Psychology

Still Charting Memory's DepthsThe New York Times20 May 2013 Read here

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U.S. workers get less time off than those in other developed countries. The result? Unhappy employees who have more physical health problems to go along with family, relationship, and mental health issues....

The new Diagnostics and Statistical Manual, DSM-V, is out. Not surprisingly, it has sparked some controversy. Psychiatry deniers are proclaiming that this is the collapse of the mental-illness fraud (I believe reports of the death of psychiatry are exaggerated). What the DSM-V does represent, to some degree, is an attempt to advance psychiatry to the next stage of our understanding of illness. It seems that we are not quite ready for this step in psychiatry, but the effort is sincere and interesting. For background, the DSM (now in the fifth edition) is essentially a list of official psychiatric diagnoses, based upon clinical criteria. For mental illness and disorders we mostly lack clear biological markers or pathology, and so we have had to make due with clinical descriptions – lists of signs and symptoms. This is very much a descriptive phase of scientific understanding. What almost every popular article I read on the subject gets terribly wrong, however, is in characterizing this as a unique feature of psychiatry, unlike the rest of medicine. A recent Wired article, for example, writes: In most areas of medicine, diagnoses are based on the cause of illness. Heartburn and heart attacks both cause chest pain, but they’re different diagnoses because they have different underlying causes. At least they added the qualifier “most”, but even that is misleading. In fact most disorders and medical illnesses begin their life as a description of signs and symptoms – a purely clinically defined entity. Scientists then investigate possible causes, with the full spectrum of success. Some illnesses we have very little idea, nothing but guesses, about the cause and pathology. In others we have a completely fleshed out model of what is happening, down to the most reductionist level. The Wired article also notes: What doctors now diagnose as schizophrenia may in fact be several disorders with different causes that happen to produce an overlapping set of symptoms. True, but his is also true of many medical illnesses. ALS (Lou Gehrig’s disease, which causes progressive weakness), for example, is a clinical syndrome. We don’t know the ultimate cause, so it is entirely defined clinically. It is very likely to be multiple pathophysiological diseases with a common manifestation. Migraine headaches are another favorite example. They are diagnosed by a list of symptoms, just like DSM diagnoses. Migraine is likely many different underlying biological entities that all manifest in a similar fashion. It is also possible that underlying biological traits manifest in some people as classic migraines, in others as a different type of headache, and in still others with no symptoms. Medical diagnoses span the entire spectrum from a pure description of clinical features, to some knowledge of mechanism, to fairly complete pathophysiologal description.  Mental illness is not unique for being at the clinical description end of the spectrum. What neuroscientists focusing on mental illness are seriously trying to do is advance pyshicatric diagnoses to the next step, from pure clinical description to at least classification by underlying mechanism. No one thinks this is going to be easy. The brain is very complex, and the higher cognitive manifestations of the brain are subject to a host of influences. Teasing apart those influences to determine their relative contribution to a mental disorder is a herculean task, but not impossible. Possible influence include genes, epigenetic factors, developmental factors, biological factors such as nutrition, and all possible environmental factors. Scientists understand this complexity, but you would not know that from reading many popular treatments of the current DSM and efforts to advance our understanding of mental illness. For example, a recent Slate article, Double Inanity, claims right in the subtitle that “twin studies are pretty much useless.” It opens with this howler

A new study of elite male strength athletes finds a link between use of anabolic-androgenic steroids (AAS) and mental health problems later in life. This is the main conclusion of a new University of Gothenburg study recently published in the British Journal of Sports Medicine. The study included almost 700 former Swedish wrestlers, weightlifters, powerlifters and throwers who competed at the elite level sometime between 1960 and 1979. Twenty per cent of them admitted using steroids during their active careers. The purpose of the study was to look for links between AAS use and mental problems. “We found a clear link. AAS users were more likely to have been treated for depression, concentration problems and aggressive behavior,” said researcher and psychologist Dr. Claudia Fahlke. Investigators also found that AAS users were more likely to have abused other illicit drugs and alcohol. Still, it remains unclear whether the steroid use actually caused the mental health problems or the mental health problems rather caused the steroid use. ‘What we were able to show, though, is that psychiatric symptoms and use of steroids and other drugs tend to reinforce each other in a vicious cycle,” Fahlke said. “This suggests that the anti-doping efforts remain very important, both in and outside of sports.” Source: University of Gothenburg Hand holding a syringe photo by shutterstock.

Yesterday I commented about Give and Take by Adam Grant, a professor at Wharton who teaches organizational psychology. When Grant was a graduate student (at the University of Michigan), he was asked to help people at the university’s fund-raising call center raise more money. They call alumni, asking for money. The person who ran the center had tried the usual motivational tactics, such as offering bonuses. They hadn’t worked. Grant noticed that most of the money being raised went for scholarships. He tried various ways of making the call center employees aware that the money they raised helped students directly. The most effective way turned out to be a 5-minute meeting with a scholarship recipient. This had a staggering effect: The average caller doubled in calls per hour and minutes on the phone per week . . . Revenue quintipled: callers averaged $412 [per week] before meeting the scholarship recipient and more than $2000 afterward. A huge effect — and a useful huge effect. And one that is not even hinted at in countless introductory psychology books. Notice that physical conditions of the job and the “physical” payoff (the salary) didn’t change. All that changed was employees’s mental models of their job. I conclude that people are far more motivated by a desire to help others than you would ever guess from reading psychology textbooks — and, even more, from reading economics textbooks. Grant says nothing about this, at least in the book, but I’d guess that the employees were considerably happier at their jobs as well. You might think that there has been so much research on job design that there were no big effects left to be discovered. You’d be wrong.

New research suggests it takes more than just practice to reach an elite skill level. In the study, Michigan State University psychologist Dr. Zach Hambrick discovered a copious amount of practice is not enough to explain why people differ in level of skill in two widely studied activities: chess and music. Hambrick believes the findings confirm that it takes more than hard work to become an expert. That is, natural talent and other factors likely play a role in mastering a complicated activity. The article has been published in the research journal Intelligence. “Practice is indeed important to reach an elite level of performance, but this paper makes an overwhelming case that it isn’t enough,” said Hambrick, associate professor of psychology. The debate over why and how people become experts has gone on for more than a century. Many theorists argue that thousands of hours of focused, deliberate practice is sufficient to achieve elite status, but emerging evidence points to innate talent as a contributing factor. “Some people do reach an elite level of performance without copious practice, while other people fail to do so despite copious practice,” finds Hamrick. Hambrick and colleagues analyzed 14 studies of chess players and musicians, looking specifically at how practice was related to differences in performance. Practice, they found, accounted for only about one-third of the differences in skill in both music and chess. The remaining two-thirds may be a result of intelligence or innate ability, and the age at which people start the particular activity, Hambrick said. A previous study also suggested that working memory capacity — which is closely related to general intelligence — may sometimes be the deciding factor between being good and great. While the conclusion that practice may not make perfect runs counter to the popular view that just about anyone can achieve greatness if they work hard enough, Hambrick said there is a “silver lining” to the research. “If people are given an accurate assessment of their abilities and the likelihood of achieving certain goals given those abilities,” he said, “they may gravitate toward domains in which they have a realistic chance of becoming an expert through deliberate practice.” Source: Michigan State University Child taking music lessons photo by shutterstock.

My 5yo has been diagnosed with severe ADHD, Autism, ODD. He is on medications and has been doing so well until about the last three months. He has always had more problems with ADHD but now it seems like Autism is taking control of him! My 3yo is very delayed and does not speak due to 18q syndrome & Autism. We are all of a sudden having major problems with both of them. I’m wondering what we need to be looking for or many what to expect next.. Thanks A: You have children who have big challenges and who can be very challenging. I hope you’ve had some help from an Early Intervention (EI) Program. In Florida, this is run by the state’s Early Steps program. Early Steps is administered by Children’s Medical Services (CMS) of the state’s Department of Health. Early Intervention programs both diagnose children under age 3 who have special needs and provide guidance about how to get further services. The phone number is (800) 654-4440. Children over the age of 3 in Florida who need significant modifications in their educational programs may be eligible for special education services through their school district. About.com has a page that describes how to obtain these services. Check out this site. In addition, ask your pediatrician if there is a local support group for parents of children with autism. Other parents are often our best resource to find out what services are available. Just as important, they completely understand what it is like to love a child who has special needs. I don’t know what it is that is making your children act up these days. I do have a guess that they react to each other and also to your stress. Often things get going in families where people start to react to each other’s reactions. So it’s very important that you parents do everything you can to de-stress and take care of each other – even while caring for the kids. That’s another good reason to get to know other parents who can commiserate and offer practical advice. I wish you well. Dr. Marie

Living with Regret You’re probably able to let go of a bad day in the morning and an argument with a friend in a few day’s time. But the decisions you made that just didn’t work out, those could potentially negatively direct your life. Because we seldom have control over what happens in our life, the desire to make the “right” decisions feel like a heavy weight on our shoulders. We can’t get away from them. And we can harbor guilt from as insignificant a problem as choosing the wrong paint color to partnering with an ill-fitted mate. The hardest yet best way to deal with the decisions we wish we could undo is to learn to forgive ourselves. We do this by realizing that we don’t have a crystal ball to know what is the right thing to do in any moment. We do our best. Part of our growth and healing involves learning to move on by accepting what is and finding the lessons in the mistakes we’ve made. It’s also about changing our focus from what’s not working to what is working. To make peace with whatever you’re regretting, scroll down to read our top posts this week. You’ll discover tips for savoring your life regardless of what you’re going through (chronic pain, difficult relationships, stressed and coping with mental illness) and learn new ways of understanding yourself. It might just change your perspective on things. And what you once deemed a bad decision, may turn into the best decision you ever made. {Flickr photo by Hammonton Photography} Why Pain Affects the Perception of our Future (Living With Chronic Pain) – Is chronic pain clouding your vision for a hopeful future? You’re not alone. Read how this blogger attempts to make peace with her present and future when filled with the day-to-day realities of chronic pain. This Weekend Create A To-Notice List (Weightless) – Switch out your routine to-do list for a to-notice list and watch your life open up. Need help on how to get started savoring the small things? Go here for sweet inspiration. 9 Steps to a Happy Marriage (Relationships in Balance) – Happy partnerships take work and tending to. If you’re in need a relationship refresher, check out these nine tips to better your marriage right now. NIMH’s Thomas Insel on a New Understanding of the Brain (Channel N) – Watch this TED video to learn about the most recent news concerning the relationship between physical and mental illness. Most notable is hearing the Director of the National Institute for Mental Health’s take on reframing mental illness as a brain disorder. Eric Maisel on Dealing With Stress To Be More Creative (The Creative Mind) – Got stress? Stress can exacerbate the creative life. But here’s one way of dealing with it that takes a simple change in perspective.

What do verbs mean? We'd like to know. For that reason, we just launched VerbCorner, a massive, crowd-sourced investigation into the meanings of verbs. Why do we need this project? Why not just look up what verbs mean in a dictionary? While dictionaries are enormously useful (I think I own something like 15), they are far from perfect. For one thing, it's usually very easy to find counter-examples even for what seem like straight-forward definitions. Take the following: Bachelor: An unmarried man. So is the Pope a bachelor? Is Neil Patrick Harris? How about a married man from a country in which men are allowed multiple wives? At VerbCorner, rather than trying to work out the whole definition at once, we have broken meaning into many different components. At the site, you will find several different tasks. In each task, you will try to determine whether a particular verb has a particular component of meaning. If you are interested in what words mean and would like to help with this project, sign up for an account at http://gameswithwords.org/VerbCorner/. Participation can be anonymous, but we are happy to recognize significant contributions from anyone who wishes it. I will be writing a lot more about this project, it's goals, the science behind it, and the impact we expect it to have over the coming weeks. In the meantime, please check it out.