The cult of the hyperpolyglot

Tags

Hyperpolyglot, Language, Polyglot

http://www.bbc.co.uk/news/magazine-17101370

Many people want to speak a second language, but for some people two can never be enough. Welcome to the world of the hyperpolyglot.

Ray Gillon speaks 18 languages. To be precise, he only speaks eight fluently. His grasp on the other 10 is merely conversational.

Throw anything at him in Portuguese, Thai, Turkish, Russian, Polish, Dutch, Danish, Norwegian, Bulgarian or Mandarin and he will banter back.

In the UK, where there has been a growing anxiety over the failure to learn additional languages, Gillon might seem to be a bit of an anomaly. More and more children have been giving up languages since the last government made learning foreign languages optional in England from the age of 14.

Publisher HarperCollins has been searching for the UK’s most multilingual student, and has discovered a 20-year-old Oxford University undergraduate who can speak 11 languages. And a new book, Babel No More: The Search for the World’s Most Extraordinary Language Learners, by Michael Erard, suggests Gillon is among a set of people who are learning languages for fun.

So what makes some people learn language after language?

For self-taught polyglot Gillon, 54, his love affair with language started by accident. He says he first learned French and Latin at the age of 11, and later studied French and German as elective courses while studying for his electronic engineering degree.

“But it wasn’t until I got my first job, and was sent to live in the south of France, that I had any real enthusiasm for languages,” he says.

It was during this chapter of his life, while designing audio visual systems for a cruise liner, that Gillon was introduced to Italian through colleagues.

“I went to Italy for a weekend, and fell in love with the language. I bought books and started teaching myself. By the end of my three years in France, I was fluent in both languages,” he says.

Gillon’s next job took him round the world, and pretty soon he was up to speed on German, Spanish, Polish, Portuguese and Swedish.

He says he used half a dozen languages every day for 10 years and his current job, which involves supervising foreign language versioning of Hollywood movies, means he has to stay on top of his skills.

“I have a massive foreign language book library, so I regularly keep up to date, revising grammar, reading newspapers, watching satellite television.

“My much better half is also Swedish and speaks six languages – we probably speak them all every day,” he says.

According to author and linguistics expert Erard, there are not many hyperpolyglots like Gillon in the world. He has identified 11 languages as a significant watershed. Those who speak more than this are very rare.

But he says it is difficult to define hyperpolyglots and polyglots because essentially it has to be about speaking and knowing rather than reading and writing. In some cases literacy is not possible, or a language does not have an alphabet.

He says the question of “how much a language weighs” is also significant in determining how unusual a linguist is.

“If the languages are English, French, Mandarin, Japanese, Hindi and Russian – that would be more significant from a learner’s perspective than 11 Romance languages such as Italian, French and Spanish,” he says.

People who are gifted linguists also often have to make the choice between getting very highly developed skills in a smaller number of languages, or focusing on one aspect like the oral language, he says.

For language-lover Matt Withers, 32, who speaks German, Portuguese, Luxembourgish, French and Welsh, it is not his vocation, but a fascination with language and the world that fuels his hobby.

But rather than relying solely on books, he also signed up to a series of courses.

“When I lived in Germany, I shared a house with three Brazilians, so I did an evening course in Portuguese to converse with them – it was interesting trying to learn Portuguese through the medium of German,” he laughs.

“For the past few years, I’ve been living in Wales – I share an office with predominantly native Welsh speakers, so I’ve been learning Welsh.”

Withers thinks that fluency in one language allows people to accumulate others more easily.

“Most monoglots in this country aren’t really able to explain English in terms such as the perfect past tense and past tense. When you learn about cases and tenses and grammatical formations, I think the tool box is there for other languages,” he says.

But he concedes it is not always the case, “as Welsh isn’t like any other major European language, in terms of the way it is constructed, and is incredibly different”.

So what enables hyperpolyglots to seemingly pick up a new language at the push of a button?

Erard says it is hard to explain, but whatever an individual’s biographical reasons are, he believes there is something that distinguishes hyperpolyglots neurologically.

“They have a neurological hardware that responds to the world, that’s fed by the world, that is suited to a pattern that is recognition-heavy, sound-heavy and memory-heavy – that is very structured, and also very sociable.

“They have an ability to switch between languages very easily, and that involves cognitive skills which are often heritable,” he adds.

But Gillon says he has no idea what the secret to his success is.

He says some “blocks” – Germanic, Slavic, Latin – make it “easier to go with the flow, and language becomes intuitive”. He agrees that by the third or fourth language, it also gets easier to assimilate vocabulary and grammar much more quickly.

“Etymology is a sport for me. I enjoy looking up the origin of words and seeing which particular invasion was responsible for bringing that word into our vocabulary. I am immersed in it for my work and it will continue to intrigue me for every day of my life.”

But he concludes: “I can’t explain it – if I could, I would bottle and sell it.”

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Zach Avery, 4, Is Among Youngest In Britain To Be Diagnosed With Gender Identity Disorder (GID)

Tags

Gender Identity Disorder

http://www.huffingtonpost.co.uk/2012/02/20/zach-avery-4-is-youngest-in-britain-to-be-diagnosed-with-gender-identity-disorder-gid_n_1288531.html?ref=mostpopular

A little boy who decided he was a girl trapped in a boy’s body has become one of the youngest-ever children to have his decision backed by the NHS – aged just four.

With his blonde pigtails and purple tutu, Zach Avery, now five, has been living as a girl for more than a year.

Little Zach was just three when he began refusing to live as a boy, instead choosing to wear pink dresses and ribbons in his long, blonde hair – because he hasGender Identity Disorder (GID).

Mum Theresa Avery, 32, said her son used to be a “normal” little boy who loved Thomas the Tank Engine, but suddenly at the end of 2010, he decided he wanted to live as a girl.

He became obsessed with the children’s TV character Dora the Explorer and started dressing in female clothing.

Theresa and Zach’s father Darren, 41, became worried by their son’s behaviour and took him to the doctor.

He was officially diagnosed with GID by NHS specialists at the Tavistock and Patman Foundation Trust in London, making Zach one of the youngest affected children in the UK.

Mum-of-four Theresa said: “He just turned round to me one day when he was three and said: ‘Mummy, I’m a girl’. I assumed he was just going through a phase and just left it at that.

“But then it got serious and he would become upset if anyone referred to him as a boy.

“He used to cry and try to cut off his willy out of frustration.”

Specialists explained to Theresa and Darren that gender identity disorder is a conflict between a person’s actual physical gender and the gender that person identifies himself or herself as.

Theresa said: “They told us that although he had a male body, his brain was telling him he was a girl.”

And Zach’s school – Purfleet Primary in Essex – has even turned their toilet block gender-neutral to support him.

Theresa added: “They have changed the toilets for Key Stage 1 pupils into Unisex instead of male/female and they address him as a girl, which is what he wants.

“When he gets a bit older, to Key Stage 2, then obviously the law changes and there will be more difficulties surrounding the bathroom issue, but we’ll cross that bridge when we come to it – it may be that Zach will use the staff toilets.

“We explained to the other kids at the school that Zachy’s body was that of a boy but in his brain he was a girl. We said Zach was just happier being a girl than a boy.

“But the other kids haven’t batted an eyelid, they’ve accepted Zach as Zach and there’s been no problems at the school with bullying.

“The school has been brilliant and really, really supportive.”

When he goes to school, Zach, known affectionately as Zachy, wears a girl’s trouser uniform and black boots with pink trim, which his mother said is female but still neutral.

And mum said that although she misses her little boy, the family is very supportive of Zachy.

She said: “He just wants to be like a little girl and he’s very happy with his long blonde hair, pink and red bedroom and a wardrobe full of girls clothes.

“He likes playing with his sister’s old toys but he still loves Dr Who too and playing with his brother. And we still put some neutral clothes in his wardrobe if he ever decides he wants to wear them.

“We leave it up to him to decide what he wants to do – if he changes his mind and wants to be a boy again then he does, but if he doesn’t, he doesn’t.

She admitted: “I would love to have my son back, but I want him to be happy. If this is the route he wants to take – if this is what makes him happy – then so be it. I would rather him have my full support.

“People need to be aware of this condition because it’s very common but even many family support workers have never heard of cases in children. There are people out there but they don’t want to talk about it.”

Figures from the Tavistock and Patman Foundation Trust clinic – the national body for GID – revealed 165 children have been diagnosed with GID this year.

A spokesperson at Tavistock Clinic in London said they were unable to comment on individual case, but only seven children under the age of 5 were diagnosed last year – making Zach one of the youngest.

The spokesperson said: “Tavistock Clinic had 97 referrals in 2009/2010; 139 in 2010/2011 and thus far this year 165 referrals.

“The trend in referrals has been up over the years – this may reflect greater awareness.

“We see children and young people up to the age of 18, from across the UK, who are experiencing difficulties in the development of their gender identity.

“This includes children who are unhappy with their biological sex. Some may be boys who prefer activities and role associated with the opposite sex, some may also identify as the opposite sex and vice versa for girls.

“In general when younger children are referred it is in relation to cross gender preferences in play, play mates and activities. It is more unusual for children of this age to express cross gender identification – that is the wish or belief that they belong to the opposite sex.

“The diagnosis of GID is made by the key workers working with the young person. We will also assess their general wellbeing. We remain in contact with young people often for many years.

“Our aim is not to predict or direct the outcome, but rather to support the young person in their general development as well as develop a trusting collaborative therapeutic relationship in which it is possible to openly explore their feelings about their gender.”

FACTS ABOUT GENDER IDENTITY DISORDER

• Gender Identity Disorder in children (GIDC) is the formal diagnosis used by psychologists and physicians to describe children who experience significant gender dysphoria.

• Gender identity disorder is a conflict between a person’s actual physical gender and the gender that person identifies himself or herself as. For example, a person identified as a boy may actually feel and act like a girl.

•  Males are diagnosed with GIDC 5-30 times more than females. The person experiences significant discomfort with the biological sex they were born. Children with GID may feel disgusted by their own genitals, have anxiety or depression or believe they will grow up to be the opposite sex.

• The exact cause of gender identity disorder is not known, but several theories exist, including one that it may be caused by generic (chromosomal) abnormalities.

 

The stroke patient for whom strangers look normal whilst family look strange

Tags

facial recognition, prosopometamorphopsia, stroke

http://bps-research-digest.blogspot.com/2012/02/stroke-patient-for-whom-strangers-look.html

Neuropsychologists in The Netherlands and the UK have documented the curious case of a 62-year-old stroke patient whose brain damage affected her perception of familiar faces whilst leaving her perception of unfamiliar faces intact

The woman, referred to as J.S., struggled to recognise family, fared slightly better with celebrities, whilst having no problems correctly categorising as unfamiliar the faces of complete strangers. When the woman’s daughters came to visit her in hospital, she had no trouble recognising the daughter she hadn’t seen for eight years, but struggled to identify her other daughter who visited daily.

Joost Heutink and his team confirmed this pattern of deficits by comparing J.S.’s performance against three age-matched women in a series of face recognition tasks. As well as having impaired recognition of her family (and to a lesser extent celebrities), J.S. also reported that the appearance of her family members was distorted. For example, she said her grandchildren looked grossly overweight and that they were a deep tanned colour. J.S. also had a general problem recognising emotional facial expressions.

Further details came from recordings of J.S.’s skin conductance (a measure of physiological arousal) when she looked at various faces. This showed that she experienced more arousal after looking at family members’ faces as opposed to strangers and celebrities. This is normal, although the peak and latency of this arousal was delayed relative to the control participants.

So what explains J.S.’s pattern of deficits? Those familiar with neuropsychology may be reminded of Capgras Syndrome, in which the patient claims that one or more close relations have been replaced by an imposter. But J.S. does not have this syndrome. People with Capgras say that the imposter is a perfect likeness to the real relation. By contrast, J.S. does not think her relations are imposters, she just struggles to identify them and thinks their appearance has been distorted.

J.S.’s condition also bears some resemblance to prosopagnosia – a specific deficit affecting face recognition. Again, this doesn’t really match J.S.’s neuropsychological profile. After all, her recognition of strangers’ faces as unfamiliar was near perfect. Moreover, the brain region that’s normally damaged in proposopagnosia – the fusiform face area – was unaffected in J.S.’s brain.

Joost Heutink and his colleauges think part of the answer may lie with a rare condition known as prosopometamorphopsia – in which other people’s faces are perceived as being warped or distorted. The researchers suggest J.S. may have a form of this condition that interacts in some way with the emotional meaning of faces. So, if a face affects her emotionally (as happens with family), she perceives their face as distorted, which also has the side-effect of affecting her conscious recognition. This account fits with the distribution of brain damage in J.S.’s brain. In particular she suffered damage to the posterior superior temporal sulcus, which it’s been suggested is involved in merging information about face identity with emotional context and meaning.

This account also helps explain two exceptions to J.S.’s relatively superior performance in recognising celebrity faces vs. family members. When it came to images of Hitler and Bin Laden (characters likely to trigger an emotional response), she believed they actually depicted imposters, and poor ones at that.

___________________________________________________________

Heutink, J., Brouwer, W., Kums, E., Young, A., and Bouma, A. (2012). When family looks strange and strangers look normal: A case of impaired face perception and recognition after stroke. Neurocase, 18 (1), 39-49 DOI:10.1080/13554794.2010.547510

Post written by Christian Jarrett for the BPS Research Digest.

£2m paid out over child asylum seekers illegally detained as adults

Tags

Child asylum seekers, detainees

http://www.guardian.co.uk/uk/2012/feb/17/home-office-payout-child-asylum-seekers

The Home Office has paid compensation of more than £1m, plus £1m costs, in a case involving 40 child asylum seekers who were wrongly detained as adults, the Guardian can reveal.

It is thought to be the first case of its kind and the largest immigration detention payout for a single case.

Government officials accepted that the policy was unlawful and changed it as a result of this case. However, data passed to the Guardian shows thatchildren are still being detained.

The case that resulted in the £2m payout involved girls and boys, including 25 aged 14 to 16, from countries including Afghanistan, Iran, Sri Lanka, Nigeria, Eritrea, Uganda, Somalia and China.

The youngest was a 14-year-old girl from Sri Lanka. Some were survivors of torture in their home countries and some of the girls were survivors of rape and other forms of sexual violence.

Some of the children were locked up for more than a month. and o. OOne boy was moved around the country and held in seven different adult centres including Dover, Campsfield and Harmondsworth during his 74-day detention. “I cried myself to sleep every night,” he said. “Nobody explained what was going on and I never knew what was going to happen to me when I woke up the next morning.”

A 16-year-old Eritrean girl who was detained said: “I couldn’t believe it. I had fled Eritrea to escape prison and thought I’d arrived in a safe country, but now I was being locked up again.”

Some of the 40 had been assessed by social services and declared to be children. They showed officials letters from social services stating that they were looked-after children, but the Home Office still detained them.

Mark Scott, of Bhatt Murphy solicitors, who acted for the 40 children, said: “These children arrived in the UK as children, without the support of their families. They had committed no crime, yet were detained by the immigration service in conditions the Home Office admitted were unsuitable for them.

“One of the most shocking aspects of the case was that, despite the widespread concerns about what was going on, the Home Office did nothing to change the situation until they were forced to do so by children bringing litigation.

“The fact that they’re still locking up child asylum seekers in these centres is a complete scandal. It’s unclear precisely what lessons the Home Office has learned.”

When the 40 children were detained as adults there was no shortage of guidance about “age-disputed” children available to the Home Office. The UN Refugee Agency, the Royal College of Paediatricians and the UN committee on the rights of the child all issued guidance on age assessment of asylum seeker children, emphasising the best interests of the children should be prioritised. In March 2002, HM Inspectorate of Prisons expressed concern about Home Office handling of age-disputed asylum seekers.

Many of the children were placed in Oakington detention centre in Cambridgeshire, which was closed in November 2010 following the expansion of other detention centres.

The lawyers argued that Home Office officials with no specialist knowledge or experience of working with children simply looked at the appearance and demeanour of the children before deciding how old they were.

On Friday night, a UK Border Agency spokesman said: “We take the welfare of young people exceptionally seriously. Where there is any doubt over an individual’s age, they will not be detained unless an independent local authority age assessment concludes that they are over 18. These checks are carried out by social workers with expert knowledge.

“All of our frontline staff receive specialist training to ensure the welfare of young people is considered at every stage.”

He said some children told officials they were over 18 but they would be released from detention pending a full age assessment if credible evidence emerged that they were under 18.

The case, concluded in 2010, was settled out of court and has only come to light now following a freedom of information request by the Guardian. A total of £1,020,000 was paid to the children in compensation for their wrongful detention in adult centres and £1,085,000 was paid in costs in a legal battle that lasted five years. Although government policy changed as a result of the case, the Refugee Council has passed unpublished statistics to the Guardian showing that this unlawful practice is continuing. In 2010, the charity worked with 26 children detained as adults and subsequently accepted as children; in 2011, 22 cases have been confirmed and some have still to be resolved.

Helen Johnson, operations manager at the children’s section of the Refugee Council, said there might be other cases it was not aware of.

Concern about the detention of all child asylum seekers – young children detained with their parents and under-18s detained in adult facilities – has grown in recent years. In 2009, 1,065 child asylum seekers were locked up.

Nick Clegg, the deputy prime minister, announced in December 2010 that the “shameful” practice of detaining children would end, to be replaced by a “fairer and more compassionate approach”.

Critics acknowledge that children are now held for shorter periods – a maximum of one week – but are concerned that children continue to be detained despite Clegg’s promise.

The most recent figures released by the Home Office show that 17 children were detained in December 2011 in three different centres. Nine of them were under five.

When the 40 children were detained as adults there was no shortage of guidance about “age-disputed” children available to the Home Office. The UN Refugee Agency, the Royal College of Paediatricians and the UN committee on the rights of the child all issued guidance on age assessment of asylum seeker children, emphasising the best interests of the children should be prioritised. In March 2002, HM Inspectorate of Prisons expressed concern about Home Office handling of age-disputed asylum seekers.

The children’s lawyers said their clients were denied the additional safeguards available to child detainees, subjected to distressing interviews with immigration officers who were not trained to deal with children, and had their welfare put at risk.

Refugee Council data shows that 55% of 275 age-disputed cases sent to Oakington between November 2003 and January 2006 were found to be children when assessed by social services.

Dawn of the age of wireless medicine

Tags

Medicine

http://www.independent.co.uk/life-style/health-and-families/health-news/dawn-of-the-age-of-wireless-medicine-6989042.html

Medical treatment is about to go wireless. New advances in microelectronics have enabled doctors to contemplate the day when they will be able to monitor and treat their patients with medical implants that use wi-fi, Bluetooth and other kinds of wireless technology.

The latest development in this area is a medical implant controlled by wireless commands to release drugs at regular intervals within the body of a patient. It has been successfully tested for the first time on women suffering from osteoporosis, the brittle-bone disease that requires regular drug injections.

Last month, in a separate development, scientists announced an edible microchip that records the precise details of a patient’s pill regime. Each ingestible sensor, smaller than a grain of sand, triggers the wireless transmission of medical information from a patient’s body to the mobile phone of a relative or heathcare worker.

Both breakthroughs are part of a wider technical revolution in medicine that exploits the miniaturisation of wireless devices and the ability to place them inside a patient where they perform a new kind of “telemedicine” – medical treatment from a distance.

Scientists at the American Association for the Advancement of Science in Vancouver yesterday hailed the latest clinical trial of an implantable microchip as an important breakthrough.

The implant is an attempt to develop ways of delivering drugs to patients in a safe and effective manner without them having to remember to take pills on time or to suffer the inconvenience and pain of regular injections.

The chips, which are about the size of a pacemaker and are fitted surgically under the skin, were loaded with 20 doses of the osteoporosis drug teriparatide which is normally administered by daily injection pens.

An external wireless device issued commands to the chip which allowed each drug dose to be released in an ordered, sequential manner to ensure that the patients received the right medication at the right time of day.

Eventually it is hoped the technology can be developed to deliver a range of drugs to a wide variety of patients suffering from illnesses ranging from heart disease and diabetes to multiple sclerosis and cancer, the scientists said.

“You could literally have a pharmacy on a chip. You can do remote-control delivery and you can deliver multiple drugs,” said Professor Robert Langer of the Massachusetts Institute of Technology. “The drugs are in different wells [in the microchip]. Each of these wells is covered by a nano-thin layer of gold which protects the drug for years if needed and prevents it from being released,” Professor Langer said.

“And there is much less variation from dose to dose than injections, so it’s safer and more effective,” he said.

Seven women in Denmark aged between 65 and 70 took part in the trial where they were given the implants under local anaesthetic in an operation lasting less than half an hour. They kept the microchips for 12 months during which time their health was monitored.

A study in the journal Science Translational Medicine and released yesterday at the AAAS meeting found that microchip worked as expected and the women showed signs of improved bone formation and reduced risk of fractures.

“Patients with chronic diseases, regular pain-management needs or other conditions that require frequent or daily injections could benefit from this technology,” said Dr Robert Farra, head of MicroChips, the company set up to exploit the invention.

“Compliance is very important important in a lot of drug regimes, and it can be very difficult to get patients to accept a drug regimen where they have to give themselves injections,” Dr Farra said. “This avoids the compliance issue, and points to a future where you have fully automated drug regimes.

“Physicians will be able to adjust their patients’ therapy using a computer or phone,” he said. “Patients will be freed from having to remember to take their medication and don’t have to experience the pain of multiple injections.”

A similar need to ensure the admission of regular drug doses was behind the development of the edible microchip announced in January by the company Proteus Biomedical of California which has signed a deal with the healthcare company Lloyds Pharmacy to begin clinical trials in the UK this year.

The aim is to develop a suite of “intelligent medicines” that can help patients and carers keep track of which pills are taken at what time of day, in order to ensure that complex regimes of drugs are given the best possible chance of working.

Ultimately, the plan is for every one of the many pills taken each day by some of the most chronically-ill patients, especially those with mental-health problems, to be digitally time-stamped as they are digested within the body.

“There is a huge problem with medicines not being taken correctly,” said Steve Gray, healthcare services director of Lloydspharmacy.

“Anyone taking several medications knows how easy it can be to lose track of whether or not you’ve taken the correct tablets that day,” he added.

Normal Grief vs Depression In DSM5- Medicalizing Grief

Tags

Bereavement, DSM, Grief, Major Depression

http://www.psychologytoday.com/blog/dsm5-in-distress/201003/normal-grief-vs-depression-in-dsm5

The recently posted draft of DSM5 makes a seemingly small suggestion that would profoundly impact how grief is handled by psychiatry.  It would allow the diagnosis of Major Depression even if the person is grieving immediately after the loss of a loved one. Many people now considered to be experiencing a variation of normal grief would instead get a mental disorder label. For example, take the case of a man whose spouse unexpectedly dies. For two weeks after the death, he feels sad, doesn’t want to go to work, loses his appetite, has trouble sleeping and concentrating. Currently, this is normal grief. The DSM 5 suggestion would have this be major depression.

Undoubtedly, this would be helpful for some people who would receive much needed treatment earlier than would otherwise be the case. But for many others, an inaccurate and unnecessary psychiatric diagnosis could have many harmful effects. Medicalizing normal grief stigmatizes and reduces the normalcy and dignity of the pain, short circuits the expected existential processing of the loss, reduces reliance on the many well established cultural rituals for consoling grief, and would subject many people to unnecessary and potentially harmful medication treatment.

Grief is an inescapable part of the mammalian experience and a necessary correlate of our ability to attach  so strongly to other people. Though grief is universal, there is no one right way to grieve. Different cultures prescribe a wide variety of different behavioral and emotional reactions and rituals. Psychiatry needs to tread lightly and have compelling reasons before encroaching with its own rituals  on such time honored and usually effective practices.

Within a given culture, normal individuals also vary enormously in the content, symptoms, duration, and impairment of their grief and in their ability to draw consolation and sustenance from others.  There is no bright line separating those who are experiencing loss in their own necessary and particular way from those who will stay stuck in a depression unless they receive specialized psychiatric help.

The numbers on each side of the normal/mental disorder divide are probably very lopsided-most people who grieve do not have a mental disorder. Ever since the dawn of man, humans have had frequent occasions to grieve. Almost all of us come to terms with the loss and the altered conditions of a new life without the benefits of psychiatry-and do just fine on our own. The change in DSM5 would attempt to identify the very small percentage of people who have a complicated grief that goes beyond the average expectable in severity, symptom pattern, and duration – those who would not remit as part of the natural evolution of their grief. But when you use a big shovel to capture a small needle in the haystack, what you mostly get is hay. Any change in the way DSM5 defines grief may gather a very large proportion of false positives who would do better avoiding psychiatric help.

The rationale given by DSM5 for its radical proposal is brief, cryptic, and fails to provide anything like a risk/benefit analysis of  potential effects. DSM5 states that there is no evidence that the depression triggered by the stress of losing a loved one is any different than  depression triggered by other severe stressors (such as job loss or divorce)- thus claiming that there is no justification to withhold the diagnosis of major depression after a loss. This  rationale places the burden of proof in the wrong direction.  DSM5 should make so consequential a change only after a careful and considered evaluation proves with compelling evidence that it will do more good than harm.

Such evidence is simply not available.  The research in this area is interesting but in very early development and we don’t know many essential things. We have no idea how any proposed criteria set would work in the general population.  What percentage of grieving individuals would get the diagnosis (especially once drug companies raise awareness of it)? Among the people who would be diagnosed, we don’t know what percentage truly need psychiatric help, what percentage would do better without it.

Pies and Ziskind (in a recent commentary in Psychiatric Times) have  gone far beyond the meager DSM5 rationale to present the strongest possible case for allowing the diagnosis of Major Depression in grief situations. They cite several lines of argument:

1) There is a clinical need- some individuals have severe, complicated grief that looks just like severe Major Depression and does not get better spontaneously. The longer that diagnosis and treatment are delayed, the greater their suffering, impairment, and risks (eg job loss, injured relationships, lowered treatment response, suicide).

2) The loss of a loved one is not essentially different from the many other serious stressors that abound in life.

3) It is impossible to predict the future misuse of the DSM5 system so we should make decisions based only on the best possible science.

4) The criteria for complicated grief could be tightened to reduce false positives.( They suggest two useful ways described below and I add two others).

5) Education can solve the problem of false positive diagnosis and the risk of providing medicine in milder cases when time, support, and/orpsychotherapy would be more indicated.

The  excellent proposal made by Pies/Ziskind to reduce false positives could be strengthened even further if two additional exclusions were added to the  two(#’s 1and 2 below) that they   suggested . The entire package differentiating grief  from depression would require:

1) An extended duration of one month.

2) A particularly severe presentation that  includes some combination of unreasonable guilt, worthlessness, hopelessness, self loathing, anhedonia, a focus on negative memories of the departed, alienation from others, and inability to be consoled.

3) To recognize the different cultural expressions, the diagnosis of depression would not be made if the person’s grief is within  cultural norms.

4) An exclusion could be added that would take into account the person’s own past experience of grief and its previous outcomes.  If the individual previously had severe grief symptoms, but recovered spontaneously (without going on to a major depression), this would suggest they are now grieving their own way and do not require diagnosis or treatment.

DSM5 has made many poorly thought through suggestions that can be fairly easily dismissed. Though I continue to disagree with the  Pies/Ziskind proposal, it is reasonable and deserves serious consideration. Here are the opposing points:

1) Re clinical need: In appropriate cases displaying  clinically significant impairment, distress, or risk, the diagnosis Depression Not Otherwise Specified covers their false negative problem.

2) I believe there is a difference between losing a loved one and most other life stressors. This  explains why grief is the universal target of communal healing rituals.  It would be unfortunate forpsychiatry to prematurely roam into problems usually better handled by family and other cultural institutions. Cultural biases would be very hard to surmount in making this diagnosis.

3) My disagreement with Pies and Ziskind is strongest on this point. All decisions for DSM5 should follow the injunction-“First Do No Harm.”Although it is impossible to predict precisely how any DSM5 change will eventually play out once the manual is in general use, that doesn’t reduce DSM’s responsibility for the problems that occur, even if they are unintended. All potential risks have to be thought thru and factored into a thorough risk/benefit analysis.  The argument that we should just go to where the science takes us ignores that the science is (as they point out) not definitive, is subject to different interpretations, and is not readily generalizable from research to real world settings. Once the genie is out of the bottle and DSM5 makes it easy to diagnose depression in grief situations, this could easily become an industry propelled fad diagnosis.

4) The tightened criteria would help reduce, but certainly not eliminate, the grave potential harm caused by the massive misidentification of false positives.
False positives and excessive treatment are not be a problem for skilled and cautious clinicians (like Pies and Zisook), but in the real world most of the prescriptions will be written by primary care physicians who have six minutes with each patient, don’t know the fine points of the criteria sets, and want the fastest solution.

The false positive problem is too unknown and potentially far too large to ignore. At a minimum, there would need to be field trials to determine prevalence, reliability, false positive, and false negative rates. I doubt that DSM5 has the time, money, and skill to pull this off.

5) It would be naïve and unwise to rest our hopes that any educational  program  would reduce over diagnosis and the overprescription of medication in grief situations. To the contrary, most of theeducation would go the other way. The drug companies devote enormous resources to “educating” physicians to be quick on the draw in prescribing medication.

I respect the arguments made by Pies and Ziskind  and believe they  work well when applied by experts like them. My worry is the misuse of even reasonable ideas in the real world  situations where most diagnosis and treatment is done. Loose diagnostic and treating habits could lead to the widespread medicalization of grief well beyond what Pies and Ziskind would themselves recommend. There are two ways of avoiding this. The first is to keep things as they are and not to diagnose Major Depressive Disorder in the first two months after the loss of a loved one.

The second is for DSM5 to allow for the diagnosis of complicated grief but with a  criteria threshold set high and including all four protections against false positives outlined above. As recommended by Pies and Ziskind, there should also be a  physician and public education campaign normalizing normal grief and  sharply delimiting the small group of grievers who need psychiatric
help.

Weighing the pluses and minuses, my call is to keep things as they are and not risk an “epidemic” of psychiatric grief.

(Predominantly Western) Psychiatry Timeline

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Psychiatry Timeline

Anomalistic Psychology

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Anomalistic Psychology, Paranormal Psychology

2009:

http://www.guardian.co.uk/science/2009/aug/11/anomalistic-psychology-paranormal-parapsychology?INTCMP=ILCNETTXT3487

From next month, potentially thousands of teenagers at schools and colleges throughout the UK will start lessons that deal with telepathy, psychokinesis, psychic healing, near-death experiences and talking to the dead. Surely the minds of the nation’s youth will be corrupted by all this mumbo-jumbo?

Don’t panic. I believe this is a development to be warmly welcomed, although I should declare a vested interest. From September, anomalistic psychology will be offered as an option on the A2 psychology syllabus for A-level students from the Assessment and Qualifications Alliance, the largest of the three English exam boards. For several years I have been teaching a course on anomalistic psychology at Goldsmiths, University of London, as part of our BSc in psychology. I have also been trying, along with others, to raise the academic profile of the discipline through the work of the Anomalistic Psychology Research Unit at Goldsmiths and am therefore delighted by this latest development.

What exactly is anomalistic psychology and why should it be taught in our schools and colleges? This is the definition offered on our website:

Anomalistic psychology may be defined as the study of extraordinary phenomena of behaviour and experience, including (but not restricted to) those which are often labelled “paranormal”. It is directed towards understanding bizarre experiences that many people have without assuming a priori that there is anything paranormal involved. It entails attempting to explain paranormal and related beliefs and ostensibly paranormal experiences in terms of known psychological and physical factors.

Given its focus upon ostensibly paranormal events, it is important to distinguish anomalistic psychology from the closely related discipline of parapsychology. This is the scientific investigation of the “paranormal” – phenomena that cannot be explained in terms of currently accepted scientific theories.

Most parapsychologists focus on three main areas: extrasensory perception (ESP), psychokinesis and evidence relating to the possibility of life after death. Alleged ESP includes telepathy (direct mind-to-mind contact), clairvoyance (picking up information from remote locations without the use of the known sensory channels) and precognition (foretelling the future). Psychokinesis is the alleged ability to influence the outside world by willpower alone – everything from subtle effects upon random events at a subatomic level through psychic healing to spoon-bending and levitation.

Anomalistic psychologists are interested in claims relating to all of these areas, but they are also interested in attempting to explain beliefs and experiences that fall outside this strict definition of paranormal, including alien abduction claims, astrology, the Bermuda triangle, dowsing and so on – in other words, all things weird and wonderful.

Another difference between parapsychologists and anomalistic psychologists is that, in practice, the former tend to focus most of their efforts upon trying to produce evidence in support of the existence of paranormal forces whereas the latter tend to be sceptical regarding the very existence of such forces, mainly focusing instead upon non-paranormal explanations of ostensibly paranormal events.

So why should psychologists expend any effort attempting to explain such experiences? The most obvious reason is that if psychologists cannot explain such phenomena, they will have nothing to say about an important aspect of the human condition. These beliefs are widespread and deep-seated. An opinion poll published by Readers Digest in 2006, for example, found that of 1,006 British adults surveyed, 43% claimed to have experienced telepathy, more than half said they had experienced precognition, a fifth said they had seen a ghost, and 29% believed near-death experiences were evidence that there was an afterlife.

Similarly high levels of belief and experience are found all over the world and throughout recorded history. To me, this can mean only one of two things.

It might be an indication that, contrary to accepted scientific opinion, paranormal forces really do exist. If this is the case, then the scientific community must learn to overcome its prejudice towards paranormal claims and embark upon the serious and sustained investigation of paranormal forces.

But what if conventional scientists are right to reject paranormal claims? If so, psychologists can learn much of value by exploring the ways in which people often believe they have experienced a paranormal event when in fact they haven’t. The challenge facing anomalistic psychologists is to explain the full range of ostensibly paranormal experiences in purely psychological terms.

It is important to realise that at this stage we cannot say with certainty whether paranormal forces exist or not. But until parapsychologists produce a robust and replicable demonstration of paranormal effects, it is perfectly legitimate for the wider scientific community to express scepticism regarding such claims.

Even if parapsychologists ultimately succeed in producing proof of such phenomena, anomalistic psychologists would still have performed a valuable service by helping them to sort the genuine psychic stuff from the stuff that simply isn’t. Personally, I’m not holding my breath. After well over a hundred years of systematic research into allegedly paranormal phenomena, I do not get the sense that ultimate proof of the paranormal is anywhere nearer than it was at the outset.

Chris French is a professor of psychology at Goldsmiths, University of London, where he heads the Anomalistic Psychology Research Unit. He also edits the [UK] Skeptic magazine

Women seeking abortion will be shown image of unborn child

http://www.independent.co.uk/life-style/health-and-families/health-news/women-seeking-abortion-will-be-shown-image-of-unborn-child-6660304.html

Everything is bigger in Texas. Including, it seems, the degree of influence which the anti-abortion lobby is able to exert over both lawmakers and members of the judiciary.

A federal judge has allowed the state to begin enforcing a high-profile new law which will require physicians who perform terminations to first either show, or describe, an ultrasound image of the unborn child to their patient.

The measure has been introduced at the behest of anti-abortion campaigners, who hold enormous sway over the largely Republican state’s legislature. They believe that pregnant women who are familiarised with the appearance of their foetus are less likely to green-light its termination. The law requires physicians to perform an ultrasound on pregnant women, show and describe the image to them, and play sounds of the unborn child’s heartbeat. Patients are allowed to decline to view images or listen to the heartbeat; but they must listen to a description of the exam.

Texas has duly acquired the toughest abortion laws in the US. Similar rules have been introduced in Oklahoma and North Carolina, but are currently on hold pending legal challenges.

This week’s decision follows a year of legal challenges. An initial lawsuit against the legislation was filed by a coalition of pro-choice physicians last summer. It alleged that the law violated their constitutional right to free speech, since it forced them to become a “mouthpiece” for the state’s ideological message. Sam Sparks, a US District Judge from Austin who issued this week’s ruling, had originally sided with those physicians, agreeing that the new law did indeed interfere with free speech rights, and was unconstitutional. However his decision was overturned last month by a three-judge panel from the US Fifth Circuit Court of Appeals, who said doctors could be legally required to provide “truthful information” to a patient.

Judge Sparks said on Monday that he would reluctantly defer to the higher status of his colleagues. But he said his decision came out of respect for their official standing, rather than a sudden conversion to their way of thinking on an issue which has for years been at the front of America’s culture wars.

In a written opinion, Judge Sparks criticised the appeal court for “making puppets out of doctors” and “eviscerating” them of their rights to free speech which are supposedly guaranteed by the First Amendment. He added that the law placed “heavy-handed, paternalistic and impractical restrictions on the practice of medicine”.

“The act requires doctors to attempt to discourage their patients from obtaining abortions… even in cases where the doctors have determined that an abortion is, for any number of reasons, the best medical option,” he said in the opinion. “There can be little doubt that [the law] is an attempt by the Texas Legislature to discourage women from exercising their constitutional rights by making it more difficult for caring and competent physicians to perform abortions.”

Though the new regulations officially took effect at 6pm on Monday, opponents aren’t about to give up the fight against it. The Centre for Reproductive Rights is seeking a full appeal hearing before all 17 judges on the Fifth Circuit.

One In Four Children Subjected To Cyberbullying, Study Finds

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Cyberbullying

http://www.huffingtonpost.co.uk/2012/02/06/one-in-four-children-cyberbullying_n_1257916.html?ref=uk

Hundreds of thousands of young people are being subjected to cyberbullying, with many being victimised for a year or more, new research suggests.

A study published on Tuesday reveals the long term impact of this abuse, with youngsters reluctant to go to school, living in fear of their safety and even resorting to self-harming or attempting suicide.

The Beatbullying survey of 4,605 children and young people in the UK, found that just over one in four (28%) 11-16-year-olds say they have been the victim of cyberbullying.

Cyberbullying is the bullying of another person through technology, such as mobile phones or the internet.

In more than a quarter of cases, the individual concerned was continuously targeted, suggesting that one in 13 secondary school children have faced persistent cyberbullying, the report claims.

The latest Virtual Violence II study says that with around 4.38 million secondary-aged children in the UK, it means that around 350,222 children have been the victim of persistent cyberbullying.

Of those that said they had been persistently cyberbullied, 23% said it last for a year or more, with 40% reporting the abuse lasting for weeks or months.

The study, which was commissioned by Nominet Trust and backed by the National Association of Head Teachers (NAHT), reveals that the effects of cyberbullying are far-reaching.

A fifth of victims said that fear of bullies made them reluctant to go to school, while 19% said their confidence and dropped and 14% said they did not feel safe.

In addition, five per cent said they had resorted to self-harming and three percent admitted they had attempted suicide.

And it is not just young people that have been the victims of cyberbullying.

The study, published to mark Safer Internet Day, found that one in 10 teachers say they have faced cyberbullying.

Almost half of the 339 teachers questioned (48%) said they have heard or witnessed colleagues being harassed.

Nine in 10 (91%) of the teachers surveyed said this bullying was an isolated incident that had arisen out of something that happened in school.

But the study also claims that cyberbullying has left some teachers afraid for their safety, or that of their family, while others said they felt emotionally and mentally violated, or that their teaching had suffered as a result.

Beatbullying chief executive Emma-Jane Cross said: “Cyberbullying continues to be a dangerous problem for a significant number of young people and we must not ignore its complex and often devastating effects.

“We as a society need to take responsibility for both preventing such harmful and anti-social behaviour, and dealing effectively with incidents of virtual violence when they occur.

“An integrated approach where we see Government, schools, parents, internet service providers and charities like Beatbullying all working together to keep our must vulnerable safe.”

A second study of more than 1,300 teachers suggests that while the majority of school staff are confident that children are safe from internet harm at school, many are concerned that this is not the case at home.

Some 88% of the teachers questioned agreed or strongly agreed that their pupils know how to use the internet safely at school.

But only 58% thought that pupils had the skills and knowledge to use the internet safely at home.

The survey, commissioned by Vital, the Open University’s Professional Development programme for teachers, also found that 91% of secondary school teachers and 52% of those working in primaries reported that their pupils have experienced cyberbullying.