Category: Togetherness

The Situationist has just alerted me to a fantastic article in the Boston Globe on the development a cognitive test for suicidal thoughts that doesn’t rely solely on the conscious mind.

The test is a variant of the Implicit Association Test (IAT) that has been used to look at our automatic associations between different concepts, based on how quickly we can categorise them.

We’ve discussed in it more detail previously but it essentially relies on the fact that if you have an pre-existing association between two concepts, say, the concepts ‘blonde’ and ‘stupid’, making similar associations will be faster than associating ‘blonde’ and ‘clever’ because you’re going to be quicker doing whichever classification best matches associations you already have.

Most of the research has been done on implicit social biases, finding that even people who have no explicit prejudices against blondes, foreigners, men or whomever, might find they automatically associate certain negative concepts with these groups.

However, as the test purely measures associations between concepts, it can be used to look for other implicit biases. In fact, the researchers featured in the Globe piece have used it to test for implicit associations between the concept of self and suicide.

Most suicidal patients will admit they are at risk of harming themselves. Contrary to popular belief, suicidal patients don’t necessarily want to die, they just want the pain to stop and will be upfront if they think professionals can help.

Some, however, may have decided that death is the only relief, or they may be unable to see clear alternatives owing to the effects of mental illness on thinking.

Suicide risk is assessed on the basis of people’s actions and what they say, so a completely determined person can talk their way through a risk assessment.

This new research is testing the IAT as a way of assessing suicide risk, even if the person is denying they are suicidal.

The study, led by Dr. Matthew Nock, an associate professor in the psychology department at Harvard University, is called the Suicide Implicit Association Test…

But critics question whether the test is actually practical, and up until now no one has tried to apply it to suicide prevention. As part of his training, Nock worked extensively with adolescent self-injurers – self-injury, such as cutting and burning, is an important coping method for those who engage in it, though they are often unlikely to acknowledge it. Nock thought that the IAT could serve as a behavioral measure of who is a self-injurer and whether such a person was in danger of continuing the behavior, even after treatment.

In their first major study, Nock and Banaji asserted that the IAT could be adapted to show who was inclined to be self-injurious and who was not. And more important, they said, the test could reveal who was in danger of future self-injury.

It’s an interesting idea and the early results look intriguing, although as the article notes, the proof will be how well it actually works in practice.

One difficulty with risk assessment in psychiatry is its almost impossible to do ‘ideal’ outcome studies because of the ethical implications.

For example, lets say your new risk measure predicts someone will kill themselves. From a statistical point of view, you’d want to wait and see if they do, so you can compare these positive predictions with the negative predictions and get an accuracy measure.

But from a purely humane point of view, you’re going to intervene and try and help the person, meaning risk assessments are not always based on ‘ideal’ statistical information.

The article has an excellent discussion of some of the wider ethical and practical issues involved, drawing on the writers own experience of his brother’s suicide.

Link to Boston Globe article ‘On the Edge’ (via The Situationist).

Oliver Sacks’ fantastic 1996 autism documentary Rage for Order is now available on Google Video, where he meets some completely remarkable people and explains some of the more curious features of the syndrome.

The programme explores the sort of interests, behaviours and talents that are associated with autism through Sacks’ irresistible interest in the human condition.

It includes the artist Jessica Park, who creates the most stunningly colourful paintings of buildings with perfectly accurate star constellations in the background (that’s one of her pictures on the left).

It’s a really wonderful piece of television and was part of a six-part series that Sacks’ made called Mind Traveller.

Sadly, the other parts of the series seem to be lost to the internet, but do get in touch if you have a copy as I would to see them.

Link to ‘Rage for Order’ on Google Video.

The BPS Research Digest covers an intriguing study that found that imagining friends, parents, and romantic partners differently affected how we rate ourselves on personality measures.

The study suggests that being primed with certain sorts of relationship seems to alter either our personality, or how we perceive our personal characteristics.

Dozens of female university students were led to believe they were participating in an investigation into the effect of visualisation on heart rate, with the appropriate medical paraphernalia in place to make the story more convincing.

The students were asked to visualise a range of fairly mundane items or experiences and then at the end they were asked to visualise in detail either one of their parents, a recent romantic partner, or a friend. Afterwards they completed a range of personality and self-esteem tests. Post-experimental debriefing confirmed they hadn’t guessed the true purpose of the study.

Students who visualised a parent subsequently rated themselves as less sensual, adventurous, dominant, extraverted and industrious, than did students asked to visualise a friend or romantic partner, consistent with the idea that people revert to a more submissive “child role” with their parents.

The paper itself doesn’t mention it, but the study has some striking relevance to rather confusingly named ‘object relations theory‘, which could be much more clearly named ‘human relations theory’.

It’s a development of a Freudian idea, but instead of suggesting that sex and aggression are the core drives which shape our psychological landscape, it suggests, rather more sensibly, that relationships are the main factor that influence who we are.

In fact, it suggests that the ‘self’ is malleable and tends to be defined in terms of the people we interact with.

One of the genuinely useful legacies of psychoanalytically-inspired psychology has been the focus on the emotional interaction between people as an important shaping force in how we think and behave.

Most of Freud’s original (lets be polite and say) ‘kookiness’ has been stripped away, which leaves us with an approach that is often both empirically testable and supported by scientific studies.

For example, psychologist Susan Anderson has done a huge amount of experimental research on ‘transference’, where feelings from one relationship affect another because the two people are perceived as similar in some way.

Link to BPSRD article ‘Mind who you think of’.

One of the myths of suicide is that if a person wants to kill themselves, they’ll always find a way. While this can occur in some cases, evidence that making methods of self-harm less accessible can reduce the suicide rate suggests that deaths can be prevented with simple safety measures.

The New York Times has a thought-provoking article on exactly this topic looking at how, particularly impulsive suicides, can be prevented.

What makes looking at jumping suicides potentially instructive is that it is a method associated with a very high degree of impulsivity, and its victims often display few of the classic warning signs associated with suicidal behavior. In fact, jumpers have a lower history of prior suicide attempts, diagnosed mental illness (with the exception of schizophrenia) or drug and alcohol abuse than is found among those who die by less lethal methods, like taking pills or poison. Instead, many who choose this method seem to be drawn by a set of environmental cues that, together, offer three crucial ingredients: ease, speed and the certainty of death.

The NYT article focuses on jumping and firearms and how erecting barriers and storing guns in locked boxes are effective preventative measures.

However, if you want a flavour of really how simple the safety measures need to be to make a difference to suicide rate, research has found that putting pills in blister packs reduces lethal overdoses.

It’s amazing if you think about it, simply making it necessary to pop each pill out of its plastic packaging rather than tipping them out of a bottle means less people kill themselves.

The difference is likely a matter of minutes, but it gives time for brief impulsive urges to pass, and every popped pill requires a single deliberate action towards suicide that gives a chance for the distressed person to reconsider. Obviously, many do.

The article merits a read in full, and Liz Spikol has an interesting video commentary on the piece that’s also well-worth checking out.

Link to NYT article ‘The Urge to End It All’.
Link to Liz Spikol on ‘Is Suicide Preventable?’.

BBC Ouch! magazine has a completely fascinating article on sign names in the deaf community. They are like mandatory formal nicknames decided by a consensus of your peers that reflect something distinctive about you.

The article describes how assigning and accepting one can be a tricky social negotiation with some having to mount campaigns against unwanted sign names.

Sign names are a weird and wonderful thing, where your average hearing names like Matt, Jack or Jane look positively plain.

But before you get too excited about the possibility of throwing your dull, former identity away, let me point something out: you don’t get to choose your sign name. You don’t even get power of veto on it. It is given to you.

It makes sense. If deaf people could choose their name, you’d get loads of guys wandering around calling themselves Stud, Beer Belly or Jackie Chan’s Lovechild. Women would probably call themselves Lip Gloss, Model or Soft Hair. I’m generalising, and stereotyping, but you get my point.

When a sign name is given to you, it’s special. A bit like losing your deaf virginity. It‚Äôs thought up after an intense period of observation, when people have worked out firstly whether they like you enough to give you one (a sign name, that is), and they’ve taken all your habits and mannerisms into account to find a name that best sums you up.

I have to say, I find watching sign language completely enthralling. It always seems like a wonderful form of cognitive ballet to me.

Obviously, it has its practical uses to, as demonstrated by this video tutorial on how to flirt using sign language.

Link to article on the social complexities of sign names (via MeFi).

R.A. Radford was an economist taken prisoner during World War Two who later wrote about the complex cigarette-based economy that thrived in the POW camps in a fascinating 1945 article.

You can also read it online as a pdf if you want to see it in its original type-print glory, which I have to say, does rather add to the atmosphere it so wonderfully evokes.

It’s a vivid insight into the social organisation of the camps, and just the descriptions of the market pressures are quite interesting in themselves.

For example, the standard currency was a cigarette, but heavy air raids meant people would smoke more, presumably owing to stress, thereby altering the value of the currency through scarcity.

The camp residents imposed trade regulations, had trading areas, and some even developed businesses:

Around D-Day, food and cigarettes were plentiful, business was brisk and the camp in an optimistic mood. Consequently the Entertainments Committee felt the moment opportune to launch a restaurant, where food and hot drinks were sold while a band and variety turns performed. Earlier experiments, both public and private, had pointed the way, and the scheme was a great success.

Food was bought at market prices to provide the meals and the small profits were devoted to a reserve fund and used to bribe Germans to provide grease-paints and other necessities for the camp theatre. Originally meals were sold for cigarettes but this meant that the whole scheme was vulnerable to the deflationary waves, and furthermore heavy smokers were unlikely to attend much. The whole success of the scheme depended on an adequate amount of food being offered for sale in the normal manner.

To increase and facilitate trade, and to stimulate supplies and customers therefore and secondarily to avoid the worst effects of deflation when it should come, a paper currency was organised by the Restaurant and the Shop.

It’s completely readable even if you’re not familiar with economics and is a captivating window into POW camp society as seen through the eyes of a monetary expert.

Link to article (via MeFi).
pdf of article.

Slate has just finished an excellent five-part series on two recent books which have attempted to paint men and women as vastly different in mind, brain and behaviour by exaggerating the science of sex difference.

The books in question are Louann Brizendine’s The Female Brain and Susan Pinker’s The Sexual Paradox.

Both have been influential because the authors write from an explicitly feminist angle, and both claim to be drawing on the latest neuroscience, suggesting that they’re overthrowing the mushy political correctness of “everyone is the same”.

The Slate series pulls no punches though, saying “Ultimately, the evangelists aren’t really daring to be politically incorrect. They’re peddling one-sidedness, sprinkled with scientific hyperbole.”

Of course, there are cognitive differences between men and women, but the punchline of almost all sex difference research is that the extent of the difference between any two individuals, be they male or female, tends to vastly outweigh the average difference between the sexes.

Furthermore, while some of these books suggest the differences are innate many studies have found the differences change markedly over time and are influenced by cultural or social factors.

The series is well-researched, easy to digest and looks at the areas of communication, empathy, maths ability and development during childhood. It’s also accompanied by a three-part video discussion, which tackles similar issues.

Slate have been doing a great job of getting some accessible, level-headed neuroscience out there recently, and this is another great example. Good work science writer Amanda Schaffer.

Link to Slate series on ‘The Sex Difference Evangelists’.

In 1965, The American Journal of Psychiatry published a curious article on delusional people who had visited the White House in Washington DC, wanting to see the President.

The article reviewed the cases of 40 people admitted to the Washington D.C. General Hospital from 1960-1.

It also outlined 10 cases in more detail, this is number 6:

Case 6. A 44-year-old Negro woman “was invited” to see the President many times and prior to her trip wrote that she was finally coming. She hoped the President would stop the “gum chewing” in her head and would stop the police persecution that had caused her ears to flop and her body to go out of shape. She complained of policemen in her ears and riding up and down her nose. The patient was acutely psychotic and her stream of thought disorganized, but she claimed that she had first visited the governor of her home state and the Pentagon before trying to see the President. She refused to discuss previous hospitalization. Diagnosis: schizophrenic reaction, paranoid type.

The paper also contains some interesting speculation: “In 1960, when Mr. Eisenhower was President, only nine patients were admitted, but 32 were hospitalized in 1961, Mr. Kennedy’s inaugural year. This would suggest that some personal characteristic of the President was important.”

The study was actually based on similar research conducted more than 20 years before, on psychotic visitors to government offices in Washington DC.

Link to full text of ‘Psychotic visitors to the White House’.
Link to ‘Psychotic visitors to government offices in the national capital’.

All this week, Canada’s Globe and Mail has a fantastic special on mental health entitled Breakdown, relating the personal experiences of people who’ve experienced the extremes of thought and mood, and talking to some of the mental health professionals who work to assist people through times of mental turmoil.

During the coming week, articles on employment and mental health, addiction, mental illness and the law, fighting stigma and the Canadian way of treating mental disorder will be published on a day-by-day basis.

It’s already incredibly comprehensive though, with video interviews, articles and audio slideshows focusing on the life stories of people who’ve been diagnosed with bipolar disorder, schizophrenia and anxiety disorders, as well as an interview with psychiatrist David Goldbloom, one of Canada’s head honchos in mental health.

From what I’ve seen already, and I’m still exploring, it’s a wonderfully put together, powerful and engaging project.

Hats off to The Globe and Mail.

UPDATE: I just watched the interview with psychiatrist David Goldbloom and the last five minutes have a striking reading from an 1841 letter. After hearing the letter, the author might surprise you. Well worth checking out.

Link to Globe and Mail special (via MeFi).

Anthropologist and explorer Wade Davis gave a couple of inspiring talks to the TED conference on how the beliefs and traditions of different cultures fundamentally alter not only views about the world, but the experience of reality itself.

Both are fantastic, not only because Davis is a gripping speaker, but also because he highlights the sheer beauty and diversity of the world’s peoples and cultural practices – from Voodoo rituals in Haiti to the Inuit of Northern Canada.

The first explores cultures in some of the world’s harder to reach areas, while the second focuses on the diversity of belief and ritual across the planet.

Davis is perhaps best known for his early work on Voodoo, the process of zombification, and his discovery that the neurotoxin tetrodotoxin may be an essential part of the process.

This work was published in the scientific literature, but also in two well-known books, The Serpent and the Rainbow and Passage of Darkness.

Administration of tetrodotoxin is unlikely to be the sole explanation for zombification, however.

A 1997 paper in the medical journal Lancet reported on three cases, where what Western medicine would call mental illness and neurological impairment seemed to be present in three cases of people labelled zombies by locals in Haiti.

Anthropology is perhaps one of the smallest schools of human study, but, I think, one of the most important. It constantly reminds us that our way of seeing the world is firmly located in the culture that we live in, and that everything we understand is filtered through our own perspective.

Link to video of ‘Cultures at the far edge of the world’.
Link to video of ‘The worldwide web of belief and ritual’.
pdf of ‘Clinical findings in three cases of zombification’.

While looking through the Journal of the American Medical Association, I found this fascinating and glowing review of Rachel Maines’ book ‘The Technology of Orgasm’ that uncovers the history of how vibrators were originally popularised created to cure ‘hysteria’ in women as a Victorian medical treatment.

Hysteria has had many medical meanings through the millenia, but at the time Maines was writing about, it was a catch-all anxiety-related diagnosis usually applied to women.

While perusing turn-of-the-century magazines such as Modern Priscilla and Woman’s Home Companion, Maines was surprised to find any number of advertisements for electric vibrators. As early as 1899, she writes, machines that closely resemble modern sexual aids were marketed to women as health-promoting, antiaging devices. “All the pleasures of youth will throb within you,” proclaimed one such advertisement for White Cross vibrators in 1913. Was this early vibrator, which predated the invention of the vacuum cleaner and electric iron by a decade, merely a sexual toy sold under the guise of a medical device?

Not so, according to Maines, who describes how the vibrator was invented in the 1880s as a medical appliance. In a scrupulously researched chapter‚Äîone of the best in her book‚ÄîMaines provides a unique and fascinating history of hysteria, ending with Freud’s revision of the diagnosis in the early 1900s. Maines shows that hysteria is described in medical texts as early as 2000 BC in Egypt. Although physicians throughout history disagreed about the exact symptoms of hysteria, “anxiety, sleeplessness, irritability, erotic fantasy, sensations of heaviness in the abdomen, lower pelvic edema, and vaginal lubrication” were said to be among its many manifestations.

Believing hysteria to be caused by sexual frustration, physicians proposed that the uterus became engorged with “seed” and wandered upward inside the body until it threatened to choke its host. Treatments for hysteria, described as early as the fifth century, include stimulating the vagina and labia of the afflicted patient in order to induce a “hysterical paroxysm.” This “crisis,” during which a patient might thrust her pelvis suggestively, utter cries of pleasure, and briefly appear to lose consciousness, was thought to return the uterus to its rightful place. Maines goes on to say that treatment for hysteria was protracted, with patients typically seen weekly for an indefinite period.

Probably for those cases of treatment resistant hysteria I would imagine.

Slate has a NSFW slideshow tracking the early history of the vibrator with photos of some of these original adverts and ‘medical aids’. Although, it’s NSFW, it’s not really that erotic I’m afraid. Sorry about that.

The review is from 1999 and it turns out that the book won two prestigious academic history awards after publication.

Sadly the JAMA book review is closed-access and behind a pay wall. Don’t the American Medical Association know information is like love? It’s better when it’s free.

Link to JAMA book review, closeted behind a pay wall.
Link to Slate slideshow on the history of the vibrator.
Link to more info on Rachel Maines’ book.

Pure Pedantry has picked up on a wonderful study that has found that incidences of road rage correlate with the number of bumper stickers a person has on their car.

The abstract below suggests that bumper stickers are potentially an expression of territorial markers and that aggressive people are more likely to use more, but I think we all know it’s just down to the fact that “my other car is a Ferrari” just isn’t funny any more.

Territorial Markings as a Predictor of Driver Aggression and Road Rage

Journal of Applied Social Psychology, Vol 38 (6) p1664-1688, June 2008

William J. Szlemko, Jacob A. Benfield, Paul A. Bell, Jerry L. Deffenbacher, Lucy Troup

Aggressive driving has received substantial media coverage during the past decade. We report 3 studies testing a territorial explanation of aggressive driving. Altman (1975) described attachment to, personalization of, and defense of primary territories (e.g., home) as being greater than for public territories (e.g., sunbathing spot on a beach). Aggressive driving may occur when social norms for defending a primary territory (i.e., one’s automobile) become confused with less aggressive norms for defending a public territory (i.e., the road). Both number of territory markers (e.g., bumper stickers, decals) and attachment to the vehicle were significant predictors of aggressive driving. Mere presence of a territory marker predicts increased use of the vehicle to express anger and decreased use of adaptive/constructive expressions.

Link to Pure Pedantry on the study.
Link to abstract of scientific study.

News that a neuroimaging study has found that the brains of gay participants more closely resemble those of their straight, opposite sex counterparts is being widely reported, but one of the most interesting details is largely being ignored.

The study was completed by neuroscientists Ivanka Savic and Per Lindstrom and had two parts.

The first and most widely reported part compared the brain structure of 25 homosexual men, 25 heterosexual men, 20 homosexual women and 20 heterosexual women.

The punchline is that in a measure of brain symmetry, straight men and gay women were similar, and gay men and straight women were similar.

But this isn’t the most interesting part in itself. Structural brain differences between gay and straight participants have been reported before, although this new study was better designed as it included both males and females.

What is most intriguing about this new study is a further investigation assessed amygdala function in each side of the brain. In particular, it looked at the balance of activity between the two hemispheres when the participants were asked just to breath in unscented air.

The study found that straight men and gay women had greater right sided activity, whereas gay men and straight women showed equal activation on both sides. As with the structural comparisons, the measurements from homosexual participants were similar to their straight, opposite sex counterparts.

The reason this new study is interesting is because it found a functional brain difference in a task that was not specifically linked to sex or attraction.

Previous studies have found functional differences in the brains of gay and straight people, but they have tended to use experiments where participants were presented with either sexual images, gender specific faces, or stimuli linked to sexual activity, such as pheromones.

These are interesting findings, but they may be the result of same-sex sexual activity, rather than an explanation for why people seek it out.

If you have experience of sleeping with same-sex partners, it’s hardly surprising that you may have a different response to same-sex material.

These new findings were from a neutral task. Now it’s possible that lots of same sex experience could affect your brain response to fresh air, but it’s highly unlikely.

It is possible, of course, that same-sex experience could alter the function of specific brain circuits which affects even non-sex related tasks, but these results also suggest the possibility that some more general differences in brain organisation are responsible for a number of effects, including sexual orientation.

This last explanation is what the researchers suggest, and it is another clue that sexual orientation is not simply the result of experience.

Of course, it’s not definite proof, but it is an interesting and important pointer.

Link to abstract of study.
Link to write-up from New Scientist.

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’.

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.

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’.