vaughanbell

A phantom head

I’ve just been reminded of one of the most remarkable case studies in the psychiatric literature, of a patient who believed he had two heads and who seriously injured himself with a gunshot wound trying to remove the ‘second’ head.

He described a second head on his shoulder. He believed that the head belonged to his wife’s gynaecologist, and described previously having felt that his wife was having an affair with this gynaecologist, prior to her death. He described being able to see the second head when he went to bed at night, and stated that it had been trying to dominate his normal head.

He also stated that he was hearing voices, including the voice of his wife’s gynaecologist from the second head, as well as the voices of Jesus and Abraham around him, conversing with each other. All the voices were confirming that he had two heads; the voice from the second head had been telling him that it was the ‘king pin’, and would also say to him that it was going to take his wife away. He did not describe any other hallucinatory or delusional experiences.

“The other head kept trying to dominate my normal head, and I would not let it. It kept trying to say to me I would lose, and I said bull-shit.” “I am the king pin here” it said and it kept going on like that for about three weeks and finally I got jack of it, and I decided to shoot my other head off.”

He stated that he fired six shots, the first at the second head, which he then decided was hanging by a thread, and then another one through the roof of his mouth. He then fired four more shots, one of which appeared to have gone through the roof of his mouth and three of which missed. He said that he felt good at that stage, and that the other head was not felt any more. Then he passed out. Prior to shooting himself, he had considered using an axe to remove the phantom head.

I was reminded of the case study by McKay and colleagues chapter in the academic book Delusion and Self-Deception. I’ve been sent a free copy to review for an academic journal and am currently ploughing through it. It’s not very accessible for the general reader but is full of thought provoking theories on the cognitive science of delusions.

Link to case study.
Link to PubMed entry for same.

2009-06-19 Spike activity

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

PsychCentral awards its 2009 Online Mental Health Journalism Awards. Mind Hacks makes the list. Still no word from Shakira.

The wonderful Dr Mezmer’s Psychopedia of Bad Psychology is released as a full free edition.

The Economist on a study finding that repeating positive statements to oneself has a negative effect of people with low self-esteem. Is this the death of √âmile Cou√©?

An excellent article on the curious pharmacological properties of the curious hallucinogen salvia divinorum is on Terra Sigillata.

BBC News covers a new call to rethink how courts should handle eyewitness testimony in the light of the science of memory.

Stereotypes about the drivers of certain cars affect our perception of how fast we think the car is going, according to a study covered by BPS Research Digest.

The Guardian Book Club podcast discusses Steve Pinker’s The Blank Slate.

There’s an excellent special issue of ye olde Philosophical Transactions of the Royal Society on predictions in the brain – using our past to prepare for the future.

The Telegraph wees itself in public.

Mental time travel and the importance of remembering forward in time are discussed by the ever excellent Neurophilosophy.

The New York Times has a rough guide to borderline personality disorder.

Patients with schizophrenia least likely to commit suicide after being treated by young female psychiatrists, according to a study in Schizophrenia Bulletin. Via the excellent Spanish language blog Nietos de Kraepelin.

Frontier Psychiatrist has an excellent piece on the complexities and depression and antidepressant prescribing.

Can a <a href="http://www.independent.co.uk/life-style/health-and-families/features/can-lack-of-sleep-drive-you-mad-1705954.html
“>lack of sleep drive you mad? asks The Independent. Correlation-causation warning applies for some of the points.

The New York Times reports on a recent study finding a higher rate of mental illness in the Chinese population than previously thought.

Hooked on a feeling. Newsweek discusses the science of placebo.

Rethinking Autism has produced a series of sexy videos to promote sensible science on autism. A strange brew indeed.

Booze to brain in six minutes. Live Science covers a study of people getting pissed in brain scanners.

An article for the ACLU Blog delves into the history of the American Psychological Association’s collusion with war-on-terror interrogation / torture / shadyness. You may be interested to know that the APA are currently focussed on backpeddling.

The New York Times tackles the ‘a glass of wine a day is good for you‘ meme, which doesn’t actually have a lot of solid evidence backing it up.

There’s a good in-depth review of Flynn’s new book on intelligence and the Flynn effect over at American Scientist.

The Kinsey Institute has a twitter feed! Make your own coming thick and fast jokes. I’m above that sort of thing.

A dodgy study that, despite its claims, didn’t find antipsychotic aripiprazole is particularly associated with increased subjective well-being is tackled in an excellent analysis by Neuroskeptic.

Discover Magazine has an excellent Carl Zimmer article on the benefits of the wandering mind and the brain’s ‘default network’.

A Harvard psychiatrist writes a spoof article on zombie neurobiology – sadly we only have a secondhand <a href="http://io9.com/5286145/a-harvard-psychiatrist-explains-zombie-neurobiology
“>write-up from io9. If only those scientists in Day of the Dead had a copy, maybe it wouldn’t have turned out so bad.

Neuron Culture has the best write-up anywhere on the recent metanalysis of the link between the 5-HTTLPR gene and depression: The (Illusory) Rise and Fall of the “Depression Gene”.

To the bunkers! New Scientist covers a plan to teach military robots the rules of war. Don’t you realise, that’s exactly what they want you to believe!

The Splintered Mind has a philosophical dream.

Unloaded dice

A new edition of the beautifully produced RadioLab has just hit the airwires with an excellent programme on the science of randomness.

The hour long science trip largely focusses on how we make sense of random or unpredictable events, from coincidences to statistical white noise.

There’s a wonderful part where the presenters visit statistician Deborah Nolan who has a neat party trick to demonstrate the properties of random sequences to her students.

She asks one group of students to write down the results of 100 coin flips, and another to write a list of imaginary coin flips. She then leaves the room, waits while each sequence is written down, returns, and tells the students which sequence was imaginary.

It works because humans are bad random number generators. Nolan looks for longer runs of heads or tails which are not included in imaginary sequences because we underestimate the variation in randomness.

In fact, there’s been quite a bit of research on how we generate ‘random’ number sequences, and it turns out that far from being a messy and effortless function of the brain, it requires some heavyweight intervention of the frontal lobes.

Brains are very good at stereotyped routines but it’s breaking these learned patterns which takes the real effort. To generate ‘random’ sequences, we need to check we’re not repeating ourselves and match the sequence against a model of randomness in our heads.

In fact, asking people to generate a sequence of random numbers is a good test of frontal lobe function, the more mathematically random it is, the better functioning the frontal cortex. And if we dampen down frontal cortex function using electromagnets, we see a drop in actual randomness of the numbers.

There are plenty more fantastic insights into the science of the unpredictable in the programme with the constantly surprising RadioLab team.

Link to RadioLab on randomness.

The holy grail of military psychiatry

Neuron Culture covers a new study on predictors of PTSD in deployed American combat troops. Predicting whether a soldier will break down through combat has been one of the Holy Grails of military psychiatry and the impressive results of this study suggest that this may be getting closer.

World War One was the crucible of military psychiatry as it became clear that even the bravest and best soldiers could break down due to combat stress.

When World War Two arrived, the British and American militaries invested a great deal in psychological screening to attempt to distinguish which soldiers would break down more quickly.

The project was widely regarded as a failure as the only reliably predictor seemed to be the duration and ferocity of the combat the soldier was exposed to.

However, as Dobbs notes, this new study finds that a simple measure of physical health could be a powerful way of preventing half of all PTSD cases in combat deployed troops.

The study found that the least healthy 15% of the troops in the study who saw combat accounted for well over half — 58% — of the post-combat PTSD cases, as indicated by either the study’s own criteria or by self-report of a PTSD diagnosis from the soldiers during follow-up.

This is a pretty stunning result. And it certainly suggests that, as the study put it, “more vulnerable members of the population could be identified and benefit from interventions targeted to prevent new onset PTSD.” The beauty of this finding is that fairly general measures of health are the indicators, so you can predict a lot from fairly simple and easy-to-collect data.

Obviously not all of the 15% who scored lowest on PTSD; but that bottom 15% accounted for more cases than do the entire remaining 85%. So at a time when we are much concerned with reducing PTSD in combat troops, it seems fairly plain that we could cut the PTSD rate by more than 50% simply by keeping the least healthy 15% — as measured by fairly simple health questionnaires we already have in any and — out of combat zones.

He also notes a curiosity that while the study was on US troops, the paper was published in the British Medical Journal, and wonders whether there were some PTSD politicking that meant it was rejected from American journals.

As we’ve discussed before, PTSD is perhaps the most politicised psychiatric diagnosis. It was originally called post-Vietnam syndrome and was created to allow the US healthcare system treat Vietnam veterans.

The direct effects of trauma where never previously thought to be a mental illness in itself, although it was known to be a risk factor for a number of conditions.

Psychologist Dave Grossman, author of On Killing, convincingly argues that Vietnam was particularly conducive to combat trauma for US troops, owing to the fact that US forces had no front line and hence no ‘safe’ areas to relax in, and that they often found themselves fighting a irregular army of civilians including women and children.

Link to Neuron Culture on predicting PTSD in combat troops.
Link to full-text of study from BMJ.

Possession and trance

Neuroanthropology has collected videos of trance states in religious rituals, where intense movement, music and mental involvement lead to profoundly altered states of consciousness.

Trance is a fundamental part of many (probably most) religions. Although it is typically associated in the popular mind with ‘voodoo’ it’s also common in many Christian denominations.

Indeed, there’s a video of trance states in Candombl√©, a fusion of Catholicism and voodoo-related Orisha worship, and one of trance states in a charismatic Christian church in the US.

Trance is usually described as involving ‘dissociation’ – originally defined by the French psychiatrist Pierre Janet as the ‘unconscious compartmentalisation of normally integrated mental functions’.

Dissociation is thought to underlie a wide range of phenomena, including hypnosis, reaction to trauma, trance and some forms of spirit possession, hysteria, conversion disorder and, more controversially, multiple personality disorder.

One of the best guides to the range of experiences and the possible neuroscience behind these states is an excellent article by anthropologists Rebecca Seligman and Laurence Kirmayer.

One notable omission from the list on Neuroanthropology is video of the female possession rituals of the Zar Cult from Northern Sudan which has been quite widely discussed in the anthropology literature.

There’s some brief footage of it online and in another video anthropologist Gerasimos Makris discusses the structure and social meaning of the possession rituals.

Link to Neuroanthropology collection of trance videos.
Link to article on trance, dissociation and neuroscience.
Link to good page on anthropology of possession.

Alien lipstick syndrome

I’ve just found this remarkable case study of a woman with an unpredictable form of ‘alien hand syndrome’ that was triggered when she had a seizure.

The syndrome, where you lose conscious control of one of your hands while it carries out unbidden actions, is normally associated with permanent damage to the brain, often in the frontal lobes, but this version only occurred when an epileptic seizure was in progress.

A 65-year-old right-handed Cuban woman experienced her first seizure while driving. She described an initial tonic posturing of her left foot with march throughout the leg.

This was followed by a counterclockwise truncal contortion and repetitive clonic movements of the foot, followed by her left hand viciously slapping her face, ‚Äúas if it was fighting with me.‚Äù

Subsequent seizure semiology
This slideshow could not be started. Try refreshing the page or viewing it in another browser.
has been similar, although her nondominant left hand has refined its movements as to pretend it is applying lipstick.

Because of the embarrassing smearing of her preferred loud cherry-red lipstick, the patient has been forced to use more natural colors.

Link to PubMed entry for paper.

In vino veritas

Wine Psychology is a curious new website dedicated to the pleasures, analysis and cognitive science of our favourite grape-based booze.

It’s been launched by psychologist Miles Thomas who has written a number of successful articles on the psychology of wine tasting, including one we featured last year.

The website’s blog looks the most promising, and the recent post on passive perceptual learning in wine tasting is a good place to start.

There’s a small but surprisingly active research community focussed on wine psychology, largely, I’m guessing, because it is a huge business with lots of dedicated fans.

Rather unusually, I seem to be uniquely affected by wine. From my observations it tends to make other people poorly coordinated and socially unskilled whereas after a few drinks my dancing vastly improves and I become increasingly witty.

Apparently this anomaly has not yet been reported in the literature, so I look forward to a full scientific investigation.

Link to Wine Psychology.

Full disclosure: Miles Thomas and I are both unpaid members of The Psychologist editorial board. He has not paid me, twisted my arm or plied my with booze to write this post.

Don’t stand so close to me

There’s a neat study in Perception finding that listening to music through headphones warps our comfort zone of interpersonal space.

The researchers asked participants to walk up to another person from various angles until they reached the edge of their comfort zone.

Without them knowing the researchers measured the distance, and this was compared between times when participants were listening to music through headphones, were wearing silent headphones or were without headphones.

When listening to music, participants maintained a greater interpersonal distance and this was particularly true when their back faced another person. In other words, people needed more distance behind them to feel comfortable.

This is likely because we use hearing to track objects, particularly behind us, and when we can no longer rely on a sense to give us this information we tend to err on the side of caution.

The researchers drop a tantalising hint that the type of music may also have an effect.

While in this study, all participants listened to unfamiliar music, they mentioned that “we have pilot data suggesting that people change their interpersonal space area when listening to music they like compared with music they dislike or no music at all”.

Turn down the Barry White buddy, you’re crowding my space.

Link to page with full text of paper.
Link to PubMed entry.

Weird Al’s brain explodes

Comedian “Weird Al” Yankovic has made a 3D movie about the brain that stars himself and will premier at the Orange County Fare in California. I didn’t think I’d ever find myself writing that sentence, but life is strange like that.

According to the spiffy website, the 10 minute movie is intended to be both entertaining and educational, and from the clips on the website, it looks kinda loca. Click on ‘Adventures of Al’s Brain’ for a taste of the chaos.

It’s interesting how neuroscience has made its way so firmly into popular culture. While walking into the tube at London’s Euston station the other day, I noticed a huge advert for a new Mercedes sports car with the slogan “Warning: May increase serotonin levels” emblazoned across it.

Presumably they’re relying on the ‘antidepressant boosts serotonin’ angle without realising that SSRIs more reliably produce sexual dysfunction than happiness.

I like to think that a bit of their unconscious was shining through.

Link to Al’s Brain website with video and merchandise (via @mocost).

I’ve hidden the drugs inside this political football

The BBC World Service broadcast an interesting programme on the effect of Portugal’s 2001 policy to decriminalise all illicit drugs, from cannabis to heroin. Far from what you might expect from your local politician, the effect was rather positive. As also recounted in a recent article for Time magazine, drug use has actually dropped.

Recreational drugs are a fascinating area precisely because the political view and the health view are so completely out of whack in most countries.

As we have reported several times in the past, the UK has a regular public ritual where the government commissions a panel of scientists to report on the health dangers of drugs, and then completely ignores them when they point out that the current policies make no sense and don’t reflect the actual impact of the substances.

This week’s Bad Science column has another example, where a now leaked 1991 World Health Organisation report [pdf] on the impact of cocaine was suppressed by the US government because it pointed out that it’s not as intrinsically poisonous to health or society as it’s made out by drug war propaganda.

This political double book-keeping is probably why the severity of drug laws around the world have virtually no relation to the drug use of the population.

I’m morbidly curious about how we’ve arrived at this odd situation where one of the culturally universal human activities, modifying our consciousness with drugs, must be looked down on publicly to the point where our politicians are free to ignore evidence when it suits them.

It’s a conspiracy of ignorance that would be unthinkable if it was applied to swine flu but perfectly acceptable for something that already kills thousands upon thousands of people every year.

Link to BBC World Service on Portugal drug decriminalisation.
Link to Time ‘Drugs in Portugal: Did Decriminalization Work?’
Link to Bad Science on suppressed WHO cocaine report.

2009-06-12 Spike activity

A slightly belated selection of quick links from the past week in mind and brain news:

If you’re a mental health professional from a low or middle income country you can apply for a grant to attend the Global Mental Health Summit happening this September in Greece. Applications need to be in by June 20th.

The mood we are in affects the way we see things by modulating the activity of the visual cortex, according to a new study expertly covered by Neurophilosophy.

Discover Magazine has a brief look at some EEG kit that aims to integrate both electrical activity from the brain with human action recording.

Altruism may have resulted from a form of natural selection caused by a state of near-continual warfare, according to a study covered by the Independent. Hang on, isn’t that the plot of 1984?

Time magazine has an article on complexity theory that doesn’t seem to have a punchline as such but is an interesting tour through various studies that can be understood on various level of explanation.

Ignore the title and skip the first line and the Boston Globe has an interesting article on the use of transcranial magnetic stimulation to study the neuropsychology of autism. The ‘testing reflexes’ bit is a minor part of it.

New Scientist covers a study that finds we prefer advice from a confident source, even when the person has a poor track record.

This is an absolutely fascinating study covered by the BPS Research Digest. We seem to have a ‘blind spot’ for our own body language.

The New York Times has an brief piece on how new guidelines on whether young athletes should return to play after a concussion are causing controversy.

Anthropology in crisis – what, still? The excellent Culture and Cognition blog looks at why anthropology is still a contested field.

New Scientist covers a wonderfully elegant study on what causes ‘tip-of-the-tongue’ just can’t remember that word experiences.

The excellent Channel N mind and brain video blog has moved. Update your bookmarks!

Neuronarrative covers some interesting research on how fictional depictions of organ donations on medical dramas affect whether people want to sign up for this life saving option.

The work of a burqa wearing Islamic <a href="http://www.nytimes.com/2009/06/06/world/middleeast/06dubai.html?_r=1&hp=&pagewanted=all
“>sex therapist who practices in Dubai is covered by The New York Times.

Furious Seasons covers a new study on how antidepressant paroxetine (Serpxat / Paxil) is linked to sperm damage in some men.

An excellent piece by an epilepsy doctor and researcher asking for a better understanding of the seizure disorder is on the BBC News site.

Wired Science reports that the Pentagon are investigating pills for PTSD prevention.

Time moves too slowly for hyperactive boys, reports New Scientist. Don’t I just know it.

The excellent philosophy of mind blog Brain Hammer has moved. Update your bookmarks!

Another big name psychiatrist gets in hot water for undeclared payments from Big Pharma. The Wall Street Journal blog has the story.

Search Magazine has an article on the neuroscience of forgiveness. It misses a study on exactly this that recently appeared in Neuropsychologia.

Excessive use of “neuro” in a book title: Neuropsychological Neurology: Neurocognitive Impairments of Neurological Disorders (thanks @sarcastic_f!)

Evidence for Freudian projection inadvertently found in a study of whether dogs can have a guilty expression or not – turns out, owners just perceive the expression when they think the dog has done something wrong but the canine face doesn’t change. BBC News is on the case.

Not Exactly Rocket Science finds an intriguing study showing that five-month-old babies prefer their own languages and shun foreign accents.

There’s a review of an interesting-looking new book and ethnographic study on heroin injectors and crack smokers on the streets of San Francisco over at Neuroanthropology.

Language as a looking glass

Edge has a fantastic essay on how the language we speak can affect how we experience and think about the world.

The piece is by psychologist Lera Boroditsky whose work has shown that the not only are there differences across people with different mother tongues, but that asking people to use different words can affect their perceptions.

Boroditsky’s article is full of fascinating snippets about how language structure enforces a different mental set on the speaker.

For example, she notes that in Russian you need to change verbs to indicate whether the action was completed or not (when someone read a book, did they finish the book or just manage part of it). In Turkish verbs indicate whether you saw the thing yourself or whether you’re describing what someone else has told you.

But one of the most vivid examples is from the language of a small Aboriginal community in Australia:

Follow me to Pormpuraaw, a small Aboriginal community on the western edge of Cape York, in northern Australia. I came here because of the way the locals, the Kuuk Thaayorre, talk about space. Instead of words like “right,” “left,” “forward,” and “back,” which, as commonly used in English, define space relative to an observer, the Kuuk Thaayorre, like many other Aboriginal groups, use cardinal-direction terms ‚Äî north, south, east, and west ‚Äî to define space.

This is done at all scales, which means you have to say things like “There’s an ant on your southeast leg” or “Move the cup to the north northwest a little bit.” One obvious consequence of speaking such a language is that you have to stay oriented at all times, or else you cannot speak properly…

The result is a profound difference in navigational ability and spatial knowledge between speakers of languages that rely primarily on absolute reference frames (like Kuuk Thaayorre) and languages that rely on relative reference frames (like English).

Simply put, speakers of languages like Kuuk Thaayorre are much better than English speakers at staying oriented and keeping track of where they are, even in unfamiliar landscapes or inside unfamiliar buildings. What enables them ‚Äî in fact, forces them ‚Äî to do this is their language. Having their attention trained in this way equips them to perform navigational feats once thought beyond human capabilities.

This research is interesting because it relates to the much maligned Sapir-Whorf hypothesis that claims that language shapes how we experience the world.

When I was a student this theory wheeled out in psycholinguistics classes to show how naive we used to be. I’m no expert on psycholinguistics, but I suspect that this was due to the dominance of Noam Chomsky’s idea that all languages are based on an underlying universal grammar, implying that, fundamentally, we all think about things in broadly similar ways. Jerry Fodor’s language of thought hypothesis might also have been a culprit.

What ever the cause, the effect of language on perception and understanding was neglected for many years and only recently have some of these interesting effects come to light through the work of people like Boroditsky.

Link to ‘How does language shape the way we think?’

Beautiful otherness

New Scientist has a gallery of artwork by savant artists, people who show exceptional artistic talents despite having impaired mental abilities in other areas.

Savantism is typically associated with autism to the point where many people assume that having a stand-out exceptional ability is present in everyone with the diagnosis.

This is not the case and although many people with autism-spectrum conditions will have a special interest, only about 10% will have what autism researchers Francesca Happ√© and Uta Frith call ‘the beautiful otherness of the autistic mind’.

Perhaps the most famous artist with autism is Stephen Wiltshire who can create stunningly vivid landscape paintings from a barely more than a single glance.

However, my favourite such artist is Jessica Park who paints the most striking paintings of buildings and architectural features but in the most inventively colourful way.

The New Scientist gallery is interesting take on the area as each picture has been selected to illustrate something about the psychology of savant abilities.

Link to New Sci ‘Savant art: A window into exceptional minds’.
Link to excellent Happ√© and Frith article on savantism.

Television tunnel vision

This week’s Nature has a feature article on how visual motion media impacts on young children. It’s an interesting article because it focuses largely on television.

This is notable for two reasons: the first is that numerous research studies have found that, as a generalisation, watching television negatively impacts on children’s concentration, increases the risk of obesity and interferes with play and communication. The second is that this rarely makes the headlines.

Despite studies appearing regularly in the medical literature, it simply isn’t fashionable to panic about television – that’s so last century.

In contrast, evidence-free panicking about computers or the internet gets broadcast across the world, because it’s something new to panic about, and that’s what the media does best.

It’s not all bad news about television and children though. There’s some evidence that it increases imaginative play and broadens knowledge.

You also may be interested to know that Sesame Street was developed with psychologists to specifically help children improve social attitudes and increase numeracy and literacy.

The programme has been carefully and scientifically evaluated, tweaked and re-evaluated and many of the studies appear in the academic literature. It was the first and most successful evidence-based children’s programme.

Link to Nature article ‘Media research: The black box’.

Brain Storm Rag

From 1907, the front cover from sheet music for a ragtime tune called Brain Storm Rag, from way before it was cool to label everything as being related to neuroscience in some way.

If you’re musically inclined you can also download the full publication as a PDF, musical notation included, to play at your leisure.

If you’d like to record it and upload it to the net, do let us know and we’ll happily link to it as I’d love to find out what is sounds like.

Link to Brain Storm Rag online version.

A night at the opera

The International Journal of Geriatric Psychiatry has a brief case report of a man who began hallucinating whole operas that would start every evening shortly after sunset.

A 74-year-old retired mathematician had to undergo emergency surgery due to an ischemic perforation of the colon. Three days after the operation, he began to suffer from near complete insomnia and mentioned only briefly that ‚Äòthis monkey music‚Äô kept him awake. His condition deteriorated and 5 days later he admitted, that he heard complete operas at night from the very first to the last chord, ‚Äòand you know how long these operas are‚Äô.

He could not offer any explanation as to where these sounds came from, could not distance himself from his elaborate musical perceptions, had no means of interrupting them, and feared the first notes of another overture (which reliably rang out soon after sunset).

On examination during daytime he appeared tired and irritable, rather uncooperative with poor concentration, but without overt evidence of a severe confusional state. His medical history was inconspicuous, but it became obvious that he was a dedicated opera-lover with a profound musical expertise, which he had acquired over decades of studying scores and librettos in every detail.

Link to PubMed entry for case report (via @sarcastic_f).