Link to abstract of Herz and Melville study (still rocks).