Monday, 25 June 2007

Drowning in data

I watched this talk yesterday given by Jeff Hawkins, someone who has worked on many well-known pieces of technology, but whose real love is the brain. I was struck by his thought that neuroscience suffers from a surfeit of data and a dearth of theory. Researchers act as though simply accumulating more data will solve their problems. Hawkins' own take on the mammalian brain is that we shouldn't think of it in terms of sensory input and behavioural output, but rather understand it as a prediction device.

Psychosomatic medicine seems to be following the neuroscience approach, a largely atheoretic accumulation of 'facts'. You can see this from recent editions of what was once the flagship journal, Psychosomatic Medicine.

Monday, 18 June 2007

Goldfish Research

I'm not sure if the research has been done, perhaps it's merely to assuage the guilt of their owners, but goldfish are often considered to have very short memories. One circumnavigation of the bowl and they forget that they've already encountered that plastic anchor.

Sometimes it seems that research along psychosomatic lines is goldfish-like. Take this article, 'A qualitative exploration of the Couvade syndrome in expectant fathers' by Brennan et al., reported here, and announced here. The Couvade syndrome (beware the use of 'psychomatic' in this Wikipedia article) is a condition in which the father of a foetus experiences some of the symptoms of pregnancy - pains, cravings, nausea, etc.

The couvade's been studied for a long while now, psychoanalytically and anthropologically, but in phenomena like this it never seems that much progress is perceived to have been made. Largely I would attribute this to researchers' shifting sense of the right way to do psychology. This abstract may depict the 'right' way to do things now, but one turn about the bowl earlier or later and it seems right to do something completely different.
The aim of this qualitative study is to explore the nature and duration of male partner's somatic and psychological symptoms, across gestation and parturition, collectively called the Couvade syndrome. Fourteen men with expectant partners aged 19-48 years from diverse social and ethnic backgrounds were interviewed. The data was processed using qualitative analytical software WinMAX Professional and the emerging themes and sub-categories identified and analysed. The first was 'Emotional Diversity in Response to Pregnancy', which varied with time and other factors and also included mixed and polarised feelings such as excitement, pride, elation, worries, fears, shock and reluctance. The second was 'Nature, Management and Duration of Symptoms', which revealed the types and duration of physical and psychological symptoms experienced by men. Attempts at managing these were influenced by social and cultural factors. Physical symptoms were more common than psychological ones, and their time course demonstrated trends similar to those reported for the Couvade syndrome. Although the former were reported to their GPs, no definitive diagnosis was made despite medical investigations being performed. The third theme, 'Explanatory Attempts for Symptoms' was influenced by cultural beliefs and conventions like religion, alternative medical beliefs or through the enlightenment by healthcare professionals in the process. Some participants were unable to find explanations for symptoms but some perceived that they were related in some way to the altered physiology of their female partners during pregnancy. These findings highlight the need for further research to acquire deeper insight into men's experiences of, and responses to, pregnancy as a way of explaining the syndrome.

Reik, Theodor (1914) 'Die Couvade und die Psychogenese der Vergeltungsfurcht', Imago, 3, 409-455.

Robert L. Munroe, Ruth H. Munroe, John W. M. Whiting (1973) 'The Couvade: A Psychological Analysis', Ethos, Vol. 1, No. 1, pp. 30-74.

Friday, 15 June 2007

Portuguese Interview

You can read an e-mail interview I gave to a Portuguese journalist here.

Thursday, 14 June 2007

What patients want

It's a start, I suppose, researchers trying to find out what patients want from a first medical encounter with regard to hand-shaking and whether to use first name, second name or both.

78% of patients want their hand shaken. But how do you know which 78%?

Thursday, 7 June 2007

Changes in the psychological environment

I've just reached the part in Dickens' Dombey and Son where the young Paul Dombey passes away. This revived a thought in me I've been pondering for some time. The improvement in the nation's health from the nineteenth to the twentieth century is largely attributed to improvements in nutrition and hygiene rather than to medical advances. Deaths from childhood illnesses such as measles were declining long before vaccinations were introduced. But, if we take the thesis of our book seriously, we should wonder whether changes in the psychological life of the child and adult were involved too.

If early death from heart disease could be staved off by familial and communal cohesion in Roseto, shouldn't we expect the kinds of psychological environment prevalent in Victorian England, at least as described by Dickens, to be positively damaging? Of course, Dickens is prone to caricature, but across all classes there's an abundance of lovelessness. Would the son have survived had Dombey senior known how to love him well as a father?

Sunday, 3 June 2007

Cortisol and the Baby

In my third post I mentioned research looking at how a mother's life situation affects cortisol levels in the foetus. From a report on a new study we learn that a correlation between their respective levels of this hormone is measurable at 17 weeks of gestation.
An earlier study, published in January and led by Prof Glover, measured the intelligence of more than 100 babies and toddlers whose mothers had suffered unusually high stress in pregnancy. It found their IQ was generally about 10 points below average, and that many had higher than average levels of anxiety and attention deficit problems. Relationship problems with a partner were the most frequent cause of stress for pregnant women, the research revealed
Perhaps Aristotle was right. Don't argue around pregnant women.

Friday, 1 June 2007

The Woodstock of the Mind

This was Bill Clinton's description of the wonderful Hay Festival. It's held every year in the tiny Welsh town of Hay-on-Wye, packed with the kind of excellent second-hand bookshop that used to be so common 30 years ago.

Just like at Woodstock, heavy rain had turned the fields to mud. Fortunately, to keep our minds dry all the events took place under canvas. Darian and I spoke about our book to an audience of around 700 people for about an hour, including time for some very pertinent questions. An excellent event. And we got to stay in the same hotel as Tony Benn and Peter Falk!

Darian had spotted an interesting detail in the report on Roseto I mentioned a while ago. Remember that Roseto was the socially cohesive town of descendants of Italian immigrants, where early death from heart disease was non-existent. It turns out that an indication of the breakdown in this cohesion was "when the town's coronet band, founded in 1890, demanded for the first time to be paid for playing at the church's big festival". This was observed in The Power of Clan: The Influence of Human Relationships on Heart Disease (1992) by Stewart Wolf and John G. Bruhn, a follow up to their The Roseto Story—An Anatomy of Health (1979).

When will we learn that health and politics are inextricably linked, and act on this?