News, Digest and Media: October 2010

Inside the autistic brain

Researchers reported in August that they'd used a 15-minute structural MRI scan to identify several brain differences between male adults with autism and healthy controls, and further, that they'd devised an algorithm that could use these differences to categorise an autistic brain as autistic with 90 per cent accuracy (Journal of Neuroscience, tinyurl.com/3xypbv7).

The distinguishing brain features included the undulation of sulci and gyri (the peaks and troughs of the cortex), as well as patterns of cortical folding and thickness, demonstrating, the researchers said, that the '"autistic brain" is not just bigger or smaller but is also "abnormally shaped"'. The participants were 20 high-functioning male adults diagnosed with autistic spectrum disorder (ASD), 20 male healthy controls and 19 males with a diagnosis of ADHD.

In their report, Christine Ecker at the Institute of Psychiatry and her colleagues mentioned the potential diagnostic utility of the findings, but acknowledged that 'further extensive exploration in the clinical setting' will be needed. The researchers also said they hoped the distinguishing features they'd identified could help 'further exploration of the genetic and neuropathological underpinnings of ASD.'

Ecker told The Psychologist that classification algorithms of the kind used here are highly specific to the sample that they are 'trained' on. 'The advantage', she explained, 'is that the classifier offers high specificity with regard to this particular subject group, but it is less specific to other cohorts on the spectrum. Therefore, the more data becomes available to us [through validating the technique on different autistic spectrum subgroups and complex cases with comorbid conditions], the better our approach will become… This highlights a huge need for the acquisition/data sharing of additional well-defined subject groups that we haven't investigated yet.'The media headlines attracted by the new findings were not so equivocal: 'New brain scan to diagnose autism' (BBC), 'Experts hail new test that can diagnose autism in 15 minutes' (The Independent). Enthusiastic journalists were helped on their way by a press release from the Medical Research Council (MRC), the body responsible for funding the research. 'The value of this rapid and accurate tool to diagnose ASD is immense,' Ecker was quoted as saying.

Sceptical experts were quick on the scene. Writing in The Guardian, Carl Heneghan, director of the Centre for Evidence Based Medicine, said that to be taken seriously, potential diagnostic tools need to be tested on patients with a broad range of disease severity, including some suspected of having, but not known to have the target condition. Heneghan also raised the issue of specificity – the risk of false positives – an especially pertinent issue for any condition where the base rate in the general population is low (ASD has a prevalence of about 1 per cent). Whereas the new algorithm correctly categorised a person with autism with 90 per cent accuracy, Heneghan said the 80 per cent specificity of the test would mean that a random person receiving a positive result would have only a 4.5 per cent likelihood of having autism.

Dorothy Bishop, Professor of Developmental Neuropsychology at the University of Oxford, echoed Heneghan's concerns and pointed to a further problem with the media presentation of the study as a diagnostic breakthrough. 'The reductionist notion that a person's behaviour is solely a function of their brain morphology is unrealistic given what we know about structural and functional brain variation in normal and abnormal development,' she said.

'Quotes attributed to the authors imply we should abandon conventional diagnostic methods and just put people in the scanner instead,' Bishop continued. 'This would be rash given the small scale of the study, the existence of false positives, and the multifactorial nature of autism etiology. It is unfortunate that interesting findings from this study have been overshadowed by misleading media hype. Worldwide, there are now plenty of brain-imaging studies of both children and adults with autism and other clinical conditions: I hope the authors will take advantage of these datasets to replicate and extend their findings before promoting their work as a diagnostic tool.'

Ecker said she and her colleagues were amazed by the huge media coverage of their research. 'Of course there is only so much scientific information that we were able to relate to the public via the press, and with good press comes bad press too. For instance, some experts said we had exaggerated the accuracy of our approach as it is unsuited for a "population screen" (i.e. assessing every single individual of the UK population). However, our test was never designed to screen the entire population. Instead it could be used: (1) if there is a suspicion of autism that needs to be confirmed using a biological test, (2) there is a high risk that an individual is affected, and (3) to confirm the diagnosis in the absence of the informants that are needed for the conventional diagnosis.

'The strong media interest and the very positive reaction by the public clearly demonstrates that we are working on something that could be of huge benefit in the future and that could be truly useful for affected individuals, their parents and the NHS,' Ecker said. 'And if we get some bad press on the way, we still know that we are working towards a goal that is well worth fighting for.' 

A-level results
Figures released in August show that 54,940 students (73 per cent of them female) sat A-level exams in psychology this year, up from 52,872 in 2009. That means the subject retains its place as the fourth most popular at A-level behind English (89,320) maths (77,001) and biology (57,854). Biology, chemistry, physics and sociology also enjoyed increases in student numbers.

While the proportion of students awarded an A grade rose overall to 27 per cent this year, psychology actually experienced a fall in the proportion of A grades awarded to 18.7 per cent (including 5.2 per cent at the new A star level), down from 19.2 per cent in 2009 and 19.3 per cent in 2008.  Girls outperformed boys, with 21.3 per cent of them achieving an A grade compared with 11.7 per cent of boys. Once again, there was a rise in the proportion of psychology students achieving a grade C or above – 69.6 per cent compared with 68.8 per cent last year and 67.7 per cent in 2008.

- The full results are at www.jcq.org.uk

Psychosis tapestry unveiled

The Bethlem Tapestry, featuring the work of patients at the Bethlem Royal Hospital's psychosis unit, will be unveiled in a new exhibition for World Mental Health Day 2010 (10 October). The display at the Bethlem Gallery was led by artist Mark McGowan and involved patients, staff, volunteers and carers.

The tapestry comprises images and text made by the participants depicting experiences, thoughts and feelings in their daily lives. It will be permanently installed on the ward for the long-term enjoyment of patients, visitors and staff.

Mark McGowan is a former patient of the Bethlem Royal Hospital – part of the South London and Maudsley NHS Foundation Trust (SLaM) – having spent time at the hospital between 1992 and 1998. Mark said: 'I was very ill and came to SLaM in a really bad state. As a patient I was given access to the arts facilities and never looked back.' Since leaving the Bethlem, Mark went on to complete an art degree and now teaches at the Chelsea and Camberwell Colleges of Art, having travelled the world through his art projects.

Dr Sukhi Shergill, who initiated the project, said: 'The tapestry project was in tune with recent National Institute for Clinical Excellence (NICE) guidelines on treating psychosis which highlight the benefits of art therapies for patients, not only in enhancing creative expression, but also in initiating dialogue and helping build confidence'. Pamela Jacobson, a clinical psychologist within the National Psychosis Unit, said the creative groups had been very beneficial to patients: 'They have given people an opportunity to feel involved and to produce something which will be valued.'

- Free entry; runs until 15 October 2010. See www.bethlemgallery.com

An evolving case of misconduct

Marc Hauser, the author of Moral Minds: How Nature Designed a Universal Sense of Right and Wrong, has been found guilty of scientific misconduct by a Harvard University investigation that began in 2007. An evolutionary biologist by training, Hauser worked in the psychology department at Harvard and is considered a leading light in the fields of animal cognition and the evolutionary basis of morality.

In a letter to colleagues that's been leaked to the press, the Dean of Harvard's Faculty of Arts and Sciences said: 'It is with great sadness that I confirm that Professor Marc Hauser was found solely responsible, after a thorough investigation by a faculty investigating committee, for eight instances of scientific misconduct under FAS standards.'

These eight counts of misconduct have led to one paper being retracted ('Rule learning by cotton-top tamarins', Cognition, 2002, 86, B15–B22), one corrected ('Rhesus monkeys correctly read the goal-relevant gestures of a human agent', Proceedings of the Royal Society B, 2007, 274, 1913–1918), with one under discussion ('The perception of rational, goal-directed action in nonhuman primates', Science, 2007, 317, 14021405). The other five counts relate to unpublished work or to problems that were corrected prior to publication.

Hauser is now on leave until autumn of next year. What other sanctions he may face remain unclear. As Hauser received federal funding for his research, he is also under ongoing separate investigation by federal authorities.

In a statement e-mailed to several news outlets, Hauser said: 'I am deeply sorry for the problems this case has caused to my students, my colleagues, and my university. … After taking some time off, I look forward to getting back to my work, mindful of what I have learned in this case. This has been painful for me and those who have been associated with the work.' Hauser's next book is Evilicious: Explaining Our Evolved Taste for Being Bad. 

I    See also Webchat, p.789

IN BRIEF

From the American Psychological Association Annual Convention, San Diego, 12–15 August 2010

Childhood trauma casts a long shadow. Janice Kiecolt-Glaser at Ohio State University College of Medicine recruited 58 participants caring for a close relation with Alzheimer's and 74 non-carer controls. Regardless of caregiver status, a history of childhood abuse (physical, emotional or sexual) was associated with depression and biochemical markers of stress, including increased inflammation. 'These early childhood experiences have lasting, measureable consequences later in life, producing effects that are large enough to be perceptible even in the face of a current major stressor…' Kiecolt-Glaser said. 'The findings show the importance of intervening early to prevent these stress effects.'

Rapid eye movement (REM) sleep – the stage associated with vivid dreams – may be particularly important to creativity. Sara Mednick at the University of California, San Diego, gave students a divergent thinking test (the Remote Associates Test) in the morning and again in the afternoon, after they'd either rested quietly, had a REM-free nap or a nap with REM. Whereas the non-REM students showed no improvement, the REM students improved by 40 per cent. 'REM sleep is important for pulling together all the information we process on a daily basis and turning it into memories we can use later,' Mednick said.

Contemporary books and films are giving boys are distorted sense of masculinity that says they must strive to be either a superhero or a slacker. That's according to Sharon Lamb at the University of Massachusetts-Boston, based on her survey of hundreds of boys, her perusal of shopping malls and interviews with shop assistants. 'Slackers are funny, but slackers are not what boys should strive to be; slackers don't like school and they shirk responsibility,' Lamb said. 'We wonder if the messages boys get about saving face through glorified slacking could be affecting their performance in school.'

Chronic pain conditions like fibromyalgia are more common in women than men, due in part to hormonal effects, but also to the contrasting ways the genders view pain. 'Women tend to focus on the emotional aspects of pain,' said Jennifer Kelly of the Atlanta Center for Behavioral Medicine. 'Men tend to focus on the physical sensations they experience. Women who concentrate on the emotional aspects of their pain may actually experience more pain as a result, possibly because the emotions associated with pain are negative.' Kelly advocated teaching coping strategies and encouraging women to feel that pain is something they can manage.

Against the backdrop of research seminars showing that children raised by same-sex parents are on a par with children raised by opposite-sex parents in terms of psychological adjustment, cognitive abilities and social functioning, the APA reaffirmed its support for same-sex marriage. 'As the world's largest organisation of psychologists, we felt it was important to make a statement here and now to demonstrate APA's unwavering support of marriage equality,' said APA President Carol D. Goodheart. 

Pakistan floods 

As we go to press, the deluge in Pakistan continues. More than 1600 people have died and about 17 million of Pakistan's 166 million people have been affected by the disaster. Deputy Prime Minister Nick Clegg described the international response as 'absolutely pitiful', and science blogger Jonah Lehrer (see tinyurl.com/29v43hk), speculated that the floods 'have received far less attention than warranted, in part because most of the stories focus on the vast scope of the disaster, and not on individual tragedies'. But there are signs that the psychological impact is being considered, even as the waters slowly subside.

So what is the situation like on the ground? 'It's extremely traumatic, and the extent of this event is beyond our imagination,' Dr Rukhsana Kausar, from the Department of Applied Psychology at the University of the Punjab, told The Psychologist. 'Day and night, watching the miseries of our country fellows on TV is so distressing and it has resulted in feelings of helplessness. It has not stopped yet – every day it is sweeping away hundreds of villages, resulting in numerous deaths and changing the geography of our country. Every day women and children are dying due to hunger, and there are areas where no one has reached yet.

Although Dr Kausar noted there was an inevitable focus on rescue and survival, she said there were also signs that a professional response was developing. 'Right now I am compiling material specifically linked to flood-related trauma. We are putting all our efforts into finding credible people who can deliver the goods to the right people. One of our senior colleagues and psychologists is Vice Chancellor of the Karakaram International University, Gilget, one of the hard-hit areas. She is mobilising fellow psychologists and acquaintances to donate so that she can help people in her area. We had been very active in previous traumatic incidents, such as earthquakes, and with internally displaced persons… we do aim to provide psychological support to the flood victims and will ask our international colleagues to also provide help, but right now sending teams to such areas – which in most of the cases are only accessible through helicopters – is not possible.' Kausar further called for the BPS, through its members, to provide support in trauma counselling training.

The International Medical Corps reported that some such interventions had indeed taken place: 'Psychosocial teams have identified people with depression, anxiety, and significant psychological distress. To date, they have conducted individual and group sessions for approximately 400 individuals, including children under the age of 12.' Falak Niaz, one of their psychologists, told us that counsellors have been conducting activities for the affected population to lessen their stress levels, such as games, drawing and colouring, singing and sharing of jokes with children. 'We would appreciate training for our psychologists and counsellors on mental health response in emergency setting, any literature on this topic, recreational materials, toys, etc. [[email protected]]. The humanitarian response was quick and immediate, but given the scale of devastation and damage to communication networks, it is still very difficult to fulfill all the needs of all the people affected by floods – more than 20 million.'

 

Remotely rewarding
 
Dr Amanda Potter, a Chartered Occupational Psychologist and Associate Fellow of the British Psychological Society, has won the BlackBerry Remote Employer Award. The scheme is aimed at identifying and honouring entrepreneurs who have proved how home working and remote working has made a beneficial impact on their business.

Dr Potter is Managing Director of Zircon Management Consulting, a business psychology company established in 2000. She told The Psychologist: 'Our expertise is drawn from a team of 140 remote consultants to deliver creative solutions for our clients. We are delighted that the judges gave us credit for proving that having a remote workforce enables companies to improve business productivity with an eco solution, whilst giving their team the opportunity to have autonomy and a positive lifestyle.'

Lords inquiry
The House of Lords Science and Technology Committee has appointed a sub-committee, chaired by Baroness Neuberger, to investigate ways to change population behaviour in relation to health, the environment and other governmental concerns (see http://ht.ly/2xVym). Chartered Health Psychologist Professor Charles Abraham at the University of Sussex is acting as special adviser. In language that sounds reminiscent of the liberal paternalism approach made popular by the 2008 book Nudge, the sub-committee's formal call for evidence explains how governments are becoming increasingly interested in 'different types of behaviour change policy interventions that rely on measures other than prohibition or the elimination of choice'.

The inquiry will explore which behavioural interventions have been successful in the past and which haven't, and the implications this has for future policy. There will be a focus on two case studies, the first of which is obesity (the second is to be announced in due course). Written evidence submissions must be received by 8 October. Public meetings are to be held from November this year, and a report on the findings is slated for publication in summer 2011.