Saturday, February 17, 2018

The biology of depression treatment: an understudied factor

Tryptophan is an essential amino acid (i.e. an amino acid that comes from one's diet). It is of interest for the subject of depression, as it is used by the body to produce serotonin, a target for many of the "first-line" anti-depressants that are widely prescribed (a key type of antidepressant being selective serotonin reuptake inhibitors). However, most of the tryptophan we consume is not converted in serotonin, but is rather broken down along the kynurenine pathway. A number of the metabolites formed along this pathway may have neuroprotective or neurotoxic effects, and there is evidence that they may be altered in patients with major depression, which may in turn be associated with alterations in relevant brain regions.

A recent article from work we did at UCC examined a number of these metabolites in blood samples from patients with prolonged major depression. We examined blood samples taken before ketamine treatment and at repeated times after three ketamine injections, spaced one week apart. (Although the anti-depressant effects of ketamine are very rapid, they also fade after a week or so, and so repeated injections are sometimes given for a number of weeks). We found that kynurenic acid, which is thought to be neuroprotective, was reduced in patients with major depression compared to healthy controls. However, although the antidepressant effects were soon evident in most of these patients (in terms of their depressive thoughts and feelings), ketamine did not lead to clear changes in kynurenine pathway metabolites.

Our results seem to suggest that depressive symptoms may be improved by ketamine, even in the absence of kynurenine pathway change. Perhaps other biological factors are more important, such as neurotrophins (proteins that are crucial for neuronal growth and development). Nor should we ignore the potential effects of ketamine on the psyche; the disassociative effects of ketamine may create a psychological "distance from the self", not unlike the effects of mindfulness meditation. Nonetheless, the observed differences in kynurenic acid in patients with depression is indicative of how depression is associated with changes in tryptophan metabolism beyond serotonin.

New research is being published regularly in this area, including in leading glamour journals, looking at more mechanistic preclincial work as well as research in patients. We will hopefully gain more understanding in the coming years into how this drug works. Such an understanding may help to develop more targeted drugs in future.

Allen, A. P., Naughton, M., Dowling, J., Walsh, A., O'Shea, R., Shorten, G., ... & Dinan, T. G. (2018). Kynurenine pathway metabolism and neurobiology of treatment-resistant depression: Comparison of multiple ketamine infusions and electroconvulsive therapy. Journal of Psychiatric Research. doi:

Related posts
Depression treatment: ketamine
I felt a funeral, in my brain

If you like this post, please follow me on Twitter: @APAllen1

Or why not check out the "Psychology in Mind" podcast with Gareth Stack:

Saturday, February 3, 2018

TV review: "Chef's Table"

This is my first TV review on this blog, and it might seem odd picking a show about fine dining as opposed to some psychologist's tale. However, as each episode of "Chef's Table" profiles an individual chef in depth, a strong sense of autobiography comes through. Many of the protagonists describe episodes they recall from their lives that have had very clear influences on specific dishes. One chef recalls a frightening incident of nearly drowning as acting as an inspiration for a dish. 

Although there is no voiceover, and despite the fact that the show has multiple directors, the sense of editorial voice is strong in this show. The typical episode climaxes with a montage of sweeping, cinematic shots of signature dishes. One suspects that there was a fairly structured set of questions posed to each chef, who lay out how their career (and indeed childhood and adolescence) has played out, leading up to the level of success that has garnered the interest of the program's producers. It is interesting to note the diversity of life experience of the various chefs; I cannot discern any clear "type" in terms of personality. The third series opens with a Buddhist nun who pursued the holy life from an early age, while a later episode concerns a Berlin chef who spent much of his youth fighting in gangs. 

Even more strong than the autobiographical slant is the sense of place. The program travels the globe, from San Fran to Peru to Australia to Thailand. At each stop, nearly all the chefs discuss how their cooking acts as an ambassador for the region they come from. Many seem to not only want to source local produce, but to use their dishes to communicate something of their region's character. If novelists sometimes feel misunderstood, I can only imagine what it must be like to attempt to communicate through the medium of a menu. (Having said that, a French chef includes poems about dishes on her menu). Outlets such as "Chef's Table" are no doubt a great forum to chefs who wish to put a message across through their cooking. 

Although there may not be a standard personality type amongst these chefs, what they nearly all have in common is a hectic work schedule. The autobiographical approach is not surprising when the lines between work and life outside of work are so blurred. The stresses of the job are quite frequently alluded to, but unlike many more "reality TV" style shows , we are generally spared the spectacle of meltdowns or shouting matches (a la Gordon "it's faaacking RAW!" Ramsay). In a program with a reasonably diverse panel of chefs, it is perhaps also refreshing to note that it is a male chef who alludes most directly to finding a balance between work and family life-an issue that has also been discussed in the field of science and research. 

Whether you're into cooking or not, it's difficult not to come away from an episode feeling pumped up about trying to pursue your passion in life. Easier said than done though; perhaps a few more shots of kitchen meltdowns could temper this!

Related posts 

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Why not check out the "Psychology in Mind" podcast with me and the talented Gareth Stack:

Sunday, January 21, 2018

I'm thinking of it right now. But will I remember later?

My google calendar overflows with tasks that I don't trust myself to remember. Despite the indefinite amount of information we seem to be able to hold in our long-term memory "store", for most of us it is all too easy to forget the epic three or even (dun dun dun) four things we mean to do between when we get in from work and when we go to bed.

This is prospective memory; remembering to do something that you (previously) decided you were going to do.

Of course, in everyday life I rarely have to remember highly important appointment etc. with "just" my mind, as I will use reminders. Interestingly, the Rivermead Behavioural Memory Test allows one to use written notes to help remember to do something. This seems like a nice psychometric acknowledgement of the extended mind (i.e. we do not purely rely on our brains, but use tools and symbols as add-ons for cognition). However, where one is employing this add-ons, it is likely that one is using one's brain in a different manner to when the same brain is running "naked".

It may nonetheless be difficult to identify incidents in everyday life where someone is not using some external cue to jog memory, whether consciously or otherwise.  Consider how the time of day, one's location or the content of conversation during a meeting might act as a reminder to do something, even if such cues have not be set up by you in advance to act as reminders. In this vein, Researchers in this area distinguish between time-based prospective memory (remembering to do something at a particular time) and episode-based prospective memory (remembering to do something once some other event occurs).

An interesting research question concerns depression. In addition to the broader evidence base for a negative impact of depression on cognition, depression has been shown by a meta-analysis to be associated with poorer prospective memory (both time-based and episode-based). The authors suggest this may relate to a dysfunction of neural circuits responsible for prospective memory in people with depression, such as connections between the amygdala (associated with emotion) and the anterior cingulate cortex (which is associated with executive function, a suite of cognitive functions that are likely to be integral to prospective memory and its enactment).

A word of warning: methods of cognitive assessment for probing this form of memory have to be appraised carefully.In much of the research in this area one is asked (a) to remember to complete a certain task later on, (b) to do a distracting task for a while, (c) do what you are asked to do in part a. As with much research into cognitive psychology, in order to get more robust data researchers will often have a few test trials. However, a problem with this is that it may only be the first test trial that is really about prospective memory-the subsequent trials may be more related to more short-term memory (because you're now repeating to yourself over and over not to forget again to carry out the instruction mentioned in part a.)

Related posts:
Autobiographical memory and thinking about the future
Where does the mind begin and end?`

If you like this post, please follow me on Twitter: @APAllen1

Saturday, January 6, 2018

Book review: "Free Will" by Sam Harris

There is no question that our attribution of agency can be gravely in error. It is my contention that it always is. (p. 25)

"Free will" is a very short book that you could skim through in about the same time it takes to watch this talk from Harris on the subject of free will. It is also very clearly written. Harris argues that free will, at least as most people understand it, simply does not exist; we are not free agents who are in control of our thoughts or actions.

According to his taped confession, Komisarjevsky stood over the sleeping man for some minutes, hesitating, before striking him in the head with a baseball bat. He claimed that the victim's screams then triggered something within him, and he bludgeoned Petit with all his strength until he fell silent. (p. 2)

The opening paragraph is followed by an account of a brutal multiple murder (which took place over a number of hours). Harris segues shortly thereafter into discussion of free will and daily choices of what to eat and drink. The juxtaposition (albeit indirect) may seem tasteless. More pressing is that it really does miss a distinction between decisions to which we do not devote much thought and decisions to which we do. Harris does highlight how some actions may involve a greater degree of conscious deliberation. However, he also points out that those factors that enter into conscious deliberation do so via unconscious mechanisms. Nonetheless, I feel he goes too far in suggesting we do not have free will simply because we cannot control thoughts that come into our conscious awareness-if we have a conscious "veto" over our decisions, as some models of reasoning suggest, then even though we may not control where our thoughts initially come from, we may at least exercise some control over our behaviour.

Harris takes in some fascinating neuroscience research in this area. He highlights a famous experiment demonstrating that in motor regions of the brain (which are associated with the initiation of behaviour) neural activity occurs prior to conscious awareness of the intention to act. However, this phenomenon occurs over the course of a few seconds or less, and is likely of limited influence when it comes to deliberating over a choice carefully, where options A and B might be evaluated repeatedly on several attributes before any overt behaviour is produced by the person making the decision.

Harris outlines a deterministic view of human thought and action, which he feels is incompatible with the idea of free will. Daniel Dennett (who Harris indicates is both a friend as well as an opponent on this particular issue) has defended the idea that determinism may be compatible with at least a modest version of free will. We may accept a deterministic stance whereby someone could only have done x, and not y, given all the factors in their life up to that point, PLUS all the details of their environment. Nonetheless, Dennett argues, if we take the environment (which exists outside of the person's self, and for which they are generally not really responsible for), if the person may have acted differently had some small aspect of the environment been different, then it probably is fair to say that the person has some degree of free will.

The book concludes with thoughts on the moral/ethical implications of free will being simply an illusion. Dennett has weighed in on this issue as well, suggesting that the idea that free will doesn't really exist appears to make people act in a less ethical fashion (because, after all, "how could they do otherwise"?), and indeed both Dennett and Harris cite interesting research suggesting that encouraging a view that free will does exist encourages research participants to behave in a more ethical fashion than if they are encouraged not to believe in free will. Harris does not offer any easy answers to this issue, although he does posit that moral responsibility "overall complexion of one's mind" rather than "the metaphysics of cause and effect". (At this point, I feel he might be alluding implicitly to the point I made above about weighing up options consciously, although he seems to stop short of saying as much).

On the subject of ethics, Harris further suggests that the legal system (e.g. in how it deals with violent offenders) could shift from less of a focus on punishment to a greater focus on safety and rehabilitation. (Such a shift in focus could sometimes lead to longer prison sentences for violent offenders, if they have served a sentence that is considered fair in terms of punishment, but the criminal nonetheless maintains a high risk of committing a similar crime outside of prison).

In conclusion, if you have always had a simple faith that you have more-or-less complete free will, this book will certainly make you think twice about whether this is the case. Although I feel it is not a complete refutation of free will, it is likely to make most readers revise their view of what free will really is. leaving them with a more modest estimate over the extent to which they (and others) are in control.

Related posts:
Book review: "Intuition Pumps" by Daniel Dennett
The autocerebroscope

If you like this post, please follow me on Twitter: @APAllen1

Saturday, December 9, 2017

Reminiscence group work diaries: Part 2

Our initial reminiscence group continues. Following some more personal autobiography, we start to probe memories of broader historical changes/events. I have suggested (taking suggestions from my colleagues and collaborators) the arrival of television and wider availability of cars as possible subjects around new technologies. The topic of television brings up memories of renting a television given the expense of buying one's own, and in turn leads to memories of telephones and the relative lack of availability in past times. One interesting suggestion from the participants was that of the washing machine (an innovation that cut down on a lot of housework).

Besides these changes that occurred relatively gradually, we also discuss distinct, one-off events. The visits of Pope John Paul II and John F Kennedy are recalled, along with the extent to which the two figures were idolised at the time. The Irish Times archive proves to be a good place for finding relevant images to provoke memory of these events.

A second historical session touches on elections and referendums. There seem to be numerous resonances with the present. With Brexit ongoing, a poster from the 1973 referendum on joining the EU (then EEC) threatens the potential of a deeper division between Northern Ireland and the Republic of Ireland. The potential for next year to see a referendum on 1983's eighth amendment has re-ignited the often bitter debate around the issue of the legal status of abortion within Ireland.

Although I want to keep things reasonably focused on the past (albeit this can be through the lens of comparison to the present), discussion of the 1983 referendum that introduced the eighth amendment leads into a discussion of more general thoughts/opinions about the issue/ethics of abortion. This is obviously something that has to be handled with sensitivity in larger groups with potentially quite diverse (and deeply held) views.

The boundaries between the political and social can become somewhat blurred. Discussion of economics relating to the referendum to joining the EEC eventually segues into a discussion of work practices in a particular industry, and how these skills gradually became outdated (unless one was working in a small company making bespoke material). Sometimes the history of one's society can be a more emotive topic than that one's own personal life, or at least particularly where one bleeds into the other.

Although I'm still trying to work out if/how this form of reminiscence is therapeutic, the participants in the group certainly seem to have enjoyed discussing their memories with us, and with each other. With the pilot group wrapping up, I'm looking forward to starting up new groups in multiple venues in 2018. Roll on next year!

If you're interested in this project, you can follow us on Twitter and Facebook: follow @RecallEire.

Related posts
Reminiscence group diaries: Part 1
Oral history and psychology

Sunday, November 26, 2017

Reminiscence group session diaries: Part 1

The project I am currently involved in examines the impact of reminiscence (via group participation) on autobiographical memory and learning of new information (as well as other factors such as executive function and mood) in older adults. The first group is currently running at a single location-in 2018 we plan to have groups running in multiple sites.

Halloween 2017. The first session got off to a slow start, with a low attendance (perhaps given the day that was in it). Nonetheless, we had an interesting discussion provoked by an activity of drawing a map of one's route to primary school as a child. Most lived quite close to their school, but in a way this allowed for a more detailed discussion of the buildings passed on the way to school. It was interesting to note that one might think one had forgotten these things until they are recalled.

The first few weeks are more focused on personal autobiography, although we are also interested in people's memory of historical events. (I'll cover this more historical content in the next post on this topic next month!) Thinking of the functions of reminiscence, maintaining one's sense of identity and giving an illustrative lesson to others have been identified as two positive reasons for using reminiscence. These two functions seem to come together when people think of their kids; they seem to draw on their own experience as young adults as a means of advising their young adult children. But older adults in turn identify with their children, and perhaps often see them as an extension of themselves.

One of the biggest influences on the content of the sessions is "remembering yesterday, caring today", which was devised for work in patients with dementia, but is actually quite easily adaptable to healthy older adults as well. I'm also currently reading the book "Working more creatively with groups" by Jarleth Benson. He takes quite a psychoanalytic approach to groupwork (a lot of references transference and counter-transference). A lot of the anecdotal material in the book seems to be based on work with clients experiencing mental health problems (often anxiety or depression), but with this caveat in mind there's quite a bit of practical advice with broad applicability too. For example, a number of chapters dedicated to the different stages of the life of a group. With this 6-week group already nearing its end, I need to re-read to chapter on bringing a group to a close. This in particular is important, as we want to do follow-up visits with participants after the group has ended.

The participants so far in this first group do seem to be enjoying the process, and discussing memories in a group with people of a similar age. If you're interested in this project, you can follow us on Twitter and Facebook at @RecallEire. The website should be live very soon-watch this space!

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Time out of mind
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Saturday, November 11, 2017

Aesthetics and the psychology of creativity

I have misgivings about the autonomy of aesthetics and the philosophy of mind

Joseph Margolis, The Cultural Space of the Arts (2010)

Given my interest in the psychology of creativity as well as in philosophy (specifically philosophy of mind), it has been remiss of me up until now not to have more of an interest in the area of philosophy known as aethetics. Having recently developed a curiosity for it, I sketch a few initial thoughts and aesthetics and psychology below.

In his Critique of Judgment, Kant argued that beauty is in the eye of the beholder (if I understand Kant's argument correctly). We do not/should not refer to the object itself in trying to discern its beauty, but rather the subject who is observing the object and their subjective appraisal thereof.

In an influential paper, Beardsley and Wimsatt posited that there is an "intentional fallacy"; although we may assume that the intention of the author can be read from a literary text, this is not the case. They rightly pointed out that the poet (for example)'s intention should not be the key yardstick for judging a piece's quality, and furthermore if the intention is not clear in the poem itself, the critic will look for information outside of the poem (e.g. an interview with the poet, a critic's or teacher's appraisal of the work). The poem does not simply belong to the poet, the critic, or both, but rather to the public at large.

Running these ideas together, we cannot assume that artists put their creativity "into" their work, which then "holds" this creativity until someone "unlocks" this creativity from the finished piece sitting in a gallery, on a bookshelf etc.

A question of interest to me, then, is whether an aesthetic sense (by which I mean the ability to have an aesthetic reaction to some creative work) is necessary for creative cognition. In stage theories of creative thinking, one of the latter stages involves appraising a creative product (this contrasts somewhat with Beardsley and Wimsatt's separation of judgement and production of creative work). Without aesthetic appreciation, is such a process possible?

This is a pressing question for artificial intelligence (AI) approaches to creative cognition. If a particular domain (say, musical notation) can be mapped out in conceptual space, then AI with good memory, rule-learning and a random output generator can generate outputs which it can compare against its memory for novelty and against certain criteria for a genre/form etc. Nonetheless, is there any reason we should think that AI has a subjective reaction to creative work? How can AI distinguish competent musical composition from a really great or deeply moving piece of music, or at least that which is deeply moving to a human?

For a broad overview of philosophical issues surrounding creativity and how they intersect with psychology, I would recommend the article linked below:

Gaut, B. (2010). The philosophy of creativity. Philosophy Compass, 5(12), 1034-1046. 

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But is it creative?
Where does the mind begin and end?
Two different ways