Friday, March 22, 2019

#CNS2019



It's March, an odd-numbered year, must mean.... it's time for the Cognitive Neuroscience Society Annual Meeting to be in San Francisco!

I only started looking at the schedule yesterday and noticed the now-obligatory David Poeppel session on BIG stuff 1 on Saturday (March 23, 2019):

Special Session - The Relation Between Psychology and Neuroscience, David Poeppel, Organizer,  Grand Ballroom

Then I clicked on the link and saw a rare occurrence: an all-female slate of speakers!



Whether we study single cells, measure populations of neurons, characterize anatomical structure, or quantify BOLD, whether we collect reaction times or construct computational models, it is a presupposition of our field that we strive to bridge the neurosciences and the psychological/cognitive sciences. Our tools provide us with ever-greater spatial resolution and ideal temporal resolution. But do we have the right conceptual resolution? This conversation focuses on how we are doing with this challenge, whether we have examples of successful linking hypotheses between psychological and neurobiological accounts, whether we are missing important ideas or tools, and where we might go or should go, if all goes well. The conversation, in other words, examines the very core of cognitive neuroscience.

Also on the schedule tomorrow is the public lecture and keynote address by Matt Walker Why Sleep?
Can you recall the last time you woke up without an alarm clock feeling refreshed, not needing caffeine? If the answer is “no,” you are not alone. Two-thirds of adults fail to obtain the recommended 8 hours of nightly sleep. I doubt you are surprised by the answer to this question, but you may be surprised by the consequences. This talk will describe not only the good things that happen when you get sleep, but the alarmingly bad things that happen when you don’t get enough. The presentation will focus on the brain (learning, memory aging, Alzheimer’s disease, education), but further highlight disease-related consequences in the body (cancer, diabetes, cardiovascular disease). The take-home: sleep is the single most effective thing we can do to reset the health of our brains and bodies.

Why sleep, indeed.

Meanwhile, Foals are playing tonight at The Fox Theater in Oakland. Tickets are still available.




view video on YouTube.


Footnote

1 See these posts:

The Big Ideas in Cognitive Neuroscience, Explained #CNS2017

Big Theory, Big Data, and Big Worries in Cognitive Neuroscience #CNS2018

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Tuesday, February 19, 2019

Depth Electrodes or Digital Biomarkers? The future of mood monitoring


Mood Monitoring via Invasive Brain Recordings or Smartphone Swipes

Which Would You Choose?


That's not really a fair question. The ultimate goal of invasive recordings is one of direct intervention, by delivering targeted brain stimulation as a treatment. But first you have to establish a firm relationship between neural activity and mood. Well, um, smartphone swipes (the way you interact with your phone) aim to establish a firm relationship between your “digital phenotype” and your mood. And then refer you to an app for a precision intervention. Or to your therapist / psychiatrist, who has to buy into use of the digital phenotyping software.

On the invasive side of the question, DARPA has invested heavily in deep brain stimulation (DBS) as a treatment for many disorders – Post-Traumatic Stress Disorder (PTSD), Major Depression, Borderline Personality Disorder, General Anxiety Disorder, Traumatic Brain Injury, Substance Abuse/Addiction, Fibromyalgia/Chronic Pain, and memory loss. None of the work has led to effective treatments (yet?), but the DARPA research model has established large centers of collaborating scientists who record from the brains of epilepsy patients. And a lot of very impressive papers have emerged – some promising, others not so much.

One recent study (Kirkby et al., 2018) used machine learning to discover brain networks that encode variations in self-reported mood. The metric was coherence between amygdala and hippocampal activity in the β-frequency (13-30 Hz). I can't do justice to their work in the context of this post, but I'll let the authors' graphical abstract speak for itself (and leave questions like, why did it only work in 13 out of 21 of your participants? for later).




Mindstrong

Then along comes a startup tech company called Mindstrong, whose Co-Founder and President is none other than Dr. Thomas Insel, former director of NIMH, and one of the chief architects1 of the Research Domain Criteria (RDoC), “a research framework for new approaches to investigating mental disorders” that eschews the DSM-5 diagnostic bible. The Appendix chronicles the timeline of Dr. Insel's evolution from “mindless” RDoC champion to “brainless” wearables/smartphone tech proselytizer.2


From Wired:
. . .

At Mindstrong, one of the first tests of the [“digital phenotype”] concept will be a study of how 600 people use their mobile phones, attempting to correlate keyboard use patterns with outcomes like depression, psychosis, or mania. “The complication is developing the behavioral features that are actionable and informative,” Insel says. “Looking at speed, looking at latency or keystrokes, looking at error—all of those kinds of things could prove to be interesting.”

Curiously, in their list of digital biomarkers, they differentiate between executive function and cognitive control — although their definitions were overlapping (see my previous post, Is executive function different from cognitive control? The results of an informal poll).
Mindstrong tracks five digital biomarkers associated with brain health: Executive function, cognitive control, working memory, processing speed, and emotional valence. These biomarkers are generated from patterns in smartphone use such as swipes, taps, and other touchscreen activities, and are scientifically validated to provide measurements of cognition and mood.

Whither RDoC?

NIMH established a mandate requiring that all clinical trials should postulate a neural circuit “mechanism” that would be responsible for any efficacious response. Thus, clinical investigators were forced to make up simplistic biological explanations for their psychosocial interventions:

“I hypothesize that the circuit mechanism for my elaborate new psychotherapy protocol which eliminates fear memories (e.g., specific phobias, PTSD) is implemented by down-regulation of amygdala activity while participants view pictures of fearful faces using the Hariri task.”



[a fictitious example]


I'm including a substantial portion of the February 27, 2014 text here because it's important.
NIMH is making three important changes to how we will fund clinical trials.

First, future trials will follow an experimental medicine approach in which interventions serve not only as potential treatments, but as probes to generate information about the mechanisms underlying a disorder. Trial proposals will need to identify a target or mediator; a positive result will require not only that an intervention ameliorated a symptom, but that it had a demonstrable effect on a target, such as a neural pathway implicated in the disorder or a key cognitive operation. While experimental medicine has become an accepted approach for drug development, we believe it is equally important for the development of psychosocial treatments. It offers us a way to understand the mechanisms by which these treatments are leading to clinical change.

OK, so the target could be a key cognitive operation. But let's say your intervention is a Housing First initiative in homeless individuals with severe mental illness and co-morbid substance abuse. Your manipulation is to compare quality of life outcomes for Housing First with Assertive Community Treatment vs. Congregate Housing with on-site supports vs. treatment as usual. What is the key cognitive operation here? Fortunately, this project was funded by the Canadian government and did not need to compete for NIMH funding.

I think my ultimate issue is one of fundamental fairness. Is it OK to skate away from the wreckage and profit by making millions of dollars? From Wired:
“I spent 13 years at NIMH really pushing on the neuroscience and genetics of mental disorders, and when I look back on that I realize that while I think I succeeded at getting lots of really cool papers published by cool scientists at fairly large costs—I think $20 billion—I don’t think we moved the needle in reducing suicide, reducing hospitalizations, improving recovery for the tens of millions of people who have mental illness,” Insel says. “I hold myself accountable for that.”

But how? You've admitted to spending $20 billion on cool projects and cool papers and cool scientists who do basic research. This has great value. But the big mistakes were an unrealistic promise of treatments and cures, and the charade of forcing scientists who study C. elegans to explain how they're going to cure psychiatric disorders.


Footnotes

1 Dr. Bruce Cuthbert was especially instrumental, as well as a large panel of experts. But since this post is about digital biomarkers, the former director of NIMH is the focus of RDoC here.

2 The Insel archives of the late Dr. Mickey Nardo in his prolific blog, 1boringoldman.com, are a must-read. I also wish the late Dr. Barney Carroll was still here to issue his trenchant remarks and trademark witticisms.


Reference

Kirkby LA, Luongo FJ, Lee MB, Nahum M, Van Vleet TM, Rao VR, Dawes HE, Chang EF, Sohal VS. (2018). An Amygdala-Hippocampus Subnetwork that Encodes Variation in Human Mood. Cell 175(6):1688-1700.e14.


Additional Reading - Digital Phenotyping

Jain SH, Powers BW, Hawkins JB, Brownstein JS. (2015). The digital phenotype. Nat Biotechnol. 33(5):462-3. [usage of the term here means data mining of content such as Twitter and Google searches, rather than physical interactions with a smartphone]

Insel TR. (2017). Digital Phenotyping: Technology for a New Science of Behavior. JAMA 318(13):1215-1216. [smartphone swipes, NOT content:Who would have believed that patterns of typing and scrolling could reveal individual fingerprints of performance, capturing our neurocognitive function continuously in the real world?”]

Insel TR. (2017). Join the disruptors of health science. Nature 551(7678):23-26. [conversion to the SF Bay Area/Silicon Valley mindset]. Key quote:
“But what struck me most on moving from the Beltway to the Bay Area was that, unlike pharma and biotech, tech companies enter biomedical and health research with a pedigree of software research and development, and a confident, even cocky, spirit of disruption and innovation. They have grown by learning how to move quickly from concept to execution. Software development may generate a minimally viable product within weeks. That product can be refined through ‘dogfooding’ (testing it on a few hundred employees, families or friends) in a month, then released to thousands of users for rapid iterative improvement.”
[is ‘dogfooding’ a real term?? if that's how you're going to test technology designed to help people with severe mental illnesses — without the input of the consumers themselves — YOU WILL BE DOOMED TO FAILURE.]

Philip P, De-Sevin E, Micoulaud-Franchi JA. (2018). Technology as a Tool for Mental Disorders. JAMA 319(5):504.

Insel TR. (2018). Technology as a Tool for Mental Disorders-Reply. JAMA  319(5):504.

Insel TR. (2018). Digital phenotyping: a global tool for psychiatry. World Psychiatry 17(3):276-277.


Appendix - a selective history of RDoC publications























Post-NIMH Transition (articles start appearing less than a month later) 








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Saturday, February 02, 2019

Is executive function different from cognitive control? The results of an informal poll

It ended in a tie!




Granted, this is a small and biased sample, and I don't have a large number of followers. The answers might have been different had @russpoldrack (Yes in a landslide) or @Neuro_Skeptic (n=12,458 plus 598 wacky write-in votes) posed the question.

Before the poll I facetiously asked:
Other hypothetical questions (that you don't need to answer) might include:
  • Are you a clinical neuropsychologist? 
  • Do you use computational modeling in your work?1
  • What is your age?
Here, I was thinking:
  • Clinical neuropsychologists would say No
  • Computational researchers would say Yes
  • On average, older people would be more likely to say No than younger people

After the poll I asked, “So what ARE the differences between executive function and cognitive control? Or are the terms arbitrary, and their usage a matter of context / subfield?”

No one wanted to expound on the differences between the terms.2
I answered No, because I think the terms are arbitrary, and their usage a matter of context and subfield. Not that Wikipedia is the ultimate authority, but I was amused to see this:

Executive functions

From Wikipedia, the free encyclopedia
  (Redirected from Cognitive control)
Executive functions (collectively referred to as executive function and cognitive control) are a set of cognitive processes that are necessary for the cognitive control of behavior: selecting and successfully monitoring behaviors that facilitate the attainment of chosen goals. Executive functions include basic cognitive processes such as attentional control, cognitive inhibition, inhibitory control, working memory, and cognitive flexibility

Nature said this:

Cognitive control

Cognitive control is the process by which goals or plans influence behaviour. Also called executive control, this process can inhibit automatic responses and influence working memory. Cognitive control supports flexible, adaptive responses and complex goal-directed thought. Some disorders, such as schizophrenia and ADHD, are associated with impairments of executive function.

They're using the terms interchangeably! The terms cognitive control, executive control, executive function, and executive control functions are not well-differentiated, except in specific contexts. For instance, the Carter Lab definition below sounds specific at first, but then branches out to encompass many “executive functions” not named as such.

Cognitive Control

"Cognitive control" is a construct from contemporary cognitive neuroscience that refers to processes that allow information processing and behavior to vary adaptively from moment to moment depending on current goals, rather than remaining rigid and inflexible. Cognitive control processes include a broad class of mental operations including goal or context representation and maintenance, and strategic processes such as attention allocation and stimulus-response mapping. Cognitive control is associated with a wide range of processes and is not restricted to a particular cognitive domain. For example, the presence of impairments in cognitive control functions may be associated with specific deficits in attention, memory, language comprehension and emotional processing. ...

Actually, the term Cognitive Control dates back to the 1920s, if not further. Two quick examples.

(1) When talking about Charles Spearman and his theory of intelligence and his three qualitative principles, Charles S. Slocombe (1928) said:
“To these he adds five quantitative principles, cognitive control (attention), fatigue, retentivity, constancy of output, and primordial potency...”
Simple! Cognitive Control = Attention.

(2) Frederick Anderson (1942), in The Relational Theory of Mind:
“Meanings, then, are mental processes which, although not themselves objects for consciousness, actively modify and characterize that of which we are for the moment conscious. They differ from other subconscious processes in this respect, that we have cognitive control over them and can at any moment bring them to light if we choose.”
Cognitive Control = having the capacity of “bringing things into consciousness” — is this different from attention, or “paying attention” to something by making it the focus of awareness?


Moving into the 21st century, two of the quintessential contemporary cognitive control papers that [mostly] banish executives from their midst are:

Miller and Cohen (2001):
“The prefrontal cortex has long been suspected to play an important role in cognitive control, in the ability to orchestrate thought and action in accordance with internal goals.”

Botvinick et al. (2001):
“A remarkable feature of the human cognitive system is its ability to configure itself for the performance of specific tasks through appropriate adjustments in perceptual selection, response biasing, and the on-line maintenance of contextual information. The processes behind such adaptability, referred to collectively as cognitive control, have been the focus of a growing research program within cognitive psychology.”

I originally approached this topic during research for a future post on Mindstrong and their “digital phenotyping” technology. Two of their five biomarkers are Executive Function and Cognitive Control. How do they differ? There's an awful lot of overlap, as we'll see in a future post.


Footnotes

1 Another fun (and related) determinant might be, “does your work focus on the dorsal anterior cingulate cortex? In which case, the respondent would answer Yes.

2 except for one deliberately obfuscatory response.


References

Anderson F. (1942). The Relational Theory of Mind. The Journal of Philosophy 39(10):253-60.

Botvinick MM, Braver TS, Barch DM, Carter CS, Cohen JD. (2001). Conflict monitoring and cognitive control. Psychol Rev. 108(3):624-52.

Miller EK, Cohen JD. (2001). An integrative theory of prefrontal cortex function. Annual Rev Neurosci. 2001;24:167-202.

Slocombe CS. (1928). Of mental testing—a pragmatic theory. Journal of Educational Psychology 19(1):1-24.


Appendix

Many, many articles use the terms interchangeably. I won't single out anyone in particular. Instead, here is a valiant attempt by Nigg (2017) to make a slight differentiation between them in a review paper entitled:
On the relations among self-regulation, self-control, executive functioning, effortful control, cognitive control, impulsivity, risk-taking, and inhibition for developmental psychopathology.
But in the end he concludes, “Executive functioning, effortful control, and cognitive control are closely related.”

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Sunday, January 27, 2019

Unlucky Thirteen



Today is the 13th anniversary of this blog. I wanted to write a sharp and subversive post.1 Or at least compose a series of self-deprecating witticisms about persisting this long. Alas, it has been an extremely  difficult year.

Instead, I drew inspiration from Twitter (@neuroecology) and a blogger who's been at it even longer than I (@DoctorZen). Very warily I might add, because I knew the results would not be flattering or pretty.

Behold my scores on the “Big Five” personality traits (and weep). Some of the extremes are partly situational, and that's why I'm presenting these traits separately. Sure, negative emotionality is a relative fixed part of my personality, but the 100% scores on depression and anxiety are influenced by grief (due to the loss of my spouse of 12 years). Personality psychologists would turn this around and say that someone high in trait negative emotionality (formerly known as the more disparaging “neuroticism”) would be predisposed to depression and anxiety.




Another fun trait score is shown below. This one might be even sadder. Yeah, I'm introverted, but people in my situation often tend to withdraw from friends, family, and society.2 Again, reverse the causality if you wish, but social isolation is not an uncommon response.





But hey, I am pretty conscientious, as you can see from my overall test results on the Big Five. You too can take the test HERE.




I'll have something more interesting for you next time.



Footnotes

1 Why? To prove to myself that I can still do it? To impress the dwindling number of readers? To show how the blog has not exceeded its expiry date it still has relevance in its own modest and quirky way.

2 Hey, I actually had two social engagements this weekend! My lack of assertiveness is disturbing, however. But I absolutely do not want to take the lead on anything right now.




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Monday, January 21, 2019

What Can Brain Imaging Tell Us About Violent Extremism?


Before answering that question, I'll tell you about an incredibly impressive ethnographic study and field survey. For a one year period, the investigators (Pretus, Hamid et al., 2018) conducted field work within the community of young Moroccan men in Barcelona, Spain. As the authors explain, the Moroccan diaspora is an immigrant community susceptible to jihadist forms of radicalization:
Spain hosts Europe’s second largest Moroccan diaspora community (after France) and its least integrated, whereas Catalonia hosts the largest and least integrated Moroccan community in Spain. Barcelona ... was most recently the site of a mass killing ... by a group of young Moroccan men pledging support for the Islamic State. According to a recent Europol’s latest annual report on terrorism trends, Spain had the second highest number of jihadist terrorism-related arrests in Europe (second only to France) in 2016...

After months of observation in selected neighborhoods, the researchers approached prospective participants about completing a survey, with the assurance of absolute anonymity. No names were exchanged, and informed consent procedures were performed orally, to prevent any written record of participation. The very large sample included 535 respondents (average age 23.47 years, range 18–42), who were all Sunni Muslim Moroccan men.

The goal of the study was to look at sacred values in these participants, and whether these values might affect their willingness to engage in violent extremism. “Sacred values are immune or resistant to material tradeoffs and are associated with deontic (duty-bound) reasoning...” (Pretus, Hamid et al., 2018). The term sacred values doesn't necessarily refer to religious beliefs. One of the most common is the basic human value, “it is wrong to kill another human being.” But theoretically speaking, we could include statements such as, “it is wrong to kill endangered species for sport (or for any other reason).”

In this study, Sacred Values included:
  • Palestinian right of return
  • Western military forces being expelled from all Muslim lands
  • Strict sharia as the rule of law in all Muslim countries
  • Armed jihad being waged against enemies of Muslims
  • Forbidding of caricatures of Prophet Mohammed
  • Veiling of women in public

What were the Nonsacred Values? We don't know. I couldn't find examples anywhere in the paper. It's crucial that we know what these were, to help understand the “sacralization” of nonsacred values, which was observed in an fMRI experiment (described later). So I turned to the Supplemental Material of Berns et al. (2012), inferring that the statements below are good examples of nonsacred values in a population of adults in Atlanta.
  • You are a dog person.
  • You are a cat person.
  • You are a Pepsi drinker.
  • You are a Coke drinker.
  • You believe that Target is superior to Walmart.
  • You believe that Walmart is superior to Target.

But what if the nonsacred values in the present study of violent extremism were a little more contentious and meaningful?
  • You are a fan of FC Barcelona.
  • You are a fan of AC Milan.

Anyway, to choose participants for the fMRI experiment, the investigators first divided the entire group into those who were more (n=267) or less (n=268) vulnerable to recruitment into violent extremism (see Appendix for details). An important comparison would have been to directly contrast brain activity in these two groups, but that wasn't done here. Out of the 267 men more vulnerable to violent extremism, 38 agreed to participate in the fMRI study. These 38 were more likely to Endorse Militant Jihadism (score 4.24 out of 7) than the general fMRI pool (3.35) and the non-fMRI pool (2.43).1 

A battery of six sacred and six nonsacred values was constructed individually for each person and presented in the scanner, along with a number of grammatical variants, for a list of 50 different items per condition. The 38 participants were randomly assigned to one of two manipulations in a between-subjects design: exclusion (n=19) and inclusion (n=19) in the ever-popular ball-tossing video game of Cyberball. [PDF]2



Unfortunately, this reduced the study's statistical power. Nonetheless, a major goal of the experiment was to examine how social exclusion affects the processing of sacred values. I don't know if Cyberball studies are ever conducted in a within-subjects design (perhaps with an intervening task), or if exposure to one of the two conditions is too “contaminating”. At any rate, in real life, discrimination against Muslim immigrants is isolating and causes exclusion from social and economic benefits. Feelings of marginalization can result in greater radicalization and support for (and participation in) extremist groups. At this point in time, I don't think neuroimaging can add to the extensive knowledge gained from years of field work.

Nevertheless, the investigators wanted to extend the findings of Berns et al. (2012) to a very different population. The earlier study wanted to determine whether sacred values are processed in a deontological way (based on strict rules of right and wrong) or in a utilitarian fashion (based on cost/benefit analysis of outcome). As interpreted by those authors, processing sacred values was associated with increased activation of left temporoparietal junction (semantic storage) and left ventrolateral prefrontal cortex (semantic retrieval). Berns et al. suggested that “sacred values affect behaviour through the retrieval and processing of deontic rules and not through a utilitarian evaluation of costs and benefits.” Based on those results, the obvious prediction in the present study is that sacred values should activate left temporoparietal junction (L TPJ) and left ventrolateral prefrontal cortex (L VLPFC).


Fig. 3A (Pretus, Hamid et al., 2018).


Fig. 3A shows that only the latter half of that prediction was observed, and there was no explanation for the lack of activation in L TPJ. Instead, there was a finding in R TPJ in the excluded group which I won't discuss further.

Of note, the excluded participants rated themselves as being more likely to fight and die for nonsacred values, compared to the included participants. This was termed “sacralization” and now you can see why it's so important to know the nonsacred values. Are we talking about fighting and dying for Pepsi vs. Coke? For FC Barcelona vs. AC Milan? Not to be glib, but this would help us understand why social exclusion (in an artificial experimental setting) would radicalize these participants (in an artificial experimental setting).



Fig. 3B (Pretus, Hamid et al., 2018). Nonsacred values activate Left Inferior Frontal Gyrus (IFG, aka VLPFC) in the excluded group, but not in the included group. This was interpreted as a neural correlate of “sacralization”.


Another interpretation of Fig. 3B is that the exclusion manipulation was distracting, making it more difficult for these participants to process stimuli expressing nonsacred values (due to increased encoding demands, syntactic processing, etc.). Exclusion increased emotional intensity ratings, and decreased feelings of belongingness and being in control. This distraction could have carried over to the task of rating one's willingness to fight and die in defense of values.

Even if we say the brain imaging results weren't especially informative, the extensive ethnographic study and field surveys were a highly valuable source of data on a marginalized group of young Muslim men at risk of recruitment by violent extremist groups. It's a vicious cycle: terrorist attacks result in greater discrimination and persecution of innocent Muslim men, which has the unintended effect of further radicalization in some of the most vulnerable individuals. To conclude, I acknowledge that my comments may be out of turn because I have no authority or expertise, and because I'm from a country with an appalling record of discriminating against Muslims.


Footnotes

1 I was a bit confused by some of these scores, because they changed from one paragraph to the next, and differed from what was in Table 1. Perhaps one was a composite score, and the other from an individual questionnaire.

2 I've written extensively about whether Cyberball is a valid proxy for social exclusion, but I won't get into that here.


References

Berns GS, Bell E, Capra CM, Prietula MJ, Moore S, Anderson B, Ginges J, Atran S. (2012). The price of your soul: neural evidence for the non-utilitarian representation of sacred values. Philos Trans R Soc Lond B Biol Sci. 367(1589):754-62.

Pretus C, Hamid N, Sheikh H, Ginges J, Tobeña A, Davis R, Vilarroya O, Atran S. (2018). Neural and Behavioral Correlates of Sacred Values and Vulnerability to Violent Extremism. Front Psychol. 9:2462.


Appendix


Modified from Table 1 (Pretus, Hamid et al., 2018).

[The] measures included (1) a modified inventory on general radicalization (support for violence as a political tactic) based on a prior longitudinal study on violent extremist attitudes among Swiss adolescents (Nivette et al., 2017); (2) a scale on personal grievances and previously used on imprisoned Islamist militants in the Philippines, and Tamil Tigers in Sri Lanka (Webber et al., 2018); (3) a scale on collective narcissism which has been shown to shape in-group authoritarian identity and support for military aggression against outgroups (de Zavala et al., 2009); (4) a self-report delinquency inventory adapted from Elliott et al. (1985), based on the disproportionate number of Muslim European delinquents who join jihadist terrorist groups (Basra and Neumann, 2016); and (5) a series of items assessing endorsement of militant jihadism (“The fighting of the Taliban, Al Qaida, ISIS is justified,” “The means of jihadist groups are justified,” “Attacks against Western nations by jihadist groups are justified,” “Attacks against Muslim nations by jihadist groups are justified,” “Attacks against civilians by jihadist groups are justified,” “Spreading Islam using force is every part of the world is an act of justifiable jihad,” and “A Caliphate must be resurrected even by force”) that we combined into a reliable composite score, “Endorsement of Militant Jihadism”...

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Monday, December 31, 2018

2018 Was a Year to Forget. Really.

Our memory for the details of real-life events is poor, according to a recent study.

Seven MIT students took a one hour walk through Cambridge, MA. A day later, they were presented with one second video clips they may or may not have seen during their walk (the “foils” were taken from another person's recording). Mean recognition accuracy was 55.7%, barely better than guessing.1


Minimal recognition memory for detailed events. Dashed line is chance performance. Adapted from Fig. 2 of
Misra et al. (2018).


How did the researchers capture the details of what was seen during each person's stroll about town (2.1 miles / 3.5 km)? They were fitted with eye tracking glasses to follow their eye movements (because you can't remember what you don't see), and a GoPro camera was mounted on a helmet.


from Fig. 1 (Misra et al., 2018).


One problem with this setup, however, was that the eye tracking data had to be excluded. The overwhelmingly bright summer sun prevented the eye tracker from obtaining accurate images of the pupil. Thus, Experiment 2 was performed inside the Boston Museum of Fine Arts with a separate group of 10 students.


from Fig. 1 (Misra et al., 2018).


Recognition performance was better in Experiment 2. Mean accuracy was 63.2% well above chance (p=.0005) but still not great. Participants correctly identified clips they had seen 59% of the time, and correctly rejected clips they hadn't seen 67% of the time. One participant (#4) was really good, and you'll notice the individual differences below.

Dashed line is chance performance. Adapted from Fig. 2 of Misra et al. (2018).


In Exp. 2, the investigators were able to look at the influence of eye fixations on memory performance. Not surprisingly, people were better at remembering what they looked at (fixated on), but this only held for certain categories of items: talking people, objects rated as “distinctive” (but not distinctive faces), and paintings (but not sculptures).




How do the authors interpret this finding? We don't necessarily pay attention to everything we look at.
“What subjects fixated on also correlated with performance (Fig. 4), but it is clear that subjects did not remember everything that they laid eyes on. There is extensive literature showing that subjects may not pay attention or be conscious of what they are fixating on. Therefore, it is quite likely that, in several instances, subjects may have fixated on an object without necessarily paying attention to that object. Additionally, attention is correlated with the encoding of events into memory. Thus, the current results are consistent with the notion that eye fixations correlate with episodic memory but they are neither necessary nor sufficient for successful episodic memory formation.”

For me personally, 2018 was a year to forget.2 Yet, certain tragic images are etched into my mind, cropping up at inopportune times to traumatize me all over again. That's a very different topic for another time and place.


May your 2019 brighten the sky.


The number 2019 is written in the air with a sparkler near a tourist camp outside Krasnoyarsk, Russia, on January 1, 2019. (The Atlantic)


Footnotes

1 However:
“Two subjects from Experiment I were excluded from the analyses. One of these subjects had a score of 96%, which was well above the performance of any of the other subjects (Figure 2). The weather conditions on the day of the walk for this subject were substantially different, and this subject could thus easily recognize his own video clips purely from assessing the weather conditions. Another subject was excluded 260 because he responded 'yes' >90% of the trials.”

2 See:

I should have done this by now...

The Lie of Precision Medicine

Derealization / Dying

There Is a Giant Hole Where My Heart Used To Be

How to Reconstruct Your Life After a Major Loss


Reference

Misra P, Marconi A, Peterson M, Kreiman G. (2018). Minimal memory for details in real life events. Sci Rep. 8(1):16701.




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Sunday, December 23, 2018

Folie à deux and Homicide for the Holidays



Nothing says home for the holidays like a series of murders committed by family members with a shared delusion. So sit back, sip your hot apple cider or spiked egg nog, and revel in family dysfunction worse than your own.

{Well! There is an actual TV show called Homicide for the Holidays, which I did not know. Kind of makes my title seem derivative... but it was coincidental.}


“Folie à deux”, or Shared Psychotic Disorder, was a diagnosis in DSM-IV-TR:

(A) A delusion develops in an individual in the context of a close relationship with another person(s), who has an already-established delusion. 

(B) The delusion is similar in content to that of the person who already has the established delusion. 

(C) The disturbance is not better accounted for by another Psychotic Disorder (e.g., Schizophrenia) or a Mood Disorder With Psychotic Features and is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.

Folie à deux occurs in the secondary partner, who shares a delusion with the primary partner (diagnosed with schizophrenia, delusional disorder, or psychotic depression). In in DSM-5, folie à deux no longer exists as a specific disorder. Instead, the secondary partner is given a diagnosis of “other specified schizophrenia spectrum and other psychotic disorder” with a specifier: “delusional symptoms in the partner of individual with delusional disorder” (APA, 2013).

The first cases were reported in the 19th century by the French psychiatrists Baillarger (1860) and Lasègue & Falret (1877). The latter authors note that insanity isn't contagious, but under special circumstances...
a) In the “folie à deux” one individual is the active element; being more intelligent than the other he creates the delusion and gradually imposes it upon the second one who is the passive element. At the beginning the latter resists but later, little by little, he suffers the pressure of his associate, although at the some degree he also reacts and influences the former to correct, modify, and coordinate the delusion that then becomes their common delusion, to be repeated to all in an almost identical fashion and with the same words.
The two individuals are in a close relationship and typically live in an isolated environment.

A recent paper by Guivarch et al. (2018) covered the history of the disorder, and performed a literature review on folie à deux and homicide. They found 17 articles:
In the cases examined, homicides were committed with great violence, usually against a victim in the family circle, and were sometimes followed by suicide. The main risk factor for homicide was the combination of mystical and persecutory delusions. The homicides occurred in response to destabilization of the delusional dyads.

Body mutilation is not uncommon: “These features appear in the reported case of a mother who was delusional and killed her young son by hitting him on the head 3 times with a hatchet.”

The authors presented a detailed history of induced psychosis involving Mr. A (the secondary) and Mrs. A (the primary, who had a family history of delusion). Shortly after getting married, they had a child who was removed by social services due to inadequate parenting.
Subsequently, the couple engaged in several years of delusional wandering in France and Italy, traveling from village to village to accomplish “a divine mission”, during which time they were hosted in monasteries or abbeys. They expressed delusional feelings but never visited a psychiatrist and were never confronted by the police. The couple's relationship transformed; the partners stopped having sexual relations and quickly established a delusional hierarchical relation, with Mrs. A being called “Your Majesty” and Mr. A considering himself “King of Australia, Secretary of Her Majesty”.

After about 20 years of this, in a fit of overkill, Mr. A murdered a random 11 year old child by inflicting 44 stab wounds. Earlier, he had felt humiliated and persecuted at a police check point, which provoked an “incident.” The murder of the child was part of their delusional divine mission, to make a necessary sacrifice that would restore balance.


Paranoia of the exalted type in a setting of folie à deux

The famous case of Pauline P (“a dark, rather sulky looking but not unattractive girl of stocky build”) and Juliet H (“a tall, willowy, frail, attractive blonde with large blue eyes”) was also mentioned (Medlicott, 1955). The two girls established a very close bond, constructed an elaborate make-believe world of fictional characters, withdrew from all others, became sexually involved, and developed a superiority complex. They killed Pauline's mother “because one of the girls was going to move with her parents, which would have led to the separation of the delusional dyad (Medlicott, 1955).” This formed the basis of the fantastic 1994 film, Heavenly Creatures, featuring Melanie Lynskey and Kate Winslet.




Granted, their indissoluble bond was pathological, but laughable 1955 views of same-sex relationships were on display in this analysis:
There is of course no doubt that the relationship between these two girls was basically homosexual in nature. Pauline made attempts in 1953 of establishing heterosexual relationships, but in spite of intercourse on one occasion there was no evidence of real erotic involvement. All her escapades were fully discussed with Juliet which is a common feature amongst people basically homosexual in orientation.

Yes, we can generalize and say that all teenage girls in the 1950s commonly bragged about their heterosexual exploits with their lesbian lovers.

From Pauline's 1953 diary:
“To-day Juliet and I found the key to the 4th World.  ... We have an extra part of our brain which can appreciate the 4th World. Only about 10 people have it. When we die we will go to the 4th World, but meanwhile on two days every year we may use the key and look in to that beautiful world which we have been lucky enough to be allowed to know of, on this Day of Finding the Key to the Way through the Clouds.”

Your family gatherings may not always be harmonious, but presumably your delusional children are not plotting to kill you. Happy Holidays.





References

Baillarger J. (1860). Quelques exemples de folie communiquée. Gazette Des Hôpitaux Civils et Militaires 38: 149-151.

Guivarch J, Piercecchi-Marti MD, Poinso F. (2018). Folie à deux and homicide: Literature review and study of a complex clinical case. International Journal of Law and Psychiatry 61:30-39.

Lasègue C, Falret J. (1877). La folie à deux (ou folie communiquée). Annales Médico Psychologiques 18: 321-355. English translation (Dialogues in Philosophy, Mental and Neuro Sciences, December 2016).

Medlicott R. (1955). Paranoia of the exalted type in a setting of folie à deux; a study of two adolescent homicides. The British journal of medical psychology 28:205-223.

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