A bait and switch trick on torture and psychologists?

A poster on Metafilter has collected together news reports on the growing number of psychologists leaving the American Psychological Association in protest at their failure to condemn members who take part in the ‘War on Terror’ interrogations.

One of the most surprising aspects is from a contributor who suggests that the APA released a different text to the one approved by a 2006 committee vote that was intended to condemn abusive practices by psychologists.

The campaign group Coalition for an Ethical Psychology released a report [pdf] claiming that the original statement reviewed by the committee defined torture in terms of the United Nations criteria, but the published resolution had been changed to refer to the US Constitution, providing a definition of torture that is being used to allow abusive interrogations.

Strong public protests over the PENS Report [which condoned psychologists participating in interrogations, without mentioning torture or other abuse] prompted the APA Divisions for Social Justice and others to craft a new resolution prohibiting psychologists from participating in abusive detainee interrogations. In August 2006, after much discussion and debate, the APA’S Council of Representatives passed a Resolution Against Torture, Cruel, Inhuman and Degrading Treatment.

However, the version published by the APA differed from the version discussed and passed by the Council, in at least one significant respect: in the document reviewed by Council, psychologists were instructed to look to the United Nations Principles of Medical Ethics and international instruments for definitions of unethical behavior and “torture, cruel, inhuman, and degrading treatment.” In the published document, the definition of torture, cruel, inhuman and degrading treatment instead was taken from the 5th, 8th and 14th amendments to the US Constitution, precisely the same definitions that had been used by the CIA, the DoD and the Bush Administration to assert that the abusive interrogation techniques in use at Guant√°namo, CIA black sites, and elsewhere were not “torture, cruel, inhuman or degrading treatment.”

The more recent August 2007 resolution refers to both the United Nations and the US Constitution criteria, presumably making for a much stricter definition, although still fails to define some key definitions concerning distress.

However, the fact that an earlier version was ‘switched’ is quite concerning as it has become clear that psychologists are an incredibly valuable part of interrogation or ‘Behavioral Science Consultation Teams’ (aka ‘biscuit teams’).

In contrast, psychologists’ colleagues in both the American medical and psychiatric associations have outright banned their members from participation.

In practice, this hasn’t stopped some physicians becoming complicit in these interrogations, but many US psychologists are embarrassed by their parent organisations unwillingness to take the equivalent ethical line when the profession is increasingly seeking equal status to doctors.

Link to MeFi on psychologists leaving the APA (via BoingBoing).

Diagnostic handshake

Mark Gurrieri was diagnosed with a brain tumour after shaking a doctor’s hand. BBC News has an interesting piece on the incident, where the doctor noticed that Gurrieri’s hand was spongy and swollen, suggesting a growth hormone problem that can be caused by a tumour on the brain’s pituitary gland.

Mr Gurrieri underwent tests and was found to have acromegaly – caused by a tumour in the pituitary gland which leads to excess growth hormone.

The condition is seen in just three people per million, and can have serious effects if left undiagnosed.

It causes problems with vision and can lead to diabetes and blood pressure problems.

If untreated acromegaly can also cause premature death.

Mr Gurrieri thought his hands were getting bigger because of too much DIY and working in his restaurant kitchen.

Link to BBC News article ‘Handshake diagnosed brain tumour’.

Encephalon: the new dawn

If you’ve been wondering what happened to the Encephalon psychology and neuroscience writing carnival, it’s been on a brief hiatus while its management has been passed on to new hands.

It was previously managed by Mo at Neurophilosophy, whose time has now been largely captured as a neuroscience postgrad.

Luckily, the ever capable Alvaro Fernandez from Sharp Brains has taken the helm and just published the first edition of its return.

Fittingly, it’s a bumper issue, and contains articles on everything from Renaissance brain look-alikes to whether robots can feel emotions.

The next edition will be hosted on Mind Hacks on March 3rd so if you want to submit an article, just email a link to

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

and we’ll feature it.

Link to new Encephalon.

Push my brain button

You can promote almost anything with a few words about the brain because it sounds like science. This week’s Bad Science column takes a close look at ‘Brain Gym’, a scheme introduced into large numbers of UK schools that attempts to boost brain function by getting the kids to do, well, complete nonsense.

For example, a “back and forward movement of the head” apparently “increases the circulation to the frontal lobe for greater comprehension and rational thinking”. According to this wisdom, a good clip around the ear has remarkable brain boosting properties.

One of my favourite examples of nonsense neuroscience is the use of the ‘explanation’ that an activity is pleasurable because it ‘boosts endorphins’ or ‘releases opioids’ in the brain.

Here’s a great example from the widely distributed and widely discarded London newspaper The Metro which managed to give a cod brain science explanation in a (NSFW but remarkably dull) article on bondage and whipping.

Apparently:

The person getting the flogging (the bottom) gets pleasure from natural opiates generated in the brain and the person doing the flogging (the top) gets pleasure watching their partner… Even a runner’s high after exercise is nothing compared with the boost of natural opiates that can be released in a flogging.

Apart from the fact that they don’t know the difference between opiates (derivatives of the opium poppy) and opioids (any substance that binds to opioid receptors, including the brain’s naturally produced chemicals) this really explains nothing about why being flogged is supposed to be pleasurable.

Opioids are definitely part of the experience of pleasure, but they’re also part of the experience of pretty much everything else.

Experiencing pain is one thing that definitely causes increased opioid activity, but if pleasure were that simple, we’d find fighting so much fun that Planet Earth would be be like Texas Chainsaw Massacre with a laugh track.

These attempts at an explanation are really nothing more than placebos that still don’t tell us how we experience pleasure as a result of the activity, or what role opioids play in this process.

Even if pleasure was purely opioid release, the trick with an explanation is to explain how and why this occurs, not just say that it does.

It’s not that these simple links aren’t important, but they’re not explanations in themselves, even though they’re often presented as such.

My other pet hate is when something pleasurable is described as having the same effect on the brain as one of the four dopamen of the neurocalypse: ‘drugs’, ‘sex’, ‘gambling’ and ‘chocolate’.

Almost any one is used to explain the effect of the others, and if you’re really lucky, all four will be invoked to make for an exciting-sounding but often scientifically empty article.

This is another example where the crucial information is how these activities have their effect on the dopamine system, not the fact that they do.

So, as with the faux science that supposedly supports ‘Brain Gym’, always ask yourself how it occurs, rather than relying on the illusion of brain magic.

Link to Bad Science article on why we fall for brain-based promotions.

A history of Freudian fiction

The changing fortunes of psychoanalysis have been reflected in some of the greatest novels of the last hundred years, a literary history recounted in an article for The Guardian.

The piece is by historian Lisa Appignanesi, author of the highly regarded new book Mad, Bad and Sad: A History of Women and the Mind Doctors from 1800.

The article notes that two recent novels (Kureishi’s Something to Tell You and Vickers’ The Other Side of You) have reversed the recent tradition of portraying psychoanalysts as somehow deviant, unethical or intellectually bankrupt.

The low-point for the creative depiction of Freudian mind doctors was probably Nabakov’s novel Lolita, which is presented as a faux psychiatric case study of a paedophile.

You might think that someone who wrote a widely-read novel about a middle-aged man who desired under-aged girls had good reasons to dislike any theory which attempted to uncover unconscious motivations, but Nabakov was famously and venomously anti-Freudian even before he began writing his masterpiece.

He first started knocking psychoanalysis in his second novel, The Defense, and he often referred to Freud as the ‘Viennese Quack’ and his theories as ‘voodooism’ for the rest of life his.

This negative portrayal is not universal though, and many novels contain sympathetic and even highly complementary depictions. For example, Appignanesi notes that in Plath’s semi-autobiographical novel The Bell Jar, Dr Nolan is “something of a guardian angel amid the horror of asylum life”.

Interestingly, the more recent positive portrayals of psychoanalysts mirror some positive results in the scientific literature.

Two recent randomised controlled trials have found that psychoanalytically-inspired treatments can be effective.

A recent trial on treatments for ‘personality disorder’ found it effective, as did a recent trial on using it as a treatment for panic disorder.

Unfortunately, these are still a drop in the ocean compared to the evidence for some other psychological treatments, but hopefully this is a sign that psychoanalysis is beginning to adopt a more scientific approach to its theories and practice and we’ll be better able to separate the wheat from the chaff.

Link to Guardian article on psychoanalysis and literature (thanks Kat!).

Them and Us

I remember a recently admitted patient, nose-to-nose with his psychiatrist, screaming at her “you don’t know what I’m going through – how the fuck do you know what it’s like little missy?”.

The psychiatrist finished the discussion, saying she’d come back to him later, and after a brief pause to collect herself, moved on to the next patient in the ward round.

It is still an incredibly vivid memory for me, partly because everyone else in the room knew that the psychiatrist had been a patient herself, as she had a lifetime’s worth of experience dealing with her own mental health issues.

Study after study has shown that psychiatrists have higher rates of mental illness than the general population.

Research published in 2001 revealed that 56% of female psychiatrists have a family history of mental illness, and just over 40% have experienced one themselves – almost twice the rate of other doctors. Undoubtedly as a consequence, psychiatrists have double the rate of suicide of the general population.

Psychiatry is certainly a stressful job, but research has also found that there are higher rates of mental disorder in future psychiatrists, suggesting many go into the profession precisely because of their experiences.

Other mental health professionals are much less studied, but from my own experience, I suspect the histories and motivations of mental health nurses, psychologists and social workers and so on are are likely to be similar.

The reason I mention this is because Phil Dawdy has just written a powerful article on responses to a recent murder of a psychologist in New York.

Several people wrote comments to his original notice saying that the murderer was likely on a whole bunch of meds that were making him crazy; and, mental health workers hurt patients all the time, so they get what they deserve.

It is quite apparent that unlike in other areas of medicine, the mental health system has a ‘them and us’ attitude.

Ironically, it is the single area of medicine where ‘them’ are most like to be ‘us’, regardless of whether you’re a patient or a professional.

Link to Phil Dawdy on murder of a New York psychologist and reaction.

2008-02-15 Spike activity

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

Psychiatrists and the fashion for corduroy suits – Fronter Psychiatrist says don’t do it kids!

Sharp Brains looks at the benefits of teaching kids mindfulness meditation in schools.

Language Log has found the headline of the year. Genius!

Campaigners want to put health warnings about cannabis on Rizla papers. Presumably, we should also put health warnings about crack on Coke cans.

The New York Times on an interesting study that found that girls’ self-perception of popularity predicted later weight gain.

An article in the The New York Times discusses the art of persuasion and the psychological research behind it.

Some thoughts really do require language. Cognitive Daily covers a study that tackles the controversial issue of whether thought and language are dependent upon each other.

Yes darling, you’re unique. Just like everyone else. Another article on the psychology and speed dating suggests it’s a maverick scientific approach when it’s already been used many times. This week, Nature joins the list of suitors.

If you’re still waiting for PBS’s The Lobotomist to appear online, it’s become available as a torrent for the impatient.

Deric Bownd’s examines a study that developed a computer-based face recognition system with 100% accuracy.

New study attempts to answer why orgasms are better when you love your lover.

More in orgasm news: Frontal Cortex looks at a real-life orgasmatron.

The wonderful Felice Frankel thinks about how to represent ideas visually in American Scientist.

Acceptance, not distraction, is the way to deal with pain. The BPS Research Digest has a fantastic complement to Lehrer’s article on the psychology and neuroscience of pain.

Eric Schwitzgebel has more reflections on his fantastic project that asks why don’t ethics professors behave better?

Psychoanalysts on love. Treatment Online captures some of their insights.

Neurology podcasts – the shocking truth

The American Academy of Neurology are now doing fortnightly super-geeky podcasts that feature discussions about studies published in their journal.

If you’re not familiar with the arcane language of neurology – tough luck, as they make no effort to explain anything to the uninitiated.

They’re not quite as bad as the American Journal of Psychiatry podcasts (which I previously described as an ‘excessively thorough lecture given by a voice synthesiser’ although I’m actually finding the fembot voice rather sexy – is that wrong?) and include some discussion rather than just spoken summaries.

Occasionally, they throw a curve ball and include poetry, or a quick hint or tip for the clinician, but mainly they’re neurologists doing what neurologists do best – talking about brain disorders in lots and lots of detail.

Also, I challenge you not to shout out “Space. The Final Frontier!” when you hear the opening fanfare.

I keep mentioning them, but the Royal College of Psychiatrist’s podcasts are excellent – dealing with the nitty gritty of the science but also explaining the concepts and debating the controversial points. They really should be a model for others to follow.

And as an aside, Nature’s NeuroPod seems to be missing in action again.

Mind Hacks. The Perez Hilton of academic neuroscience podcast gossip.

The operation of the skulls: a trepanation video

Neurophilosophy has found a gory but completely astonishing film of a Kisi medicine man in Tanzania performing a trepanation operation. A young lady endures the seven hour procedure that puts a hole in her skull without any anaesthetic.

Mo has been doing some fantastic work on the history of trepanation and his illustrated article on the topic is a must read if you want an overview of this ancient procedure.

This film emphasises the importance of the operation in some cultures and highlights quite what a remarkable, if not, somewhat hazardous procedure trepanation really is.

And by the way, if you saw our recent rather whimsical post on ‘brain hats’, the end of the video gives a whole new meaning to the phrase.

Link to video of Kisi trepanation.
Link to illustrated history of trepanation.

Love blossoms in the lab

Love is the most exalted and sublime of human emotions. It has inspired breathtaking works of art, journeys through continents and even the tragedies of war. Given its powerful hold on humanity it’s surprising that it’s been traditionally neglected by the brain sciences. In spite of this, a new dawn in romance research has begun to bud in recent years, and love has finally blossomed in the lab.

While romantic love has always been an obsession of the psychoanalysts, they were often creating little more than a new poetry of emotion, often beautiful, often bizarre, but rarely explaining more than their own metaphors.

Always a little late to the game, it wasn’t until the end of the 1990s that neuroscience fell head over heals for love. The first to become inspired by this new passion was, as if we needed to ask, an Italian.

Psychiatrist Donatella Marazziti and her colleagues measured levels of a protein that transports the neurotransmitter serotonin in the blood of 20 people who had recently fallen madly in love, 20 people with obsessive compulsive disorder (OCD) and 20 healthy comparison participants.

People with OCD experience intrusive, obsessive thoughts and are often described as having an ‘over-valued idea’ – an almost semi-delusional state where a particular thought becomes the focus of attention.

Marazziti, already an established OCD researcher, knew that serotonin had previously been linked both to obsessional thoughts and to sexual attraction, and wondered whether something similar might be going on in the early stages of romance.

She found that the group of patients with OCD and the recently love-struck were no different in terms of the serotonin transporter protein, suggesting the brain began to function markedly differently as love blossomed.

Although measuring the blood is a fairly crude way of looking at how the brain works, the researchers were struck by the similarities between these two states:

This aspect we believe underlies the obsessive pre-occupation so characteristic of the early stage of love (which, in rare instances, might persist for a lifetime of abstract idealization that leads to poetry and music dedicated to the love object). As far as we are aware, this is the first report of changes in the 5-HT [serotonin] transporter during a physiological state; it would suggest that being in love literally induces a state which is not normal – as indeed suggested by a variety of colloquial expressions used throughout the ages in different countries, all of which refer generally to falling ‘insanely’ in love or to being ‘lovesick’

Since this initial flirtation, love has become a hot topic in the neurosciences, with whole conferences dedicated to it and numerous scientific studies being published every year.

Perhaps unsurprisingly, the traditional connection between love and madness has not been dispelled by these recent studies.

In fact, a 2007 study that looked at new love in adolescents found so many striking similarities between the intensity of teenage romance and hypomania, a symptom of manic-depression, that the authors warned researchers to look out for the love-struck when conducting research with young people, so as not to bias their results.

Link to abstract of study of the serotonin transporter and romantic love.
Link to abstract of study on hypomania and adolescent love.

Faking a labour of love

I’ve just found an interesting page on Wikipedia that discusses the concept of ‘emotional labour‘: where employees are expected to regulate their outward emotional reactions so they are consistent with the company’s goals, regardless of their internal feelings.

A classic ’emotional labour’ worker would be a shop assistant or a waitress, where the employee has to control their emotions and maintain a pleasant demeanour even when customers are being difficult, annoying or even abusive.

This concept was apparently first devised by the sociologist Arlie Hochschild in the book The Managed Heart.

However, a distinction is made between ‘surface acting’, where the display doesn’t need to match internal feelings at all (as when waitressing), and ‘deep acting’ where the employee is expected to genuinely feel the emotions (like in nursing).

Apparently, ‘surface acting’ jobs are associated with stress, feeling inauthentic and depression, while ‘deep acting’ jobs are associated with increased job satisfaction.

How well this is supported by empirical evidence is anyone’s guess, but it’s an interesting concept.

Link to Wikipedia page on ’emotional labour’.

Will the PTSD diagnosis disappear?

Psychiatrist Gerald Rosen argues that the diagnosis of post-traumatic stress disorder (PTSD) should be abandoned because it just re-describes emotional reactions that would otherwise be diagnosed as depression or anxiety, and is increasingly used where there was never any clear trauma in the first place.

He’s made his case in an editorial for the British Journal of Psychiatry and debates his ideas in an engaging discussion in a BJP podcast.

PTSD is the only psychiatric diagnosis where a clear cause forms part of the diagnosis. The person must have experienced a life-threatening event to themself or others, and must have experienced intense fear, helplessness, or horror at the time.

If this is followed by intrusive memories of the event, increased arousal (feeling ‘on edge’), avoidance of any reminders and these are long-lasting and they interfere with everyday life, the disorder can be diagnosed.

The trouble is, all of these can be found in people who have not experienced classical ‘trauma’. Some people, including Rosen, are arguing that many of the normal reactions to negative events are now being described in terms of mental illness and the concept of PTSD is becoming meaningless:

Peer-reviewed articles have even discussed the possibility of developing PTSD from watching traumatic events on television. It has been suggested that rude comments heard in the workplace can lead to PTSD because a victim might worry about future boundary transgressions: the conceptual equivalent of pre-traumatic stress disorder. New diagnostic categories modeled on PTSD have been proposed, including prolonged duress stress disorder, post-traumatic grief disorder, post-traumatic relationship syndrome, post-traumatic dental care anxiety, and post-traumatic abortion syndrome. Most recently, a new disorder appeared in the professional literature to diagnose individuals impaired by insulting or humiliating events ‚Äì post-traumatic embitterment disorder. Even expected and understandable reactions after extreme events, such as anxiety and anger, are now referred to as ‘symptoms’.

This does not mean that anyone who becomes disturbed after a negative experience shouldn’t be helped, just that PTSD is not a useful way of guiding the treatment. Critics argue that the existing categories of depression and anxiety are more than adequate.

In the podcast, Rosen discusses the possibility that PTSD may be ‘popular’ as a diagnosis because it’s perfectly suited to the legal system.

It defines a cause and an effect, a compensation lawyer’s dream. This is more important for the American health care system where mental health treatment is often only reimbursed by the insurance companies if a doctor can make a diagnosis.

PTSD might be the only way for a doctor to get insurance companies to pay for treating someone who is having difficulty adjusting to a bad experience.

Interestingly, the diagnosis of PTSD was largely accepted into the diagnostic manuals due to pressure from campaigners wanting the US government to treat Vietnam veterans’ mental health needs on their return from the conflict.

A recent study checked the service records of Vietnam veterans who were being treated for PTSD and found only 41% had been exposed to combat, despite their being no difference in the symptoms between ‘combat’ and ‘no combat’ troops.

This isn’t to suggest that some veterans were ‘faking’, just that there isn’t always a clear connection between a traumatic event and the symptoms of PTSD.

With these points in mind, Rosen makes for an interesting guest on a diagnosis that we now tend to take for granted.

Link to BJP podcast ‘Problems with the PTSD diagnosis’.
Link to PubMed entry for editorial.

Better living through caffeine

Developing Intelligence has a fantastic post on what pharmacology and neuropsychology has told us about getting optimally wired on caffeine.

In small amounts, caffeine boosts mental function, and the article looks at scientific studies that have told us which are the optimal doses, which psychological abilities are most affected and what you can take with caffeine to modulate its effect.

Obviously, caffeine has its health risks. Psychologically speaking, even everyday doses run the risk of withdrawal symptoms and have the tendency to increase anxiety, so as with any drug, it’s important to educate yourself so you can judge the risks for yourself.

The Wikipedia page on caffeine is wonderful, so it’s a great complement to the fantastic round-up of stimulation-related tips from Developing Intelligence.

Link to article ‘A User’s Guide to Getting Optimally Wired’ (via BadScience).
Link to Wikipedia page on caffeine.

Hats off to you sir

It’s not often you find yourself thinking ‘you know, I really need a brain hat, but I just can’t decide which one to buy’.

The pictured head piece is undoubtedly for the discerning customer, revealing a large section of the upper cortex with added plastic blood. Nice.

However, there’s also an alien brain hat for babies, a brain cap for keeping the sun out of your eyes, or even a high fashion wooly brain hat by a top designer.

Importantly though, friends don’t let friends wear brain golf visors.

Implicit associations

You might have prejudices you won’t admit to, or, don’t even know about. The Implicit Attribution Test claims to measure these hidden associations and it’s been one of the most important psychological developments during the last decade.

Edge has a video interview with two of its creators, psychologists Mahzarin Banaji and Anthony Greenwald, and an online version of the IAT which allows you to test your unconscious associations in relation to the US presidential candidates.

The IAT is a computer task that measures the strength of automatic, implicit or unconscious associations between concepts.

Let’s say we’re interested in whether black or white faces are more linked to positive or negative associations.

Faces of black or white people, and either pleasant or unpleasant words are flashed up on screen, one at a time. Participants are asked to press one key if the face is black or the word is pleasant, and other if the face is white or the word is unpleasant.

In other words, you’re asked to classify both black faces and pleasant words using the same response, and white faces and unpleasant words using the same response.

Next, you’re asked to do the same thing, but with the reverse associations: so you’re asked to classify black faces and unpleasant words together, and white faces and pleasant words together.

The idea is that you’re going to be quicker doing whichever classification best matches associations you already have.

So, if you already have unconscious associations between white and pleasant, and black and unpleasant, you’re going to be quicker when these two responses are grouped.

Importantly, the idea is that these associations are different from our conscious attitudes. Someone who is definitely not racist might still have negative associations with black people, perhaps because of exposure to social stereotypes.

Most studies have more than just the two conditions, to control for order, practice and other effects and if you’re interested, you can take part in this exact experiment online.

It was originally thought that the test could uncover people’s implicit or hidden attitudes (indeed, it was originally called the Implicit Attitude Test) but it’s now generally thought of just in terms of associations, because, in effect, it measures how closely two things are linked, and implicit attitude sounds more like a sort of evaluation or stance on something.

The value in this sort of test is not only in that it can pick out associations we might have but don’t admit to or aren’t aware of, but it can also map out how various things influence the unconscious structure of meanings in the mind and brain.

Needless to say, it’s been researched intensively since it was first uncovered, with research suggesting it can even pick up on hidden violent associations in psychopathic murderers.

Link to video interview and presidential IAT at Edge.
Link to previous WashPost article on the IAT.