About Constance A. Cummings

Constance A. Cummings, PhD, is Project Director of the non-profit 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 (Cambridge University Press, 2010) and (with Laurence Kirmayer and Rob Lemelson) the forthcoming Re-Visioning Psychiatry: Cultural Phenomenology, Critical Neuroscience, and Global Mental Health (Cambridge, 2015). She received her doctorate in theoretical linguistics from New York University.

3×5: Culture, Neuroscience, and Psychiatry Weekly Roundup: Empathy (August 6)

UPDATE: New links from Lori Hogenkamp via Facebook at end of post.

Brief note: I’ve come to realize that empathy (and its putative component processes – mirror neuron networks, affect sharing, mentalizing) brings out almost everything that’s problematic in social neuroscience research: problems of a conceptually vague cover term, problems with extrapolating from animal models (e.g., monkeys don’t imitate); problems with fMRI/ROI, problems with science writing for the public (e.g., this publisher blurb for Marco Iacoboni’s Mirroring People: “From imitation to morality, from learning to addiction, from political affiliations to consumer choices, mirror neurons seem to have properties that are relevant to all these aspects of social cognition”), problems with a too-powerful metaphor (err, the mirror) that’s hard to repack in the box after that last quote :( problems with extrapolating in other ways (see Emily Willingham’s post on what she describes as the “no empathy in autism meme” – as Ian Hacking said, “The history of late 20th century medicine will … also [be] a history of advocacy groups”), etc., etc.

On second thought, there are many positive implications that hover over all this work – for theory of mind, radical embodied cognition, network science approaches to the brain’s structural and functional connectivity  . . .

Many thanks to the Neuroanthropology Interest Group on Facebook for suggestions and Center for Building a Culture of Empathy and Compassion for inspiration! 

Culture

1. “Empathy as cultural process: Insights from the cultural neuroscience of empathy” by Bobby Cheon, Vani Mathur, and Joan Chiao (WCPRR, 2010).

2. Via Eugene Raikhel (Neuroanthropology Interest Group): See the just-published special issue of “Science in Context” on “The Varieties of Empathy in Science, Art, and History.” It includes an article by Shaun Gallagher (“Empathy, Simulation, and Narrative“), one by Allan Young (“The Social Brain and the Myth of Empathy“) and a number of others.

3. Roundup on “Anthropology, Teaching, and Empathy” in early 2012 by Jason Antrosio of Anthropology Report and a related post by Rex on Savage Minds, “Empathy, or, seeing from within.”

4. Hollan, D. C., & Throop, C. J. (2011). The anthropology of empathy: Experiencing the lives of others in Pacific societies. New York: Berghahn.

5. Blog post by Emily Willingham (Dec 2011): “Autistic people: Insensitive to social reputation, sure, but what about empathy?” on the website Autism and Empathy.

Neuroscience

1. Bernhardt, B. C., & Singer, T. (2012). The neural basis of empathy. Annual Review of Neuroscience, 35, 1–23.

2. Decety, J. Norman, G. J., Berntson, G. G., & Cacioppo, J. T. (2012). A neurobehavioral evolutionary perspective on the mechanisms underlying empathy. Progress in Neurobiology, 98(1), 38–48. See also, Decety, J. (2011b). The neuroevolution of empathyAnnals of the New York Academy of Sciences, 1231, 35–45.

3. Zaki, J., & Ochsner, K. N. (2012). The neuroscience of empathy: Progress, pitfalls and promiseNature Neuroscience: Focus on Social Neuroscience [Perspective], 15(5), 675–680.

4. Decety, J. (2011a). Dissecting the neural mechanisms mediating empathy. Emotion Review, 3,92–108. See also, Decety, J. (2010). To what extent is the experience of empathy mediated by shared neural circuits? Emotion Review, 2(3), 204–207.

5. “Empathy and pro-social behavior in rats” Inbal Ben-Ami Bartal, Jean Decety, and Peggy Mason. See also 2011 Science paper by same group.

 

Psychiatry

1. Cheng, Y., Hung, A., & Decety, J. (2012). Dissociation between affective sharing and emotion understanding in juvenile psychopathsDevelopment and Psychopathology, 24, 623–636.

[From Abstract]. . . youth with HCU [high callous-unemotional traits] exhibit atypical neural dynamics of pain empathy processing in the early stage of affective arousal, which is coupled with their relative insensitivity to actual pain. Their capacity to understand intentionality, however, was not affected. Such uncoupling between affective arousal and emotion understanding may contribute to instigating aggressive behaviors in juvenile psychopaths.

[From the paper] It is  important that the affective arousal deficit . . . cannot be explained by a lack of sensorimotor resonance [i.e., mirror neurons], as measured by mu wave suppression [this was an ERP study], which was present in a ll participants. This finding indicates that affective arousal is not mediated by the mirror neuron system.

2. “Empathy and alterity in cultural psychiatry” by Laurence Kirmayer (Ethos, 2008).

3. “Empathy and otherness: Humanistic and phenomenological approaches to psychotherapy of severe mental illness” by Elizabeth Pienkos and Louis Sass (Pragmatic Case Studies in Psychotherapy, 2012).

4. Empathy in mental illness edited by Tom Farrow and Peter Woodruff (CUP, 2007).

5. “Zero degrees of empathy” by Simon Baron-Cohen, covering disorders of empathy (borderline personality disorder, psychopathy, narcissism) and genetic, endocrine, and social influences.

UPDATE:

3×5: Culture, Neuroscience, and Psychiatry Weekly Roundup (July 30)

Culture

1. Ginger Campbell (Brain Science Podcast) interviews UC Berkeley biological anthropologist Terrence Deacon about his book Incomplete Nature: How Mind Emerged from Matterwhich was reviewed by Raymond Tallis is WSJ last November. But see also “Stolen Ideas? Or Great Minds Thinking Alike?” by Tom Bartlett in the Chronicle of Higher Education, which discusses the book’s overlap with works by Alicia Juarrero (Dynamics in Action) and (our favorite) Evan Thompson (Mind in Life). (The FPR interviewed Evan Thompson last year.)

2. Neuroanthropology’s Daniel Lende’s post “Inside the Minds of Mass Killers” is a must-read.

3. Another terrific post on Aurora, which Daniel’s links to, is philosopher Evan Selinger’s “The Philosophy of the Technology of the Gun,” which appeared in the Atlantic.

I think Daniel and Evan throw some much-need light on the social, political, and material environment (including cultural scripts and how technology, to use a thread-bare metaphor, “gets under the skin”) from which acts of violence emerge and, in addition,  the importance of not “lightly equat[ing] mental illness and violence.”

But a commentator (“N” – and I’m assuming “N” is the same author whose brilliant work is featured in a post by David Dobbs) questioned “the divide” Daniel seemed to be drawing “between the cultural & sociopolitical and ‘mental illness,'” as well as that between violence and certain forms of psychosis. A thoughtful back-and-forth with “N” and other commentators followed. I highly recommend reading the whole thing!

4. Speaking of Daniel, Neuroanthropology’s Facebook page is a lot of fun!

5. Somatosphere has a great summary by Dörte Bemme and Nicole D’Souza of a recent global mental health workshop and conference hosted by Laurence Kirmayer and McGill’s Division of Transcultural Psychiatry.

There seems to be a shift among this new generation of researchers (including the post’s authors) to move beyond “static dichotomies (north, south, west, HIC, LMIC, global, local)” and top-down or bottom-up approaches but I’m not sure to what, precisely, apart from recognizing “interesting frictions”?

One advance that has gotten less press is DSM-5’s recognition that mental health, like physical health, is a developmental process and exquisitely sensitive to the timing as well as the intensity of experiences and events. Another comes from recognition of the need for a developmentally oriented network of primary care at the community level that address biological, social, and environmental risk factors for mental as well as medical illnesses – infectious diseases, poverty, stress, migration. (See, e.g., Sunday’s NYT magazine article, “What Can Mississippi Learn from Iran?” re primary health care reform.)

[Dr. Aaron] Shirley [creator of HealthConnect, a model inspired by Iran’s primary health care systems] says he believes that the problems of the American poor — living conditions, deficient education, harmful behaviors and the lack of family support and access to healthful lifestyles — demand house calls. This approach was used by groups in Atlantic City and Camden, N.J., profiled by Atul Gawande in The New Yorker last year, which identified the worst offenders of emergency-room readmission and deployed social workers and nurses to figure out the myriad sources of ill health. What was clear above all else from Gawande’s account is that what these people needed was constant attention. Because one stumble — an unpaid electricity bill, for example — can lead to cascading health setbacks.

Neuroscience

1. Great Book, Great Interview: Ginger Campbell interviews Olaf Sporns about Networks of the Brain (MIT, 2011).

2. John Hawks linked to a fascinating paper on his blog, “Evolutionary History and Adaptation from High-Coverge Whole-Genome Sequences of Diverse African Hunter Gatherers” by Lachance et al. in Cell., which points out high levels of genetic diversity within African hunter-gatherer populations.

To reconstruct modern human evolutionary history and identify loci that have shaped hunter-gatherer adaptation, we sequenced the whole genomes of five individuals in each of three different hunter-gatherer populations at >60× coverage: Pygmies from Cameroon and Khoesan-speaking Hadza and Sandawe from Tanzania. We identify 13.4 million variants, substantially increasing the set of known human variation. We found evidence of archaic introgression in all three populations, and the distribution of time to most recent common ancestors from these regions is similar to that observed for introgressed regions in Europeans. Additionally, we identify numerous loci that harbor signatures of local adaptation, including genes involved in immunity, metabolism, olfactory and taste perception, reproduction, and wound healing. Within the Pygmy population, we identify multiple highly differentiated loci that play a role in growth and anterior pituitary function and are associated with height.

3. Russell Fernald’s “Social Control of the Brain,” in latest Ann Rev of Neurosci using a fish model.

4. Latest SCAN: “The Association Between Financial Hardship and Amygdala and Hippocampal Volumes: Results from the PATH Through Life Project.

5. Finally, here is a link to the pdfof the 2012 Human Brain Project report because I’m obsessed with this image:

And, in my simple minded way, if we can do this, our collective experts can come up with a solution for Mississippi.

Psychiatry

1. Rutgers press release dd. 7/19/12: Anxiety Disorders in Poor Mothers More Likely to be the Result of Poverty, not Mental Illness.

2. In the July 2012 issue of BJPsych, Psychotic symptoms in young people without psychotic illness: mechanisms and meaning by Graham Murray and Peter Jones.

Psychotic symptoms are common in the general population. There is evidence for common mechanisms underlying such symptoms in health and illness (such as the functional role of mesocorticostriatal circuitry in error-dependent learning) and differentiating factors (relating to non-psychotic features of psychotic illness and to social and emotional aspects of psychotic symptoms). Clinicians should be aware that psychotic symptoms in young people are more often associated with common mental disorders such as depression and anxiety than with severe psychotic illness.

3. Also in the same issue,, psychiatric neuroscientist Mary Phillips has an editorial on “Neuroimaging in Psychiatry: Bringing Neuroscience into Clinical Practice.”

4. Freedman et al’s “Treating a physician patient with psychosis,” Asian Journal of Psychiatry, June 2012 via @JonesNev

5. Also via Nev Jones (@JonesNev): “Voice Hearing and Pseudoseizures in a Maori Teenager: An Example of Mate Maori and Maori Traditional Healing” in Australas Psychiatry, 19 July 2012. See also “Maori Healers’ Views on Wellbeing: The Importance of Mind, Body, Spirit, Family and Land” in Social Science & Medicine (June 2010).

Abstract

Objective: The aim of this paper is to describe a Māori traditional healing approach to assessment and treatment of distressing psychiatric symptoms in a young man.Method:We describe the case of a 17 year old Māori male with voice hearing and pseudoseizures and the assessment and intervention by one of the authors (WN). We report on the young man’s and his family’s experience of this treatment. We outline concepts from a Māori world view that illuminate an indigenous rationale for this approach. Results: A single session traditional Māori healing intervention was associated with immediate resolution of this young man’s psychiatric symptoms and restoration of his sense of wellbeing, despite cessation of antipsychotic treatment. He and his family felt satisfied with the cultural explanation about the origin of his distress, which was congruent with their world view. He remained well at follow-up one year later. Conclusions: Collaboration between psychiatrists and traditional Māori healing practitioners can enhance the mental health care of Māori whaiora (service users) and their families. Indigenous research is required to further evaluate the acceptability and effectiveness of such joint approaches.

Deadline Extension to 8/3: Ethnographic Perspectives on Global Mental Health

Just received this notice via McGill’s listserv. See also Somatosphere’s excellent summary of McGill’s Global Mental Health workshop and conference (Global Mental Health and Its Discontents) by Dörte Bemme and Nicole D’Souza.

We invite paper submissions for a panel titled: Ethnographic perspectives on
‘global mental health’ at The 17th World Congress of the International Union
of Anthropological and Ethnological Sciences (IUAES), University of
Manchester, UK, 5-10 August 2013.

Deadline: August 3rd, 2012

Panel LD36: Ethnographic perspectives on ‘global mental health’

Conveners

Sumeet Jain (University of Edinburgh), Email: sumeet.jain@ed.ac.uk
David Orr (University of Sussex), Email: d.orr@sussex.ac.uk

Short Abstract

The ‘global mental health’ (GMH) agenda has attained considerable policy
influence. However, debates continue about its universal validity. This
panel takes an ethnographic approach to how GMH-informed interventions
respond in practice to disparate manifestations of mental distress.

Long Abstract

This panel takes an ethnographic approach to investigating how interventions
informed by the ‘global mental health’ (GMH) movement respond in practice to
disparate manifestations of mental distress. The GMH agenda now dominates
academic and policy discussions of mental health in low and middle income
countries. Its rise can be traced to specific developments in the 1990s that
shaped how the ‘disability burden’ of mental health disorders came to be
measured, and a series of policy and research reports on mental health which
afforded direction and impetus to efforts to push mental health up the list
of governmental priorities. Today the GMH agenda is backed by the World
Health Organisation and has played its part in the continuing worldwide
spread of psychiatry’s reach. Yet social scientists and psychiatrists have
questioned how ‘globally’ valid some of its concepts and assumptions prove
in framing and acting on experiences of mental distress in diverse contexts
and social configurations. This panel invites papers that draw on
anthropological theory and ethnographic data to comment on, add to, or
critique the evidence base for claims on both sides, and consider how these
discourses are formed and re-formed on the ground. High on the list of
questions we seek to address are:

How are GMH policies deployed in diverse locales?

What are the effects of these policies on local populations?

How is this agenda re-shaping clinical and non-clinical settings?

How do GMH discourses transform the interaction between patient and health
professional?

How does this approach mould health-seeking behaviours?

Please note that the deadline for paper proposals is August 3rd, 2012.
Proposals should be submitted by August 3rd, 2012 through the ‘Propose a
paper’ link on the following page :

http://www.nomadit.co.uk/iuaes/iuaes2013/panels.php5?PanelID=1705

If you require further information, do not hesitate to contact either of us.

Best wishes,

Sumeet Jain & David Orr

What Are We Talking About When We Talk About X? (Embodied Cognition, Phenomenological Psychiatry, Theory of Mind): FPR Roundup

Here’s a short list of new(ish) books focusing on embodied cognition, phenomenological psychiatry, and theory of mind.

Beyond the Brain: How Body and Environment Shape Animal and Human Minds by Louise Barrett (Princeton University Press, 2011)

Removing our human-centered spectacles, Louise Barrett investigates the mind and brain and offers an alternative approach for understanding animal and human cognition. Drawing on examples from animal behavior, comparative psychology, robotics, artificial life, developmental psychology, and cognitive science, Barrett provides remarkable new insights into how animals and humans depend on their bodies and environment – not just their brains – to behave intelligently. . . . Arguing that thinking and behavior constitute a property of the whole organism, not just the brain, Beyond the Brain illustrates how the body, brain, and cognition are tied to the wider world.

Psychiatry as Cognitive Neuroscience: Philosophical Perspectives edited by Matthew Broome and Lisa Bortolotti (Oxford University Press, 2009)

Psychiatry as Cognitive Neuroscience is a philosophical analysis of the role of neuroscience in the study of psychopathology. The book examines numerous cognitive neuroscientific methods, such as neuroimaging and the use of neuropsychological models, in the context of a variety of psychiatric disorders, including depression, schizophrenia, dependence syndrome, and personality disorders.

Psychiatry as Cognitive Neuroscience includes chapters on the nature of psychiatry as a science; the compatibility of the accounts of mental illness derived from neuroscience, information-processing, and folk psychology; the nature of mental illness; the impact of methods such as fMRI, neuropsychology, and neurochemistry, on psychiatry; the relationship between phenomenological accounts of mental illness and those provided by naturalistic explanations; the status of delusions and the continuity between delusions and ordinary beliefs; the interplay between clinical and empirical findings in psychopathology and issues in moral psychology and ethics.

Mindreaders: The Cognitive Basis of Theory of Mind by Ian Apperly (Psychology Press, 2010)

Theory of mind, or “mindreading” as it is termed in this book, is the ability to think about beliefs, desires, knowledge and intentions. It has been studied extensively by developmental and comparative psychologists and more recently by neuroscientists and cognitive psychologists. This book is the first to draw together these diverse findings in an account of the cognitive basis of “theory of mind”, and establishes the systematic study of these abilities in adults as a new field of enquiry. Apperly focuses on perceptions, knowledge and beliefs as paradigm cases of mindreading, and uses this as a basis from which more general lessons can be drawn. The book argues that an account of the cognitive basis of mindreading is necessary for making sense of findings from neuroscience and developmental and comparative psychology, as well as for understanding how mindreading fits more broadly into the cognitive system. It questions standard philosophical accounts of mindreading, and suggests a move away from the notion that it consists simply of having a “theory of mind”.

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.