Very nice talk. You might think it’s complicated at first but she shows you the simple tests live with kids, very well done. She shows the brain region for thinking about other people thoughts and it’s development. How does this brain region develop during childhood to adulthood? Is this the cognitive side of empathy?
The researchers also tried to Transcranial Magnetic Stimulation to influence this specific brain region, can it change peoples moral judgment? She already had telephone calls from the CIA but luckily she doesn’t answer them. Be sure to see the interview at the end of the video.
Sensing the motives and feelings of others is a natural talent for humans. But how do we do it? Here, Rebecca Saxe shares fascinating lab work that uncovers how the brain thinks about other peoples’ thoughts — and judges their actions.
Welcome to the forty-fifth edition of Brain Blogging. In this round, we discuss new trials using stem cells for stroke, the neurobiology of empathy, if brain tonics really work, the connection between obesity and mental illness, and many more topics.
Remember, we review the latest blogs related to the brain and mind that go beyond the basic sciences into a more human and multidimensional perspective.
Maybe I have told you in the a previous post that I tried to do some programming in Python. It was nice but extremely difficult. This old brain wasn’t quick enough to pick up the routine. Enjoyed it while it lasted but took a lot of time and effort without much progress.
As you will probably know the human brain is capable of adaptation, not only in childhood but also in adulthood. Experience and learning can alter the brain, genetic predisposition also plays a role. Maybe learning to program needs to much adaption beyond my genetic predisposition.
During my medical education my gray matter increased mostly in the posterior and inferior parietal cortex bilaterally, as well as in the posterior hippocampus. In a study with medical students during and after a medical exam the graymatter in the posterior hippocampus continued to increase in the 3 months after the learning period. Results of this study suggest that learning a great amount of highly abstract information leads to a specific pattern of structural gray matter modifications. Also learning-induced changes of cerebral activation patterns have also been demonstrated.
Learning to programming and using algorithms as a lot like learning arrhythmic. What brain regions and their development are involved in learning arrhythmic?
Arithmetic requires different types of knowledge such as memory, attention and conceptual knowledge and several different parts of the brain. A number of studies have shown that number processing and calculation are mediated by a distributed network within the frontal brain regions and parietal lobes: angular gyrus (AG) bilaterally, bilateral horizontal intraparietal sulci, posterior parietal attention system.
How does learning arithmetic affect brain development?
In children and in adults, the gain of arithmetic expertise is characterized by a shift in activation from
fronto-parietal networks to specific parietal areas.This shift indicates a change in the cognitive processes involved in task
performance following practice, although in the case of children some of the changes observed might also bedue to brain maturation.
Practice leads to a decrease in activation in frontal brain areas. These areas sustain general-purpose processes such as working memory and attention control, and are likely to be involved in non automatised and complex calculation.
Practice also leads to a relative increase in activation within the left AG.
People with average calculation skills build expertise upon a preexisting cerebral network involved in arithmetic processing, as inter-individual arithmetic performance differences are observed to modulate activation within this network such as, for example, in the left AG. The proficiency of expert individuals is, however, a different matter. Calculation prodigies and abacus masters seem to recruit other cognitive processes and cerebral areas.
So due to my medical education other parts of my parietal lobe and hippocampus used all the adaptation juice and probably still are, so my other parietal parts refuse to adapt very quickly in order to allow me to learn how to program, harsh but simple.
Why is this important?
The acquisition of arithmetic competence is a precondition for successful participation in social and professional life as well as for effective exercise of citizenship in a numerate society. Individuals with deficits in numerical and arithmetic processing face limitations in their autonomy and have poor chances to qualify for adequate professional occupation. Improved knowledge on the acquisition of arithmetic skills and concepts is not only essential in the case of disturbances (dyscalculia), but also for efficient teaching to normally achieving students.
Intrinsic motivation occurs when people engage in an activity without obvious external incentives. Research has found that it is usually associated with high educational achievement and enjoyment by students. Intrinsic academic motivation has been shown to be related to better academic achievement in medical students. Extrinsic motivation refers to the desire to do something because it leads to a particular outcome.
Students are likely to be intrinsically motivated if they:
attribute their educational results to internal factors that they can control (e.g. the amount of effort they put in)
believe they can be effective agents in reaching desired goals (i.e. the results are not determined by luck)
are interested in mastering a topic, rather than just rote-learning to achieve good grades
The TCI was developed by Cloninger and his colleagues. They proposed a biosocial model of personality including four temperament dimensions, novelty seeking (NS), harm avoidance (HA), reward dependence (RD), and persistence (P) as well as three character dimensions, self-directedness (SD), cooperativeness (C), and self-transcendence (ST). Temperament and Character Inventory (TCI), a 240-item false-true questionnaire, was developed to measure the four temperament dimensions and the three character dimensions. Cloninger suggested that the three original temperaments, novel seeking, harm avoidance and reward dependance, was correlated with low basal dopaminergic activity, high serotonergic activity, and low basal noradrenergic activity, respectively.
The TCI dimensions of persistence, self-directedness and co-operativeness were positively associated with intrinsic academic motivation. To identify independent associations the analysis were adjusted for age and gender. The TCI dimensions of persistence, self-directedness and self transcendence were positively associated with intrinsic academic motivation.
Now what are these dimensions in normal speech. Persistence is continuing your study despite frustration and fatigue, indeed a valuable character asset when trying to become a physician. Self-directedness is being responsible and resourcefulness in initiating and organizing steps to achieve your personal goals. Self-transcendence involves the spontaneous feeling of participation in one’s surroundings as a unitive whole. It is associated with wise judgment, and selfless spirituality, as opposed to egocentric rational materialism. Cooperativeness is social tolerance, empathy, helpfulness, compassion and moral principles rather than hostile revengefulness and selfishness.
Indeed important character traits in order to become a empathetic and wise physician. The found characteristics all add up to a well balanced mature character. But shouldn’t any mature man or woman score the same character traits, how are med students different from e.g. pilots, judges, plumbers etc?
How was this study done?
The study group consisted of 119 Year 2 medical students at Osaka City University Graduate School of Medicine. They completed questionnaires dealing with intrinsic academic motivation (the Intrinsic Motivation Scale toward Learning) and personality (the Temperament and Character Inventory [TCI]).
What do you think, are med students different in character from other professionals? Let me know in the comments.
Why is this important?
Knowing more about this relationship might help the medical education community to develop screening procedures to identify those at high risk of low intrinsic academic motivation, and to conduct early interventions to achieve lower
incidences of and higher rates of recovery from low motivation.
Tanaka, M., Mizuno, K., Fukuda, S., Tajima, S., & Watanabe, Y. (2009). Personality traits associated with intrinsic academic motivation in medical students Medical Education, 43 (4), 384-387 DOI: 10.1111/j.1365-2923.2008.03279.x
In a recent post on Singularity Hub they have collected the most recent and their favorite robots and robot videos of the last year or so. Above is a very realistic one. They have collected 16 videos on robots, amazing. Many from Japan, I wonder?
There is a humor–health hypothesis. This hypothesis claims that there is a link between humor and health. It is perceived that there is a positive link between humor and health. Humor should improve your health. There are many suggestions as how humor can improve health or not.
Humor, in terms of laughter, creates accompanying physiological changes in the body which are positive and conducive to health
Humor and/or laughter may create a positive emotional state which improves health.
Humor and/or laughter may assist in moderating adverse effects of stress, it may enhance the coping and negating the known negative physical effects of stress.
Humor is also known to benefit relations, it improves interpersonal skills or social support.
Humor is used to facilitate communication and avoid conflict
In a recent research in a hospital setting humor was present in 85% of interactions and was patient-initiated 70% of the time
Humor is inappropriate and unethical when used with patients who are in some way psychologically or cognitively impaired
Humor about sex or gender, ethnicity, politics, humor or joking about tragedy or disease-related symptoms are considered humor exclusion zones
Humor is also considered inappropriate when the nurse or doctor is unfamiliar with or indeed, unknown to the patient
Almost every time empathy is considered as an important prerequisite for humor
These relationships come from a recent review of 88 published articles on humor and health. It is concluded from this review that the humor health link may exists but but current research is limited in design and results are therefore ambiguous.
Humor may affect patients’ perceptions of health and symptoms, their ability to cope, propensity to report symptoms or seek health care and their subsequent interaction with health care professionals.
The direction of the influence of humor on health is not always clear. For instance besides positive effects of humor on health the question remains whether patients with humor are less likely to ask for help and therefore more likely to be diagnosed and treated later.
What do you think, do you know of more effects of humor on health?
May McCreaddie, Sally Wiggins (2008). The purpose and function of humour in health, health care and nursing: a narrative review Journal of Advanced Nursing, 61 (6), 584-595 DOI: 10.1111/j.1365-2648.2007.04548.x
The first post discusses the differences between results of brain imaging in men and women while playing video games.
While playing video games on a computer men generally exhibit greater activation of the mesocorticolimbic reward circuitry and also greater connectivity. Male were more effective in gaining space and learned the implicit goal faster than females. This was the only observed gender difference in performance.
The second post is about researchers that propose chronic inflammation of tissues in the circulatory system is a risk factor for cardiovascular disease. A marker for inflammation in the blood is called C-reactive protein. The researchers found a relationship between dark chocolate intake and levels of this protein in the blood of 4,849 subjects in good health and free of risk factors (such as high cholesterol or blood pressure, and other parameters).
previous studies have utilized inconsistent criteria to define Internet addicts, applied recruiting methods that may cause serious sampling bias, and examined data using primarily exploratory rather than confirmatory data analysis techniques to investigate the degree of association rather than causal relationships among variables.
From all the posts about neurostimulation the most popular is about TMS not being effective in depression treatment. It is a extensive review kind of post, the core being a placebo controlled trial comparing TMS with sham TMS for depression.
Rapid Transcranial Magnetic Stimulation (rTMS) to the left prefrontal cortex is not more effective than sham rTMS for depression. This was the result of a recent published randomized controlled trial with 4 month follow-up.
Enjoyed blogging a lot, have learned even more form writing posts. I have neglected the developments of health 2.0 and medical education, will focus some more on that topic in the coming year 2009. Make medical education more fun for students and teachers. Suggestions for blogs, sites and social networks are very welcome. Already received a suggestion by Bertalan Besko on Twitter about Medical Education Evolution.
What did you like, enjoy would like to read more about? Please let me know in the comments.
Both Shrink Rap and Mind Hacks report on a debate about how transparent the process for developing the upcoming DSM-V should be. This debate is published in the LA Times. Those in charge of the revision want secrecy, nobody knows why. It is suggested in the comments it could have something to do with the insurance companies?
Besides transparency of the making of the new revision of this psychiatric diagnostic bible other problems were mentioned on this blog as well as others:
Will Internet addiction be a new diagnosis in the DSM V? Medicalize problems again. In an editorial in the American Journal of Psychiatry Internet Addiction is proposed as a new diagnosis in DSM V. Now the American Journal of Psychiatry used to be a serious peer reviewed journal although some of us doubt this feature for a while now.
More than half the 28 new members of writers of the next edition of the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM) have ties to the drug industry.
Suicidal behavior as Sixth Axis in DSM VIt is suggested in an editorial of the American Journal of Psychiatry that suicidal behavior be considered a separate diagnostic category documented on a sixth axis. Ridiculous. Suicidal behavior (death and attempts) is a symptom of various psychiatric conditions. We will need a seventh axis for addiction, another item often overlooked. It is a kind of safe guard against lack of interest, lack of empathy for psychiatric patients.
There is still a long way to go. The DSM-V is due out in May 2012, and all mental illness and proposals for the classifications of new mental illness are currently under review by the DSM-V committee.
It is suggested in an editorial of the American Journal of Psychiatry that suicidal behavior be considered a separate diagnostic category documented on a sixth axis. Ridiculous. Suicidal behavior (death and attempts) is a symptom of various psychiatric conditions.
Their main concern is that during assessment, clinicians evaluate the principal diagnosis responsible for the chief complaint and use overview questions to identify comorbid conditions. They further reason that suicidality in high-risk groups can easily go unidentified.
What they overlook to my opinion is that this addition of another axis will not end. We will need a seventh axis for addiction, another item often overlooked. It is a kind of safe guard against lack of interest, lack of empathy for psychiatric patients. The lack of being able to feel the trouble these patients can have, even resulting in suicidal behavior. We should train our residents in empathy, in getting them to understand the consequences of the symptoms these patients suffer including suicidal behavior.
For that matter another editorial in the same issue hits the nail on the head:
The course asks residents to consider the fact that our sociocultural context is just as critical as basic neurobiology in shaping how we understand and intervene in our patients’ illnesses.
The authors of this editorial describe a course that focuses on the heterogeneity of mental illness
experience, and they describe outcomes in a comprehensive narrative. Texts on illness experience remind residents that they see an extremely brief slice of an individual’s life in the clinic.
In short: the person and his or her world behind the “patient”, that is what important, not another axis in DSM V.
The course consists of lectures, readings, and homework, the course engages residents in discussions about the psychiatric task. Social science is taught not as a set of abstract theories but as a set of tools to use as residents consider the responsibilities, complexities, and uncertainties of clinical work.
M. A. Oquendo, E. Baca-Garcia, J. J. Mann, J. Giner (2008). Issues for DSM-V: Suicidal Behavior as a Separate Diagnosis on a Separate Axis American Journal of Psychiatry, 165 (11), 1383-1384 DOI: 10.1176/appi.ajp.2008.08020281 E. Bromley, J. T. Braslow (2008). Teaching Critical Thinking in Psychiatric Training: A Role for the Social Sciences American Journal of Psychiatry, 165 (11), 1396-1401 DOI: 10.1176/appi.ajp.2008.08050690
For the first time on this blog I wrote a series, yes about patient doctor relationship. It was fun and not easy to stop. You can look at it from very different angles and I did have some more.
The most liked by the “audience” was the first piece on empathy. Now empathy is for most of us confusing. It depends on what definition you use. I discussed it from the view point of a very strict definition as mainly used in psychotherapy. From that point of view I concluded that
Empathy is a quality not every human or doctor possesses. Moreover, experience and age enhance the use of empathy. Not to say that lack of experience or being young excludes the possibility for showing empathy, there are still natural talents out there.
Another important topic is can we teach empathy in Med School?
In short: No I don’t think so. For several reasons. Empathy is a process with different steps. Especially feeling what the patients feels is a quality not every doctor has. And if they do it is not always appropriate nor possible to be sensitive enough to use it. Moreover this process not only needs the quality it is also costs energy, depends on the relationship with the patient, and needs experience.
Sharing strong beliefs or emotions without understanding the patient’s perspective seems risky; a practitioner may unknowingly infuse the dialogue with his or her needs without carefully tying them to the patients’ needs
In contrast to empathy, emotional intelligence is an easier concept to handle. You van even measure emotional intelligence. There is also some evidence that higher Emotional Intelligence (EI) in doctors is important to the patient doctor relationship. Assessment of EI is now used as part of the selection process for some medical school applicants in an effort to consider an applicant’s competence in interpersonal skills. Is that a good thing or bad?
Accidentally I bumped in to a nice video and description of emotibots. Through the combination of cameras,sensors, artificial neural networks and software development ICT results are developing robots that can respond to human emotions.
The last post in that series was about Humanism and professionalism. The opinion that humanism and professionalism are one and the same carries the risk of isolating the physician from the lay public. The tension between adapting to a new professional identity and the lay position is most visible and even palpable during clerkship and residency training. To me this topic is very recognizable and new. Really an eye opener.
Well that sums it up. And yes I liked it so much that tomorrow I will start another series about mass media and psychiatry. What do they write about mental illness in newspapers and why is that important. Also gender influences on description of patients in newspapers and how is ECT portrayed in the newspapers. Can’t wait.