Like tears in the rain

The New York Times has a great short article on the science of crying, covering recent studies that have investigated the common idea that it is a useful way of releasing pent-up emotion.

The idea that crying is cathartic has been researched more than I realised with numerous large scale studies tackling in what situations people cry, as well what impact it has on our emotional state.

Now, some researchers say that the common psychological wisdom about crying ‚Äî crying as a healthy catharsis ‚Äî is incomplete and misleading. Having a ‚Äúgood cry‚Äù can and usually does allow people to recover some mental balance after a loss. But not always and not for everyone, argues a review article in the current issue of the journal Current Directions in Psychological Science. Placing such high expectation on a tearful breakdown most likely sets some people up for emotional confusion afterward…

In a study published in the December issue of The Journal of Social and Clinical Psychology, Dr. Rottenberg, along with Lauren M. Bylsma of the University of South Florida and Ad Vingerhoets of Tilburg University in the Netherlands, asked 5,096 people in 35 countries to detail the circumstances of their most recent crying episode. About 70 percent said that others’ reactions to their breakdown were positive, comforting. But about 16 percent cited nasty or angry reactions that, no surprise, generally made them feel worse.

The science of crying was also covered in a recent BPS Research Digest post that discussed another one of Rottenberg’s studies that focused entirely on females.

Link to NYT piece ‘The Muddled Tracks of All Those Tears’.

Hello, my name is Trouble

Time magazine has an interesting article on links between given names and behaviour, with a new study finding children with unpopular names are more likely to be get in trouble with the law.

This doesn’t mean that being called an unusual name causes criminality – the article notes that boys with unpopular names are likelier to live in single-parent households and be poorer, which are also known to be linked to higher levels of offending.

However, it does add to a growing body of research suggests that our names have a curious influence on our life.

A great review article in The Psychologist from last year covered much of findings, including the fact that people tend to buy products they share initials with, those whose names start with C or D are more likely to receive those grades than are other students, and people called Louis are more likely to live in St. Louis, Mary in Marysville and so on.

The same effect also seems to happen with initials, so Marys are also more likely to live in Manchester.

However, the Time article focuses more on how your name affects how others react towards you and perceive you, which may have a reciprocal impact on your own life chances:

The short answer is that our names play an important role in shaping the way we see ourselves — and, more important, how others see us. Abundant academic literature proves these points. A 1993 paper found that most people perceive those with unconventionally spelled names (Patric, Geoffrey) as less likely to be moral, warm and successful.

A 2001 paper found that we have a tendency to judge boys’ trustworthiness and masculinity from their names. (As a guy whose middle name is Ashley, I can attest to the second part.) In a 2007 paper (here’s a PDF), University of Florida economist David Figlio found that boys with names commonly given to girls are likelier to be suspended from school.

And an influential 1998 paper co-authored by psychologist Melvin (a challenging first name if there ever was one) Manis of the University of Michigan reported that “having an unusual name leads to unfavorable reactions in others, which then leads to unfavorable evaluations of the self.”

Link to Time on the effects of names.

If Freud were a woman

I’ve just found this clever short essay that parodies Freud by imagining that he was a woman.

It discusses the work of Phyllis Freud, rather than the better known Sigmund, who puts a female perspective in the centre of his male-centric theories.

As Phyllis observed…there was ‚Äúyet another surprising effect of womb envy, or the discovery of the inferiority of the penis to the clitoris, which is undoubtedly the most important of all…that masturbation…is a feminine activity and that the elimination of penile sensuality is a necessary pre-condition for the development of masculinity.‚Äù

In this way, Phyllis Freud wisely screened all she heard from her testyrical patients through her understanding, still well accepted to this day, the men are sexually passive, just as they tend to be intellectually and ethically. After all, the libido is intrinsically feminine, or, as she put it with her genius for laywoman’s terms, “man is possessed of a weaker sexual instinct.”

This was also proved by man’s mono-orgasmic nature.

Apparently it’s taken from one of the many, many feminist critiques of Freud’s work, who famously focused on theories of male psychology because women just seemed too baffling.

Link to ‘What if Freud were Phyllis?’

Peering into the darkness, through the key hole

Locked-in syndrome is a dramatic condition where, after brain stem damage, patients are conscious but paralysed and can only communicate with the outside world by an eye-blink or muscle twitch.

Because of limited communication it has been difficult to assess the impact of the damage on thinking and reasoning, but a French team have created tests that can be completed by simple yes / no movements – allowing the first comprehensive study into the cognition of the locked-in mind.

The syndrome usually occurs after a stroke, where an interruption to the blood supply selectively damages the neurological ‘relay station’ that transmits movement impulses to the rest of the body, leaving an almost total paralysis – classically except for a facial muscle.

It has been assumed that affected people are paralysed but cognitively intact – their thinking isn’t affected.

In one famous example, the editor of Elle magazine, Jean Dominique Bauby, wrote the book The Diving Bell and the Butterfly after suffering locked-in syndrome by painstakingly selecting letters with an eye-blink. It’s both stunningly beautiful and eloquent, demonstrating a keen and focused mind.

But because of extremely limited communication, it’s difficult to say whether this level of preserved mental ability is common because traditional neuropsychological tests usually require relatively complex responses.

To address the problem, a French team, led by neurologist Marc Rousseaux, designed tests to assess nine patients that included everything from visual recognition tasks to logical-mathematical reasoning problems, all which could be answered with yes / no responses – just eye-blinks in some cases.

The appendix of their article has the full list of the tests and they are remarkable for their ingenious design.

They team found that while the patients were generally mentally sharp, problems in particular areas were not uncommon, with a significant minority showing selective impairments in areas such as comprehension, understanding meaningful connections, or problem solving.

Sadly, this means that it is unlikely that all locked-in patients share Jean-Dominique Bauby’s remarkably preserved intellect, but the development of these ingenious tests means that we can better understand the impact of the syndrome, and the strengths and weakness of affected patients.

Link to full-text of study on locked-in patients.

Literature and psychiatry

This month’s British Journal of Psychiatry has another one of its fantastic ‘psychiatry in 100 words’ series, with this month’s column focusing on literature.

The short piece is by psychiatrist Femi Oyebode who is the author of a recent book (pictured on the left) on the subject that covers everything from literary accounts of drug abuse to the use of narrative in fictional accounts of mental illness.

Literature and psychiatry — in 100 words

Reading works of fiction and attending to the language, the dialogue, the mood is like listening to patients. In both activities, we enter into other worlds, grasp something about the inner life of characters whose motivations may be unlike our own. D. H. Lawrence referring to this aspect of the novel wrote: `It can inform and lead into new places the flow of our sympathetic consciousness, and it can lead our sympathy away in recoil from things gone dead. Therefore the novel, properly handled, can reveal the most secret places of life’. Is this not also, partly, the task of psychiatry?

Link to ‘Literature and psychiatry ‚Äî in 100 words’.
Link to details of ‘Mindreadings: Literature and Psychiatry’ book.

The long term effects of banging heads on the field

Sportsmen who suffer concussion in early adulthood may experience long-term reduction in brain function well into later life, according to a study released this week.

Although the study had only 40 participants, it is striking as it looked at the effects 30 years after the original concussions and used a wide and diverse range of tests for cognitive and neurological function, the majority of which showed some level of impairment.

This comes in the same week that Boston University School of Medicine reported that former American football player, Tampa Bay Buccaneer Tom McHale, was suffering from chronic traumatic encephalopathy (CTE), a degenerative brain disease caused by head trauma, when he died in 2008 at the age of 45.

CNN has a good write-up of the news with photos and images of the long-term effects of persistent sports concussion and we covered the work of Dr Bennet Oamlu, who does post-mortems on cognitively impaired American football players, back in 2007.

Repititive sports concussion is now recognised as having a significant neurological impact and has also been found in rugby and boxing.

Interestingly, ex-professional football players (known as soccer players to Americans and other football philistines) probably have higher levels of dementia and there is an ongoing debate about whether this is due to the low level impact of heading the ball.

Some think it is, other think it might be due to the fact footballers consume a lot of alcohol, and so the higher levels of dementia just might be wear and tear from all the booze.

Link to full text of long-term sports concussion study.
Link to CNN on sports concusion and dementia (via NeuronCulture).

Shattered delusions

I’ve just found a fascinating article in the History of Psychiatry about a type of delusion that was widely reported in the 15th to 17th centuries but rarely occurs in modern times. The reports were of patients who believed that they were made of glass and thought they might shatter if they suffered even the lightest of knocks.

In some of the more unusual forms, people struck with this form of madness might even consider themselves to be an oil lamp, a drinking vessel or even trapped in glass bottle.

The belief could even be specific to certain parts of the body:

Reports of glass bones, arms, and legs appeared much later, but Early Modern accounts were particularly rich in allusions to glass hearts/chests, and fragile heads. Tommaso Garzoni, an Italian monk,wrote a series of character sketches of mentally-disturbed people in 1586. In one of these cameos, drawn from Galen, the fragile delusion presents as a man who thought that his body consisted of only a large head, which he protected from injury by avoiding all contact with his fellows.

The delusion was reported in medical and the proto-scientific literature of the time, but also shows up in plays and literature.

Reportedly, one famous sufferer was King Charles VI of France, who allegedly refused to allow people to touch him, and wore reinforced clothing to protect himself.

While we tend to be most interested in how new delusional themes arise in response to cultural developments, we pay much less attention about delusions which were once common but now rarely occur.

This is a lovely example of a very well researched look at the history of no-longer popular delusions.

It’s also worth noting that Wikipedia has a page on the delusion where someone has briefly summarised some of the main points of the article.

Link to ‘Reflection of the Glass Delusion of Europe’.
Link to DOI entry for same.
Link to glass delusion page on Wikipedia.

Legal threat for criticising neurobabble ‘lie detector’

Francisco Lacerda is a professor of phonetics and the author of an academic article criticising the use of the unproven voice analysis ‘life detector’ technology in the legal system. He highlighted “discrepancies between the claims the producers and vendors make and what their products are capable of delivering” and as a result, is now being threatened with a libel suit by a company that makes these devices.

The academic journal received similar threats and, rather disappointingly, has now taken the article offline.

But have no fear, a copy was grabbed from the International Journal of Speech Language and the Law before it disappeared and is now available online for all to read.

The article makes for interesting reading, as it looks at the claims and scientific basis of both specific products and the whole project of using voice stress for ‘detecting’ lies.

The company concerned are Nemesysco, who manufacture devices that supposedly detect lies by analysing speech patterns, despite the fact that there is no conclusive peer-reviewed evidence that the devices reliably detect untruths.

The company claim that their products works like this:

The technology detects minute, involuntary changes in the voice reflective of various types of brain activity. By utilizing a wide range spectrum analysis to detect minute changes in the speech waveform, LVA detects anomalies in brain activity and classifies them in terms of stress, excitement, deception, and varying emotional states, accordingly. This way, LVA detects what we call ‘brain activity traces,’ using the voice as a medium. The information that is gathered is then processed and analyzed to reveal the speaker’s current state of mind.

If that made no sense to you, read it again. It won’t make any more sense but it does get funnier.

Rather than presenting data showing that their devices work, the company is resorting to legal action to silence their critics.

UPDATE: Grabbed from the comments:

The article is quite unusual for a scientific article. For example, it has a section titled “who is Mr. Liberman?” addressing a private person and claiming that he is a charlatan based on a visit by a friend made to a private company.

Link to report of legal threat from Stockholm University.
Link to copy of pulled article.

2009-01-30 Spike activity

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

The BPS Research Digest reports on how the weather can affect our memory.

Hallucinations, psychosis found as rare side-effect of ADHD drugs in children, reports The Washington Post. Study abstract here.

The New York Times reports that coffee intake is associated with a lower risk of developing <a href="Coffee lower dementia risk
http://www.nytimes.com/2009/01/24/health/research/24coffee.html?em”>dementia.

The neuroscience of acalculia, an impairment in understand number and calculation, is discussed in a feature article from New Scientist.

The LA Times reports on a new study finding children who had thimerosal based vaccines are cognitive and neurologically normal later in life. Study abstract here.

There’s a great article over at Computer World on building better CAPTCHAs. Sort of an anti-AI science as it has to require something that computers can’t easily do.

New Scientist reports that video game conditioning spills over into real life, although actually, it would be much more surprising if it didn’t.

Two teenage boys singing about CBT on YouTube. History now officially complete.

Neurophilosophy discusses a lovely study finding that touches to the face when we’re trying to understand speech can affect how we perceive what is being said.

An in-depth article on the ‘connectome‘ and the quest to understand the brain’s wiring appears in Nature.

American Psychologist published the first replication of the Milgram conformity experiments for 30 years and has lots of commentary.

Nintendo brain-trainer ‘no better than pencil and paper’, reports The Times.

Neuroanthropology has a brilliantly written piece on veteran’s experiences of PTSD and combat trauma.

Reviews of books on AI morality and embodied cognition appear in this week’s Nature.

New Scientist reports that overweight seniors who consume fewer calories show improved memory.

An interview with Edward Vul of the ‘voodoo correlations’ controversy is on SciAm Mind Matters. The latest reply from some of the ‘red list’ researchers is now online as a pdf.

The Economist reports that we are more like to procrastinate when asked to think in the abstract.

Pharmacy students also have a negative attitude towards mental health patients, reports Dr Shock MD.

Science News reports on a neuroimaging study finding that key emotion areas are involved in empathetic understanding of others’ pain.

The neuroscience of legal and courtroom decision making is discussed on SciAm Mind Matters.

ABC Radio National’s Ockham’s Razor discusses the neurological impact of viral diseases and the history of rabies vaccination.

The Seattle Times reports on the US Army’s highest suicide rate since records began.

A new paper that might give a ‘theory of everything’ for memory is discussed by Developing Intelligence.

Furious Seasons reports on a new head-to-head metanalysis of which are the best antidepressants.

New SciAmMind on play, placebo, lies and illusion

The new edition of the excellent Scientific American Mind has just hit the shelves and several of the feature articles are freely available online – covering the psychology of play, some fascinating new research on the placebo effect, the quest to build a brain scan lie detector and several other fantastic reports.

I found the article on the cognitive benefits of free play particularly interesting. In this instance ‘free play’ is where kids are playing without set rules or requirements, as are needed when playing structured games or doing tasks.

The article is full of intriguing studies that indicate the immediate and long-term benefits of imaginative play. Even rough-and-tumble seems to be associated with better social skills:

Play fighting also improves problem solving. According to a paper published by Pellegrini in 1989, the more elementary school boys engaged in rough-housing, the better they scored on a test of social problem solving. During the test, researchers presented kids with five pictures of a child trying to get a toy from a peer and five pictures of a child trying to avoid being reprimanded by his mother. The subjects were then asked to come up with as many possible solutions to each social problem; their score was based on the variety of strategies they mentioned, and children who play-fought regularly tended to score much better.

As well as checking out the latest issue of SciAmMind, you may also want to have a look at a fantastic online gallery they’ve put together which captures numerous visual illusions that have been realised as 3D sculpures, some of epic proportions.

If you want to see some of M.C. Escher’s impossible staircases rendered in lego, or several impressive sculptures that change depending on the light or viewing angle, do have a look.

Link to Feb 2009 SciAmMind with plenty of freely available articles.
Link to visual illusions sculpture gallery.

‘Internet addiction’ lacks validity finds another study

Dr Shock covers a new study examining the validity of one of the most popular methods for diagnosing ‘internet addiction’, Young‚Äôs Diagnostic Questionnaire, finding it lacks even the most basic ability to distinguish between frequent and infrequent net users.

Validity is one of the essential components of a psychological measure. It refers to whether it is actually measuring what it says it’s measuring.

One of the most common ways of testing validity is to see whether the scale predicts other aspects of behaviour or psychological functioning that we would expect would go along with the target behaviour.

In this case, we would expect ‘internet addicts’, as identified by a cut-off score on the Young’s Diagnostic Questionnaire, to spend more time on line than ‘non-addicts’, have greater levels of mental distress or behavioural impairment and would be more focused on specific internet activities.

Two psychologists, Nicki Dowling and Kelly Quirk, set out to test this on over 400 students – a group who have been previously highlighted as likely to be vulnerable to excessive internet use.

They found that those students who were clearly identified by the questionnaire as ‘internet addicts’ were no different in time spent online or psychological dysfunction from those students who were just below the cut-off.

What they did find, however, is those students who ticked zero to two items, the lowest ‘risk’ category, on the 8-item questionnaire typically used the internet for fewer hours and were likely to be depressed or anxious than the people who scored above the ‘addiction’ cut-off.

However, as three of the diagnostic items specifically refer to spending longer time online, and three specifically refer to low mood, anxiety or preoccupation, this is hardly surprising.

It’s like finding out people who say they are sad are more likely to be depressed.

What the study did clearly show, however, is that the criteria for distinguishing ‘addicts’ from ‘non-addicts’, which has been the basis of the majority of ‘internet addiction’ research, doesn’t even reliably distinguish between amount of use and psychological distress.

This is important, because the criteria have been offered by proponents as the basis of a possible ‘internet addiction’ diagnosis in the forthcoming updated psychiatric diagnostic manual, the DSM-IV.

This comes only a few weeks after a recent study reported the damning conclusion that previous studies used “inconsistent criteria”, where subject to “serious sampling bias” and usually reported associations rather than doing any sort of work on causal influences.

Link to Dr Shock internet addiction post ‘Garbage In, Garbage Out’.
Link to study.
Link to DOI entry for same.

The economics of crack hustling

I just found this fascinating TED lecture by economist Steven Levitt on the social structure and economics of ghetto crack dealing. What’s surprising is that hustling rocks is a below-minimum-wage occupation with a 7% per annum employee death rate – despite the hype, a very shitty job.

Levitt is famous for being one of the co-authors of the book Freakanomics but is mostly known in the academic world for his research on the economics of crime and the underworld.

His lecture recounts some of the findings of a 10-year research project into the economics of a crack-dealing gang from an inner city US housing project.

Unsurprisingly, being a hustler is incredibly dangerous, but perhaps more of an eye-opener is that the business is run very much like a franchise and that most street dealers had second jobs, moonlighting in the mainstream economy, because dealing crack pays below the minimum wage.

The career prospects are slightly better higher up the ladder, but are still surprisingly modest in the grand scheme of things.

In other crack news, The New York Times recently published an article discussing research on ‘crack babies’, now many children whose mothers were addicted to crack while they were pregnant have grown up to be adolescents.

During the 1990s, a huge fear was that the children of ‘crack moms’ would be neurologically impaired, as when born they tend to be smaller in body and head size.

Although there are detectable differences in the teenage years, these aren’t as bad as expected, and it seems that being a ‘crack baby’ isn’t a life sentence as it was once thought.

Link to Steven Levitt on sociology and economics of crack dealing.
Link to NYT on ‘The Epidemic That Wasn’t’.

War trauma and brain impact

Although much of The Telegraph’s science coverage seems to have gone down the pan recently, they’ve just published a remarkably well balanced and informative article on war trauma and how it is associated with measurable changes in brain structure.

Brain imaging studies have found that people with post-traumatic stress disorder tend to have smaller hippocampi, an area known to be key for emotional memory.

But it’s not clear whether this is a direct consequence of PTSD, or simply that people with smaller hippocampi are more likely to develop the disorder after trauma.

The article does a fantastic job of presenting a balanced look at the causality hypnotheses, and quotes psychiatrist Simon Wessely, known for his research on the psychology, neuroscience and history of combat trauma.

But Prof Wessely has found that the very thing that exposes soldiers to PTSD might also help them deal with it: their job. According to his research at King’s, group cohesion and firm leadership are critical in reducing the impact of psychological distress.

“You have to remember we are talking about professional soldiers who have been highly trained,” he says. “Their training is designed to harden them against the unpleasant nature of war. The military is actually very effective at reducing the risk of PTSD with their training, their professionalism, esprit de corps and morale. War is a stressful business and this all prepares soldiers for that.”

The flip side is that the memories that provoke trauma are not necessarily those of gruesome battles or injuries. “The kind of events that affect them are not simply seeing bad things and coming under fire ‚Äì it is when the rules they have come to expect are somehow broken. It is when errors of omission or commission lead to the feeling they have been let down, or that they have let their comrades down, that mental health problems occur. This is why ‘friendly fire’ incidents are so psychologically damaging ‚Äì it violates the soldiers’ rules of who is supposed to be shooting at them. They will feel anger at those responsible.”

The only bizarre bit is the second to last paragraph where it mentions “new treatment is being developed, drawing on neurolinguistic programming, relaxation techniques and even Eye Movement Desensitisation Therapy”.

It mentions EMDR as if it is something unusual, when it is an increasing well researched evidence-based treatment, and NLP as if it is nothing out-of-the-ordinary, when it is largely pseudoscience that lacks even the most basic empirical support.

Link to ‘How brain scans show the trauma of war’.

The Straight Dope on Learning Styles

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The glorious truth is that people think and learn differently. Some people like words, but not pictures, some like movements rather than sounds. Why are people different? Who knows, perhaps because Allah loves wondrous variety.

A funny thing is that we have the tendency to ignore this fact. Perhaps because empathy is difficult, perhaps because learning makes itself invisible. I have a dear friend, Cat, who doesn’t have visual imagery. When she thinks of a dog, for example, she doesn’t see one in her mind’s eye. She doesn’t see anything. When she dreams she rarely has pictures — she just knows what is happening in the dream. People often don’t believe this. They think that everyone must experience their inner world in pictures, the way they do. Sorry. People are just different. Some always see things when they imagine them, some don’t. Some people have a sense of pitch, some don’t. So it goes.

So the idea of learning styles makes a lot of intuitive sense. Surely if we know that people think and learn differently, we should be able to design our teaching to take advantage of different learning styles. Right?

This is where we hit problems. Are learners either primarily visual, auditory, kinesthetic (as claimed in NLP)? Or are they primarily analytic, creative or pragmatic (as proposed by Robert Sternberg). Is the world made of Convergers, Divergers, Assimilators and Accomodators? Maybe instead we should use the Myers-Briggs categories of Sensers, Intuitors, Thinkers and Feelers?

Faced with these possibilities an academic psychologist has a standard set of questions they would like answered: can you really divide people up into a particular set of categories? Are the tests for these categories reliable; if you take the test twice will you come out the same both times? Are the categories you are trying to use related to how people learn? If you use a theory of learning styles, do people learn better? Can you use learning styles to predict who will benefit most from particular styles of instruction? Does using a learning styles system – any system – for teaching have other effects on learners or teachings, such as making them more confident or making them expend more effort?

These questions stem from the way academic psychologists systematically approach topics: we like to establish the truth of psychological claims. If someone comes to us with a theory about learning styles we want to know (a) if learning styles really exist, (b) if they really are associated with better learning and also (c) if, when learning styles are taken into account, learning is better because of something about the specific learing style theory rather than just being a side effect of an increase in teacher confidence, effort or somesuch.

So, what have academic psychologists found out about learning styles? We know that some of the supposed categories of learning styles are actually dimensions that vary continuously across the population. For example visual imagery: it is not that some people are visual thinkers, it is that most people have some visual imagery and a few have very strong imagery and a few, like my friend Cat, have less than average. We also know that people can change their learning styles over time, for different tasks and in different contexts. We also know that it is very difficult to prove that teaching that uses learning styles is better because of the particular theory of learning styles used, rather than merely because a learning style theory, any learning style theory, is being used and this makes people pay more attention to what they are doing.

Learning styles seem intuitively sensible. Having thought about learning styles helps teachers improve their teaching and also helps increase their confidence and motivation. But there is no strong evidence that any one theory of learning styles is the best, or most true, compared to the others. Learning style theories can be useful without being true, and it isn’t clear that knowing the truth about the differences in how people learn will be immediately useful or produce a more useful theory of learning styles. This difference between truth and utility is a typical dilemma of psychology.

Sadly, the headlines for this conclusion aren’t snappy. It is easier to say that “Some people are visual thinkers and others are auditory thinkers” than it is to say that “Thinking about presenting information in different sensory modalities will make your teaching more varied and help those you are teaching who have different preferences to yourself”. Using a learning style theory is great, but you lose a lot of flexibility and potential for change if you start to believe that the theory is based on proven facts about the way the world is, rather than just being a useful set of habits and suggestions which might, sometimes, help guide us through the maze of teaching and learning.

Cross-posted at schoolofeverything.com

Part of a series:

Image: jelly belly by House of Sims

Giant killing

The Wall Street Journal is reporting that pharmaceutical giant Pfizer are about to settle a legal case brought by the US Government over illegal promotion of their now withdrawn painkiller Bextra (valdecoxib) for a staggering $2.3 billion.

This follows the news that Eli Lilly have just settled a similar case against them for a previous record of $1.42 billion related to illegal promotion of their antipsychotic drug Zyprexa (olanzapine) with several cases against them still ongoing.

The cases relate to ‘off-label marketing’, an illegal practice where companies explicitly encourage doctors to prescribe drugs for conditions that the compound isn’t licensed for. In the case of olanzapine, this included dementia, and we now know the combination of antipsychotics and dementia greatly increases short and longer-term mortality.

The practice of off-label promotion is widespread and has been for years but this is the first time that such massive cases have been settled against the companies concerned.

As an aside, one of the most useful sources for news on the pharma industry and psychiatry is a blog we often link to called Furious Seasons.

It’s written by Phil Dawdy, an ex-newspaper journalist and ex-antipsychotic user who does some remarkable investigative journalism that is almost entirely supported by donations from readers of the website.

I mention this as he’s just had another experience of a journalist pumping him for information and then neglecting to mention him, despite the fact that he’s not only been on the pulse of developments for the last few years, he’s actually been part of the story as he publicly hosted some incriminating documents for the Zyprexa case.

He was recently flagged up as a great example of independent web journalism by respected science writer David Dobbs, but only seems to get credit from writers who already get self-publishing.

I don’t always agree with his take but find Furious Seasons essential reading nonetheless, which must be a sign of a good writer.

I credit him with having a sort of underground sensibility for sorting through the spin of corporate psychiatry but it won’t be long before he goes mainstream, so catch him while he’s still live and direct.

Link to WSJ on Pfizer settlement.
Link to Furious Seasons.

Neuroimaging, before the invention of television

Neuroscience textbooks often suggest that the ability to image the structure of the brain in living patients started in the 1970s with the introduction of the CT scanner. What they tend to forget is that brain surgeon Walter Dandy was already neuroimaging patients as early as 1918.

We think of x-rays as only being useful for getting pictures of bones but soft tissue does show up on an x-ray.

The images rely on certain bits of the body having a higher density and therefore blocking more of the rays falling on the photographic plate.

Bones are obviously very dense so show up well but look at this image of a hand x-ray. You can clearly see the difference between bone, flesh and air. What you can’t see is any difference in the soft tissue.

The crucial difference that struck Walter Dandy was the possibility of distinguishing flesh and air on an x-ray.

Knowing that the brain is surrounded by cerebrospinal fluid (CSF), which also fills internal spaces called the ventricles, he decided to simply replace the fluid with air and x-ray the patient.

He published his first results in 1918. He described how he drilled a hole in the skull of a patient and carefully removed the CSF from the ventricles and replaced it with air.

Now known as ventriculography, one of the images he took is illustrated on the top left. For the first time, you could clearly see the ventricles in a living patient.

During the procedure, he noted that some of the air has escaped the ventricles and was occupying the space between the skull and the brain.

The following year he published another study where he deliberately filled this space with air as well, so the surface of the brain was surrounded by the gas and so could show up on an x-ray.

The bottom left image shows the result of this, and you can see it clearly shows some of the ‘trenches’, the cerebral sulci, on the surface of the brain.

Now called pneumoencephalography, the procedure was immensely useful, but, extremely unpleasant. In his 1918 article he noted that the patient’s reaction “was characterized by a rise of temperature, nausea, vomiting, and increased headache”.

Furthermore, it takes weeks, if not months, for the CSF to be replaced by the body, leaving the patient in a debilitated and fragile state.

However, it was used throughout the 20th century and the research literature is peppered with the results of this early neuroimaging research.

Link to 1918 paper on imaging of the ventricles.
Link to 1919 paper on imaging the brain surface.