Autism’s Plot

By: | June 15, 2011

Erika wants to know about the state of autism research. “How is the field doing in terms of rigorous science?” she asks. “What is the most promising theory about how autism develops?”

The first question’s easy to answer: pretty damn well. In 2008 (the last time a good survey was done), autism research reaped $144 million in tax dollars and $78 million from private funds. That’s a helluva lot of interest in a disorder that is diagnosed in 1 percent of the population. In no small part because of this investment, autism science is constantly making headlines. In just the past month, seven gangbuster autism papers have come out in the likes of Nature, Nature Genetics, Science Translational Medicine and Neuron.

The other question, about smart theories of autism, is one I’ve been trying to sort out for awhile.* No answer is wholly satisfying, but I’ll tell you a bit about recent findings and how I see them fitting into a bigger picture. The short version: autism can begin with one of hundreds, if not thousands, of different glitches during fetal development, all of which eventually result in a similar kind of abnormal wiring in the brain. It’s like roots, separate yet impossibly tangled, which, with water, sun, and time, give way to an awesome, immutable tree.
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Why Don’t We Know More about Our Ancient Past?

By: | June 14, 2011

Today, I’ll wrestle with a question that Ann posed during our birthday celebration: People have been living and building things in North America for tens of thousands of years, the same tens of thousands that they’ve been in India, China, Egypt, Mesoamerica, Europe; so why do we know comparatively so little about North American paleolithics? My numbers could be off by a factor of 10 or 1000.

I’ve often wondered this myself, Ann. Why do most of us know so much about ancient Egyptians with their stone sarcophagi and their pyramids and mummies and Book of the Dead. And why do we often draw blanks when it comes, say, to the Mississippian peoples with their Woodhenge and their Black Drink and their towering, millennium-old earthen mounds?

Are archaeologists slipping up on the job,  moving more dirt and gleaning more data in place like Egypt, Europe or India than they are here in North America (which I am defining as just the United States and Canada, in keeping with the spirit of Ann’s question)? Continue reading →

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.

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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 →