News, July 2012

Towards 'personal connectomics'?

Researchers in Los Angeles workingon an ambitious programme to create a complete wiring diagram of the brain – the Human Connectome Project – have turned their attention to one of the most famous brains in the history of neuroscience, the one belonging to Phineas Gage.

Gage of course was the 19th-century railway worker who survived an explosives accident in which an iron rod shot through the front of his brain. Several attempts have been made over the years to estimate the precise brain damage that Gage suffered – no easy task given that his brain was never preserved.

Before now the most comprehensive reconstruction of Gage's injuries was published in 2004 by Peter Ratiu and his colleagues at Brigham and Women's Hospital and Harvard Medical School. They overlaid a 3D representation of a brain within a 3D reconstruction of Gage's skull and simulated the path of the iron rod. Their conclusion was that Gage suffered damage to the left frontal lobe only, just as Gage's doctor Harlow had speculated in 1868.

Now John Darrell Van Horn and his colleagues at the Laboratory of Neuro Imaging, University of California, Los Angeles have made the first-ever attempt to estimate the damage that Gage suffered to the white-matter pathways of his brain (PLoS One: tinyurl.com/c9psbgh). To do this, they averaged MRI and diffusion tensor scans of 110 healthy men of similar age to Gage at the time of his injury, to create an estimate of his 'connectome' – the term used to describe the brain's long-distance communications network (diffusion tensor scans use the movement of water molecules down the brain's neurons to build a connectivity map). The researchers then employed Ratiu's reconstruction of the path of the iron rod to see which aspects of Gage's connectome would have been compromised by his accident.

Their estimate is that 4 per cent of Gage's grey matter was damaged in the left hemisphere and 11 per cent of his cortical white matter. Among the important connective bundles that the researchers believe were damaged are the uncinate fasciculus (which connects the frontal lobes with the limbic system), the cingulum bundle (connecting parts of the limbic system with each other), and the superior longitudinal fasciculus (long-distance fibres linking the front and back of the brain).

This spread of damage to Gage's white-matter tracts would have affected not only the left frontal lobe, the researchers said, but indirectly would have affected the functioning of the right hemisphere too. Moreover, they explained that abnormalities in the uncinate fasciculus have previously been associated with mental illness and related to cognitive deficits in traumatic brain injury. Taken together, Van Horn's team said their findings suggested Gage's injuries would have had 'a considerable impact on executive as well as emotional functions', and 'likely combined to give rise to the behavioural and cognitive symptomatology originally reported by Harlow'.

The degree to which Gage was affected by his injuries is a matter of ongoing debate. Traditional accounts say that Gage's personality changed dramatically and permanently; that he went from being a conscientious, sociable employee to a drunken aggressive waster. In recent years, however, the Australian historian and psychologist Malcolm Macmillan and his colleague Matthew Lena have argued (see www.bps.org.uk/gage) that Gage made an impressive psychosocial recovery, including working as a stagecoach driver in South America. At first the new results appear to be at odds with this idea, but as Macmillan explained to us, the findings are likely only to apply to the immediate years after Gage's accident. 'If Lena and I are right about the post-accident Phineas gradually changing from the commonly portrayed impulsive and uninhibited person into one who made a reasonable "social recovery",' he said, 'we need to know if and how changes in the tracts contributed. As I see it, and unfortunately, it seems unlikely that we will ever be able to reconstruct those long-term changes.'

As well as shedding light on the Gage myth, the new findings are part of the broader, ongoing mission of the Connectome Project to find out how the brain's connective pathways are related to mental function, including predicting the chances of rehabilitation after injury or illness.

Van Horn told us that several studies have already been published attempting to 'identify those imaging-based white-matter biomarkers which can predict clinical outcome and accordingly guide treatments.' He also explained that it's becoming routine in most major medical centres around the world with the available technology to collect structure and diffusion tensor imaging from brain-injured patients. 'We look forward to an era of "personalised connectomics",' he said, 'in which individual patients with traumatic brain injury as well as degenerative diseases (e.g. Alzheimer's, Huntington's, frontotemporal dementia, etc.) can have their unique patterns of connectivity mapped to help physicians tailor and customise patient-specific treatments and lead to improved clinical outcomes.' CJ

Parenting classes on trial

A two-year trial of parenting classes for the parents of children aged five or under has launched at three locations in England – Middlesbrough, High Peak in Derbyshire, and the London Borough of Camden. Parents in those areas can pay for classes using a £100 voucher provided by the government and distributed via Boots, the high-street chemist. Third-party organisations, including the National Childbirth Trust, Barnardo's and Parent Gym, are running the classes.

The trial has attracted accusations of nanny-statism in some sections of the media, but the government says long-term evidence shows that early support for parents leads to better outcomes for children.

Announcing the 'CANparent' trial last year, the Minister for Children and Families, Liberal Democrat MP Sarah Teather, said the aim was to overcome the stigma attached to parenting classes and that the participating organisations 'will attract and engage parents through a mixture of face-to-face and online classes, and in a variety of community settings including schools and children's centres'.

Information released by the Department for Education says that the classes will adhere to evidence-based principles, including: helping parents develop secure attachment and stimulate their child's development; using engaging delivery styles likely to engender behaviour change; and maintaining workforce training and supervision for those delivering the classes to ensure they stick to evidence-based principles.

The CANparent trial is being evaluated by BPS Fellow and past-president Professor Geoff Lindsay (University of Warwick), a Chartered Educational Psychologist, together with colleagues at the research agency TNS-BMRB, Bryson Purdon Social Research and London Economics. 'Bringing up a child is one of, if not the most important tasks we carry out,' Lindsay said. 'There is now substantial evidence for the effectiveness of evidence-based parenting classes. Our research will provide evidence to inform the development of effective policy, for the benefit of parents and their children across the country.'   cj   

www.canparent.org.uk
Geoff Lindsay was interviewed in our 'Careers' section last month

 

Report tackles negative body image

A cross-party group of MPs has co-authored a report with the charity Central YMCA that claims over half the UK population now suffers from a negative body image, with girls as young as five worrying about their size and appearance.

The All Party Parliamentary Group (APPG) on Body Image took evidence from a diverse range of expert witnesses, including the Chartered Psychologists Professor Nichola Rumsey (Centre for Appearance Research, UWE) and Dr Viren Swami (University of Westminster), representatives from Girl Guides, Debenhams, and the British Association of Aesthetic and Plastic Surgeons.

Jo Swinson MP, Chair of the APPG said: 'Body image dissatisfaction in the UK has reached an all-time high, and the pressure to conform to an unattainable body ideal is wreaking havoc on the self-esteem of many people.'

The report makes a number of recommendations including exploring alternatives to BMI as a measure of health, and a commitment from advertisers to develop campaigns that feature more realistic and diverse portrayals of body shape. Central YMCA is working on a campaign to launch this autumn that aims to promote the report's recommendations. There are also plans to roll out a 'kite mark' or brand to be awarded to businesses that take action to combat negative body image.     cj

www.ymca.co.uk/bodyimage

 

DSM – Concerns remain
The task force working on the next edition of psychiatry's Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has announced that controversial plans to include the new conditions 'attenuated psychosis syndrome' and 'mixed anxiety depressive disorder' have been shelved, pending further research.

However, in its final consultation response the British Psychological Society maintained 'reservations in relation to the underlying assumptions and methodology within the revision process. The BPS's view is that the revision is not based on a scientific methodology, that many of the categories have poor reliability in field trials, and that the extension of "catch all" categories such as "atypical" or "subclinical" risk pathologising normal experiences. This is considered a particular concern in relation to children and young people where behaviour that may be merely "young for age" may lead to a diagnosis that has life long psychological and physical impact if it leads to stigma and inappropriate use of medication.' 

For the full Society response, see tinyurl.com/bpsdsm2012

IoP appointment
The Institute of Psychiatry has appointed Professor Francesca Happé Head of Department and Director of the MRC Social, Genetic and Developmental Psychiatry Centre. Happé, a BPS member and former Spearman Medal winner (see www.tinyurl.com/bpsspearman), said she was delighted and privileged to follow in the footsteps of Sir Michael Rutter, Professor Robert Plomin, and Professor Peter McGuffin. 'It is a huge responsibility, and honour,' she added, 'to steer the SGDP Centre as it approaches 20 years since its founding.'

Memory training ineffective
Based on a meta-analysis of 23 studies, researchers at the University of Oslo and UCL have concluded that working-memory training fails to provide widespread intellectual benefits and is an ineffective
form of intervention for children with ADHD (Developmental Psychology: tinyurl.com/bstb7m2). Lead author Monica Melby-Lervåg said 'simply loading up the brain with training exercises will not lead to better performance outside of the tasks presented within these tests'.

 

Promoting the right type of intergroup contact

A pair of social psychologists at the University of Kent say that for multiculturalism to work, social policy needs to recognise the way our minds have evolved to respond to outsiders.

Writing in the prestigious journal Science, BPS Fellow Professor Richard Crisp and postgraduate researcher Rose Meleady explain that we have two cognitive systems for thinking about social groups (tinyurl.com/8yvkmzz). The first is fast and automatic and allowed our ancestors quickly to identify allies from foes in a world where intergroup contact was rare. Studies today show this system in action when observers are able to classify people by social category in a matter of milliseconds.

However, a second system also evolved that allowed crude ingroup/outgroup categorisation to be overruled, making it possible to forge new alliances. Research shows that this second system can be activated when attention is drawn to an outsider having multiple group memberships, especially if these co-occur relatively rarely (e.g. a German Muslim). This reduces prejudice by highlighting the person's individuality. Research also shows that prejudice can be reduced if attention is drawn to an outgroup member belonging to social categories that overlap with an ingroup member (e.g. the outgroup member may belong to a different ethnic category but the same age category).

Crisp and Meleady argue that policy makers need to recognise the kind of social contexts that switch-on the second system. They explained, for example, that simply bringing two groups together will do little other than activate System 1. By contrast, 'when policy encourages individuals to embrace new, cross-cutting bases for social affiliation, particularly those that defy category-based expectancies, then activation of System 2's coalition-building function may more readily reduce the negative emotions that inhibit intergroup contact, and in turn promote more positive engagement with outgroups'.

Crisp and Meleady's paper 'Adapting to a multicultural future' is part of a Science special section on human conflict, which is open access via free registration (tinyurl.com/cvkowjc). cj

Honorary award

Professor Fiona Patterson (University of Cambridge), a Chartered Psychologist, has been awarded an honorary fellowship from the Royal College of General Practitioners at their Spring General Meeting, in recognition of her long-standing contribution to the UK GP Specialty Training recruitment process.

Professor Patterson has  long been at the forefront of developing medical selection and recruitment. Her research in this area began in the 1990s with an analysis of the GP job role, which in turn led to the development of a competency-based selection system. She has continued to lead the ongoing development of the UK GP Specialty Training recruitment process to include the development of new tests focusing on key professional attributes such as empathy and integrity, using Situational Judgement Tests and an assessment centre methodology.

On receiving the award Professor Patterson said: 'Over the years, it's been an exciting partnership working in collaboration with senior leaders in general practice. I would like to extend my thanks for their support, enthusiasm and hard work that has allowed us to develop and continually improve a world-class recruitment process for GP training in the UK.

The Queen's Nursing Institute has funding available for projects that will help community nurses deliver improvements in patient care. Any nurse working in clinical practice in a community setting is eligible to apply. Applications from teams of nurses are preferred.
The closing date for application is 17 October 2012.
www.qni.org.uk/for_nurses/project_funding

For more, see www.bps.org.uk/funds
Funding bodies should e-mail news to Elizabeth Beech on [email protected] for possible inclusion