Category: News

New Scientist reports on a neck-band technology that allows the wearer’s silent thoughts to trigger messages over a phone line.

It sounds impressive, but the video that accompanies the story makes it look like the technology reads your inner thoughts and transmits them as sounds, when it fact it does something far more basic.

Whenever we think to ourselves, rather curiously, the vocal chords get activated very slightly – faintly mirroring what would happen if we were to say the words out loud.

This is known as subvocal speech and can be picked up by EMG sensors on the neck that pick up the tiny electrical signals generated by the weakly activated muscles.

While the technology doesn’t exist to turn these signals back into speech, it is possible to train the system to distinguish between a number of different general patterns which can trigger specific computer commands.

Lancet Neurology reported in 2004 that the same team had a basic system running that recognised six words (stop, go, left, right, alpha, omega) and 10 digits, to allow ‘silent’ control of a machine or a software application.

The team seem to have developed the technology and it can apparently now recognise many more commands, however, it doesn’t ‘translate’ thoughts into their corresponding words.

In the video, the wearer is triggering sound recordings of specific sentences, pre-arranged to provide answers to the rehearsed telephone ‘conversation’. Still impressive, but not a genuine conversation in the way we would normally think of it.

As an aside, for more than 20 years now, we’ve know that subvocal speech accompanies hallucinated voices in people who have been diagnosed with psychosis.

This means people who hear constant hallucinated voices will probably not be able to use the system effectively.

However, we now know that healthy individuals have much higher levels of hallucinations than previously thought, although most people are not bothered or distressed by them.

For example, in a 2004 study Louise Johns and colleagues found that 0.7% of the British population had experienced an auditory hallucination in the last year.

It’s interesting to speculate that a significant minority of the population might experience problems with this technology as their hallucinations accidentally trigger commands or send messages on their behalf!

Link to NewSci story ‘Nerve-tapping neckband allows ‘telepathic’ chat’.
Link to video of product presentation.

A recent 60 country World Health Organisation study found that depression is the most serious chronic illness, worse than angina, arthritis, asthma, and diabetes. Unfortunately, the majority of people who experience depression live in low income countries where help is least likely to be available.

The New York Times has a fascinating article on an ongoing project in Goa, India, that screens every attendee at a local health centre and then uses psychological therapy to help with low mood or anxiety.

It’s not a simple case of just using Western techniques in a new environment.

As the NYT article mentions, mental illness carries a significant stigma in many cultures. For example, a diagnosis may not only be stigmatising for the affected person, but it may also mean the person’s children are less likely to be thought of as suitable marriage partners, potentially affecting the whole family’s future.

Futhermore, depression is known to present quite differently in some non-Western cultures. Studies have found that people are more likely to report ‘somatic symptoms’ such as diffuse pains or tiredness, rather than low mood or emotional problems.

This is partly due to stigma, but sometimes because certain languages don’t have the same, or even such a varied vocabulary for emotions and mental states.

I’m currently working with a Pakistani psychiatrist who often surprises me by pointing out that even what I assume are relatively straightforward words, such as depression or anxiety, might not have a direct translation in some Asian languages.

All of these issues mean that the treatment centre in Goa tackles the issue in a slightly different way:

Most are also apparently wary of visiting a mental hospital. In India, the stigma of mental illness remains strong. To minimize the problem, health workers avoid using the words “mental illness,” “depression” or “anxiety” with patients, relying on more commonly used words like “strain” and “tension.”

The patients “are happy to talk,” Dr. Sudipto Chatterjee, a psychiatrist at Sangath, said, “as long as you stay away from the idea of mental illness.”

I find the issue of having different vocabularies for our mental states fascinating.

The philosopher Wittgenstein noted how difficult it is to agree on common words for internal states because errors are so hard to correct.

If a mother and child see a rabbit and the child says “elephant!”, the mother can point to the rabbit and correct the misnomer. But what can a mother, or anyone do, if someone ‘misnames’ an emotion?

Or to put it another way, as we don’t have external things to refer to for internal states, how do we ever agree on a vocabulary that is at all meaningful?

I’m always curious when I come across differences concerning emotion words in other languages. For example, Spanish has the same word (verg√ºenza) for shame and embarrassment.

From my native language perspective it strikes me as amazing that another language doesn’t individually label these two states which seem to have such different personal and social implications.

I’m sure there are many reverse examples and many other emotional vocabulary mismatches across the world’s languages.

Link to NYT article ‘Psychotherapy for All: An Experiment’.

Discover Magazine has an exposé of a recent surge of news stories on insomnia and sleep disorders that stretch from the dull to the frankly unbelievable.

It turns out a fair number seem to be based on press releases from PR firms, some trying to promote hotels, but others coming from the National Sleep Foundation.

The author of the piece looked at the 2005 financial figures from this organisation and discovered that over 80% of its funding came from drug companies and almost three quarters was spent on ‘public education’ – i.e. advertising the existence of sleep disorders.

Of course, sleep disorders can be distressing, disabling and potentially dangerous but research suggests that particularly for insomnia, the judicious use of drugs should be a last resort (most have the potential for addiction), as behavioural and psychological treatments are safer and more effective for most people.

Unfortunately, these approaches are often not available, meaning ‘public awareness’ increases diagnosis but leads to drug prescription, partly because people go to doctors and list what symptoms they think they have from the advertising rather than describing their experiences.

The National Sleep Foundation do a lot of excellent work but the article suggests that there seems to be an element of disease mongering and astroturfing to their promotions.

Link to article ‘Deflating the Bogus Insomnia ‚ÄúEpidemic‚Äù’

Film-maker Martin Hampton has created a revealing documentary on four people with different degrees of compulsive hoarding, where individuals incessantly collect household objects, even to the point of not being able to throw out rubbish.

Compulsive hoarding is often linked to obsessive-compulsive disorder, where affected people experience intrusive thoughts or urges to complete certain actions (most commonly ‘washing’ or ‘checking’) even though they know how seriously these intrusions are affecting their lives.

Hampton’s documentary is a remarkably well made account of people with similar urges, in this case to collect and retain, and just lets the individuals and the images speak for themselves (it is also freely available online as wide screen HD, so looks wonderful).

Apparently the documentary was created as part of a Master’s course in visual anthropology, a field I’d not come across before, but which seems to be concerned with documenting the diversity of human experience through film.

Possessed does this admirably and seems to have garnered numerous awards since it’s release.

UPDATE: Grabbed from the comments. An update and a request from the director!

I am the director of this film and am now researching the next stage of the project. I am trying to compile a collection of peoples experiences of OCD and other anxiety based disorders. I have found from experience that although symptoms might be similar, the actual particularities of the obsessions and compulsions are often very varied. For example, one might wash ones hands 30 times a day, but have a very unique self discovered reason for doing so. I would be very grateful to hear of your or any friend / acquaintances experiences / difficulties. Many thanks and I hope you find the film interesting. Please email me at martin@martinhampton.com

Link to Martin Hampton’s documentary Possessed (via MeFi).

The New York Times has a fun article on how psychotherapists decorate their office and what this might portray about the inner life of the shrink.

Psychoanalysts (Freudian psychotherapists) in particular are very careful about what sort of impression they project about themselves, preferring, at least initially, to be as insubstantial as possible so the patient can transfer feelings and impressions onto them, allowing relationship patterns and emotional reactions to be uncovered and worked on.

However, many psychotherapists work from home, using rooms in their house as offices. The NYT piece notes that a recent academic paper in the journal Psychoanalytic Psychology caused a storm by questioning the ethics of this practice, as impressions or even people from the therapists family life might interfere in the crucial relationship forming process.

Of course, the office is also a way of making the patient feel comfortable and at ease and so the tension between how the therapist attempts to express this, and how they express themselves, can be quite revealing.

Freud famously had a painting over his psychoanalytic couch of Jean-Martin Charcot (Freud’s mentor) presiding over the swooning and almost bare breasted young woman ‘Blanche’. No wishful thinking going on there of course.

In the UK, where most psychological treatment happens in the NHS, the rooms are often comfortable but plain outpatient appointment rooms that are shared and booked as necessary.

Occasionally, clinicians will have their own office in which to see patients. In these case, I’ve noticed that psychotherapists and counsellors have a much better sense of interior decoration (all rugs and soft lighting) than clinical psychologists, who tend to go for books and photocopied papers look.

Link to NYT article on therapists’ offices.

Thanks to Debbie from the My Mind on Books blog who managed to track down the original academic article from psychologist Benny Shanon who argues that Moses’ experiences on Mount Sinai may have been due to a hallucinogenic experience.

Shannon suggests that a mixture prepared from the acacia tree and the bush peganum harmala could have been responsible.

The article is freely available so you can read it in detail for yourself. As well as Shanon’s main idea, it also contains a wealth of information about the use of psychedelic plants in the ancient world.

Link to article ‘Biblical Entheogens: a Speculative Hypothesis’.

Placebo has its effect through our beliefs and expectations. Because we get many of our assumptions through culture, changing social attitudes could alter how effective it is.

Placebo is sometimes called the ‘expectancy effect’ and describes the fact that our expectations of what the dummy treatment will do can influence the outcome.

We noted before that the colour of the pill can significantly alter its effect, but it’s intriguing to think that we probably get most of these sorts of expectations from our culture.

Bad Science looks at how the strength of the placebo effect has changed over time for different drug trials, suggesting that as our cultural beliefs change, the effectiveness dummy treatments might also change depending on how they’re presented.

Similarly, The New York Times have just published a brief article on a new study that found placebos described as costing $2.50 a dose are more effective pain killers than those presented to participants as costing 10 cents a dose.

In other words, if placebo is a form of faith healing, changes in our collective faith will alter the healing potential of a placebo associated with those ideas.

These social effects on placebo are interesting, because we judge the effectiveness of medications by comparing them to placebo. Furthermore, we know the effectiveness of most medications will be partly explained by the placebo effect.

In other words, changes in our cultural attitudes influence the effectiveness of medication.

While we assume that much of medicine objectively definable, much is only comprehensible by making sense of social issues.

For example, drug side-effects are usually talked about as if they are objectively described properties of the chemical.

However, its easy to see that these actually depend on the person, not the drug.

For example, take the drug terazosin. It lowers blood pressure and shrinks the prostate.

If you have high blood pressure but a normal prostate, the side-effect is a reduced prostate. If you have prostate problems but normal blood pressure, the side-effect is reduced blood pressure. If you have both high blood pressure and prostate problems, it’s potentially side-effect free.

One man’s treatment is another man’s side-effect. This is why the sociology of medicine is as important as biology, chemistry or another other bench-based science in understanding illness and treatment.

Link to Bad Science on placebo.
Link to NYT on price of placebo study.

RadioLab, one of the most wonderfully produced radio shows around, has just started a new series with a fantastic edition on the psychology and neuroscience of laughter.

Tuning in to RadioLab is like listening to the enthusiastic daydreams of some slightly stoned but fantastically well informed scientists.

This edition looks at laughter, the behaviour that Aristotle thought was one of the few that were uniquely human.

Most interesting, the programme looks at the social uses of laughter and how it signals dominance and superiority, and how we use it to make others feel safe. But there much more than that, including laughing rats and laughing hysteria.

Another great edition and a pleasure to listen to.

Link to RadioLab on laughter (with streamed and mp3 audio).

Seed Magazine has a fantastic article on the ‘Blue Brain’ project that aims to eventually create a biologically accurate simulation of the human brain on a supercomputer.

So far, they’ve only managed to simulate a cortical column but this in itself is quite impressive as many thought it could never be done.

The project is currently simulating about 10,000 neurons and a total of about 30 million synaptic connections.

If you’ve heard about artificial neural networks before this might not sound very impressive, but the difference between this project and most others is that it attempts digitally simulate the biological processes of each individual cell.

In contrast, most neural networks are made up of individual elements that are usually little more than metaphors of how neurons actually work.

A huge boost is that the project has shown that their software cortical column spontaneously acts like its biological equivalent when its switched on and stimulated.

It didn’t take long before the model reacted. After only a few electrical jolts, the artificial neural circuit began to act just like a real neural circuit. Clusters of connected neurons began to fire in close synchrony: the cells were wiring themselves together. Different cell types obeyed their genetic instructions. The scientists could see the cellular looms flash and then fade as the cells wove themselves into meaningful patterns. Dendrites reached out to each other, like branches looking for light. “This all happened on its own,” Markram says. “It was entirely spontaneous.” For the Blue Brain team, it was a thrilling breakthrough. After years of hard work, they were finally able to watch their make-believe brain develop, synapse by synapse. The microchips were turning themselves into a mind.

It’s an engrossing article that captures both the science behind the project and some of the personalities involved.

Link to Seed article ‘Out of the Blue’.

I’ve been listening to some of Dr Ginger Campbell’s brain science podcasts recently and am thoroughly enjoying them.

Campbell has been broadcasting for a fair while now (she’s just put her 31st podcast online) but these latest editions are particularly good.

I caught a few of the early ones and found them a little rough around the edges to be honest. I have only recently revisited to discover I’ve been missing out on some great discussions.

Not tied down by the dictates of a radio schedule, the programmes are often wonderfully satisfying and in-depth. She doesn’t like Chomsky’s theories very much though as you’ll discover in a recent edition on the evolution of language!

Campbell has obviously also put a lot of hard work into getting neuroscientists on the show to be interviewed, which make for some of the most interesting exchanges.

Link to Dr Ginger Campbell’s Brain Science podcast.

Scientific American Mind has a fantastic article on the endemic use of antidepressant drugs in the United States. It starts with some surprising statistics: 11 percent of American women and 5 percent of men are on antidepressants.

Serious clinical depression is devastating, and if ever you needed convincing that mental illness should be taken as seriously as physical illness, you only need to meet someone suffering in the depths of a mood disorder.

In contrast, the article notes that the modern concept of depression and the diagnostic criteria have been increasingly widened to cover states of low mood or disinterest that would previously have never been thought of as a medical problem.

It’s full of interesting snippets from the scientific literature to suggest the pervasive influence of this new broader ‘depression’ on society.

For example, a 2007 study found that 1 in 4 people treated for depression have recently experienced a major emotional setback, such as a marriage break-up, a job loss or a financial crisis – suggesting the emotional difficulties may be part of a normal reaction to a serious life event.

A 2006 study found that three-quarters of people prescribed antidepressants receive them for a non-licensed or ‘off label’ reason – for a purpose that there is no strong evidence for.

Furthermore:

If statistics serve, we know a number of things about the Medicated American. We know there is a very good chance she has no psychiatric diagnosis. A study of antidepressant use in private health insurance plans by the New England Research Institute found that 43 percent of those who had been prescribed antidepressants had no psychiatric diagnosis or any mental health care beyond the prescription of the drug. We know she is probably female: twice as many psychiatric drugs are prescribed for women than for men, reported a 1991 study in the British Journal of Psychiatry. Remarkably, in 2002 more than one in three doctor’s office visits by women involved the prescription of an antidepressant, either for the writing of a new prescription or for the maintenance of an existing one, according to the ­Centers for Disease Control and Prevention.

This is not to dismiss the suffering of those who have less disabling mood problems – each of which can be a torment in itself.

The key question though, is should it be the responsibility of medicine to prevent these unpleasant mood states, and if so, is medication the answer?

Psychological therapies are known to be effective treatments when depression first occurs and better than drugs in preventing relapse, and for much mild – moderate depression increasing activity levels and light exercise can be strikingly effective.

For more serious cases, a combination of drugs and psychological treatment is the most effective treatment.

The boundaries of illness say as much about our society as they do about our medical advances because it is impossible to define illness without making a value judgement about what point normal variation becomes a pathology.

Depression and antidepressants and complicated because there are many interests – individual, professional, scientific and financial – all shaping how we detect and treat ‘it’.

Over these last few months it has become clear that medication is not as effective as the published evidence has led us to believe, and that we need to radically rethink how we understand mood problems and help those who suffer them.

While the SciAm article focuses on the US where the problem is most apparent, it is clear that this is an issue facing many countries in the West.

Link to SciAm article ‘The Medicated Americans’.

Just a reminder that we will be hosting the next edition of the Encephalon psychology and neuroscience writing carnival here, next Monday.

So if you want your writing featured send a link to your article to:

encephalon{dot}host{at}gmail{dot}com

…and we’ll look forward to including it.

The new generation antidepressants are no better than placebo in mild-moderate depression according to a new analysis of published and unpublished trials that were submitted during the drugs’ approval.

The study is published in PLoS Medicine and despite the huge headlines it has generated, is not entirely surprising.

Psychologist Irving Kirsch, who led this new research, has conducted several previous studies looking at the effectiveness of SSRI antidepressant drugs and found similar results, although this is the first time that the study has factored in the severity of depression.

This study focused on the drugs fluoxetine (Prozac), venlafaxine (Effexor), nefazodone (Serzone), and paroxetine (Seroxat or Paxil) and used the US Freedom of Information Act to request data on (mainly) negative trials that haven’t been published to complement the data set from published trials.

In this new analysis, only in severe depression did these medications show a distinct improvement over placebo, and this, the authors suggest, is because of the reduced placebo effect in the severely depressed, rather than than the fact that the medication has a differential effect in those most affected by mood disorders.

It’s important to note that the study didn’t show that the drugs had no effect in mild-moderate depression. They were all associated with an improvement in depression, but this was no different from placebo (a powerful effect in itself).

It’s also important to note that this finding doesn’t apply to all antidepressant drugs, and that it doesn’t apply to the use of these four drugs in all situations. They are also commonly prescribed for anxiety disorders which weren’t investigated in this study.

However, this is another example of how drug companies’ attempts to obscure data from negative trials are coming back to haunt them.

The Times has one of the best write-ups but as usual, the PLoS article has a jargon-free summary included so you can get the findings from the source even if you’re not familiar with scientific writing.

UPDATE: An important clarification from PJ, taken from the comments:

I think that by saying “this was no different from placebo” you are being misleading. Strictly speaking it was statistically different from placebo but did not reach the NICE criteria for a clinically significant difference:

“a three-point difference in Hamilton Rating Scale of Depression (HRSD)scores or a standardized mean difference (d) of 0.50”

Thanks PJ!

Link to full-text of PLoS Medicine paper.
Link to Times write-up.

After being put back from January, the fantastic documentary on Walter Freeman and the rise and fall of the frontal lobotomy is finally available to view online.

Unfortunately, it’s been cut up into little chunks and is only available as a Quicktime or Windows Media stream, which makes it a pain to watch and completely inaccessible to anyone not using Windows or Mac.

Needless to say, a better quality version is available on some torrent servers as a sensibly packaged video file and the healthiest torrent seems to be this one.

It’s a fantastically well-researched and balanced documentary, looking at the history of the procedure, Freeman’s over-identification with the operation and its abandonment as the problems became clear.

The tale is tragic for many reasons, not least of which is Freeman’s flawed personality and unwillingness to admit that the lobotomy was not the miracle cure he initially claimed.

There’s plenty more background information on the programme website and the Neurophilosophy article on the history of the procedure has some more details.

Link to The Lobotomist website and streamed version.
Link to Mininova torrent.

Only the morally weak and degenerate became mentally ill in the 18th century. At least, that’s what the popular theories of the time suggested. Madness was caused by moral failings and those who lost their mind were sinners.

We like to think that we live in enlightened times and that only in the far outskirts of the religious fringe are mental disorder and immorality thought to be (presumably gay) bedfellows.

Politics is one of the few areas were accusations of mental illness are considered fair game. I don’t mean simply calling someone or their ideas ‘mad’, ‘loony’ or ‘crazy’. I mean suggesting a politician or a political group has a diagnosable mental disorder.

US psychiatrist Lyle Rossiter published a book in 2006 claiming that liberalism was a form of clinical mental illness. Bang up to date with the latest in 1920s Freudian analysis, Rossiter claims that liberalism is caused by problems with relationships as a child, leading to a pathological fear of abandonment and an obsessive need for an omnipotent control of others.

Presidents fair little better. A 2004 book claimed George W Bush is an untreated alcoholic, while a 2000 book claimed Clinton was racked with compulsions.

In the UK, so many people accused Tony Blair of being insane that an article was published in the Journal of the Royal Society of Medicine that gathered the accusations and wondered why otherwise respectable clinicians feel the need to diagnose public figures.

It seems this is one of our last bastions of publicly acceptable prejudice against mental illness. We would be horrified if politicians were labelled epileptic because of their views, but barely blink an eyelid when they’re called schizophrenic.

This makes it all the more ironic that numerous successful politicians have been genuinely mentally ill. Winston Churchill was famously pursued by his ‘black dog’ throughout his time as Prime Minister and a recent biographical study by Duke University found evidence for psychiatric problems in 37 US Presidents from 1776 to 1974.

One of the most remarkable stories from recent years comes from Scandanavia, where Kjell Magne Bondevik, the then serving Prime Minister of Norway, announced he needed three weeks sick leave owing to an episode of depression.

Bondevik returned to work and was re-elected in the subsequent election. He’s now retired from politics, campaigns to fight the stigma associated with mental illness and was recently interviewed (realvideo) about his experiences on BBC’s Newsnight programme.

It’s a optimistic story for many reasons, but the fact that the Norwegian electorate seemed more concerned with his past record than his diagnosis gives us genuine hope that we’re slowly banishing the ghost of moral madness.

Link to JRSM article ‘The Madness of Politics’.
realvideo of Kjell Magne Bondevik interview.

The drowning of five children by their mother, Andrea Yates, was a case that forced many to confront an issue that most would rather ignore. Yates was one of the rare cases of women with puerperal (childbirth associated) psychosis who kill their children.

This week’s ABC Radio National’s All in the Mind talks to three forensic clinicians who research and work with women who have either killed or injured their children while mentally ill.

It’s an extraordinarily emotive issue, both due to the cries of condemnation from those appalled by what they consider ‘evil’ acts, and the concerns of others worried that focusing on the issue will strengthen the largely unfounded stereotype of the ‘dangerous mentally ill’.

All in the Mind manages to tackle the issue incredibly sensitively, a rarity in a world where these tragic situations only ever seem to get attention as sensational news stories or political point-scoring.

The programme looks at the sorts of mental states which have led to these tragedies and talks to two female forensic psychiatrists about how they deal with the strong emotions that these cases stir up.

If you’re interested in a more academic approach to the research in this area, psychiatrist Margaret Spinelli wrote an important 2004 article on maternal infanticide in the American Journal of Psychiatry that’s freely available online.

The programme also tackles the difficult subject of female sex offenders and how clinical science is being applied to preventing and treating this subset of the forensic population.

Link to AITM on maternal disorder.
Link to AJP article on maternal infanticide.