Conference review: reserve and resilience in cognitive ageing and dementia workshop 2019

Having had the good fortune of receiving a generous travel award from its committee, I visited Washington D.C. for the Reserve and Resilience workshop. The meeting is the first of three annual meetings that aim to create a consensus around definitions of key concepts in this area, such as cognitive reserve, brain reserve, and resilience.

The conference had a very focused structure, with keynote speakers giving very brief presentations restricted to three PowerPoint slides. Each was required to give the definitions they used for key terms relevant to the meeting, such as cognitive reserve, brain reserve and resilience. This made visible some of the distinctions between how people in the field had somewhat different conceptualisations of the same words. To give just one example, in defining resilience, Catherine Kaczorowski included the repair and replenishment of the brain in response to damage, whereas Emrah Duzel was working with a definition of resilience as preventing a decline in neural resources in the presence of manifest pathology.

Such differences in how the same concept may be understood or operationalised could undermine replicability of research. For any given study, larger researcher degrees of freedom allowed by different definitions of the "same thing" could lead to Type 1 errors, and even if a further piece of research is labelled as a conceptual replication at one level, if the concept in question is being operationalised in different ways then it may not be that findings relating to specific outcomes are as reliable as we might think.

The keynote presenters talks were kept unusually short in order to allow more time for questions from the floor. Although this sometimes fell into people trying to plug their pet projects rather than grappling with the key problem of the meeting, there was some very productive discussion. One  point that influenced a lot of subsequent discussion is how the definitions we work with can be looked at at a conceptual, operational, and mechanistic level. There was also some discussion about whether to combine some terms, such as brain and cognitive reserve, although my impression was that by the end of the meeting the delegates felt that it still be useful to have the distinction between brain and cognition (notwithstanding the occasional statement that came close to endorsing a simplistic one-to-one correspondence between the brain and cognition).

The meeting closed with a commitment to continue working together between now and next year's meeting. The organisers are keen to promote data-sharing between people involved at the meeting to further collaboration. They have also helpfully made the presentation slides available online.

At larger conferences it can be easy to get lost when their range of topics are so broad and aims so diffuse, but this was a smaller and intensely focused meeting. The inclusion of three key papers to read posted in advance on the conference website was surely a statement of intent, and the organisers were careful throughout to keep pushing for the key aims of the meeting to try and sound out how we should talk about these concepts. By the close of the third meeting it is hoped that there should be some broad consensus on reserve and resilience-for anyone working in this area it will be worth feeding into this process in the coming two years.

Related posts
Conference review: APS Young Investigator colloquim


You can follow me on Twitter: @ArchivePsych

Dementsploitation

Media doesn't come to us from without- we get the media we demand. Stories that tap into the fear and neurosis of our times sell.

I'd rather raise questions than level accusations, but it's worth thinking about the number of times dementia has come up in recent and not-so-recent TV shows. While the older Sherlock Holmes sketch in Mitchell and Webb show has a high degree of pathos, a sketch from a reunion of The Fast Show is played more for laughs, albeit there is pathos (I think) here as well. Besides comedy, the Black Mirror episode Playtest plays dementia for the horror genre.

It is perhaps not surprising that the horror and comedy have dealt with dementia-these genres often trade on the collision between our subjective sense of self and the objective world around us, seen at a distance from a third person's perspective. What could be a more intense version of this than the juxtaposition of a person's subjective life story and their sense of autonomy with the undermining of this by dementia?

Where does entertainment or even raising awareness etc. start to descend into exploitation? There are many facets to this, but one point I'll make is that although depictions of dementia can be used to inject an emotional punch into a story, this isn't so great if it just leaves the viewer with a sense that dementia is the worst thing that could happen to anyone, as if there were no help whatsoever. People with dementia can have a good quality of life. The understand together campaign is aiming to tackle stigma towards people with dementia: https://www.understandtogether.ie/

Related posts
Stigma "goes meta"
The loved ones

You can follow me on Twitter: @ArchivePsych

It's all in your body, mind or soul: causal attributions for depression

Given how depression can manifest in different ways, and the multiple methods of intervention from talk therapy to pharmacological to lifestyle change to ECT, it is hardly surprising that people hold mixed opinions on where depression "comes from", and what the best choices are for help-seeking and therapeutic intervention.

A cool new study employed an online survey platform to run an experimental study of how different vignettes emphasising different causal attributions for depression might affect attitudes towards intervention, both in terms of help-seeking and treatment options. Although lifestyle interventions or psychotherapeutic treatment were generally preferred to medical intervention, a vignette that emphasised biological attributions (compared to social or biopsychosocial attributions) for depression reduced the perceived efficacy of less biological treatments

The results suggest that encouraging a less Cartesian, body OR mind understanding of the etiology of depression might affect attitudes towards different intervention modalities. Such an approach may help to overcome ethical concerns the authors raise of "manipulating" patient's attitudes/causal attributions towards major depression. Of course, it can be easier to say this than it is to achieve it, when it is so easy to lapse into traps such as, for example, using phrases like "medical treatment" to mean pharmacological treatment, even though many physicians prescribe things like exercise or going to a therapist for cognitive behavioural therapy.  

Interestingly, a clear majority of respondents to the online survey reported a history of major depression. Those with a personal history tended to rate a more medical approach to treatment more highly than people with no personal history of depression. Having a high proportion of respondents with a personal history of depression is not unusual or surprising, particularly as the study was advertised as examining treatment preferences for depression. It might nonetheless be interesting to see whether one would observe similar results in a large cohort of more clearly "naive" respondents (e.g. with no personal history of depression or history of depression in family/close friends, and who report no training/particular interest in major depression).

Nolan, A. & O'Connor, C. (2019). The Effect of Causal Attributions for Depression on Help-Seeking and Treatment Preferences. Journal of Affective Disorders, 257, 477-485.

Related articles: 
Stigma goes meta
I felt a funeral in my brain

Follow me on Twitter: @ArchivePsych

Revisiting Recall

In a recent Irish Times obituary for actor Karl Shiels, Peter Crawley recalls "...he once played a role in the Gate Theatre, and a role in the Abbey Theatre, on the same damn night, dashing down O’Connell Street to make his entrance" 

Many people's autobiographies contain a wealth of these tidbits alongside the broader changes in life. I think one of the best things to come out of the reminiscence project I was working on with Richard Roche, Caoilainn Doyle and others was the archive we created of participant's memories. Some of my personal favourites include:

Teaching in Nigeria in the 1960's: This one captures a formative time near the start of a young woman's career-the other people in the group were keen to hear of her experiences in Africa.

Early morning weddings and the mail train: A reminiscence that wryly captures the difference between experience in the moment and hindsight, and subtly tells of major changes in Irish society.

Emigration to UK and USA: A familiar experience to many Irish people; this individual emigrated to different countries at different phases in life.

Nuclear war fear: A moment in history from a child's eye view-captures the anxiety of the time, but still packs a laugh-out-loud moment near the end.

Mining in Connacht in the 1950's: Memories of a father's working in the mines, an accident at work and its aftermath.

These are just a handful of selections from the collection. Although material on the internet can disappear over time if it's not maintained, as this archive is on the Digital Repository of Ireland, these recordings will be preserved for posterity. People wishing to make use of this archive for social sciences/humanities research are free to do so-just get in touch!  

Related articles: 

Reminiscence group session diaries

Time out of mind

Follow me on Twitter: @ArchivePsych

Creativity: new stages from old pages?

Having written an article on applying stage theories of creativity, I was aware that different thinkers have broken the creative process down into different numbers of stages. However, I was unaware that another stage was hidden in plain sight in the classic 1920's work of Wallas. Typically, those citing Wallas's work refer to four main stages in the creative process: (1). an initial preparatory phase, (2) an incubation phase when the creative task is left aside for sometime (and, it is often presumed, unconscious processes are at work), (3). an illumination phase, when there is some kind of breakthrough in the creative process and (4). a verification phase, when the creative idea is tested, probed or checked for its quality.

However, in a recent article, Eugene Sadler-Smith proposes that intimation is a further stage in the creative process, between incubation and illumination. This is described as a fringe consciousness that links incubation to illumination. It could be described as straddling conscious and unconscious thinking. An indicative description (taken from conversation with a civil servant) is how a person can sense that the solution is coming, but they do not yet know what form this solution will take.

A bit embarrassing that I only encountered this idea recently, but the 4-stage description has been quite pervasive. To me, this extra stage does seem to place an emphasis on more active unconscious processes than other factors that break "writer's block" or comparable phenomena in other creative domains, such as forgetting an unhelpful conceptualisation of a problem, reduction in fatigue or serendipitous discovery of a helpful method of approaching the problem. It will be interesting to see if more researchers and thinkers start trying to pin this stage down in more detail in the coming years.

Sadler-Smith, E. (2015). Wallas’ four-stage model of the creative process: More than meets the eye? Creativity Research Journal, 27(4), 342-352.


Related posts: 
Two different ways 


Follow me on Twitter: @ArchivePsych

International literature festival Dublin: Insider's guide to publishing

The International Literature Festival Dublin is a great series of events-I had the good fortune to attend Patrick McCabe and Nicole Flattery in conversation about their influences (with Flattery counting McCabe, author of "The Butcher Boy" as one).

Given that I'm currently writing a book, I was particularly psyched to attend the full-day Insider's Guide to Getting Published.

The first panel, of five different agents, didn't always have the same preferences for submissions or how to handle them. Nonetheless, they give a clear sense of an agent's remit (and repeatedly emphasize not to sign a contract with a publisher until the agent has had a look!) We also get some useful advise on editing, and three authors (with work spanning literary to more commercial work) describe how their debuts got published. Vanessa Fox-O'Loughlin (who writes as Sam Blake) also delivers a commendably clear solo masterclass on nailing your synopsis, pitch and cover letter.

The main reason I'm at this event is that I was selected for a 10 minute one-on-one with a literary agent. The 60 people put forward for this 'date' with an agent have been selected from circa 480 submissions. Speaking to a few of them during the day, I was surprised at the extent to which some struggled to give a concise pitch about their work. Even when getting set up to meet an agent, it's easy to forget that beyond writing your work, there is a separate skillset to flogging your work!

Not that I'm so great in this regard either. I have a few pithy elevator pitch statements to make about my book, but at the meeting with the agent it's clear that my synopsis can undermine the apparent marketability of the book. It can be difficult to sell something that's straddling two different areas of literature, particularly at as broad a level as combining fiction and non-fiction (what shelf is the book going to go on?). So even if I go with fiction with non-fiction elements, it's best to pigeonhole the book as one or the other. Given that I'm not going "high" literary with this book, the agent's suggestion that I include a student's perspective on the lectures makes a lot of sense (it might be a big ask for a mainstream audience to spend an entire book in the mind of such an unlikeable/alienating protagonist as David Hector).

It's certainly made me think a bit about what I want to do with my book. From the Q & A at the broader sessions, it's clear most people taking part (myself included) are probably engaging in certain number of cognitive biases (confirmation) to keep ourselves going in the face of the challenge of actually getting published. But who knows-one of the debut authors giving a talk was in the audience five years ago.


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

Conference review: British Neuroscience Association Festival of Neuroscience

For the first time, the British Neuroscience Association held its Festival of Neuroscience outside the UK. Risking a Brexit crash-out which thankfully didn't come to pass a couple of weeks before the festival, BNA2019 was co-hosted with Neuroscience Ireland at the Convention Centre in Dublin city. The venue was a good size for the meeting. Although the posters covered everything from benchwork to animal models to my own poster describing reminiscence therapy and a rare memory disorder, the poster space was physically concentrated enough to get a good level of engagement going. The exhibitors included not just the usual publishing houses and companies with new toys for technique junkies, but also a career zone for job networking and a "credibility zone" to act as a thinktank for increasing factors such as reproducibility to allow neuro- and other scientists to be better able to stand over the validity of findings.

Speaking of which, a highlight of the conference was the chance to see autism researcher Uta Frith grapple with the thorny issue of the replication crisis within psychology (and empirical research in general). She called for a move towards "slow science", with theories being tested more carefully, and resisting the temptation to publish anything as fast as you can out of a fear of getting scooped. Perhaps the most impressive research plenary came from Ileana Hanganu-Opatz, who is using electrophysiological techniques to study connectivity in the brain. John Cryan (pictured centre below), whose group I have worked with, also chaired an interesting symposium on diet, brain and microbiome.

There was a great breakout session on political advocacy. Although it could have been better attended, there was a serious discussion from those in attendance about issues around how to make biggest impact in getting through to politicians (and indeed others in the public sector who are less visible but perhaps more influential) about the importance of investing in neuroscience funding. There was a particularly interesting case study of when the BBSRC made major cuts to brain research around the start of this decade, and how brain scientists leveraged the media to push back.

But this wasn't just talks and posters: this was a festival of neuroscience. There were a ton of events around the city, including theatre, dance, music and visual art. I got to the opening of Joanna Hopkin's "Connecting" exhibition. (I felt I had better show up as I had helped Hopkins to access an MRI scanner to inform this piece.) The minimal techno of the scanner pervaded the exhibit, a highlight of which was the strange homonculus pictured below. The work conjures up images of embodied cognition under an anatomical gaze. 

The Age of Arts was a great way to finish up, with a performance from the MISA choir and a commandeering of the audience by Jane Bentley to produce a percussive musical act. There were also talks from a number of people at the Global Brain Health Institute, and a representative from the Bealtaine festival, with a spirited discussion on whether the intersection between art, science and health could be used to undermine the inherent value of the arts. As a psychologist I know that it's easy to describe projects in any funding bid I write as being about all these things and more.

BNA2019 has been a huge undertaking, and any individual's perspective can only capture a snapshot of this event. I've come away with a renewed enthusiasm for the creativity that goes into both science and art. Francesca Farina noted at Age of Arts that science and art may not always have been thought of as separate endeavours; perhaps they are drawing closer together once again.

You can follow me on Twitter: @ArchivePsych