About Constance Cummings

Constance A. Cummings, Ph.D., is Project Director of the non-profit The Foundation for Psychocultural Research, which supports and advances interdisciplinary research and scholarship at the intersection of brain, mind, culture, and mental health and illness. She is co-editor (with Carol Worthman, Paul Plotsky, and Dan Schechter) of Formative Experiences: The Interaction of Caregiving, Culture, and Developmental Psychobiology (New York: Cambridge University Press, 2010). She received her doctorate in theoretical linguistics from New York University.

The FPR Interviews U Wisconsin Psychologist Carol Ryff on Well-Being and Aging in the US and Japan

 Dr. Carol D. Ryff, Professor of Psychology and
 Director of the Institute on Aging 
at the University of Wisconsin, Madison, speaks with science writer Karen A. Frenkel about well-being in the United States and Japan, and different attitudes towards aging. She also compares Western and Eastern types of intervention to promote well-being. Since 1995, Dr. Ryff and her Wisconsin team have been studying 7,000 individuals and examining factors that influence health and well-being from middle age through old age. The study is called MIDUS (Mid-Life in the U.S. National Study of Americans). Dr. Ryff is also involved in a parallel study in Japan known as MIDJA (Midlife in Japan). A reference list of works cited is included at end of the post. 

Dr. Ryff will be discussing “Varieties of Resilience in MIDUS” at the next  FPR-UCLA conference on Culture, Mind, and Brain: Emerging Concepts, Methods, and Applications, which will take place at UCLA on 19–20 October 2012, in a session chaired by neuroanthropologist Daniel Lende (USF) on “Stress and Resilience.” 

[This interview is cross-posted at PLoS Neuroanthropology.]

KAF: How did you get interested in well-being and aging?

CR: My interest in formulating psychological well-being is traceable to my distant interest in  existential, humanistic, and developmental psychology, particularly formulations about people struggling to deal with challenges they confronted in life, finding ways to manage them, if not learn from them, and deepen their sense of life meaning.

KAF: Please describe what’s meant by well-being in our culture and in Japanese culture.

CR: The topic of well-being has proliferated recently in our culture, so that there are many definitions. I’ll put forth one, but it’s certainly not the only one. The model of psychological well-being I developed was based on the integration of theories from developmental, clinical, humanistic, and existential psychology.

Six key components of well-being seem to capture what it means to function positively. One is positive self-regard, what I call “self-acceptance.” Another is having high-quality relationships with other people – “positive relationships with others.” Another is having a sense of direction in your life – “purpose in life.” Another component is feeling that you’re making the most of your talents and potential, utilizing your capacities, which I refer to as “personal growth.” Feeling you can make choices for yourself and your life even if they go against conventional wisdom is referred to as “autonomy.” The last one is managing the demands and opportunities in your environment in ways that meet your needs and capacities. We call that “environmental mastery.”

These components of well-being fall under a broad umbrella of eudaimonic well-being, which comes from a term used by Aristotle to describe the highest of all human good – “eudaimonia” used by him referred to the realization of one’s true potential. However, even the ancient Greeks had differing views about what might constitute the ultimate targets in living.  Epicurus, for example, wrote about hedonia, which corresponds to the contemporary interest in happiness, positive affect, and feeling good. Those aspects of well-being also get a lot of attention in current scientific studies.

Core dimensions of psychological well-being and their theoretical dimensions. With kind permission from Springer Science+Business Media: Journal of Happiness Studies, Know thyself and become what you are: A eudaimonic approach to psychological well-being, 9, 2006, p. 20, C. D. Ryff & B. H. Singer, Fig. 1.  

KAF: Do people from different cultures find eudaimonia/purposefulness differently?

CR: Your question points to a growing area of scientific investigation – namely, how does well-being vary across cultural contexts? There’s growing evidence to suggest that it does vary. Some differences reflect themes of independence vs. interdependence that have been key ideas in formulating cultural psychology. Well-being in the West is formulated more in terms of the individual and how he or she may feel about how they’re doing in life. In the East, well-being is much more about the self embedded within social relationships; for example, how well you’re doing in meeting your obligations to others.

Another difference between the U.S. and Japan pertains to how positive or negative affect are put together. In the U.S., our self-report tools with well-validated scales ask people to report on their levels of positive and negative affect in general, or in the last week or month. In the U.S. we find that the two types of affect tend to be inversely correlated. There are obviously exceptions for those suffering from depression and dealing with major life stressors. But the typical profile in the U.S. is for someone to report high levels of positive affect and low levels of negative affect.

That is not true in Japan. Both tend to be more moderately reported. That is, there is no cultural prescription for feeling mostly positive emotion and not feeling much negative. If anything, there is socialization to feel both, as strands of a rope that are woven together. This is traceable to philosophy and religion perspectives that underlie cultural psychology in Japan and Asian cultures more generally. The basic idea is that embedded within every positive is a negative and vice versa. In such a cultural context, it is expected that individuals experience both kinds of affect. In addition, such feelings are construed as fleeting and not necessarily under one’s own control; instead, they are seen as inherently in flux. That’s very different than in the West where we see all kinds of prescriptive messages to be happy. Oodles of websites and popular books exemplify this pursuit of happiness, which is a big part of life in the West.

KAF: In another paper on dialectical and non-dialectical emotional styles, you ask whether cultural differences can be observed across different kinds of emotional styles. You found that moderate dialectical emotional types had poor health in the U.S. and in Japan. How do you explain these findings?

CR: The idea of dialectical emotions comes back to how positive and negative affect are put together in the U.S. compared to Japan. The idea of dialecticism is that there is a back and forth between positive and negative affect in Japan, so it’s common for people to experience both, to some degree.

Emotion typology. From Cultural differences in the dialectical and non-dialectical emotional styles and their implications for health, Y. Miyamoto & C. D. Ryff, Cognition & Emotion, 25(1), 2011. Reprinted by permission of the publisher.

In the U.S., when we look at how emotions are related to people’s health, we find that those with more positive and less negative affect report better health.  This is true even when we look at more objective health criteria, like stress hormones, or other biological risk factors.

When we looked at how positive and negative affect are put together in Japan, it raised interesting questions – what does affect mean for health in Japan and is it different from what we see in U.S.? In a culture where negative affect is not seen as something that you need to get rid of, or run from, does it imply different links to health outcomes?

In the Myamoto and Ryff (2011) paper,  we reported that dialectical emotion – which is this blend of positive a negative affect – was predictive of better health in Japan than in the U.S. We have since found that negative affect in the U.S. predicts worse self-reported health and worse biomarkers, such as measures of inflammation (interleukin-6, IL-6), a marker that is a precursor to various disease outcomes. That is not true in Japan. This is important because it is not just about subjective experience and how that relates to self-reported health; even for more objective indicators such an inflammatory markers, negative affect is not predictive in Japan. That’s very interesting because it says the U.S. formulation of emotions, including which are the best kinds to have and how they impact your health, is culturally specific – it does not generalize to Japan.

KAF: Please highlight the most salient neural correlates of well-being.

CR: Richard Davidson, of the University of Wisconsin, Madison, brings a neuroscience perspective to some of the research we’re doing in the MIDUS study. Some of Davidson’s research looks at neural correlates. Originally it was about negative affect. He found, based on EEG-based responses to laboratory stimuli that those prone to negative affect or depression show greater right prefrontal activation patterns.  In contrast, those with more positive dispositional styles, defined in terms of high levels of psychological well-being, showed the opposite pattern, that is, greater left pre-frontal activation in response to laboratory stimuli. The findings were summarized in “Making a life worth living: Neural correlates of well-being” by Urry et al. (2004). Moreover, the strong signal between my measures of well-being and greater relative left prefrontal activation was evident, even after controlling for hedonic reports of well-being (positive affect).  Such findings underscore the importance of distinguishing between different types of well-being. It is not the same as hedonic well-being. That’s what they found – that the signal with eudaimonic well-being was there even when adjusted for feeling good.

KAF: Do you have information about neural correlates of well-being in Japan?

CR: No. We hope such assessments might be added eventually, but do not have them as yet. Because Japanese adults are more likely to report some degree of both negative or positive affect, it would be interesting to examine whether the affective neuroscience data observed in U.S. samples extends to the east Asian context.

KAF: In your most recent article “Cultural perspectives on aging and well-being:  A comparison of Japan and the U.S.” you describe different attitudes towards life among the aged. Please summarize the East-West distinctions.

CR: In the U.S., we’ve seen evidence that eudaimonic aspects of well-being look compromised in older compared to younger age groups, particularly with regard to existential things, like purpose in life and personal growth and feeling that you’re making the most of your talent. In Japan, a culture that is respectful of elders via traditions of filial piety, there are many ways in which the language itself and forms of interaction show honor for elders. We wondered if  contrasted to our American culture, which reveres youth and in some ways construes getting old as a personal failing, might we find a different pattern of aging and well-being in Japan?  We found that older people in Japan, unlike their U.S. counterparts, did not report lower levels of personal growth. This somewhat supported our idea that it may be easier to grow old in Japan than in the U.S.

On the other hand, we found lower scores on purpose in life for older people in both cultures. The fact that older people in both of these first world countries are living longer is a challenge.  Japan, in fact, has the highest proportion of older people of any country in the world at present. That older people are reporting lower scores on purpose in life compared to younger age groups is a concern in both contexts. Both of our countries face serious challenges in figuring out how to best utilize the talents and capacities of our older populations.

KAF: I’m surprised because I had the impression that they were better utilized in Japan.

CR: There is some evidence of that with regard to personal growth, but keep in mind that for assessments on whether they feel their life has purpose, meaning, and direction, older persons in both cultures scored lower than middle-age people. The life of older people in Japan is changing, with fewer extended families living in the same households. Growing numbers of elderly persons in Japan live alone, which was not at all common in previous decades. Their family patterns are becoming westernized.

KAF: You describe Western well-being therapy, and two Japanese psychotherapeutic techniques: Morita therapy, developed by Shoma Morita in the 1900s, and Naikan, which Yoshimoto Ishin developed in the 1950s. Please compare them here.

CR: Using well-being therapy as developed by Fava in the West, the core objective is to get people out of the experience of negative emotion – whether it’s anxiety or depression. The way that well-being tries to do that is to get patients to focus on their experiences of well-being by keeping daily diaries of positive experience. It’s a kind of cognitive therapy that tries to help individuals understand how their thinking patterns may prematurely curtail their experiences of the positive, maybe because they think they don’t deserve it, or because it feels foreign.

Morita therapy in Japan is remarkably different. It is designed to treat distressed or maladjusted people, but the focus is not on fixing emotions. In fact, they are viewed as beyond the person’s control. Emotions come and go and people do not control them. They may be positive or negative, and you can observe them, but it’s not worth your time to try to fix them. What you can fix is what you do. So the therapy tries to get people to shift into thinking not so much about how they feel, but what they are doing. The idea is to focus on daily behaviors, over which one can exercise control. That path is intended to help people function better while at the same time learn not to be done in by feeling bad about some things some of the time. The message there is that bad feelings happen. It’s not your job to eliminate them. It’s your job to focus on what you can do. That’s a dramatically different therapeutic model.

Naikan therapy goes to the heart of this interdependent way of being in Japan because the therapy is built around your relationships with key others. Three questions are the focus: how you feel about your mother, which from psychodynamic perspectives is not new idea. But the question is first, what have you received from your mother? Second, what have you given to your mother? And third, what trouble, inconvenience, deceit, pettiness, have you caused your mother? You are never given the option to answer the question, how has your mother caused problems for you, which constitutes the focus of vast amounts of psychotherapy in the West.

KAF: I was so fascinated by this because it is considered improper, or bad form, to dwell on how you might have been badly treated.

CR: If the cultural prescription is to care about and do a good job of meeting obligations to other people, it requires that you recognize what these people have done for you, that you be appreciative of it and aware of ways in which you have fallen short in doing well by them. That kind of therapy seems unheard of in the West. Most people, no matter what kind of therapy they’re receiving, probably spend a lot of time going over how others have mistreated them.

KAF: Is there no emphasis on that because that, too, is not in your control?

CR: That could be an explanation. However, even the core questions of Naikon therapy are not so much about what feelings might have gone on between you and your mother. Instead, the focus is on what has your mother done for you and what have you done for your mother and what have you given to her? It’s more about actions.

KAF: How does that relate back to the goal of promoting well-being?

CR: All forms of therapy try to improve the human condition or experience, but they have different goals and ways of getting there.

KAF: How can a deeper understanding of well-being benefit the planet? Why should lay people be interested in differences in American and Japanese well-being?

CR: That’s a great question. It’s really the “so what?” question. What does it add up to? Do we have something more to say than that cultures differ? Clearly, they differ in terms of what well-being is, what mental maladjustment is, and how they treat it. But there is also the question of whether one form of well-being is better than another? Are some cultures doing a better job of answering these questions than others? How to grapple with these issues?

One response is to look at what these different types of well-being in different parts of the world mean for peoples’ health as they age. That’s what we’re trying to do in MIDUS and MIDJA. We have only begun to look at the evidence, but it appears that different aspects of well-being matter for health in differ ways depending on the cultural context where people reside. Thus, inter-dependent aspects of well-being, social obligations and how well you’re managing the needs of others around you may matter more for health over the long-term in Japan than in the U.S. We don’t know, but’s that’s what we want to find out from the data.

Another response to the “so what?” question, which intrigues me more, is to consider whether learning about our respective differences is a route to improving the human condition in some more fundamental way?  This is asking whether it is beneficial to have knowledge of how well-being is construed in different cultural contexts. For example, in Japan there’s nothing wrong with feeling negative emotion; it’s not viewed as something amiss that possibly needs to be fixed in therapy. Such an insight might be useful for us to know in the West.

Similarly, it might be useful for people in Japan to know something about how we function. We give the individual more leeway and encouragement to realize personal talents and capacities, and make the most of themselves; that it’s OK sometimes to choose for yourself some of the time rather than thinking only about others around you. This might be useful to consider in Japan.

Embedded within these reflections is the idea that varieties of well-being around the world each are prone to their own forms of excess and inadequacy. However, until we look at well-being in multiple contexts, we may be blind to what these forms of excess are.  The way to gain this understanding is to look at the experiences of, and ideals about, well-being around the world.

It’s like looking in a mirror. We see ourselves and our own views about what it means to be well by looking in a different cultural mirror. Maybe that helps us we see that what we do isn’t always the best. Maybe it needs to be slightly shifted this way or that.

That’s a bias I bring. I think learning about cultural differences enriches everybody.

References Cited

Karasawa, M., Curhan, K. B., Markus, H. R., Kitayama, S. S., Love, G. D., Radler, B. T., & Ryff, C. D. (2011). Cultural perspectives on aging and well-being: A comparison of Japan and the United States. International Journal of Aging and Human Development, 73 (1), 73–98. http://dx.doi.org/10.2190/AG.73.1.d

Miyamoto, Y., & Ryff, C. D. (2011). Cultural differences in the dialectical and non-dialectical emotional styles and their implications for health. Cognition & Emotion, 25(1), 22–39. http://dx.doi.org/10.1080/02699931003612114

Ryff, C. D., & Singer, B. H. (2006). Know thyself and become what you are: A eudaimonic approach to psychological well-being. Journal of Happiness Studies, 9, 13–39. http://dx.doi.org/10.1007/s10902-006-9019-0

Urry, H. L. Nitschke, J. B., Dolski, I., Jackson, D. C., Dalton, K. M., Mueller, C. J., Rosenkranz, M. A., Ryff, C. D., Singer, B. H., & Davidson, R. J. (2004). Making a life worth living: Neural correlates of well-being. Psychological Science, 15(6), 367–372. pdf

3×5: Culture, Neuroscience, and Psychiatry Weekly Roundup (July 17)

Culture

1. New book: Medical Anthropology at the Intersections: Histories, Activisms, and Futures, ed. by Marcia Inhorn and Emily Wentzell (2012, Duke University Press). TOC available here. This collection, which seems to have emerged from the SMA meeting at Yale a few years ago, includes a chapter by Didier Fassin on “The Obscure Object of Global Health.”

2. Tanya Lurhmann’s new paper in the latest issue of Current Anthropology,A hyperreal god and modern belief: Toward an anthroplogy of the mind.”

3. Tom Stafford’s “Berlin cognitive science safari: Report” on Mind Hacks, includes video of a fresh change blindness “door” experiment on unwitting Berliners.

4. I think I mentioned Daniel Lende’s post on Boas last week. Here’s a followup: “Hybridity, race, and science: The voyage of the Zaca, 1934–1935 by Warwick Anderson in the latest issue of the history of science journal Isis.

5. Thanks to Daniel Lende, monkeys doing cannonballs into a pool.

Neuroscience

1. I hesitated about putting this in, but – as recapped on Storify – Ed Yong attacks TED talks AND oxytocin (‘the moral molecule’ according to Paul Zak). Sometimes it’s refreshing to read someone on Twitter who is very annoyed (or just watch a bunch of monkeys doing cannonballs). Also, serves as a useful reminder to read Meyer-Linderberg et al’s 2011 Nature Rev Neurosci (“Oxytocin and vasopressin in the human brain: Social neuropeptides for translational medicine“).

2. And Micah Allen critiques Shaun Gallagher (“The brain as an enactive system,” Gallagher, Daniel Hutto, Jan Slaby, & Jonathan Cole, n.d.) in his wordpress blog Neuroconscience. Here’s a brief excerpt on the changing paradigm (toward individual differences, functional connectivity), but best to read the Gallagher et al. paper and Micah Allen’s response. Their cordial relationship (Shaun Gallagher was Micah Allen’s “first mentor”) makes this an unusually thoughtful engagement between philosopher and neuroscientist.  Pace Gallagher,

[M]ost neuroscientists today would agree that [functional] segregation is far from the whole story of the brain. Which is precisely why the field is undeniably and swiftly moving towards connectivity and functional integration, rather than segregation. I’d wager that for a few years now the majority of published cogneuro papers focus on connectivity rather than blobology.

3. More productive critique from Jonathan Eisen of UC Davis on “Badomics words and the power and peril of the ome-meme.” One of his concerns is making everything sound “genomic-y”:

[T]he spread of the ome-meme, to me, is attaching too much importance to genomics. Mind you, I love genomics. I have been doing it for almost 20 years and never imagine stopping. I think it is a wonderful thing. But it still can be oversold and that can be dangerous.”

4. Nature brief on Takao Hensch’s work on plasticity: “Neurodevelopment: Unlocking the brain.”

5. Olaf Sporns’ talk at first annual meeting of One Mind for Research (May 2012) is now available: “Wiring the Mind – Brain Networks.”

Psychiatry

1. The blog Ruminations of Madness has posted a co-authored chapter on user/survivor led research. Here’s a brief excerpt from their concluding remarks:

User/survivors can only speak with authority if traditional researchers, policy makers and members of the general public come to agree that systems change must be guided both by the lived experience of disability and recovery and through the ongoing critical questioning of often unspoken assumptions about power, truth, and science.

Challenging hierarchies is something that resonates very deeply, also “critically engaging with the complexity of [and meaning ascribed to] user/survivors’ experiences, as well as ideological tensions and contradictions within the user/survivor movement.”

2.The DSM-5 Personality Work Group resignations are a worrisome sign that one of the major innovations, cross-cutting dimensionality of most disorders, has utterly failed (except in the most superficial way).

As we see it, there are two major problems with the proposal. First, the proposed classification is unnecessarily complex, incoherent, and inconsistent. The obvious complexity and incoherence seriously interfere with clinical utility. Although the proposal is touted as an innovative and integrative hybrid system, this claim is spurious. In fact, it consists of thejuxtaposition of two distinct classifications (typal and dimensional) based on incompatible models without any attempt to reconcile or integrate them into a coherent structure. This structure also creates confusion since it is not clear whether the clinician should use one or both systems in routine clinical practice.

Second, the proposal displays a truly stunning disregard for evidence. Important aspects of the proposal lack any reasonable evidential support of reliability and validity. For example, there is little evidence to justify which disorders to retain and which to eliminate. Even more concerning is the fact that a major component of proposal is inconsistent with extensive evidence. The latter point is especially troublesome because it was noted in publication from the Work Group that the evidence did not support the use of typal constructs of the kind recommended by the current proposal. This creates the untenable situation of the Work Group advancing a taxonomic model that it has acknowledged in a published article to be inconsistent with the evidence.

3. From the Daily Beast, “Why Rep. Jesse Jackson Jr. Has Remained Mum About His ‘Mood Disorder‘: As the congressman’s staff reveals the nature of his condition, Allison Samuels looks at why mental illness remains taboo in the African-American Community.”

4. Claire Weaver’s interview with Vikram Patel, a guest co-editor of the PLoS Medicine Global Mental Health Practice series. See also the Didier Fassin paper I mentioned above.

5. Anything else by Ruminations on Madness. See, e..g., “Labeling, diagnosis and the politics of reading first-person accounts http://wp.me/p10aTj-8b and “An intergenerational narrative of psychosis” http://wp.me/p10aTj-8d .

The FPR Interviews Psychologist Carol Ryff on Well-Being and Aging

 Dr. Carol D. Ryff, Professor of Psychology and
 Director of the Institute on Aging 
at the University of Wisconsin, Madison, speaks with science writer Karen A. Frenkel about well-being in the United States and Japan, and different attitudes towards aging. She also compares Western and Eastern types of intervention to promote well-being. Since 1995, Dr. Ryff and her Wisconsin team have been studying 7,000 individuals and examining factors that influence health and well-being from middle age through old age. The study is called MIDUS (Mid-Life in the U.S. National Study of Americans). Dr. Ryff is also involved in a parallel study in Japan known as MIDJA (Midlife in Japan). A reference list of works cited is included at end of the post. 

Dr. Ryff will be discussing “Varieties of Resilience in MIDUS” at the next  FPR-UCLA conference on Culture, Mind, and Brain: Emerging Concepts, Methods, and Applications, which will take place at UCLA on 19–20 October 2012, in a session chaired by neuroanthropologist Daniel Lende (USF) on “Stress and Resilience.” 

[This interview is cross-posted at PLoS Neuroanthropology.]

KAF: How did you get interested in well-being and aging?

CR: My interest in formulating psychological well-being is traceable to my distant interest in  existential, humanistic, and developmental psychology, particularly formulations about people struggling to deal with challenges they confronted in life, finding ways to manage them, if not learn from them, and deepen their sense of life meaning.

KAF: Please describe what’s meant by well-being in our culture and in Japanese culture.

CR: The topic of well-being has proliferated recently in our culture, so that there are many definitions. I’ll put forth one, but it’s certainly not the only one. The model of psychological well-being I developed was based on the integration of theories from developmental, clinical, humanistic, and existential psychology.

Six key components of well-being seem to capture what it means to function positively. One is positive self-regard, what I call “self-acceptance.” Another is having high-quality relationships with other people – “positive relationships with others.” Another is having a sense of direction in your life – “purpose in life.” Another component is feeling that you’re making the most of your talents and potential, utilizing your capacities, which I refer to as “personal growth.” Feeling you can make choices for yourself and your life even if they go against conventional wisdom is referred to as “autonomy.” The last one is managing the demands and opportunities in your environment in ways that meet your needs and capacities. We call that “environmental mastery.”

These components of well-being fall under a broad umbrella of eudaimonic well-being, which comes from a term used by Aristotle to describe the highest of all human good – “eudaimonia” used by him referred to the realization of one’s true potential. However, even the ancient Greeks had differing views about what might constitute the ultimate targets in living.  Epicurus, for example, wrote about hedonia, which corresponds to the contemporary interest in happiness, positive affect, and feeling good. Those aspects of well-being also get a lot of attention in current scientific studies.

Core dimensions of psychological well-being and their theoretical dimensions. With kind permission from Springer Science+Business Media: Journal of Happiness Studies, Know thyself and become what you are: A eudaimonic approach to psychological well-being, 9, 2006, p. 20, C. D. Ryff & B. H. Singer, Fig. 1.  

KAF: Do people from different cultures find eudaimonia/purposefulness differently?

CR: Your question points to a growing area of scientific investigation – namely, how does well-being vary across cultural contexts? There’s growing evidence to suggest that it does vary. Some differences reflect themes of independence vs. interdependence that have been key ideas in formulating cultural psychology. Well-being in the West is formulated more in terms of the individual and how he or she may feel about how they’re doing in life. In the East, well-being is much more about the self embedded within social relationships; for example, how well you’re doing in meeting your obligations to others.

Another difference between the U.S. and Japan pertains to how positive or negative affect are put together. In the U.S., our self-report tools with well-validated scales ask people to report on their levels of positive and negative affect in general, or in the last week or month. In the U.S. we find that the two types of affect tend to be inversely correlated. There are obviously exceptions for those suffering from depression and dealing with major life stressors. But the typical profile in the U.S. is for someone to report high levels of positive affect and low levels of negative affect.

That is not true in Japan. Both tend to be more moderately reported. That is, there is no cultural prescription for feeling mostly positive emotion and not feeling much negative. If anything, there is socialization to feel both, as strands of a rope that are woven together. This is traceable to philosophy and religion perspectives that underlie cultural psychology in Japan and Asian cultures more generally. The basic idea is that embedded within every positive is a negative and vice versa. In such a cultural context, it is expected that individuals experience both kinds of affect. In addition, such feelings are construed as fleeting and not necessarily under one’s own control; instead, they are seen as inherently in flux. That’s very different than in the West where we see all kinds of prescriptive messages to be happy. Oodles of websites and popular books exemplify this pursuit of happiness, which is a big part of life in the West.

KAF: In another paper on dialectical and non-dialectical emotional styles, you ask whether cultural differences can be observed across different kinds of emotional styles. You found that moderate dialectical emotional types had poor health in the U.S. and in Japan. How do you explain these findings?

CR: The idea of dialectical emotions comes back to how positive and negative affect are put together in the U.S. compared to Japan. The idea of dialecticism is that there is a back and forth between positive and negative affect in Japan, so it’s common for people to experience both, to some degree.

Emotion typology. From Cultural differences in the dialectical and non-dialectical emotional styles and their implications for health, Y. Miyamoto & C. D. Ryff, Cognition & Emotion, 25(1), 2011. Reprinted by permission of the publisher.

In the U.S., when we look at how emotions are related to people’s health, we find that those with more positive and less negative affect report better health. This is true even when we look at more objective health criteria, like stress hormones, or other biological risk factors.

When we looked at how positive and negative affect are put together in Japan, it raised interesting questions – what does affect mean for health in Japan and is it different from what we see in U.S.? In a culture where negative affect is not seen as something that you need to get rid of, or run from, does it imply different links to health outcomes?

In the Myamoto and Ryff (2011) paper,  we reported that dialectical emotion – which is this blend of positive a negative affect – was predictive of better health in Japan than in the U.S. We have since found that negative affect in the U.S. predicts worse self-reported health and worse biomarkers, such as measures of inflammation (interleukin-6, IL-6), a marker that is a precursor to various disease outcomes. That is not true in Japan. This is important because it is not just about subjective experience and how that relates to self-reported health; even for more objective indicators such an inflammatory markers, negative affect is not predictive in Japan. That’s very interesting because it says the U.S. formulation of emotions, including which are the best kinds to have and how they impact your health, is culturally specific – it does not generalize to Japan.

KAF: Please highlight the most salient neural correlates of well-being.

CR: Richard Davidson, of the University of Wisconsin, Madison, brings a neuroscience perspective to some of the research we’re doing in the MIDUS study. Some of Davidson’s research looks at neural correlates. Originally it was about negative affect. He found, based on EEG-based responses to laboratory stimuli that those prone to negative affect or depression show greater right prefrontal activation patterns.  In contrast, those with more positive dispositional styles, defined in terms of high levels of psychological well-being, showed the opposite pattern, that is, greater left pre-frontal activation in response to laboratory stimuli. The findings were summarized in “Making a life worth living: Neural correlates of well-being” by Urry et al. (2004). Moreover, the strong signal between my measures of well-being and greater relative left prefrontal activation was evident, even after controlling for hedonic reports of well-being (positive affect).  Such findings underscore the importance of distinguishing between different types of well-being. It is not the same as hedonic well-being. That’s what they found – that the signal with eudaimonic well-being was there even when adjusted for feeling good.

KAF: Do you have information about neural correlates of well-being in Japan?

CR: No. We hope such assessments might be added eventually, but do not have them as yet. Because Japanese adults are more likely to report some degree of both negative or positive affect, it would be interesting to examine whether the affective neuroscience data observed in U.S. samples extends to the east Asian context.

KAF: In your most recent article “Cultural perspectives on aging and well-being:  A comparison of Japan and the U.S.” you describe different attitudes towards life among the aged. Please summarize the East-West distinctions.

CR: In the U.S., we’ve seen evidence that eudaimonic aspects of well-being look compromised in older compared to younger age groups, particularly with regard to existential things, like purpose in life and personal growth and feeling that you’re making the most of your talent. In Japan, a culture that is respectful of elders via traditions of filial piety, there are many ways in which the language itself and forms of interaction show honor for elders. We wondered if  contrasted to our American culture, which reveres youth and in some ways construes getting old as a personal failing, might we find a different pattern of aging and well-being in Japan?  We found that older people in Japan, unlike their U.S. counterparts, did not report lower levels of personal growth. This somewhat supported our idea that it may be easier to grow old in Japan than in the U.S.

On the other hand, we found lower scores on purpose in life for older people in both cultures. The fact that older people in both of these first world countries are living longer is a challenge.  Japan, in fact, has the highest proportion of older people of any country in the world at present. That older people are reporting lower scores on purpose in life compared to younger age groups is a concern in both contexts. Both of our countries face serious challenges in figuring out how to best utilize the talents and capacities of our older populations.

KAF: I’m surprised because I had the impression that they were better utilized in Japan.

CR: There is some evidence of that with regard to personal growth, but keep in mind that for assessments on whether they feel their life has purpose, meaning, and direction, older persons in both cultures scored lower than middle-age people. The life of older people in Japan is changing, with fewer extended families living in the same households. Growing numbers of elderly persons in Japan live alone, which was not at all common in previous decades. Their family patterns are becoming westernized.

KAF: You describe Western well-being therapy, and two Japanese psychotherapeutic techniques: Morita therapy, developed by Shoma Morita in the 1900s, and Naikan, which Yoshimoto Ishin developed in the 1950s. Please compare them here.

CR: Using well-being therapy as developed by Fava in the West, the core objective is to get people out of the experience of negative emotion – whether it’s anxiety or depression. The way that well-being tries to do that is to get patients to focus on their experiences of well-being by keeping daily diaries of positive experience. It’s a kind of cognitive therapy that tries to help individuals understand how their thinking patterns may prematurely curtail their experiences of the positive, maybe because they think they don’t deserve it, or because it feels foreign.

Morita therapy in Japan is remarkably different. It is designed to treat distressed or maladjusted people, but the focus is not on fixing emotions. In fact, they are viewed as beyond the person’s control. Emotions come and go and people do not control them. They may be positive or negative, and you can observe them, but it’s not worth your time to try to fix them. What you can fix is what you do. So the therapy tries to get people to shift into thinking not so much about how they feel, but what they are doing. The idea is to focus on daily behaviors, over which one can exercise control. That path is intended to help people function better while at the same time learn not to be done in by feeling bad about some things some of the time. The message there is that bad feelings happen. It’s not your job to eliminate them. It’s your job to focus on what you can do. That’s a dramatically different therapeutic model.

Naikan therapy goes to the heart of this interdependent way of being in Japan because the therapy is built around your relationships with key others. Three questions are the focus: how you feel about your mother, which from psychodynamic perspectives is not new idea. But the question is first, what have you received from your mother? Second, what have you given to your mother? And third, what trouble, inconvenience, deceit, pettiness, have you caused your mother? You are never given the option to answer the question, how has your mother caused problems for you, which constitutes the focus of vast amounts of psychotherapy in the West.

KAF: I was so fascinated by this because it is considered improper, or bad form, to dwell on how you might have been badly treated.

CR: If the cultural prescription is to care about and do a good job of meeting obligations to other people, it requires that you recognize what these people have done for you, that you be appreciative of it and aware of ways in which you have fallen short in doing well by them. That kind of therapy seems unheard of in the West. Most people, no matter what kind of therapy they’re receiving, probably spend a lot of time going over how others have mistreated them.

KAF: Is there no emphasis on that because that, too, is not in your control?

CR: That could be an explanation. However, even the core questions of Naikon therapy are not so much about what feelings might have gone on between you and your mother. Instead, the focus is on what has your mother done for you and what have you done for your mother and what have you given to her? It’s more about actions.

KAF: How does that relate back to the goal of promoting well-being?

CR: All forms of therapy try to improve the human condition or experience, but they have different goals and ways of getting there.

KAF: How can a deeper understanding of well-being benefit the planet? Why should lay people be interested in differences in American and Japanese well-being?

CR: That’s a great question. It’s really the “so what?” question. What does it add up to? Do we have something more to say than that cultures differ? Clearly, they differ in terms of what well-being is, what mental maladjustment is, and how they treat it. But there is also the question of whether one form of well-being is better than another? Are some cultures doing a better job of answering these questions than others? How to grapple with these issues?

One response is to look at what these different types of well-being in different parts of the world mean for peoples’ health as they age. That’s what we’re trying to do in MIDUS and MIDJA. We have only begun to look at the evidence, but it appears that different aspects of well-being matter for health in differ ways depending on the cultural context where people reside. Thus, inter-dependent aspects of well-being, social obligations and how well you’re managing the needs of others around you may matter more for health over the long-term in Japan than in the U.S. We don’t know, but’s that’s what we want to find out from the data.

Another response to the “so what?” question, which intrigues me more, is to consider whether learning about our respective differences is a route to improving the human condition in some more fundamental way?  This is asking whether it is beneficial to have knowledge of how well-being is construed in different cultural contexts. For example, in Japan there’s nothing wrong with feeling negative emotion; it’s not viewed as something amiss that possibly needs to be fixed in therapy. Such an insight might be useful for us to know in the West.

Similarly, it might be useful for people in Japan to know something about how we function. We give the individual more leeway and encouragement to realize personal talents and capacities, and make the most of themselves; that it’s OK sometimes to choose for yourself some of the time rather than thinking only about others around you. This might be useful to consider in Japan.

Embedded within these reflections is the idea that varieties of well-being around the world each are prone to their own forms of excess and inadequacy. However, until we look at well-being in multiple contexts, we may be blind to what these forms of excess are.  The way to gain this understanding is to look at the experiences of, and ideals about, well-being around the world.

It’s like looking in a mirror. We see ourselves and our own views about what it means to be well by looking in a different cultural mirror. Maybe that helps us we see that what we do isn’t always the best. Maybe it needs to be slightly shifted this way or that.

That’s a bias I bring. I think learning about cultural differences enriches everybody.

References Cited

Karasawa, M., Curhan, K. B., Markus, H. R., Kitayama, S. S., Love, G. D., Radler, B. T., & Ryff, C. D. (2011). Cultural perspectives on aging and well-being: A comparison of Japan and the United States. International Journal of Aging and Human Development, 73 (1), 73–98. http://dx.doi.org/10.2190/AG.73.1.d

Miyamoto, Y., & Ryff, C. D. (2011). Cultural differences in the dialectical and non-dialectical emotional styles and their implications for health. Cognition & Emotion, 25(1), 22–39. http://dx.doi.org/10.1080/02699931003612114

Ryff, C. D., & Singer, B. H. (2006). Know thyself and become what you are: A eudaimonic approach to psychological well-being. Journal of Happiness Studies, 9, 13–39. http://dx.doi.org/10.1007/s10902-006-9019-0

Urry, H. L. Nitschke, J. B., Dolski, I., Jackson, D. C., Dalton, K. M., Mueller, C. J., Rosenkranz, M. A., Ryff, C. D., Singer, B. H., & Davidson, R. J. (2004). Making a life worth living: Neural correlates of well-being. Psychological Science, 15(6), 367–372. pdf

Social Neuroscience of Psychiatric Disorders: Emotion, Theory of Mind

Psychology Press has published a hardback version of a special issue of the journal Social Neuroscience focusing on psychiatric disorders (Vol. 6[5–6]) that was published in Oct 2011.  Here is a brief description of the volume, which was edited by Facundo Manes Of Favaloro University (Argentina) and Mario Mendez of UCLA, from the book’s website:

The need to belong to social groups and interact with others has driven much of the evolution of the human brain. The relatively young field of social neuroscience has made impressive strides towards clarifying the neural correlates of the Social Brain, but, until recently, has not focused on mental and neurological disorders. Yet, the Social Brain underlies all brain-behaviour disorders, and nearly every neuropsychiatric illness involves social behavioural disturbances. . . . Investigators evaluate neuropsychiatric disorders in the context of recent advances in social neuroscience to reveal the impact of social brain mechanisms on neuropsychiatric disorders and allow readers to glimpse the exciting potential advances in this field in the years to come.

Lots to read and process but to give a sense of what’s in store (and betraying my own bias) here are abstracts of papers from the special issue – one on schizophrenia and emotion, and two on theory of mind (cultural differences and possibly impaired in persons with schizophrenia). I’ve also pasted the TOC of the book below.

Social Neuroscience

Volume 6Issue 5-6, 2011

Special Issue: Social Neuroscience of Psychiatric Disorders

Abstract

Most studies investigating emotion recognition in schizophrenia have focused on facial expressions and neglected bodily and vocal expressions. Furthermore, little is known about affective multisensory integration in schizophrenia. In the first experiment, the authors investigated recognition of static, face-blurred, whole-body expressions (instrumental, angry, fearful, and sad) with a two-alternative, forced-choice, simultaneous matching task in a sample of schizophrenia patients, nonschizophrenic psychotic patients, and matched controls. In the second experiment, dynamic, face-blurred, whole-body expressions (fearful and happy) were presented simultaneously with either congruent or incongruent human or animal vocalizations to schizophrenia patients and controls. Participants were instructed to categorize the emotion expressed by the body and to ignore the auditory information. The results of Experiment 1 show an emotion recognition impairment in the schizophrenia group and to a lesser extent in the nonschizophrenic psychosis group, and this for all four expressions. The findings of Experiment 2 show that schizophrenia patients are more influenced by the auditory information than controls, but only when the auditory information consists of human vocalizations. This shows that schizophrenia patients are impaired in recognizing whole-body expressions, and they show abnormal affective multisensory integration of bimodal stimuli originating from the same source.

Transcultural differences in brain activation patterns during theory of mind (ToM) task performance in Japanese and Caucasian participants

Background: Theory of mind (ToM) functioning develops during certain phases of childhood. Factors such as language development and educational style seem to influence its development. Some studies that have focused on transcultural aspects of ToM development have found differences between Asian and Western cultures. To date, however, little is known about transcultural differences in neural activation patterns as they relate to ToM functioning.
Experimental methods: The aim of our study was to observe ToM functioning and differences in brain activation patterns, as assessed by functional magnetic resonance imaging (fMRI). This study included a sample of 18 healthy Japanese and 15 healthy Caucasian subjects living in Japan. We presented a ToM task depicting geometrical shapes moving in social patterns. We also administered questionnaires to examine empathy abilities and cultural background factors.
Results: Behavioral data showed no significant group differences in the subjects’ post-scan descriptions of the movies. The imaging results displayed stronger activation in the medial prefrontal cortex (MPFC) in the Caucasian sample during the presentation of ToM videos. Furthermore, the task-associated activation of the MPFC was positively correlated with autistic and alexithymic features [based on the behavioral data] in the Japanese sample [i.e., their activation equals Caucasians'].
Discussion: In summary, our results showed evidence of culturally dependent sociobehavioral trait patterns, which suggests that they have an impact on brain activation patterns during information processing involving ToM.
[And here are some thoughts from the paper that anthropologists might weigh in on.]

We believe the above-mentioned group comparisons indicate that Japanese participants activate the MPFC to a lesser extent because they have been taught from early childhood to “read the air” (kuuki wo yomu), or to be attuned to unspoken social signals all around and to react in a socially accepted way. Naito and Koyama (2006) argued that Japanese individuals have a delay in ToM development compared with Western children but that they are able to understand social implications without explicit information. Thus, even though Japanese children seem to develop ToM abilities later than Western children, their performance might be more sophisticated, and they may mentalize with a lower level of ToM network activation.
This interpretation is partially consistent with a previous study by Chiao and colleagues (2009), who showed that during a self-estimation task, Westerners activated the MPFC more than Asian controls. They associated this finding with individualistic traits. However, they interpreted that individualistic Caucasians overactivate the MPFC because they constantly need to distinguish between themselves, others, and their surroundings, citing findings by Kitayama and colleagues (Kitayama, Duffy, Kawamura, & Larsen, 2003). They found that even when judging external objects, North Americans tend to relate this information to themselves, while Asians attend more to the social context. We could not simply reduce our findings to cultural differences because we could not find any significant between-group differences on the IND/COL. Therefore, this discrepancy should be addressed in further studies.

Theory of mind in schizophrenia: Exploring neural mechanisms of belief attribution

Junghee Leeab*Javier QuintanaabPoorang Noriab & Michael F. Greenab

Abstract

Background: Although previous behavioral studies have shown that schizophrenia patients have impaired theory of mind (ToM), the neural mechanisms associated with this impairment are poorly understood. This study aimed to identify the neural mechanisms of ToM in schizophrenia, using functional magnetic resonance imaging (fMRI) with a belief attribution task.

Methods: In the scanner, 12 schizophrenia patients and 13 healthy control subjects performed the belief attribution task with three conditions: a false belief condition, a false photograph condition, and a simple reading condition.
Results: For the false belief versus simple reading conditions, schizophrenia patients showed reduced neural activation in areas including the temporoparietal junction (TPJ) and medial prefrontal cortex (MPFC) compared with controls. Further, during the false belief versus false photograph conditions, we observed increased activations in the TPJ and the MPFC in healthy controls, but not in schizophrenia patients. For the false photograph versus simple reading condition, both groups showed comparable neural activations.

Conclusions: Schizophrenia patients showed reduced task-related activation in the TPJ and the MPFC during the false belief condition compared with controls, but not for the false photograph condition. This pattern suggests that reduced activation in these regions is associated with, and specific to, impaired ToM in schizophrenia.

Table of Contents (Book)

1. Introduction

2. Comparing social attention in autism and amygdala lesions: Effects of stimulus and task condition

3. Atypical neural specialization for social percepts in autism spectrum disorder

4. The specific impairment of fearful expression recognition and its atypical development in pervasive developmental disorder

5. Cortical deficits in emotion processing for faces in adults with ADHD: Its relation to social cognition and executive functioning

6. Neural correlates of social approach and withdrawal in patients with major depression

7. Are you really angry? The effect of intensity on facial emotion recognition in frontotemporal dementia

8. Multimodal Perception of Emotion in Psychiatric Disorders

9. Perceiving emotions from bodily expressions and multisensory integration of emotion cues in schizophrenia

10. Social impairment in schizophrenia revealed by Autistic Quotient correlated with gray matter reduction

11. Event-related potential correlates of suspicious thoughts in individuals with schizotypal personality features

12. Theory of mind in schizophrenia: Exploring neural mechanisms of belief attribution

13. Neural Networks Mediating Theory of Mind in Adolescents with Moderate to Severe Traumatic Brain Injury

14. Social and emotional competence in traumatic brain injury 15. Trans-cultural differences of brain activation patterns during Theory of Mind (ToM) task performance in Japanese and Caucasian participants

16. Identification of psychopathic individuals using pattern classification of MRI images 17. A Somatic Marker Perspective of Immoral and Corrupt Behavior 18. Apathy Blunts Amygdala Reactivity to Money

Author/Editor Biography

Facundo Manes is Professor of Behavioural Neurology and Cognitive Neuroscience at Favaloro University, Argentina. He is also Director of the Institute of Cognitive Neurology (INECO) in Buenos Aires.

Mario F. Mendez is Professor of Neurology and Psychiatry & Biobehavioral Sciences at the University of California, Los Angeles, School of Medicine, and is also Director of the Neurobehavior Unit at the Greater Los Angeles VA Medical Center, California, USA.

3×5: Culture, Neuroscience, and Psychiatry Weekly Roundup (July 10)

Culture
1. Daniel Lende thoughtfully considers a recent issue of Anthropological Theory with special emphasis on neuroanthropology in his 6/29/12 post on “Franz Boas and Neuroanthropology.” 

2. Daniel also has a great post and link to a talk by Cal Tech physicist Leonard Mlodinow (and Star Trek: The Next Gen writer, err, everyone knows that, right?) on his new book, Subliminal: How Your Unconscious Mind Rules Your Behavior.

3. Patrick Clarkin has done it again with a beautiful post on “Adversity, Reslience, and Adaptation.”

4. Wilson Will reviews Pamela Klassen’s Spirits of Protestantism: Medicine, Healing, and Liberal Christianity for Somatosphere. (This is a fascinating subject/review, but, Will also warns, for “those lured by the book’s cover image of a primitive surgical ward and expecting a treatment of liberal Christianity within the clinical context will find relatively little ethnographic detail about religion in the hospital setting; instead, they will have to wait for Wendy Cadge’s Paging God: Religion in the Halls of Medicine, under contract with Chicago.”)

5. Beth Bromley has a new paper in September 2012 issue of Social Science & Medicine,Building patient-centeredness: Hospital design as an interpretive act.

Neuroscience

1.  Sepulcre, Sabuncu, & Johnson’s “Network assemblies in the functional brain,” in August 2012 Curr Opinion Neurology: “Functional connectivity MRI and corresponding analytical tools continue to reveal novel properties of the functional organization of the brain, which will in turn be key for understanding pathologies in neurology.”

2. Interview in July 6(?) Science with Laurence Steinberg on the (neuro)science behind Supreme Court’s ruling against mandatory life sentences for juveniles.

3. Review of  Lorraine Daston and Elizabeth Lunbeck’s edited volume, Histories of Scientific Observation, which “includes a fascinating exploration of empathy in 20th-century psychoanalysis (Lunbeck).” (Lorraine Daston is also the co-author (with Katharine Park) of Wonders and the Order of Nature, 1150–1750, a book of which I’m inordinately fond, aboutthe ways in which European naturalists from the High Middle Ages through the Enlightenment used wonder and wonders, the passion and its objects, to envision themselves and the natural world.”)

4. Mathalon and Ford’s May 2012 Neurobiology of schizophrenia: Search for the elusive correlation with symptoms in Frontiers in Human Neuroscience cites some well-known obstacles: “small samples, questionable reliability and validity of measurements, medication confounds, failure to distinguish state and trait effects, correlation–causation ambiguity, and the absence of compelling animal models of specific symptoms to test mechanistic hypotheses derived from brain-symptom correlations.”

5. Suzana Herculano-Houzel on “The remarkable yet not extraordinary, human brain as a scaled-up primate brain and its associated cost,” in special PNAS June issue on evolution.

[From Abstract] Here, I review . . . recent evidence and argue that, with 86 billion neurons and just as many nonneuronal cells, the human brain is a scaled-up primate brain in its cellular composition and metabolic cost, with a relatively enlarged cerebral cortex that does not have a relatively larger number of brain neurons yet is remarkable in its cognitive abilities and metabolism simply because of its extremely large number of neurons.

Psychiatry

1. Laurence Kirmayer has a new paper in Juy 2012 Social Science & Medicine,”Cultural competence and evidence-based practice in mental health: Epistemic communities and the politics of pluralism.”

2. Two news items: In Kuala Lumpur: “Sword-wielding couple suffer from mental illness – police.” According to the 7/10/12 Sun Daily, “Khalil Afandi Hamid, 47, and the woman’s extremist religious beliefs might have caused them to run amok, initial police investigations have revealed.” Immediate thoughts of  Byron J. Good and Mary-Jo DelVecchio Good’s already classic paper on this form of illness, “Why Do the Masses So Easily Run Amok? Madness and Violence in Indonesian Politics.” Latitudes 5:10-19 (June 2001).

3. And more evidence from Australia that “Police lockups overflowing with mentally ill,” according to the 7/12/12 Sydney Morning Herald.

4. Rhona MacDonald’s 7/9/12 post from PLoS Medicine on GlaxoSmithKline guilty plea to promoting antidepressants for unapproved uses. “Should complicit physicians remain unscathed?”

5. Not specifically on psychiatry, but a great read on history of medicine: June NEJM Perspective: The Burden of Disease and the Changing Task of Medicine by Jones, Podolsky, and Greene.

In many respects, our medical systems are best suited to diseases of the past, not those of the present or future. We must continue to adapt health systems and health policy as the burden of disease evolves. But we must also do more. Diseases can never be reduced to molecular pathways, mere technical problems requiring treatments or cures. Disease is a complex domain of human experience, involving explanation, expectation, and meaning. Doctors must acknowledge this complexity and formulate theories, practices, and systems that fully address the breadth and subtlety of disease.

______________

In 2010, more than 1 in 5 US children were living in poverty.

3×5: Culture, Neuroscience, and Psychiatry Weekly Roundup (June 26)

Culture


1. Thanks to Greg Downey I am reading Cecilia Hayes in August 2012 Phil. Trans. R. Soc. B theme issue on evolution of human cognition (including causal reasonining, imitation, language, metacognition, and theory of mind), which is described as a “much more gradual and incremental than previously assumed” with “crucial roles” for “cultural evolution, techno-social co-evolution and gene–culture co-evolution.”

The evolution of human cognition has not merely involved the addition of processes that supervise and control more primitive ways of thinking; it has accelerated an ancient trend towards increasingly powerful and coordinated “embodied” modes of thought [i.e., "thinking that is not fundamentally distinct from acting"].”

2. Also Greg’s latest (6/25/12) in Neuroanthropology: a really beautiful exploration of “Man-Sheep-Dog: Interspecies Social Skills,” which ties in with (1)  by exemplifying humans’ domain-general and (with experience) domain-specific cognitive-develomental mechanisms.

3. Daniel Lende of Neuroanthropology (6/24/12) takes a look at a new paper on the prisoner’s dilemma by William Press and Freeman Dyson in PNAS. For Daniel,

[t]he implications of this paper are fascinating. For biological evolution, it opens up new thinking about reproductive strategies and life history theory, as well as the direct impact on ideas about the evolution of cooperation.
For cultural evolution, it seems to provide some powerful insights into the evolution of inequality in human society. As the agriculture revolution and population growth led to the ability to monopolize social resources and create differential wealth, what happened with social class? Did human cooperation turn from fairness to enforcing the sort of unfair game that Press and Dyson outline?

4. Travis Saunders’s recap (“Is Obesity a Disease?”), exemplifies the problems of medicalization. On the one hand, medicalization can create stigma and diminish personhood; on the other, lack of medicalization can result in a dearth of qualified medical and emotional support for persons living with a health issue. For me the post was a useful reminder that most of the discussion about psychiatry in the media has centered on “bracket creep” of psychiatric diagnosis (over-medicalization) and not on the equally troubling lack of adequate systems of care for persons living with a chronic, severe psychiatric disorder (for UCLA pediatrician and science/policy researcher Neal Halfon [see below], “there is far too little education about the early signs of mental illness and what kinds of interventions can make a difference, and it can be difficult to find appropriate help for a troubled child or adolescent”).

5. This year’s brain series on Charlie Rose featured a segment on depression. Participants included UCLA’s Peter Whybrow, Eric Kandel (Columbia/Howard Hughes), Helen Mayberg (Emory) and Frederick Goodwin (George Washington University). The segment also included Andrew Solomon, who wrote a book about his experiences, The Noonday Demon: An Atlas of Depression ( 2001).

Like Elyn Sacks, Andrew Solomon is unusually eloquent about his illness experience in the segment and in his book and offers a lot of food for thought. Solomon describes his major depression as a gradual onset from within. Eventually, he came to live in a “slowed, paralyzed state” in which making lunch felt like the “stations of the cross.” (Even at the time, he recognized that this predicament was “ridiculous.”) What was particularly interesting was the way in which he described the experience in almost wholly physical terms as a loss of vital energy rather than, for example, a loss of happiness. The anxiety which followed the illness’s onset resembled “that moment when you slip and trip, before you actually hit the ground, that feeling of out-of-control terror” that lasts “day after day.” Overall, he felt that something external was bearing down on him and at the same time “something from inside had been removed.” What followed was a cyclical period of treatment (psychopharmaceuticals and psychotherapy), improvement, and relapse, which he experienced “over and over” until he recognized his illness as “diabetes-like,” organic and permanent, probably to the great relief of the panel. Yet Solomon gives us precisely what Clark Lawlor thinks biomedical psychiatry needs in his new book on the cultural history of depression (Oxford, 2012): “a more richly human and specific vision of this protean but very real illness.”

Neuroscience

1. Joshua Buckholtz (Harvard) and Andreas Meyer-Lindenberg (Heidelberg) have published a major review in the latest issue of Neuron on
Psychopathology and the human connectome: Toward a transdiagnostic model of risk for mental illness. (See also my post on recent reviews on connectomics and psychopathology.)

The panoply of cognitive, affective, motivational, and social functions that underpin everyday human experience requires precisely choreographed patterns of interaction between networked brain regions. Perhaps not surprisingly, diverse forms of psychopathology are characterized by breakdowns in these interregional relationships. Here, we discuss how functional brain imaging has provided insights into the nature of brain dysconnectivity in mental illness. Synthesizing work to date, we propose that genetic and environmental risk factors impinge upon systems-level circuits for several core dimensions of cognition, producing transdiagnostic symptoms. We argue that risk-associated disruption of these circuits mediates susceptibility to broad domains of psychopathology rather than discrete disorders.

2.  Patric Hagmann [who coined the term “connectomics”], Patricia Grant, and Damien Fair’s recent paper in Frontiers in Systems Neuroscience: “MR Connectomics: a conceptual framework for studying the developing brain.”

3. Update by Ed Yong in The Scientist on Alzheimer’s rogue protein story .

4. From Elizabeth Phelps’s human neuroimaging group at NYU in June 2012 Current Biology: “Nonconscious Fear is Quickly Acquired But Swiftly Forgotten,” suggesting a qualitatively different pathway for nonconscious emotional stimuli.

5. Latest from Drury et al. (Molecular Psychiatry) reports on: “Telomere length and early severe social deprivation: Linking early adversity and cellular aging.”

Psychiatry (with a special focus on implementing nonseparable systems of mental/physical health care)

1. Here is the full link to UCLA’s Neal Halfon’s 6/12/12/ op-ed piece in the LA Times (quoted above): “Mental Illness and Lessons from Kelly Thomas’ Last Cry for Help.”

The latest Journal of the American Academy of Child & Adolescent Psychiatry includes three interesting articles (behind a paywall). The first is co-authored by Stephanie Drury (see the telomere paper above):

2. Recovering From Early Deprivation: Attachment Mediates Effects of Caregiving on Psychopathology
Lucy McGoron, Mary Margaret Gleason, Anna T. Smyke, Stacy S. Drury, Charles A. Nelson, Matthew C. Gregas, Nathan A. Fox, Charles H. Zeanah

3. Maternal Early Life Experiences and Parenting: The Mediating Role of Cortisol and Executive Function
Andrea Gonzalez, Jennifer M. Jenkins, Meir Steiner, Alison S. Fleming

4. Examining Autism Spectrum Disorders by Biomarkers: Example From the Oxytocin and Serotonin Systems
Elizabeth Hammock, Jeremy Veenstra-VanderWeele, Zhongyu Yan, Travis M. Kerr, Marianna Morris, George M. Anderson, C. Sue Carter, Edwin H. Cook,Suma Jacob.

5. Finally, here are links to “Early Childhood Adversity, Toxic Stress, and the Role of the Pediatrician: Translating developmental Science into Lifelong Health” a policy statement by the American Academy of Pediatrics and “The Lifelong Effects of Early Childhood Adversity and Toxic Stress” by Shonkoff et al. (who propose an “ecobiodevelopmental” framework),  Leeb et al. (CDC) respond :Early childhood adversity and toxic stress: A strategic opportunity for multi-disciplinary partnership between the pediatric and public health communities.

Connectomics and Psychopathology: A Budding Grove of New Thinking, Research

Neuroscience is moving toward a fairly unified explanation of psychopathology at the level of circuits and systems. The following articles/reviews on connectomics redirect our attention to mental illness as a disorder of connectivity. I’ve also embedded a foundational talk by Olaf Sporns, author of Networks of the Brain (MIT, 2010; reviewed by Terrence Sejnowski for American Scientist Online).

Behrans, T. E. J., & Sporns, O. (2012). Human connectomics. Current Opinion in Neurobiology, 22(1), 144–153. http://dx.doi.org/10.1016/j.conb.2011.08.005

Recent advances in non-invasive neuroimaging have enabled the measurement of connections between distant regions in the living human brain, thus opening up a new field of research: Human connectomics. Different imaging modalities allow the mapping of structural connections (axonal fibre tracts) as well as functional connections (correlations in time series), and individual variations in these connections may be related to individual variations in behaviour and cognition. Connectivity analysis has already led to a number of new insights about brain organization. For example, segregated brain regions may be identified by their unique patterns of connectivity, structural and functional connectivity may be compared to elucidate how dynamic interactions arise from the anatomical substrate, and the architecture of large-scale networks connecting sets of brain regions may be analysed in detail. The combined analysis of structural and functional networks has begun to reveal components or modules with distinct patterns of connections that become engaged in different cognitive tasks. Collectively, advances in human connectomics open up the possibility of studying how brain connections mediate regional brain function and thence behaviour.

Buckholtz, J. W., & Meyer-Lindenberg, A. (2012). Psychopathology and the human connectome: Toward a transdiagnostic model of risk for mental illness [Review]. Neuron, 74(6), 990–1004. http://dx.doi.org/10.1016/j.neuron.2012.06.002

The panoply of cognitive, affective, motivational, and social functions that underpin everyday human experience requires precisely choreographed patterns of interaction between networked brain regions. Perhaps not surprisingly, diverse forms of psychopathology are characterized by breakdowns in these interregional relationships. Here, we discuss how functional brain imaging has provided insights into the nature of brain dysconnectivity in mental illness. Synthesizing work to date, we propose that genetic and environmental risk factors impinge upon systems-level circuits for several core dimensions of cognition, producing transdiagnostic symptoms. We argue that risk-associated disruption of these circuits mediates susceptibility to broad domains of psychopathology rather than discrete disorders.

Bullmore, E. T., & Sporns, O. (2012). The economy of brain network organization.  Nature Reviews Neuroscience, 13, 336–349. http://dx.doi.org/10.1038/nrn3214

The brain is expensive, incurring high material and metabolic costs for its size — relative to the size of the body — and many aspects of brain network organization can be mostly explained by a parsimonious drive to minimize these costs. However, brain networks or connectomes also have high topological efficiency, robustness, modularity and a ‘rich club’ of connector hubs. Many of these and other advantageous topological properties will probably entail a wiring-cost premium. We propose that brain organization is shaped by an economic trade-off between minimizing costs and allowing the emergence of adaptively valuable topological patterns of anatomical or functional connectivity between multiple neuronal populations. This process of negotiating, and re-negotiating, trade-offs between wiring cost and topological value continues over long (decades) and short (millisecond) timescales as brain networks evolve, grow and adapt to changing cognitive demands. An economical analysis of neuropsychiatric disorders highlights the vulnerability of the more costly elements of brain networks to pathological attack or abnormal development.

Fornito, A., & Bullmore, E. T. (2012). Connectomic intermediate phenotypes for psychiatric disorders. Frontiers in Psychiatry, 3(32). http://dx.doi.org/10.3389/fpsyt.2012.00032

Psychiatric disorders are phenotypically heterogeneous entities with a complex genetic basis. To mitigate this complexity, many investigators study so-called intermediate phenotypes (IPs) that putatively provide a more direct index of the physiological effects of candidate genetic risk variants than overt psychiatric syndromes. Magnetic resonance imaging (MRI) is a particularly popular technique for measuring such phenotypes because it allows interrogation of diverse aspects of brain structure and function in vivo. Much of this work however, has focused on relatively simple measures that quantify variations in the physiology or tissue integrity of specific brain regions in isolation, contradicting an emerging consensus that most major psychiatric disorders do not arise from isolated dysfunction in one or a few brain regions, but rather from disturbed interactions within and between distributed neural circuits; i.e., they are disorders of brain connectivity. The recent proliferation of new MRI techniques for comprehensively mapping the entire connectivity architecture of the brain, termed the human connectome, has provided a rich repertoire of tools for understanding how genetic variants implicated in mental disorder impact distinct neural circuits. In this article, we review research using these connectomic techniques to understand how genetic variation influences the connectivity and topology of human brain networks. We highlight recent evidence from twin and imaging genetics studies suggesting that the penetrance of candidate risk variants for mental illness, such as those in SLC6A4, MAOA,ZNF804A, and APOE, may be higher for IPs characterized at the level of distributed neural systems than at the level of spatially localized brain regions. The findings indicate that imaging connectomics provides a powerful framework for understanding how genetic risk for psychiatric disease is expressed through altered structure and function of the human connectome.

Fornito, A., Zalesky, A., Pantelis, C., & Bullmore, E. T. (2012). Schizophrenia, neuroimaging and connectomics [Review]. NeuroImage. Advance online publication. http://dx.doi.org/10.1016/j.neuroimage.2011.12.090

Schizophrenia is frequently characterized as a disorder of brain connectivity. Neuroimaging has played a central role in supporting this view, with nearly two decades of research providing abundant evidence of structural and functional connectivity abnormalities in the disorder. In recent years, our understanding of how schizophrenia affects brain networks has been greatly advanced by attempts to map the complete set of inter-regional interactions comprising the brain’s intricate web of connectivity; i.e., the human connectome. Imaging connectomics refers to the use of neuroimaging techniques to generate these maps which, combined with the application of graph theoretic methods, has enabled relatively comprehensive mapping of brain network connectivity and topology in unprecedented detail. Here, we review the application of these techniques to the study of schizophrenia, focusing principally on magnetic resonance imaging (MRI) research, while drawing attention to key methodological issues in the field. The published findings suggest that schizophrenia is associated with a widespread and possibly context-independent functional connectivity deficit, upon which are superimposed more circumscribed, context-dependent alterations associated with transient states of hyper- and/or hypo-connectivity. In some cases, these changes in inter-regional functional coupling dynamics can be related to measures of intra-regional dysfunction. Topological disturbances of functional brain networks in schizophrenia point to reduced local network connectivity and modular structure, as well as increased global integration and network robustness. Some, but not all, of these functional abnormalities appear to have an anatomical basis, though the relationship between the two is complex. By comprehensively mapping connectomic disturbances in patients with schizophrenia across the entire brain, this work has provided important insights into the highly distributed character of neural abnormalities in the disorder, and the potential functional consequences that these disturbances entail.

Hagmann, P., Grant, P., & Fair, D. (June, 2012). MR connectomics: A conceptual framework for studying the developing brain [Review]. Frontiers in Systems Neuroscience. http://dx.doi.org/10.3389/fnsys.2012.00043

The combination of advanced neuroimaging techniques and major developments in complex network science, have given birth to a new framework for studying the brain: “connectomics.” This framework provides the ability to describe and study the brain as a dynamic network and to explore how the coordination and integration of information processing may occur. In recent years this framework has been used to investigate the developing brain and has shed light on many dynamic changes occurring from infancy through adulthood. The aim of this article is to review this work and to discuss what we have learned from it. We will also use this body of work to highlight key technical aspects that are necessary in general for successful connectome analysis using today’s advanced neuroimaging techniques. We look to identify current limitations of such approaches, what can be improved, and how these points generalize to other topics in connectome research.

Power, J. D., Cohen, A. L., Nelson, S. M., Wig, G. S., Barnes, K. A., Church, J. A., . . . Petersen, S. E. (2011). Functional network organization of the human brain. Neuron, 72, 665–678. http://dx.doi.org/10.1016/j.neuron.2011.09.006

Real-world complex systems may be mathematically modeled as graphs, revealing properties of the system. Here we study graphs of functional brain organization in healthy adults using resting state functional connectivity MRI. We propose two novel brain-wide graphs, one of 264 putative functional areas, the other a modification of voxelwise networks that eliminates potentially artificial short-distance relationships. These graphs contain many subgraphs in good agreement with known functional brain systems. Other subgraphs lack established functional identities; we suggest possible functional characteristics for these subgraphs. Further, graph measures of the areal network indicate that the default mode subgraph shares network properties with sensory and motor subgraphs: it is internally integrated but isolated from other subgraphs, much like a “processing” system. The modified voxelwise graph also reveals spatial motifs in the patterning of systems across the cortex.

Tost, H., Bilek, E., & Meyer-Lindenberg, A. (2011). Brain connectivity in psychiatric imaging genetics. NeuroImage. Advance online publication. http://dx.doi.org/10.1016/j.neuroimage.2011.11.007

In the past decade, imaging genetics has evolved into a highly successful neuroimaging discipline with a variety of sophisticated research tools. To date, several neural systems mechanisms have been identified that mediate genetic risk for mental disorders linked to common candidate and genome-wide-supported variants. In particular, the examination of intermediate connectivity phenotypes has recently gained increasing popularity. This paper gives an overview of the scientific methods and evidence that link indices of neural network organization to the genetic susceptibility for mental illness with a focus on the effects of candidate genes and genome-wide supported risk variants on brain structure and function.

3×5: Culture, Neuroscience, and Psychiatry Weekly Roundup (June 19)

NOTE: I’ve posted four hour-long videos this week. If time doesn’t permit, I’d suggest listening to the Robert Sapolsky videos on depression and schizophrenia, maybe in your car on your way to work or finally taking that drive across the country. You couldn’t have more excellent company on a road trip!

Culture

1. I really enjoyed historian Jesse Ballenger’s first post on his new blog, To Conquer Confusion: A Historian’s Perspective on the Science and Experience of Alzheimer’s Disease and Dementia, entitled: “Blogging and Dementia: Why This Blog.” I think blogging is a good way to throw some light on the curious contents of our “work” minds in process. (Like archeologists, we should “embrace the messiness” and, in Ballenger’s case, ambivalence.) But Ballenger also grapples with an important question, “how can choking the virtual world with one more blog possibly be an act of communicative meaning?”

2. Kristi Lewton’s review in American Anthropologist, “Complexity in Biological Anthropology in 2011: Species, Reproduction, and Sociality.”

3. The Ethnographer’s guide to big data, part 1 and part 2. Jenna Burrell’s dispatch from the DataEdge conference hosted by UC Berkeley’s School of Information.

4. Via Jason Antrosio’s Anthropology Report, with some skepticism, Zoe Corbyn’s Nature news item, “How Geography Shapes Cultural Diversity.”

5. Norbert Ross, Catherine Timura, and Jonathan Maupin in 6/11/12 Medical Anthropology Quarterly, “The Case of Curers, Noncurers, and Biomedical Experts in Pichátaro, Mexico: Resiliency in Folk-Medical Beliefs.”

Neuroscience

1. I liked neuroscientist Bradley Voytek’s 6/16/12 post “Defending Jonah Lehrer,” which describes some critical issues regarding imaging (and also captures some of the angst surrounding the popularization of research by “non-experts”).

2. Vittorio Gallese (mirror neurons) YouTube video on “The Body in Aesthetic Experience: A Neuroscientific Perspective” from Berkeley’s Science, Technology, Medicine & Society. The talk focuses on his interdisciplinary approach to intersubjectivity and social cognition.

3. Apologies for posting TWO lengthy videos, but I loved Mario Biagioli’s book, Galileo, Courtier, so I had to post HIS Berkeley STMS talk, “Secrecy and Openness Revisited: A Genealogy of Priority in Science.”

4. Interesting 6/12/12 PNAS paper by a group of Finnish researchers, “Emotions Promote Social Interaction by Synchronizing Brain Activity Across Individuals.”

5. Andreas Bartels’ commentary in July 2012  Neuropsychopharmacology, “Oxytocin and the Social Brain: Beware the Complexity,” one of the lessons of which is, “we need to find clever ways to present social stimuli in truly social context.”

Psychiatry

1. The is almost the all-video edition of 3×5, but Robert Sapolsky’s talk on depression is worth hearing. I agree with a commentator who described it as: “Absolute genius. Elegant, simplified without being simplistic, and cohesive.”

2. A second video by Sapolsky on Schizophrenia:

3. I’ve just started reading Andrew Pickering’s The Cybernetic Brain: Sketches of Another Future. Here is link to U of Chicago description and excerpt:

[The Cybernetic Brain] explores the largely forgotten group of British thinkers—Bateson included—that tripped the light fantastic at the frontiers of psychiatry, systems management, politics, epistemology, and Eastern thought as the twentieth century came of age. In the excerpt that follows below, he locates Bateson’s ideas on schizophrenia and enlightenment alongside Western appreciations of Zen, as a form of what Foucault might call “gymnastics of the soul.”

4. Simon Baron-Cohen’s 6/13/12 commentary in The Guardian on “What the McLean Brain Bank Malfunction Means for Autism Research.”

5. From Psychiatric Times, Michael Casher and Joshua Bess on “Determination and Documentation of Insight in Psychiatric Inpatients,” which “reviews the relevant studies involving insight and offers an overview and critique of the various rating scales.”

3×5: Culture, Neuroscience, and Psychiatry Weekly Roundup (June 12)

What’s new for week of 2–9 June 2012

Culture

1. Jens Seeberg in 6/11/12 Medical Anthropology Quarterly: “Connecting Pills and People: An Ethnography of the Pharmaceutical Nexus in Odisha, India.”

2. Good review of a good book about the sensitivity of our diagnostic systems to cultural factors, Jonathan Metzl’s The Protest Psychosis: How Schizophrenia Became a Black Disease (Beacon Press, 2009).

3. Research by Yina Ma and Shihui Han (who is coming to our next conference) is featured in “Christians Find It Harder than Atheists to Recognize their Own Faces.”

4. This is a reminder that the Advanced Study Institute in Cultural Psychiatry, which is hosted by McGill’s Division of Social & Transcultural Psychiatry, will take place July 5–7, 2012. The theme is: “Global Mental Health: Bridging the Perspectives of Cultural Psychiatry and Public Health.”

5. Wonderful Emily Martin 3/15/12 lecture at Science, Technology, Medicine & Society (Berkeley), “Steps Toward an Anthropology of the Human Subject in Experimental Psychology,” which begins by describing the rich, entwined history of psych/anthro field expeditions:  “The expedition scientists assumed that the social and cultural environment determined the way the mind perceived the world. (That’s pretty radical. . . . Eighteen-ninety-eight.)  They also assumed that after immersion in the daily life of villagers . . . they could serve as appropriate experimental subjects, comparable to the native inhabitants.”

Neuroscience

1. Rule, Freeman, and Ambady’s June 2012 review, “Culture in Social Neuroscience: A Review” published in Social Neuroscience

2. Latest from PNAS (June 5, 2012): Archie, Altmann, and Alberts in 6/5/12 PNAS: “Social Status Predicts Wound Healing in Wild Baboons.”

3. . . . And Crews et al. using a systems biology approach: “Epigenetic Transgenerational Inheritance of Altered Stress Responses.”i

4. Przyrembel, Smallwood, Pauen, and Singer’s 6/7/12 review “Illuminating the Dark Matter of Social Neurocience: Considering the Problem of Social Interacrtion from Philosophical, Psychological, and Neuroscientific Perspectives” in Frontiers in Human Neuroscience. “This analysis draws attention to the need for paradigms that allow two individuals to interact in a spontaneous and natural manner and to adapt their behaviour and cognitions in a response contingent fashion . . .”

5. See Patrick McGowan commentary and Labonte, Yerko, Gross, Mechawar, Meaney, Szyf, and Turecki study on epigenetics, suicide, and history of child abuse in July issue of Biological Psychiatry.

Psychiatry

1. Howard Markel’s 6/5/12 opinion piece, “The DSM Gets Addiction Right,” in the New York Times.

2. Jeremy Holmes, former chair of the Faculty of Psychotherapy, Royal College of Psychiatrists in BJ Psych on “Psychodynamic Psychiatry’s Green Shoots.”  One example the author discusses is the Scandinavian “needs adapted” approach to schizophrenia, whereby “ the uniqueness of each patient is recognised, medication kept to a minimum, the family dynamics around psychosis charted, and a long-term one-to-one relationship with a key-worker seen as vital to improvement.” See also Alanen et al., Psychotherapeutic Approaches to Schizophrenia Psychosis: Past, Present and Future (Routledge, 2009).

3. Hmm, may have mentioned this one in a previous post, but this is an interesting read if you like history of psychiatry: “Between phenomenological and Community Psychiatry: The Comprehending Anthropology of Jürg Zutt” by Peter Schöonknecht and Tom Dening in June 2012 issue of History of Psychiatry. Speaking in 1957 on the topic of anthropological psychiatry, Zutt said:

It is something relatively new in psychiatry. One may assume that we consider psychosis as psychogenic disorders, and that we do not consider anatomical and physiological causation. This is a misunderstanding … Anatomy and physiology remain two major basics of psychiatry. But we think that the phenomena traditional psychiatry cannot understand in logical terms have to be considered by using other approaches.

4. Last week I reported on the One Mind for Research annual meeting, here’s a link to a background article on the group by Matthew Herper for Forbes: “A Father’s Battle to Change the Future of Brain Research.”

5. Another must-read by Gregory Miller and Steve Cole: “Clustering of Depression and Inflammation in Adolescents Previously Exposed to Childhood Adversity” in July issue of Biological Psychiatry.

Psychiatric Neuroscience, Stigma and the Aging Brain: Dispatch from the Annual Meeting of One Mind for Research

A few weeks ago I attended the first annual meeting of the One Mind for Research Campaign: Curing Brain Disease. (The group’s new CEO is Ret. General Peter Chiarelli, the commanding officer of the 1st Cavalry Division during the Iraq War, and you could practically taste the battle dust in your mouth at the end of the 3-day offensive to eliminate brain disease and its stigma within 10 years.) The meeting, which included NIMH director Thomas Insel, former NIMH director Steven Hyman, and American Psychiatric Association newly elected president John Oldham, featured sessions on the latest psychiatric neuroscience, stigma, and the aging brain. Here are some highlights:

Heterogeneity

One non-surprising take-home message is that psychiatric disorders are not only heterogeneous but many (most?) may eventually be best characterized at the level of circuits/systems. Regarding heterogeneity, the consensus among several speakers was that patients classified as having one illness or another should be further “stratified” as much as possible in order to treat with different neurodeficit-specific compounds  (which is interestingly contrary to some of the proposed changes to DSM-5, such as lumping Asperger’s and Autism, or eliminating subtypes of schizophrenia). UPDATE (8/24/12) This statement requires clarification. The elimination of subtypes in schizophrenia (paranoid, disorganized, catatonic, undifferentiated, etc.) is due to the belief that the disorder’s clinical heterogeneity may be best understood by using a single diagnosis with distinct symptom “dimensions” of psychopathology – hallucinations, delusions, disorganized speech, abnormal psychomotor behavior, negative symptoms (restricted emotional expression or avolition), impaired cognition, depression, mania – each of which, it is proposed, would be measured on a 4-point severity scale. But it’s important to note that these dimensions, or “domains,”  will “cross diagnostic boundaries” introducing a new set of challenges, especially for drug development (Carpenter, 2012).

Here’s an example of why categories can be confounding. Rene Hen gave a fascinating talk on a hippocampus-related process – pattern separation, the way in which our brains are able to reduce “the average overlap between two representations, thus making similar representations more distinct or orthogonalized in order to afford rapid learning without inducing interference and retrieval errors,” which is balanced by pattern completion. Pattern separation is impaired in PTSD as well as schizophrenia.

Connectivity

But I noticed that interest in the intermediate phenotype concept prevalent in psychiatric neuroscience literature during the last decade is now accompanied by an interest in big science, e.g., fresh efforts (reminiscent of Galen’s rete mirabile) to understand structural and functional connections within and across regions of the brain that are, also, exquisitely sensitive to environmental interactions. And this has significant treatment implications. As Emory fear scientist Kerry Ressler remarked, “we have to change how we think about therapy, the brain is not a bag of molecules that can be treated by a drug.”

MIT computational neuroscientist and TED pundit Sebastian Seung (“I am my connectome”) has received a lot of attention in the popular press recently for his work on the connectivity of individual neurons. (According to Seung, the dynamic or functional connectivity of neurons and the white-matter structural “connectome” interact in much the same way water rushing down a mountainside and the terrain over which it flows do.) But one of the most exciting sessions at the conference featured the work of Olaf Sporns and colleagues, who are focusing on structural and functional connectivity at the macro-scale, based on the concept of brain networks. These investigations rely on diffusion imaging (for structural connectivity) and resting state fMRI (for functional connectivity). In his talk, Sporns likened these anatomical connections to complex social or other kinds of networks that exist in the world. (“A common language is emerging,” said Sporns, one that is able to link network interactions within and across multiple levels of organization, which he referred to as “network science.”) Focusing on these interactions seems a little more doable than trying to link objective biomarkers to subjective experience (which Vaughan Bell of Mind Hacks likened to counting commas in a poem).

In the same session, William Seeley gave a fascinating talk on the connectional architecture of neurodegeneration in brain disorders, including Alzheimer’s, each of which has a distinct pattern. His group found, for example, that resting-state connectivity patterns of healthy brains related to episodic memory using fMRI mirrored the atrophy patterns in Alzheimer’s as the disease progressed from the medial temporal lobe to the neocortex. (The more radical idea (that may be reappearing in the science), another speaker said, is that these disorders are connectopathic and initially triggered by rogue proteins.) Here’s a link to the relevant Neuron 2012 paper.

 Stigma

In the session on stigma, Elyn Saks (USC), author of The Center Cannot Hold, discussed the “positive, negative, and cognitive” dimensions of schizophrenia, in regard to the latter dimensions specifically referring to short-term memory, visuo-spatial abilities, etc. She discussed how she was able to balance borderline impairment in some areas of cognition, e.g., short-term memory, by leveraging her strengths and “passed” for many years in academia as “normal.” During the talk I was struck by Dr. Saks’s certainty that psychotherapy is the reason for her lack of negative symptoms, which made me wonder, just how correlated are these symptoms with a person’s level of social disconnection? (The social neuroscience in this area by Naomi Eisenberger – who just published a review in Nature – and others relating social disconnection to some of the same pathways as physical pain is really interesting in this regard.)

Unfortunately, stigma is “alive and well,” according to sociologist Bernice Pescosolido, who spoke eloquently around the depressing fact that despite huge leaps in scientists’ neurobiological understanding of mental illness, despite the disappearance by the rest of us into what Mary-Jo DelVecchio Good calls the “biotechnical embrace” re matters of the mind, there has been virtually no change in Americans’ level of prejudice regarding persons whom NYU anthropologist Emily  Martin refers to as living under the description of a mental disorder. We just don’t believe it’s a disease like any other, and if you or your family have the rotten luck to be on the receiving end, this adds astronomically to the confusion, anxiety, and fear about which neuroanthropologist Greg Downey has so eloquently written ( “Slipping into Psychosis”).

Alzheimer’s and the Fountain of Youth

But I don’t want to end this post on such a depressing note. Stanford researcherTony Wyss-Coray discussed the importance of not seeing the brain as an isolated organ. His group is studying the effects of stress, inflammation, and other environmental insults on brain function. In one experiment, the investigators infused the blood of young mice into old mice, and there were many positive effects in terms of neurogenesis, increased synaptic activity, increased spine density, reduced neuroinflammation, and improved spatial memory. (This announcement initiated a small wave of mouse jokes.) A brilliant neuroscientist sittling behind me said in a vaguely accented English (seriously) that it would be a difficult and expensive process to determine which substances within the blood to focus on; in the meantime, why not just transfuse old people with young people’s plasma? This is precisely what John Huston, playing a Joseph Kennedy-esque character, does in the movie Winter Kills (“I get it from the kids up at Amherst”). As the general concluded, “What I’ve learned among other things is that, THIS IS A GOOD TIME TO BE A MOUSE.”