Diagnosing Grief

By: | June 13, 2011

Last week Jessa wrote about psychiatric diagnoses moving from the quantum to the continuum, from neat little packages to subtleties that include shades of gray and something called “a quantifiable baseline of life functioning.”  The same week, Ginny published a story about the same diagnostic changes but applied specifically to pathological grief – the problem being that normal grief already looks crazy.

I remember being at a meeting of a support group for bereaved parents maybe a year after my son died and listening to a sweet pretty lady tell how her golfing partner had asked her when she was going to get over her child’s death, and how the sweet lady had run the partner over with the golfcart.  The group thought her reaction was reasonable and appropriate.  I thought, with the amount of anger floating around in this group, we should form a roving SWAT team. Continue reading →

Secrets of British gravitas revealed!

By: | June 9, 2011

Before I left for England, a surprising number of people pulled me aside for a frank talk about The Accent. You know the one. It’s that slightly off, trans-Atlantic dialect acquired by expats; the one whose distracting inauthenticity annoys you during otherwise decent period dramas. Fortunately for me, I was never in any real danger: I didn’t even speak English until I was eight, when I traded my native German for a Long Island-flavored New York accent, atop which I later shellacked a coat of Baltimore. The resulting mashup can withstand anything the Brits can throw at it.

But no one warned me about the phrases. Oh, their tempting little expressions! Chuffed! (Excited.) Gutted! (Very sad.) Naff! (Gross. [sigh, wrong. See correction]) And then there’s my personal downfall: “can’t be arsed.” God, I love that phrase. “Can’t be bothered” purports to mean the same thing, but it’s nowhere near as evocative. But when I attempted to slip it unnoticed into conversation last time I was back in the States, I got a very stern talking-to by our own Cassandra Willyard. “Sally, no,” she told me in plainspoken Midwestern. “No.”

I never said it again, but I couldn’t let it go. Why couldn’t I say “can’t be arsed”? Continue reading →

Psychiatry Comes of Age

By: | June 8, 2011

Whenever one paradigm gives way to another in science, the transition is traumatic. Hard-earned knowledge from the earlier perspective cannot be meaningfully compared with new research in the next paradigm, because even the language of the new scientific generation is slightly different. Information is lost or devalued. Such is the price of progress.

The coming revolution – and I don’t use that term lightly – in psychiatry promises to be so disruptive that the creators of the field’s bible, The Diagnostic and Statistical Manual of Mental Disorders (DSM) have been forced to delay the publication of their next (5th) edition. It was originally scheduled for this year, but won’t be out now until 2013 when they have figured out how to accommodate the looming storm.

As a Master’s student in Counselling Psychology, I know many of the textbooks I bought this year – the honking great thing called Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry and the more readable Diagnosis Made Easier: Principles and Techniques for Mental Health Clinicians, for example – will be obsolete when I graduate in two years.

For 150 years, psychopathology has been categorizing mental disorders as if they were discrete entities. The DSM, published every ten years or so since the early 1950s, adheres to this tradition, categorizing each illness and sub-illness in neat little packages. You’ve got your mood disorders and anxiety disorders, your eating disorders and sleeping disorders, your schizophrenias and dissociative disorders. Within these categories are more specific variants. For example, in “Impulse-control disorders not elsewhere classified” we find intermittent explosive disorder, kleptomania, pyromania, pathological gambling, trichotillomania, and impulse-control disorder not otherwise specified. All a clinician must do is check off a list of symptom criteria, and if a client meets them, they have the disorder.

Continue reading →

Why Circumcision Protects Against HIV

By: | June 7, 2011

Uncircumcised David has a higher risk of contracting HIV than the average circumcised man. At least he would if he were sexually active and not made of marble.

On LWON’s first birthday, Richard Panek asked me to explain why being circumcised makes a man less likely to catch HIV. So I will. Here you go, Richard.

Let’s be honest. Foreskin is weird. The rules of evolution suggest that it once conferred an advantage, but I can’t fathom what that advantage might have been. These days, it seems like having foreskin may be more of a hindrance than a help. Not only does foreskin have a tendency to get painfully caught in pants zippers. It also substantially increases a man’s chances of contracting sexually transmitted diseases like HIV.

Researchers have long observed that HIV rates are generally higher in countries where male circumcision is not common practice. This correlation between circumcision and HIV is intriguing, but any scientist will tell you (ad nauseam) correlation does not equal causation.

So three research groups set out to test whether having foreskin could really influence a man’s risk of contracting HIV. The teams conducted three separate randomized clinical trials — one in South Africa, one in Uganda, and one in Kenya. In each study, they enrolled between 2,000 and 5,000 HIV-negative men and circumcised half. Taken together, the studies found that circumcision reduced a man’s risk of contracting HIV by about 60%. “It’s just a slam dunk,” Maria Wawer, an HIV researcher at Johns Hopkins, told me in 2007.

Now that I’ve convinced you that circumcision does provide protection against HIV, let’s turn to the question Richard asked—why? Continue reading →

Giving Up on Aliens. Or Not.

By: | June 3, 2011

Heather asked about the SETI telescope at the Hat Creek Radio Observatory, whether having its budget zeroed out mattered in any way.  Had it ever found anything? Could it be re-purposed?  No it hasn’t and yes it can, but I don’t care because, ma’am, I am seriously running out of patience with the whole enterprise.  I never wanted to meet intelligent extraterrestrials in the first place.

I should be more respectful.  Serious people have put serious money into searches for extraterrestrial intelligence. Continue reading →

The Inca Empire’s Afghanistan

By: | June 1, 2011

Pambamarca isn’t a household name, not like Machu Picchu. Few backpackers trek its steep slopes each year seeking out the elusive Inca past. There is no sleek Vistadome train, no fleet of gleaming Mercedes-Benz buses whisking crowds to the ruins, no luxury lodge at the top. But Pambamarca bristles with the ruins of Inca ambitions. Five centuries ago, an Inca emperor led a great army to northern Ecuador to conquer the local lords. Pambamarca and the surrounding countryside promptly became the Afghanistan of its day.

The region lies roughly 1000 miles northwest of Cuzco, in a land of old snow-topped volcanoes.  It’s rough, blustery, high-altitude country, a cold place that has an edge-of-the-known-universe feel to it, or at least that’s the sense I had there. But in the early 16th century, this forbidding land was home to the Caranqui and their allies who wanted little to do with the overbearing empire to the south. To make their position clear, they slaughtered the men that the emperor Huayna Capac sent out to rule them.

The emperor, whose Quechua name means Powerful Youth, called for conscripts from his provinces, mustering an army of tens of thousands of men. Continue reading →

A Tech Journalism Cheat Sheet

By: | May 31, 2011
Photo credit: thelunch_box

A few weeks ago, the Human Brain Project announced that it had been selected as a finalist in a competition whose winners will get €1 billion worth of funding from the EU. The Human Brain Project (HBP) plans to use the prize money to build a simulation of the human brain on a supercomputer.

HBP is a consortium of heavy hitters, combining neuroscience expertise with supercomputing know-how. The project’s leader, Henry Markram, has been working towards this goal for years with HBP’s predecessor, the Blue Brain project. Markram is a big deal; in the mid-1990s, he identified a crucial property of the brain’s function called spike timing dependent plasticity, a property of neurons that explains, for example, how they wire together to form memories. In 2005, he partnered with IBM to build a detailed model of the neocortex–the part of the brain that’s involved in perception and conscious thought–on what was at the time the world’s fourth-fastest supercomputer, the Blue Gene L (which explains the Blue Brain moniker).

A full-scale brain simulation would help us obtain insights into neurological disorders and perhaps even untangle the neurobiological underpinnings of intelligence and personality. No Blue Brain story was complete without hints that the Blue Brain simulation might become conscious: When I interviewed Markram in 2008, he told me that he envisioned a Pinocchio-like entity that would autonomously surf the internet to develop and augment its understanding of itself and its universe.

Big plans! But, over the past couple of years, no one seems to done much investigation into Blue Brain’s actual progress, instead repeating that we might be on the brink of building a conscious machine. As far as I can tell, the Blue Brain/Human Brain Project team is still working with a single simulated neocortical column, a 2 millimeter-diameter hunk of brain matter that contains 10,000 of the brain’s roughly 100 billion neurons. I suspect that further research will get underway when the EU funding happens, and now that they’ve gotten a supercomputer upgrade from IBM.

And when that happens, it’s important for us tech journalists to bring our A-game. Because to quote everyone’s favourite AI, “All this has happened before, and all this will happen again.” If the coverage of the Blue Brain project in the past few years is any indication, journalists covering the Human Brain Project will fall down some familiar rabbit holes. Continue reading →

The Stuff of Hot

By: | May 30, 2011
El chile gordo

Late Saturday evening, I was cutting jalapeños for the salsa for the next day’s barbeque party. I had a few other things on my mind — like my bean salad, and cleaning the bathroom, and figuring out what to write for this post — and so I forgot the lesson learned the last time I cut hot peppers: just wear gloves, you idiot. Five minutes later, my hands were on fire.

The stuff that makes jalapeños hot is a colorless, odorless compound called capsaicin, found mostly in the white pith that connects the seeds to the shell. Capsaicin works by binding to ‘TRPV1’ receptors in your nerve cells, which in turn sets off pain messages. Inside your mouth, small amounts of capsaicin makes for a pleasantly tingling spice, which I happen to love when mixed with the salt of a tortilla chip. But when rubbed in large quantities over both sides of both hands, capsaicin feels like a bad, bad sunburn.
Continue reading →