Excellent talk about oxytocin, also described in some posts on this blog about empathy. Found this video at Basal Science Clarified . Accompanied by excellent explanation about oxytocin and it’s relation to empathy.
As the authors state: a lot of energy and time is allocated during medical education on technical procedures and neurbiological explanatory theories. Empathy and professionalism some of the important qualities of a good doctor also according to the CanMEDS framework are threatened to be “up-regulated through education” comparable to serotonergic receptors in the limbic system.
Before medical students undergo a neurobiological training for professionalism medical humanities could help in the evaluation of the patients’ personal experience of the disease and therapy. Moreover, research shows a decline in empathy during medical education and residents’ training.
focus should form the core of a good doctor-patient relationship in which the doctor has empathic skills, such as the ability to appreciate the patients’ emotions and cognitions. Empathy and an appreciation of the patients’ own perception of their illness and treatment have been shown to improve patient adherence, clinical outcome and patients’ as well as doctor’s satisfaction
Since it’s difficult to understand these personal experiences, cognitions and emotions of patients, especially in mental illness such as psychosis, literary fiction could help. Recent research is published on the use of literary fiction and psychotic illness. Students studied the meaning of psychosis in a real life patient and a person in a literary source (The Black Monk by Chekhov).
Given our experiences, we strongly believe that by combining the biomedical issues of an illness with biopsychosocial issues, medical students can learn about medical humanities as well as increase their understanding of the patients’ condition.
The article is a nice overview of the use of literature and medical humanities and the teaching approaches used. Also suggested is a website as source of literature about psychiatry: Madness and Literature.
Kaptein, A., Koopman, J., Weinman, J., & Gosselink, M. (2011). ‘Why, why did you have me treated?’: the psychotic experience in a literary narrative Medical Humanities DOI: 10.1136/jmh.2010.006270
The Millenial generation are those in college from 2000 to late 2010. It’s the same period in which social networking sites such as Facebook, MySpace and Hyves in The Netherlands saw a massive increase in users. To some, the millennial generation are more narcissistic than earlier generations. From wikipedia, the millennial generation is generally marked by an increased use and familiarity with communications, media, and digital technologies.
Might their be some connection between increased narcissism in this generation and the increase of use of social networking sites?
We’re talking about subclinical narcissists. They hold an inflated view of themselves, believe they are special and unique, and expect special treatment from others while believing they owe little or nothing in return. They lack empathy and have few, if any, close relationships, yet they strongly desire social contact, as others serve as their primary source of admiration and attention. Because narcissists are unable to regulate their own self-esteem, they must rely on external sources for affirmation. Almost comparable to clinical entity of narcissistic personality disorder but to a lesser degree.
Why social networking sites?
Because narcissists crave attention of others and seek admiration and attention from others in order to maintain their self-esteem.
SNSs provide an ideal outlet for narcissists to satisfy these needs as SNSs allow users to receive relational benefits from a large number of loose or ‘‘weak tie’’ connections
A total of 361 participants recruited from undergraduates completed an online survey. This survey consisted of the narcissistic personality inventory, items about social networking sites use, reasons for use of social networking sites, the use of photos with themselves on it, questions about other activities on the social networking sites and questions about the importance of their profile image.
Narcissism predicted reasons why Millennials use social networking sites:
Narcissism did not predict more use of social networking sites compared to non-narcissists. This study doesn’t proof a causal relationship between use of social networking sites and narcissism in Millennials. The use of social networking sites might be just a product of the times. Previous generations might have used other means of communication for staying connected. Using social networking sites might be another outlet for narcissistic types.
The online environment allows narcissists to effectively manage their image by controlling the information and activities that are displayed. This control allows narcissists to hide their inadequacies and, thus, bolster their selfesteem.
Bergman, S., Fearrington, M., Davenport, S., & Bergman, J. (2011). Millennials, narcissism, and social networking: What narcissists do on social networking sites and why Personality and Individual Differences, 50 (5), 706-711 DOI: 10.1016/j.paid.2010.12.022
Oxytocin is the new hormone possibly responsible for increase of trust, “the hormone of love”, and improvement of social cognition. This optimism is sometimes turned around in the way that some researchers believe that oxytocine could also ameliorate social deficits such as present in social phobia and autism. I don’t share this optimism, in biology and human neuroscience you can’t simply turn the proof around. We’ve seen a lot of trouble from this simple method. In depression not only the neurotransmitters are dysregulated, nor the lack of dopamine doesn’t explain Schizophrenia and so on and so on.
Then why write about oxytocin? Well, I’m interested in empathy. Empathy is an interesting phenomenon of which we only understand very little. Moreover, a recent study had the important premises that oxytocin may selectively facilitate social cognition given certain constraints. They had a very thought provoking hypothesis. To me someone should need some social cognition in order to be able to improve empathy with oxytocine but the researchers had an other hypothesis. They hypothesized that oxytocin would be of more value, improve empathy more in those with less social proficiency. They used a double blind placebo controlled crossover trial: participants received either intranasal oxytocin or a placebo and performed an empathic accuracy task that naturalistically measures social-cognitive abilities. Baseline social competencies were measured with the Autism Spectrum Quotient.
Oxytocin only improved empathetic accuracy in less socially proficient individuals not in more socially proficient individuals. Oxytocin does not acts as a universal prosocial enhancer that can render all people social-cognitive experts. This is against my hypothesis but nevertheless more in relation to reality that oxytocin is not the new social drug we thought it to be.
Bartz, J., Zaki, J., Bolger, N., Hollander, E., Ludwig, N., Kolevzon, A., & Ochsner, K. (2010). Oxytocin Selectively Improves Empathic Accuracy Psychological Science, 21 (10), 1426-1428 DOI: 10.1177/0956797610383439
This is the title of an article recently published and written by a psychiatrist and a cardiac surgeon. It’s about an important question not only for physicians but also for other professionals. I found their answer recognizable for most of their concepts.
In short, it’s about five concepts that can be helpful in the work of busy professionals.
For me coping with the stress is the most important, the other aspects usually result or cause the stress. A kind of vicious circle can result from this mechanism. Stress causes a lack of empathy followed by a lack of motivation for treating patients and finding the positive aspects of your work. What do you think?
Dickey, J., & Ungerleider, R. (2007). Managing the demands of professional life Cardiology in the Young, 17 (S2) DOI: 10.1017/S1047951107001242
Dr Shock is utterly biased when it comes to gaming. Especially when Call of Duty is used for research into the topic of possible negative or positive influences of exposure to violent games. This recent research with the action game “Call of Duty” did not support any negative influence of gaming on prosocial behavior or civic engagement. On the contrary this research found some support for increased prosocial behavior and civic engagement in those playing action games especially when their parents were more technically savvy and involved in game play. So all parents should play with their kids, even action games. Probably the team oriented multiplayer options in many of these games increase more social behavior.
Prosocial behavior is caring about the welfare and rights of others, feeling concern and empathy for them, and acting in ways that benefit others
Civic engagement or civic participation has been defined as “Individual and collective actions designed to identify and address issues of public concern.”
Some other interesting information from this article: Violent behaviors among youth has decreased since the 1990s rather than risen while the number of violent games sold has increased since than. As depicted in this fugure
The only drawback of this study is that it’s about correlation not causation and the sample size is somewhat small.
Ferguson, C., & Garza, A. (2010). Call of (civic) duty: Action games and civic behavior in a large sample of youth Computers in Human Behavior DOI: 10.1016/j.chb.2010.10.026
I’ve been busy today preparing education for third year medical students. It’s their first engagement with psychiatry. In preparing before psychiatric examination they have to watch several video’s and answer questions about the psychiatric examination. These video’s were made by actors and some of them are small parts of Hollywood movies.
For OCD or obsessive compulsive disorder I used a fragment of The Aviator. It’s the story of the life of Howard Hughes.
With The Aviator, director Martin Scorsese and star Leonardo DiCaprio breathe fresh life into this old story with a soaring and soulful portrait of the enigmatic, troubled millionaire Howard Hughes. They succeed by focusing on the triumph that preceded the tragedy and sustaining a deep sense of empathy and compassion for this misunderstood trail blazer
The movie itself has some nice scenes expressing symptoms of OCD. Further on in the movie the psychiatric symptoms become severe. In 1947 when Howard Hughes was 42 years he descended into one of the most bizarre episodes of his life. So bizarre that it almost puts to question the diagnosis of OCD. Especially with younger patients with bizarre OCD symptoms the diagnosis of schizophrenia should be considered. Was Howard Hughes suffering from OCD or was it more complicated than that. Probably, but we’re unable to do a thorough psychiatric examination. He died on April 5, 1976 in extremely poor physical condition.
A subsequent autopsy noted kidney failure as the cause of death. Hughes was in extremely poor physical condition at the time of his death; X-rays revealed broken-off hypodermic needles still embedded in his arms and severe malnutrition. While his kidneys were damaged, his other internal organs were deemed perfectly healthy.
Here is a short video with movies depicting some sort of mental illness.
Frontal lobes is the shorthand for the prefrontal cortex. It’s an important part of the human brain, the conductor of the large orchestra called the brain. It’s the seat of our executive functioning. Executive function relates to abilities to differentiate among conflicting thoughts, determine good and bad, better and best, same and different, future consequences of current activities, working toward a defined goal, prediction of outcomes, expectation based on actions, and social “control” (the ability to suppress urges that, if not suppressed, could lead to socially-unacceptable outcomes).
Before, I wrote about gender difference in empathy and other neurobiological subjects. Mark the word difference, not superior or inferior, not better of worse, just different. Reading the book “The New Executive Brain, frontal lobes in a complex world” I came across an interesting chapter about gender differences in cognitive styles and frontal lobes.
Men and women differ in decision making strategy. They tested humans with the cognitive bias test for decision making. In this test you’re presented with three geometric forms. One target and two choices. You’re asked after showing the target geometric figure which of the other two you “liked the most”. Women tend to choose more context independent, meaning that they mostly choose the other figures based on stable preferences. They always picked blue or red, square or circle. Men choose context dependent, meaning they match their choice to the target. As the targets changed so did their choices. Although their was an overlap between the two curves the difference between gender was robust and significant.
The book gave an excellent example. Women tend to always save 5% of their income, for men this is different. If his monthly income is below a certain amount he saves nothing, if it’s the usual he will save about 5%, if the income is higher he will save 10%. The optimal strategy is probably a dynamic balance between both. Novel situations mostly prefer the context dependent strategy, the “default strategy”. Neither strategy is better than the other, a balance depending on the situation is best.
Other gender differences in frontal lobes:
It’s probable that the frontal lobes are functionally different between men and women.
This video is about mirror neurons. These mirror neurons are the key to many aspects of social interaction. It allows us to understand the actions, feelings of others. In a way to “read their minds”. Possibly mirror neurons play an important role in empathy , an important asset for physicians.
But were do they come from these motor neurons?
One explanation could be that mirror neurons are an adaptation:
an adaptation for action understanding concerns the origins, rather than the current utility, of mirror neurons. It asserts that a certain process – genetic evolution – produced mirror neurons, and that they were favoured by natural selection because they supported action understanding.
The mirror neurons helped to understand what others were doing, which could be of importance during the survival in the evolution of human kind.
The other explanation could be that mirror neurons are a product of associative learning:
Associative learning is a form of learning that results from exposure to a relationship between two events. ‘Conditioning procedures’ arrange different types of relationship between events. Research examining the effects of conditioning procedures on animal behaviour has shown that associative learning depends on ‘contiguity’ – the closer the two events occur in time, the stronger the association – and ‘contingency’ – there needs to be a correlation or predictive relationship between them.
This suggests that mirror neurons were created during the experience of observing and executing the same action. Motor neurons become mirror neurons in the course of individual development.
In a recent publication arguments were put forward in favor of the associative learning origin of mirror neurons. The most important arguments being that mirror neurons do play a role in some social functions but do not play a dominant role in action understanding. You probably don’t need them to understand actions coming about. The other argument is that even in adulthood the mirror neuron system can be reconfigured by sensorimotor learning.
The associative account implies that mirror neurons come from sensorimotor experience, and that much of this experience is obtained through interaction with others. Therefore, if the associative account is correct, the mirror neuron system is a product, as well as a process, of social interaction.
Wouldn’t it be great that humans can develop mirror neurons during life? The experience of interactions being enough to create mirror neurons. I think this is a very optimistic makable point of view, what do you think?
Heyes, C. (2010). Where do mirror neurons come from? Neuroscience & Biobehavioral Reviews, 34 (4), 575-583 DOI: 10.1016/j.neubiorev.2009.11.007
Mirror Neurons are important for imitation and emulation but also empathy. Watch this video. They also explains the enthusiasm for social networks.
Neuroscientist Vilayanur Ramachandran outlines the fascinating functions of mirror neurons. Only recently discovered, these neurons allow us to learn complex social behaviors, some of which formed the foundations of human civilization as we know it.
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