Brain Blogger » Psychology & Psychiatry http://brainblogger.com Health and Science Blog Covering Brain Topics Sun, 21 Jun 2015 22:00:34 +0000 en-US hourly 1 http://wordpress.org/?v=4.2.2 Best and Worst of Psychology and Psychiatry — May 2015 http://brainblogger.com/2015/06/19/best-and-worst-of-psychology-and-psychiatry-may-2015/ http://brainblogger.com/2015/06/19/best-and-worst-of-psychology-and-psychiatry-may-2015/#comments Fri, 19 Jun 2015 14:00:03 +0000 http://brainblogger.com/?p=19874 We have been seeing some groundbreaking developments in understanding psychological disorders and how best to treat them this year. It seems that May was the cream on the cake, with game changing advances in autism, schizophrenia and depression research — quite fitting for International Mental Health Awareness Month.

There were two main themes that emerged from the best and worst research: Insights that can help improve how we interact with one another, and insights regarding how chemicals interact with and affect us.

Here’s to International Mental Health Awareness Month and the fantastic researchers that are taking us one step closer to a happier, healthier and wealthier life for us all!

THE BEST

Autism brain may be hyper-functional, not anti-social

Autism is generally considered a form of mental retardation, a brain disease that impairs the ability to learn, feel emotions and empathize. However, new research suggests that initially, early in development, children with autism brains have supercharged brain circuits that require environmental stability to further develop symptom free.

The study demonstrates that in a rat model of autism, unpredictable environmental stimulation and an impoverished environment drives autistic symptoms, while conversely predictable stimulation and a pleasant environment can prevent these symptoms. Autistic rats that lived in calm, safe, socially and sensory-rich environments that are highly predictable with little surprise do not develop symptoms of emotional over-reactivity such as fear and anxiety, nor social withdrawal or sensory abnormalities.

The authors suggest that having hyperfunctional brain circuits with advanced processing of the environment leaves autistic children more sensitive to environmental surprises, promoting symptom development. This means that if brain hyper-function can be diagnosed soon after birth, we can prevent autism symptom development using highly specialized environmental stimulation that is safe, consistent, controlled, announced and only changed very gradually at the pace determined by each child.

Specific stress-related causes for chemical imbalances in schizophrenia

This revolutionary study published in Neuron is in line with decades of research, finally bringing it all together to paint a more cohesive and less fragmented understanding of schizophrenia. The researchers created the largest ever expansive genetic data set of gene copy number variations (CNVs) that combined three separate studies amounting to 11,355 schizophrenia cases and 16,416 controls. The authors found changes in the number of copies of specific genes and genes with schizophrenia-linked mutations that encode molecules that form complexes central to the induction and maintenance of synaptic plasticity, and provide strong novel evidence for the involvement of stress sensitive changes in GABA inhibition of communication between neurons.

Interestingly, one needs only a subset of genetic changes to disturb these interlinked processes and generate a schizophrenic phenotype. This fits perfectly with why there is so much disease-related genetic variation between schizophrenic individuals.

Pathogenicity in schizophrenia therefore depends upon the total burden of disease relevant genes influenced by copy number variations, with different genes implicated in different individuals depending upon their genetic and environmental context. The authors’ analysis also suggests that there are many more locations in the human genome where CNVs influence the development of schizophrenia that are waiting to be discovered.

Stress-responsive common genetic variants predict risk of psychiatric disease

Work from the MaxPlank Institute of Psychiatry has unwrapped the genetic basis of why some people are more prone to major depression and psychiatric disorders than others when experiencing stressful life events.

The experiments suggest that when cortisol is released during stressful life events, certain genetic mutations result in differences in the transcription of stress-sensitive proteins in the brain and blood, which makes some people more at risk for stress-induced depression and other psychiatric disorders than others. Interestingly, these changes are associated with inappropriate over-reactivity of the human amygdala.

By taking a closer look at these genetic variants in future experiments we will take one step closer to the effective prevention and treatment of stress-related psychiatric disorders and mental health problems and promotion of general mental health well-being through stress-response targeted interventions. Watch the video here.

Kid’s altruism linked to improved health despite low income

New research indicates that children’s altruistic behaviors, family wealth and physiological health are closely intertwined. 74 pre-schoolers averaging 4 years old had physiological data, including information about heart rate and vagal tone, recorded while earning tokens that they could trade for prizes at the end of their visit. To test their altruistic behavior the children were given the chance to donate some or all of their prize tokens to imaginary sick children who weren’t able to come to the lab.

The children who sacrificed tokens to help sick kids showed greater vagal flexibility during the task. Vagal tone is a measure of tension in the vagus nerve, which connects the brain and the body on a largely subconscious level, where high tension is an indicator of good general health and the body’s ability to regulate physiological stress responses. The act of donating itself was associated with higher vagal tone by the end of the task, indicating that fostering altruistic behaviors in children is good strategy for promoting good health.

Additionally children from more wealthy families in the study shared fewer tokens than the children from less wealthy families. The authors suggest that a boost in vagal tone from being altruistic might help to offset some of the physiological disadvantages a child may experience that are associated with growing up in a lower-income household.

People prefer fragrances that spark personal memories

We don’t have to be perfumers to experience the power of certain smells sparking memories from our past. The links between our nose and our memories are strong, this is well-known. However, new research indicates that we don’t necessarily place value to and enjoy a fragrance because of how nice it smells, but rather we enjoy smells more when they elicit the recall of fond memories.

These findings are likely to influence how we develop fragrances: understanding where and how we culturally experience various scents may help develop products with scents which are most likely to elicit odor-related memories.

THE WORST

BPA may adversely affect parenting behavior

Previous research indicates that maternal care of children can be negatively affected when females are exposed to widely prevalent endocrine-disrupting chemicals including bisphenol-A (BPA) and ethinyl estradiol (EE).

Now, a study in monogamous and co-parenting California mouse species proves that offspring born to mothers and fathers that were both exposed to BPA receive decreased parental care by both the mother and father. Females exposed to EE or BPA spent less time nursing, grooming and being associated with their pups than controls. Care of pups by males was less affected by exposure to the chemicals, but control, non-exposed females appeared able to “sense” a male partner previously exposed to either compound and, as a consequence, reduced their own parental investment in offspring from such pairings.

As hormones and regions of the brain that regulate biparental behaviors have been found to be similar across species, these studies on the California mouse may have considerable relevance to humans. Watch the video here.

Lack of perspective and forward thinking drives unethical behaviour

Have you ever stolen office supplies, called into work sick when you were A-ok, or intentionally worked slowly to avoid additional tasks? Don’t feel you are alone, for example, faking “a sickie” is so common that one study in Australia calculated that a whopping 43% of 20-24 year old workers in their survey had pulled a sickie in the last year.

In a series of experiments that involved commonly experienced ethical dilemmas, like faking a sickie, the researchers found that two factors promote ethical and honest behavior: The identification of a potential ethical dilemma as connected to other similar incidents, and anticipating that there may be the temptation to act unethically in the near future.

These findings will likely inspire the development of strategies to encourage people to behave ethically. For example, we are all aware of the commonality of politicians claiming outrageous expenses for a work trip despite the act being considered unethical. An email reminder that warns against the temptation to inflate expenses before political work trips, and that also reminds politicians that this is a temptation they will experience frequently, could effectively encourage ethical decision-making.

Alcohol misuse disorder in US is more widespread than previously thought

Alcohol use disorders (AUDs) are among the most prevalent mental health disorders worldwide, with recent changes to the diagnostic criteria in the DSM-5 prompting updating our understanding of the prevalence, correlates, psychiatric comorbidity, associated disability, and treatment of AUD diagnosis.

Twelve-month and lifetime prevalences of AUD in the US were 13.9% and 29.1%, respectively. Prevalence was generally highest for men, caucasians and Native Americans and younger, previously married or never married adults with low income levels. Significant disability increased with the severity of AUD. Moreover, strong associations were founds between AUD and other substance abuse disorders and mental health problems. Shockingly, only 19.8% of respondents with lifetime AUD had ever been treated.

The authors prompt an urgent need to educate the public and policy makers about AUD and its treatment alternatives, to destigmatize the disorder and to encourage those who cannot reduce their alcohol consumption on their own, despite substantial harm to themselves and others, to seek treatment.

No improvement in cognition with post-menopausal hormones

There has been much confusion as to whether menopausal hormone therapy (MHT) might protect against cognitive aging, such as difficulty recalling words or numbers, forgetting events and actions and difficulty concentrating. By conducting a randomized placebo-controlled clinical trial including 693 recently postmenopausal women living in the US the researchers concluded that MHT given to recently postmenopausal women in the US for up to four years does not improve cognition.

Interestingly however, depression-related mood symptoms were significantly improved for women treated with oral estrogen pills and progesterone, but not those treated with transdermal estradiol patches and progesterone. Although this initial study has its limitations, the findings can be used to help women make more informed decisions about whether to use MHT to manage their menopausal symptoms and direct future investigations.

Interpersonal conflict is the strongest predictor of community crime and misconduct

Neighborhoods with more private, interpersonal conflict like domestic violence and landlord/tenant disputes, see more serious crime according to a new research, highlighting the important role individuals in promoting community safety. In fact, private conflict was a better predictor of the future deterioration of a neighbourhood than public disorder, such as vandalism.

The researchers suggest that people facing stressful conflicts with others may respond violently to problems within the community, neglect private property and be less inclined to take a stand against neighborhood decline. Therefore, incentives that promote interpersonal cohesion and conflict resolution in neighborhoods may prove highly effective in preventing neighborhood crime and violence.

References

Arloth, J., Bogdan, R., Weber, P., Frishman, G., Menke, A., Wagner, K., Balsevich, G., Schmidt, M., Karbalai, N., Czamara, D., Altmann, A., Trümbach, D., Wurst, W., Mehta, D., Uhr, M., Klengel, T., Erhardt, A., Carey, C., Conley, E., Ruepp, A., Müller-Myhsok, B., Hariri, A., & Binder, E. (2015). Genetic Differences in the Immediate Transcriptome Response to Stress Predict Risk-Related Brain Function and Psychiatric Disorders Neuron, 86 (5), 1189-1202 DOI: 10.1016/j.neuron.2015.05.034

Favre, M., La Mendola, D., Meystre, J., Christodoulou, D., Cochrane, M., Markram, H., & Markram, K. (2015). Predictable enriched environment prevents development of hyper-emotionality in the VPA rat model of autism Frontiers in Neuroscience, 9 DOI: 10.3389/fnins.2015.00127

Gleason, C., Dowling, N., Wharton, W., Manson, J., Miller, V., Atwood, C., Brinton, E., Cedars, M., Lobo, R., Merriam, G., Neal-Perry, G., Santoro, N., Taylor, H., Black, D., Budoff, M., Hodis, H., Naftolin, F., Harman, S., & Asthana, S. (2015). Effects of Hormone Therapy on Cognition and Mood in Recently Postmenopausal Women: Findings from the Randomized, Controlled KEEPS–Cognitive and Affective Study PLOS Medicine, 12 (6) DOI: 10.1371/journal.pmed.1001833

Grant, B., Goldstein, R., Saha, T., Chou, S., Jung, J., Zhang, H., Pickering, R., Ruan, W., Smith, S., Huang, B., & Hasin, D. (2015). Epidemiology of Alcohol Use DisorderJAMA Psychiatry DOI: 10.1001/jamapsychiatry.2015.0584

Miller, J., Kahle, S., & Hastings, P. (2015). Roots and Benefits of Costly Giving: Children Who Are More Altruistic Have Greater Autonomic Flexibility and Less Family Wealth Psychological Science DOI: 10.1177/0956797615578476

O’Brien, D., & Sampson, R. (2015). Public and Private Spheres of Neighborhood Disorder: Assessing Pathways to Violence Using Large-scale Digital Records Journal of Research in Crime and Delinquency, 52 (4), 486-510 DOI: 10.1177/0022427815577835

Sheldon OJ, & Fishbach A (2015). Anticipating and Resisting the Temptation to Behave Unethically. Personality & social psychology bulletin, 41 (7), 962-75 PMID: 26001580

Sugiyama, H., Oshida, A., Thueneman, P., Littell, S., Katayama, A., Kashiwagi, M., Hikichi, S., & Herz, R. (2015). Proustian Products are Preferred: The Relationship Between Odor-Evoked Memory and Product Evaluation Chemosensory Perception DOI: 10.1007/s12078-015-9182-y

Image via lightpoet / Shutterstock.

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Are We All Schizophrenic? Part II – Hallucinations http://brainblogger.com/2015/05/22/are-we-all-schizophrenic-part-ii-hallucinations/ http://brainblogger.com/2015/05/22/are-we-all-schizophrenic-part-ii-hallucinations/#comments Fri, 22 May 2015 12:00:18 +0000 http://brainblogger.com/?p=19692 In the last installment of the series, we discovered that delusional thinking is a part of normal life, with an estimate of 1-3% of non-schizophrenic individuals having severe delusional thinking on par with schizophrenia. You might think that hallucinations – the arguably more extreme schizophrenia symptom – would be rarer? You’d be wrong!

Have you ever heard, seen, smelt, felt or tasted something that wasn’t actually there? If you have, you are probably like the overwhelming majority of the world’s population, schizophrenia and psychosis free. Hallucinations, despite common misconceptions, are a part of normal healthy living that most of us put down to a “brain glitch”. Let’s take a look at just how common hallucinating is and how this relates to individuals experiencing schizophrenic hallucinations.

May the destigmitazation commence!

Hallucinations are defined as the perception of an object or event, using any of the five senses (sight, hearing, touch, smell and taste), despite there being no external stimulus. We will leave out hypnagogic (falling asleep) and hypnopompic (waking up) hallucinations, or there we would be no discussion, we would end the debate here by simply stating that we all have the potential to hallucinate practically every day!

For that matter, let’s put sleep deprivation to one side too, as 8 out of 10 of us are likely to have visual hallucinations if sleep deprived for long enough. The longer you go without sleep, the more intense the hallucination. Moreover, forget including childhood in the equation, or bouts of delirious fever.

We should also recognize that even in science research, self-reports of hallucinations are likely under-reported in healthy people for multiple reasons. One reason established by research is an individuals fear of appearing insane. Thankfully, reports of hallucinations are not so easily effected by the need to be socially desirable as reports of delusions are.

A revealing analysis of the World Health Organization’s World Health Survey from 52 countries indicates that the frequency of self-reports of hallucinations in the general population are greatly impacted by culture. For example, estimates of the number of people reporting hallucinations over a 12 month period in Nepal were a hearty 32%. Meanwhile, in Kazakhstan this number was a meagre 0.5%.

While currently there aren’t any real, solid ideas as to why, and more questions being posed than answers being given, let’s put cultural differences aside and take a look at the various forms of hallucinations in a little more detail.

Auditory Hallucinations

“What? Did someone call my name?”

Auditory hallucinations are the most commonly reported type of hallucination in schizophrenia (present in 60-90% of patients) and most commonly manifests as hearing voices, with music hearing also being commonly reported.

One of the largest and most detailed studies on hearing voices estimates that 5-15% of all adults will experience hearing voices at some point during their lifetimes. One percent of these healthy, non-schizophrenic individuals may hear multiple and at times interacting voices with character-like qualities that are typically associated with chronic schizophrenic hallucinations. For many, it’s just a normal mode of experience.

Visual Hallucinations

“I am sure there was a man standing there!”

Visual hallucinations typically involve flashes of light or sightings of people and/or animals and are the second most commonly reported type of hallucination in schizophrenia (16-72% of patients). Let’s not forget that in certain religious circles, seeing a flash of light may be considered a gift or glimpse of God.

Reports estimate that 4-12% of healthy individuals have visual hallucinations (although numbers vary greatly between different countries, as mentioned previously).

Tactile and Somatic Hallucinations

“Ahhhh! Was that a beasty crawling up my leg?!”

Tactile hallucinations involve sensations felt on the skin, like being tapped on the shoulder or an insect crawling along the surface. Somatic hallucinations on the other hand involve more internal physical sensations, like feelings of electricity in the brain or snakes slithering inside the stomach.

One US-based study estimates that tactile and somatic hallucinations occur in around 20% of schizophrenic patients. Currently, how common this is in the general populace is largely unknown. One UK report estimates that 3% of the population experience touch-based hallucinations, 24% of which have no association with poor mental health.

Olfactory and Gustatory Hallucinations

“Can you smell/taste that? No? Just me?”

Olfactory (smell) and gustatory (taste) hallucinations, known as phantosmia and gustatory phantasma respectively, are the least reported hallucinations in schizophrenic patients. This may very well be because they are less distressing and less infamous, but that does not necessarily mean that they are uncommon, and are suspected to be grossly under-reported.

In a US-based study, 17% and 8% of schizophrenic patients experienced olfactory and gustatory hallucinations respectively. Interestingly, initial estimates of hallucinations of smell and taste in the general UK population are pretty similar at 7-8%, with 2-3% of participants having had experienced the hallucinations the month prior to when the study was conducted.

Hallucinations in Schizophrenia

So what is the difference between hallucinations experienced when a person is diagnosed as schizophrenic, compared to when they are diagnosed as mentally healthy? Its worthy of note that not all schizophrenic patients experience hallucinations, with the International Pilot Study of Schizophrenia estimating that approximately 70% of schizophrenic patients experience them. For those that do they are rarely benign or pleasant.

In the schizophrenic population, these hallucinations – that healthy people tend to chalk down to an intriguing blip in reality – are more frequent, intrusive and distressing. The real game-changer is when one believes that these glitches in our naturally skewed, flawed and limited interpretation of reality are real.

Hallucinations as a Sign of Ill-Health?

That being said, there are numerous reports of hallucinations being associated with physical health problems independently of a mental disorder, and those that persist may be worthy of clinical examination. They are often reported in individuals with epilepsy, brain tumors, migraines, visual impairment, stroke, drug withdrawal, sinus diseases, sensory deprivation, narcolepsy, inborn errors of metabolism and various neurodegenerative diseases.

However, an individual that is blessed by never having mental health issues and is in perfect physical health may still experience regular hallucinations. Experiencing hallucinations are far more common than schizophrenia or a related mental disorder, as well as most of the more physical ailments that hallucinations are associated with!

With the misplaced idea that hallucinating is a dead cert sign of mental illness free from your mind, please feel free to share your hallucinatory experiences and let’s see just how common they are.

References

Beavan V, Read J, & Cartwright C (2011). The prevalence of voice-hearers in the general population: a literature review. Journal of mental health (Abingdon, England), 20 (3), 281-92 PMID: 21574793

Chabrol H, Chouicha K, Montovany A, & Callahan S (2001). [Symptoms of DSM IV borderline personality disorder in a nonclinical population of adolescents: study of a series of 35 patients]. L’Encephale, 27 (2), 120-7 PMID: 11407263

DeVylder JE, & Hilimire MR (2014). Screening for psychotic experiences: social desirability biases in a non-clinical sample. Early intervention in psychiatry PMID: 24958508

Kessler, R., Birnbaum, H., Demler, O., Falloon, I., Gagnon, E., Guyer, M., Howes, M., Kendler, K., Shi, L., Walters, E., & Wu, E. (2005). The Prevalence and Correlates of Nonaffective Psychosis in the National Comorbidity Survey Replication (NCS-R) Biological Psychiatry, 58 (8), 668-676 DOI: 10.1016/j.biopsych.2005.04.034

Lewandowski KE, DePaola J, Camsari GB, Cohen BM, & Ongür D (2009). Tactile, olfactory, and gustatory hallucinations in psychotic disorders: a descriptive study. Annals of the Academy of Medicine, Singapore, 38 (5), 383-5 PMID: 19521636

Moreno C, Nuevo R, Chatterji S, Verdes E, Arango C, & Ayuso-Mateos JL (2013). Psychotic symptoms are associated with physical health problems independently of a mental disorder diagnosis: results from the WHO World Health Survey. World psychiatry : official journal of the World Psychiatric Association (WPA), 12 (3), 251-7 PMID: 24096791

Ohayon MM (2000). Prevalence of hallucinations and their pathological associations in the general population. Psychiatry research, 97 (2-3), 153-64 PMID: 11166087

Teeple, R., Caplan, J., & Stern, T. (2009). Visual Hallucinations The Primary Care Companion to The Journal of Clinical Psychiatry, 11 (1), 26-32 DOI: 10.4088/PCC.08r00673

Image via ysuel / Shutterstock.

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Dissociation and Psychosis http://brainblogger.com/2015/05/21/dissociation-and-psychosis/ http://brainblogger.com/2015/05/21/dissociation-and-psychosis/#comments Thu, 21 May 2015 12:00:59 +0000 http://brainblogger.com/?p=19594 Dissociation represents a condition of disconnection from events and states that are usually integrated. These include many conditions of consciousness, such as memory, identity and perception. For the purposes of this article, there is a focus on depersonalization and derealization.

Depersonalization is a sense of existence in which one inhabits a consciousness that allows for the feeling that one is not in her own body. In this feeling-state, the individual’s body is perceived as disconnected from one’s sense of self. This state typically results from physical or sexual abuse or other types of trauma.

Derealization comprises a state in which the world and the environment “feel” unreal to the individual residing in this state. Both depersonalization and derealization are aspects of dissociation represented by subjective states that usually result from trauma.

Both of these aspects of dissociation, specifically, depersonalization and derealization, can be considered psychological mechanisms of defense. Nevertheless, living in a dissociative state is not ideal: it represents an emotional withdrawal from one’s healthy sense of self and the world. However, dissociation can protect the individual in that state from future trauma, such as physical abuse that results in psychological abuse.

Dissociation in the forms of depersonalization and derealization provide a thin, albeit very thin, emotional buffer against physical or psychological harm.

The science of psychiatry treats psychotic disorders through the application of medication to the problems of hallucinations and delusions. The reality or unreality of hallucinations, which may be considered a semantic onslaught, can cause one to withdraw into the self and experience dissociation, such as depersonalization and derealization. While meds might culminate in the elimination of hallucinations (which is a great achievement), psychotic states whose symptoms are represented by auditory hallucinations, are experienced by the psychotic individual as torture amounting to trauma. Delusions compound this suffering.

Trauma can result in regression through emotional withdrawal of the self from the material self and the material world. While it might seem sentimental to procure the phrase, “a return to the womb”, this may be exactly what dissociation represents.

While perhaps not understood to be a salient precursor to Eriksons’s stages of development, this “return to the womb” may be considered to be an internal state of those who have experienced trauma, including the subjective experience of psychosis.

Regressive psychotherapy based upon the Eriksonian stages, proceeding with a a focus on “trust versus mistrust” and on to psychological dichotomies at the psychotic person’s natural level of development, such as “intimacy versus isolation”, may prove to be effective. This psychotherapy might be created utilizing appropriate interventions, such as Rogerian therapy as an initial stage focusing on trust, moving toward the cultivation of feelings of autonomy using Adlerian therapy, reinforcing acts of initiative and industrious accomplishment using behaviorism, engendering identity using cognitive therapy that addresses the emergence of abstract thought.

Overall, the dissociative person is a fragile shell of a person as a result of trauma. Nurturing this budding human being through appropriate psychotherapy might ameliorate the trauma associated with the expression of depersonalization and derealization.

Image via Anna Tamila / Shutterstock.

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Interview with Dan Pink – Manipulating the Masses and Hacking your Life http://brainblogger.com/2015/05/12/interview-with-dan-pink-manipulating-the-masses-and-hacking-your-life/ http://brainblogger.com/2015/05/12/interview-with-dan-pink-manipulating-the-masses-and-hacking-your-life/#comments Tue, 12 May 2015 12:00:48 +0000 http://brainblogger.com/?p=19556 We recently caught up with Dan Pink, the mastermind and host of Crowd Control, a 12-part National Geographic TV series in which Dan and his team use behavioral science, design and technology to solve public problems. He has over 20 years experience as a journalist and writer, and is the author of five bestselling books about human behavior, including his latest book, To Sell Is Human: The Surprising Truth About Moving Others.

With his TED talk on the science of motivation below being one of the 10 most-watched of all time (nearly 10 million views!) we asked him a few questions about Crowd Control, and more specifically, on motivating the masses and motivating ourselves to change our lives for the better.

Dan Pink in OfficeWhat are the main academic theories that you draw from in the devising of your crowd control experiments?

Dan: We drew on a variety of studies and lines of research for the show. For instance, we used the famous research showing that a certain shade of pink — called “Drunk Tank Pink” — had a calming effect and then painted a towing lot reception area pink to calm frustrated drivers.  

Along those lines, we drew on research showing that the smell of lemons triggers thoughts of cleanliness and pumped lemon scent into a baseball stadium men’s room to increase hand-washing. We used research showing that the color blue operates as an appetite suppressant — then painted a dining room blue to slow people’s eating and deter their overeating.

And that’s just the beginning. We used some principles of gamification. We harnessed research showing that it’s possible to alter behavior simply by explaining why the behavior is necessary. We used the principle of social proof — that is, our tendency to look to others for cues about how to behave — to get people to walk more carefully on sidewalks while using their cell phones.

Reward versus punishment and orders versus encouragement seem to be to be recurring themes in your social experiments, could you comment on this?

Dan: Sort of. For simple, short-term tasks if-then rewards and punishments (as in if you do this, then you get that) can be pretty effective. But sometimes they don’t last very long. We instated a speed camera lottery to reward drivers who stayed under the speed limit. While the lottery was in place, speeds dropped. But once we removed it, my guess is that people went back to their bad behavior.

On orders versus encouragement, that’s tricky, too. But in general, human beings don’t like being told what to do. In fact, we have only two basic reactions to control. We comply. Or we defy. But that often doesn’t lead to lasting behavior change. Encouragement — whether helping people make regular progress or understand the “why” of their efforts — often has less short-term impact. But its effects can last longer.

Has Crowd Control inspired any crowd-controlling action by governments, organizations or businesses that you know of?

Dan: Yes! In New Mexico, we installed a musical road to deter speeding. When drivers go the speed limit over this stretch, grooves in the highway vibrate and play the song America the Beautiful. That road will be there for years — and several other states (as well as a few other countries) are now investigating building these sorts of roads themselves.

Also, in one episode we went to Austin, Texas, to try to crack down on people parking illegally in spaces reserved for the disabled. Our technique was to install signs, alongside the existing signs, that read “Think of Me. Keep it Free.” The signs also featured a photograph of a local person in a wheelchair. That technique eliminated illegal parking in the area. Now cities in the states of Texas, Connecticut, and Colorado are doing the same.

And finally, how can we invite some of the life and society benefits from your Crowd Control experiments to our own personal real-lives?

Dan: There are all kinds of ways. Take the lemon scent experiment. During flu season office, schools, even homes could put a bowl of lemons in the washroom to encourage hand-washing. Or if you want to lose weight, use blue tablecloths, blue napkins, and blue plates to see if that dampens appetite. (Use smaller plates, too, since we found those substantially cut down on overeating.) We did a great experiment using a photo booth to show people what they’d look like without apply sunscreen. That got them — at least that day — to change their ways.

Since we do a terrible job planning for the future, if you’re trying to get yourself to save for retirement or exercise more or use sunscreen, try a smartphone aging app like Aging Booth or Oldify. Snap a picture of current you, wait for a picture of future you, and you might be shocked into changing your ways.  

More broadly, recognize that most of us go through life pretty blindly, barely thinking about what we’re doing. So try whatever you can — fun, surprise, games, etc — to jolt people out of that default behavior and jolt them into better, more productive behavior.

Image via STH / Shutterstock.

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Rape – Why Do We Blame the Victim? http://brainblogger.com/2015/05/11/rape-why-do-we-blame-the-victim/ http://brainblogger.com/2015/05/11/rape-why-do-we-blame-the-victim/#comments Mon, 11 May 2015 12:00:33 +0000 http://brainblogger.com/?p=19567 For years there has been global outrage over why we continually handle sex abuse allegations badly, with quite shocking statistics and stories of rapists and abusers escaping punishment and repeating their crimes, which undoubtedly instils even less incentive to report abuse for the overwhelming majority of victims that do not come forward.

For example, in a recent analysis of the American Justice Department’s data by the Rape, Abuse and Incest National Network (RAINN), only three out of every 100 rapists will ever spend even a single day in prison. Although these statistics come from the US, the problem is global.

While there are multiple factors that contribute to this heinous permittance of horrible crimes, new research published in the journal Emotion, hints at ways to prevent jurors’ judgement from being clouded by victim blaming and may also help professionals improve rape counselling.

The Experiments

Researchers from Rutgers University-Newark (RU-N) and the New Jersey Institute of Technology, led by professor of psychology Dr. Kent Harber, conducted two main studies that involved showing participants two video clips: Either the violent sexual assault of a woman depicted in scenes of the 1998 film, The Accused, or the heated economic debates and verbal attack of former British Prime Minister Margaret Thatcher, who although embattled, was not a victim. The viewers were mock witnesses or jurors being presented with evidence if you will.

The viewers were divided into two main groups, either “Suppressors” or “Disclosers”, and were asked to write about what they saw:

“Participants in the disclosure condition received written instructions to freely express their deepest thoughts and feelings about their assigned movie. Participants in the “suppression” condition were instructed to write only about superficial details of their assigned movie, such as how many people were in the movie and what these people were wearing and were explicitly forbidden from disclosing any personal feelings or opinions.”

Whether expressing emotions in writing, or not, this did not influence viewers’ attitudes toward Thatcher, the non-victim, but for the rape victim there was a clear cut difference. Suppressors were more likely to blame the victim for being raped. In marked contrast, disclosers succumbed to victim blaming much less. What’s more is that the more words the disclosers wrote, and the more distress they conveyed, the less they blamed the victim.

As Prof Harber notes:

“This first study confirmed that disclosure reduces victim blaming, but it left a somewhat troubling possibility unanswered… What if disclosure, by alleviating the emotions that trigger blaming, tempers blaming of assailants as well as assault victims? If so, disclosure would absolve victimizers as well as victims.”

This would be a dangerous situation in the courtroom, where disclosing ones emotions about the crime, in writing, may reduce blaming of both the victim and the attacker, wrongfully swaying opinions so that the abuser may still get away with their crime, scot-free. Or on the flip-side, one might overtly blame the accused, which could result in wrongful incarceration.

The second study addressed this issue by having the viewers also evaluate the adversarial men in the clips they viewed:

“Disclosure moderated blaming of Sarah, the victim in The Accused, but did not [reduce or increase] blaming of Sarah’s assailants… Victim/disclose participants blamed Sarah less than they blamed her assailants… Victim/suppress participants did not blame Sarah less than her assailants.”

The researchers surmised that, coupled with related research, these results imply that victim blaming arises from the just-world threats that the victims themselves represent. In other words, blaming the victim helps to counteract threats to the viewers’ core belief that we live in a just world and that when bad things happen to people, it is because these individuals are bad people or have done something to deserve their misfortune.

Expressions like “what goes around comes around”, “they got their just deserts” and “karma is a bitch” represent this ideology. It seems that emotion and viewpoint disclosure selectively addresses these just-world threats, thereby inhibiting unjust victim blaming.

Interestingly, to better understand the disclosure effect, four dimensions (reflecting shock, confusion, dismay and anger) were extracted from the subjects’ writing samples and further analyzed:

“It is noteworthy that disclosing general distress (reflecting shock, confusion, and dismay) had these [beneficial] effects, but that disclosing anger did not.”

And while this study did confirm previous reports of men more readily blaming victims (and victimizers) than women, disclosure equally reduced victim-blaming by both men and women.

As Prof. Harber states, the implications of these studies’ findings are profound:

“…people can best help victims by first addressing their own emotional needs. [The research] has already raised interest among law scholars, because of its implications for juries. Jurors are often prohibited from discussing cases until final deliberation. Our research suggests that this forced suppression might affect jurors’ attitudes toward the victim/plaintiffs.”

Moreover, he suggests that survivors might be spared inadvertent blaming from those closest to them by encouraging survivors’ families and friends to disclose rather than suppress their emotions, perhaps to trained therapists.

References

Hafer CL, & Bègue L (2005). Experimental research on just-world theory: problems, developments, and future challenges. Psychological bulletin, 131 (1), 128-67 PMID: 15631556

Harber KD, Podolski P, & Williams CH (2015). Emotional Disclosure and Victim Blaming. Emotion (Washington, D.C.) PMID: 25799160

Vonderhaar RL, & Carmody DC (2014). There Are No “Innocent Victims”: The Influence of Just World Beliefs and Prior Victimization on Rape Myth Acceptance. Journal of interpersonal violence PMID: 25236676

Image via otnaydur / Shutterstock.

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Best and Worst in Psychology and Psychiatry – April 2015 http://brainblogger.com/2015/05/08/best-and-worst-in-psychology-and-psychiatry-april-2015/ http://brainblogger.com/2015/05/08/best-and-worst-in-psychology-and-psychiatry-april-2015/#comments Fri, 08 May 2015 12:00:12 +0000 http://brainblogger.com/?p=19589 So far in our monthly “Best and Worst” roundups, there have been some pretty clear themes linking together interesting and impactful findings in psychology and psychiatry research. This month however, I couldn’t gleam any clear-cut themes. Instead it seemed that for every significant “Worst” finding, there was a related “Best” finding to match. As science research tells us that we typically like to have news delivered to us in improving sequences (as the last thing you hear affects you mood), the bad news comes first!

WORST: Most Psychotropic Drugs are Carcinogenic in Animal Models

Drugs used to treat psychiatric conditions require safety studies of carcinogenicity in animals that provide a database for assessment of the potential biological risk of the drug causing cancer in humans. A systematic review of this database revealed that a shocking 71.4% (30 of 42) of all drugs examined showed evidence of carcinogenicity in 43.2% (38 of 88) of the experimental studies. New generation antipsychotics (9 of 10 tested) and anticonvulsants (6 of 7) showed the highest evidence of carcinogenicity among those drugs assessed. While animal studies do not allow us to draw definitive conclusions, it’s a serious warning requiring immediate investigation.

BEST: Drug Reduces OCD Symptoms with Limited Side Effects

Obsessive compulsive disorder (OCD) is  far from a walk in the park, it can be chronically debilitating and there is a lack of reliable and safe pharmacotherapies available. N-acetyl cysteine (NAC) has been showing potential for treating OCD. It is a precursor to the amino acid cysteine, which ultimately has two key metabolic roles, it has antioxidant activities and influences the reward-reinforcement pathway. The review paper published this month indicates that NAC appears to be extremely well tolerated, with minimal adverse effects reported and is actually considered to be protective against cancer, with the main reported side-effect being bad wind (which ceases within one week of administration).

Most importantly, the review revealed that from the four clinical trials and five case reports/series identified, within 8-12-weeks of 2,400-3,000 mg/day of NAC the severity of OCD symptoms was reduced. However, there were notable inconsistencies in treatment efficacy that require larger cohorts, higher doses and longer treatment to help provide more definitive answers regarding the benefits of NAC, and its potential for future OCD suffers to have a speedier, side-effect free and over the counter route to getting rid of OCD.

WORST: Pathological Gamblers More Willing to Bet on Make-Believe Money-Making Illusions

If you have ever played roulette, you may have fallen for seeing illusory patterns, i.e. it was black six times in a row, the chances are 50:50 so I need to start betting on the red! In reality, we know that for every spin the odds are ALWAYS 50:50, the previous history is irrelevant. The study compared habitual gamblers and regular community members on which of two slot machines they put their money into: The better slot machine that has a 67% chance of winning each turn and the worse slot machine has 33% chance of winning each turn.

The gamblers had a false impression of intuitively knowing which of the two machines to play and rather than sticking to the better slot machine like the non-gamblers. Instead the gamblers matched their choices to the probabilities and chose the better one 67% of the time and the worse one 33% of the time. This adds to the body of evidence that habitual gamblers in a sense, are more gullible to illusions that are part in the parcel of gambling games, as they perceive and believe in, as well as more impulsively bet on, illusory patterns more readily. They are ready and willing to literally waste their money on an illusion.

BEST: Love Inspires Being Charitable and Giving More To Distant Strangers

The study involved participant engaging in self-reflective writing when viewing emotion-laden charitable advertisements for some causes that they felt connected to such as a food drive for local families, and others that felt more distant to, such as rainforest conservation in a faraway country. The findings revealed that while positive emotions, like compassion and hope, in general encouraged people to give to those they felt connected to, love was the only emotion that enhanced giving to distant people and charities – love transcended geographical location.

WORST: Short-Term Debt and Depression Symptoms

Many of us have near enough monthly short-term household debt i.e. credit card payments and overdue bills to pay. The new study on 8,500 working adults indicates that this short-term debt, as opposed to mid- or long-term debt, increases depressive symptoms, with a particularly strong effect among unmarried people, people reaching retirement age and those who are less well educated. Future research will likely focus on if the effects can be reversed and if reducing short-term debt can help alleviate symptoms of depression.

BEST: Identifying Ways to Improve E-Mental Health Treatment for Depression

E-Mental health services accessed online have been shown to be effective and cost-effective for the treatment of depression. A new study outlined promising strategies, including endorsement of e-mental health services by government entities, education for clinicians and consumers, adequate funding of e-mental health services, development of an accreditation system, development of translation-focused activities and support for further translational research to optimize their impact. While the study had a specific focus on the Australian health care system these strategies and their associated economic, treatment efficacy and accessibility benefits are likely transferable to other healthcare systems.

WORST: Stronger Case for Childhood Adversity Translating Into Adult Mental Health Problems

A systematic review of the association between childhood adversity and the course and development of psychotic experiences, disorders and symptoms over time was conducted. Childhood diversity includes maltreatment, exposure to domestic violence or living with another person with serious mental illness. 17 out of 20 studies that met inclusion criteria reported positive associations between exposure to adversity and experiencing psychotic experiences and symptoms later in life.

A meta-analysis of the studies pooled together the odds of psychotic symptoms occurring, revealing that children experiencing adversity had almost double (1.5-1.8 times) the chance of psychotic experiences compared to the children not experiencing diversity. Bear in mind that the authors found high heterogeneity in the results, and encourage caution in interpreting the results. Nonetheless, the as of yet limited evidence suggests that exposure to adverse events in childhood is associated with persistence of psychotic experiences and clinically relevant psychotic symptoms.

BEST: Parent-Child Warmth May Play a Key Role in Long-Term Positive Functioning for Children Exposed to Intimate Partner Violence

This study gives us more hope for children experiencing childhood adversity. Models of the relationships between intimate partner violence (IPV) exposure, parent-child warmth, symptoms of psychopathology during adulthood and life satisfaction were made from self-report surveys completed by 703 Swedish 20-24 year olds. IPV exposure was related to lower levels of parent-child warmth, higher levels of psychopathology symptoms and lower life satisfaction. Conversely, for those exposed to IPV, positive outcomes in adulthood were mediated by parent-child warmth.

WORST: Worriers may more readily detect errors at the cost of cognitive control

We have action-monitoring systems functioning in our brains so that we can optimize our behavior by detecting conflicts, responding to errors, and preventing future errors by signalling the need for greater cognitive control. Worrying is well-established to alter how the action-monitoring works, and is similarly dysfunctional in depression and obsessive compulsive disorder.

The study in the spotlight suggests that while worrying may heighten your chances of correctly predicting when something is amiss, there are negative consequences. Worriers upon detecting an error are less likely to improve their cognitive control to prevent the error from occurring again (such as appropriate stimulation of reasoning and action, and flexibly changing goals to suit the context). So in simple terms, overt worrying might make problems stand out more, but doesn’t typically give your brain the boost it needs to effectively overcome the problem. The take home message, worry less, think more.

BEST: Belief in the Afterlife Raises Hope When Thinking about Death for People with Low-Self Esteem

Some might argue that the opposite of worrying is hope. A new study reports that people with low self-esteem lose hope when thinking about death, but not for those with high self-esteem, in alignment with Terror Management Theory. While thoughts of death caused individuals with low self-esteem to lose hope when reading an argument that there is no afterlife, when they read “evidence” supporting life after death, or an essay affirming scientific medical advances that promise immortality, their hope remained strong – literal immortality beliefs can aid psychological adjustment when thinking about death.

References

Amerio A, Gálvez JF, Odone A, Dalley SA, & Ghaemi SN (2015). Carcinogenicity of psychotropic drugs: A systematic review of US Food and Drug Administration-required preclinical in vivo studies. The Australian and New Zealand journal of psychiatry PMID: 25916799

Batterham PJ, Sunderland M, Calear AL, Davey CG, Christensen H, Teesson M, Kay-Lambkin F, Andrews G, Mitchell PB, Herrman H, Butow PN, & Krouskos D (2015). Developing a roadmap for the translation of e-mental health services for depression. The Australian and New Zealand journal of psychiatry PMID: 25907269

Berger, L., Collins, J., & Cuesta, L. (2015). Household Debt and Adult Depressive Symptoms in the United States Journal of Family and Economic Issues DOI: 10.1007/s10834-015-9443-6

Gaissmaier W, Wilke A, Scheibehenne B, McCanney P, & Barrett HC (2015). Betting on Illusory Patterns: Probability Matching in Habitual Gamblers. Journal of gambling studies / co-sponsored by the National Council on Problem Gambling and Institute for the Study of Gambling and Commercial Gaming PMID: 25921650

Miller-Graff LE, Cater ÅK, Howell KH, & Graham-Bermann SA (2015). Parent-child warmth as a potential mediator of childhood exposure to intimate partner violence and positive adulthood functioning. Anxiety, stress, and coping, 1-15 PMID: 25800826

Moran TP, Bernat EM, Aviyente S, Schroder HS, & Moser JS (2015). Sending mixed signals: Worry is associated with enhanced initial error processing but reduced call for subsequent cognitive control. Social cognitive and affective neuroscience PMID: 25925270

Oliver G, Dean O, Camfield D, Blair-West S, Ng C, Berk M, & Sarris J (2015). N-acetyl cysteine in the treatment of obsessive compulsive and related disorders: a systematic review. Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology, 13 (1), 12-24 PMID: 25912534

Trotta A, Murray RM, & Fisher HL (2015). The impact of childhood adversity on the persistence of psychotic symptoms: a systematic review and meta-analysis. Psychological medicine, 1-18 PMID: 25903153

Wisman A, & Heflick NA (2015). Hopelessly mortal: The role of mortality salience, immortality and trait self-esteem in personal hope. Cognition & emotion, 1-22 PMID: 25920481

Image via Stepan Kapl / Shutterstock.

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Learning Skills and Psychosis http://brainblogger.com/2015/04/14/learning-skills-and-psychosis/ http://brainblogger.com/2015/04/14/learning-skills-and-psychosis/#comments Tue, 14 Apr 2015 12:00:05 +0000 http://brainblogger.com/?p=19404 As a doctor of clinical psychology, I address differently the problem of psychosis. I approach psychosis as a result of trauma and mental phenomena as opposed focusing on the brain, the empirical and the medical model of mental illness.

I was very recently reading an article on the subject of new advances in medications to treat disorders that implicate the biochemistry of the brain. This article was entitled “Brain Boom”, and it was written by Mathew Herper. In this article it was stated that, in treating schizophrenia: “Currently, drugs can be effective at treating hallucinations and paranoia, but don’t yet treat cognitive problems and social difficulties caused by the disease.”

There are distinct differences between the experiences of hallucinations and paranoia that may explain why these characteristics are able to be ameliorated by medication while the others are not. It should be noted that hallucinations and emotional problems such as paranoia are visceral experiences, and, for that reason, they may be more implicated in the abnormal brain chemistry from which psychosis emerges. Cognitive and social problems, problems, however, may depend more on experience in the mental and material worlds.

When discussing cognition in a schizophrenic, certain difficulties in schizophrenic thinking are obvious. Loose associations, word salad and poverty of speech are some examples of what signifies cognitive difficulties in these individuals with psychosis. One fact that is seldom considered is that schizophrenics deal with experience that is uncharted — it is novel — and it cannot easily be understood cognitively in that it is difficult to cognitively manipulate the experience of psychosis by the schizophrenic’s own efforts. Why would anyone expect the schizophrenic to be able to think about experience that is uncommon and non-normative? There is no real basis, no real tradition in thought, that would allow the schizophrenic to think productively about psychosis.

While I was in graduate school, I asserted that I wanted to write theory concerning meta-belief systems. Essentially, I wanted to generate belief systems about belief systems — to understand psychosis from a theoretical and essentially cognitive perspective based in cognitive theory. The point that I wish to make is that psychosis, as a thought disorder, should not be encapsulated as a biochemical disorder exclusively. As indicated, it is my belief that the expression of psychosis as psychopathology depends on the mind and the environment as well as biochemical phenomena.

Clearly social deficits in schizophrenics depend on experience in the material world. Given the fact that psychosis tends to emerge in adolescence and young adulthood, there are very important developmental activities that are compromised in terms of maturing socially. This is seen most prominently in Erikson’s stages of social development. When schizophrenia typically emerges, the individual is in the “identity versus role confusion stage” or the “intimacy versus isolation stage”. Psychosis leads to problems with identity formation and interpersonal alienation. This may be attributed to non-normative experience and impoverished social experience.

Essentially, the schizophrenic’s poor cognitive and social skills are impacted by non-normative experience, and hallucinations and paranoia have causal effects on deviant cognition and a lack of social skill. If hallucinations and paranoia can be diminished early in the course schizophrenia, perhaps this non-normative experience would not have this negative impact on cognition and social skill. Clearly, paranoia and hallucinations are implicated in a causal way in terms of their effect on cognition and social skills. Nevertheless, poor cognitive activity and limited social skill depend on non-normative experience in the mental and material worlds.

Overall, poor cognitive and social skills result from a diminished fund of learning. Nevertheless, cognitive skills may be reflected in meta-cognition as it relates to psychosis. Enhancement of cognition about cognition, or cognition about psychosis, may allow for the schizophrenic’s detachment from her psychotic experience. This may prove to be therapeutic. Similarly, the therapeutic benefits of social skills training may be therapeutic. As learning deficits, poor cognitive and social skills have the capacity to respond to learning, and this is a positive correlate to the fact that cognitive and social skills are learned.

Addendum

Since submitting this article, I have given more thought to the assertion I made regarding the statements within the article Brain Boom. It was stated in Brain Boom, by Matthew Herper, that “currently, drugs can be effective in treating hallucinations and paranoia, but don’t yet treat cognitive problems and social difficulties caused by the disease.”

In terms of cognitive problems in schizophrenics, it may be said that medication improves cognitive organization. While not a replica of intelligence, IQ may be considered to approach cognitive ability based on cognitive organization. There is no doubt that a schizophrenic who is being treated with antipsychotic medication will score higher on an IQ test than that same person might score while taking an equivalent test while taking no antipsychotic meds. This illuminates the effect of medication on cognitive problems in schizophrenics. While not aligned with the quoted statement in the article Brain Boom, my statements herein support the dramatic and positive effects of antipsychotic medication.

In terms of social skills, I have stated that these are learned, and, correspondingly, these are not learned in schizophrenics due to aspects of poor development in the Eriksonian stages of “identity versus role confusion” and “intimacy versus isolation”. When the Eriksonian stages of development are compromised, the resulting deficits in social skill and ability can be understood. Moreover, treating and diminishing paranoia with antipsychotic medication will have a positive effect on social skills in time. The important part of this last statement is “in time”.

Overall, there exists a synergy between biochemical effects of meds and the realities of cognitive deficits as well as the role of negative emotional states affecting traits. Attempting to separate the material biochemical brain functions treated by antipsychotic meds, from cognitive and social processes that are aligned with schizophrenia is confounded by the synergy between biochemical, cognitive and social aspects of the disease of schizophrenia.

The key to seeing cognitive and social progress in the medicated schizophrenic could be the longevity with which improvement in psychotic process is observed — after the fact of administration of antipsyhcotic medication to the schizophrenic individual.

Image via Volt Collection / Shutterstock.

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Are We All Schizophrenic? Part 1, Delusions http://brainblogger.com/2015/04/10/are-we-all-schizophrenic-part-1-delusions/ http://brainblogger.com/2015/04/10/are-we-all-schizophrenic-part-1-delusions/#comments Fri, 10 Apr 2015 12:00:24 +0000 http://brainblogger.com/?p=19347 The ignorance in the public understanding of schizophrenia and related disorders is shockingly poor, with a survey by the National Alliance on Mental Illness indicating that 64% of Americans are unable to recognize its symptoms or incorrectly think the symptoms include split or multiple personalities. Misunderstanding schizophrenia is a key driver of the stigmatization of individuals with the condition, which has detrimental consequences, such as reduced housing and employment opportunities, diminished quality of life and health, low self-esteem, more symptoms and stress – which only further exacerbates the condition and reduces chances of recovery.

While misportrayal in the media and the name itself (schizo = split, phrenia = mind) are partly to blame, schizophrenia continues to be largely misunderstood as many of us think we are unable to relate. We are unable to put ourselves in the shoes of someone with the disorder. So let’s take the time now to set the record straight.

What you are about to discover is that we may be more able to relate to people that have experienced schizophrenic episodes than we think. Both new and not so new research reveals that the symptoms of schizophrenia are more common in non-schizophrenic individuals than we like to think.

The first criteria in the DSM-V for a schizophrenia diagnosis lists five main symptoms, at least two of which must be present for at least one month. One of the two symp­toms must be delu­sions, hal­lu­ci­na­tions or dis­or­ga­nized speech.

  • Delu­sions
  • Hal­lu­ci­na­tions
  • Dis­or­ga­nized speech (e.g., fre­quent derail­ment or inco­her­ence)
  • Grossly dis­or­ga­nized or cata­tonic behav­ior
  • Neg­a­tive symp­toms (i.e., dimin­ished emo­tional expres­sion or avolition)

Yet having only one symptom is sufficient for meeting symptom criteria if the delusions are considered bizarre (totally and utterly impossible, not understandable to same-culture peers and not derived from ordinary life experiences), or if auditory hallucinations involve a voice keeping up a running commentary of thoughts and behaviors or two or more voices talking with each other.

The key question is how common are these symptoms in the general populace? For the first part in the series we will consider delusions.

Symptom 1 – Delusions

Delusions are classified in the DSM-V as:

“…fixed beliefs that are not amenable to change in light of conflicting evidence. Their content may include a variety of themes (e.g. persecutory, referential, somatic, religious, grandiose)… The distinction between a delusion and a strongly held idea is sometimes difficult to make and depends in part on the degree of conviction with which the belief is held despite clear or reasonable contradictory evidence regarding its veracity.”

Have I ever had beliefs that I believed to be true despite conflicting evidence ? Or, although no proof against the truth of my belief can be found, did I believe with my mind, body and soul despite other people finding the idea implausible? Check! And have I ever had these beliefs persisting for a month or more? Check! Have I ever had schizophrenia or a related disorder? No.

A large body of evidence supports this idea, that we all have experienced non-pathological delusional beliefs throughout our lifetime and even generally in day to day life, and some delusions may actually be good for us (see the end of this article). For example one study found that over 10% of the non-clinical general population experience grandiose beliefs, i.e. that they are extraordinarily special in some way, although the belief is typically held with less conviction, less resistance to change and causes less significant social and occupational impairment than in those diagnosed with schizophrenia.

Professor of Clinical Psychology at Oxford University, Daniel Freeman, published a review of the literature in 2006 stating that:

“Approximately 1% to 3% of the nonclinical population have delusions of a level of severity comparable to clinical cases of psychosis. A further 5% to 6% of the nonclinical population have a delusion but not of such severity. Although less severe, these beliefs are associated with a range of social and emotional difficulties. A further 10% to 15% of the nonclinical population have fairly regular delusional ideation.”

Moreover, there is an inverse relationship between our age and how common and strongly held our delusional beliefs are. I don’t think anyone would argue that children are inherently delusional creatures: Magical, superstitious, bizarre, grandiose, paranoid and all kinds of delusions are not unusual for their rapidly developing yet immature belief systems.

Who here believed monsters lived under their beds or in the closet despite being shown repeatedly that there is nothing there? When I was around four or five, I believed I was a magical being that faeries had gifted sacred magical dust for super powers like flying off of the couch. I was so frustrated and furiously upset when no one would believe me that I tried to run away with the faeries, quite literally!

Similarly, delusional beliefs are pretty common in adolescents and young adults. In comparison to our previously mentioned grandiose delusions held by 10% of the general population, some studies have shown that the same beliefs are experienced by up to a colossal 75% of 15-26 year old’s. What’s more is that another study has shown that this subset of highly delusional individuals experience more distress and preoccupation associated with their delusional beliefs than the general population, as found in schizophrenia.

Interestingly, the extent to which a delusion is believed, how much it interferes with a person’s life and its emotional impact are what researchers often use to set pathological delusions apart from non-pathological ones, as these factors are typically more extreme in schizophrenic patients. If you can recall however:

“Approximately 1% to 3% of the nonclinical population have delusions of a level of severity comparable to clinical cases of psychosis.”

Herein lies the rub, “normal” and seemingly non-pathological delusions can be highly distressing, make you and perhaps others question your sanity and have huge emotional and life changing impacts.

Let’s say one day you have a profound religious experience where you believed that God was talking directly to you, reminding you of your sins or your importance and offering you a chance to repent by sending you on a personal mission. This is not an overwhelmingly uncommon experience in religious communities. You might believe in your mission to the core of your being, quit your job, feel overwhelmingly distressed, leave your family and friends despite their pleas, abandon everything and head off into the unknown on your religious mission.

Or let’s say that you less extravagantly “find God/Jesus”, believing that God/Jesus can hear you and is watching you and that you can influence real-life world events through praying to God/Jesus. This belief is not considered a delusion seeing as millions of other people believe the same – despite their being no way to conclusively prove this is true.

But if you replace God with the all-powerful Mars alien Lord Ziltoid, and there is not a group of individuals believing this too, it could easily be considered a pathological delusion. Unless you are a child of course, then we just chalk it down to an overactive imagination or a phase.

The same goes for non-religious beliefs that may or may not be considered delusional. For a little perspective, here are a few examples of common delusion themes, and a typical related question used in research-based diagnostic tools like the Peters et al. Delusions Inventory (PDI):

  • Delusions of grandeur – Do you ever feel that you are a very special, unique or unusual person or are destined to be someone important?
  • Delusions of control Do you ever feel as if electrical devices such as computers can influence the way you think, or that there is a force, power or other people that can interfere with your thoughts or actions?
  • Delusions of guilt Do you ever feel that you have sinned more than the average person?
  • Delusions of reference Do you see any special meaning for yourself in everyday objects?
  • Delusions of persecution Do you ever feel there is a conspiracy against you?
  • Delusion of jealousy or paranoia Do you ever think that someone/your spouse is talking about you, hiding things from you or being unfaithful to you behind your back?
  • Magical delusions – Do you believe in the power of witchcraft, voodoo or the occult?

Some of these delusions are relatively commonly held beliefs that can cause high levels of distress, make life difficult to live and socially isolate you from others that don’t share your belief, all while not having schizophrenia.

For example delusional jealousy, is an all too common phenomena. We all know someone has let their social media stalking green-eyed monster rear their ugly head, despite having no proof or justifiable reason to believe anything untoward is going on. Likewise, delusions of reference are pretty standard day to day operations for many healthy individuals, where a person falsely believes that insignificant remarks, events, or objects in one’s environment have personal meaning or significance:

“the clock read 3:33 today, the 33 bus broke down right in front of me and then I was handed 33 cents change. Doo do doo do doo do doo do – the universe is trying to tell me something!”

So ultimately, no matter how bizarre a belief might seem to some, no matter how distressing and life-shattering, it seems that ultimately it is the cultural context which dictates whether a belief is truly delusional or not.

Can delusions be good for us?

On a final note, there is actually evidence suggesting that a certain amount of delusional thinking might actually be good for us! Often we cling onto delusions that make us feel good, or prevent us from feeling bad, whether they are about ourselves, other people or any aspect of life.

For example students may choose to believe more job offers and higher salaries upon graduation are in store for them despite statistics saying otherwise, aiding motivation to complete their studies. Take marriage as another example. Although researchers estimate that 40–50% of all first marriages end in divorce, we marry anyway, many believing unshakably of being together until death do us part, which presumably enhances our feelings of security in the relationship and validates the purpose of the commitment.

Moreover, self-delusional overconfidence in ones abilities and importance, i.e. believing you are better than you are in reality, has been outlined as advantageous in numerous studies as:

“…it serves to increase ambition, morale, resolve, persistence or the credibility of bluffing, generating a self-fulfilling prophecy in which exaggerated confidence actually increases the probability of success.”

In light of this, delusions are not always cognitive flaws, or indeed indicative of schizophrenia and related disorders. They can be life, emotion and peace disrupting; be purposeful and useful features of cognition; or simply be culturally acceptable quirks in our collective thinking and belief system.

“Respect the delicate ecology of your delusions.”
~Tony Kushner, Angels in America

References

Armando M, Nelson B, Yung AR, Ross M, Birchwood M, Girardi P, & Fiori Nastro P (2010). Psychotic-like experiences and correlation with distress and depressive symptoms in a community sample of adolescents and young adults. Schizophrenia research, 119 (1-3), 258-65 PMID: 20347272

Freeman D (2006). Delusions in the nonclinical population. Current psychiatry reports, 8 (3), 191-204 PMID: 19817069

Hatzenbuehler ML, Phelan JC, & Link BG (2013). Stigma as a fundamental cause of population health inequalities. American journal of public health, 103 (5), 813-21 PMID: 23488505

Johnson DD, & Fowler JH (2011). The evolution of overconfidence. Nature, 477 (7364), 317-20 PMID: 21921915

Knowles R, McCarthy-Jones S, & Rowse G (2011). Grandiose delusions: a review and theoretical integration of cognitive and affective perspectives. Clinical psychology review, 31 (4), 684-96 PMID: 21482326

Lincoln TM, & Keller E (2008). Delusions and hallucinations in students compared to the general population. Psychology and psychotherapy, 81 (Pt 3), 231-5 PMID: 18426692

Peters ER, Joseph SA, & Garety PA (1999). Measurement of delusional ideation in the normal population: introducing the PDI (Peters et al. Delusions Inventory). Schizophrenia bulletin, 25 (3), 553-76 PMID: 10478789

Peters E, Joseph S, Day S, & Garety P (2004). Measuring delusional ideation: the 21-item Peters et al. Delusions Inventory (PDI). Schizophrenia bulletin, 30 (4), 1005-22 PMID: 15954204

Image via Sergey Nivens / Shutterstock.

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Best and Worst in Psychology and Psychiatry – March 2015 http://brainblogger.com/2015/04/09/best-and-worst-in-psychology-and-psychiatry-march-2015/ http://brainblogger.com/2015/04/09/best-and-worst-in-psychology-and-psychiatry-march-2015/#comments Thu, 09 Apr 2015 12:00:30 +0000 http://brainblogger.com/?p=19387 March served us a whole host of significant research developments, highlighting the effectiveness and ineffectiveness of various medications, therapies, drugs and techniques for the treatment of disorders of the mind. Harder to swallow although equally important are reports identifying and exploring how causal and contributing factors influence and exasperate these conditions.

But before we dish out this month’s Best and Worst Psychology and Psychiatry research news, we have some very special birthdays to honor. Among some of THE most distinguished and well-known psychologists in the world, are the thought leaders and publishing power houses, Prof. Philip George Zimbardo and Dr. Daniel Goleman.

Born New Yorker turned Californian Professor Emeritus at Stanford University, Philip George Zimbardo is best-known for his controversial Stanford Prison Experiment that highlighted how people can adapt to roles and hurt others because of the role and inspired a deeper investigation of psychology research ethics. He now focuses research on the psychology of heroism and has published more than 50 books and 400 professional and popular articles and chapters, among them, Shyness, The Lucifer Effect, The Time Cure and The Time Paradox. Prof. Zimbardo is currently promoting his non-profit organization, The Heroic Imagination Project, that teaches people how to take effective action in challenging situations.

Born Californian turned New York Times journalist, psychologist and writer, Dr. Daniel Goleman is best-known for his internationally best-selling books Emotional Intelligence and Social Intelligence, and development of the experimentally validated emotional intelligence (EQ) appraisal test, shown to accurately predict leadership performance. Goleman has also written books on topics including self-deception, creativity, transparency, meditation, social and emotional learning, ecoliteracy and the ecological crisis and has rightfully been honored as one of the most influential business thinkers of our time.

Prof. Zimbardo and Dr. Goleman, we salute you!

THE BEST

Brain Activity Test in Infants Predicts Language Outcomes in Autism Spectrum Disorder

A large-scale fMRI study on ASD children with poor language outcomes revealed that when these children were toddlers or infants, they had very little activity in the language-sensitive brain region, the superior temporal cortex,  when compared with ASD children with strong conversation abilities.

By combining fMRI scans detecting superior temporal cortex activity with behavioral questionnaires, the prognostic accuracy for non-verbal ASD reached a sizable 80%. This is one of the first large-scale studies to identify very early neural precursors that help to predict which children may develop non-verbal ASD, and benefit from early language intervention.

Could A Dose of Nature Be Just What The Doctor Ordered?

Researchers are trying to establish a basis for effectively measuring and comparing the therapeutic effects of exposure to nature as one would for a medical drug, using dose-response curves. In this sense, the greater the nature exposure is, the greater the “dose” is. Ultimately, this could help us understand how best to manipulate urban nature to enhance human health in a world were more and more people are living in cities.

Light Therapy Promising for Gulf War Illness and PTSD

Light emitting diode (LED) therapy known best for wound healing and treating joint problems, as well as muscle aches and pains, is now proving promising in treating the mind as well as the body. Following up on encouraging results from pilot work, researchers at the VA Boston Healthcare System are testing the effects of light therapy on brain function in veterans with Gulf War Illness.

The researchers hypothesize that light therapy can be a valuable adjunct to standard cognitive rehabilitation, in order to exercise the brain in various ways in order to take advantage of brain plasticity and forge new neural networks. While LED therapy use targeting the brain has its skeptics, the US department of veteran affairs has funded multiple studies to test its efficacy in treating veterans with PTSD and chronic traumatic brain injury.

Promising Potential of Technology-Based Psychological Interventions for Anorexia and Bulimia Nervosa

A systematic review of 45 publications that includes 3,646 anorexia and bulimia nervosa patients, evaluated the efficacy of using technology-based interventions (including computer-, mobile- and Internet-based interventions) for both prevention and treatment of eating disorder patients, as well as for their carers.

Computer and Internet based interventions (CBIs) were particularly effective for improving symptoms of bulimia nervosa, with videoconferencing also showing promise as a therapeutic tool. For anorexia patients, CBIs may be better suited for relapse prevention. Furthermore, CBIs may also be considered in the prevention and early intervention of eating disorders as well as for supporting carers of eating disorder patients. Mobile interventions on the other hand may be more useful for relapse prevention.

The analysis emphasized that human contact in the form of guidance may augment technology-based interventions. A clearer picture as to how much and what kind of contact is required will be essential in devising the most effective treatment programs.

New Parents Should Aim to Enhance Relationship Satisfaction, Communication and Closeness to Prevent Perinatal Depression and Anxiety

A meta-analysis of data from 120 studies identified risk and protective factors for perinatal depression and anxiety, which effects more than 13% of parents, that are feasibly modifiable by relationship partners in the absence of professional intervention or assistance. The findings suggest that future prevention programs should aim to enhance relationship satisfaction, communication and emotional closeness, as well as to facilitate instrumental and emotional support and minimize conflict between partners.

THE WORST

Prenatal Exposure to Maternal Anxiety is Related to More Extensive Processing of Fear-Related Stimuli

The study involved 9-month-old infants and their mothers, investigating how infants process fearful versus happy faces and voices in the context of prenatal exposure to maternal anxiety. The main finding from the research reveals that the higher the level of maternal anxiety during pregnancy the child was exposed to in the womb, the greater the child’s response to fearful sounds.

The researchers discuss how maternal anxiety during pregnancy influences the development of the child’s brain in the womb, where the child pays more attention to and is more heavily influenced by fearful stimuli, potentially through changes in cortisol and placental enzyme levels induced by the mother’s anxious mental states.

Heroes’ Extent of World Trade Center Exposure May Compound Post-Disaster Life Stress

The research found that the greater a World Trade Center responder’s disaster exposure (hours spent working on the site, dust cloud exposure, and losing friend/loved one), the greater post-disaster life stress was, negatively influencing posttraumatic stress disorder (PTSD) symptoms and overall functioning. Results indicate that the more extreme exposure experienced by police responders led to more severe WTC-related PTSD symptoms and decreased overall functioning over time.

Adolescent Drinking Affects Adult Behavior Through Long-Lasting Changes In Genes

Researchers may have identified the mechanisms through which youth binge drinking increases risk for psychiatric problems and addictions, including alcoholism and anxiety. The researchers gave 28-day-old rats alcohol for two days in a row, followed by two days off, and repeated this pattern for 13 days, reminiscent of binge-drinking weekends in teens. This resulted in epigenetic changes observed in the amygdala, including lowered expression of genes coding for brain-derived neurotrophic factor (BDNF) and activity-regulated cytoskeleton-associated (Arc) protein, that nerve cells need in order to form new synaptic connections.

When the binge-drinking teen rats reached adulthood, nerve connectivity in the amygdala was diminished, their anxiety-like behaviors increased and they preferentially drank more alcohol over water than non-binge drinking rats. Researchers surmised that teen binge-drinking in humans may similarly degrade the ability of the brain to form the connections it needs to during adolescence, through epigenetic alteration in gene activity.

Publication Bias and ‘Spin’ Raise Questions about Drugs For Anxiety Disorders

Gross overestimates of the effectiveness of the increasingly common use of antidepressent drugs to treat anxiety disorders, and underestimates the drugs’ harmful effects, are all too common in the scientific literature. In some cases these medications, which are some of the most commonly prescribed in the world, are not significantly more useful than a placebo, although some antidepressants can have value in treating anxiety disorders.

This mirrors what was found previously for both antidepressents and antipsychotics in the treatment of depression. The researchers remind us that this level of bias is extremely worrying, indicating that conclusions are being manipulated and over-exaggerated, perhaps to receive greater scientific attention, faster and more impactful publication and ultimately, higher drug sales and profits.

Higher Antipsychotic Drug Doses Lead To Greater Death Risk for Dementia Patients

Yet another article providing evidence against the use of behavior-calming antipsychotic drugs as a treatment for the delusions, hallucinations, agitation and aggression that many people with Alzheimer’s disease and other dementias experience. The retrospective case-control study involved a colossal 90,786 dementia patients reveals that the absolute effect of antipsychotics on mortality in elderly patients with dementia may be higher than previously reported and increases with dose.

For example, mortality risk is increased by 12.3% for patients taking the antipsychotic haloperidol when compared to patients taking antidepressants, with only 8 patients needing to take the drug, for one individual’s treatment to be associated with death. Conversely, the study puts emphasis on the use of non-pharmacological strategies first and foremost.

The researchers provide a framework that doctors and caregivers can use to make the most of what’s already known, called Describe, Investigate, Evaluate and Create (DICE) that individually tailors approaches to each person with dementia, and as symptoms change.

References

Lombardo et al. Neuron. “Different functional neural substrates for good and poor language outcome in autism” http://dx.doi.org/10.1016/j.neuron.2015.03.023

Maust DT, Kim HM, Seyfried LS, Chiang C, Kavanagh J, Schneider LS, & Kales HC (2015). Antipsychotics, Other Psychotropics, and the Risk of Death in Patients With Dementia: Number Needed to Harm. JAMA psychiatry PMID: 25786075

Naeser MA, Zafonte R, Krengel MH, Martin PI, Frazier J, Hamblin MR, Knight JA, Meehan WP 3rd, & Baker EH (2014). Significant improvements in cognitive performance post-transcranial, red/near-infrared light-emitting diode treatments in chronic, mild traumatic brain injury: open-protocol study. Journal of neurotrauma, 31 (11), 1008-17 PMID: 24568233

Otte RA, Donkers FC, Braeken MA, & Van den Bergh BR (2015). Multimodal processing of emotional information in 9-month-old infants I: Emotional faces and voices. Brain and cognition, 95, 99-106 PMID: 25839109

Pandey SC, Sakharkar AJ, Tang L, & Zhang H (2015). Potential role of adolescent alcohol exposure-induced amygdaloid histone modifications in anxiety and alcohol intake during adulthood. Neurobiology of disease PMID: 25814047

Pilkington PD, Milne LC, Cairns KE, Lewis J, & Whelan TA (2015). Modifiable partner factors associated with perinatal depression and anxiety: A systematic review and meta-analysis. Journal of affective disorders, 178, 165-180 PMID: 25837550

Roest AM, de Jonge P, Williams CD, de Vries YA, Schoevers RA, & Turner EH (2015). Reporting Bias in Clinical Trials Investigating the Efficacy of Second-Generation Antidepressants in the Treatment of Anxiety Disorders: A Report of 2 Meta-analyses. JAMA psychiatry PMID: 25806940

Schlegl S, Bürger C, Schmidt L, Herbst N, & Voderholzer U (2015). The Potential of Technology-Based Psychological Interventions for Anorexia and Bulimia Nervosa: A Systematic Review and Recommendations for Future Research. Journal of medical Internet research, 17 (3) PMID: 25840591

Zvolensky MJ, Farris SG, Kotov R, Schechter CB, Bromet E, Gonzalez A, Vujanovic A, Pietrzak RH, Crane M, Kaplan J, Moline J, Southwick SM, Feder A, Udasin I, Reissman DB, & Luft BJ (2015). World Trade Center Disaster and Sensitization to Subsequent Life Stress: A Longitudinal Study of Disaster Responders. Preventive medicine PMID: 25840022

Image via wavebreakmedia / Shutterstock.

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Can Monster Spiders Cure Arachnophobia? http://brainblogger.com/2015/04/07/can-monster-spiders-cure-arachnophobia/ http://brainblogger.com/2015/04/07/can-monster-spiders-cure-arachnophobia/#comments Tue, 07 Apr 2015 12:00:01 +0000 http://brainblogger.com/?p=19293 Don’t. Scroll. Down. OK… you can scroll down, but certainly not unwittingly. Some of the images are of terror-inducing, digitally enhanced monster spiders used in a study conducted by the University of Tasmania in a bid to help cure one of the most common phobias known to man, arachnophobia.

The Fear

With some research reporting a fear of spiders of up to 50% in women and 18% in men, reaching a pathological, phobic level in 13% of all women and 4% of all men during their lifetime, it is one of the most pervasive yet relatively irrational fears worldwide.

Yes. Spiders are fear-relevant. There IS a minute, less than 1% chance of death, even when the most poisonous spiders, like the Guinness World Record breaking Brazilian wandering spider or the notorious black widow, dig in their fangs and successfully inject their venomous toxins. They can kill. If you are extremely, extremely unlucky and in a high risk group that is.

For a little perspective, in the U.S. you are around five times more likely to be killed by lightening and over 300 times more likely to die from alcohol poisoning. Yet completely and utterly freaking out, losing the plot and screaming bloody murder while writhing around uncontrollably is not generally something we see too much of when a storm is a-brewin’ or someone breaks out a bottle of booze.

The Feardrop

If you are one of the many arachnophobes out there, don’t fret. The creators of the franken-spiders used in the study, led by Professor of Psychiatry, Kenneth Kirk, have not only been studiously pulling out therapeutically applicable findings from their research, they also provide free therapy in the form of an online trial of a fear reduction program called Feardrop. You can start to tackle your spider fear without even leaving your couch, and they plan to use the same system to treat other phobias in the near future.

There were three main aims in the team’s latest study, published in the Journal of Behavior Therapy and Experimental Psychiatry. The first was to test the effectiveness of Feardrop in the laboratory.

Feardrop presents images of spiders and allows the user to rate their anxiety as they go. In the experiment, each participant aimed to complete a hierarchy of eight stages, where the images got scarier and scarier as they went, and they were not allowed to pass on to the next stage unless they successfully lowered their level of anxiety, a “feardrop” if you will.

As lead researcher, Dr. Allison Matthews describes, Feardrop was highly successful:

“We found large reductions in questionnaire measures of phobic symptoms, but we also found large improvements on a behavioral avoidance task in which participants were asked to approach a real live spider. Importantly, this suggests that the treatment effects generalized to a real world situation. When we looked at the clinical significance of our findings, two-fifths (42%) of the real image group showed a clinically significant reduction in symptoms, according to very stringent criteria, with the remainder generally showing some improvement.”

Great news for two-fifths of our arachnophobic readers out there!

Moving onto the monster spiders, the second aim of the study was to see how increasing fear and disgust, through exposure to hyperreal spiders, affects symptom improvement.

However, contrary to expectancies, there were no overall differences in fear activation for the real and hyperreal images. Despite the hyperreal images were reportedly more scary and disgusting, both graphically mutated and regular spiders were equally as effective in the process of curing arachnophobia.

Real Spider Hyperreal Spider

In fact, there was one difference. A greater number of participants couldn’t handle the monster spiders and quit the hyperreal image condition, and as Dr. Matthews suggests:

“It is possible that hyperreal images are not an acceptable treatment option for some people. There seems to be individual differences in how people will react to images of feared stimuli, and we don’t fully understand these differences yet. We do know that people with lower levels of fear are more likely to adhere to an exposure hierarchy which contains video clips rather than stationary spider images. So those with lower levels of fear may need more stimulation to benefit from the program.”

As only highly fearful arachnophobes were used in the study, future research may see a comeback of the monster spider, where it may have a more heroic role than regular old spiders in saving phobics with lower levels of fear, or that have already largely reduced more extreme levels of fear.

The third aim of the study was to relate their findings to emotional processing theory (EPT) – a unifying theory that attempts to explain the processes of and guide the use of exposure in the treatment of anxiety disorders. The theory suggests that activation of fear and habituation of the fear response, both within and between exposure stages, is crucial for successful treatment, although this has not always been reflected in research.

In support of EPT, Dr. Matthews reports that:

“We found that generalization of habituation between the first and last exposure stage was the best predictor of approaching a real spider in the future. This is relatively consistent with the concept of between-session habituation in EPT, and is also consistent with inhibitory learning perspectives, which place lots of emphasis on the resilience of new learning to different times and contexts.”

Basically, if you are an arachnophobe, the greater your reduction of fear is between online exposure sessions, the greater your fear extinction learning is, and in turn, the greater your fear-busting and courage-conjuring potential is when face to face with your nemesis, a real live spider.

At least where this study is concerned, having greater fear activation or greater fear reduction within an exposure stage are the moth-eaten aspects of EPT theory and are not predictors of therapeutic success, or indeed failure, as previously suspected.

The Research

Including the main study in question, there have already been 12 arachnophobia research articles published this year alone (summarized at the end of this article), with many practical applications that could maximize the efficiency of curing fearful phobics, and may even lead to the near extinction of arachnophobia. Here is a summary of some of those practical applications:

    • When progressing from images to real-life spiders, exposure treatment to real spiders in different locations and contexts can help generalize therapeutic effects to previously unexperienced spider-encounters and prevent the all too common renewal of fear after therapy.
    • For those that can’t even handle regular spider images, very brief exposure to images, where the images were flashed for 25-33 milliseconds (considered subliminal and consciously undetectable), induces a process of fear reduction without causing distress, allowing highly fearful and extreme arachnophobes to start treatment more gradually.
    • The stronger the behavioral avoidance displayed by arachnophobic mothers, the stronger the fear is in their children. If you are a parent, reducing your overt expressions of avoidance may lower the risk of fears being transmitted to children.
    • The broad-spectrum antibiotic drug, D-cycloserine, known as Seromycin®, with potential efficacy for the treatment of anxiety, phobias and addiction, may have therapeutic benefit for treating phobias in children. Although it did not improve cure rates it did enable children to better retain their fear extinction learning across different stimuli and contexts.
    • Trying to distract yourself by thinking of baseball, your in-laws naked or any other distraction technique might not be beneficial. In fact, counter intuitively, thinking of spiders during exposure to spider images actually decreased emotional and avoidance responses between exposure sessions (fear habituation) than when imagining fear-relieving distractions, which led to a complete return of fear 16 days later.
    • Stop expecting to find a spider in cupboard, drawer, bush or shoe! Irrational expectations that spiders are lurking in every corner in phobics is part of a neural web of irrationality, fear-focused attention and loss of self and emotional control in the brain. Therapeutic interventions should improve the phobics’ capacity to integrate other information, such as signals and expectations of safety that can counteract their fear, during distressing anticipations of spider confrontations.

The Cure

A recent meta-analysis comparing available therapies for phobias indicates that exposure therapy is the bees knees when it comes to curing arachnophobia. Trying out Feardrop is a great place to start to see where one’s fear is at, as well as to significantly reduce phobia symptoms (for about ~40% that complete the program).

When too scared to even deal with images, and even if not, seeking out a cognitive behavioral therapist is a good move to completely obliterate arachnophobia, or indeed any phobia. A therapist will help deconstruct and reconstruct some thinking patterns to allow easing into future exposure sessions.

Once the presence of spiders is juuust bearable, don’t pour any hard earned fear reduction down the drain, relish every single opportunity to keep the fear at bay… expose, expose, EXPOSE!

References

Aue T, Hoeppli ME, Piguet C, Hofstetter C, Rieger SW, & Vuilleumier P (2015). Brain systems underlying encounter expectancy bias in spider phobia. Cognitive, affective & behavioral neuroscience PMID: 25694215

Bandarian-Balooch S, Neumann DL, & Boschen MJ (2015). Exposure treatment in multiple contexts attenuates return of fear via renewal in high spider fearful individuals. Journal of behavior therapy and experimental psychiatry, 47, 138-44 PMID: 25601294

Bartoszek G, & Winer ES (2015). Spider-fearful individuals hesitantly approach threat, whereas depressed individuals do not persistently approach reward. Journal of behavior therapy and experimental psychiatry, 46, 1-7 PMID: 25164091

Byrne SP, Rapee RM, Richardson R, Malhi GS, Jones M, & Hudson JL (2015). D-CYCLOSERINE ENHANCES GENERALIZATION OF FEAR EXTINCTION IN CHILDREN. Depression and anxiety PMID: 25775435

Dethier V, Bruneau N, & Philippot P (2015). Attentional focus during exposure in spider phobia: the role of schematic versus non-schematic imagery. Behaviour research and therapy, 65, 86-92 PMID: 25588928

Lebowitz ER, Shic F, Campbell D, MacLeod J, & Silverman WK (2015). Avoidance moderates the association between mothers’ and children’s fears: findings from a novel motion-tracking behavioral assessment. Depression and anxiety, 32 (2), 91-8 PMID: 25424469

Leutgeb V, Sarlo M, Schöngassner F, & Schienle A (2015). Out of sight, but still in mind: electrocortical correlates of attentional capture in spider phobia as revealed by a ‘dot probe’ paradigm. Brain and cognition, 93, 26-34 PMID: 25500187

Matthews A, Naran N, & Kirkby KC (2015). Symbolic online exposure for spider fear: habituation of fear, disgust and physiological arousal and predictors of symptom improvement. Journal of behavior therapy and experimental psychiatry, 47, 129-37 PMID: 25577731

Michalowski JM, Pané-Farré CA, Löw A, & Hamm AO (2015). Brain dynamics of visual attention during anticipation and encoding of threat- and safe-cues in spider-phobic individuals. Social cognitive and affective neuroscience PMID: 25608985

Rinck M, Koene M, Telli S, Moerman-van den Brink W, Verhoeven B, & Becker ES (2015). The time course of location-avoidance learning in fear of spiders. Cognition & emotion, 1-14 PMID: 25707541

Shiban Y, Brütting J, Pauli P, & Mühlberger A (2015). Fear reactivation prior to exposure therapy: does it facilitate the effects of VR exposure in a randomized clinical sample? Journal of behavior therapy and experimental psychiatry, 46, 133-40 PMID: 25460259

Siegel P, & Gallagher KA (2015). Delaying in vivo exposure to a tarantula with very brief exposure to phobic stimuli. Journal of behavior therapy and experimental psychiatry, 46, 182-8 PMID: 25460265

Wolitzky-Taylor KB, Horowitz JD, Powers MB, & Telch MJ (2008). Psychological approaches in the treatment of specific phobias: a meta-analysis. Clinical psychology review, 28 (6), 1021-37 PMID: 18410984

Image via Stuart Jenner / Shutterstock.

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Is Your Walking Style Making You Depressed? http://brainblogger.com/2015/04/04/is-your-walking-style-making-you-depressed/ http://brainblogger.com/2015/04/04/is-your-walking-style-making-you-depressed/#comments Sat, 04 Apr 2015 12:00:48 +0000 http://brainblogger.com/?p=19299 We hear time and time again about new studies hashing out the specifics and therapeutic details regarding what many infer from experience: Upping the amount and intensity of exercise we do benefits our physical health and psychology and greatly improves symptoms of depression. That’s old news. The new news from our interviewee, Professor Johannes Michalak, is that the style of movement we use may also be important.

The study, published in the Journal of Behavior Therapy and Experimental Psychiatry had 39 participants wearing motion capture suits. Unbeknown to themselves, they were coaxed into walking in either a happy or depressed style by altering the way they walk in order to increase the level of a gauge on a biofeedback monitor that reflects their movement.

While unwittingly walking happily or depressedly, participants were asked if a series of 40 words described them or not. Then, after another 8 minutes of happy or depressed walking they were asked to recall as many of those 40 words as possible. Thus the participants had no idea the real aim was to test their memory while walking in a happy or depressed style, so as not to confound the results.

As outlined in the paper:

“Participants manipulated to walk in a more happy way recalled a higher proportion of positive self-relevant material… We found that memory for negative words did in fact change substantially with walking pattern. Our results show that biased memory towards self-referent negative material can be changed by manipulating the style of walking.”

Basically, the happier the participant walked, the more positively inclined their episodic memory was. When walking more depressed, the more negatively inclined their episodic memory was. In other words, negative biases in memory that are well-documented in depressed and anxious patients were achieved in healthy participants, simply by walking in a more depressed style.

Interestingly, despite walking style profoundly influencing positive or negative word recall, the participant’s mood itself did not change with walking style within the short 20 minute experiment. What this tells us is that the mechanisms behind walking style influencing the brain’s informational processing were not mediated by the emotional state experienced during walking, or the intensity of the walk (as all subjects walked at the same steady pace), but the walking style itself.

In an ode to Aerosmith, it’s “walk this way, remember this way”. But overtime, if we predominantly walk a certain way, does this lead to “think this way, feel this way, behave this way, be this way”? Can walking in a depressed style every day eventually make you feel depressed? Or on the flipside, can walking in a happy style every day eventually lead to greater happiness? Should we fake it to make it?

Professor Michalak draws our attention to related research by Riskind and colleagues where participants experienced failure trying to solve unsolvable puzzles and actually benefited from slumping in their seats, by minimizing both feelings of helplessness, depression and a lack of motivation:

“Riskind interpreted this finding as that it may be useful to get in a mood-congruent posture to overcome failure experiences. If you have an incongruent position this is not possible. Therefore it may be useful to walk in a depressed walking style to overcome a depressed mood.”

So while research may ultimately find that generally improving your gait to be more happy at baseline can lead to having a generally more happy mood at baseline, faking it, through your body posture and movement style may not be fruitful when the situation calls for a little huff and puff.

However, when negative body postures have become second nature, as in depressed patients, as Professor Michalak puts it:

 “It may be advisable to change such a movement pattern when it’s so habitual and decoupled from emotional processing, then it might be useful. However, when a congruent or incongruent movement pattern is or is not useful, is a complex issue that requires further research.”

While Professor Michalak is building on the walking style study to include depressed patients, he is also the lead researcher in a 2014 study proving that even very minor positive changes to the seating posture of depressed patients can render their depressive memory bias obsolete.

Moreover, another study used botox to specifically target frowning muscles of the brow, resulting in more than half (52 percent) of patients reporting significant and sustained improvements in mood, compared to only 15 percent for patients injected with salt water.

It seems that even the most minute and seemingly harmless postures, body and muscle movements can have a profound effect on our mood.

With the myriad of complexly intertwined causal factors contributing to depression it is difficult to say without further experimentation if a negative walking style could overtime lead to depression. What we can say with some certainty is that if you want to recall more positive memories from your daily wanderings, then walk tall, walk bouncy, walk happy, walk sure and walk proud.

Embody positivity and walk the happy walk so you can talk the happy talk when recalling your travels later!

References

Magid M, Reichenberg JS, Poth PE, Robertson HT, LaViolette AK, Kruger TH, & Wollmer MA (2014). Treatment of major depressive disorder using botulinum toxin A: a 24-week randomized, double-blind, placebo-controlled study. The Journal of clinical psychiatry, 75 (8), 837-44 PMID: 24910934

Michalak J, Rohde K, & Troje NF (2015). How we walk affects what we remember: gait modifications through biofeedback change negative affective memory bias. Journal of behavior therapy and experimental psychiatry, 46, 121-5 PMID: 25310681

Michalak J, Mischnat J, & Teismann T (2014). Sitting posture makes a difference-embodiment effects on depressive memory bias. Clinical psychology & psychotherapy, 21 (6), 519-24 PMID: 24577937

Image via JRCasas / Shutterstock.

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Who Needs Another Self-Help Series? http://brainblogger.com/2015/04/01/who-needs-another-self-help-series/ http://brainblogger.com/2015/04/01/who-needs-another-self-help-series/#comments Wed, 01 Apr 2015 11:00:11 +0000 http://brainblogger.com/?p=18840 In 2012 an estimated 43.7 million adults aged 18 or older in the U.S. suffered from a mental illness (NIMH). That’s 18.6% of all American adults – an astonishing figure. Mental health issues are increasingly affecting both people’s professional and personal lives, but the 24/7 society we live in – in which we’re expected to be all things to all people at all times – can provoke and aggravate emotional concerns as well as make it hard to seek help for them.

While attitudes surrounding mental health are thankfully changing, people can still be frightened to admit they’re not coping. In today’s ‘have it all’ competitive culture asking for help can feel like an admittance of failure – which couldn’t be further from the truth.

It’s important that those suffering recognise that they are not alone – that what they’re experiencing is exceptionally common – and that there are treatments that can make a real difference to their lives. Treatments that are simple, accessible and preventative, that aren’t intimidating, don’t cost the earth and that elevate mental health to the same level of importance in people’s minds as physical health. All reasons why we wrote our series, ‘This Book Will Make You Happy/Calm/Confident/Sleep’ based on a Cognitive Behavioural Therapy (CBT) framework.

CBT is one of the leading treatments for a variety of mental health disorders including depression, anxiety, low self-esteem and insomnia. Focused on problem-solving, it’s a brilliant and highly effective approach to dealing with issues people are facing in the here and now. It breaks the problem down in simple ways so it becomes less all-consuming and more manageable.

CBT is evidence-based and has been rigorously tested in trials. It’s been suggested that one of the reasons CBT is so successful is that it gives people control in a situation that otherwise feels very out of control, teaching them the skills to manage their own problems so they can become their own therapist. Our series helps readers to understand how they personally think and react to situations and then gives them the tools to make changes.

CBT in a nutshell

CBT is based on the belief that it’s not what happens to you that matters, it’s how you interpret what happens. How you think about an event will affect your behaviour, your physicality and your emotions.

For example, say you see someone you know across the street. You wave and they don’t wave back. If you think, ‘Wow, Steve just blanked me. What a rude idiot/He must hate me/I must have done something wrong’, it’ll start a negative cycle: your body will tense up or slump (physicality), you might ignore him when you next see him (behaviour) and you’ll feel emotionally angry or anxious. Whereas, just by interpreting the event differently that negative domino-effect stops. By instead thinking, ‘Oh, Steve must not be wearing his glasses’ your physicality and mood would both remain neutral and you wouldn’t behave defensively or aggressively in response.

This chain-reaction is illustrated below in a diagram we call a mind map. Reactions can start from any point. For example, you may react very physically to events and so can fill in the map from there, i.e. you receive an intensely annoying phone call (event), your fists clench and you grind your teeth (physicality) which makes you feel furious (emotions) so you kick the wall (behaviour). You then think, ‘Now I’ve broken my toe, marked the wall and I still have to deal with that annoying phone call’ (thoughts).

CBT Diagram

How CBT can change your brain

Scan research suggests CBT can actually rewire your brain. Primitive survival instincts like fear are processed in a part of the brain called the limbic system which includes the amygdala, a region that processes emotion, and the hippocampus, a region involved in reliving traumatic memories.

“Brain scan studies have shown that over-activity in these two regions returns to normal after a course of CBT in people with phobias.” (Paquette et al., 2003).

Studies have found that CBT can also change the prefrontal cortex, the part of the brain responsible for “higher-level” thinking, proving the therapy can make real, physical changes to both our “emotional brain” (instincts) and our “logical brain” (thoughts). Amazingly these changes are similar to drug treatments, indicating therapy and medications may work on the brain in parallel ways.

A preventative treatment that’s effective for everybody

CBT isn’t only useful to those with diagnosed clinical disorders – it will make a huge difference to anyone who just wants to feel their best more of the time. Understanding your emotional health is the best form of future disorder prevention. By recognising how, why and when you feel you can’t cope, you’ll know if and when you need further help.

Thoughts aren’t facts

The most important message to remember with CBT is: thoughts are not facts. Starting to question your thoughts and their validity will help you formulate more credible alternatives to negative assumptions. You can then test out different ways of interpreting your experiences, allowing you to respond to events in new and more helpful ways. We explain the affects adopting this “motto” has on your thoughts, body, mood and behaviour in our series.

So, who needs another self-help series?

Self-help often promises grand changes without actually delivering. Either readers don’t know how to put what they’ve read into practice or the strategies don’t work! We wanted to write a series that really made a difference to people by providing straight-forward and immediate advice, with no overly-complicated and off-putting jargon, giving them the tools to change their lives.

Each book focuses on a different issue (so they’ll know everything in the book is relevant to what they’re going through) and provides simple strategies that are proven to work, backed up with real examples and anecdotes.

We believe that looking after your emotional wellbeing is an integral part of having a good life. Looking after your mental health should be as normal and natural as looking after your physical health – it’s essential for feeling happy, calm, content and confident. Hopefully our books will help spread that message.

Dr Jessamy Hibberd and Jo Usmar, co-authors of This Book Will Make You Happy/Calm/Confident/Sleep, out now, Quercus $12.99

References

Paquette, V., Lévesque, J., Mensour, B., Leroux, J., Beaudoin, G., Bourgouin, P., & Beauregard, M. (2003). “Change the mind and you change the brain”: effects of cognitive-behavioral therapy on the neural correlates of spider phobia NeuroImage, 18 (2), 401-409 DOI: 10.1016/S1053-8119(02)00030-7

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The Psychology of Dating http://brainblogger.com/2015/03/31/the-psychology-of-dating/ http://brainblogger.com/2015/03/31/the-psychology-of-dating/#comments Tue, 31 Mar 2015 11:00:10 +0000 http://brainblogger.com/?p=19068 In this age of rationality and endless data, intuition is often looked upon as an inferior means of problem-solving. Yet in many situations, even in the hard sciences, it is the most useful means of all. “I believe in intuitions and inspirations… I sometimes feel that I am right. I do not know that I am,” remarked Albert Einstein before his theory of relativity was tested and confirmed as the basis of a new way of looking at the world.

The value of intuition is underplayed in many areas of life, nowhere less so than in online dating. Most dating websites are engines of algorithmic-powered rationality. For example, they require you to describe yourself in words (your characteristics and interests, loves and hates); to sum up the attributes of the sort of person you’d like to be with (fun-loving? bookish? likes owls?); to fill out various personality and psychometric profiles; and generally to ruminate a great deal about your path to a fulfilling relationship.

The psychologists Keith Stanovich and Richard West (and, more recently, Daniel Kahneman in his book Thinking, Fast and Slow) call this kind of approach to problem-solving “system 2”. It is slow, deliberative and analytical, a product of our (relatively) recently evolved prefrontal cortex; it enables us to make complex computations, and to direct our attention at particular tasks.

System 1, by contrast, is fast, automatic and emotion-led, driven by far older neural circuits; it operates automatically and with little sense of agency. System 1 is intuition. Effective decision-making requires both systems – but sometimes it is better to use one over the other.

Take dating. In the real (offline) world, sussing out a potential partner is – at least in the beginning – indisputably a system 1 activity. Humans are remarkably adept at navigating complex social worlds and instinctively picking up on familiar signs that might indicate compatibility. As a species we’ve been doing this for millions of years; as individuals all our lives. Walk into a room full of people and it won’t take you long to pick out those who appeal to you, based on the colour of their shirt, the style of their shoes, how they speak, or the countless other indicators that work beneath our conscious awareness.

This is intuition in over-drive. Try deliberating your way through all those social signals and weighing them up based on their individual merits and you’ll end up making some strange choices, or going home single. Curious, then, that this is exactly what many dating sites compel us to do.

Thinking carefully about our dream date, and about our own personality, and allowing an algorithm to compute a match, may be an intriguing exercise. But as Eli Finkel at Northwestern University and colleagues have shown, it isn’t that helpful. Not only is it difficult to guess what others will find attractive in us, but we also can’t be sure what we really want in our partners until we meet them.

Is there a way around it? I have a vested interest in that question. In January, I launched a new dating site called 21Pictures which tries to use insights from psychology to create a more intuitive experience, where daters can make the most of their hard-wired social intelligence when choosing a partner. It’s based on research I did for my book The Power of Others: Peer Pressure, Groupthink, and How the People Around Us Shape Everything We Do, published by Oneworld this week. Although 21Pictures is a fully functional dating site, it is also a social experiment, since it offers various new approaches that haven’t really been tried before.

The main “intuition hack” on 21Pictures – as you may already have guessed – is to get people to describe themselves in pictures; not just a series of head shots, but pictures from all aspects of their lives. The idea is to make it easier for users to grasp, intuitively, what someone is really like, as they might in the real world; to allow them to use all their social smarts to pick out hints of compatibility and familiarity. So a person’s profile might feature a shot of their bookcase, say, or their favourite coffee shop, their pet, some photos from their travels, a poster of a favourite film, and so on. The effect is to evoke a sense of someone, rather than an algorithmic representation of them.

Intuitively building an idea of a person from snapshots of their life – “thin-slicing” as it is known in psychology – is the next best thing when you can’t actually meet them face-to-face. There’s plenty of science behind it.

Psychologist Sam Gosling at the University of Texas, who studies how people form impressions of others from cues in their environment, has found that someone’s possessions can teach us more about them than a direct conversation, and more even than what their friends or colleagues might say about them. If you’re seeking to “read” someone from pictures of their apartment, Gosling’s research can help you. He’s discovered, for instance, that a messy desk does not necessarily denote a messy mind, or even a creative one: variety of reading material is more telling than quantity.

The point of our social experiment on 21Pictures is to prime people’s dating instincts and encourage them to go with their hunches on just these kinds of cues. We hope to learn, among other things, what kind of pictures give the best insights, what content users most readily connect with, and what someone’s choice of pictures says about them. We’d also like to know if users, when given the opportunity to delve more deeply into people’s lives (rather than just swiping through a series of head shots), spend more time considering individual profiles, and are more satisfied and ultimately more successful if they have fewer profiles to browse (as predicted by numerous studies).

The actor and science communicator Alan Alda has spoken of the need at times for us to:

“…leave the city of your comfort and go into the wilderness of your intuition. What you’ll discover will be wonderful. What you’ll discover is yourself.”

Apply that to dating and perhaps what you’ll discover is someone you actually like. The research I’ve looked at suggests that in this domain at least, you’re more likely to succeed if you follow the Alda route.

References

Stanovich, K., & West, R. (2000). Individual differences in reasoning: Implications for the rationality debate? Behavioral and Brain Sciences, 23 (5), 645-665 DOI: 10.1017/S0140525X00003435

Kahneman, D. (2011). Thinking, Fast and Slow. Farrar, Straus and Giroux

Gillath, O., Bahns, A., Ge, F., & Crandall, C. (2012). Shoes as a source of first impressions Journal of Research in Personality, 46 (4), 423-430 DOI: 10.1016/j.jrp.2012.04.003

Selfhout, M., Denissen, J., Branje, S., & Meeus, W. (2009). In the eye of the beholder: Perceived, actual, and peer-rated similarity in personality, communication, and friendship intensity during the acquaintanceship process. Journal of Personality and Social Psychology, 96 (6), 1152-1165 DOI: 10.1037/a0014468

Finkel, E., Eastwick, P., Karney, B., Reis, H., & Sprecher, S. (2012). Online Dating: A Critical Analysis From the Perspective of Psychological Science Psychological Science in the Public Interest, 13 (1), 3-66 DOI: 10.1177/1529100612436522

Gosling, S. (2008). Snoop: What your stuff says about you. Basic Books

Iyengar, S., & Lepper, M. (2000). When choice is demotivating: Can one desire too much of a good thing? Journal of Personality and Social Psychology, 79 (6), 995-1006 DOI: 10.1037//0022-3514.79.6.995

Image via Sangoiri / Shutterstock.

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Genes, Stress, and Behavior – Is Your Child an Orchid or a Dandelion? http://brainblogger.com/2015/03/27/genes-stress-and-behavior-is-your-child-an-orchid-or-a-dandelion/ http://brainblogger.com/2015/03/27/genes-stress-and-behavior-is-your-child-an-orchid-or-a-dandelion/#comments Fri, 27 Mar 2015 11:00:23 +0000 http://brainblogger.com/?p=19136 Picture a group of children coming to the school for the first time in their life. In this group you will always notice that some children tend to spend the day moping and sulking in a corner of the classroom while other children clearly enjoy the new experience. Why this behavioral difference is so great? After all, being away from home for the first time and spending a day in the midst of strangers would be equally stressful for any child. How can one kid be so resilient while his peer so sensitive? Is it nurture, or does Mother Nature have a hand in this?

Scientists believe that sensitivity and resilience to stress is determined by genes. The presence or the absence of a specific gene variant makes a child emotionally delicate (like the fragile orchid that needs a lot of TLC to thrive) or resilient (like the robust dandelion that flowers even in the harshest of environments). However, scientists hasten to add that nurture can triumph over genes and undo some of their undesirable effects.

How Do Genes Influence Response to Stress?

A recent study has nailed down the reason behind hypersensitivity to the environment and vulnerability to stress in kids to the activity of the glucocorticoid receptor (GR) gene NR3C1. The promoter region of this gene controls the activity of the gene and determines how many glucocorticoid receptors will be produced. The glucocorticoid receptor binds to the stress hormone cortisol and enables it to communicate with the cells in the body. This activity determines how an individual responds to stress.

According to the findings of another study carried out on children aged between 11 and 14 years, those who have been mistreated during their childhood have reduced expression of the NR3C1 gene. This indicates there is less production of glucocorticoid receptors in their brains.

We need cortisol to perform. During times of stress, secretion of cortisol makes us alert to the environment. But excess secretion of cortisol causes us to become anxious and panic, which lead to stress and may cause a drop in performance. The higher the number of glucocorticoid receptors in the body, the larger the amount of cortisol that gets docked. So you can tolerate more stress without feeling “stressed.”

But when individuals have a condition where the NR3C1 gene produces less glucocorticoid receptors, more cortisol hormones slosh around in their blood. The higher the level of cortisol in your blood, the more vulnerable you are to the effects of stress.

How Does Early-Life Stress Alter Gene Expression?

There have also been studies on how stress during the early years of development can alter the genetic makeup of an individual, and whether that goes on to influence how he reacts to stress.

Scientific interest in this matter was fuelled by a belief that children who have been subjected to physical and emotional abuse during their developmental years are at a higher risk of developing substance abuse disorders, depression, post-traumatic stress disorders, and anti-social behavior. This is not a surprising development considering that individuals who suffer from childhood trauma tend to grow up believing that the world is a dangerous and unfriendly place. So they tend to respond to stressful situations as someone would react to a threat—anxiously and aggressively.

Adverse life conditions and/or abuse suffered during childhood may lead to modifications of the glucocorticoid receptor (GR) gene expression. Alterations in the expression of this gene is believed to be the principal cause underlying the association between childhood trauma, reactivity to stress, and risk for developing psychopathological tendencies. Childhood traumatic events include maternal neglect, separation from the mother, loss of one or both parents, and physical and/or mental abuse.

Incidentally, scientists have also noted similar epigenetic changes in the GR gene in rodents that did not receive maternal care during infancy. This gene is sensitive and in infants, it can be affected even by pre- and antenatal maternal anxiety and depression.

An “Orchid” Child Can Blossom into a “Dandelion” Child

The orchid is a delicate beautiful plant. Given the right growing conditions, the orchid sports beautiful blooms. The “orchid” child too, can grow up into a human being with exemplary moral and mental strength if he is provided with a loving, caring, and supportive environment. Such environment is also believed to diminish the chances of an “orchid” child developing psychopathological disorders later in life.

It is this belief that led to the development of the Fast Track program in the U.S. The Fast Track program is an initiative by university researchers to monitor high-risk children in schools and across communities and initiate timely interventional measures to help them learn how to deal with stress.

A landmark study was carried out on about 980 kindergartners with behavioral problems, hypersensitivity to the environment, and vulnerability to stress. They were put through a 10-year intervention program where they learned social skills and coping mechanisms. Their parents were made to undergo behavior-management training programs. Regular home visits and peer coaching sessions were also conducted during this time period.

It was eventually found that those individuals who went through the interventional program reported lower instances of violent criminal behavior and drug-crime convictions and higher well-being index later in life than those “orchid” children who did not go through the program. The study also indicates that the success rate of the intervention program increases the earlier an individual with behavioral problems comes under its aegis.

The above-mentioned findings clearly prove the case for early intervention programs for high-risk children. This is for the authorities to take note of, but parents, teachers, school counselors, and psychologists should also ensure that they do not write off the “orchid” children. Children not only need tender, loving care to thrive but also guidance and support to build their confidence levels, learn to follow their dreams, and have the courage of conviction to stick to their beliefs and ideals.

When an “orchid” blossoms into a “dandelion,” you have that rare person who is sensitive, artistic, and creative whilst also being strong and resilient.

References

Albert, D., Belsky, D., Crowley, D., Latendresse, S., Aliev, F., Riley, B., , ., Dick, D., & Dodge, K. (2015). Can Genetics Predict Response to Complex Behavioral Interventions? Evidence from a Genetic Analysis of the Fast Track Randomized Control Trial Journal of Policy Analysis and Management DOI: 10.1002/pam.21811

Dodge, K., Bierman, K., Coie, J., Greenberg, M., Lochman, J., McMahon, R., Pinderhughes, E., & , . (2015). Impact of Early Intervention on Psychopathology, Crime, and Well-Being at Age 25 American Journal of Psychiatry, 172 (1), 59-70 DOI: 10.1176/appi.ajp.2014.13060786

Ellis, B., & Boyce, W. (2008). Biological Sensitivity to Context Current Directions in Psychological Science, 17 (3), 183-187 DOI: 10.1111/j.1467-8721.2008.00571.x

Oberlander, T., Weinberg, J., Papsdorf, M., Grunau, R., Misri, S., & Devlin, A. (2014). Prenatal exposure to maternal depression, neonatal methylation of human glucocorticoid receptor gene (NR3C1) and infant cortisol stress responses Epigenetics, 3 (2), 97-106 DOI: 10.4161/epi.3.2.6034

Romens, S. et al. (2015). Associations Between Early Life Stress and Gene Methylation in Children. Child Development 86Romens, S., McDonald, J., Svaren, J., & Pollak, S. (2015). Associations Between Early Life Stress and Gene Methylation in Children Child Development, 86 (1), 303-309 DOI: 10.1111/cdev.12270
(1). p.303-309. DOI: 10.1111/cdev.12270

Tyrka, A., Price, L., Marsit, C., Walters, O., & Carpenter, L. (2012). Childhood Adversity and Epigenetic Modulation of the Leukocyte Glucocorticoid Receptor: Preliminary Findings in Healthy Adults PLoS ONE, 7 (1) DOI: 10.1371/journal.pone.0030148

Image via Suzanne Tucker / Shutterstock.

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Proactive Intervention for the Emergence of Psychosis http://brainblogger.com/2015/03/20/proactive-intervention-for-the-emergence-of-psychosis/ http://brainblogger.com/2015/03/20/proactive-intervention-for-the-emergence-of-psychosis/#comments Fri, 20 Mar 2015 11:00:08 +0000 http://brainblogger.com/?p=18301 It is known that mental illness – and serious psychotic disorders in particular – tend to afflict young adults who are socially, vocationally and academically disadvantaged individuals. While this is not always the case, it is true that those people who emerge with psychotic disorders tend to be isolative individuals who have social difficulties in the arenas of junior high and high school.

It is much less likely that young people who are fully integrated academically, vocationally and socially with their primary peers groups will emerge with schizophrenia and other psychotic disorders generally. Intuitively congruent with this is the assertion that young adults and adolescents who engage in academic and social activities in junior high and high school may be able to ward off the expression of mental illness and psychotic disorders themselves. In fact, social involvement, whether this is constituted by belonging to the Latin Club or the Soccer Team, may provide a buffer against the emergence of mental illness, in spite of  individuals  having a genetic predisposition to psychosis.

It has been asserted that diagnoses of schizophrenia in identical twin studies demonstrate an approximately 50% concordance rate. This means that environmental factors are as much complicit in the emergence or lack of it of schizophrenia as biological factors and genetic factors in particular.  It is obvious that there exists a synergy between the mind, the brain and the environment.  Attributions about one’s experience of the material world alters how the environment is perceived by the individual.  Mental experience is unique to the individual, whether that individual is an identical twin or not so.  Based upon these facts, identical twins will differ to some extent in whether psychosis will emerge.

This fact bodes well for the potential of all persons who may or may not emerge with schizophrenia in spite of genetic predispositions. It is obvious that an adolescent’s academic and social involvement activities with peers in young adulthood will impact social his skills as a mature adult.

This does not mean that, if psychotic disorders do emerge, there is no reason to expect that the adult with a psychotic disorder will not be able to pursue and achieve social, academic and vocational success. Most if not all individuals have resources and avenues to success.  However, positive academic, vocational and extracurricular involvement with peers in junior high and high school will provide the individual who genetically predisposed to schizophrenia with a foundation for success in later life, regardless of whether that individual emerges with schizophrenia.

It has been stated by one of my mentors that, if a child has one adult in his life who supports him in ways that may approach unconditional validation, that child will emerge as resilient. Unconditional love and support may, however, be a myth.

Nevertheless, a good enough role model may be able to guide and and support the psychotic individual and work with his strengths in all or even one area. This might make a considerable difference in individual’s ability to cope with schizophrenia and emerge as successful in areas of love and work in spite of it.

Image via Antonio Diaz / Shutterstock.

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