Author: vaughanbell

Bling of the hill

The Atlantic magazine has an interesting article on how conspicuous consumption – the practice of showing off luxury goods – differs across social groups and seems to be more common when your peers are low earners.

The piece discusses work led by economist Kerwin Charles who was interested in why, despite being less well off on average, black and latino Americans spent a larger proportion of their income on visible goods.

Their research found that race, in itself, wasn’t important, as conspicuous consumption was explained in all racial groups as being almost entirely due to the wealth of the community in which the person lives.

It turns out that the poorer the community, the larger the level of conspicuous consumption. In other words, people from less well off communities have a greater need to advertise their wealth through the visible goods they buy.

The full paper is available online as a pdf if you want the full details, but the Atlantic article goes on to observe that in higher-income communities people tend to spend their money on luxury goods others can’t see, but which provide experiences.

Russ Alan Prince and Lewis Schiff describe a similar pattern in their book, The Middle-Class Millionaire, which analyzes the spending habits of the 8.4million American households whose wealth is self-made and whose net worth, including their home equity, is between $1 million and $10 million. Aside from a penchant for fancy cars, these millionaires devote their luxury dollars mostly to goods and services outsiders can’t see: concierge health care, home renovations, all sorts of personal coaches, and expensive family vacations. They focus less on impressing strangers and more on family- and self-improvement. Even when they invest in traditional luxuries like second homes, jets, or yachts, they prefer fractional ownership. “They’re looking for ownership to be converted into a relationship rather than an asset they have to take care of,” says Schiff. Their primary luxuries are time and attention.

Based on nothing but complete speculation, I wonder whether this simply provides a form of consumption which is conspicuous through other means – conversation or public display of action.

A study published last year (and covered by the Economist) found that priming people with ideas about attracting members of the opposite sex did trigger conspicuous consumption, at least in men, but also resulted in conspicuous altruism.

Perhaps a more subtle form of economic signalling, but with a similar intent – to display our status to others.

 
Link to Atlantic article ‘Inconspicuous Consumption’.
pdf of full text of study.
Link to Economist article on ‘conspicuous altruism’.

Northern Ireland health chief, homosexuality an illness

Homosexuality is a mental illness, at least according to the head of Northern Ireland’s health committee. Iris Robinson MP, who, with impeccable timing, put forth her views on a radio show while responding to the news that a local man had been badly beaten in a homophobic attack.

After apparently branding homosexuality as “disgusting, loathsome, nauseating, wicked and vile” she went on to recommend that “I have a very lovely psychiatrist who works with me in my offices and his Christian background is that he tries to help homosexuals – trying to turn away from what they are engaged in”.

The “lovely psychiatrist” turns out to be Paul Miller who doesn’t actually seem to defend the idea that homosexuality is a mental illness but does seem to have a sideline in assisting people to change their sexual orientation.

In a recent newspaper article Miller claims this is based on research:

Dr Miller cited a study by American psychiatrists Stanton Jones and Mark Yarhouse which he said concluded that people can change sexual orientation and that the process of change was not damaging.

“That was a very robust study because in the past, and rightly so, people who worked in this field were criticised for not having robust research.”

So what is this research Miller talks about? A randomised controlled trial from the peer-review medical literature? A meta-analysis of past treatment programmes? Perhaps just an exploratory outcome study?

No, it’s a book released by a Christian publisher and written by a psychologist and psychiatrist employed by a private evangelical college in the States.

In a subsequent BBC interview on her comments, Mrs Robinson well, just keeps on digging.

For those of you interested in the new fangled practice of ‘evidence based medicine’ that seems not to have caught up with Iris Robinson, one of the most influential studies on the mental health of homosexuals was published in 1957.

Conducted by psychologist Evelyn Hooker, it used several measures to profile a group of homosexual and heterosexual males and asked a number of psychiatrists to determine who was gay and straight just by looking at the data from the mental health assessments.

They couldn’t, and two thirds of both of gay and straight samples were rated as well-adjusted. This was the first of many studies that showed that there is nothing innately psychopathological about homosexuality.

Link to Petra Boyton with some good coverage.
Link to full text of Evelyn Hooker’s 1957 study.

Best visual illusion of the year announced

Mixing Memory has alerted me to the fact that the winner of the Best Visual Illusion of the Year Contest has been announced, and what a fantastic illusion it is.

It’s an animated one, so you need to go to the page and stare at the dot in the centre for 20-30 seconds.

The creators of the winning illusion, psychologists Rob van Lier and Mark Vergeer, have put up a pdf with their explanation of the effect.

And if you’re still illusion hungry after that, you can check out the rest of the finalists that came in the top 10.

On a related note, Scientific American have recently released one of their ‘special editions’ that collects V.R Ramachandran and Diane Rogers Ramachandran’s monthly articles on illusions into one magazine. I got mine from a newsagent but you can also purchase it as a DRM-free pdf online for $4.95.

Link to Top 10 2008 contest winners.
Link to Mixing Memory’s take on the winner.

Culture shock

Neuroanthropology has an excellent article on how culture influences the experience of trauma, particularly in light of soldiers returning from Iraq and Afghanistan diagnosed with post-traumatic stress disorder.

We tend to think of trauma as being similar across cultures. Something awful happens, we have ‘trauma’. In actual fact, both the experience and expression of trauma are heavily culturally influenced.

The Neuroanthropology piece makes the point that what counts as traumatic differs between individuals because not all dangerous situations are perceived as traumatic whereas some have a deeply personal and disturbing effect.

The author is apparently doing research on US combat veterans and has noted a common element in his interviews:

The classic example of this, and a running theme in [non-commissioned officers’] trauma stories, occurs when a lower-ranking soldier is hurt while following orders to which the NCO personally objects. For example, one veteran told me about the day when one of ‚Äúhis‚Äù soldiers was wounded while following the unnecessarily risky orders of his superior, orders that he protested at the time but ultimately felt compelled to obey.

His story, and others like it, reveal that the trauma of these events lies not only in the wounding of a fellow soldier, but in the inability to protect a subordinate for whom one feels deeply responsible, and the sense that the damage might have been prevented. Thus the meaning of events creates much of their resonance, and their cultural embeddedness – e.g. in the communal socialization and strict power structures of the military – is partially responsible for the emotional overload that defines trauma.

The expression of trauma is also culturally influenced as can be seen in the differing presentation of combat stress in Western soldiers during the last 150 years.

During the American Civil War and the Boer War, most expressions of trauma took the form of heart troubles and were diagnosed as ‘soldier’s heart’, ‘effort syndrome’ or Da Costa’s syndrome.

However, it quickly became clear that the majority of affected soldiers had no physical problems with their hearts, and seemed to be expressing their psychological stresses as physical problems.

During these wars, trauma seemed most commonly expressed as problems with the autonomic system (heart function, breathing, blood pressure etc), while by the time the First World War came round, the expression seems to have largely shifted to problems with motor function and the senses.

Labelled ‘shell shock’, film footage shows that the effects were dramatic, but despite early theories of brain disturbance caused by ‘concussion’, no neurological damage could be detected in most cases.

The UK government quickly banned military psychiatrists from diagnosing ‘shell shock’, and as as World War Two approached combat stress was labelled as ‘psychoneurois’, ‘neuraesthenia’ and a number of other non-specific labels instead.

It wasn’t just the labels that changed though. Dramatic ‘shell shock’ presentations were rarely seen during the Second World War, with the effects of trauma more commonly resembling how we think of it today: intrusive memories, intense anxiety, disrupted sleep.

The Vietnam War was a turning point for the diagnosis of trauma, as veteran’s pressure groups, not unreasonably, wanted, medical care for psychological problems when they returned from service.

They successfully lobbied to have a new disorder included in the diagnostic manuals so the problems could be officially diagnosed and treatment funded. Originally called ‘post-Vietnam syndrome’ in the literature it was quickly renamed to post-traumatic stress disorder or PTSD for its official diagnosis.

For many people today, including clinicians, PTSD is trauma, but its construction owed as much to political expediency than cut-and-dry scientific evidence.

That’s not to say that traumatised people aren’t suffering or don’t exist, just that our ideas about trauma are fluid, malleable and culturally influenced.

Indeed, a recent review of the assumptions behind the definition of PTSD concluded that “virtually all core assumptions and hypothesized mechanisms lack compelling or consistent empirical support”.

When watching the debate unfold over trauma and mental health in the current wars, it’s possible to see some striking parallels in the push and shove of cultural influence.

In 1922 the UK government stopped doctors diagnosing ‘shell shock’ to reduce war pension costs. A recent leaked email from the US Veterans Administration advised doctors to avoid diagnosing PTSD to reduce disability payment costs.

World War One ‘shell shock’ was originally thought to arise from concussion from nearby explosions but was later attributed largely to trauma. Physical problems after mild traumatic brain injury in Iraq have been attributed to nearby explosions but are largely explained by depression and PTSD.

One of the most powerful things to come out of both a historical view and contemporary research is that our beliefs about how should trauma affect us, partly dictates how it does.

In other words, our bodies, beliefs and culture are bound together and when damaged, each contributes to how disability expresses itself.

Needless to say, with this much diversity from a relatively short space of time in similar Western cultures, the difference across cultures can be even more striking.

While being traumatised is a universal experience, the experience of trauma is not, and our expression of distress is a reflection of both our common humanity and our cultural diversity.

Link to Neuroanthropology on Cultural Aspects of PTSD.

2008-06-13 Spike activity

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

A fascinating personal account of ‘supposed demoniacal possession‘ from an 1849 edition of the Journal of Psychological Medicine.

‘Key to All Optical Illusions Discovered’ says over-enthusiastic headline for very interesting article.

An article in Seed Magazine discusses quantum physics and whether we create the world just by looking at it.

Dr Petra looks at new research showing that tackling depression may reduce risky sexual activity.

Six ground-breaking discoveries about the brain are covered by Neurophilosophy.

PsychCentral has a wonderful bit of detective work showing the Scientific American just replaced ‘writing’ with ‘blogging’ to re-release an article entitled ‘Blogging: It‚Äôs Good for You’.

Harvard psychiatrists and child bipolar researchers are caught out not declaring millions in drug company payouts, reports Furious Seasons.

BBC News reports that light therapy ‘can slow dementia’ and that a new ‘dual action’ Alzheimer’s drug may be on the horizon.

Which Cognitive Enhancers Really Work: Brain Training, Drugs, Vitamins, Meditation or Exercise? PsyBlog is on the case and Sharp Brains follows up with a considered analysis and commentary.

American Scientist tackles the ‘Britney Spears Problem’, which actually turns out to be about search algorithms.

Archaeologists discover a <a href="http://sciencenews.org/view/generic/id/32999/title/Acrobats_last_tumble
“>sacrificed acrobat in ancient Mesopotamian ruins, according to Science News.

Neurophilosophy looks at some proposed DARPA developed neurobinoculars.

A new study on the neuroscience of fairness is covered in a piece from the BPS Research Digest.

Eric Schwitzgebel considers the ability of the mind to self-perceive, with an interesting discussion continuing in the comments.

I love watching point-light motion video and Cognitive Daily has a fascinating research on how viewing motion give us such a clear way of identifying living things.

My Mind on Books previews a list of forthcoming cognitive science books for 2008.

Solomon Asch’s famous conformity experiment is recreated in a video hosted by The Situationist. Still just as powerful.

Philosophy Bites has an audio discussion on human agency – i.e. how we can understand when someone is doing something on purpose.

Serious threats distinguished by style over substance

Last September’s Journal of Forensic Sciences had an intriguing study comparing email and handwritten threats to members of the United States Congress.

While threats by letter were more thoughtfully composed, they need to taken more seriously as they were more often followed by a threatening physical approach and more frequently written by people with a significant criminal history.

A comparison of email versus letter threat contacts toward members of the United States Congress.

J Forensic Sci. 2007 Sep;52(5):1142-7

Schoeneman-Morris KA, Scalora MJ, Chang GH, Zimmerman WJ, Garner Y.

To better understand inappropriate correspondence sent to public officials, 301 letter cases and 99 email cases were randomly selected from the United States Capitol Police investigative case files and compared. Results indicate that letter writers were significantly more likely than emailers to exhibit indicators of serious mental illness (SMI), engage in target dispersion, use multiple methods of contact, and make a problematic approach toward their target. Emailers were significantly more likely than letter writers to focus on government concerns, use obscene language, and display disorganization in their writing. Also, letter writers tended to be significantly older, have more criminal history, and write longer communications. A multivariate model found that disorganization, SMI symptoms, problematic physical approach, and target dispersion significantly differentiated between the correspondence groups. The group differences illuminated by this study reveal that letter writers are engaging in behavior that is higher risk for problematic approach than are emailers.

Link to PubMed entry for study.

Consciousness happens between the panels

A letter in today’s New Scientist noted that artist Scott McCloud’s comments on how we infer the narrative from comic strips might also explain how consciousness works.

It reminded me of this panel from McCloud’s book Understanding Comics.

Understanding Comics is about the visual language of comic books and is written as a comic. It’s fantastically put together but is also fascinating if you’re interested in psychology because it largely discusses how we construct rich and complex meanings from very basic visual input.

One of the crucial points is that the comic itself is not the story, our mind builds it as we go and fills in the gaps with perception, cultural associations and our experience of how the world works.

The New Scientist letter reads:

David Bainbridge’s description of consciousness (26 January, p 40), including, for example, the fact that we do not know where in the brain consciousness happens, was evocative. Scott McCloud, in his book Understanding Comics, describes a comic’s story as whatever is happening in the blank spaces between the panels.

What if our minds function like a comic: they snap pictures, and our consciousness is simply the story the mind constructs around those pictures? – Saskia Latendresse, Montreal, Quebec, Canada

This is a lovely analogy and captures a well-argued approach in cognitive science that suggests that consciousness functions as a ‘narrative maker’ to make sense of the output from the disparate functions of the brain into a coherent sense of self.

Link to previous post on narrative and consciousness.
Link to NewSci letter.
Link to info on Understanding Comics.

Language specific madness

I’ve just found this fascinating study on language and psychosis that found that multilingual psychotic patients can present with either different or less psychotic symptoms depending on the language they use.

It’s a 2001 study from The British Journal of Medical Psychology that collected existing case studies from the medical literature and reports on several new examples.

There have been previous accounts of bilingual or ‘polyglot’ patients who only hear voices in one of their languages, but this seems to be the first study to assess psychotic symptoms using a standardised measure.

This is from the introduction, which outlines some of the curious effects:

Zulueta’s (1984) review article on the implications of bilingualism in the study and treatment of psychiatric disorders showed that certain psychotic fluent bilinguals, who had learnt their second language during or after puberty, could present with different psychotic phenomena depending on which language they used. Most of these patients tended to present as more disturbed in their primary ‘mother tongue’ and as less disturbed in their second language (Castillo, 1970; Hemphill, 1971).

Some patients were thought disordered in one language and less so or not at all in their other language; some complained of having delusions in one language and not in their other language, and some experienced auditory hallucinations in one language and not in another. Moreover, some patients who were fluent bilinguals lost their linguistic competence in their second language during their psychotic illness (Heinemann & Assion, 1996; Hughes, 1981).

The case of Mr Z illustrates the marked change in phenomenology that can be observed in such patients. He was a 30-year-old patient diagnosed as hypomanic with a history of bipolar illnesses. His mother tongue was English, and he had learnt Spanish after puberty. When he spoke in English, he was markedly thought-disordered and complained of hallucinations. On one occasion, whilst being interviewed by his psychiatrist, he addressed her spontaneously in Spanish, knowing that she was a Spanish speaker.

To his surprise, and hers, he discovered that when he spoke in Spanish, he no longer appeared to be thought-disordered. He commented on this difference by observing, in Spanish, that when he spoke in this language, he felt he was ‘sane’, but when he spoke in English, he went ‘mad’ (Zulueta, 1984). This bilingual dialogue took place within the space of half an hour. It would seem that in this case and in others with similar differences in psychotic phenomena across languages, the second language may, in some cases, exert a protective function in terms of psychotic symptoms.

Link to PubMed entry with summary.

Tripping with Jeff Warren

Bookslut has an interview with Jeff Warren, author the excellent The Head Trip: Adventures on the Wheel of Consciousness, a book I raved about last year after having a copy thrust into my hand by Tom.

It sounds like a recipe for disaster on the surface – a guy writing about his altered states charted on a self-invented ‘wheel of consciousness’ – but it’s scientifically thorough, philosophically engaging and avoids every clich√© you think it might throw up.

The interview is great fun too, and contains some interesting points about what we prioritise, mentally or scientifically, when thinking about consciousness-warping states.

Except for one footnote, you largely avoid the question of drugs and altered consciousness…

I‚Äôm interested in drug-induced alternations of consciousness, but my feeling is they‚Äôre the really obvious shit. Too many ‚Äúinvestigators of consciousness‚Äù overlook the fine-grained shifting texture of day-to-day consciousness. It‚Äôs the difference between the big budget Hollywood blockbuster and the art house Henry James adaptation. Drug-induced alterations of consciousness have great CGI — which is fine, I mean who doesn‚Äôt appreciate form constant explosions and DMT Machine Elves? — the problem is, character development sucks, or rather, the characters — and by characters I mean the objects of consciousness — tend to be cartoons. They‚Äôre exaggerated, that‚Äôs what psychedelics do — ‚Äúnon-specific amplifiers‚Äù Stanislav Grof calls them. They expand the whole topography of the mind. It‚Äôs possible more than this is going on but that‚Äôs another story.

This expansion can be valuable for understanding consciousness since it boosts the resolution of previously discreet mental dynamics. But cartoons, of course, are caricatures. If you watch only Jerry Bruckheimer movies you risk losing your ability to appreciate — and even notice — the subtleties and complexities of real life and consciousness, which, to circle back to my original metaphor, is more like a Henry James adaptation.

Link to Bookslut interview with Jeff Warren.

Synapse structure varies across species

The New York Times covers new research which has found significant cross-species variation in the structure of the synapse – the chemical ‘connection points’ that allow neurons to communicate.

The study itself has been published in Nature Neuroscience and the full text is available online for those who want the in-depth science.

A whole new dimension of evolutionary complexity has now emerged from a cross-species study led by Dr. Seth Grant at the Sanger Institute in England.

Dr. Grant looked at the interconnections between neurons, known as synapses, which until now have been regarded as a standard feature of neurons.

But in fact the synapses get considerably more complex going up the evolutionary scale, Dr. Grant and colleagues reported online Sunday in Nature Neuroscience. In worms and flies, the synapses mediate simple forms of learning, but in higher animals they are built from a much richer array of protein components and conduct complex learning and pattern recognition, Dr. Grant said.

The finding may open a new window into how the brain operates. “One of the biggest questions in neuroscience is to answer what are the design principles by which the human brain is constructed, and this is one of those principles,” Dr. Grant said.

The paper itself doesn’t mention the issue, but I wander what implications this might have for the generalisation of animal experiments to humans.

The majority of cellular-level neuroscience research is done on animal tissue. While some of this focuses on the molecular level, where differences in the structure of, let’s say, ion channels, would be easily apparent in comparison to humans, some studies simply look at the ‘synapse’ as the smallest functional unit.

In fact, a considerable amount of neuroscience research is done on the 1mm long microscopic worm C. elegans and the fruit fly, drosophila. This new research suggests that neuroscientists may need to be additionally cautious when assuming that the findings relate to general laws that might apply in humans.

UPDATE: Neurophilosophy has a great write-up of this study, which discusses it in more detail.

Link to NYT article ‘Brainpower May Lie in Complexity of Synapses’.
Link to PubMed entry for scientific paper.
Link to full text.

Web making us worried, but probably not stupid

The cover article of this month’s Atlantic magazine argues that our increasing reliance on internet technology means we’re becoming less able to focus and absorb ourselves in a task because we’re so used to mentally ‘jumping around’. It’s a common concern, but is almost entirely devoid of evidence.

Similar arguments have been put forward before, and they usually take the form of suggesting that digital technology influences how we think to point of it affecting our fundamental ability to concentrate and reflect for sustained periods (tellingly, the example usually given is ‘reading books’).

Probably the first version of the argument was put forward by Jane Healy in her 1990 book Endangered Minds, and expanded in the 1998 book Failure to Connect.

Healy argues that children’s increasing exposure to computers has created a “toxic environment” that leads to patterns of “disorganized thinking” and “mental restlessness” akin to ADHD.

Interestingly, computer use has been linked to the symptoms of child ADHD in a 2006 study, but it only reported an association between computer use and symptoms reported by parents – no measure of attention was used.

One other study found that ADHD kids have more problems playing the games, but the only study I know of that actually measured sustained attention during video gaming found that ADHD kids could concentrate equally as well as other kids.

In other words, their inability to focus seemed to ‘disappear’ when using a computer, which might explain the association mentioned earlier. In other words, kids with ADHD might use computers more because they help them focus.

Nevertheless, the argument has now broadened to encompass the effects of adults, the ‘brain plasticity’ is almost always mentioned as an explanation.

While the Atlantic article warns against conclusions drawn from anecdotes, it is almost entirely anecdotal. Tellingly, it quotes not a single study that has measured any of the things mentioned as a concern by the author or anyone else.

So here’s what we’d want to do to test this concern out: use some neuropsychological tests of sustained attention to investigate whether internet use is linked to worse concentration.

A cross-sectional study that just compared heavy web users with light web users would provide suggestive, but ultimately weak, evidence, because it may just be that those with worse concentration find the web more attractive (like the ADHD kids with games).

A longitudinal study would be more useful. It would need to test a group of people at the beginning to make sure they were all equivalent and would then re-test everyone at a later date and see whether those who became heavy web users had worse sustained attention.

A randomised controlled trial would be the best evidence, and it would randomly assign a group of equivalent people to heavy or light web use and then it would measure the effects on the ability to concentrate.

As far as I can tell, not a single study has been completed that has actually tested sustained attention in web users – even for the weakest form of evidence. If you know of one, do let me know, because I’d be interested to find out. So far though, I know of none.

There have been some related studies on video games, but they tend to show the reverse, that video games are linked to better mental performance.

The improvements here all almost all in divided attention or visual search – the ability to take in information over a wider space – so it’s difficult to generalise to sustained attention.

In terms of any new technology, it’s obvious having tools to hand changes the strategies we use to solve problems, but so far, there is no strong evidence that Google, YouTube, Facebook or any other part of the web affects the fundamentals of how we think.

As the article mentions, concerns about new technology go back to Plato’s worries that writing will make people mentally dull because it encourages ‘laziness’.

Until the hard evidence comes in, anxieties about the web remain fear rather than fact. The data just doesn’t exist.

Link to Atlantic article ‘Is Google Making Us Stupid?’.

Long live the new Encephalon! Edition 47 arrives

According to the 1983 movie Videodrome, the television screen is the retina of the mind’s eye. The latest edition of psychology and neuroscience writing carnival Encephalon is hosted by the Channel N video blog, showing us that the online video screen is equally a window into the psyche.

An article on a rather dubious link between synaesthesia and metaphor is one of my favourites, as is a video of a robot choreographed by input from a sleep EEG.

Sadly, it seems, someone has removed the archive of the Karen Carpenter biopic focusing on her struggle with anorexia, echoing its banning some years earlier. It seems to be working!

After all, there is nothing real outside our perception of reality, is there?

Link to Encephalon 47.

Uncle Clonazepam’s Army

This week’s Time magazine has a cover article on ‘America’s Medicated Army’, discussing the widespread use of antidepressant and anxiety-reducing drugs in US Army troops in Iraq and Afghanistan.

The saying goes that ‘military psychiatry is to psychiatry what military music is to music’, and, certainly, military mental health clinicians have quite different objectives to their civilian counterparts.

Treating someone who has been traumatised by a war zone with the priority of returning them to combat is an unusual way of working from a civilian perspective.

While military psychiatry has traditionally relied on rest from combat operations using the ‘PIE‘ principle of minimal withdrawal from the theatre of war, for the first time, the American military are now allowing deployed troops to be prescribed psychiatric medication, principally to treat depression and anxiety.

The article is an interesting angle on the sorts of intense stresses that soliders endure, but it’s probably worth remembering that having soldiers medicated against the traumas of war is not particularly new.

Traditionally, however, soldiers have medicated themselves with whatever substances were to hand.

Drug use by US troops in the the Vietnam War has been widely portrayed in Hollywood films but it is based on hard medical evidence. Contemporary medical studies reported that approximately 1 in 5 soldiers was addicted to heroin, with marijuana and alcohol use even more widespread.

I looked and couldn’t find any data on illicit drug use in troops in Iraq, but a recent report notes that 11% of US soldiers in Iraq who sought mental health care had ‘severe misuse of alcohol’, rising to 18% if ‘moderate’ cases are included.

These figures are hard to compare directly, but that’s 18% of soldiers referred to military psychiatrists, not 18% of the total troop population, which makes me think there’s probably less self-medication occurring during this war than the Vietnam war at least, and possibly others.

Even if this rather rough estimate turns out to be true, it’s impossible to say whether the availability of prescribed medication is reducing drug and alcohol misuse, or whether it is being used to shore up the troops in an geographical area where recreational substances are just harder to come by.

The history of military psychiatry has told us that the single best way of preventing mental illness (and death, injury and civilian causalities) is to not deploy troops into combat.

Unfortunately, history has also told us that the blindingly obvious has never been particularly popular with political leaders, and until that time, the military may simply be trying to avoid widespread illicit self-drugging by making army approved medication available to its depressed and anxious soldiers.

Link to Time article ‘America’s Medicated Army’.

Memes exist: tell your friends

High-end talking shop, TED, has a couple of video lectures on ‘memes‘ – the supposedly self-contained units of information, ideas or actions that replicate through human culture and are selected by a process akin to natural selection.

The first is by philosopher Daniel Dennett from 2002, while the second is from earlier this year and was presented by psychologist Susan Blackmore who updates the idea by proposing that new technology is having a unique effect on the cultural transmission of ideas.

The concept of memes is controversial, not least because it’s hard to see exactly what empirical predictions follow from the theory. Rather than a set of specific hypothesis, it’s really a different framework with which we can re-interpret aspects of culture.

What particularly annoys the critics is the idea that cultural ideas are subject to a Darwinian-style process of selection and (presumably) evolution.

In an exchange with Dennett, philosopher Michael Ruse defended his Darwinian credentials by saying to Dennett “[I am] more hardline than you are, because I don’t buy into this meme bullshit but put everything… in the language of genes”.

Link to Dennett talk on ‘the awesome power of memes’.
Link to Blackmore talk on ‘memes and temes’.

A sagacious old dame and some wonderful archives

The placebo effect is usually thought to involve the patient’s belief in a treatment, but as Tom pointed out in an earlier post, the doctor’s belief in a treatment seems also to play a part.

I just found this fantastic footnote on a page from the 1849 edition of The Journal of Psychological Medicine and Mental Pathology, where an elderly lady patient decides to select her doctors based on their faith in her treatment.

An old lady, who was attended by her physician and apothecary, seriously requested them to inform her whether she was likely to die. After a deliberate consultation, they resolved to comply with her request, and they told her they she was near the end. “Very well”, replied the sagacious old dame, “then I must dismiss you, because, if you think so, it is evident that you are not the persons to get me well again!” and she accordingly discharged them both.

There are now several historical texts and journals from the 1800s available online, in full, without restrictions via Google Books.

In fact, May’s edition of The Psychologist (full disclosure: I’m an unpaid associate editor) had an <a href="http://www.thepsychologist.org.uk/archive/archive_home.cfm?volumeID=21&editionID=160&ArticleID=1351
“>article on John Perceval, famous for his influence on 19th century mental health reform after being admitted to several institutions and writing very eloquently about his experiences.

A scanned copy of an original of Perceval’s book is available online. It has the truly wonderful title of:

A Narrative of the Treatment Experienced by a Gentleman During a State of Mental Derangement Designed to Explain the Causes and the Nature of Insanity and to Expose the Injudicious Conduct Pursued Towards Many Unfortunate Sufferers Under That Calamity.

35, single and psychoneurotic

The Bonkers Institute for Nearly Genuine Research has added a gallery of vintage drug adverts to its site, showcasing some of the more outlandish psychiatric advertising from the 20th century.

One of the most striking things is the Thorazine gallery, that highlights how the drug, also known under its generic name chlorpromazine, was advertised for pretty much everything.

This included alcoholism, hostility, menopause, senility, arthritis and cancer to name but a few.

While we now think of chlorpromizine and other selective D2 dopamine antagonists (blockers) as ‘antipsychotics’, it’s important to remember that the fact we now describe these compounds in terms of their effect on psychosis was a marketing coup in itself.

For example, Thorazine was also sold under the name ‘Largactil’, to give the impression it was ‘large acting’ and could be used in a number of different conditions.

In fact, these drugs were originally marketed as major tranquillisers, then neuroleptics, then antipsychotics, and now, history has come full circle, as drug companies are now trying to reposition ‘atypical antipsychotics’ as general psychiatric medicines by getting them licensed as treatments for more general conditions such as depression and anxiety.

It’s a classic marketing technique to sell products as solutions to problems, but we simply don’t understand enough about the neurobiology of mental illness to design medication to selectively treat a specific diagnosis.

In other words, labels like ‘antidepressant’, ‘antipsychotic’ or ‘mood stabiliser’ tell us next to nothing about the action of the drug and only inform us how they are used.

It’s like the word ‘shampoo’. While the product may have a few tweaks that make it better for washing hair, it doesn’t mean it cleans your hair and nothing else. That’s just how this particular soap product is used and sold.

So if someone decides to promote antipsychotics to treat anxiety, or shampoo to wash your car, the same principle applies as if they’re being marketed to treat psychosis or clean your hair.

Don’t take the labels as evidence, and look for the scientific data for their effectiveness.

Link to Bonkers Institute Gallery.