Tuesday, February 15, 2011

Looking at affected body parts reduces pain

Here's an interesting little study showing that acute physical pain is diminished in intensity when one is looking at the affected body part;   if this body part is artificially made to look larger, then the subjective pain is reduced even further. 

 In applying this type of idea to psychological pain, I guess one could say that "looking at the affected body part" could translate to discussing the problem in a therapeutic dialog. 

A limitation of the study, and with pain studies in general, is that a brief intervention for an acute pain may not necessarily be equivalently helpful as a prolonged intervention for a chronic pain.  In fact, some effective physical treatments for acute pain potentially exacerbate a chronic or recurrent pain disorder (e.g. using opiates to treat mechanical back pain or migraine). 

However, I believe that studies of this type do illustrate that simple, brief psychological techniques can be surprisingly powerful in modulating perceptions or sensation.  

Working memory exercises for treating addictions?

Here's a link to an interesting article from Biological Psychiatry this month:

It is based on the notion that the decision to engage in an addiction is often made based on a short-term, possibly impulsive, analysis of benefits and risks; consequently, longer-term risks or benefits associated with the behaviour are undervalued.  This phenomenon is termed "delay discounting."   Resistance to delay discounting could be considered a cognitive faculty that would help, on an intellectual level, with making a healthy decision in the face of strong impulses in the moment.

The authors note a relationship between addictive disorders and increased delay discounting.  They also note a previously described relationship between delay discounting and reduced working memory function. 

Based on these relationships, they did a controlled study of persons with stimulant addiction, in which the active group did a set of memory training exercises for 1-2 months. They found that the memory exercises led to improved (reduced) delay discounting.

This study does not show that memory exercises directly improve the course of addictive disorders; but it does present a promising therapeutic idea which I think is currently underutilized in the therapeutic community, not only for addictions but for other types of problems.

Cognitive exercises could have a variety of benefits for various psychological problems:
1) the improvement one would see with practice could help with self-esteem
2) arguably, the exercises would favourably alter the balance between executive function and visceral, limbic emotional drives (which could often be turbulent or disruptive)
3) the exercises could be an introduction to the various mental and physical disciplines required to effect psychological or behavioural change

In terms of the specific exercises used in this study, I do think that the number of practice sessions was far too small.  I believe that most psychologically beneficial activities start to show substantial results after 50-100 hours of practice.  This study  used only a maximum of 15 training sessions.  The memory practice itself could have been organized in a more engaging, game-like manner.  I think of some quite unique working memory games from the lumosity.com website, which tap into a type of activity most people would rarely work on directly, but yet are quite entertaining and allow gradual progress.

In summary, this was an interesting article looking at the promising theme of using cognitive training exercises as part of the  treatment of  a psychological problem.  This is a relatively new idea, showing up only a few other times so far in the research literature.

Monday, January 31, 2011

Omega-3 deficiency and low dietary omega-3 to omega-6 ratio may exacerbate depression and reduce neuroplasticity

Here's an interesting update on the dietary fatty acid issue, as it pertains to mood disorders and neuroplasticity:

This article, published in Nature Neuroscience (January 30, 2011), is an example of some good research being done by a group at the University of Bordeaux in France.  They demonstrate substantial negative neurophysiological changes in mice as a result of an omega-3 deficient diet.  It is interesting to note that the brain's endocanniboid system is specifically affected by omega-3 deficiency, according to this research.

This is further evidence supporting the importance of attending to a healthy diet, in maintaining optimal mental health.  Omega-3 fatty acids are one element of a healthy diet.  While omega-6 fatty acids are also needed in the diet, these lipids behave to some degree competitively with omega-3.  Therefore,  the ratio of dietary omega-3 to omega-6 is is very important.  Western diets tend to have an unhealthy ratio of these lipids, due to excessive omega-6. 

An ongoing issue of debate has to do with whether plant sources of omega-3 (primarily ALA) are as useful as fish sources (DHA and EPA).  Existing evidence shows that DHA and EPA are more important.  ALA can be converted in the body to DHA and EPA, but the efficiency of this may vary from person to person.

Wikipedia has a nice review of this subject: http://en.wikipedia.org/wiki/Omega-3_fatty_acid
but some of the sources are less than ideal.

It is interesting to consider that the DHA/EPA issue is not a "micronutrient" issue.  They could be considered  "macronutrients."  The solid mass of the brain consists mostly of lipids (60-80 % of the non-aqueous mass); DHA and EPA  make up over 10% of this lipid mass, which is a very high concentration.

Here's a link to a paper which quantifies the  high fractions of omega-3 lipids in brain mass:
http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=921064   --this paper also showed that dietary changes substantially altered the proportion of omega-3 lipids in brain tissue

Monday, January 24, 2011

"Outlier": The causes of high achievement

Outlier by Malcolm Gladwell, is a brilliant book about the causes of success, outstanding achievement, and personal greatness.

Gladwell describes a variety of interesting life stories, of people with outstanding ability or outstanding achievement, then looks carefully at the factors leading to these successes.

He does not claim that "inborn traits" or hereditary factors are unimportant.  But he shows quite convincingly that inborn talents correlate with achievement only to a certain point.  Individuals with extreme talents tend not to achieve more than those with merely "sufficient" talents. A recurring theme in this book, shown through one example after the next, is that the simple stories many people might have, to account for a person's great achievements, are often appealing and believable, but are in fact often inaccurate or at the very least incomplete.

He shows that various situational biases can have a profound, snowballing effect on the course of successfulness in a person's life.  A trite detail such as birthdate can lead to a cascade of advantages or disadvantages for athletes, which then accumulate over many years (his example is of successful hockey players being much more likely to have an early birthday--if you're born in December, this is an instant disadvantage, as you will be a little bit smaller and weaker on average compared to your teammates, therefore the older players will tend to outperform you, leading to a smaller chance of  you being noticed or advanced to a more challenging team, or to be deemed "gifted" and given more ice time, etc.)  

He emphasizes the role of thousands of hours of intensive practice being required to master a skill.  Those who have 10 000 hours of practice under their belt early on in their lives--particularly if some serendipitous quirk of fortune allowed them to be one of the only individuals, or one of the first, to gain this experience-- have a strong chance of succeeding spectacularly in their fields.  He gives examples such as Bill Gates, or the Beatles, or some of the most successful New York lawyers doing a particular type of law. 

One of the psychologists cited in this book,  who has studied the area of "exceptional achievement" is AK Ericsson, who generally argues that "extended, intense practice"  is the primary determinant of elite performance, as opposed to inborn talent.  The ability to do this type of practice, of course, requires or is greatly facilitated by, motivational resources as well as environmental opportunity, parental support, a culture which favours such as endeavour, etc.) Here are some references to articles of his:
I suspect that heredity is quite relevant, but may manifest itself in many ways aside from what many people might assume.  Factors that could be considered at first glance to be a disadvantage, either hereditarily or environmentally, may, in the world of successfulness, end up being compelling advantages.

Guillermo Campitelli is another excellent researcher in this field; here's a reference to one of his recent papers: http://www.ncbi.nlm.nih.gov/pubmed/17201516.  The evidence here, looking specifically at chess players as a model of acquiring expertise, affirms the extreme importance of thousands of hours of  practice, but also recognizes that some players improve much more than others with the same amount of practice.  This is probably the influence of inherited talent.  Maybe there could be other hidden variables, including family or cultural factors.   He suggests that the age at which the practice begins is another important variable.  

It should be noted that, in this literature, "deliberate practice" refers to a type of activity which is specifically directed towards performance improvement, is adequately difficult, has feedback about performance, and which has opportunity to correct errors.  This differs from "ordinary" work experience, which may be quite a bit less intense and much less geared towards improving skills.  I suspect that the quality of "deliberate practice" may vary quite a bit, depending on the degree of immersion, concentration, energy, engagement, and meaningfulness there is in the action.  I wonder if enjoyment of the practice is a major variable too, I would be interested to see if some of these researchers would look at this.  If someone finds their 100 hours of practice meaningful and enjoyable, I have to wonder if they might advance much more than someone whose 100 hours were a drudgery.    

Another excellent angle of discussion in Gladwell's book has to do with understanding a person's cultural background and childhood developmental history, as extremely important determinants of success.   This leads to discussions about opportunity, pedagogical technique and policy, etc.  Sometimes cultural or developmental factors cause individuals to lack a certain skill necessary to succeed, or put individuals at risk of recurrent severe problems or frustrations.  Good examples are given, including the story of a profoundly gifted intellect who was never able to share his talents; and of highly trained pilots who were too quietly respectful of authority to be able to proactively use strong assertive social skills to prevent an aviation disaster.

I'll add to this post later on, to expand some thoughts about achievement and success.  In the meantime, I think Outlier is a worthwhile and entertaining read.

Friday, January 21, 2011

Writing about worries can ease exam anxiety

Here's another simple research finding, published recently in Science by Sian Beilock:  students who spent ten minutes--immediately before a test--writing down their thoughts about what was causing them fear, performed substantially better on the test.


I'll have to review this paper in more detail to comment further, but I think it is another simple anxiety-management tactic for exam or performance preparation.  A frantic review or a frantic bout of anxious rumination right before an exam is unlikely to help -- an anxiety-management exercise such as expressive writing is very much more likely to help, and a study like this is strong evidence of this.

The article shows that the effective action was specifically to write about negative thoughts and feelings during the ten minutes before the beginning of a stressful exam.  A control activity--of writing about anything that comes to mind--was not effective.   So the effectiveness of this technique was not simply due to distraction. 

I would be interested to see the authors' opinions and/or research about whether specific journaling techniques could work particularly well, or less well, in various anxiety scenarios.  Sometimes, purely "negative" journaling can end up being a somewhat ruminative activity which entrenches negative emotional states and attitudes (e.g. one can get worked up in a cynical, pessimistic rant, which could increase or magnify one's following cynicism or pessimism, or increase one's filtered attention to negative events in the day).
See the following references:
   A "balanced" journaling style, which includes room for free discussion of thoughts and feelings, but also room for positively-focused or constructive discussion may prevent this risk of snowballing rumination or negativity from a journaling activity.   One simple aspect of this experiment was that the journaling was immediately before a performance, and was very time-limited (10 minutes); these factors may reduce the potential for the journaling to be a negative or ruminative behaviour, and may increase the chance of the activity serving to process anxious emotion effectively.