It came from the Amazon

The Guardian has a curious report about “the latest drug to emerge from South America” which is supposedly “twice as powerful as crack cocaine at just a fraction of the price”. What the journalist doesn’t know, I suspect, is that this is a common form of cocaine paste that is widely known around the region.

The article and video report tackle what is described as “a highly addictive mix of cocaine paste, gasoline, kerosene and quicklime called Oxi” that is supposedly highly hallucinogenic.

However, everything in the description of the drug and its appearance in the video seems to suggest it is just a new name for a widely used form of cheap cocaine paste known by the Spanish names basuco or paco.

For those not aware of how cocaine is produced from the coca leaf, a 1993 Forensic Science Review article (full-text mirrored here) outlined the usual stages of illegal manufacture.

Although ‘Oxi’ is described as including “gasoline, kerosene and quicklime” all of these are standard ingredients in the creation of cocaine paste itself, which itself is an intermediate stage in the production of powder or crack cocaine.

In fact, in the most common production process the subsequent stages just remove the unpleasant solvents, like gasoline and kerosene, from the cocaine paste to produce the purified product.

However, unrefined cocaine paste that still contains these chemicals is widely sold in South America as a cheap but nasty high. Refined cocaine is largely created for export but the paste mainly appears on the local market and is most prevalent in economically deprived areas.

It usually comes as a powder or as crack cocaine-like rocks that can be smoked for a short intense euphoria – which encourages frequent use – and a mid-brain dopamine boosting neurochemical profile that often induces paranoia and paranoid psychosis of exactly the sort described by users in the video.

My guess would be that ‘Oxi’ is just a new name being used to locally market this form of cocaine paste in the Brazilian area of the Amazon region whereas it is sold as basuco in the rest of the Spanish speaking areas.
 

Link to Guardian report about ‘Oxi’.
Link to mirror for paper on illegal cocaine production.
Link to search of scientific article on basuco (mainly in Spanish).

A reflection of the greatest

A surprising study has just appeared in The Journal of Personality and Social Psychology about whether narcissists realise what others think about their egotistical self-image.

Narcissism is a trait where people are more concerned about themselves than others and tend to think they are better and more important than their peers.

This has often been considered to be a form of self-delusion or self-serving cognitive bias, while this new study deliberately tested whether highly narcissistic realised what others thought about them.

The study came to the surprising conclusion that narcissism is usually accompanied by a crystal clear insight into how others don’t share the shining view that narcissists have of themselves.

You probably think this paper’s about you: Narcissists’ perceptions of their personality and reputation

J Pers Soc Psychol. 2011 May 23. [Epub ahead of print]

Carlson EN, Vazire S, Oltmanns TF.

Do narcissists have insight into the negative aspects of their personality and reputation? Using both clinical and subclinical measures of narcissism, the authors examined others’ perceptions, self-perceptions, and meta-perceptions of narcissists across a wide range of traits for a new acquaintance and close other (Study 1), longitudinally with a group of new acquaintances (Study 2), and among coworkers (Study 3).

Results bring 3 surprising conclusions about narcissists: (a) they understand that others see them less positively than they see themselves (i.e., their meta-perceptions are less biased than are their self-perceptions), (b) they have some insight into the fact that they make positive first impressions that deteriorate over time, and (c) they have insight into their narcissistic personality (e.g., they describe themselves as arrogant). These findings shed light on some of the psychological mechanisms underlying narcissism.

 

Link to PubMed entry for study.

Human nature is a moving target

I just caught up with a fascinating discussion on ABC Radio’s Future Tense on what artificial intelligence showdowns like the Turing Test tell us about the evolution of human nature.

It sounds like a bit of clichéd subject but the interview with author Brian Christian is full of novel, thoughtful insights into how human nature is evolving in response to technological innovations.

This is one of many fascinating bits, about the effect of mobile phone technology on the dynamics of conversation.

One of the comments that we’ve heard several times on our program in the past is that people are now starting to interact with each other like computers. That computers aren’t just learning from us, we’re learning from computers…

…I would also say that the shift in telephone technology from landlines to cellphones has had a kind of unforeseen trade-off, which is that we’re now much more accessible geographically, but the cost is that the lag on the connection is six times greater. So it’s about half of a second instead of a little bit less than a tenth of a second.

And it may not seem like much, but in fact it is enough to disrupt a lot of the subtle dynamics of timing and pauses, and yielding to other people, and it’s turning communication much more into a kind of peer data exchange, you know, pure content.

 

Link to ABC Future Tense on technology and human nature.

A mind of our own

The New York Times has an amazing article on conjoined twins Tatiana and Krista Hogan who share part of their brains and seem to be aware of each others’ minds at work.

It’s a long read but worth it both for how the piece captures both the scientific interest in the possibility of shared consciousness and the personalities of the twins.

Twins joined at the head — the medical term is craniopagus — are one in 2.5 million, of which only a fraction survive. The way the girls’ brains formed beneath the surface of their fused skulls, however, makes them beyond rare: their neural anatomy is unique, at least in the annals of recorded scientific literature. Their brain images reveal what looks like an attenuated line stretching between the two organs, a piece of anatomy their neurosurgeon, Douglas Cochrane of British Columbia Children’s Hospital, has called a thalamic bridge, because he believes it links the thalamus of one girl to the thalamus of her sister.

The thalamus is a kind of switchboard, a two-lobed organ that filters most sensory input and has long been thought to be essential in the neural loops that create consciousness. Because the thalamus functions as a relay station, the girls’ doctors believe it is entirely possible that the sensory input that one girl receives could somehow cross that bridge into the brain of the other. One girl drinks, another girl feels it.

We covered an earlier article that touched on whether the two young children had access to each others’ experiences but the NYT piece explores the issue in far more depth.
 

Link to excellent NYT piece on the Hogan twins (via @mocost).

Empathy in shades of grey

Scientific American has an insightful and beautifully written article asking whether it is possible to make sense of empathy using brain scans.

Neuroscience studies are increasingly focusing on what science calls ‘high level’ concepts and what those outside the field might just call ‘vague’.

Empathy is probably not in the ‘vague’ category although it is true to say that there are several competing definitions and no standard way of measuring it.

It does have huge intuitive appeal, however, leading to a boom in brain scanning studies that are trying to pin down how we understand other people’s emotions.

The SciAm piece takes a trip to the Saxelab Social Cognitive Neuroscience Laboratory at MIT to take a look at how at how a study is attempting to understand the neuroscience of empathy, as well as asking some searching questions about whether we are over-simplifying the problem

A short but excellent piece of writing.
 

Link to SciAm article ‘Looking for Empathy’ (via @edyong209).

Face to face with psychopathy

The Guardian has a curious article where journalist Jon Ronson investigates what it means to be a psychopath and meets a patient diagnosed with psychopathy at one of Britain’s highest security psychiatric hospitals.

In popular culture, ‘psychopath’ refers to a crazed killer but in psychiatry it refers to someone with anti-social personality traits along with low empathy and manipulative behaviour. Although psychopathy is more common amongst violent criminals it is not restricted to this group and the many other people can have ‘psychopathic traits’.

Ronson explores the concept and his experiences of meeting someone with the condition, but also recounts some surprising anecdotes from the history of the condition.

In the late 1960s, a young Canadian psychiatrist believed he had the answer. His name was Elliott Barker and he had visited radical therapeutic communities around the world, including nude psychotherapy sessions occurring under the tutelage of an American psychotherapist named Paul Bindrim [see previously on Mind Hacks]. Clients, mostly California free-thinkers and movie stars, would sit naked in a circle and dive headlong into a 24-hour emotional and mystical rollercoaster during which participants would scream and yell and sob and confess their innermost fears…

And so he successfully sought permission from the Canadian government to obtain a large batch of LSD, hand-picked a group of psychopaths, led them into what he named the “total encounter capsule”, a small room painted bright green, and asked them to remove their clothes. This was truly to be a radical milestone: the world’s first ever marathon nude LSD-fuelled psychotherapy session for criminal psychopaths.

 

Link to Guardian article on psychopathy (via @tomstafford)

The psychology of the end of the world

I’ve written an article for Slate on tomorrow’s predicted doomsday and how believers cope with the non-arrival of the apocalypse.

Although many people are familiar with When Prophecy Fails, a book by psychologist Leon Festinger that charted how a flying saucer cult dealt with the non-arrival of the Armageddon, it’s less widely know that it is only one among many studies that investigated how believers coped with failed prophecies.

When Prophecy Fails has become a landmark in the history of psychology, but few realize that many other studies have looked at the same question: What happens to a small but dedicated group of people who wait in vain for the end of the world? Ironically, Festinger’s own prediction—that a failed apocalypse leads to a redoubling of recruitment efforts—turned out to be false: Not one of these follow-ups found evidence to support his claim. The real story turns out to be far more complex.

Psychologists and sociologists have eagerly accompanied those waiting for the second coming of Christ, alien visitation and nuclear apocalypse to see how the followers would react.

While none of the apocalyptic groups reacted as Festinger predicted, they have given us a fascinating insight into how we make sense of stark contradictions and have helped us understand why our beliefs are more resilient that many would assume.
 

Link to Slate article on the psychology of failed prophecy.

Grief, mental illness and psychiatry’s sad refrain

Scientific American covers a coming shake-up in how grief is defined in relation to mental illness as the forthcoming DSM-5 diagnostic manual aims to radically redefine how mourning is treated by mental health professionals.

It’s worth saying that the DSM-5 has yet to be finalised and will not appear until 2013 but the changes to how grief is classified seem quite drastic.

Two proposed changes in the “bible” of psychiatric disorders—­the Diagnostic and Statistical Manual of Mental Disorders (DSM)—­aim to answer that question when the book’s fifth edition comes out in 2013. One change expected to appear in the DSM-5 reflects a growing consensus in the mental health field; the other has provoked great controversy.

In the less controversial change, the manual would add a new category: Complicated Grief Disorder, also known as traumatic or prolonged grief. The new diagnosis refers to a situation in which many of grief’s common symptoms—such as powerful pining for the deceased, great difficulty moving on, a sense that life is meaningless, and bitterness or anger about the loss—­last longer than six months. The controversial change focuses on the other end of the time spectrum: it allows medical treatment for depression in the first few weeks after a death. Currently the DSM specifically bars a bereaved person from being diagnosed with full-blown depression until at least two months have elapsed from the start of mourning.

It is particularly striking that normal grief could be classified as a mental illness under the new proposals as this brings into question how we define mental illness itself.

Contrary to popular belief, there is not one ‘standard way’ of grieving and people’s response vary widely in response to losing a loved one. However, it’s true to say that being sad and withdrawn is certainly common enough for it to count as a normal reaction to loss.

This brings to mind psychologist Richard Bentall’s tongue-in-cheek proposal to classify happiness as a mental disorder due to the fact that it is “statistically abnormal, consists of a discrete cluster of symptoms, is associated with a range of cognitive abnormalities, and probably reflects the abnormal functioning of the central nervous system”.

Perhaps we can also look forward to simmering anger, dashed hopes and unrequited love disorders for the DSM-6?
 

Link to SciAm article ‘Shades of Grief’.

The testing of Alan Turing

The Providentia blog has a brilliant three part series on Alan Turing, focusing on how his homosexuality was treated at the time both as a mental illness and a criminal act.

As with all of the posts of Providentia it’s wonderfully written and captures the sad circumstances leading to the death of one of the world’s artificial intelligence pioneers and breaker of key German codes in the Second World War.

The piece places Turing’s ‘treatment’ in the context of how homosexuality was conceived and dealt with by the medical establishment of the time

In a 1949 paper, F.L. Golla and his colleagues presented the results obtained from a sample of thirteen convicted homosexuals and concluded that “libido could be abolished within a month” with sufficiently high dosages of female sex hormones. The authors concluded that “in view of the non-mutilating nature of this treatment and the ease with which it can be administered to a consenting patient we believe that it should be adopted whenever possible in male cases of abnormal and uncontrollable sexual urge”. Politicians and newspaper editorials alike praised the potential value of hormonal therapy. While critics warned that there was still too many unknowns involving the treatment, the potential gain was felt to be worth the risks involved. Controlling “unnatural” sexual urges with hormone treatments fit in well with the radical advances being made in other areas of psychiatry. Considering other types of experimental treatment being tried (including aversive conditioning, lobotomies, and electroconvulsive therapy), such treatment seemed relatively benign.

A highly recommended read about an exceptional man who was sadly let down by the country for whom who worked to protect.
 
Link to ‘The Turing Problem’ Part 1.
Link to ‘The Turing Problem’ Part 2.
Link to ‘The Turing Problem’ Part 3.

X-rated neuroanatomy

Slate has a curious article on how many of the anatomical names for parts of the brain are based on the nether-regions of the human body or bawdy allusions to sex.

Régis Olry, of the University of Quebec, and Duane Haines, of the University of Mississippi, brought the whole sordid tale to light in an intriguing pair of articles for the Journal of the History of the Neurosciences. These “historians of neuroanatomy” (yes, there is such a profession, and we should be grateful for it) reviewed a very old, circuitous medical literature and found that the human brain was once described as comprising its very own vulva, penis, testicles, buttocks, and even an anus. In fact, part of the cerebrum is still named in honor of long-forgotten whores.

A past professor of neuroanatomy told me that one of the old arguments for why women couldn’t be doctors is because the their delicate nature would be affected by all the rude Latin jokes in the anatomical names.

Following this line of argument, we might expect atheists to be scared away from neuroscience as well owing to the number of structures that are named after gods.

If you remain unshocked by the vulgarity of the brain, the Slate article may be for you.
 

Link to Slate article on bawdy neuroanatomy.

Is free will spent by a knock-out drug?

I’ve got a brief article in Wired UK about whether the knock-out drug burundanga could help us understand the neuroscience of free will.

The drug is actually an extract of plants from the brugmansia family with the active ingredient being scopolamine.

The urban legend goes that when you’ve been spiked with the drug you do whatever you’re told and can’t remember anything afterwards. The truth is probably less spectacular but surprisingly, its effect on conformity has never been tested.

You may remember I made a radio programme on the same topic with the lovely people from ABC All in the Mind and although the article has just come out, it was actually the inspiration for the documentary.
 

Link to Wired UK article on knock-out drugs and free will.
Link to ABC All in the Mind documentary on burundanga.

An anatomy of The Anatomy of Melacholy

BBC Radio 4’s In Our Time tackled one of the most important books in the history of psychology, psychiatry and literature – Robert Burton’s classic 17th Century text The Anatomy of Melancholy.

Although the book is commonly referred to by its abbreviated title it actually has the far more wonderful name of ‘The Anatomy of Melancholy, What it is: With all the Kinds, Causes, Symptomes, Prognostickes, and Several Cures of it. In Three Maine Partitions with their several Sections, Members, and Subsections. Philosophically, Medicinally, Historically, Opened and Cut Up’.

In the book, Burton explores melancholy, depression and low spirits in all of its forms as well as curating views and opinions of the state from literature, history and medicine.

It is known as a huge labyrinth of a work that is as chaotic as it is beautiful. It has barely been out of print since it was first published in 1621.

In Our Time discusses the writing of the book, the somewhat mysterious life of its author and its historical significance.

I have to say, I’ve not read it all, as even the modern paperback clocks in at an impressive 1,382 pages.

However, one of my favourite parts is the description a description of the glass delusion – a false belief that one is made of glass and might shatter. Curiously, this was widely reported at the time of Burton’s book but has now almost entirely disappeared.

As, to be honest, I will probably never read the book in its entirety, I fully intend to use the latest edition of In Our Time to get a excellent grounding in Burton’s landmark tome to sound much cleverer than I really am.

As the discussion is so fascinating, you could probably do the same.
 

Link to streamed version and info for this edition of In Our Time.
Link to podcast page.

The return of BBC All in the Mind

I’ve just realised the latest series of BBC Radio 4’s excellent All in the Mind has started and has been running some fantastic shows.

So far, the programmes have covered everything from portable baby labs to psychopaths to mirror-touch synaesthesia where people feel the sensations that they see in other people.

If you want the podcasts you’ll have to go to a completely separate page called ‘Medical Matters’ (good ‘old BBC) which you can find here.

Enjoy.
 

Link to AITM homepage with streaming audio and programme details.
Link to podcast downloads.

Diamond in the rough

We’ve covered a few cases of people swallowing unusual things before, although this is probably one of the strangest cases we’ve yet come across in the medical literature.

A diamond thief was caught by a security guard during a burglary and needed a free hand to fight him off, so he swallowed the precious stone.

He was detained and taken to hospital but the diamond failed to pass naturally, so the police obtained a court order allowing the doctors to remove the diamond through the, er… tradesman’s entrance.

Often, the presence of unusual foreign objects inside the body are the result of mental illness or accident but this is the first case I know that has occurred due to quick thinking.

A 36-year-old man involved in the burglary of a precious diamond was surprisingly found at the crime scene by a security agent while he was just holding in his hand the precious stone. To keep the stone in a safe place during the battle with the security agent, the thief put the stone in his mouth and swallowed it.

Once the thief was arrested by the police, he was kept under surveillance and the stools were screened to retrieve the stone. Unfortunately, the bowel movements of the suspect were rare and the stone was not evacuated in a timely fashion. The patient was then referred to our hospital for an abdominal X-rays recommended by current medical and forensic guidelines.

The abdominal X-ray showed the stone in the cecal area. Because of court order, we shortened the waiting time until natural expulsion. Therefore, the patient underwent a total colonoscopy in the presence of police officers that easily allowed uncommon stone retrieval using a basket catheter.

The picture above, by the way, is what a diamond looks like through an endoscope, after is has got stuck up the nether regions of a burglar.
 

Link to case study.
pdf of full text.

The psychology of the dead in the Amazon

Anthropologist Anne Christine Taylor lived with the Achuar people of the Northern Amazon and described the traditional beliefs about how death causes specific psychological impairments to the deceased although their presence can be experienced through drug-induced visions that form a part of a boy’s voyage into manhood.

In an article on the mourning practices of the Achuar, Tayor describes how the tribe have no concept of an ‘afterlife’ as they make no distinction between planes of existence and believe that the wakan or disembodied essence of the dead still remain in the area.

Strikingly, death is thought to affect the mind of the deceased so that the disembodied person retains sensory perception and some limited understanding but they remain entirely unaware of the nature of their own (un)existence.

This lack of understanding of their new ‘situation’ is thought to cause intense intense loneliness and psychological distress in the dead.

The funeral ceremony serves to inform the deceased that they have died and provides a way of disremembering the deceased. There are no rituals of remembrance, tombs or markers.

In fact, the tribe makes efforts to ensure that the dead are no longer talked about, remembered or memorialised in any way because thinking about the ‘dead’ is thought to be a form of dangerous contact in which the mentally impaired wakan can capture people to alleviate their solitude and anguish.

The wakan do, however, play a part in the rituals of manhood. From the age of about ten or twelve the menfolk of the village go into the forest to drink a mixture of green tobacco juice and datura stramonium – a plant common around the world and known by a list of poetic names such as jimson weed, devil’s trumpet and burundanga.

The plant is highly hallucinogenic and despite the fact that it grows almost everywhere it is rarely used recreationally as it usually leaves the affected person completely delirious and dangerously close to death.

But for the Achuar men, the drink separates the wakan from the body of the drinker, allowing a meeting with a wakan of the dead. Taylor describes the visions:

The apparition eventually comes forth, first in the shape of a huge ball of fire rolling towards the supplicant (the payar or comet evoked in many mourning chants), or of two giant, intertwined anacondas thrashing about in the clearing, or of a huge, dead and blackened tree, a blood-soaked warrior, or possibly a looming, mutilated arm cracking the joints of its fingers. The seeker must then go up to this horrifying vision and touch it with his hand or a stick, whereupon it explodes and disappears.

After this almighty vision, the seeker encounters the wakan of one of the deceased who communicates a verbal message to the seeker which he must never reveal.

The ceremony is repeated throughout the lifespan in order to establish the manhood of the Achuar males and build up both their fighting spirit and self-control.
 

Link to locked Anne Christine Taylor on mourning in the Achuar.

Update: Now, thanks to Galina Miklosic a Ukrainian translation of this post (we’re told!)