A study finds that women with bipolar disorder are poorer at identifying emotions based on prosody (vocal pitch, tone, word stress, etc.) than people without bipolar disorder. This was particularly true for fear and surprise.   The study was on people in remission, so it is difficult to attribute it to mood problems.
Here’s the weirder thing, though: men with bipolar disorder, on the other hand, look like people without bipolar disorder.

This is one of those areas where normal but not popularly-known areas of research send a little spike up into the news media, and it’s exciting and weird because you don’t know why they chose that measure or expected that finding.

Like the research on lesbians and finger-length ratios a number of years ago – seemed out of the blue at the time, but actually it came out of some reasonable hypotheses about (prenatal?) hormone levels, as represented in finger-length ratio, which is a common (albeit contested) way to measure that kind of thing.

Checklists are often simple and straightforward, and very short checklists can carry the unfortunate implication that the person using the checklist can’t remember to do simple things. But sometimes they can’t. Or don’t. The NY Times has an article discussing the rewards – in lives saved – of medical professionals using checklists, sometimes very simple one, to ensure that they don’t forget – or skip out on (do you wash your hands every single time you go to the bathroom?) – important steps under pressure, particularly those that may not seem as important as others.

The practice of medicine gets a little more scientific here , and rewards clinical intuition a little less, by reducing the human element involved in medicine. I’d bet you money that most patients would think that a doctor who uses a checklist is less competent than one that doesn’t, because they’re following delineated steps set up by someone else.

And that’s the dilemma: you can get the best healthcare available, or you can get healthcare that feels intuitively right.

If we keep going, healthcare may wind up being executed by health professionals but determined by information professionals. Good news for us science of info people…although I could just be expecting this potential from based on personal bias…
Using checklists (NYT article).

A follow-up on JasophrenicsWhat “Psychopath” means.  I think it’s interesting to note that sociopaths can do massive amounts of damage to other people in non-physically-violent ways, and if you could measure damage along the same scale, you’d probably find that the amount of interpersonal damage well exceeds the amount of physical damage.  But violent killing gets all the attention…

And a followup on  some posts I’ve made on culture and evolution: Gene-culture co-evolution. A (very, very) quick primer.  Worth the read unless you’re familiar with it already.

The actual headline is “Fever can unlock autism’s grip“, which is catchier but inaccurate.  Autism is not some external thing that has ahold of of a child or adult; it’s a developmental disorder that causes autistic kids’ brains to develop in ways that differ from how normal kids’ brains develop.  Consequently, they show features of autism like impaired social skills and upset in response to change.

I don’t know what to make of this overall.  They say fever “restores” nerve communication in the brain, enabling autistic kids to act like normal kids.  Without real clear evidence that kids with autism initially have normal nerve communication, then they don’t, then they get a fever and they do, I’d vote for “alters” nerve communication.

In the same way that brains of people with mental disorders are not normal brains minus adequate practice, brains of autistic children (as far as we know at this point) are not normal brains with autism added on.

Be pretty intriguing if that turned out to be wrong, though.

I looked up a review of MPD/DID treatment practices, and their effects. I’m skipping the extensive and disturbing description of the lengths practitioners go to in order to elicit alters, but it includes things like spending 4-8 hours in therapy without breaks attempting to elicit personalities (i.e., you don’t get to go home till you show me a personality), and taking momentary silence or a glance around the room to indicate a switch in personalities.

Selections from the article:

This proliferation of alters is typically accompanied by clinical deterioration that is often quite marked. In one investigation, more than 8 of 10 patients “developed florid posttraumatic stress disorder during [DID therapy]”; the authors commented that this result is typical (6, p 361). Hallucinations, increasing discomfort, and severe dysphoria often cause patients to be in states of chronic crisis for long periods of time after DID treatment begins (9,11,52–54).
Moreover, suicide attempts may occur in the weeks following the diagnosis: Fetkewicz and associates showed that, after the diagnosis had been made, MPD-diagnosed patients attempted suicide more frequently than age- and sex-matched patients suffering from major depressive disorder (55). In another study, 4 of 5 MPD patients improved dramatically when they were rediagnosed and treated in more conventional ways (56).

Such deterioration should surprise no one, given the treatment practices that leading DID proponents recommend. These proponents believe that successful treatment requires DID patients to search their memories for each supposed trauma and then to abreact (that is, experience in therapy) the memories and associated emotions (1,11,57). Such searches frequently consume hours of each day, and the abreactions are extremely draining (58,59). Patients thus sink ever more deeply into a swamp of ruminations about past mistreatment, abuse, and trauma.

(emphases mine)

We don’t have a lot of research on this, unfortunately. It would be nice to have more. Part of it is for the reason the article talks about – in practice MPD/DID is often specified in ways that dodge testable definitions, which sets things up so that you can’t ever find out that a diagnosis is wrong, regardless of whether it is. Part is because it’s fringe, which is unfortunate because it’s also important.

This is in agreement with other research I’ve read – eliciting alters is a good way to get someone’s mental health to deteriorate. I’ve heard this cited as a reason that a lot of North American MPD clinics have closed, but I don’t know if that’s really the reason; my guess would actually be that they closed because they weren’t getting new patients, not because they were serving their old patients poorly.

Here is part 1 of the article above (with a historical review of MPD).

New idea: Kids with attention deficit disorder are just late bloomers.

This is not being said (at least outright) by some major news outlets like ABC and Time, although the public is jumping on it.

To their (minimal) credit, Time even noted that the study has not been peer reviewed (meaning no one other than the researchers has yet evaluated their work, and it should not yet be being reported as fact), and a number of news outlets are even reporting that the study only found that about half the kids catch up to their peers.

An article in the NY Times even mentioned the fact that the study wasn’t about ADHD. Not the article on the front page, but an article in the opinion section, in which the author reports actually contacting the researcher to verify their findings.

Greg J. Duncan, a professor in the School of Education and Social Policy at Northwestern University and the lead author of the school study, was somewhat mystified that his research – which attempted to understand the links between kindergarteners’ math, reading, attention-paying and “socioemotional” skills and their later academic achievement – was being discussed in the same breath with ADHD at all. The study, he said, wasn’t “about clinical levels of attention problems.”

This was true. Duncan’s research didn’t measure the effect of ADHD on future achievement; in fact, it made no mention of ADHD at all.

As a quick note: Often kids with developmental disabilities have delayed maturation of skills/abilities (and often don’t catch up entirely). This is one of the core impairments in kids with autism or Asperger’s. Delay in maturation doesn’t necessarily mean things will turn out fine if you just wait. What it does mean is that children with delays like this are hitting developmental and social milestones unevenly. As a (possibly more extreme) example, someone who doesn’t learn to speak until they’re nine – even if they catch up to normal levels by the time they’re 18 – is not going to have the same set of educational or social experiences that their normally-developing peers do.

Some people develop symptoms that could indicate future schizophrenia, but never actually develop it.  Other people with the same symptoms do. The better we get at telling who will and who won’t develop schizophrenia, the better we can treat it.

Anxiety, Addiction, Depression, and Depression Treatments reports on a study that exposed people with symptoms indicating possible future schizophrenia to a mix of six voices speaking simultaneously.  It was designed so that only four words were clearly audible in the noise.  When asked to describe any words they heard, most people reported words and phrases that were not spoken.  The interesting finding, though, was that 6% who reported phrases under three words developed schizophrenia within two years – but 80% who heard phrases of four or more words did.

This doesn’t tell us whether the under-three-words people will ever develop schizophrenia, but it suggests a time frame in which most of them won’t, and a time frame in which many of the four-words-or-more people will.

I hope this finding holds up!  An easy test that could help doctors know who best to medicate to help avert development of full-blown schizophrenia could mean a lot fewer people developing it.

I store interesting things up for when I have time to post, but I’m too jaded today to do anything but criticize them.

Finding a single gene causing schizophrenia? May be being misunderstood by the science writer – people have been looking for years and years for a (meaning one single) gene that causes bipolar disorder, schizophrenia, etc., and it’s much more likely that multiple genes are in play. And the body of the article doesn’t talk about a single gene, just the leader into the article.
ADD is not overdiagnosed. They define “overdiagnosed” as the number of people mistakenly diagnosed with ADD exceeding the number of people who have ADD but no diagnosis. While evidence does suggest it’s underdiagnosed much more often than overdiagnosed, by this definition you could misdiagnose the entire population of several countries with ADD, while failing to diagnose the population of substantially more (let’s say 10) countries with ADD (and failing to diagnose anyone properly at all). I think a lot of people would still be justifiably concerned with overdiagnosis, were that the case. (And I think that’s what a lot of people are thinking of when they mean “overdiagnosis” – how many people don’t have ADD and get diagnosed with it.)

Cardiovascular disease, not suicide, is the #1 killer of the mentally ill. That sounds pretty counterintuitive until you realize that cardiovascular disease is the #1 killer in the U.S. Although I don’t want to minimize the damage caused by cardiovascular disease, the appropriate comparison here is the ratio of mentally ill with cardiovascular disease to the general population with cardiovascular disease, versus the mentally ill/non-mentally ill ratio for suicide.

Losing 25 to 30 years of life (on average) compared to the general population is still pretty scary, though. I’m not jaded about that. I would think it might be better in countries that don’t require you to have a job with benefits to get good medical insurance, rather than the crappy jobs that many people with severe mental illness get, if they’re able to hold one down at all. But I don’t know that.

An article on OCD discusses what disorders are related enough to group together.
OCD in some respects differs from the other anxiety disorders in terms of phenomenology, brain circuitry, family history, and treatment response. Instead, it shares features of basic etiology, brain circuitry, and genetics with a group of other related or OCD spectrum disorders. These may include Tourette’s syndrome; body dysmorphic disorder; autism and the developmental disorders; eating disorders, including binge-eating disorder; Huntington’s disorder and Parkinson’s disorder; pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) or Sydenham’s chorea; some of the impulse control disorders; some of the newly emerging compulsive and impulsive disorders; and obsessive-compulsive personality disorder. At issue for the DSM-V is also whether the hoarders that are currently considered a subtype of OCD should be thought of as distinct from OCD and placed into one of the obsessive-compulsive spectrum disorders.

It’s from 2005, but this is the first time I’ve run into spectrum notions that weren’t bipolar or autism-related.

I wish there were some way of sitting in on DSM-V committee meetings.  I’d love to watch the process by which people attempt to arrive at a working compromise on What Things Are.

Psych Central has developed a test purporting to give you a sanity score, with useful-looking subscores.  There is some actual science behind this, which looks pretty reasonable – they’re doing the standard appropriate things you do with tests, like make sure the questions you mean to measure the same thing are all measuring the same thing, and are similar to questions from other tests that have been shown to measure what they mean to measure reasonably well.

It looks like their plan is get lots of people so that they can estimate for any given person where they lie in comparison to the rest of the population.  Note that this is not the same thing as the DSM, which gives criteria by which to diagnose people.

It’s still in beta, meaning that they don’t have a big enough sample to be comfortable with their numbers yet.  Also, although they don’t mention this, keep in mind that it’s a test that people who are curious about how sane they are will opt to take, and not a test that your average joe will necessarily be interested in.  So, on average, they may have people who are less sane than the general population.   If that’s true, then people who take it will look saner than they would compared to the average joe.

I got a 47 of 288, which they say is “good mental health” – somewhat saner than I was expecting.

It reminds me of an Ursula Le Guin short story (“SQ,” in the collection The Compass Rose) about a  sanity quotient test.  Everyone over 50 got committed, which meant eventually everyone in the entire world, except for the narrator.

And that reminds me of the part from one of the Hitchhiker’s Guide To The Galaxy novels where a character has built a sanitarium to enclose the entire world.

Although I don’t think either of those relate to this – it sounds more likely to say that people saner than they are, than to say that people are crazier than they are.