Category Archives: Psychology

Why Psychology is Still Relevant

chickenpiratefreud

A lot of people seem to believe that psychology is a course, major, what have you that people study at university because they do not know what else to study or major in (my flat mate included). Also, as it is science that is not heavy in the triad (chemistry, physics and biology), as I have just now decided to call them, it has garnered the reputation of being an easy course to get on. The fact that one of my assigned textbooks is called Statistics without Math for Psychology kind of gives you a good indication of the level of higher thinking associated with psychology degrees. Then there is the fact that in almost every television programme where a psychologist or psychiatrist is part of a single episode, they are either a) the murder b) crazy or c) all of the above. All in all, despite Freud being discredited to the core, most people still hold the commense view that psychology just proves what everyone already knew or is about finding a relationship between the jeans you put on this morning and some repressed adolescent, sexual fantasy.

Now I am not going to say that there are not people in my psychology course at university that choose psychology just because it seem convenient and easy. As I said from the start, my flat mates admits to those exact motives, and despite the fact that I go to a leading university of psychological research and study, he is not the only one. But the thing that actually matters is that there are people there, who like me, believe psychology is relevant.

Psychology was built upon the foundations of medicine, philosophy and neuroscience and struggles with the complex concept that is the mind. Even erudite minds such as Aristotle and Descartes where baffled. Aristotle believed the seat of intelligence was the heart and Descartes thought the mind was housed in the pineal gland. Which just goes to prove that trying to understand the complexity of what makes us who we are and act the way we do is not exactly simple. Yes, you can pass my course without really making any effort or without having any true zest. You will in no way have a chance at being accepted for masters course or graduating anywhere close to a first, but you can easily pass. And no, that statement cannot be applied to fields such as medicine or astrophysics when a keen interest in key, but that does not make psychology any less important. If you chose to take psychology seriously it requires time, education, patience and intelligence just like any other field of study.

But you ask, how does this make psychology relevant or rather, why should you believe me? I am after all one of the most biased people towards psychology; however, if you have taken any time at all to read my past blog posts you will see that psychology is as relevant now as ever and that relevance is growing exponentially. Psychology is the key to becoming more efficient, more empathetic and more self-aware than ever. Journals, such as my personal favourites Scientific American Mind and Psychology Today, prove that every day research in the field of psychology has immeasurable applications.

The Sleep Cycle

Sleep is a confusing topic of study because despite every human needing it, no one really knows with 100% certainty why we do it. There is no single theory that is accepted by the entire scientific community; however, two main hypotheses seem most fitting. First, the restoration hypothesis proposes that we sleep to rest and recover, a preparation for when we wake. What is being restored remains unclear. The second hypothesis proposes that sleep is an adaptive process that keeps us out of trouble for a large chunk of the day: hiding us from predators and conserving our energy reserves. The only thing we do know about sleep is that we cannot survive without it.

The Stages

The majority of our sleep (75%) is spent in non-REM (rapid-eye movement) sleep and occurs in four stages. An entire sleep cycle takes approximately 90 minutes and is classified as a form of ultradian rhythm (faster than circadian which is a 24 hour cycle).

Stage 1: The Transitional Stage

Stage 1 is known as the transitional stage as it is when our brain waves become less regular and begin to wane. If you were to look at an EEG we would pretty much look wide awake. You have probably felt the sensation of shifting between the two stages if you have ever fallen asleep in class or in front of the TV. That sense of falling is due to the slowing of our brain waves. Activity levels begin to change from alpha to theta waves; they are high amplitude but very low frequency. Due the small difference, however, stage 1 is the lightest stage of sleep and we are easily woken. Our eyes are making slow, rolling movements and the whole stage only lasts a few minutes. All in all though, it only occurs at the beginning of sleep and only lasts 5-10 minutes.

Stage 2: The First NREM Stage 

Stage 2 marks the true beginning of non-REM sleep. During stage 2, our brain waves become slightly deeper and occasional variations in wave movement (oscillations) occur between 8-14 Hz occurs. These oscillations are called sleep spindles and are produced by thalamic pacemaker cells.  It is proposed that sleep spindles occur because the brain is trying to inhibit processing to ease the transitional into sleep. Another characteristic stage 2 indicator is the K-complex. K-complexes are a high-amplitude, sharp wave and the largest brain event during sleep. Scientists believe that K-complexes help suppress arousal and aid in memory consolidation. Lastly, another indicator of transition from stage 1 to stage 2 sleep is that eye movements cease.

Stage 3 and 4: The Delta Rhythm Stages 

During stage 3, an EEG would show large-amplitude, low rhythm delta waves. Eve movements as well as body movements will be usually be absent. Stage 3 can also be seen as a transitional stage but between light and deep sleep. As we enter into deep sleep our body and brain become increasingly less sensitive to stimuli and less susceptible to arousal. Common childhood sleep issues such as bed wetting, night terrors and sleep walking tend to occur towards the end of stage 3. The main difference between stage 3 and 4 is the amount of delta waves. When less than 50% of deep sleep is delta, we are in stage 3. When more than 50% of our brain activity is delta waves, we are in stage 4 of sleep. As delta waves correspond with very deep sleep, a person in stage 4 of sleep is the hardest to wake. This can be extremely scary if a person is sleep walking or a child is having night terror. They may seem awake but they are completely unresponsive to external stimuli. Stage 4 of sleep only happens during the first cycle as such, our sleep becomes lighter throughout the night. This is extremely helpful as it prepares our body for waking. From an evolutionary stand point this makes sense. Our ancestors certainly could not set an alarm clock, the noise of other animals and the rising sun needed to be sufficient to wake us.

REM Sleep 

REM sleep is probably the most exciting and important of all the stages of sleep. REM stands for rapid eye movement and is suitable name for this stage as an EOG would show rapid eye movement under our eyelids. During this phase we also experience dreaming. Our brain activity mimics waking, showing a myriad of different brain waves: alpha, beta and dysynchronous waves. Despite our brain activity showing an incredible change in activity, our muscles are actually paralysed. A scary albeit common phenomenon known as sleep paralysis is when we wake-up during REM sleep and our muscles remain effectively paralysed.  During sleep however, this “paralysis” is known as sleep atonia. It is a beneficial process as it prevent us from acting out our dreams and putting ourselves in harms way. Certain neurons in our brain stem (specifically the tegmentum) known as REM sleep-on cells release monoamines inhibit motor neuron activity. Another curious attribute of REM sleep is the incredible recall of a person woken from it. Our dream world becomes as real and vivid as the real world. As REM mimics wakefulness, waking someone during REM means they will feel very alert. The exact reason for REM sleep is as elusive as sleep itself; however, scientists do know that like sleep, it is vital. When a person is repeatedly disturbed during REM sleep or does not get enough sleep in general, we go through a process called REM rebound. In other words, we spend the majority of our following sleep in REM. Lastly, scientists have also discovered that newborns and foetuses spend the majority of their sleep in REM. All in all, these findings suggest REM is vital to proper human functioning and development.

In Conclusion 

As we progress through the night we spend increasingly less time in stages 3 and 4. After the first cycle stage 1 of sleep is replaced by REM sleep and the amount of time spent in REM sleep increases. Even though the reason why we sleep is unclear, the change in brain activity and the determent of not sleeping is enough to say with certainty that sleep is necessary for normal human function.

References

Bear, M., & Connors, B. (2007). Neuroscience: Exploring the brain (3rd ed.). Philadelphia, PA: Lippincott Williams & Wilkins.

Dement, W.C. (1978). Some must watch while some must sleep. New York: W.W. Norton.

Hall, R. (1998, January 1). Stages of Sleep. Retrieved September 14, 2014.

K-complex. (2014, August 24). Retrieved September 14, 2014, from http://en.wikipedia.org/wiki/K-complex

Pinel, J.P.J. (1992). Biopsychology. Needham Heights, MA: Allyn & Bacon.

Sleep spindle. (2014, August 24). Retrieved September 14, 2014, from http://en.wikipedia.org/wiki/Sleep_spindle

Maps and Infinite Homuncular Regression

Although maps provide an excellent structural representation of what is going on the brain, in themselves they have no intrinsic value (Deacon, 2012). Maps do not really tell us about how the brain is interpreting or processing the information, only how it stores and forwards the information. To be fair, even that is only based on visual interpretation not on concrete behaviour. Unfortunately, that brings up the issue of whether or not topological maps are of any value. The retinotopic map may just be a consequence of development and evolution, an attempt to minimise wiring of the brain. Deacon (2012) stresses that there is massive flaw with the current use of mapping; he summarizes it as the ‘infinite homuncular regression.’ Basically, we have come to a point where other maps are just reading maps. The actual perceptual neurology has not been determined. Deacon warns scientists of the dangerous of neuroimaging and maps when trying to prove the existence of neural activity and behaviour. All this boils down to really is the classic argument in psychology; correlation does not prove causation.

1421_sensory_homunculus

Fortunately, Graziano and his colleges (2009) suggest that perhaps a homunculus does exist that can bridge perception and behaviour: the motor cortex. To put it plainly, a motor homunculus represents the sensitivity and innervation dedicated to particular muscles in our body. This homunculus can be mapped onto our motor cortex, and stimulation of these regions leads to an immediate motor response. Hence, we can bridge the gap between map and action. In other words, the motor cortex may in fact put an end to the infinite homoncular regression. A recent study carried out by Bouchard et al. (2013) found that when participants vocalised constants and vowels, scans showed smooth trajectories in the motor cortex.

UPDATED – Neuroimaging: EEG, MRI, fMRI, MEG, PET and TMS

Electroencephalogram (EEG)

EEG

EEGs measure electrical signals generated by the brain through electrodes placed on the scalp (ibid). Gel or a conduction solution is used to connect the electrodes to the scalp. Electrical signals are produced by partially synchronized waves of neural activity measured in Δ voltage/time (up to 2000 Hz). Signals are able to amplify the waves of neural activity so that sense can be made of them. Waves themselves represent stages of conscious; different frequencies represent different stages. Most of the time our brain is emitting alpha waves, which are of a regular frequency (8-12/sec), high amplitude and represent relaxed wakefulness. Should the wave amplitude decrease, it can indicate neural activity further from the cortex.

When EEG waves accompany physiological events, they are known as event-related potential (ibid). Event-related potentials are calculated by averaging the signal trails epochs, averaging reduces the noise of surrounding activity and increases strength of the signal.

Advantages of the EEG:

–       High temporal resolution (accurate at recording fast changes in neural activity)

–       Less subject to motion artifacts

–       Not claustrophobic

–       Portable

–       Can be used on infants

Disadvantages of the EEG

–       Weak spatial resolution

–       Synchronous firing of 10K neurons is required to produce a magnetic field which is large enough to measure

MRI: Structural and Functional

MRIs produce high-resolution, three-dimensional images from the measurement of waves that hydrogen atoms emit when they are activated by radio frequencies waves in a magnetic field (Pinel, 2011). High spatial resolution means MRIs are able to detect and represent different spatial locations. The images produced are far clearer than CT scans; however, fMRIs are seen as even greater improvement.

The fMRI produces images that represent increased oxygen flow in response energy needs of specific brain regions. Oxygenated blood has magnetic properties due to its high iron content making it sensitive to magnetic fields emitted from protons in the MRI. Deoxygenated blood is not sensitive to magnetic fields; as such brightly light portions of the fMRI reflect high-energy consumption. If you want to read, more about the BOLD fMRI click here, BOLD stands for blood oxygen level dependent signal. The job of the fMRI is to record this BOLD signal.

Advantages of the fMRI

–       Accurately depecits structural data

–       Reasonable temporal resolution

Disadvantages of the fMRI

–       Claustrophobic

–       Noisy (literally, not signal noise)

–       Very susceptible to movement artifacts

–       No metal-based equipment can be around the machine

–       BOLD is not a direct measure of neural activity, only oxygen consumption

Magnetoencephalogram (MEG)

EEG2

The MEG measures changes in magnetic fields on the surface of the scalp (ibid). Unlike the fMRI, magnetic fields are produced by changes in neural activity, which activate pyramidal cells of the cortex. Neural activity is not being affected by magnetic fields.

Advantages of the MEG

–       High temporal resolution

–       Acceptable spatial resolution

–       Compared to an EEG, it is less distorted by the scalp

Disadvantages of the MEG

–       Just like the EEG, it requires a high baselines firing rate in order for a magnetic field to be produced

–       Normally it has to be paired with an MRI

–       Expensive

–       Not portable

Positron Emission Tomography (PET)

The PET scan is a bit more controversial than some of the other scans because it involves injecting a radioactive substance. Specifically, 2-deoxyglucose is injected in the carotid artery. This substance is used because of its similarity to glucose, a quality which neurons like very much. Neurons take 2-DG into their system, but cannot metobolise it. The result accumulates in active regions of the brain resulting in measurable levels of radioactivity.

Advantages of the PET:

–       Reasonable structural accuracy

–       Direct reflection of current activity

–       No motion artifacts

–       Not claustrophobic

Disadvantages of the PET:

–       Radioactive substance is involves

–       No temporal resolution and no structural information

–       Poor spatial resolution

–       Expensive and not very portable

Transcranial Magnetic Stimulation (TMS) 

In 1985, Tony Barker invented the TMS, which is now known for its ability to prove a particular brain activity causes certain behaviour. A non-invasive technique, the TMS causes depolarisation and hyperpolarisation of neurons in the brain. Electromagnetic induction causes a weak electrical current in the cortex to evoke synaptic potentials. With the TMS it is possible to create a stimulated temporary lesion of the brain by preventing normal brain function without causing any adverse effects.

Advantages of the TMS

–       Almost portable

–       Can  prove causality

–       Can simulate a lesion

Disadvantages of the TMS

–       Difficult to specify precise regions of the brain

–       Only surface regions are detectable

ADHD/ADD: Symptoms, Aetiology and Treatment Options

Symptoms

In 2012, CDC data showed that 11% of school children in the US had been diagnosed with ADD/ADHD. It remains unclear why these figures are rising. Perhaps any or all of theses things are contributing: constant changes in diagnostic criteria that are expanding the symptomology, a greater acceptance of neurological disorders has prompted more people to step forward and accept a diagnosis, a shift in society that is actually increasing the rate of ADD/ADHD or even just misdiagnosis. One of the major changes in the DSM-V diagnosis is the recognition of adults with ADD/ADHD. Previously, ADD/ADHD has merely focused on the symptoms observed in childhood onset. In fact, the majority of children that develop the disorder go on to experience a variety of difficulties into adulthood. Being able to recognise ADHD as a long-term condition will hopefully improve the level of care for adults with a childhood diagnosis.

ADD

The symptoms of diagnosis can be broken down into two major categories: inattention and hyperactivity with impulsivity. Classic examples of these behaviours include: difficulty to failure to pay attention to details, difficulty organising tasks, fidgeting, excessive talking and inability to remain still or seated for a prolonged period. In order to be diagnosed with ADD/ADHD according to DSM-V guidelines, a child must present with six symptoms in either or both the inattention criteria and hyperactivity and impulsivity categories. Accordingly, the disorder can present in three ways: combined, predominately inattentive and predominately hyperactive-impulsive presentative. Adults (over the age of 17) must be present with a minimum of five symptoms. For both children and adults, these symptoms must be present for 6 months prior to diagnosis and should interfere with normal, daily life. Finally, these symptoms should be present in two or more settings, before the age of 12 and not singularly in conjunction with any other mental disorder.

Inattention Symptom – Taken directly from the DSM-V

  • Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activities.
  • Often has trouble holding attention on tasks or play activities.
  • Often does not seem to listen when spoken to directly.
  • Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., loses focus, side-tracked).
  • Often has trouble organising tasks and activities.
  • Often avoids, dislikes, or is reluctant to do tasks that require mental effort over a long period of time (such as schoolwork or homework).
  • Often loses things necessary for tasks and activities (e.g. school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones).
  • Is often easily distracted
  • Is often forgetful in daily activities.

Hyperactivity and Impulsivity Symptoms 

  • Often fidgets with or taps hands or feet, or squirms in seat.
  • Often leaves seat in situations when remaining seated is expected.
  • Often runs about or climbs in situations where it is not appropriate (adolescents or adults may be limited to feeling restless).
  • Often unable to play or take part in leisure activities quietly.
  • Is often “on the go” acting as if “driven by a motor”.
  • Often talks excessively.
  • Often blurts out an answer before a question has been completed.
  • Often has trouble waiting his/her turn.
  • Often interrupts or intrudes on others (e.g., butts into conversations or games)

I was very fortunate to receive permission to use a first hand report of how ADHD/ADD feels. Below are his experiences in his own words. Please check out the Reddit post where he discusses his experiences with ADHD/ADD. It is linked in the reference section under the author Jonathan Michael. His personal experience really helped my understanding of what these symptoms feel like, not just what they are.

“ADD is almost like having a regulator switch turned off in my head…I feel like my mind is racing at 90 miles per hour, constantly thirsting to take in information and sense perception all around me.”

“It’s not that I can’t “pay attention”, it’s that I’m paying attention to almost everything around me and can’t consciously order which is “most important” to pay attention to fast enough, or sometimes at all.”

“ADD isn’t about “becoming bored”, it’s about losing the natural instinct to be able to prioritize what should be focused on instead of what shouldn’t be…For us, we literally lose chunks of time because we were so wrapped up in something else.”

Psychiatrist Edward M. Hallowell, M.D. describes ADHD/ADD as such, and Jonathan Michael mentioned in his post that he found it a very accurate metaphor for the disorder. 

“In ADD, time collapses. Time becomes a black hole. To the person with ADD it feels as if everything is happening all at once. This creates a sense of inner turmoil or even panic. The individual loses perspective and the ability to prioritize. He or she is always on the go, trying to keep the world from caving in on top.”

Aetiology and Treatment Options 

Genetics

Researchers suggest a strong correlation between genetics and ADD/ADHD. A meta-analysis of 20 international twin studies revealed a heritability estimate of 0.76 for ADHD, making it the most heritable psychiatric disorder (2). However, despite a high concordance rate between monozygotic twins (72-83%) and fraternal twins (21-45%), pinpointing what genes are different has proven difficult. One of the main reasons it has been so hard to map the genetic component to the disorder is because many genes seem to be implicated. This makes sense because ADD/ADHD is so complex that it is far more likely the phenotypes found result from the additive characteristics of many different genes. Not only that but the variation in symptoms suggests the possibility that ADD/ADHD involves endophenotypes. In other words, ADHD has hereditary characteristics associated with it but that are not a direct symptom of  it or dependent upon it.

ADD Brain

Natalie M. Zahr, Ph.D., and Edith V. Sullivan, Ph.D. “Translational Studies of Alcoholism Bridging the Gap” Alcohol Research & Health, Volume 31, Number 3, p.215- (2008)[1]

The Brain 

As with genetic factors, the brain regions involved in ADHD/ADD are not completely clear either. One region that appears to be most involved is the prefrontal cortex. The prefrontal cortex’s main role is executive function – planning, self-control and attention. Catecholimanergic (dopamine and noradrenaline) neurotransmitter pathways in the prefrontal cortex have been implicated. Symptoms of ADD/ADHD reflect problems in executive function. Drug therapies prescribed to individuals target these catecholaminergic pathways by inhibiting the re-uptake of dopamine and noradrenaline to increase the levels of these neurotransmitters in the synaptic cleft. Common drug treatments that act as a reuptake of inhibitor of dopamine an/or noradrenialine have methylphenidate, dexamfetamine or atomoxetine as an active ingredient. These active ingredients are stimulants which may seem counterintuitive when treating a hyperactivity disorder. However, as dopamine and noradrenaline in the prefrontal cortex increase self-control, attention, planning, etc. stimulating the release of these neurotransmitters is suitable. Unfortunately as with all drugs, those used in treatment of ADD/ADHD have side effects that sometimes outweigh the benefits of the treatment for some. Common side effects of Ritalin f.eg. includes depression, irritability, anxiety, aggression, reduced sex drive, heart palpitations and more. Other options include behavioural therapy which works on central executive tasks such as goal setting, impulse control, planning and organisation.

Common ADHD/ADD drugs:

  • Concerta XL (methylphenidate)
  • Dexamfetamine
  • Elvanse (lisdexamfetamine)
  • Equasym XL (methylphenidate)
  • Medikinet (methylphenidate)
  • Ritalin (methylphenidate)
  • Strattera (atomoxetine)

Diet and Environment

Researchers suggest that damage or trauma to a foetus’ brain or trauma in early childhood can in some cases lead to the development of ADHD/ADD later in life. A  foetus exposed to drugs, alcohol, cigarettes and/or high levels of stress due to their mother’s habits or environment whilst in the womb are more likely to develop ADHD. From birth into childhood, brain diseases or infection, trauma during birth, head injury or exposure to secondhand smoke are also seen as risk factors. Some parents argue that diet or supplements reduce the symptoms of or prevent ADHD; however, little evidence supports this belief. A few studies have found that children with ADHD have lower levels of fatty acids, but it remains unclear whether this actually plays any role in the pathogenesis of the disorder. A poor family environment, a difficult upbringing or many life upheavals in early life are found more often in children with ADHD, but as of yet there is no way of knowing whether a difficult family environment acts as a stressor or if related genes in ADHD put the family at risk for more familial conflicts and unlawful behaviour. Importantly, as with any disorder or even personality a poor familial or social environment aggravates any imperfect aspects of our character. As I emphasise with any post on mental health, the key is to recognise the true severity of the disorder and to respect those who fight through it on a daily basis.

For those seeking help for ADD/ADHD:

  • Contact your local GP
  • Speak to a family member or friend
  • http://www.nhs.co.uk/ (UK)
  • http://www.youngminds.org.uk/ (UK)
  • http://www.mentalhealth.org.uk/ (UK)
  • http://www.help4adhd.org/ (US)
  • http://www.addhelpline.org/ (Global)
  • http://www.cdc.gov/ (US)

References

American Psychiatric Association. (2013). The Diagnostic and Statistical Manual of Mental Disorders: DSM 5. bookpointUS.

Attention Deficit Hyperactivity Disorder. (2012, January 1). Retrieved November 10, 2014, from http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder/index.shtml#pub5

Faraone SV, Perlis RH, Doyle AE, et al.: Molecular genetics of attention deficit hyperactivity disorder. Biol Psychiatry 2005, 57:1313–1323.

Hallowell, E.M (2012). What’s it Like to Have ADHD?. [ONLINE] Available at: http://www.huffingtonpost.com/edward-m-hallowell-md/what-adhd-feels-like_b_1627463.html. [Last Accessed 10 November 2014].

Khan, S. A., & Faraone, S. V. (2006). The genetics of ADHD: a literature review of 2005. Current Psychiatry Reports, 8(5), 393-397.

Michael, J. (2014). My husband was diagnosed with ADD because he can’t focus on reading or similar tasks. I can read a book all day but simply *cannot* focus on a movie or a TV show. My mind will not stay focused. How come he has ADD and I don’t?. [ONLINE] Available at: http://np.reddit.com/r/NoStupidQuestions/comments/2b6bt9/my_husband_was_diagnosed_with_add_because_he_cant/cj2e6a6. [Last Accessed 20 July 2014].

Millichap, J. Gordon, and Michelle M. Yee. “The diet factor in attention-deficit/hyperactivity disorder.” Pediatrics 129.2 (2012): 330-337.

Rutherford, D. (2014, January 24). What causes ADHD? Retrieved November 10, 2014, from http://www.netdoctor.co.uk/adhd/whatcausesadhd.htm

Symptoms and Diagnosis. (2014, September 29). Retrieved November 10, 2014, from http://www.cdc.gov/ncbddd/adhd/diagnosis.html