vaughanbell

Paranoia espresso

A case study just out in CNS Spectrums describes an apparent case of ‘caffeine-induced psychosis’. The summary is below although the full paper is available online as a pdf.

If you’re a regular coffee drinker, I don’t think you should worry though. It’s impossible to say whether caffeine was the definite cause in this case, and the gentleman concerned was drinking about 36 cups of coffee a day.

Caffeine-induced psychosis

Hedges DW, Woon FL, Hoopes SP.

As a competitive adenosine antagonist, caffeine affects dopamine transmission and has been reported to worsen psychosis in people with schizophrenia and to cause psychosis in otherwise healthy people. We report of case of apparent chronic caffeine-induced psychosis characterized by delusions and paranoia in a 47-year-old man with high caffeine intake. The psychosis resolved within 7 weeks after lowering caffeine intake without use of antipsychotic medication. Clinicians might consider the possibility of caffeinism when evaluating chronic psychosis.

pdf of full-text article.
Link to PubMed entry for same.

Sweden bound for Scandinavian cognitive science

Apologies if updates are a little sporadic over the next couple of days as I’ve been kindly invited to speak at KVIT 2009 in Sweden, which is the only cognitive science conference I know of that has an accompanying music video.

It looks like it should be a fantastic few days and it’s my first time in Scandinavia, let alone Sweden, so I look forward to meeting some of their many talented mind and brain scientists.

If I manage to get some internet access, I’ll try and get some updates online.

Link to KVIT 2009.

100 years of attitude

I’ve just noticed an excellent article in the Times about Rita Levi-Montalcini, the Nobel prizewinning neurologist who’s still working at 100.

Levi-Montalcini won the Nobel in 1986 for her discovery of brain-derived neurotrophic factor (BDNF), a protein that helps control when and where brain cells grow.

Fiercely independent, she’s escaped fascist regimes, anti-semitism and the bombing of Turin, where she continued her work by setting up a laboratory in a country cottage.

Do the workings of the brain still hold mysteries? ‚ÄúNo, it is much less mysterious. We have the most amazing scientific and technological advances. We have been able to see how the brain does work. And now discoveries are being made by by anatomists and physiologists or experts in behavioural science, physicists and mathematicians, computer experts, biochemists, and molecular scientists. The barriers are breaking down between disciplines. At 100 years of age I am still making discoveries about the factor that I myself discovered more than half a century ago.‚Äù

Despite her neurobiological nous, cognitive neuroscience is obviously not her strong point as she does spout some nonsense about brain hemispheres in a few places though, like “The important thing is to have lived with serenity using the rational left-hand side of one’s brain, and not the right side, the instinctive side, which leads to misery and tragedy.”

Or the backside, which leads to… oh forget it.

Link to the Times on Rita Levi-Montalcini.

The hunting of the SNARC

Cognitive Daily has an excellent article on the fascinating SNARC effect, where we react quicker to numbers with the hand that most approximates their position in space as if they were written out in front of us.

In other words, people react faster with their left hand for small numbers, and faster with their right hand for big numbers. This suggest that our number concepts are mapped partly mapped out in space.

Of course, this has largely been tested on English readers, who all read left to right, but Cognitive Daily reports on some new research that tested Arabic readers, for whom larger numbers would be on the left, and found that they show show the same effect, but in reverse.

Finally, the study investigated the effect on Israeli students, who know both left-right and right-left texts, as they learn both English and Arabic, and found that the effect didn’t appear.

In case you’re wondering, SNARC stands for the rather unwieldy phrase ‘spatial numerical association of response codes’.

While we’re on the subject of the excellent Cognitive Daily blog, you may be interested to know that they’ve started a new in-depth feature called ‘Cognitive Monthly‘ which you can download to your computer, iPhone or Kindle reader for $2.

They kindly sent me a free copy of the first edition, on the psychology of film and theatre, and I can heartily recommend it as excellent.

Link to post on culture and the SNARC effect.
Link to Cognitive Monthly details.

Mad pride of place

Newsweek has a good article on the ‘Mad Pride’ movement in the US, a British import where those diagnosed with mental illness reject the medical view of their experiences and decide to live with ‘extreme mental states’ both good and bad.

It makes a good complement to last year’s New York Times article on ‘mad pride’ although this focuses on the impressive The Icarus Project, a group of activists who campaign for mental health reform and work to support those who decide to forego psychiatric treatment.

After all, aren’t we all more odd than we are normal? And aren’t so many of us one bad experience away from a mental-health diagnosis that could potentially limit us? Aren’t “normal” minds now struggling with questions of competence, consistency or sincerity? Icarus is likewise asking why we are so keen to correct every little deficit‚Äîit argues that we instead need to embrace the range of human existence.

While some critics might view Icaristas as irresponsible, their skepticism about drugs isn’t entirely unfounded. Lately, a number of antipsychotic drugs have been found to cause some troubling side effects.

There are, of course, questions as to whether mad pride and Icarus have gone too far. While to his knowledge no members have gravely harmed themselves (or others), Hall acknowledges that not everyone can handle the Icarus approach. “People can go too fast and get too excited about not using medication, and we warn people against throwing their meds away, being too ambitious and doing it alone,” he says.

Link to Newsweek article ‘Listening to Madness’.

Help, I’m a prisoner in a brain fiction factory

The Sunday Times has one of the most gullible neuroscience articles I’ve read in a very long time. While most mainstream press articles are happy to make a hash of one study at a time, this manages to misinterpret virtually every headline-grabbing neuroscience experiment from the last couple of years.

The article claims that neuroscience is much more advanced than we realise and sets out to demonstrate this by over-interpreting recent discoveries, padding the article with false information, and using fallacies to discuss the implications.

It’s full of howlers:

Then, in the 1980s, a range of new technologies began to emerge, including positron emission tomography (Pet) computerised axial tomography (Cat) and, perhaps the best known, functional magnetic resonance imaging (fMRI).

PET was invented in the late 1960s / early 1970s, CAT was invented at virtually the same time, and fMRI was invented in the 1990s.

In a simplistic example, a scientist might show a picture of a scantily-clad woman to a man, and then see the parts of the brain associated with sex and lust lighting up as they consumed more oxygen. Meanwhile, the areas linked to reasoning and morality might go dark as they rapidly shut down.

I’m not sure whether “simplistic example” is a malapropism, a Freudian slip, or a grim admission of the the nonsense to come. Not only is the description of the technique completely misleading (all functional scans are comparisons between different situations, not just a measure of one reaction) but the example is completely bizarre.

The piece then goes on to suggest that neuromarketing gives a better idea how to market products (not one example to date), that brain scanning is a form of advanced lie detection (so advanced it doesn’t work very well) and that studies on the neuroscience of criminal behaviour (like writing crap brain articles) “suggest it could be wrong to hold such people responsible for their actions” (you wish).

I can’t face going through the rest of the examples because I keep weeping over my computer, but look out for the ‘this complex human attribute = this one brain area’ drivel, a profound confusion where brain activation is used to justify a behavioural or psychological conclusion, and the invention of the term “brainjacking” which is reported as if it’s already used.

I also noted that one of the quotes has just been lifted from other news reports.

Perhaps its only redeeming feature is that it could be a useful teaching aid if you’re giving a class on how neuroscience gets misrepresented in the media because it has at least virtually every type of slip-up in one handy place.

Link to ropey Sunday Times article.

Art and mental illness at the birth of modern psychiatry

If you’re in London before the end of June, make sure you drop into the Wellcome Collection museum which has two fantastic free exhibitions on the art and history of mental illness. If you can’t make it, the exhibition website is excellent and has video and images from the shows.

The first exhibition, Madness and Modernity, explores mental illness and the visual arts in Vienna in 1900, then the epicentre of the medical world.

Modern psychiatry was beginning to emerge and the ‘mad doctors’ employed some of Europe’s most pioneering architects to create asylums that were intended to be therapeutic by their very design.

For example, this poster is for one of the newly developed asylums of the time, as well as being beautiful in itself. The image to the right is the somewhat more intimidating ‘Tower of Fools’.

Also the use of art as a tool to document and disseminate ideas about mental illness became popular, as did an interest in the ‘art of the insane’.

There’s a video on the site which is a wonderful summary of the exhibition as well as being a great standalone discussion of how art and psychiatry influenced each other in the heady culture of 1900s Vienna.

The other exhibition is a series of diary paintings made by artist Bobby Baker from 1997-2008, as she charted her experience of mental illness and treatment. They’re only really done justice when seen as larger pictures, and the online gallery will give you a feel for their impact and humour.

A couple of things you can’t get online are the free events that accompany the exhibitions, which sadly seem all booked up, and the bookshop, which has a special section where they’ve collected (curated?) a great collection of books on almost everything to do with madness, the mind, art and history.

If you’re just visiting the website, you may need to do a bit of clicking around to see the best of the online material, but it’s well worth the visit. Watch the video if nothing else.

Link to Wellcome Collection Art and Mental Illness website.

Full Disclosure: I’m an occasional grant reviewer for the Wellcome Arts scheme, but I’m not associated with this exhibition in any way.

Tell me about your mother superior

I found this fascinating aside in a 1969 article on ‘Psychiatric Illness in the Clergy’ about a group of monks who underwent psychoanalysis, causing two thirds of them to realise they were “called to married life”.

The Pope immediately banned psychoanalysis from the priesthood as a result:

[Bovet] suggests that many clergy would benefit from psychotherapy during their training. This was attempted in Mexico when in 1961 a group of 60 Benedictine monks underwent group and individual psychoanalysis. However, of the original 60 monks taking part in this experiment, only 20 are still monks ; and of the 40 who have left the monastery it is reported that “there are some who realized that they were really called to married life” (Lemercier, 1965).

The Papal Court answered this “threat” the following decree: “You will not maintain in public or in private psychoanalytical theory or practice, under threat of suspension as a priest, and you are rigorously forbidden under threat of destitution to suggest to candidates for the monastery that they should undergo psychoanalysis” (Singleton, 1967).

This would not be the last time psychotherapists cause stirrings in the faithful.

The book Lesbian Nuns, Breaking Silence contains a chapter by the former Sister Mary Benjamin of the Immaculate Heart of Mary convent in California.

Psychotherapists Carl Rogers and William Coulson arranged for the nuns to take part in encounter group, essentially a form of fashionable 60s group psychotherapy aimed at well people rather than patients for ‘personal growth’.

The effect was disastrous for the convent, with hundreds of the nuns defaulting on their vows, and several, including Sister Mary Benjamin, discovering repressed lesbian desires.

The convent eventually collapsed and was closed in 1970.

There’s a brief online article that also recounts this story and I was intrigued to see a footnote at the end:

Having abandoned his once lucrative career, Dr. William Coulson now lectures to Catholic and Protestant groups on the dangers of psychotherapy, with a particular emphasis upon the “encounter group” dynamic.

There’s a whole novel right there in that footnote.

Link to summary of ‘Psychiatric Illness in the Clergy’.
Link to online article about Dr William Coulson.

Between a rock and a kind face

Newsweek has an article on human good and evil that trots out the usual Milgram-fuelled moral pondering before morphing into a fascinating piece on the psychology of compassion.

The most interesting part is where it discusses which psychological traits predict compassionate behaviour:

A specific cluster of emotional traits seem to go along with compassion. People who are emotionally secure, who view life’s problems as manageable and who feel safe and protected tend to show the greatest empathy for strangers and to act altruistically and compassionately.

In contrast, people who are anxious about their own worth and competence, who avoid close relationships or are clingy in those they have tend to be less altruistic and less generous, psychologists Philip Shaver of the University of California, Davis, and Mario Mikulincer of Bar-Ilan University in Israel have found in a series of experiments. Such people are less likely to care for the elderly, for instance, or to donate blood.

The Newsweek article labels these characteristics ’emotional traits’ but the researchers are actually using the psychological concept of attachment – an approach to relationships and human interaction style that can be seen throughout the lifespan.

The same research team has completed studies showing that increasing people’s perceived security increases altruistic behaviour.

Link to Newsweek on ‘Adventures In Good And Evil’.

2009-05-01 Spike activity

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

Wired has a great piece on illusionist Teller and how stage magic could help cognitive science.

Some fascinating research on the use of video to give insight to brain injured patients unaware of their own paralysis is covered by BPS Research Digest.

The Journal of Neurology, Neurosurgery, and Psychiatry has a case report on restless legs syndrome affecting a phantom limb.

The curious link between the urban environment and schizophrenia is explored by Frontier Psychiatrist.

Channel N finds a video lecture on mental illness and creativity by Kay Redfield Jamison.

Funny or offensive? Probably both. The Onion has a satirical news report on World’s Oldest Neurosurgeon Turns 100.

BoingBoing finds an usual vintage comic book series entitled ‘The Strange World of your Dreams‘.

In 2001, all illicit drugs were decriminalised for personal use in Portugal. Time magazine investigates what happened, it turns out drug use has fallen.

The New York Times has an extended article on the meeting of Zen Buddhism and Freudian psychoanalysis.

A wonderful neurophilosophical quote from Melville’s Moby Dick is captured by Brain Hammer.

Cognition and Culture reviews new book ‘The Art Instinct’.

Do ‘brain training‘ games really work? asks ScAim. The answer, a bit.

PsyBlog has an excellent post on the psychology of consumption.

The media creates concept of media psychologists, encourages them to be unethical, then acts amazed when they are, says Dr Petra.

Wired talks to psychologist Craig Haney about the mental impact of solitary confinement.

Important new research on the genetics of autism spectrum is covered by Not Exactly Rocket Science.

BBC News reports on musician Prince discussing his childhood epilepsy and how he revealed it in a coded message on The Love Symbol Album.

Lithium levels in drinking water linked to fewer suicides

Higher levels of naturally occurring lithium in the water supply are associated with fewer suicides in the local population, reports a study just published in The British Journal of Psychiatry.

Lithium is one of the fundamental elements, but is also used by psychiatrists as one the most effective drug treatment for mood disorders, in the form of lithium carbonate and lithium citrate, where it is also known to reduce the risk of suicide.

This new study suggests that even trace amounts might have an influence on the whole population level, and this is not the first time this link has been made.

A 1990 study found higher levels of lithium in drinking water were linked to fewer incidences of crimes, suicides, and arrests related to drug addictions.

This leads to the intriguing question of whether lithium should be added to the water supply as a public health measure.

The idea of adding psychoactive substances to the water supply sounds creepy, but some might argue that if we add fluoride simply to prevent tooth decay, boosting lithium concentrations to the high end of naturally occurring levels to reduce deaths could be justified.

Philosophers and conspiracy theorists start your engines.

Link to BJP lithium study.
Link to DOI entry for same.

Extreme altitude climbs and the Sherpa brain

It’s now well known that high altitude mountain climbing damages the brain and causes a marked reduction in mental functioning.

I naively assumed this was true for everyone but I just found an intriguing 1996 study that compared brain function of lowland mountain climbers and Nepalese Sherpas after ascent to high altitude, which found that the Sherpas suffer few of these neurological problems.

Are Himalayan Sherpas better protected against brain damage associated with extreme altitude climbs?

Garrido E, Segura R, Capdevila A, Pujol J, Javierre C, Ventura JL.

Clin Sci (Lond). 1996 Jan;90(1):81-5.

1. The potential risk of brain damage when low-landers attempt to climb the highest summits is a well-known fact. However, very little is known about what occurs to Himalayan natives, perfectly adapted to high altitude, when performing the same type of activity.

2. Taking into account their long-life climbing experience at extreme altitudes, we examined seven of the most recognized Sherpas with the aim of performing a comprehensive neurological evaluation based on medical history, physical examination and magnetic resonance brain imaging. We compared them with one group of 21 lowland elite climbers who had ascended to altitudes of over 8000 m, and another control group of 21 healthy individuals who had never been exposed to high altitude.

3. While all of the lowland climbers presented psychoneurological symptoms during or after the expeditions, and 13 of them (61%) showed magnetic resonance abnormalities (signs of mild cortical atrophy and/or periventricular high-intensity signal areas in the white matter), only one Sherpa (14%) showed similar changes in the scans, presenting neurological symptoms at extreme altitude. The neurological examination was normal in all three groups, and no neuroimaging abnormalities were detected in the control group.

4. The significant differences, in both clinical and neuroimaging terms, suggest that Sherpa highlanders have better brain protection when exposed to extreme altitude. Although the key to protection against cerebral hypoxia cannot be established, it is possible that an increase in the usually short period of acclimatization could minimize brain damage in those low-landers who attempt the highest summits without supplementary oxygen.

Link to study of neurology of lowland climbers and Sherpas.

NeuroPod oscilates 100 year-old autistic robots

The latest edition of Nature’s excellent neuroscience podcast NeuroPod has just the wires and discusses using light to control the brain, a quite remarkable breakthrough in the genetics of autism, emotional robots and neurologist Rita Levi-Montalcini, the first Nobel prizewinner to turn 100.

The highlight is probably the section about Rita Levi-Montalcini who jointly won the Nobel prize for her discovery of nerve growth factor, a protein that is known to be key in neuroplasticity.

Although actually, it’s one of the most interesting and varied NeuroPod’s I’ve heard in a while, which is saying something for a programme which is usually on top form. Enjoy.

Link to NeuroPod page with streaming and download.
mp3 of April edition.

Blast from the past

New Scientist covers the debate on the causes of the non-specific emotional and cognitive symptoms that are appearing at an alarming rate in US soldiers who have been caught up in blasts while on service.

The controversy centres on whether the symptoms of ‘post concussional syndrome’ (which can include depression, irritability, concentration difficulties, headaches and reduced memory function) are caused by damage to the brain or from shock waves of the explosion, or are largely triggered by an emotional reaction to the stress of war.

It’s an interesting debate, not least because it’s almost 100 years since almost exactly the same debate raged over shell shock.

This is from an excellent article by medical historian Edgar Jones and colleagues who discuss the similarities between the ‘shell shock’ debates, and the current controversy:

Frederick Mott, then Britain‚Äôs leading neuropathologist, who was recruited by the War Office to discover the etiology of the disorder, argued that in extreme cases shell shock could be fatal if intense commotion affected “the delicate colloidal structures of the living tissues of the brain and spinal cord,” arresting “the functions of the vital centers in the medulla”. It was also speculated that the disorder resulted from damage to the CNS from carbon monoxide released by the partial detonation of a shell or mortar. In other words, shell shock was formulated as an organic problem even though the pathology remained unclear.

However, research conducted in 1915 and 1916 by Myers, consultant psychologist to the British Expeditionary Force, led to a new hypothesis. Based on his own observations, an increasing appreciation of the stress of trench warfare, and the finding that many shell-shocked soldiers had been nowhere near an explosion but had identical symptoms to those who had, Myers suggested a psychological explanation. For these cases, the term “emotional,” rather than “commotional,” shock was proposed. The psychological explanation gained ground over the neurological in part because it offered the British Army an opportunity to return shell-shocked soldiers to active duty.

As mentioned by the NewSci two big studies have recently found strikingly similar results: many soldier who have the symptoms of ‘post concussional syndrome’ were never actually in an explosion.

Extreme stress and trauma, of whatever type, seems to predict the likelihood of someone having the symptoms better than actually being caught up in an explosion.

The more things change, the more they stay the same.

Link to NewSci ‘Brain shock: The new Gulf War syndrome’.
Link to ‘Shell Shock and Mild Traumatic Brain Injury: A Historical Review’.

Voodoo II: this time it isn’t personal

More analysis problems with brain scanning research have come to light in a new study just released in Nature Neuroscience and expertly covered by the BPS Research Digest. It demonstrates that the common practice of using the same data set to identify an area of interest and then home in on this area to test further ideas can lead to misleading results.

This usually occurs when brain activation is compared between two conditions where participants are doing different tasks. A whole brain analysis looks for statistically significant differences at every point in the brain.

It’s very complete, but because of the large amount of data, but the data also contains a large amount of noise, so it’s hard to find areas which you can confidently say are more active in one condition than the other.

An alternative approach is to only look at activation in one area of the brain, perhaps an area where it is most likely to occur based on what we already know about how the brain works. This is called region of interest analysis (often done with the wonderfully named ‘MarsBaR‘ tool) and because the data set is much smaller, it is more likely to find a reliable difference.

However, some studies do a whole brain analysis to find likely areas, and then home in using region of analysis tools to examine them ‘more closely’. This ‘magnifying glass’ metaphor seems intuitive, but because your using the same data set to create and test hypothesis, it can be problematic.

It’s like shooting arrows randomly into a wall and then drawing a target around ones which landed together. Someone looking at wall afterwards might think the archer was a good shot, but this impression is caused by the after-the-event painting of the target, and the same problem could affect these brain imaging studies.

After the recent furore over the ‘voodoo correlations’ study, this new study is markedly more measured in its language and doesn’t list individual offenders.

Indeed, the ‘Voodoo Correlations in Social Neuroscience’ paper was actually retitled on publication to ‘Puzzlingly high correlations in fMRI studies of emotion, personality, and social cognition’, presumably to avoid stirring the pot any further.

However, this new study takes a similar tack, demonstrating through several careful simulations that ‘double dipping’ a data set is likely to distort the results just due to statistical problems.

From the BPS Research Digest:

Nikolaus Kriegeskorte and colleagues analysed all the fMRI studies published in Nature, Science, Nature Neuroscience, Neuron and Journal of Neuroscience, in 2008, and found that 42 per cent of these 134 papers were guilty of performing at least one non-independent selective analysis – what Kriegeskorte’s team dub “double dipping”.

This is the procedure, also condemned by the Voodoo paper, in which researchers first perform an all-over analysis to find a brain region(s) that responds to the condition of interest, before going on to test their hypothesis on data collected in just that brain region. The cardinal sin is that the same data are used in both stages.

A similarly flawed approach can be seen in brain imaging studies that claim to be able to discern a presented stimulus from patterns of activity recorded in a given brain area. These are the kind of studies that lead to “mind reading” headlines in the popular press. In this case, the alleged statistical crime is to use the same data for the training phase of pattern extraction and the subsequent hypothesis testing phase.

Link to BPS Research Digest on the fMRI analysis problems.
Link to PubMed entry for study.

Stylish psychotherapy magazine launches

Contemporary Psychotherapy is a new magazine dedicated to the practice of psychological treatment of all types and the current debates in this sometimes hotly contested field.

The first issue contains articles on the future of psychotherapy, CBT in North America, how psychiatrists deal with somatic or psychogenic symptoms and the challenges in conducting psychotherapy with asylum seekers, to name but a few.

It makes a good complement to the US-based Psychotherapy Networker magazine, it’s stylishly put together, you can download it for free as a PDF file, and long may it continue as it’s off to a brilliant start.

Link to Contemporary Psychotherapy with PDF download.