Raising An Issue in Indian Psychology

A recent literature search threw up an interesting-looking paper; a randomised controlled trial (RCT) on the effect of yoga on gunas (personality) in healthy volunteers (free to read). I was surprised as I rarely come across academic papers on yoga, that too with explicit reference to 'gunas' in the title. . I couldn’t help noticing at the outset that the study appeared to have been carried out at the Department of Yoga Research, Swami Vivekananda Anusandhana Samsthana, a deemed-to-be yoga university. The study was also published in the International Journal of Yoga, which appears to be the university’s own journal publication. So there is plenty of scope for bias to creep in.

Despite that RCTs are the 'gold standard' of psychological research when done properly, the stated aims of this paper didn't exactly fill me with confidence. The study itself wasn't what interested me, but rather one of the tools that the researchers used to assess the participants' personalities. In psychology, personality is assessed using specific scales or questionnaires that have been designed to measure a particular construct, say, anxiety or depression. The Beck Depression Inventory is probably the best known and widely used example of a scale to measure depression, and you can find information about other scales at Wikipedia.

An important concept in the construction of such scales is known as construct validity, the ability of the scale to measure what it is supposed to measure. Using the BDI as an example, can it be that a set of questions is capable of measuring the presence and intensity of depression in a person? All other things being equal, the answer is that it is probably the most reliable tool we have for measuring depression at the moment and that it has been consistently used in a number of different medical fields. Much research has been done in the field of personality psychology in an attempt to construct a real-term workable scale with which to assess personality. Many scales exist, but generally speaking researchers have come to agree that personality can be defined in terms of the "Big 5" factors: Neuroticism, Extraversion, Agreeableness, Conscientiousness and Psychopathy, and that all of our personalities can be measured in different ratings of these. The Reliability of such scales is another important issue that also means something different to the popular sense of the word, and we'll get to that at some point.

For this study the research team wanted to analyse the effects of a yoga course on personality and self-esteem, and they measured these with Karunanidhi's Self-Esteem Inventory (1996) and, wait for it, the Gita Inventory of Personality (Das, 1991). According to this paper, the GIP (referred to as GIN within the paper) was to measure three dimensions of personality: Sattva, Rajas and Tamas.

There is reason to suspect that, at least in the case of the GIP, something mischievous is afoot in the name of psychology. The Gita referred to is of course the Bhagavad-Gita, a Hindu scripture (traditionally believed to be 5000 years old), and the three personality dimensions being assessed are described in the 14th chapter of the text. I'm aware of issues of sensitivity surrounding cross-cultural research in psychology, the importance of accepting cultural boundaries, and so on. If you were to rely on Wikipedia, cross-cultural psychiatry (or transcultural psychiatry) is that which is "concerned with the cultural and ethnic context of mental disorders and psychiatric services".

I have to wonder, though, are cases like this something that ought to be a concern or to be praised? On one hand we have here a different outlook on personality that is independent of Western-oriented psychology, but on the other we have to wonder about the appropriateness of assessing people's individual personality traits on the basis of definitions provided in an antiquated religious text. Psychological research is frequently slighted or condemned (depending on who you listen to) as being overly WEIRD - analysing and assessing people that are dominantly Western, Educated, Industrialised, Rich, and Democratic, and that is a fair criticism in context. In general, the field is crying out for fresh perspectives.

However, it remains unclear if ethnically contextual research from the other end of the spectrum will be able to provide new insight into the field of personality psychology if little to no effort is made to work collegially, and using similar standards of measurement with which to assess people and carry out much needed research.

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Deshpande S., Nagendra H.R. & Nagarathna R. (2009). A randomized control trial of the effect of yoga on Gunas (personality) and Self esteem in normal healthy volunteers., International Journal of Yoga, 2 (1) 13-21. PMID: 21234210

Terminator Vision: I Can Haz It?

You've all seen The Terminator film and it's sequels and, admit it, you loved them. Not just because of the creepy futurealistic storyline but because of the stunts, the camerawork, the casting, and the sheer action of it all. And, of course, the special effects. As an example of the best sci-fi films out there, the Terminator films franchise has grossed nearly $1.5 billion worldwide. Some of the iconic scenes in the movies related directly to the Terminator itself, that ice-cold stare as a mistaken victim was brutally gunned down in pursuit of the target. But what was it about that scary stare? Surely it was the gleaming infrared light in the robotic eyeball that was shielded most of the time by the humanlike exterior. That infrared light enabled the Terminator itself to view its own surroundings:

Composite image. Credits: odysseyart.net and Orion Pictures

 In the emerging field of neuroprosthetics, the most well-known examples of the technology are cochlear implants for the deaf and retinal implants for the blind. Generally speaking, they work by receiving auditory and visual signals and then transmit them to the relevant brain areas after being transformed into electrical impulses. Obviously, these tools are extremely useful in restoring hearing/vision functions to those who weren't born with them or who have lost them due to injury. In some cases, depending on the nature and extent of the absence/injury, it may be necessary to augment rather than restore the functions fully.

Now a new study by researchers at Duke University suggests that 'Terminator Vision' could one day be a reality for some, after successful experiments on rats found increased learning and perception skills when prosthetics were fitted into their brains. Eric Thomsen, Rafael Carra and Miguel Nicolelis trained a cohort of six rats on a simple visual discrimination task: Rats were placed in a circular chamber that had three reward ports. On each trial, a visible LED was activated in a particular port and rats who poked their noses in the correct port were rewarded with a drink of water. After three weeks of training, the rats managed to be 70% correct on average. They were then fitted with an infrared detector as well as implants into the whisker region of the S1 cortex, a touch-sensitive area of the parietal lobe which is largely responsible for spatial navigation.

Bearing in mind that rats are normally blind to infrared light (as are we), it would be worth putting them back into the chamber to see if they could perform the task as well as before. As for how it works: The IR detector transmits electrical impulses directly into the rats' S1 cortex if the rat moved towards the infrared light, which were increased as the rats moved closer or oriented their heads in the light's direction. And here's where it gets interesting: Not only did the rats perform better on the task as before by finding the infrared lights with greater accuracy, but other interesting behaviour was noticed too. Namely, "they learned to actively forage through the behaviour chamber, sweeping the IR sensor on their heads back and forth to sample their IR world".

Read that again: They learned to incorporate their new IR vision relatively quickly into their normal sensory range as a type of "IR vision". And they did this by taking the time to re-orient themselves and make sense of their surroundings. They didn't immediately associate the new stimulation with the task but just assumed it was "something new" for them, scratching their faces in response to the electrical microstimulation. Isn't that awesome?!

It is possible that criticism of this study may cite 'training effects', that the rats had an idea of what to do in the experimental condition because of their previous training with the LED light. But this can be rebutted by how the rats learned to navigate their way with normally invisible infrared light purely by their movement and guidance, what to speak of more additional difficulty layers being added to the original task which were relatively aced by the rats (above 93%) in the IR condition.

In conclusion, the researchers felt that the rats learned to treat microstimulation as an external stimulus originating in the surrounding environment rather than within their body, which is an interesting finding that reflects the understanding of vision in humans too. Even though we have innate eyeballs that look 'out', vision occurs by light entering 'into' the eye. So even though the rats' brains were being stimulated in (correct) response to invisible infrared light, they appeared to act as if the light was shining at them in order to attract them. It was beyond the scope of this study, however, to determine if the rats thought of microstimulation as a separate sense, although the researchers suggest that a potential application of this technology could be in developing motor neuroprostheses - artificial(?) limbs that would be improved in terms of reaction times and accuracy because of the closed-loop bidirectional interaction that the technology can offer.

And of course, a plethora of possibilities that offer the curious possibility of sensory augmentation, the potential to expand sensory range to see forms of light that are normally invisible to human eyes. So it is entirely possible for Terminator Vision to emerge one day.

UPDATE Feb 13th: Coverage of this paper at Scientific American has fallen into the trap of describing the augmented vision as a "sixth sense", oddly proclaiming it as a seventh sense too. Minor but amusing errors.

UPDATE Feb 14th: Wow, now BBC coverage has also fallen into the "sixth sense" trap. Makes you wonder as to who has actually read the paper.

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Thomson E.E., Carra R. & Nicolelis M.A.L. (2013). Perceiving invisible light through a somatosensory cortical prosthesis, Nature Communications, 4 1482. DOI: 10.1038/ncomms2497

When a Man becomes a Woman

Interesting article in The Guardian the other day, about how virtual reality (VR) can be used in certian circumstances to change a male's sense of self into that of a woman's, the perceived experience being so powerful that the men reacted quite sharply (i.e. like a woman) to a slap. Patronising as that sounds, the state of mind does remain an interesting feature and it reminded me of a particular religious tradition that urges it's male adherents to emulate a type of female consciousness. Perhaps I may write more on this later, here's the article for now:

Virtual reality used to transfer men's minds into a woman's body

Researchers projected men's sense of self into a virtual reality woman, changing the way they behaved and thought

* Ian Sample
* guardian.co.uk, Wednesday 12 May 2010 22.00 BST

Scientists have transferred men's minds into a virtual woman's body in an experiment that could enlighten the prejudiced and shed light on how humans distinguish themselves from others.

In a study at Barcelona University, men donned a virtual reality (VR) headset that allowed them to see and hear the world as a female character. When they looked down they could even see their new body and clothes.

The "body-swapping" effect was so convincing that the men's sense of self was transferred into the virtual woman, causing them to react reflexively to events in the virtual world in which they were immersed.

Men who took part in the experiment reported feeling as though they occupied the woman's body and even gasped and flinched when she was slapped by another character in the virtual world.

"This work opens up another avenue for virtual reality, which is not just to transform your sense of place, but also your sense of self," said Mel Slater, a virtual reality researcher at the Catalan Institute of Research and Advanced Studies and University College London. "There isn't any other technology that allows you to look down and see another body that isn't yours and give you the illusion that it is," he said.

"If you can temporarily give people the illusion that their bodies are different, then the evidence suggests it also affects their behaviour and the way they think. They can have new experiences: a person who is thin can know what it's like to be fat. A man can have an experience of what it's like to be a woman."

In the study, 24 men took turns wearing a VR headset that immersed them in a virtual room. Some men saw the virtual environment through the eyes of a female character who was sitting down, while others had a viewpoint that was just to the side of her.

During the experiment, a second virtual female approached and appeared to rub the person's shoulder or arm. Researchers in the lab mimicked this sensation in the real world for some of the volunteers by rubbing their shoulder or arm, helping to reinforce their feeling of occupying the character's body.

Later in the study, the second character lashed out and slapped the face of the character the men were playing. "Their reaction was immediate," said Slater. "They would take in a quick breath and maybe move their head to one side. Some moved their whole bodies. The more people reported being in the girl's body, the stronger physical reaction they had."

Sensors on the men's bodies showed their heart rates fell sharply for a few seconds and then ramped up – a classic response to a perceived attack.

As expected, the body swapping effect was felt more keenly by men who saw their virtual world through the female character's eyes than those whose viewpoint was slightly to one side of her. In all cases, the feeling was temporary and lasted only as long as the study.

The study, which appears in the online science journal PLoS One, suggests that our minds have a very fluid picture of our bodies. The research is expected to shed light on the thorny neuroscientific puzzle of how our brain tells the difference between a part of our own body, and something else in the wider world.

The work might also improve rehabilitation for patients who have experienced strokes and other medical problems by immersing them in a world that helps them to use their bodies to the full again.

700-year-old Brain Found Preserved!

Evolutionary psychology tends to receive harsh criticism, and often rightly so. One of the main reasons for this is the severe lack of evidence for many of it's proposals given that the paucity of fossilised brains fails to bolster many a case. And it isn't even anyone's fault. That's just the way it goes sometimes, that the brain is a jelly-like substance that is subject to decay after death, and there's no way we can objectively analyse or verify any differences in brains of long ago with brains of today.

This isn't set to change anytime soon, but the remarkable discovery of a medieval child's brain was the subject of a Neuroimage paper published recently. This is extremely exciting on many counts: the brain has been so fantastically preserved that it is possible to identify the frontal, temporal and occipital lobes, and even the sulci and gyri, the grooves and furrows channeled into brains.



However it is only the left-hemisphere that survived and not the entire brain, which had also shrunk to about 80% of it's original weight due to the (natural) mummification process. Although it was first discovered in 1998 and preserved all this time in a formalin solution, it was found in the skull of a 13th Century infant that was exhumed at an archaeological dig in north-west France. The body of the 18-month-old child was wrapped in leather and kept in a wooden coffin with a pillow underneath the head.

The presence of acidic clay soil and fresh briny water around the burial site is believed to have contributed towards the excellent preservation of the brain. To a certain degree, even the innate cellular structure had been preserved, so much so that intact neurons and dendrites - branched fibres that extend from the cell body of a neuron - had survived for observation in the 21st Century. It was also possible to identify grey and white matter. Apart from the external burial conditions, the toughness of the neuronal myelin sheath and collagen fibres are said to be the reasons for why the brain tissue had been nicely preserved.

It cannot be said for sure how the infant died, but the presence of an unhealed circular head fracture may have been the likeliest cause. High levels of hemosiderin suggested that the infant had heavy bleeding for several days prior to death. Poor little mite.
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Papageorgopoulou, C., Rentsch, K., Raghavan, M., Hofmann, M., Colacicco, G., Gallien, V., Bianucci, R., & Rühli, F. (2010). Preservation of cell structures in a medieval infant brain: A paleohistological, paleogenetic, radiological and physico-chemical study NeuroImage, 50 (3), 893-901 DOI: 10.1016/j.neuroimage.2010.01.029

What is "Self Transcendence"?

A recent study by Italian researchers uncovered the fact that neurosurgery involving certain brain structures can effect personality changes that make one feel more "spiritual". 88 patients underwent pre- and post-surgical personality assessments while treated for tumours, and the results were combined with lesion mapping procedures (to precisely locate lesions) after surgery to measure changes in a personality construct called Self-Transcendence (ST). It was found that patients with posterior lesions experienced a considerable increase in 'spirituality' after the surgical removal of their tumours than those with anterior lesions, and that those with more aggressive types of tumour were most likely to describe themselves as religious. For a fuller report and discussion of this fascinating study, please see Mo Costandi's Neurophilosophy.

As I read through various articles detailing this announcement, I became intrigued at the constant mention of ST as a measure of personality. In his paper, Cosimo Urgesi describes ST as reflecting "the enduring tendency to transcend contingent sensorimotor representations and to identify the self as an integral part of the universe as a whole." ST is among several other personality dimensions in the psychobiological Temperament and Character Inventory (TCI) that was devised by C. R. Cloninger and colleagues in 1994. The TCI has been used in genetics to show ST as a heritable trait, and in molecular neurosciences to show ST related to the functioning of the serotoninergic system. According to Cloninger et al. (1993) their model followed on from previous research that confirmed four dimensions of temperament; novelty-seeking, harm avoidance, reward dependence, and persistence, and added three more dimensions that mature in adulthood; self-directedness, cooperativeness and self-transcendence.

In their discussion of ST, Cloninger et al. begin with the amusing sentence: "Most people meditate or pray daily, which is more frequent than sexual intercourse according to population surveys". They go on to note the lack of spirituality-related traits from personality inventories including the well-known Five Factor Model, which is odd considering that spirituality is an integral aspect of people's lives and mental activity. In describing their definition of spirituality, they say:

"Self-transcendence refers generally to identification with everything conceived as essential and consequential parts of a unified whole. This involves a state of 'unitive consciousness' in which everything is part of one totality. In unitive consciousness, there is no individual self because there is no meaningful distinction between self and other—the person is simply aware of being an integral part of the evolution of the cosmos. This unitive perspective may be described as acceptance, identification, or spiritual union with nature and its source ... The person may identify (or feel a sense of spiritual union) with anything or everything. They may experience the feeling that they are part of or being guided by a wonderful intelligence, which is possibly the divine source of all phenomena. Ultimately, there may be loss of all distinctions between self and other by identifying with the concept of an immanent God as one-in-all."

So it all sounds rather New-Agey (the paper mentions Buddhism and nirvana, Taoism and Advaita Vedanta), but I was still curious about the actual questions themselves. In formulating questions to measure personality dimensions, care is taken to ensure that they accurately represent the concepts they try to measure. Moreover, statistics such as Cronbach's Alpha are employed to ensure that the measure has a high level of internal consistency; the higher, the better it is at measuring a personality construct. In this context ST consisted of three sub-scales; Self-forgetfulness vs. self-consciousness, transpersonal identification, and spiritual acceptance vs. materialism, all three exhibiting a Cronbach Alpha of above 0.7. This indicates that each of the three sub-scales were reliable in excess of 70% in measuring what they claimed to measure.

PsychMaven kindly helped me aquire a copy of the TCI. Bearing in mind that the "questions" are actually statements that one ought to rate on a 5-point scale (1 = Definitely false, 5 = Definitely true), here is the complete list (in order of appearance) that purport to contribute to the ST dimension of personality:

12. I often feel a strong sense of unity with all the things around me.

25. Often I have unexpected flashes of insight or understanding while relaxing.

29. I sometimes feel so connected to nature that everything seems to be part of one living process.

32. I think that most things that are called miracles are just chance.

42. Sometimes I have felt like I was part of something with no limits or boundaries in time and space.

43. I sometimes feel a spiritual connection to other people that I cannot explain in words.

52. Sometimes I have felt my life was being directed by a spiritual force greater than any human being.

56. I have had moments of great joy in which I suddenly had a clear, deep feeling of oneness with all that exists.

68. I often become so fascinated with what I’m doing that I get lost in the moment – like I’m detached from time and place.

73. I often feel a strong spiritual or emotional connection with all the people around me.

91. I have made real personal sacrifices in order to make the world a better place – like trying to prevent war, poverty and injustice.

95. It often seems to other people like I am in another world because I am so completely unaware of things going on around me.

99.I often feel like I am a part of the spiritual force on which all life depends.

106. I have had personal experiences in which I felt in contact with a divine and wonderful spiritual power.

112. Often when I look at an ordinary thing, something wonderful happens – I get the feeling that I am seeing it fresh for the first time.

118. Religious experiences have helped me to understand the real purpose of my life.

143. I believe that all life depends on some spiritual order or power that cannot be completely explained.

148. I often feel so connected to the people around me that it is like there is no separation between us.

151. I am often called “absent-minded” because I get so wrapped up in what I am doing that I lose track of everything else.

157. I often do things to help protect animals and plants from extinction.

175. I have a vivid imagination.

190. I would gladly risk my own life to make the world a better place.

206. I think it is unwise to believe in things that cannot be explained scientifically.

212. Often I become so involved in what I am doing that I forget where I am for a while.

223. I have had experiences that made my role in life so clear to me that I felt very excited and happy.

232. Reports of mystical experiences are probably just wishful thinking.

It could be argued that statements such as these are anything but 'transcendent'. As Costandi eloquently put it in his report, Urgesi et al. fall short in their study of truly defining spirituality because it is likely that different patients will hold different ideas of spirituality and how it affects their lives. Furthermore, spirituality is an area that consists of many ideas apart from 'transcendence' which, by all accounts, is generally taken to refer to a state of being philosophically and affectively 'above and beyond' this world and all forms of mundane issues. Although many items deal with experiencing spiritual connections and having a sense of oneness with the universe, items that attempt to measure patients' attempts to save plants and animals from extinction hardly qualify as being transcendent and neither does gladly risking one's life for any purpose do the same. Having a "vivid imagination", however, is certainly a questionable inclusion which is bound to draw some sarcastic remarks.

We may quibble about the exactness of ST items and whether they accurately measure spirituality, the neurological findings nevertheless support the dependence of religious beliefs on brain function and even further increases evidence that religious beliefs can be experimentally studied. Urgesi et al. even go as far as to say that "dysfunctional parietal neural activity may underpin altered spiritual and religious attitudes and behaviours".
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Urgesi, C., Aglioti, S., Skrap, M., & Fabbro, F. (2010). The Spiritual Brain: Selective Cortical Lesions Modulate Human Self-Transcendence Neuron, 65 (3), 309-319 DOI: 10.1016/j.neuron.2010.01.026

Cloninger CR, Svrakic DM, & Przybeck TR (1993). A psychobiological model of temperament and character. Archives of General Psychiatry, 50 (12), 975-90 PMID: 8250684

Mr. Crowley's Suicide Solution

Wine is fine,
But whiskey's quicker.
Suicide is slow with liquor.
Take a bottle, drown your sorrows,
THEN IT FLOODS AWAY TOMMORROW!!

So goes the first verse of 'Suicide Solution', an infamous song of Ozzy Osbourne's that deals with the dangers of alcohol abuse, and which was the central feature in two legal cases against him where he was charged with inciting the suicides of heavy metal fans after they listened to the song. In fact, controversy has dogged Osbourne since the beginning of his career with the founding of the influential heavy metal group Black Sabbath, who are credited with having invented the genre. Although Osbourne was found not guilty in those cases, other related matters referred to the issues of including satanic imagery in song lyrics, stage performances and album covers, as well as allegations of surreptitious backmasking of satanic messages in said albums, all things that were said to be bad infuences on young adults. Osbourne has claimed he harbours no satanic beliefs and that the inclusion of such imagery in his musical corpus was purely for reasons of showmanship.

Similarly, the music of Marilyn Manson is said to have contributed to at least one fan's suicide. But more seriously the students who carried out the Columbine High School massacre and the SuccessTech Academy shootings were said to have been heavily influenced by Manson's music. Around 50 churches were also burned down between 1992 and 1996 in Norway, for which many fans of the developing black metal scene claimed responsibility.

It isn't just the fans who are supposedly influenced adversely. Mayhem vocalist Per Yngve Ohlin, better known by his stage name 'Dead', was notorious for mutilating himself on stage with hunting knives and broken glass. Finally in 1991, and almost as a fitting homage to his nom de plume, he sat down among his bandmates and calmly slashed his wrists and neck with small cuts before inserting a shotgun into his mouth and blowing his brains everywhere. Other bandmates were famous for regular conflicts, culminating in the brutal murder of guitarist Øystein Aarseth by bassist Varg Vikernes.

If one looks deeper in the issue, one is sure to find many more horror stories of murders and depressive suicides with the common denominator of metal music. Indeed, one wouldn't be blamed for automatically assuming that individuals attracted to such music may tend to be prone to depression and/or exhibit anti-social behaviour of other kinds. But is there any actual data to substantiate this?

Vaughan Bell of mindhacks.com was kind enough to alert and send me a paper published late last year that attempts to analyse if there is a link between mental health and the enjoyment of such music. The main research questions that the study sought to answer were:

• Do metal music fans in France exhibit great levels of anxiety and depression?
• What variables mediate the levels of anxiety and depression for metal music fans?

Recours et al. (2009) surveyed 333 French metal fans by administering the Hospital Anxiety and Depression Scale (HADS), a simple test that aims to detect, obviously, notable anxiety and depression. Among other things, they analysed differences in gender, age, status, education, motivation and level of participation in metal culture. This included intimate items such as the behaviour of participants at metal concerts and whether they had body modifications such as piercings and tattoos.

Summary of the very interesting results: Out of 333 participants, 282 were male (87.8%) and 39 were female (12.15%), the mean age of which was 22.6 years old. (age range: 13-44 years). Half of them were students, 41.7% of the rest being employed and the remainder being both students and employed. Average years immersed in metal music culture was 9.22 years with average concerts attended per year was 16. Slightly over one-third had a tattoo or piercing while just 5.3 had a combination of both. The most popular subgenres of metal music indulged in were death metal (37.7%), black metal (22.7%) and thrash metal (18%). Motivations for attending concerts included the expectedly high 95.9% to enjoy the music, followed by 84.6% attending for the "ambience". Only 33.9% cited drinking as a reason to attend, and very small percentages of people attended in order to sample drugs (4.98%), sell drugs (2.72%), and to fight (0.91%).

Factor analyses revealed a three-dimensional structure, and an orthagonal rotation was performed to analyse how pertinent the depression and anxiety factors were. These two factors ended up explaining 38.71% of the variance (27.55% = anxiety, 11.17% depression), with reliability factors using Cronbach's Alpha being 0.70 and 0.67 respectively. In plain language, this means that - based on the answers provided - the HADS test was 70% and 67% reliable in detecting anxiety and depression respectively.

All in all, the results showed that the respondents exhibited low levels of anxiety and depression. The HADS instrument can be used to determine an arbitrary cutoff point as there is no generally accepted cutoff. The creators of the instrument, Zigmond & Snaith (1994), recommended a cutoff of 7/8 for possible and 10/11 for probable anxiety or depression. Following previous research Recours et al. chose 11 as a cutoff score for each dimension of anxiety and depression, implying that respondents exhibiting a score greater than 11 would be considered to have a serious level of anxiety or depression. The results found the average scores to be 7.26 and 3.76 for anxiety and depression respectively, far below the chosen cutoff levels. However, as in all populations there were some individuals scoring above the cutoff (15.6% anxiety, 3.4% depression) but these cannot be said to be due to the influence of metal music.

Multiple regression analyses revealed that none of the other variables (age, gender, concert attendance, etc.) had a link to mental health in terms of either anxiety or depression, but surprisingly the same analyses revealed a relationship between mental health and writing song lyrics, drinking at concerts, and having scarifications. Also, links were revealed between mental health, education level and employment status. However, these relationships were still nowhere near the 'danger' cutoff point of 11.

In conclusion, the authors discuss the huge gender bias towards males among other things, and suggest it as being 'very' representative of the culture of metal music. Maybe so, but let's get to discussing the drawbacks of this study:

The study was carried out over the Internet. The HADS instrument is effectively a questionnaire that was administered over a non-personal medium, but even with personal contact there is no way to certify the replies as genuine. In this way Internet-administered tests contain an extra layer of uncertainty. The authors state that they considered 'personal' measures such as approaching "morbidly dressed" metal fans on the street, but this would isolate metal fans who do not attire themselves in such an "obvious" way. But at least they entered 10 different Internet forums dedicated to metal music in order to have a realistic possibility of contacting individuals with an almost certain interest in metal music and culture. However, another category of isolation occurs here as genuinely depressed people are least likely to complete a questionnaire.

Also, by the authors' admission, France happens to be a country where the growth of cults are strictly controlled, and where "French officials are particularly concerned about Satanic cults related to metal music". Apparently a Govt. ministry has warned parents to limit their children's exposure to metal music and also to monitor their access to metal-oriented websites. Could it be possible that the majority of the French metaller population aren't exposed to the most extreme of metal subgenres? After all, throughout the entire paper scant mention is made of any specific group and metal music is referred to in categorical format; black, death, and thrash. Passing mentions are made of Slayer, Black Sabbath, Megadeth and Metallica, bands that have a certain notoriety but are also decidedly mainstream. Aren't French teenagers aware of bands like Arch Enemy, Goatwhore, Amon Amarth, Dimmu Borgir, Extol, Kult ov Azazel, and others? These are things to consider.

It was also interesting to observe how the results pointed to an unnoted third factor before orthogonal rotation enabled relevance to the anxiety and depression factors. So I agree with the authors that further research needs to be undertaken in order to determine which factor(s) can aptly describe the 61.3% of the variance that wasn't accounted for by anxiety and depression.

In closing, the authors offer reasons for why the general conclusions point to lower levels of anxiety and depression among metal lovers. It is proposed that the predominant themes of satanism, gloom and death give airing to subjects infrequently discussed in society and which are treated in a somewhat taboo manner. Although metal music is classed as entertainment in contrast to real images of death, it presents such themes as "typical occurrences that are not outside the norm" and I interpret that as a desensitising factor of sorts. So metal music lovers who frequently indulge in this pastime are more often exposed to morbid themes that have the effect of eventually desensitising them and enabling them to treat it more of the entertainment that it is supposed to be.

But then, what of all the horror stories referred to earlier? What about Dead's suicide? What about the terrible Marilyn Manson-inspired school shootings? Ozzy Osbourne's "satanism"? A tentative proposal is that metal music has a malevolent effect on individuals with certain vulnerabilities, and this is precisely why further research is needed in order to uncover these details. It is for this reason that I do not heartily share the confident assertions of the authors that their "representative" sample (from one country!) indicates low levels of anxiety and depression among metal lovers. Typical quote:

"The results indicate that fans of metal music are in good health with respect to anxiety and depression ... [and] indicate that, contrary to critics who suggest that images of death and destruction in metal music have harmful consequences, the mental health of fans of this type of music is generally good."

Hmmm, when they put it that way it's hard not to agree, but only tentatively. A more accurate representation of this study is that it simply provides an indicative snapshot rather than a comprehensive description.

Speaking of which, it's been ages since I've been to a Motörhead concert...


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Recours, R., Aussaguel, F., & Trujillo, N. (2009). Metal Music and Mental Health in France Culture, Medicine, and Psychiatry, 33 (3), 473-488 DOI: 10.1007/s11013-009-9138-2

Snaith, R. Philip, and Anthony S. Zigmond (1994). HADS: Hospital Anxiety and Depression Scale. Windsor: NFER Nelson.

Ain't Taking This Lying Down..!

Apologies for the lack of activity in recent months, I have been absorbed in a number of promising projects as well as taking a much-needed vacation.

An interesting report in New Scientist magazine suggests that insults are handled better when lying down rather than sitting or standing up. According to the article, University students who were insulted while seated exhibited neural activity consonant with "approach motivation", which describes to desire to approach and explore. This activity appeared absent in a control group insulted while lying down. Eddie Harmon-Jones, a cognitive scientist at Texas A&M University, interprets this as suggesting that one might be more inclined to attack if one were in the upright state, whereas while lying down we may be more inclined to brood.

At first glance this seems a little odd to me. Brooding is quite different to receiving insults and possibly reacting to them. Brooding means a certain amount of thinking and contemplation is occurring. It isn't the done thing to offer or accept anecdotal evidence as important fact, but from personal experience I've sometimes become more enraged over an incident by brooding about it (while lying down) than I have reacted to insults while sitting or standing upright. Would that mean my reactions contradict this research? The real value of psychological research lies in the ability to translate insights and findings into our lives and observe how relevant or useful they are, and I also have to consider these things personally. I downloaded and read the paper for this experiment; technically it is not an actual paper but a 'short report', a brief description of the subject and experimental method followed by conclusions. A mini-paper. Here's an extract:

"Body movements affect emotional processes. For example, adopting the facial expressions of specific emotions (even via unobtrusive manipulations) affects emotional judgments and memories (Laird, 2007). Manipulated body postures can affect behavior: slumped postures lead to more ‘‘helpless behaviors’’ (Riskind & Gotay, 1982). Simple body postures may also affect other emotive responses and the neural activations associated with them."

That's from the very first paragraph, and to me it seems to get more unreal every time I think about it. I don't dispute that body postures can affect neural activation (anything can affect neural activation, that's kind of what the brain does in the first place, reacting and responding to stimuli) but it seems overstated a bit much. The link between body posture and affectability on emotional reaction looks tenuous when compared with something as fundamental as the availability of oxygen and the human requirement to inhale it to live. But let's take a look at the study: 23 females and 23 males (n = 46) were randomly assigned to write a polemical essay featuring their views on a hot topic (e.g. smoking in public, abortion, etc.) and were told assessment would be carried out by another participant. After attaching EEG sensors, participants were randomly assigned to the upright or lying positions on a reclining chair while hearing themselves being rated on six characteristics including intelligence (1 = unintelligent, 9 = intelligent). Needless to say, participants heard negative reviews of themselves and fumed.

To be more specific, all 'reclined' participants heard negative reviews of themselves while only half 'uprights' heard negative. The other half heard slightly positive reviews. It's good to add a little variety to these things to account for different causes and effects, but I think the total sample size here was too small. Gender effects were accounted for too; males and females were randomly assigned to the two conditions, and male participants heard male-voiced feedback with females hearing female-voiced feedback. For future research, switching gender-voice feedback would make an interesting manipulation.

The results showed that for those in the upright position, the left prefrontal cortex (PFC) was substantially activated more than those who were reclining. Even though both sets of participants expressed similar levels of anger in response to the negative feedback, the left PFC has been linked to anger and approach motivation. This suggests a marked reduction in approach motivation when lying down.

What this means in reality remains under question: Does body posture really affect emotional reactions that much? Similar levels of anger existed between both groups, but those who were lying down appeared less inclined to do something about it? How might those students have reacted with the absence of inhibitory factors? I know that this is preliminary research but these are just some of the questions that need to be researched and accounted for.

Why? Because although some people may consider a study like this to be "fluff psychology" and a little boring, clinicians need to take these types of things a little more seriously when you consider that a large proportion of serious neuroscience is carried out with reclining participants in fMRI-scanners. So I agree with the conclusion of Harmon-Jones' paper; that research is required to help evaluate neuroimaging techniques requiring supine positions. There may not be much to it, but it's worth an exploration.
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Harmon-Jones, E., & Peterson, C. (2009). Supine Body Position Reduces Neural Response to Anger Evocation Psychological Science DOI: 10.1111/j.1467-9280.2009.02416.x

If You Had Half a Brain..

A great story made its way onto the interwebz lately. The Daily Mail reports:

"A 10-year-old girl born with half a brain has both fields of vision in one eye, scientists said today. The youngster, from Germany, has the power of both a right and left eye in the single organ in the only known case of its kind in the world.

"University of Glasgow researchers used Functional Magnetic Resonance Imaging (fMRI) to reveal how the girl’s brain had rewired itself in order to process information from the right and left visual fields in spite of her not having a whole brain."

BBC News goes further with:

"In the case of the German girl, her left and right field vision is almost perfect in one eye. Scans on the girl showed that the retinal nerve fibres carrying visual information from the back of the eye which should have gone to the right hemisphere of the brain diverted to the left ... 'Despite lacking one hemisphere, the girl has normal psychological function and is perfectly capable of living a normal and fulfilling life. She is witty, charming and intelligent.'"

Get that? The only known case in the world where brain plasticity (the ability of the brain to reorganise itself after injury) is displayed for all to see. Plasticity doesn't always work this way, there are many cases where plasticity effects haven't achieved the mark of restoring all or most of the impaired brain function. Epilepsy patients, for example, who undergo a hemispherectomy (removal of a half of a brain) in order to prevent the onset of severe seizures, among other things tend to lose an entire field of vision in both eyes; they only see people and objects in one half of their visual field, as in the illustration below:



Neither was this a case of brain injury; the anonymous girl (known only as 'AH') failed to adequately develop her cerebral right hemisphere in the womb. As a result, she is without a right-brain and also without the use of her right eye. She also has a slight left-hemiparesis (weakness affecting half of the body) but close to normal vision in both hemifields of her normal left eye.

In a study published by the Proceedings of the National Academy of Sciences (PNAS), a team led by Lars Muckli of the University of Glasgow used fMRI to investigate how the visual cortex had remapped itself. In a healthy individual, the cerebral cortex contains "maps" for vision, sound, motion and touch, which develop and modify over time dependent on several factors including genetic cues and neural activity. In the mammalian brain (that is, human brain) the visual cortex is made up of distinct sections dealing with vision, the main one being an area known simply as 'V1', the primary visual cortex. 'V2' deals with quarterfield representations in the area of vision, effectively dealing with the 'up' and 'down' areas of both the right and left hemispheres of vision, while 'V3' is a structure in front of V2 that, among other things, performs a supporting role for V2. There is also the question of retinotopic maps, a direct mapping of the spatial arrangement of the retina, located in visual structures including the cortex and thalamus.

As per materials provided by the University of Glasgow, "visual information is gathered by the retina at the back of the eye and images are inverted when they pass through the lens of the pupil so that images in your left field of vision are received on the right side of the retina, and images from the right are received on the left." The part of the retina close to the nose is known as the nasal retina whereas the other part is referred to as the temporal retina, being in proximity to the temples. Both halves transmit received information through separate nerve fibres. In a normal situation, the nerve fibres of the nasal retina cross over in the optic chiasm, a brain structure located at the bottom of the brain near the hypothalamus, and are processed by the hemisphere on the opposite side. The nerve fibres of the temporal retina remain in the same hemisphere (ipsilateral), meaning that the left and right visual fields described earlier are processed by opposite sides of the brain.



[DIGRESSION]Vision is not the only modality to be processed in this strange way. It actually reflects the larger processing activities of the intact brain which tends to process all other modalities in opposite sides of the brain. To wit, touch and hearing for example that is "entered" into the right side of the body (right body, right ear) are processed by the left-brain, and touch/hearing entered into the left body/ear is processed by the right-brain. This is generally referred to as contralateral processing, when input is processed by the 'opposite' half of the brain. Those inputs processed by the 'same' side of the brain is known as ipsilateral processing. For more information, please read about Basic Visual Pathways.[/DIGRESSION]

The MRI scan displays the complete lack of a right-hemisphere: The optic chiasm is shown here (top l-r) in the transverse and enlarged transverse planes, and (bottom l-r) in the coronal and saggital planes. A rudimentary optic nerve is pointed out in the enlargement by the green arrow but with no discernible optic tract, and it can also be seen how the left-hemisphere is spilling over into the right-domain. The vacant right-hemisphere is filled with cerebrospinal fluid (CSF).

In AH's fascinating case, it was found that the nasal retinal nerve had connected to her left-brain. A possible interpretation for AH's condition is suggested by the authors: The lack of a right-brain prevented an opposite connection from being made, which led the optic nerve fibers to "connect" with ipsilateral structures instead.

Remembering that normal cases require a crossing in the optic chiasm, and AH's connections were essentially ipsilateral, how exactly does AH see both visual fields with only one eye? After all, if the entire right hemisphere is missing, AH should see only the left hemifield. The answer lies with the Lateral Geniculate Nucleus (LGN), a structure that is embedded deep in the thalamus and which processes visual information from the retina. In AH, both the nasal and temporal retina would need to be mapped onto the LGN to allow for the processing of both hemifields. Again a similar suggestion of ipsilateral projections were presented as being the solution, instead of the usual contralateral connections, and that a mirror-symmetric representation of the hemifields would be received and processed by the thalamus. Similar cases have been seen in achiasmatic dogs where optic nerve fibres terminated in the ipsilateral LGN.

'Islands' were also found to have formed in the left-hemisphere to deal especially with processing of the left hemifield, to compensate for the missing right-brain activity.

The loss of AH's right-hemisphere was discovered at age 3 when she was treated for brief seizures and twitching taking place on her left side. It is speculated that the right-brain failed to develop between Day 28 and Day 49 of embryonic development. Despite the situation, she is able to engage quite capably in activities that require a fair amount of balance, such as riding a bicycle or roller-skating. Truly an extraordinary case in more ways than one.

For a professional view, please see Dr. Steven Novella's entry on this case.
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Muckli, L., Naumer, M., & Singer, W. (2009). Bilateral visual field maps in a patient with only one hemisphere Proceedings of the National Academy of Sciences DOI: 10.1073/pnas.0809688106

Gonna (Evolve To) Sing You My Love Song

Why do we like to sing soppy love songs to our loved one? What is it about them that evokes a mood of affinity and bonding? Why do tears spring to our eyes when we hear a lyric that reminds us of a friendship, relationship or other close bond?

The composition and interpretation of music through song, dance, and playing a musical instrument, are complex and high-level tasks of the creative brain. Indeed, the 'creative' aspects of personality are thought to constitute a particular division of intelligence in itself. Although it is possible to gain a certain level of proficiency in playing the works of Beethoven and Mozart through social and/or environmental factors (parental support, music school), the phenomenon of the child prodigy does in fact suggest an innate genetic basis for talent. Creativity itself is a complex process that draws largely from areas of the right hemisphere, not activating the frontal lobes or cortices very much. And since we are talking mainly of cognitive processes,we can expect hormones such as arginine vasopressin (AVP), which helps to control higher functions such as memory and learning, to take a lead role. Given that this hormone is mediated by the AVP receptor 1A (AVPR1A) gene, that affects many behavioural, social and emotional traits such as male aggression, pair bonding, altruism, parenting, sibling relationships, love etc., it stands to reason that this key gene is the one to watch.



A team of researchers at Helsinki University, headed by Liisa Ukkola, carried out a study purporting to investigate the neurobiological basis of music in human evolution by analysing the role of the AVPR1A gene and five others and their effects on general creativity and musical aptitude by testing 343 multigenerational participants from 19 Finnish families, professional and amateur musicians alike. Ages varied from 9 to 93 (mean age 43) and DNA was obtained by 298 (86.9%) of those over age 15. Three measures were administered: an extensive online questionnaire to assess creativity in those who composed, improvised or arranged music; Carl Seashore's pitch and time discrimination subtests (SP and ST respectively); and a Karma Music Test (KMT) designed by one of the research team. The results showed that high scores on the music tests associated well with high levels of creativity, and also higher in creative individuals than non-creative individuals. Genetic testing confirmed that creativity was a heritable trait.

Wait a minute - what does all this have to do with the brain?

This study showed how auditory structuring ability (gleaned from the KMT test) were associated with the AVPR1A gene, with the strongest effect found in the RS1+RS3 haplotype. The ST and SP tests also suggested this association, and this was further confirmed when the associations were replicated with combined music test score (COMB). The kicker is that the AVPR1A gene is instrumental in modulating social and cognitive behaviours, and music is certainly a medium that initiates, enhances and accelerates certain behaviours! We all know about the peculiar social customs of singing songs of romantic content in order to attract the opposite sex, music played to enhance group cohesion and initiate vigorous hip-spinning activity, and mothers singing soothing lullabies to their offspring in order to induce a state of quietness.

But aside from all of that, the genetic studies provided interesting tidbits of information relating to the homologies of the AVPR1A gene as various alleles were recognised to associate with either composing, arranging and performing music. Higher spatial scores were found among musicians than non-musicians, a possible explanation being that musicians tend to need to read and memorise notes and/or sheet music. Research into the recently discovered TPH2 gene may uncover the details behind the numerical sense necessary to perceive rhythm. The A1 allele associated with the dopamine receptor D2 (DRD2) gene is suggested to be linked to courtship.

The releases related to this story hyped up the evolutionary implications in a big way but I can find very little basis for that in this paper. As usual, evolutionary extrapolations are mainly speculative but interesting nevertheless. The text specifically mentions that evolutionary contributions are speculated on the basis of PET imaging that show partial overlapping between music and language-related areas of the brain. As improvising music usually consists of collaboration with other musicians or between a performer and their audience it makes sense that the role of these brain areas and the genes associated with musical talent be highlighted as it has. As the paper itself says:

"Creativity is a multifactorial genetic trait involving a complex network made up of a number of genes."

And it is because of that and the connections to social/cognitive areas of the brain that there is justification for the idea that music enables and enhances social communication in a way that increases attachments. This can explain why people automatically feel closer when they find they share the same types of music.

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Ukkola, L., Onkamo, P., Raijas, P., Karma, K., & Järvelä, I. (2009). Musical Aptitude Is Associated with AVPR1A-Haplotypes PLoS ONE, 4 (5) DOI: 10.1371/journal.pone.0005534

Bloody Brains

I did tell you that I liked brains, but rather than losing myself in the effevescent and vibrant beauty of neurons or brainbows, we rarely get the chance to see a real live fleshy bloody spongy brain. And so I came across this fantastic specimen:



That's a ventral (upside down) view of a fresh brain before processing at the Allen Institute. The folks there are engaged in an impressive project ("Allen Brain Atlas") to map the entire brain with all its individual neurons so as to aid future neurological research. Call it a "Neural Genome" if you like. It's due for completion in 2012, after which it is expected that the constructions of our neural networks will be discovered, analysed and explained.

Fresh brains have to be collected soon after the donor's death, else nucleic acids beging to work and dissolve the cell membranes. Researchers have a limited window in which to cut the brain into slices and photograph each of them before and quickly packing them away in ice for storage before future RNA analysis.


Read Jonah Lehrer's article at Wired, and view the full gallery of images.

(Thanks to Mo for the tip.)

So Gay, So Very Gay

It's unbelievable what's uncovered sometimes. A recent survey of British psychologists and psychiatrists has uncovered that a sizeable amount have attempted to "convert" homosexual patients or clients to heterosexual orientations!

It's a well-known axiom that (biological) homosexuality is an orientation that cannot be changed, what to speak of the scientific consensus on the matter, and what do you think might happen if any such changes are encouraged? Psychological harm and damage.

After all, what is "normal"? Anyone with even a layman understanding of psychology and/or neuroscience will know that definitions of normality are as subjective as one's colour preferences. And when you have a discriminating society that is ever-willing to ostracise on the slightest grounds of anything perceived as different, it isn't that hard to imagine how seriously this counts as psychological abuse especially concerning a topic so fundamental to someone's 'personhood' as sexual identity.

Annie Bartlett and her colleagues sent postal questions to members of the British Psychological Society, the British Association for Counselling and Psychotherapy, the United Kingdom Council for Psychotherapy and the Royal College of Psychiatrists, in which they were asked to give their views on "conversion treatment" and to describe up to six patients they may have treated accordingly. Of the 1328 examinable anonymous responses received, a flabbergasting 17% reported having assisted in reducing, changing, suppressing their gay or lesbian desires. Of these 17% (222 practitioners), 159 of them (72%) thought that a "service" should be available for homosexuals who wish to change their orientation.

Am I missing something here? Did I suddenly enter the Twilight Zone and wind up in Iran or something? This is England 2009! And it was back in 1973 that homosexuality was removed as a mental disorder from the Diagnostic and Statistical Manual of Mental Disorders (DSM), so why are these attitudes still prevailing in psychotherapeutic practice? Do old habits die hard? Because of the anonymous nature of the survey there is no information provided as to the average age of the sample, even when the authors selected a random sample of responses from the members of each organisation. Even though only 4% (55 respondents) of the total sample said they would consider therapy to change patient orientations upon requests for such therapy, it is much more worrying that the aforementioned 17% have actually attempted to do so. Considering the absense of compelling evidence that patients can even be successfully treated, trying to force or encourage such a change can only heighten and intensify the emotional conflicts that homosexuals may undergo (due to peer pressures, etc.) and cause lasting psychological damage.

This study appears to follow on from earlier 2004 research (also by the same authors) in which an oral history of homosexual patients was gained. 29 homosexuals who had received treatment for their "disorder" were interviewed about their experiences, which revealed a nominal amount of coercive and peer pressures and also resulted in lasting emotional distress.

What can I say? It's sad that these professionals appear to have no real knowledge of social identity issues. And I'd hate to be cynical, but what's the betting that serious conflict of interest issues are responsible for this grave failure of psychotherapeutic services? The type of conflict of interest that arises from personal convictions and beliefs?

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Bartlett, A., Smith, G., & King, M. (2009). The response of mental health professionals to clients seeking help to change or redirect same-sex sexual orientation BMC Psychiatry, 9 (1) DOI: 10.1186/1471-244X-9-11

Smith, G., Bartlett, A., & King, M. (2004). Treatments of homosexuality in Britain since the 1950s--an oral history: the experience of patients BMJ, 328 (7437) DOI: 10.1136/bmj.37984.442419.EE

The "Cancer Faith" Study

An interesting study released earlier this week attracted the attention of many bloggers and commentators. It's basic premise is that religious patients with advanced cancer are more likely to opt for aggressive end-of-life treatment. In other words, the more religious they are, the more likely it is that they will place less faith in God and more faith in medical treatment and technology. Let's analyse:

Andrea Phelps and colleagues acknowledge that religion and beliefs account for a high amount of coping strategies employed by patients with advanced cancer, as it affords them a sense of "meaning, comfort, control, and personal growth while facing life-threatening illness." Rather understandably, positive strategies are employed that highlight God's "loving care" rather than the negative strategies that view the condition as "divine punishment", which are said to be uncommon. Aside from simply coping with disease, faith is said to be a major factor in medical decisions; Other research in similar areas found that after oncologist recommendations it was faith that was said to be the second most important factor in deciding the course of the treatment, and also that 68% of a sample of a thousand individuals explicitly stated that their faith would guide their medical decisions if they experienced a critical injury, with 57% believing that a divine cure could be obtained in the case of medical incapability to resolve the issue. So while there is evidence that religion is associated with a preference for receiving intense treatment, Phelps and her colleagues wanted to find out whether patients who relied heavily on their religious faith were more likely to receive intensive medical care, such as cardiopulmonary resuscitation or being placed on a mechanical ventilator, before death.

The study was longitudinal, and recruited 345 patients (out of a total of 941 eligibles) from 2003 up till 2007, and were interviewed (at baseline) in either English or Spanish by Yale students, with follow-ups until their deaths. Demographic (ethnic) considerations were accounted for due to the diversity of religious beliefs, and typical measures were undertaken in order to code beliefs accordingly. To avoid selection bias, patients were not told that religion/spirituality was the focus of the study. Other measures of coping strategy were employed; most curiously, patients were asked to rate how much their religious beliefs were supported by the medical staff (doctors, nurses, even hospital chaplains!) and those who rated it highly were coded as having support for their spiritual needs. I can understand chaplains, but what are doctors and nurses doing to support patient beliefs? Did this occur in a sympathetic/empathising context just to keep the patients' spirits up? The study doesn't mention.

Here come the brief stats: 79% stated that religion helped them to cope to a moderate extent, while 32% endorsed the statement that it was the "most important thing that kept them going". 56% engaged in daily prayer or meditation. Positive coping strategies were correlated highly with being black or Hispanic (p < .001). Patients with higher levels of religious coping were younger, less educated, less likely to be insured, less likely to be married, and were more likely to be recruited from Texas (!!) than those who had negative styles of coping. Overall, patients with 'high' religion preferred medical interventions such as being put on a ventilator, resuscitation, transport to the Intensive Care Unit, approved 'heroic' measures by doctors to save lives, than those with 'low' religion. They also didn't think much of advance care planning, Do-Not-Resuscitate orders, making a will or giving anyone power of attorney over their affairs. Even after controlling for other alternatives, 'high' religion remained a significant predictor of preference for life-prolonging measures.

This appears to be the first study to directly examine the influence of religious beliefs on medical care, and although the authors acknowledge that further research ought to be undertaken in order to understand why they wield such a strong influence, this is still an interesting collection of facts. Among the usual disclaimers about the drawbacks of the study, Phelps et al. say something quite interesting: "Religious copers may choose aggressive therapies because they believe that God could use the therapy to provide divine healing, or they hope for a miraculous cure while intensive medical care prolongs life." And again, "religious copers may decide to undergo therapies with high risks and uncertain benefits because they trust that God could heal them through the proposed treatment." Huh? Does this make sense to you? It strikes me that the hope for a divine intervention and it's timely arrival would occur at a time convenient for both medical staff and the patient, instead of leaving it to literally the last minute? The authors haven't submitted the RCOPE scale with their paper that was used to define beliefs, but I'm guessing that it didn't include any questions about fear of death? Perhaps that is an idea for future research: analyse patients' preference for intensive medical care at end-of-life and find out the extent to which it is mediated by fear of death! Duh.

I'm not trying to be deliberately sarcastic because I know that this is a sensitive issue that is especially painful for those who have experienced cancer, or know someone who has suffered it and died etc., but those were really silly things Phelps said. It may be that patients themselves articulated such things in their interviews, but we can never know unless we look through the data. Sensibility returns when other research is cited suggesting that patients do not seem to understand what a DNR is (perhaps due to cultural/language barriers) or thought that it ws morally wrong to institute one (if they think it is God's decision for their "time to die"). It is also noted that believers tend to think illness as a "trial" from God, and it is possible that they deliberately opt to endure further suffering and this might explain their enlisting of life-saving measures.

However, at the end of the day, the study is clear on one thing: terminally patients with high religiosity prefer intensive life-saving care over and above all other forms of coping strategies or medical treatment, and that the decision to opt for this type of care is influenced and mediated by religiosity. The authors pre-empt criticism of misinterpreting their findings as evidence of religiosity accounting for insecurity and/or crises of faith which may lead to the opting for aggressive care, by saying that it cannot "completely account" for the observed associations. Why not? By their own admission they controlled for other eventualities including self-acknowledgement of having a terminal illness and it made no difference at all to the overall results, and only further research can look deeper into the reasons as to why this takes place, but it is understandable if people look to the obvious inference.

For more on this topic, please visit Respectful Insolence.

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Phelps, A., Maciejewski, P., Nilsson, M., Balboni, T., Wright, A., Paulk, M., Trice, E., Schrag, D., Peteet, J., Block, S., & Prigerson, H. (2009). Religious Coping and Use of Intensive Life-Prolonging Care Near Death in Patients With Advanced Cancer JAMA: The Journal of the American Medical Association, 301 (11), 1140-1147 DOI: 10.1001/jama.2009.341

Further Thoughts On 'No More God Spot?'

Regarding my previous blog of a few days ago, discussing the recent research by Kapogiannis et al. (2009) on the psychological and neuroanatomical framework of religious belief they've provided, I had some further thoughts on the study that I'd like to delineate. But first, just a quick note. Some may wonder whether my treatment of the issues reveal a sympathy in me for affairs religious and/or that I might be a - shock horror! - a Creationist (ID) infiltrator. I'm putting that to bed right now: I am NOT an IDiot! :-)

I am simply aware that there may be many in my audience who are religious, and so I treat the subject neutrally as I see no need to offend. But then again, some might take offence at my describing ID proponents as 'IDiots' as I just did above, and before I know it I'll be wallowing in qualifications and disclaimers and everyone'll have forgotten what I came to say. Blah blah, this is my space in the end. In seriousness, however, a neutral attitude is the best attitude to take. To be properly academically trained in matters scientific means to maintain a neutral - and yet sceptical - attitude. Apart from the fact that it helps you save face at a later date when your assertions turn out to be wrong ("Oh well I was always neutral about it anyway"), it is really the only position you can take with any measure of comfort given the extremely fast pace at which scientific research is being carried out and announced. Maintaining an attitude of scepticism is also important as it helps promote an attitude of critical thinking, which itself helps to spot numerous errors in studies (if any) as well as gaps and drawbacks in any research by which further endeavours can plug up.

That said, the Kapogiannis study is being touted by some as "proof" that religious faith is "deeply embedded" in the brain which is "programmed for religious experiences". You know this is a media article when you hear the word 'proof', for only they can give masterclasses in sensationalist articles and headlines. However in my last post I showed that it isn't quite that simple. I spoke of the earlier "God Spot" research that I encountered in 2004/2005 and how this new study seemed to contradict the idea of a single spot in the brain that mediated almost all religious feeling.

I also mentioned how I had not kept up with the research specifically investigating this "God Spot" and that this represents a gap in my knowledge that I'll have to catch up on. (By the way, if anyone has any good links to sites or papers I can read, it'd be appreciated.) But from what I recall of it, God Spot research mainly focused on the capacity of the brain that enabled sufferers of temporal lobe epilepsy to have regular spiritual experiences in the form of "religious visions", which we know as visual hallucinations. In the wider context of the limbic system, it was thought that various elements of the limbic architecture combined together along with amgydala and hippocampal functions (and vague links to the autonomic nervous system, ANS) in order for a visual hallucination to be produced. To me, it seemed like a workable theory that explained several instances of the physiological and emotional phenomena that sometimes characterises the incidence of deeply held faith. However, there are obvious gaps in this argument: Not all temporal-lobe epileptics are religious, and also, not all religious people are temporal-lobe epileptics.

This is why I clearly mentioned that this latest Kapogiannis paper simply set out to understand how religious beliefs and feelings are modulated in "normal" brains. Indeed, you do not get many religious people going around making claims of receiving divine and prophetic visions and the Vatican ain't deluged with nominations for sainthood. Most religious people are "normal" in the sense of going to church on Sundays, scriptural study, prayer, and just having a general religious worldview that is satisfying for them. And this is what Kapogiannis and his colleagues wanted to understand: Do their brains used specialised "God Spot" circuitry to modulate all these feelings, or do they use normal processes?

That the answer turned out to be the latter option does not necessarily contradict previous God-Spot research, in my opinion. I personally find it interesting that studies take place on different ends of the spectrum; how the 'normal' and 'visionary' brains are functionally activated for religious processing.

I still don't think much of the criticism referring to the drawback of testing only 'thinking' participants, those who agreed or disagreed with the statements being read out to them, instead of analysing a 'visionary' brain. How exactly would that work? Who made such a criticism like this? Do they even know what fMRI scans involve and how difficult or expensive they are to do? Ask Andrew Newberg (MD), the guy who apparently thinks it's sooo easy to scan a brain in the middle of a religious experience that he hasn't tried to do it himself. Or has he? Looking over his website and the research papers he's come out with, I notice that most of them were written for Zygon. If you've been following my blog for a while, you'll know exactly what I think of Zygon. Now I don't want to seem like I'm unnecessarily attacking some poor guy without provocation, but it comes to something when a titan like PZ Myers doesn't think much of him either. It is incidences like this that make it so hard for genuine science to reach the public and educate their little cotton socks, because Templeton yes-men like Newberg tend to pop up when you're least expecting them and feed something silly into the public imagination which, when investigated, turns out to be an overblown exaggeration.

That is why an attitude of neutrality and scepticism is needed. It is indeed hard to maintain neutrality especially in a world where the Creationist/ID movement have drawn 'first blood' in an unwinnable war, but by being on guard through the critical examination of new research (especially hyped research) it may be possible to score a few points in the service of scientific endeavour and public education.

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Kapogiannis, D., Barbey, A., Su, M., Zamboni, G., Krueger, F., & Grafman, J. (2009). Cognitive and neural foundations of religious belief Proceedings of the National Academy of Sciences DOI: 10.1073/pnas.0811717106