Category: Togetherness

Psychologist Dr Petra Boyton has just completed her yearly review of the past year in sex, revisits last year’s predictions and looks forward to possible developments in 2008.

One of her predictions is that the media will become obsessed with ‘future sex’. Indeed, the recently published book Love and Sex with Robots got a huge amount of media coverage, including a review in The New York Times, despite being big on speculation and short on current evidence.

My own personal barometer of the progress of sex research is the balance of how many papers have been published on the neuroscience of orgasm compared to the neuroscience of hiccups.

At the time of writing, PubMed lists 99 papers on the neuroscience of hiccups, whereas only 71 are listed as discussing the neuroscience of orgasm.

Let’s hope 2008 does a better job of redressing the balance than 2007.

Link to Dr Petra’s review of 2007.
Link to review of last year’s sex predictions.
Link to predictions for 2008.

The New York Times has a fantastic article on the neuroscience of Alzheimer’s disease, as well as the human impact of the disorder on individuals and their families.

The article is accompanied by two video reports that weave together personal stories with some of the latest developments in understanding the disorder.

Alzheimer’s is a form of dementia, which is where the mind and brain break down quicker than would be expected through normal ageing.

Like many forms of dementia, the first symptoms (such as memory, attention, language or movement problems) appear after a significant amount of brain damage has already been done.

One of the key aims of dementia research is to identify this process while it is still ‘silent’ to understand how it forms and try and prevent it developing further.

Genetics are one focus, but they are known to be complex. Certain genes (most famously ‘ApoE’) are known to alter the risk of developing the Alzheimer’s in older people, but they’re only one part of the puzzle.

However, there is one form of Alzheimer’s that is inherited in an autosomal dominant pattern, meaning that if one of your parents has it, you’ve got a fifty percent change of getting it too.

It means that if you’ve inherited the gene or genes (autosomal dominance implies a single gene, but several are currently candidates), you’re almost definitely going to develop the disorder.

Interestingly, this autosomal dominant version of Alzheimer’s tends to happen much earlier in life, in the early 60s, 50s or in some cases, even the 40s.

A similar thing happens with other similarly inherited dementias, like CADASIL, where a single gene has been fairly confidently identified.

It’s both terrifying and amazing to think that a difference in a single gene, expressing a single different protein, can cause such as massive break down in brain function.

The article also looks at a new type of dye which allows abnormal clumps of amyloid protein, a brain change characteristic of Alzheimer’s, to be seen on a PET brain scan done on living people.

At the moment, Alzheimer’s can only be diagnosed with 100% accuracy after death, but this new technique could allow brain changes to be tracked in people before they develop any symptoms.

However, it’s become clear that you can have protein clumps without having the disease.

Researchers are increasingly talking about ‘cognitive reserve‘, a measure of ‘wear and tear’ or ‘fitness’ of the brain, with the idea that the disease happens where various factors tip the brain ‘over the threshold’ into physical decline.

The ‘threshold’ is thought to be set by a combination of genetics, physical health, cognitive ability, education and level of activity.

The New York Times article is a wonderful guide to the scientific debates behind the quest to understand the disorder, and the videos really bring home the effect of it.

Link to NYT article ‘Finding Alzheimer‚Äôs Before a Mind Fails’ with videos.

The Boston Globe has produced a powerful video documentary and article series on prison suicide and mental illness.

Treating mental illness in prison is a complex business. As Time reported earlier this year, the rates of mental illness are much higher among offenders, confinement is known to worsen mental health, and prison treatment facilities are usually poor.

On top of this, some prisoners attempt to fake mental illness to gain hospital privileges, so working out whether someone is genuinely at risk of harming themselves can be quite tricky.

All of these factors can contribute towards the high suicide rate in prisons, and create tension between staff and families.

As prisons become the asylum of last resort for the mentally ill, desperation, frustration and violence are rising on both sides of the cell door. About 50 times each month, inmates are assaulting prison staff members. And, at nearly the same rate, inmates, many of whom say they are abused by officers, attempt to kill or injure themselves. The Spotlight Team examines the tension between mentally disturbed inmates and their jailers.

The Boston Globe has produced a remarkably comprehensive resource, with video, articles, prisoners suicide notes, official reports, and personal stories.

Link to Boston Globe special report on prison suicide.

The New Yorker has a completely gripping article on intensive care medicine that while fascinating in its own right, is also interesting as it contains an amazing account of a how a three year old girl was resuscitated and recovered brain function after near drowning, and stresses the importance of behavioural interventions in high-tech medicine.

The article is essentially about an incredibly simple idea that is vastly reducing infection rates and improving survival rates in intensive care – using checklists to make sure that each step of complex procedures are completed.

It’s been championed by physician Dr Peter Pronovost and is simple but effective way of reducing cognitive error in high pressure situations.

It’s interesting that the idea has found a fair amount of resistance among some doctors, who think that it somehow diminishes their expertise if they have to check against a list, despite the fact that common slips affect even the most competent of people.

One illustration of how complex the intensive care process has become is given near the beginning of the article when it describes a case of a three-year-old girl saved from drowning with what has become a hugely complex, multi-expertise, high-tech medical effort.

Consider a case report in The Annals of Thoracic Surgery of a three-year-old girl who fell into an icy fishpond in a small Austrian town in the Alps. She was lost beneath the surface for thirty minutes before her parents found her on the pond bottom and pulled her up. Following instructions from an emergency physician on the phone, they began cardiopulmonary resuscitation. A rescue team arrived eight minutes later. The girl had a body temperature of sixty-six degrees, and no pulse. Her pupils were dilated and did not react to light, indicating that her brain was no longer working.

But the emergency technicians continued CPR anyway. A helicopter took her to a nearby hospital, where she was wheeled directly to an operating room. A surgical team put her on a heart-lung bypass machine. Between the transport time and the time it took to plug the inflow and outflow lines into the femoral vessels of her right leg, she had been lifeless for an hour and a half. By the two-hour mark, however, her body temperature had risen almost ten degrees, and her heart began to beat. It was her first organ to come back.

After six hours, her core temperature reached 98.6 degrees. The team tried to put her on a breathing machine, but the pond water had damaged her lungs too severely for oxygen to reach her blood. So they switched her to an artificial-lung system known as ECMO—extracorporeal membrane oxygenation. The surgeons opened her chest down the middle with a power saw and sewed lines to and from the ECMO unit into her aorta and her beating heart. The team moved the girl into intensive care, with her chest still open and covered with plastic foil. A day later, her lungs had recovered sufficiently for the team to switch her from ECMO to a mechanical ventilator and close her chest. Over the next two days, all her organs recovered except her brain. A CT scan showed global brain swelling, which is a sign of diffuse damage, but no actual dead zones. So the team drilled a hole into the girl’s skull, threaded in a probe to monitor her cerebral pressure, and kept that pressure tightly controlled by constantly adjusting her fluids and medications. For more than a week, she lay comatose. Then, slowly, she came back to life.

First, her pupils started to react to light. Next, she began to breathe on her own. And, one day, she simply awoke. Two weeks after her accident, she went home. Her right leg and left arm were partially paralyzed. Her speech was thick and slurry. But by age five, after extensive outpatient therapy, she had recovered her faculties completely. She was like any little girl again.

It’s a wonderful article that speaks to a number of important issues in medicine, including the self-perception and culture of clinicians, the importance and power of simple changes in behaviour, and why low-tech capital-free solutions are often the hardest to implement.

Link to New Yorker on checklists and intensive care medicine.

The science of morality is becoming a hot topic at the moment, and this week two articles, one in Time and one in Reason, have both tackled the issue.

The Time article is a particularly good example. It’s wonderfully written and takes a comprehensive look at the field, taking in evolution, empathy, cognitive neuroscience and culture.

If the entire human species were a single individual, that person would long ago have been declared mad. The insanity would not lie in the anger and darkness of the human mind‚Äîthough it can be a black and raging place indeed. And it certainly wouldn’t lie in the transcendent goodness of that mind‚Äîone so sublime, we fold it into a larger “soul.” The madness would lie instead in the fact that both of those qualities, the savage and the splendid, can exist in one creature, one person, often in one instant.

Link to Time article ‘What Makes Us Moral’.
Link to reason article ‘The Theory of Moral Neuroscience’.

The Charlie Rose Show had a recent discussion on the science of sex, and the video of the programme is available to view online. It’s a fascinating discussion, largely focusing on biology and neuroscience, but as Dr Petra Boyton notes it’s quite a narrow consideration in some respects.

For me, simply seeing a discussion of sex research in the still remarkably prudish American media is a huge step.

I suspect their achingly academic approach to the subject reflects the need to be seen to be serious, but it’s also interesting that the Charlie Rose show is sponsored by Pfizer, the makers of Viagra, which may also account for the almost unrelenting focus on biology.

Petra Boynton suggests areas which weren’t tackled by the programme, and highlights that there’s much more to sex research than measuring the mechanisms of our bodies.

It’s well worth watching, but definitely with some of the context in mind.

One of the best programmes on sexuality I have seen on TV was The Truth About Female Desire, which was a collaboration with the Kinsey Institute and involved several women taking part in a number of scientific experiments on female sexuality.

Unfortunately, it doesn’t seem to be available on public servers, but I’ll post on Mind Hacks if ever I find a reliable torrent.

Link to Charlie Rose discussion on Human Sexuality.
Link to Petra Boynton on the programme.

The New York Times has a brief but interesting article on the psychology of denial, which according to the piece has got a bad rap. It’s actually a useful and necessary process in many types of relationship.

Yet recent studies from fields as diverse as psychology and anthropology suggest that the ability to look the other way, while potentially destructive, is also critically important to forming and nourishing close relationships. The psychological tricks that people use to ignore a festering problem in their own households are the same ones that they need to live with everyday human dishonesty and betrayal, their own and others’. And it is these highly evolved abilities, research suggests, that provide the foundation for that most disarming of all human invitations, forgiveness.

In this emerging view, social scientists see denial on a broader spectrum — from benign inattention to passive acknowledgment to full-blown, willful blindness — on the part of couples, social groups and organizations, as well as individuals. Seeing denial in this way, some scientists argue, helps clarify when it is wise to manage a difficult person or personal situation, and when it threatens to become a kind of infectious silent trance that can make hypocrites of otherwise forthright people.

The article also discusses a number of experiments where participants ‘cheat’ on certain aspects, but which demonstrate that we seem to manage not only how much we admit to others about the deception, but we also our own awareness of what we’re doing (mostly unconsciously it seems).

Link to NYT article ‘Denial Makes the World Go Round’.

PsyBlog has just concluded a great series of articles, each of which tackled a classic experiment in social psychology that demonstrated something counter-intuitive, curious or even shocking about ourselves.

You may recognise some of them, as they’ve become various shades of legendary to notorious, even to people without a special interest in psychology.

Others are well known within the field but have yet to filter out to the general consciousness.

To my mind, one of the best is the theory of cognitive dissonance. Perhaps one of the most important findings in social psychology – explaining how we are motivated to reconcile conflicting beliefs and actions.

The rest of the experiments have been equally as influential and the whole series makes for a great overview of some of the foundation stones of the modern science of mind.

Link to “Why We do Dumb or Irrational Things: 10 Brilliant Social Psychology Studies”.

Someone’s posted examples of artwork created by patients that were undergoing LSD psychotherapy when it was originally trialled by Stanislav Grof, before research in this area was suspended by panicked world governments when the drug became widely used.

The images are from Grof’s book LSD Psychotherapy, and range from the whimsical, to the abstract, to the terrifying.

The early explorations of using psychedelic drugs in psychotherapy seemed promising but were over far too soon to give a definite answer of whether they helped overcome any mental health or behavioural problems.

It’s only very recently that scientific research into this area has re-started, largely due to the careful work of MAPS – the Multidisciplinary Association for Psychedelic Studies.

Link to artwork of patients undergoing LSD psychotherapy.

Filmmaker Jo McGinley has created a brief and adorable film about her cat, Charley, who has cerebellar hypoplasia – a disorder in the development of the cerebellum that causes marked movement and coordination problems.

Cerebellar hypoplasia also occurs in humans and can lead to similar movement difficulties.

The complete function of the cerebellum is poorly understood, but it is well known that it is a key part of the brain’s movement system.

Damage to the cerebellum can affect coordination and timing, and the effect of alcohol on movement may, at least in part, be explained by its effect on the cerebellum.

‘Hypolasia’ means ‘incomplete growth’ and so the ‘cerebellar hypoplasia’ refers to the physical growth problem with this part of the brain.

The movement problem associated with this, as can be seen in Charley, is known as ‘cerebellar ataxia’.

‘Ataxia’ literally means ‘without order’ and refers to the coordination of muscles. So, ‘cerebellar ataxia’ refers to a disordered movement of muscles caused by problems with the cerebellum.

The film of Charley is wonderfully endearing, and it makes the point that kittens are often destroyed if they have this problem, despite the fact that they are in no pain, need no special care, and have a normal life span.

Link to film ‘This is Charley’

I found this quote from Charles Dickens on the first page of Samuel Barondes’ book Mood Genes. It is both sage advice and reassuringly optimistic.

To lighten the affliction of insanity by all human means is not to restore the greatest of divine gifts; and those who devote themselves to the task do not pretend that it is… Nevertheless, reader, if you can do a little in any good direction – do it. It will be much, some day.

Dickens himself was no stranger to mental distress. Despite being recognised as one of the greatest writers of his generation, he reportedly suffered severe bouts of depression.

Unfortunately, Barondes’ book doesn’t mention the source of the quote, so if anyone knows which of Dickens’ works it comes from, do let me know.

UPDATE: An answer gratefully received from crabbydad. Grabbed from the comments:

Apparently, the quote is from “A Curious Dance Round a Curious Tree,” an essay written by Dickens after a visit to St. Luke’s hospital, a hospital for the “impoverished mentally ill.” You can find more info here.

As well as the commentary linked to above, the full text of Dickens’ article is also available online.

Harvard journalism magazine Nieman Reports has a brief 2004 article (pdf) by psychiatrist Anthony Feinstein on how war journalists respond to what they witness and why they return to cover traumatic situations.

The article briefly summarises some of Feinstein’s research on war journalists, and also notes the results on an interesting study that looked at differences between final year journalism students who wanted to become war journalists, and those who did not.

Given the dangers confronted, the high mortality, and increased risk of developing PTSD and depression, what motivates journalists to return repeatedly to war zones?

The journalists in my study spent, on average, 15 years covering war. Those I interviewed spoke of factors such as the importance of bearing witness, keeping the public informed of important events, having a ringside seat as history unfolded, and personal ambition. Yet there seems to be another pivotal factor that may override all of these. There is evidence that individuals who are attracted to risky and dangerous professions are to a high degree biologically primed for this type of activity…

Preliminary data from a recently completed study in my laboratory demonstrate that final year Canadian journalism students who propose following a career in foreign lands not only have a fundamentally different personality profile from their peers who wish to remain at home, but also possess different cognitive attributes. This last point refers to a certain pattern of thinking and approach to problem solving that correlates with well-defined neural networks.

Feinstein has written a book on the subject called Dangerous Lives that apparently explains his work in more detail.

pdf of ‘The Psychological Hazards of War Journalism’.

Time magazine has a great article discussing psychological differences that have been picked up by research looking at birth order effects. Interestingly, while first and last borns seems to have distinct traits, middle children are still a bit of a mystery.

Birth order effects seem to be one of those things that can be reliably found when examining large groups but, because of the large amount of individual variation, strong effects are not reliably present on the level of single families.

Nevertheless, the research has found over the population there are, on average, some interesting psychological differences linked to birth order – particularly between first and last borns.

…personality tests show that while firstborns score especially well on the dimension of temperament known as conscientiousness ‚Äî a sense of general responsibility and follow-through ‚Äî later-borns score higher on what’s known as agreeableness, or the simple ability to get along in the world. “Kids recognize a good low-power strategy,” says Sulloway. “It’s the way any sensible organism sizes up the niches that are available.”

Even more impressive is how early younger siblings develop what’s known as the theory of mind. Very small children have a hard time distinguishing the things they know from the things they assume other people know. A toddler who watches an adult hide a toy will expect that anyone who walks into the room afterward will also know where to find it, reckoning that all knowledge is universal knowledge. It usually takes a child until age 3 to learn that that’s not so. For children who have at least one elder sibling, however, the realization typically comes earlier. “When you’re less powerful, it’s advantageous to be able to anticipate what’s going on in someone else’s mind,” says Sulloway.

We featured some studies previously on Mind Hacks that suggested that first born children have marginally higher IQ scores, although a similar study in Thai medical students found the reverse effect, younger siblings tended to be more intelligent.

This highlights the role of culture in these effects, and the Time article illustrates a similar point with regards to girls. Perhaps fifty years ago when girls were less expected to go to college and have careers, the birth order effect may have been much less clear because of the cultural limitations on female work and education.

Now the cultural expectations have changed, the effect of birth order on psychological development may also be different.

Link to Time article ‘The Power of Birth Order’.

Newsweek has a brief article on what research has told us about the link between money and happiness. Essentially, more money makes you happier until you’re comfortable, and then, it really doesn’t do much good.

Interestingly though, a study that looked at how happy a number of similarly earning young people were, found that the happier ones went on the make more money later in life.

If money doesn’t buy happiness, what does? Grandma was right when she told you to value health and friends, not money and stuff. Or as Diener and Seligman put it, once your basic needs are met “differences in well-being are less frequently due to income, and are more frequently due to factors such as social relationships and enjoyment at work.” Other researchers add fulfillment, a sense that life has meaning, belonging to civic and other groups, and living in a democracy that respects individual rights and the rule of law. If a nation wants to increase its population’s sense of well-being, says Veenhoven, it should make “less investment in economic growth and more in policies that promote good governance, liberties, democracy, trust and public safety.”

(Curiously, although money doesn’t buy happiness, happiness can buy money. Young people who describe themselves as happy typically earn higher incomes, years later, than those who said they were unhappy. It seems that a sense of well-being can make you more productive and more likely to show initiative and other traits that lead to a higher income. Contented people are also more likely to marry and stay married, as well as to be healthy, both of which increase happiness.)

It’s not only the case that money doesn’t buy happiness, being materialistic is also associated with worse mental health and overall adjustment.

Link to article ‘Why Money Doesn’t Buy Happiness’.

ABC Radio National’s All in the Mind has just broadcast the first of a two-part series on two of the most important collections of art by psychiatric patients. The programme considers the ethical and artistic issues raised by displaying the creative work of people who may be experiencing profound alteration in their thinking.

The first part explores Australia’s Cunningham Dax Collection, named after Eric Cunningham Dax, a psychiatrist who realised the therapeutic potential of art and encouraged artistic expression by patients.

Cunnigham Dax collected the artworks not for the aesthetic value, however, and saw their interest largely in clinical terms – as a way of better understanding the problems of the mind.

In contrast, the Prinzhorn collection (which we discussed earlier on Mind Hacks) was meant to highlight the artistic talents of people with mental illness, and so historically has had quite a different approach.

The programme is incredibly thought provoking both in terms of how we understand the artistic significance of these works, and the ethics of these collections.

For example, considering the works purely of clinical interest seems to rob the creator of any artistic voice or creative credit, while considering them of purely artistic interest perhaps robs the creator of the rights of confidentiality ascribed to medical patients.

The programme also touches on the power of these artworks to stir strong emotions and communicate seemingly alien experiences and has obviously generated a lot of interest, as the Dax Collection website has slowed to a snail’s pace.

Next week’s programme will examine the Prinzhorn Collection and its remarkable survival during a period when the Nazi’s attempted to eradicate what they considered ‘degenerate art‘.

Link to AITM on ‘Art in the Asylum’.
Link to Cunningham Dax collection.