The rise and fall of antidepressants

Newsweek has an excellent article that charts the rise and fall of antidepressants from their status as a wonder drug that made people ‘better than well’ to the recent evidence that suggests for many people, they’re not much better than placebo.

The piece particularly follows the work of psychologist Irving Kirsch who was the first to conduct a meta-analysis of the effects of anti-depressants back in 1998.

Titled “Listening to Prozac but hearing placebo” it suggested that the drugs were hardly more effective than placebo and, for many, marked Kirsch out as a biased and dangerous ‘anti-psychiatrist’.

However, later studies in a similar vein by both Kirsch and others have supported his original findings and many countries have now changed their treatment recommendations as a result.

The Newsweek article tracks this story but also picks up on many important subtitles in the story, notably that the research doesn’t suggest that antidepressants are useless – quite the opposite – just that their effect is only in part due to their direct chemical effect; and that many patients in trials work out that they’re not taking placebo because of the side-effects and this realisation can trigger a stronger placebo effect.

It also integrates evidence from the recent STAR*D study, one of the most complete on the best methods to treat depression.

If you want a good overview of the debate on the effectiveness of these iconic drugs, this is a good place to start.

Additionally, if you’re interested in a good analysis of the most recent study in this area, just published in the Journal of the American Medical Association, the Neuroskeptic blog has a great write-up and analysis of what this means for the concept of depression itself.

Link to Newsweek piece on antidepressants (via @DrDavidBallard).
Link to write-up of JAMA study at Neuroskeptic.

World changing images

BBC Radio 4 has just concluded a wonderful series on medical imaging that overs everything from the microscope, to ultrasound, to the brain scanner.

The series is five 15 minute programmes that tackles the technology and its controversies. The brain scanning programme is particularly good and shows both ends of the spectrum of enthusiasm for the use of functional brain scans to understand human nature.

Because of the BBC’s black hole of death archive, the programmes will start being sucked into the void in three days time, so do catch them before then.

The programmes also cover DNA imaging and X-rays and the website apparently has a gallery of images on but I have given up trying to find them on the dreadful Radio 4 website.

Link to ‘Images That Changed The World’ audio links.

Can you actually be frightened to death?

Photo by Flickr user Kman999. Click for sourceScience isn’t sure whether fear can kill but several courts have been convinced and have convicted people for murder on the basis that they caused death through fright. An article just published in the American Journal of Cardiology summarises the eight murder trials.

The cases are not, as I first suspected, where someone had deliberately tried to kill someone else using fright as a ‘weapon’ (like in the infamous scene in Belgian serial killer mockumentary Man Bites Dog – clip here – warning: not pleasant).

Instead, they typically describe where someone has died of a heart attack in the midst of an armed robbery or assault, despite not being mortally wounded.

In a similar case, State v. Edwards,10 the defendant and his accomplices entered a bar in Tucson, Arizona and committed a robbery at gunpoint. Shortly after the robbers had fled, the proprietor experienced a heart attack and died. The defendant argued that the victim’s death was accidental and unintended and could not constitute murder. Moreover, the defendant maintained that the evidence was insufficient to prove that the robbery actually caused the victim’s death.

The court disagreed on both counts, finding first that accidental, unintended consequences could form the basis of a murder conviction. Second, the court pointed to the testimony of a pathologist that the death was caused by anxiety resulting from the robbery at gunpoint. The court held that this provided adequate evidence to support causation.

However, this is not the only area where supposedly being ‘frightened to death’ has caught the interest of psychologists. There is a small psychological literature on ‘psychogenic death’ that attempts to explore reports of death after curses, spells or violation of cultural taboos.

This is from an excellent brief article from 2003, published in the journal Mental Health, Religion & Culture:

Landy (1977, p. 327) describes the phenomenon as follows: ‘a process is set in motion, usually by a supposed religious or social transgression that results in the transgressor being marked out for death by a sorcerer acting on behalf of society through a ritual of accusation and condemnation; then death occurs within a brief span, usually 24 to 48 hours’. Ellenberger (1965) distinguishes acute from slow psychogenic death. In some cases, the death can be rapid, in other cases the process occurs over several weeks where the patient sickens and dies. There has been some doubt expressed as to whether voodoo death is part of ‘colonial folklore’ only based on anecdotal reports (Williams, 1928).

Lewis (1977, p. 11) asks, ‘Is it really the case that healthy people have died in a day or three days because they know they were victims of sorcery? Who has seen this happen with his own eyes? Is there no explanation for it but sorcery?’ Yap (1977) calls for concrete findings from anthropologists and medical field workers that can be appraised critically. Questions have arisen as to whether or not these victims had pre-existent pathological conditions predisposing them to death. There is however some direct evidence for its occurrence.

The evidence is not people just dropping dead, but from several documented cases where perfectly healthy people rapidly give up eating and drinking after being ‘cursed’ and dehydration leads to death.

Link to PubMed entry for ‘Homicide by fright’ article.
Link to DOI entry and summary for ‘psychogenic death’ article.

2010-01-29 Spike activity

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

io9 has a great brief summary of a citation analysis that describe how neuroscience became a major scientific discipline in just one decade. Interestingly, it didn’t happen in the Decade of the Brain.

The ability to resist temptation is contagious, according a new study covered by The Frontal Cortex. I suspect this means I am patient zero of giving in to temptation.

Salon has an interview with psychologist Susan Clancy about her new book ‘The Trauma Myth’ on child abuse, which is likely to be both important and controversial. The comments are a mix of the insightful, angry and loopy.

This chap might have found a photo of Phineas Gage from before his injury.

Radio 4 has a good documentary on ‘Super Recognisers’ that will disappear off the face of the earth in only a few days if you miss your chance to listen to it.

The Prison Photography blog is excellent.

NPR has a brief segment on new evidence suggesting that heavy drinking in teenage years may have a lasting impact on the brain.

Special therapy bears work through mirror neurons (what else) according to a bizarre claim unearthed by The Neurocritic.

NeuroPod has just released a new edition covering optogenetics, AI cockroaches, stem and grid cells.

Does time dilate during a threatening situation? asks Neurophilosophy.

Science Daily reports that thinking of the past or future causes us to sway backward or forward on the basis of a new study.

C.G. Jung’s famous ‘Red Book‘ has finally been published and Brain Pickings has a fantastic review and preview.

The Journal of Neurology, Neurosurgery, and Psychiatry has launched a new podcast which is aimed at clinicians and is. a. bit. stilted. but sounds promising.

There’s a good piece about the new and not very effective female ‘sex drug‘ flibanserin in Inkling Magazine.

Horizon, the flagship BBC science programme, recently had an episode on the Big Pharma, medicalisation and disease mongering. Apart from some minor pharmacological dodginess (ADHD a ‘chemical imbalance’, Ritalin a ‘clever pill’) it’s excellent and features our very own Dr Petra. Torrent here.

A new study finding people’s personality is reflected in their internet use is covered by the BPS Research Digest. See also a new study finding social behaviour is similar both online and offline.

Quirks and Quarks, the excellent Canadian radio show, discusses kuru disease immunity in cannibals.

Why is there no anthropology journalism? asks Savage Minds.

The Economist covers a new study finding that the more widespread a language, the simpler it is, suggesting that that languages become streamlined as they spread.

Incoming! APA press release forewarns of imminent clinical psychology fight: psychodynamic therapy best says not yet published meta-analysis.

PsyBlog has an excellent round-up of 10 studies on why smart people do irrational things.

The secrets of looking good on the dance floor and research on the psychology of social dance is covered in Spiegel magazine.

Life magazine has a gallery of famous literary drunks and addicts.

The US is quietly abandoning the ‘war on drugs‘ according to an article in The Independent. Does this mean the expansion of military bases in Colombia is to be re-justified as part of a war on salsa music? Kids told to ‘just say no’ to fake tans and enthusiastic rhythm sections.

The BPS Research Digest reports the development of what could be the first anti-lie detector in neuroscience.

Bootleg Botox, a potent neurotoxin, could be a weapon of mass destruction according to a piece in the Washington Post.

Wired reports on the Jan 25th anniversary of the first recorded human death by robot which occurred in Flint, Michigan, 1979.

The marriage market and the social economics of high-end prostitutes are tackled in a new study discussed in Marginal Revolution.

Better Thinking Through Chemistry

This chapter was due for inclusion in The Rough Guide Book of Brain Training, but was cut – probably because the advice it gives is so unsexy!

rgbt_cover_small.jpgThe idea of cognitive enhancers is an appealing one, and its attraction is obvious. Who wouldn’t want to take a pill to make them smarter? It’s the sort of vision of the future we were promised on kids TV, alongside jetpacks and talking computers.

Sadly, this glorious future isn’t here yet. The original and best cognitive enhancer is caffeine (“creative lighter fluid” as one author called it), and experts agree that there isn’t anything else available to beat it. Lately, sleep researchers have been staying up and getting exciting about a stimulant called modafinil, which seems to temporarily eliminate the need for sleep without the jitters or comedown of caffeine. Modafinil isn’t a cognitive enhancer so much as something that might help with jetlag, or let you stay awake when you really should be getting some kip.

Creative types have had a long romance with alcohol and other more illicit narcotics. The big problem with this sort of drug (aside from the oft-documented propensity for turning people into terrible bores), is that your brain adapts to, and tries to counteract, the effects of foreign substances that affect its function. This produces the tolerance that is a feature of most prolonged drug use – whereby the user needs more and more to get the same effect – and also the withdrawal that characterises drug addiction. You might think this is a problem only for junkies but, if you are a coffee or tea drinker just pause for moment and reflect on any morning when you’ve felt stupid and unable to function until your morning cuppa. It might be for this reason that the pharmaceutical industry is not currently focusing on developing drugs for creativity. Plans for future cognitive enhancers focus on more mundane, workplace-useful skills such as memory and concentration. Memory-boosters would likely be most useful to older adults, especially those with worries about failing memories, rather than younger adults.

Although there is no reason in principle why cognitive enhancers couldn’t be found which fine-tune our concentration or hone our memories, the likelihood is that, as with recreational drugs, tolerance and addiction would develop. These enhancing drugs would need to be taken in moderate doses and have mild effects – just as many people successfully use caffeine and nicotine for their cognitive effects on concentration today. Even if this allowed us to manage the consequences of the brain trying to achieve its natural level, there’s still the very real possibility that use of the enhancing drugs would need to be fairly continuous – just as it is with smokers and drinkers of tea and coffee. And even then our brains would learn to associate the drug with the purpose for which they are taken, which means it would get harder and harder to perform that purpose without the drugs, as with the coffee drinker who can’t start work until he’s had his coffee. Furthermore, some reports suggest that those with high IQ who take cognitive enhancers are mostly likely to mistake the pleasurable effect of the substance in question for a performance benefit, while actually getting worse at the thing they’re taking the drug for.

The best cognitive enhancer may well be simply making best use of the brain’s natural ability to adapt. Over time we improve anything we practice, and we can practice almost anything. There’s a hundred better ways to think and learn – some of them are in this book. By practicing different mental activities we can enhance our cognitive skills without drugs. The effects can be long lasting, the side effects are positive, and we won’t have to put money in the pockets of a pharmaceutical company.

Link to more about The Rough Guide book of Brain Training
Three excellent magazine articles on cognitive enhancers, from: The New Yorker, Wired and Discover

We go with the flow

The Psychologist has a completely fascinating article on how we perceive things to be more appealing, easier to handle and more efficient based on how simple they are to understand – even when this is based on irrelevant or superficial properties – like its name or the font it is described in.

The core idea is that we partly judge things on ‘processing fluency’, that is, how easy it is to immediately grasp something. This seems intuitive, as we tend to prefer things that make sense to us, but it turns out that this preference is also heavily influenced by surface features.

For example, the article discusses the surprising amount of work on how simply changing the font can change our opinion of what the text is describing.

When they were presented [with physical exercise instructions] in an easy-to-read print font (Arial), readers assumed that the exercise would take 8.2 minutes to complete; but when they were presented in a difficult-to-read print font, readers assumed it would take nearly twice as long, a full 15.1 minutes (Song & Schwarz, 2008b). They also thought that the exercise would flow quite naturally when the font was easy to read, but feared that it would drag on when it was difficult to read. Given these impressions, they were more willing to incorporate the exercise into their daily routine when it was presented in an easy-to-read font. Quite clearly, people misread the difficulty of reading the exercise instructions as indicative of the difficulty involved in doing the exercise…

Novemsky and colleagues (2007) presented the same information about two cordless phones in easy- or difficult-to-read fonts. They observed that 17 per cent of their participants postponed choice when the font was easy to read, whereas 41 per cent did so when the font was difficult to read. Apparently, participants misread the difficulty arising from the print font as reflecting the difficulty of making a choice.

The article contains numerous examples of how changing surface features, such as giving something an easy or difficult to pronounce name, alters what we think about it.

However, the piece also mentions that giving something difficult-to-process or unfamiliar features also means we scrutinise it more closely, which means we often pick up errors more easily.

This is is a wonderfully elegant example:

As an example, consider the question ‚ÄòHow many animals of each kind did Moses take on the Ark?‚Äô Most people answer ‚Äòtwo‚Äô despite knowing that the biblical actor was Noah, not Moses. Even when warned that some of the statements may be distorted, most people fail to notice the error because both actors are similar in the context of biblical stories. However, a change in print fonts is sufficient to attenuate this Moses illusion. When the question was presented in an easy-to-read font, only 7 per cent of the readers noticed the error, whereas 40 per cent did so when it was presented in a difficult-to-read font…

Link to Psychologist article on processing fluency.

Full disclosure: I am an unpaid associate editor and columnist for The Psychologist and I have an unfamiliar first name – draw your own conclusions.

John Cleese on neuroanatomy

British comedian John Cleese tackles the brain and gives a tour of the organ’s major anatomical landmarks in this short video from 2008.

It’s a tour de force of descriptive neuroanatomy and even the most experienced neuroscientist is likely to encounter much that is new and interesting.

It also finished on a short but important piece of advice that is worth bearing in mind in all lab situations.

Link to John Cleese on the brain (via @brainshow).

Information channelling

Photo by Flickr user leSiege. Click for sourceThe Frontal Cortex has a fantastic piece discussing a new study finding that people choose TV news based on which channels are more likely to agree with their pre-existing opinions and how we have a tendency to filter for information that confirms, rather than challenges, what we believe.

Lehrer discusses various ways in which we selectively attend to information we agree with but the best bit is where he goes on to discuss a wonderful study from 1967 where people demonstrated in the starkest way that they’d rather block out information that doesn’t agree with their pre-existing beliefs.

Brock and Balloun played a group of people a tape-recorded message attacking Christianity. Half of the subjects were regular churchgoers while the other half were committed atheists. To make the experiment more interesting, Brock and Balloun added an annoying amount of static – a crackle of white noise – to the recording. However, they allowed listeners to reduce the static by pressing a button, so that the message suddenly became easier to understand. Their results were utterly predicable and rather depressing: the non-believers always tried to remove the static, while the religious subjects actually preferred the message that was harder to hear. Later experiments by Brock and Balloun demonstrated a similar effect with smokers listening to a speech on the link between smoking and cancer. We silence the cognitive dissonance through self-imposed ignorance.

Link to Frontal Cortex piece ‘Cable news’.
Link to summary of 1967 static study.
Link to PubMed entry for same.

The missing psychiatric file of Adolf Hitler

Photo by Flickr user ninja M. Click for sourceI’ve just found this fascinating 2007 snippet from the European Archives of Psychiatry and Clinical Neuroscience on Adolf Hitler’s mysteriously missing psychiatric file from the time he was admitted to hospital following First World War injuries.

The article mentions that he was reportedly diagnosed with hysterical or non-organic blindness, something that nowadays would be diagnosed as dissociative disorder or conversion disorder, which signifies that a seemingly ‘physical’ problem occurs without any detectable physical origin.

The traditional and still popular explanation is that the mind is converting trauma to a physical symptom to protect itself from distress, although there is not a great deal of evidence for this theory.

However, it seems his file from this hospital admission disappeared and everyone who had knowledge about the case was apparently killed by the SS.

The recent 60 years anniversary of the end of World War II and the Nazi regime may be reason for a short psychiatric-historical note to point out a frequently overlooked detail of Hitler’s life‚Äîhis hidden psychiatric biography. Besides his extreme anti-semitism, mentally ill were among the most threatened individuals with some 200,000 being killed. This was made public during World War II by the Muenster cardinal Galen who most recently was beatified by pope Benedikt XVI. While Hitler’s late Parkinson disease has attracted some attention, his former functional ‚Äòhysteric‚Äô blindness is almost unknown.

In fact on 14th October 1918 Hitler, who served as a private in World War I, survived a mustard gas attack in Belgium near Ypern. There are some reports that he consecutively had a mild resultant conjunctivitis. He also suffered from nonorganic blindness. His further treatment is nearly unknown. Hitler was transferred to the military hospital in Pasewalk near Stettin/Baltic sea. Prof. Forster, chair at that psychiatric clinic, treated him by using hypnosis. Hitler was discharged on 19th November 1918 and never mentioned this period again.

His treatment is proven by eyewitness of Dr. Karl Kroner who later reported the facts to the US intelligence Office of Strategic Services (OSS). Hitlers’ file disappeared and all people who were closely involved or had special knowledge of this file were killed by the ‘Gestapo’, including Prof. Forster who probably was forced to commit suicide on 9th November 1933. Before that he succeeded in presenting these documents to exile writers in Paris where his brother was employed at the German embassy. The German Jewish writer Ernst Weiss, a physician himself, used the original documents in his novel ‘Der Augenzeuge’ (The Eyewitness) before he committed suicide during the German occupation of Paris on 6th May 1940.

The original file is lost but for all we know Hitler had a psychiatric history, which may not explain his savage ideas but throws an interesting light on his anti-psychiatric attitude.

Maybe it’s in the Albert Hall, along with that other important medical artefact from the F√ºhrer.

However, I note from the Wikipedia page on Hitler’s medical history that there have been many claims about Hitler’s health, many of them not well verified.

Nevertheless, he was subject to not one, but two, wartime Freudian character analyses commissioned by the OSS – the forerunner to the CIA. The first was completed by psychologist Henry Murray and the second by psychoanalyst Walter Langer.

The reports have many oddities and are largely opinion but they concluded that Hitler was a neurotic psychopath, probably had paranoid schizophrenia, was likely impotent, was a repressed homosexual and, most famously, would likely kill himself.

Although to be fair, the latter point did not describe dying a miserable death in a bunker but included various movie-style scenarios where he would blow himself up in a dynamite rigged mountain, use a single silver bullet or throw himself off a parapet as troops came to take him prisoner.

I’ve no idea how useful these reports ever were but they probably tell us more about the trends in psychology of the time than anything about the Nazi leader’s mind.

UPDATE: Grabbed from the comments… There’s an excellent post on the wartime character analysis reports over at the Providentia blog.

Link to short article on ‘Hitler‚Äôs missing psychiatric file’.

The evolution of death and dying

The New Yorker has a wonderful article on the psychology of death and dying which is carefully woven into the curious life story of psychiatrist Elisabeth Kübler-Ross, the originator of the ‘stage’ model of grief.

If you only read one popular article on grief, you’d do a lot worse than reading this carefully researched and sensitively written piece which journeys through both the social and cultural rituals of dying and how psychological theories have changed over the years.

It also tackles the fascinating life of Elisabeth Kübler-Ross who was responsible for the influential but now discredited ‘stage’ model that suggested that both dying and grieving people experience denial, anger, bargaining, depression and acceptance.

Subsequent studies have not supported these stages but Kübler-Ross was a pioneer in encouraging clinicians to address death with their gravely ill patients and her first book, On Death and Dying, opened up the practice of bereavement counselling for people who feel they need help coming to terms with their own death or the loss of loved-ones.

Kübler-Ross later became interested in a range of, it must be said, fairly flaky practices, such as mediumship and ‘channelling’ the dead, and she fell out of favour with the medical mainstream.

Late in life, she was disabled by a stroke and had a great deal of trouble coming to terms with her own mortality although the experience helped her write her final and widely regarded book, On Grief and Grieving, where she reflects on her own death and her life’s work.

The New Yorker article looks at Kübler-Ross’ legacy, but much more than that, examines a great deal of what we know about the process and how it is being integrated into modern medicine. Highly recommended.

Link to New Yorker article ‘Good Grief’ (via @mocost).

Forgetting fear

Photo by Flickr user ia7mad. Click for sourceThe Times has an excellent article summarising recent research on the possibility of treating traumatic memories by tempering their impact either just after the event or when remembering the experience at a later point.

The ability to update our memories with new information highlights the flexibility of our brain. Every act of remembering gives us an opportunity to shape memories, or even erase them. The discovery of the reconsolidation window has kick-started a lot of new memory research, advances in which could have important implications for people who suffer from unwanted fearful memories. Potential treatments for anxiety, phobias or post-traumatic stress disorder (PTSD) may be close at hand.

It’s a remarkably wide-ranging article that covers both chemical and psychological methods that have been drawn from recent research and is probably the best concise summary of this research you’ll be likely to read for a good while.

Much of the initial interest in this area was on a drug called propranolol, that doesn’t affect the brain’s memory circuits directly but does reduce tension in the body. Several experiments showing it reduced traumatic responses when taken immediately after a severe event generated a lot of hope that it might be a new way of preventing catastrophic reactions.

Recent findings have dulled the excitement a little though, as two studies have come out on burns victims, one in soldiers and another in children, and the drug had no detectable effect on trauma.

The Times article also mentions that “the drug merely changes the emotional content of memories, rather than erasing them” although this point is controversial.

Some studies that have tested the effect on recalling tragedy or trauma stories have found a genuine reduction in the amount of information recalled, not only the emotional ‘kick’ of the memories.

One similar study didn’t find this effect and a recent experiment directly compared propranolol to placebo and the stress hormone cortisol and found no effect of propranolol on memory, but another study found it did reduce short-term memory overall although it also lessened the impact of emotional distractions.

This is an important issue, because, as The Times notes, it could have massive implications if memories of a traumatic event form part of a court case after the drug may have ‘tampered’ with the evidence.

The piece by Ed Yong and Alice Fishburn, the former who you may know from the Not Exactly Rocket Science blog and who has put an added an interview with neuroscientist Todd Sacktor online who has completed recent work on the role of the PKMzeta protein in memory.

Link to Times article ‘How to forget fear’.
Link to NERS interview with Todd Sacktor.

Brain scan diagnoses misunderstanding of diagnosis

There have been a lot of media stories in the past week about a study from the US military supposedly showing that a new form of brain scan can diagnose post-traumatic stress disorder (PTSD) in army veterans. Although interesting, the study doesn’t show any such thing and this is an example of a common misconception that regularly appears as a form of ‘new biological test diagnoses mental disorder’ story.

The study used a form of brain scan called MEG, essentially a high-tech form of EEG that picks up magnetic fluctuations from the brain’s electrical activity rather than the electrical signals themselves, and found that the coherence of signals across the resting brain was reliably different in vets diagnosed with PTSD by interview, compared to healthy people without mental illness.

Crucially, the scan didn’t pick out cases of PTSD among people with a range of mental illnesses, it just found a difference between people with PTSD and healthy people. But this is not a diagnosis, it’s just a difference.

If you’re not clear on this distinction, imagine that I claimed I found a new way of diagnosing malaria in under 2 seconds – I just measure body temperature and if the person has a fever, I decide they have malaria.

I hope you would point out that this is ridiculous, because people with flu can have fever, as can people with typhoid, mumps, dengue and so on.

My test would genuinely distinguish between people with malaria and healthy people, but in no way is it a diagnosis.

And this is the same situation with this new PTSD study. The difference could be due to levels of anxiety, common in many mental disorders, or to people who’ve experienced life threatening situations, regardless of whether they have PTSD or not, or any other factor I’ve not accounted for.

In other words, like with my fever example, it could be common to many different problems and not specific to the diagnosis I’m studying and I would need to make sure my method made a differential diagnosis – i.e. specifically ‘picked out’ the disorder among many – to be a useful diagnostic tool.

However, this latest PTSD story follows a common format in mental health news. I’ve lost count over how many reports I’ve read on how a ‘new test’ could diagnose schizophrenia based entirely on the fact that a study has found a difference between people with schizophrenia and people who don’t have it.

From reading these stories, I suspect it’s often the researchers who are at fault in describing their research.

When asked about to publicly justify their work, I suspect researchers often go for the easy “it could help diagnose the disorder”, which sounds immediately useful, as compared to the more truthful “it’s a small piece of knowledge in a very large area and we won’t know if it is reliable until it is replicated and if so, we may not fully understand its significance for many years to come. However, these small incremental advances are all useful even if they prove to be dead ends as they help us understand the problem from all angles”.

In this case, the researchers wrongly suggest in their scientific article that their findings “can be used for differential diagnosis” and so we can hardly blame the media for picking up on the hype.

So the next time you read a ‘new test diagnoses mental illness’ story, check to see whether it is genuinely picking out the problem among many others, or whether it’s just reporting a non-diagnostic difference.

Link to PubMed entry for new study.

The soporific boogaloo

The Guardian has a short piece and gallery on what couple’s sleeping positions say about their relationship. The article is based on a humorous book called The Secret Language Of Sleep and it’s not quite clear that the writer has picked up on the fact its not meant to be taken too seriously.

The idea that sleep position is linked to personality is surprisingly popular but largely untested. Only poorly controlled study has ever tried to investigate the issue. It chose only 6 out of 14 sleep position recorded from 51 females and concluded that “Sleep positions, particularly the full fetal position, appear to be related to CPI [California Psychological Inventory] variables of Sociability, Sense of Well Being, Achievement by Conformance, Femininity, and Social Maturity”.

The general idea, however, has quite an interesting history. It was originally suggested in passing by the early psychoanalysts and fits well into Freud’s theory of dreaming.

He suggested that when we sleep we are left alone with our unconscious which may contain lots of unpleasant or unwanted desires we don’t want to think about. If we did, we might become so emotionally disturbed as to wake up, therefore, according to Freud, dreams serve to hide our unconscious desires from us by presenting them to us in a more acceptable symbolic form.

From this perspective, dreams serve to keep us asleep and Freud’s big idea was that we can analyse the dream’s ‘manifest’ or obvious content to give us an insight into the ‘latent’ or unconscious meaning. This is why Freud famously wrote that dreams are a “royal road to the unconscious”.

According to Freudian theory, our personalities are largely a reflection of how we manage and ‘defend’ against out our unconscious desires. As our dreaming life occasionally breaks through into movement or speech when we sleep, it’s not a big leap to link sleep position with personality.

This link was made explicitly in a 1979 book called Sleep Positions: The Night Language of the Body by the psychoanalytically inclined psychiatrist Samuel Dunkell. In the book, Dunkell readily admits there is no research to back up his ideas but links personality with sleep position on the basis of individual cases and anecdotes from his own practice, as psychoanalysts have a tendency to do.

Despite being based almost entirely on one man’s opinion, the book has been remarkably influential in pop culture and there has been a steady trickle of media interest ever since that has repeated the main ideas.

In fact, the Huffington Post, which has become an unintentional champion of dodgy science, ran a piece only last week that claimed to explain ‘What Your Sleep Position Says About You’ based almost entirely on Dunkell’s book.

There was a brief media splash in 2003 when sleep psychologist Chris Idzikowski claimed almost exactly the same based on a ‘new study’ but it never appeared and was presumably a PR piece for the private sleep clinic he worked for.

So we don’t really know if sleep position is linked to personality, and certain can’t ‘read’ anything about you from your night-time body position.

But the theory is so popular that even a satirical book can apparently be misinterpreted as supporting the idea.

Link to Guardian piece ‘The politics of sharing a bed’.

2010-01-22 Spike activity

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

Drug Monkey covers a fascinating study finding that mental health workers judge patients differently depending on whether they’re described as being a ‘substance abuser’ or as having ‘a substance use disorder’. We covered a similar study on personality disorder previously.

To the bunkers! The robots are coming but are we ready for them? asks Remember: see a twitch? Check for a switch. Species security is everyone’s responsibility.

NPR has a fascinating segment on the relationship between lies and wishful thinking.

To the bunkers! The age of the killer robot is no longer a sci-fi fantasy, says an article in The Independent. Remember: a disabled robot can be rebuilt, leave no component in working order. Clunk, clip, every chip.

Normal face recognition abilities are influenced by genetics finds new twin study reported by Wired Science.

To the bunkers! The Daily Express reports on the unveiling of robot planes hailed as ‘the future of warfare’. Remember: robot soldiers have no souls – make a dent, don’t repent.

The Neurocritic asks ‘Is this aspirin playful or serious?’ and covers a curious neuromarketing study that looked at the personalities of products.

To the bunkers! H+ Magazine reports on a nanotechnology robot arm that places atoms and molecules with 100% accuracy. Remember: he may look clean, but have you scanned? Even live humans may have robot parasites.

Neuronarrative reports that making a constant public commitment to lose weight improves dieting success.

To the bunkers! Popular Science reports on a robot that takes surer steps due to ‘chaos control’. Remember: see a wire? Open fire. Humans always fight for liberty.

PsyBlog lists the the 7 psychological principles of scams.

To the bunkers! CNET reports that Korean scientists have created a robot housemaid. Remember: Stepford Wives – check the eyes.

Wiley Science puts the first issue of its new Interdisciplinary Reviews: Cognitive Science magazine online with an impressive list of academic articles freely available to download.

To the bunkers! Toyota predicts robot nurses will care for the frail elderly, according to a story in Wired Gadget Lab. Remember: a family with a robot is a massacre in the making. Take care of the robots, before they take care of you.

BBC News reports on a study finding that video game success is related to brain structure size: nucleus accumbens size predicts initial success, basal ganglia long-term success.

To the bunkers! TG Daily reports on Roxxxy, an AI sex robot that “has personality, and can even answer back”. Remember: nothing compares to human sex, don’t let the robots get you by the balls.

The Guardian has an excellent eight part summary of Heidegger’s ‘Being and Time’.

To the bunkers! New Scientist reports on a study finding that exposure to robots in the movies and television could affect our ability to empathise with synthetic beings. Remember: detect a bug? Pull the plug. Even loved ones can be androids.

New Scientist reports on a new study finding a link between symmetry of activity in the brain’s hemispheres and susceptibility to hypnosis.

To the bunkers! The New York Times reports that a new generation of ear bud headphones have built in artificial intelligence-based signal processing. Remember: your ears are a backdoor into the brain, don’t let the robots in – keep neural tissue pure.

The BPS Research Digest reports on a study finding that early risers are more proactive than evening people. Shortly to be the basis of a new diagnosis and licensing application for modafinil.

To the bunkers! An article in Popular Mechanics argues against the concept of the ‘uncanny valley‘, although neglects to mention a couple of relevant studies that support the concept. Remember: if it’s too good to be true, it’s robot through and through. Your intuition is the best defence against the robot menace.

The Psychiatric Times blog notes that families of US soldiers who commit suicide do not get condolence notes from the government like other military casualties.

To the bunkers! Geeky Gadgets sells an awesome Google / SkyNet t-shirt. Remember: humans, biology is our heritage. Metabolism pride!

The Telegraph reports that even the founder has given up on the idea of bullshit Blue Monday. Thankfully, we were relatively unafflicted this year although Dr Petra had a good antidote for any remaining infections.

To the bunkers! The Engineer reports on the development of a fire fighting robot. Remember: heat tolerance is a robot trait. No sweat, no soul.

Neuroworld takes apart the ‘blonde women get angry’ news that was completely made up from a barely related study.

To the bunkers! Entertainment Weekly reports that the next Spike Jonez film is a robot love story. Remember: to a robot, your heart is just a machine. Don’t let them capture it.

New Scientist covers and interesting study that mathematically modelled the social effects of monogamy and polygamy.

To the bunkers! USA Today reports on the unveiling of a new anti-terrorism robot at Boston’s Logan Airport. Remember: only humans feel fear, anti-terrorism is anti-humanism, fight the robot overlords.

Skeptical Inquirer magazine has an excellent piece on highlights of mass delusions and hysteria from the last millennium.

To the bunkers! The Guardian has an article looking at the history of robots in sport. Remember: sport strengthens human relationships, don’t let robots infiltrate your team.

The Economist covers an intriguing study find that power corrupts, but it corrupts only those who think they are entitled to take advantage of the situation.

To Bedlam and Part Way Back

BBC Radio 4 has a fantastic documentary on one of then 20th century’s great poets, Anne Sexton, who struggled with mental illness throughout her adult life and eventually committed suicide at the age of 46.

Uniquely, tapes of Sexton’s psychotherapy sessions with psychiatrist Martin Orne were found after her death giving an alternative insight into her mental life.

The programme dramatises excerpts from the tapes and talks to members of her family about her life, writing and frequent hospitalisations.

Sexton is typically classified as one of the ‘confessional’ poets, although, regardless of the label, her work is certainly very personal and reveals an articulate if not fragile look at many key relationships in her life.

Because of the BBC’s archive of doom, you only have three days to listen to it before it disappears for good into the abyss, although it is well worth catching if you get the chance.

Link to BBC Radio 4 documentary ‘Consorting with Angels’.

Two drugs show best treatment possibility for MS

In massive news for neurology, The New England Journal of Medicine has published three important studies reporting that two new drugs for multiple sclerosis are more effective than existing treatments and can be taken in pill form.

Multiple sclerosis is a bitch. It’s a neurological disorder where the immune system starts attacking myelin – the protective covering of nerves in the brain and spinal cord – leading to unpredictable attacks that typically leave the person a little more disabled each time.

Problems can include movement difficulties, chronic pain, fatigue, cognitive problems, mood instability and impairments to the body’s automatic processes like digestion, bladder and bowel control.

One problem with the the current treatments that try and slow down the disease itself, rather than just manage the effects, is that they all require regular injections or infusions via a drip.

These new studies report on two drugs: one is cladribine which is already widely used in leukaemia, and the other is fingolimod, which is not yet available commercially. Crucially, both can be taken as pills without the need for injections.

The studies that investigated these drugs were very impressive. They had large numbers of patients in many countries; they were conducted with the co-operation of drug companies but were led by independent researchers; they continued for about two years; they were compared against placebo and, in the case of fingolimod, against the current best available treatment – beta interferon; and they looked at both chances of relapse and at changes in brain structure.

The studies did not include the most disabled people with MS are all were able to walk, although patients with mild and moderate disability were included.

The results suggest that the drugs are not only easier to take but are better than the current best available treatments and reduced the chances of the patient having a relapse of MS as well as the damage to the white matter in the brain.

The drugs work quite differently from current treatments – which largely reduce inflammation directly – by changing the balance of how the immune system releases T cells so more antiinflammatory ‘helper’ T cells are available.

Unfortunately, the drugs are not without side effects, and although these effects were rare, altering the immune system led to more herpes infections and an increase in the development of cancer.

Herpes infections can take the form of the annoying but relatively benign, like in local infections such as cold sores, shingles and genital herpes, but when it gets into the whole body or brain it can cause serious damage or even lead to death, which happen to two patients in the trial, although in this case it was out of more than 1,100 people in total. The people with cancer generally recovered well – there was one death but it isn’t entirely clear it was linked to the treatment.

Although these drugs are not cures, they only slow the disease down, this is still massive news and a major development in neurology.

One of the practical big issues will be how the drugs are priced by the pharmaceutical companies and you can be sure they’re not going to be cheap.

However, one small hope is that the two compounds are owned by rival companies and as they seem to have broadly equivalent effects it will be hoped that competition will drive the price down.

Link to good write-up from The Times.
Link to good technical summary in the NEJM, sadly paywalled.