Duke Research Blog

Following the people and events that make up the research community at Duke.

Category: Behavior/Psychology Page 1 of 17

The Importance of Moms

Emily Bray, Ph.D., might have the best job ever. Since earning her bachelor’s at Duke in 2012, she has been researching cognitive development in puppies, which basically means she’s spent the last seven years playing with dogs. If that’s not success, I don’t know what is.

Last Friday marked the 10th birthday of Duke’s Canine Cognition Center, and the 210th birthday of Charles Darwin. To celebrate, Brian Hare, Ph.D., invited former student Bray back to campus to share her latest research with a new generation of Duke undergraduates. The room was riveted — both by her compelling findings and by the darling photos of labs and golden retrievers that accompanied each slide.

Dr. Emily Bray shows photos of her study participants

During her Ph.D. program at the University of Pennsylvania, Bray worked with Robert Seyfarth, Dorothy Cheney, and James Serpell to investigate the effects of mothering on puppy development. For her dissertation, she studied a population of dog moms and their puppies at The Seeing Eye, Inc. The Seeing Eye is one of the oldest and largest guide dog schools in the U.S. They have been successfully raising and training service dogs for the blind since 1929, but like most things, it is still an imperfect science. Approximately half of the puppies bred at The Seeing Eye fail out of program. A dog that completes service training at The Seeing Eye represents two years of intensive training and care, and investing so much time and money into a dog that might eventually fail is problematic. Being able to predict the outcomes of puppies would save a lot of wasted time and energy, and Emily Bray has been doing just this.

What makes a good dog mom? (Photo from Dirk Vorderstraße, from Wikimedia Commons)

Through her work at The Seeing Eye, Bray found that, similar to humans, dogs have several types of mothering styles. She discovered that dog moms tend to fall somewhere on the spectrum from low to high maternal involvement. Some of the moms were very involved with their puppies, and seldom left their side. These hovering moms had high levels of cortisol, and became quite stressed when separated briefly from a puppy. They coddled their children, and often nursed from a laying down position, doing everything they could to make life easy for their babies. On the other side of the spectrum, Bray also observed moms that displayed much more relaxed mothering. They often took personal time, and let their puppies fend for themselves. They were more likely to nurse while sitting or standing up, which made their children work harder to feed. They were less stressed when separated from a puppy, and also just had generally lower levels of cortisol. Sound like bad parenting? Believe it or not, this tough love actually resulted in more successful puppies.

Duke’s very own assistance dogs in training!

As the puppies matured, Bray conducted a series of cognitive and temperament tests to determine if maternal style was associated with a certain way of thinking in the puppies. Turns out, dogs who experienced high maternal care actually performed much worse on the tests than dogs who were shown tough love when they were young. At The Seeing Eye graduation, it was also determined that high maternal care and ventral nursing was associated with failure. Puppies that were over-mothered were more likely to fail as service dogs.

Her theory is that tough love raises more resilient puppies. When mom is always around, the puppies don’t get the chance to experience small stressors and learn how to deal with challenge. The more relaxed moms actually did their kids a favor by not being so overbearing, and allowed for much more independent development.

Bray is now doing post-doctoral research at the University of Arizona, where she is working with Canine Companions for Independence (CCI) to determine if maternal style has similar effects on the outcomes of dogs that will be trained to assist people with a wide range of disabilities. She is also now doing cognition and temperament tests on moms pre-pregnancy to determine if maternal behavior can be predicted before the dogs have puppies. Knowing this could be a game changer, as this information could be used for selective breeding of better moms.

Me snuggling Ashton, one of the Puppy Kindergarten dogs

If you got the chance to hang out with puppies Ashton, Aiden, or Dune last semester, you have an idea of how awesome Bray’s day-to-day work is. These pups were bred at CCI, and sent to Duke to be enrolled in Duke Puppy Kindergarten, a new program on campus run through Duke’s Canine Cognition Center. Which of these three will make it to graduation? I’ve got money on Ashton, but I guess we’ll have to wait and see.

The bottom line according to Bray? “Mothering matters, but in moderation.”

Overcoming Judgment Biases in STEM

Beginning in childhood we all develop unconscious stereotypes that influence how we see ourselves and others – including what careers we choose, and who we choose to recruit, hire or promote in the workplace.

Researchers discussed the origins and effects of these judgement biases during a virtual conference titled Mitigating Implicit Bias: Tools for the Neuroscientist, which was put on by the Society for Neuroscience and screened by DIBS at Duke on Jan. 23 and 24.

Associate professor of neuroscience Anne Churchland of Cold Spring Harbor Laboratory proposed several ideas for overcoming gender bias in the workplace, especially for women in STEM or other male-dominated domains. Asking questions, speaking with authority (particularly about one’s own work), finding a way to communicate with senior colleagues, trying risky experiments, making one’s achievements known, sending one’s work to high-level journals, and applying to awards and grants are her main suggestions. Above all these strategies, she recommends finding good friends and colleagues to help. As research shows, when women are successful in arenas that are viewed as distinctly male, both women and men like them less. These negative reactions can be discouraging and even career-affecting, and any support system will help to overcome that struggle.

The ‘Brilliance Barrier ‘ is a judgement bias explored by Andrei Cimpian’s research at New York University. One study shows that for every ten parents who searched on Google, “Is my daughter talented?”, twenty-five parents looked up “Is my son talented?”

Another study describes the gendered reviews on ratemyprofessor.com. Men are two to three times more likely to be called genius than women. Women though are more likely to be portrayed as warm or caring.

Cimpian uses these studies to develop the Field-specific Ability Beliefs hypothesis (FAB). FAB attributes women’s underrepresentation to a combination of the idolized brilliance/genius and the “brilliance” equals men stereotype. The higher the FAB in a field, the greater the emphasis on brilliance in it. When graphing the percentage of women with PhDs and the FAB for a specific field such as philosophy or physics, higher FABs are associated with a lower number of PhDs. African American representation also decreases as the FAB increases. Cimpian classifies one potential mechanism of this trend as minorities having less interest in fields with high FABs. In addition, increased bias, discrimination, and imposter syndrome could explain why minorities appear to avoid getting PhDs in high FAB fields.

Cimpian also demonstrates how susceptible children are to judgement biases. At age five, the percentage of girls who pick their own gender as “really, really smart” and the percentage of boys who do the same are similar. When children reach seven though, the percentage of boys choosing men exceeds the girls picking women. He suggests de-emphasizing brilliance, genius, and gifted in favor of work ethic because minorities are more likely to be recommended when the job description asks for commitment than when it asks for intelligence. Language has the potential to change the amount of representation in high FAB fields, such as STEM.

Image result for jackie fleming cartoons
Never Give Up – Cartoon by Jackie Fleming

Lastly, psychology professor Ione Fine at the University of Washington talked about the hiring process in her lab and how she reduces bias by laying out and weighting criteria beforehand. Instead of focusing on objective criteria like GPA and GRE scores, she advocates for more interviews with set lists of questions and a paper discussion. She also recommends calling the recommendation letter writers. After selecting a diverse group of research assistants, Fine then makes sure they have the proper support and mentoring. Reinforcing that they were chosen for their potential and that she is their advocate helps them feel empowered to succeed in her lab. Through mentoring and supporting diversity, anyone can help minorities overcome the judgement biases surrounding them.   

Nature vs. Nurture and Addiction

Epigenetics involves modifications to DNA that do not change its sequence but only affect which genes are active, or expressed. Photo courtesy of whatisepigenetics.com

The progressive understanding of addiction as a disease rather than a choice has opened the door to better treatment and research, but there are aspects of addiction that make it uniquely difficult to treat.

One exceptional characteristic of addiction is its persistence even in the absence of drug use: during periods of abstinence, symptoms get worse over time, and response to the drug increases.

Researcher Elizabeth Heller, PhD, of the University of Pennsylvania Epigenetics Institute, is interested in understanding why we observe this persistence in symptoms even after drug use, the initial cause of the addiction, is stopped. Heller, who spoke at a Jan. 18 biochemistry seminar, believes the answer lies in epigenetic regulation.

Elizabeth Heller is interested in how changes in gene expression can explain the chronic nature of addiction.

Epigenetic regulation represents the nurture part of “nature vs. nurture.” Without changing the actual sequence of DNA, we have mechanisms in our body to control how and when cells express certain genes. These mechanisms are influenced by changes in our environment, and the process of influencing gene expression without altering the basic genetic code is called epigenetics.

Heller believes that we can understand the persistent nature of the symptoms of drugs of abuse even during abstinence by considering epigenetic changes caused by the drugs themselves.

To investigate the role of epigenetics in addiction, specifically cocaine addiction, Heller and her team have developed a series of tools to bind to DNA and influence expression of the molecules that play a role in epigenetic regulation, which are called transcription factors. They identified the FosB gene, which has been previously implicated as a regulator of drug addiction, as a site for these changes.

Increased expression of the FosB gene has been shown to increase sensitivity to cocaine, meaning individuals expressing this gene respond more than those not expressing it. Heller found that cocaine users show decreased levels of the protein responsible for inhibiting expression of FosB. This suggests cocaine use itself is depleting the protein that could help regulate and attenuate response to cocaine, making it more addictive.

Another gene, Nr4a1, is important in dopamine signaling, the reward pathway that is “hijacked” by drugs of abuse.  This gene has been shown to attenuate reward response to cocaine in mice. Mice who underwent epigenetic changes to suppress Nr4a1 showed increased reward response to cocaine. A drug that is currently used in cancer treatment has been shown to suppress Nr4a1 and, consequently, Heller has shown it can reduce cocaine reward behavior in mice.

The identification of genes like FosB and Nr4a1 and evidence that changes in gene expression are even greater in periods of abstinence than during drug use. These may be exciting leaps in our understanding of addiction, and ultimately finding treatments best-suited to such a unique and devastating disease.   

Post by undergraduate blogger Sarah Haurin

Post by undergraduate blogger Sarah Haurin

Finding Success in Science and the Economic Brain

How can we understand how humans make decisions? How do we measure the root of motivation?

Gregory Samanez-Larkin, an assistant professor in Psychology & Neuroscience at Duke, uses neuroeconomic and neuromarketing approaches to seek answers to these questions. He combines experimental psychology and economics with neuroimaging and statistical analysis as an interdisciplinary approach to understanding human behavior.

Gregory Samanez-Larkin 

From studying the risk tendencies in different age groups to measuring the effectiveness of informative messages in health decision-making,Samanez-Larkin’s diverse array of research reflects the many applications of neuroeconomics.

He finds that neuroeconomic and neurofinance tools can help spot vulnerabilities and characteristics within groups of people.

Though his Motivated Cognition & Aging Brain Lab at Duke, he would like to extend his work to finding interventions that would encourage healthier or optimal decision-making. Many financial organizations and firms are interested in these questions.

While Samanez-Larkin has produced some very influential research in the field, the path to his career was not a straightforward one.Raised in Flint, Michigan, he found that the majority of people around him were not very career-oriented. He found a passion for wakeboarding, visual art, and graphic design.

As an undergraduate at the University of Michigan-Flint, he was originally on a pre-business track. But after taking various psychology courses and assisting in research, Samanez-Larkin was captivated by the excitement and the advances in brain imaging at the time.

However, misconceptions about the field caused him to question whether or not going into research was the right fit, leading him to seek jobs in marketing and advertising instead. But in job interviews, he ended up questioning the methods and the ways companies explained the appeal of different ways of advertising. Realizing that he really enjoyed asking questions and evaluating how things work, he reconsidered pursuing science.

After a series of positive experiences in a research position in San Francisco, Samanez-Larkin began his graduate studies at Stanford University. The growing field of neuroeconomics — which combined his diverse set of interests in neuroscience, psychology, and economics — continued the “decade-long evolution” of Samanez-Larkin’s career.

Samanez-Larkin’s experiences in his career journey are reflected strongly in his approach to teaching.

“I feel like my primary responsibility is to help people become successful,” he says, as we sit comfortably on the sofas in his office.“Everything I do is for that.”

In his courses, Samanez-Larkin emphasizes the need to think critically and evaluate information, consistently asking questions like, “How do we know something works or not? How do I know how to evaluate if it works or not? How can I become a good consumer of scientific information?”

In his teaching, Samanez-Larkin hopes to set students up with usable, translatable skills that are applicable to any field.

Samanez-Larkin also hopes to support his students in the same way he received support from his previous mentors. “It’s cool to learn about how the brain works, but ultimately, I’m just trying to help people do something.”

Guest Post by Ariba Huda, NCSSM 2019

Biology by the Numbers

Michael C. Reed was trained as a pure mathematician, but from the start, he was, as he explained to me, a “closet physiologist.” He’s a professor of mathematics at Duke, but he’s always wondered how the body works.

Michael Reed in his office

Reed explains an example to me: women have elbows that are bent when their arms are straightened, but men do not. He rationalized his own explanation: women have wide hips and narrow shoulders; their bodies are designed so their arms don’t knock into their sides when they walk. (That basically ended up being the answer.)

Still, Reed never really explored his interest in physiology until he was 40 years old, when he realized that if he wanted to explore something, he should just do it. Why not? He had tenure by that point, so it didn’t really matter what his colleagues thought. He was interested in physiology, but was a mathematician. The obvious answer was mathematical biology.

Now he uses mathematics to find out how various physiological systems work.

In order to decide on a research project, he works with a biologist, Professor Fred Nijhout. They meet for two hours every day and work together. They have lots of projects, but they also just talk science sometimes. That’s how they get their ideas, mainly focusing on things in cell metabolism that have to do with important public health questions.

Reed has been investigating dopamine and serotonin metabolism in the brain, in a collaborative project with Nijhout and Dr. Janet Best, a mathematician at The Ohio State University.

Maybe better math is going to help us understand the human brain

As he explained to me, the brain isn’t like a computer; you don’t know how it works and there are a lot of systems in play. Serotonin is one of them. Low serotonin concentration is thought to be one of the causes of depression. There’s a biochemical network that synthesizes, packages, and transfers serotonin in the brain.

He told me that his work consists of making mathematical models for systems like this that consist of differential equations for concentrations of different chemicals. He then experiments with the system of differential equations to understand how the system works together. It’s not really something you can learn by having it explained to you, he told me. You have to learn through practice.

In a way, biology doesn’t seem like it would be the most compatible science, especially with math. But as Reed explained to me, “Math is easy because it’s very orderly and organized. If you work hard enough, you can understand it.” Biology, on the other hand, “is a mess.”

Everything in biology is linked to everything else in a system of connectedness that ends up all tangled together, and it can be hard to identify how something happens in the human body. But Reed applies math – an organized construct – to understand biological systems.

In the end, Reed does what he does because it’s how we — as human beings — work. He has no regrets about the choices he’s made at all.Mathematical biology seems to be his calling — he’s more interested in understanding how things work, and that’s what he does when he works.

Or rather, he doesn’t really work; because, as he told me,“try to find something to do that you really like, and are passionate about,because if you do, it won’t seem like work.” Reed doesn’t see coming into work as a struggle. He’s excited about it every single day and “it’s because you want to do it, it’s fun.”

Guest Post by Rachel Qu, NCSSM 2019

Aging and Decision-Making

Who makes riskier decisions, the young or the old? And what matters more in our decisions as we age — friends, health or money? The answers might surprise you.

Kendra Seaman works at the Center for the Study of Aging and Human Development and is interested in decision-making across the lifespan.

Duke postdoctoral fellow Kendra Seaman, Ph.D. uses mathematical models and brain imaging to understand how decision-making changes as we age. In a talk to a group of cognitive neuroscientists at Duke, Seamen explained that we have good reason to be concerned with how older people make decisions.

Statistically, older people in the U.S. have more money, and additionally more expenditures, specifically in healthcare. And by 2030, 20 percent of the US population will be over the age of 65.

One key component to decision-making is subjective value, which is a measure of the importance a reward or outcome has to a specific person at a specific point in time. Seaman used a reward of $20 as an example: it would have a much higher subjective value for a broke college student than for a wealthy retiree. Seaman discussed three factors that influence subjective value: reward, cost, and discount rate, or the determination of the value of future rewards.

Brain imaging research has found that subjective value is represented similarly in the medial prefrontal cortex (MPFC) across all ages. Despite this common network, Seaman and her colleagues have found significant differences in decision-making in older individuals.

The first difference comes in the form of reward. Older individuals are likely to be more invested in the outcome of a task if the reward is social or health-related rather than monetary. Consequently, they are more likely to want these health and social rewards  sooner and with higher certainty than younger individuals are. Understanding the salience of these rewards is crucial to designing future experiments to identify decision-making differences in older adults.

A preference for positive skew becomes more pronounced with age.

Older individuals also differ in their preferences for something called “skewed risks.” In these tasks, positive skew means a high probability of a small loss and a low probability of a large gain, such as buying a lottery ticket. Negative skew means a low probability of a large loss and a high probability of a small gain, such as undergoing a common medical procedure that has a low chance of harmful complications.

Older people tend to prefer positive skew to a greater degree than younger people, and this bias toward positive skew becomes more pronounced with age.

Understanding these tendencies could be vital in understanding why older people fall victim to fraud and decide to undergo risky medical procedures, and additionally be better equipped to motivate an aging population to remain involved in physical and mental activities.

Post by undergraduate blogger Sarah Haurin

Post by undergraduate blogger Sarah Haurin

The Complicated Balance of Predators and Prey

If you knew there was a grizzly bear sitting outside the door, you might wait a while before going to fill up your water bottle, or you might change the way you are communicating with their other people in the room based on your knowledge of the threat.

Ecologists call this “predation risk,” in which animals that could potentially fall prey to a carnivore know this risk is present, and alter their habits and actions accordingly.

A yellow slider turtle.

A yellow slider turtle.

One way in which animals do this is through habitat use, such as a pod of dolphins that changes where they spend most of their time depending on the presence or absence of predators. Animals might also change their feeding habits and diving behavior because of predation risk.

Animals do this all of the time in the wild, but when predators are removed from ecosystems by hunting or over-fishing, the effect of their absence is felt all the way down the food chain.

For example, large amounts of algae growth on coral reefs can be traced back to over-fishing of large ocean predators such as sharks, who then don’t hunt smaller marine mammals like seals. As seal numbers increase, there are more of them to hunt smaller fish that feed on vegetation, which means fewer smaller fish or plankton to keep algal growth in check, and algae begins to grow unchecked.

Meagan Dunphy-Daly

Meagan Dunphy-Daly

This is a “trophic cascade” and it has large effects on ecosystems, Duke Marine Lab instructor Meagan Dunphy-Daly  t0ld the Sustainable Oceans Alliance last Thursday. She has performed research both in labs and in the field to study the effects that removing large predators have on marine ecosystems.

Dunphy-Daly discussed one lab experiment where 10 yellow-bellied slider turtle hatchlings were kept in tanks where they couldn’t see people or anything else on the outside. In real life, blue herons and other large birds prey on these turtle hatchlings, so the researchers made a model skull of a blue heron that they painted and covered with feathers.

Turtles are air-breathing, so each hatchling was given the option to sit where they could be at the surface of their tank and breathe, but this spot was also where the turtle hatchlings thought the bird beak might shoot down at any time to try to “eat” them.

Their options were to get air and risk getting hit by the bird beak, or diving down to the bottom of the tank to get food. During this experiment, Dunphy-Daly found that turtle hatchlings actually decreased their dive time and spent more time at the surface. If the turtles are continuously diving, they are expending lots of energy swimming back and forth between the surface and the bottom, she said, which means if the predator were to actually attack, they would have less energy left to use for a rapid escape.

Even when there is food at the bottom, when a predator is present, these turtles alter their activity by taking deep dives less frequently so as to not max out their aerobic limit before they actually need to escape a predator.

This is one way in which animals alter their behavior due to predation risk.

But let’s say that predators were disappearing in their real habitats, so turtles didn’t feel the need to build up these emergency energy reserves to escape them. They might dive down and feed more frequently, which would then decrease the amount of the vegetation they eat.

This in turn could have an effect on oxygen levels in the water because there would be fewer plants photosynthesizing. Or another species that feeds on the same plant could be out-competed by turtles and run out of food for their own populations.

The absence of large or small predators can have large impacts on ocean ecosystems through these complicated trophic cascades.

Victoria PriesterPost by Victoria Priester

Smart Phones Are the New Windows to the Soul

It’s one of those things that seems so simple and elegant that you’re left asking yourself, “Geez, why didn’t I think of that?”

Say you were trying to help people lose weight, prep for a surgery or take their meds every day. They’re probably holding a smartphone in at least one of their hands — all you need to do is enlist that ever-present device they’re staring at to bug them!

So, for example, have the health app send a robo-text twice a day to check in: “Did you weigh yourself?” Set up a group chat where their friends all know what they’re trying to accomplish: “We’re running today at 5, right?”

This is a screenshot of a Pattern Health app for pre-operative patients.

It’s even possible to make them pinky-swear a promise to their phone that they will do something positive toward the goal, like walking or skipping desert that day. And if they don’t? The app has their permission to lock them out of all their apps for a period of time.

Seriously, people agree to this and it works.

Two app developers on this frontier of personalized, portable “mHealth” told a lunchtime session  sponsored by the Duke Mobile App Gateway on Thursday that patients not only willingly play along with these behavioral modification apps, their behaviors change for the better.

The idea of using phones for health behavior came to pediatric hematologist Nirmish Shah MD one day while he attempted to talk to a 16-year-old sickle cell disease patient as she snapped selfies of herself with the doctor. Her mom and toddler sister nearby both had their noses to screens as well. “I need to change how I do this,” Shah thought to himself.

Pediatric hematologist Nirmish Shah MD

Pediatric hematologist Nirmish Shah MD is director of Duke’s sickle cell transition program.

Twenty health apps later, he’s running phase II clinical trials of phone-based interventions for young sickle cell patients that encourage them to stay on their medication schedule and ask them often about their pain levels.

One tactic that seems to work pretty well is to ask his patients to send in selfie videos as they take their meds each day. The catch? The female patients send a minute or so of chatty footage a day. The teenage boys average 13 seconds, and they’re grumpy about it.

Clearly, different activities may be needed for different patient populations, Shah said.

While it’s still early days for these approaches, we do have a lot of behavioral science on what could help, said Aline Holzwarth, a principal of the Center for Advanced Hindsight and head of behavioral science for a Durham health app startup called Pattern Health.

Aline Gruneisen Holzwarth

Aline Holzwarth is a principal in the Center for Advanced Hindsight.

“It’s not enough to simply inform people to eat better,” Holzwarth said. The app has to secure a commitment from the user, make them set small goals and then ask how they did, enlist the help of social pressures, and then dole out rewards and punishments as needed.

Pattern Health’s app says “You need to do this, please pick a time when you will.” Followed by a reward or a consequence.

Thursday’s session, “Using Behavioral Science to Drive Digital Health Engagement and Outcomes, was the penultimate session of the annual Duke Digital Health Week. Except for the Hurricane Florence washout on Monday, the week  has been a tremendous success this year, said Katie McMillan, the associate director of the App Gateway.

Quantifying Sleepiness and How It Relates to Depression

Sleep disturbance is a significant issue for many individuals with depressive illnesses. While most individuals deal with an inability to sleep, or insomnia, about 20-30% of depressed patients report the opposite problem – hypersomnia, or excessive sleep duration.

David Plante’s work investigates the relationship between depressive disorders and hypersomnolence. Photo courtesy of sleepfoundation.org

Patients who experience hypersomnolence report excessive daytime sleepiness (EDS) and often seem to be sleep-deprived, making the condition difficult to identify and poorly researched.

David Plante’s research focuses on a neglected type of sleep disturbance: hypersomnolence.

David T. Plante, MD, of the University of Wisconsin School of Medicine and Public Health, studies the significance of hypersomnolence in depression. He said the condition is resistant to treatment, often persisting even after depression has been treated, and its role in increasing risk of depression in previously healthy individuals needs to be examined.

One problem in studying daytime sleepiness is quantifying it. Subjective measures include the Epworth sleepiness scale, a quick self-report of how likely you are to fall asleep in a variety of situations. Objective scales are often involved processes, such as the Multiple Sleep Latency Test (MSLT), which requires an individual to attempt to take 4-5 naps, each 2 hours apart, in a lab while EEG records brain activity.

The MSLT measures how long it takes a person to fall asleep. Individuals with hypersomnolence will fall asleep faster than other patients, but determining a cutoff for what constitutes healthy and what qualifies as hypersomnolence has made the test an inexact measure. Typical cutoffs of 5-8 minutes provide a decent measure, but further research has cast doubt on this test’s value in studying depression.

The Wisconsin Sleep Cohort Study is an ongoing project begun in 1988 that follows state employees and includes a sleep study every four years. From this study, Plante has found an interesting and seemingly paradoxical relationship: while an increase in subjective measures of sleepiness is associated with increased likelihood of depression, objective measures like the MSLT associate depression with less sleepiness. Plante argues that this paradoxical relationship does not represent an inability for individuals to report their own sleepiness, but rather reflects the limitations of the MSLT.

Plante proposed several promising candidates for quantitative measures of excessive daytime sleepiness. One candidate, which is already a tool for studying sleep deprivation, is a ‘psychomotor vigilance task,’ where lapses in reaction time correlate with daytime sleepiness. Another method involves infrared measurements of the dilation of the pupil. Pupils dilate when a person is sleepy, so this somatic reaction could be useful.

High density EEG allowed Plante to identify the role of disturbed slow wave sleep in hypersomnolence.

Another area of interest for Plante is the signs of depressive sleepiness in the brain. Using high density EEG, which covers the whole head of the subject, Plante found that individuals with hypersomnolence experience less of the sleep cycle most associated with restoration, known as slow wave sleep. He identified a potential brain circuitry associated with sleepiness, but emphasized a need for methods like transcranial magnetic stimulation to get a better picture of the relationship between this circuitry and observed sleepiness.

By Sarah Haurin

Detangling Stigma and Mental Illness

Can you imagine a world without stigma? Where a diagnosis of autism or schizophrenia didn’t inevitably stick people with permanent labels of “handicap,” “abnormal,” “disturbed,” or “dependent”?

Roy Richard Grinker can. In fact, he thinks we’re on the way to one.

It’s a subject he’s studied and lectured on extensively—stigmas surrounding mental health conditions, that is. His expertise, influence, and unique insight in the field led him to April 12, where he was the distinguished speaker of an annual lecture commemorating Autism Awareness Month. The event was co-sponsored by the Duke Center for Autism and Brain Development, the Duke Institute for Brain Sciences, and the Department of Cultural Anthropology.

Roy Richard Grinker was the invited speaker to this year’s annual Autism Awareness Month commemorative lecture. Photo credit: Duke Institute for Brain Sciences

Grinker’s credentials speak to his expertise. He is a professor of Anthropology, International Affairs, and Human Sciences at George Washington University; he has authored five books, several New York Times op-eds, and a soon-to-be-published 600-page volume on the anthropology of Africa; he studied in the Democratic Republic of the Congo as a Fulbright scholar in his early career; and, in the words of Geraldine Dawson, director of the Center for Autism and Brain Development, “he fundamentally changed the way we think about autism.”

Grinker began with an anecdote about his daughter, who is 26 years old and “uses the word ‘autism’ to describe herself—not just her identity, but her skills.”

She likes to do jigsaw puzzles, he said, but in a particular fashion: with the pieces face-down so their shape is the only feature she can use to assemble them, always inexplicably leaving one piece out at the end. He described this as one way she embraces her difference, and a metaphor for her understanding that “there’s always a piece missing for all of us.”

Grinker and Geraldine Dawson, director of the Center for Autism and Brain Development, pose outside Love Auditorium in the minutes before his talk. Source: Duke Institute for Brain Sciences

“What historical and cultural conditions made it possible for people like Isabel to celebrate forms of difference that were a mark of shame only a few decades ago?” Grinker asked.  “To embrace the idea that mental illnesses are an essential feature of what it means to be human?”

He identified three processes as drivers of what he described as the “pivotal historical moment” of the decoupling of stigma and mental illness: high-profile figures, from celebrity talk-show hosts to the Pope, speaking up about their mental illnesses instead of hiding them; a shift from boxing identities into racial, spiritual, gender, and other categories to placing them on a spectrum; and economies learning to appreciate the unique skills of people with mental illness.

This development in the de-stigmatization of mental illness is recent, but so is stigma itself. Grinker explained how the words “normal” and “abnormal” didn’t enter the English vocabulary until the mid-19th century—the idea of “mental illness” had yet to make its debut.

“There have always been people who suffer from chronic sadness or had wildly swinging moods, who stopped eating to the point of starvation, who were addicted to alcohol, or only spoke to themselves.” Grinker said. “But only recently have such behaviors defined a person entirely. Only recently did a person addicted to alcohol become an alcoholic.”

Grinker then traced the development of mental illness as an idea through modern European and American history. He touched on how American slaveowners ascribed mental illness to African Americans as justification for slavery, how hysteria evolved into a feminized disease whose diagnoses became a classist tool after World War I, and how homosexuality was gradually removed from the Diagnostic and Statistical Manual of Mental Disorders (DSM) by secretly gay psychiatrists who worked their way up the rankings of the American Psychiatric Association in the 1960s and 70s.

Source: Duke Institute for Brain Sciences

Next, Grinker described his anthropological research around the world on perceptions of mental illness, from urban South Korea to American Indian tribes to rural villages in the Kalahari Desert. His findings were wide-ranging and eye-opening: while, at the time of Grinker’s research, Koreans viewed mental illness of any kind as a disgrace to one’s heritage, members of Kalahari Desert communities showed no shame in openly discussing their afflictions. Grinker told of one man who spoke unabashedly of his monthly 24-mile walk to the main village for antipsychotic drugs, without which, as was common knowledge among the other villagers, he would hear voices in his head urging him to kill them. Yet, by Grinker’s account, they didn’t see him as ill — “a man who never hallucinates because he takes his medicine is not crazy.”

I could never do justice to Grinker’s presentation without surpassing an already-strained word limit on this post. Suffice it to say, the talk was full of interesting social commentary, colorful insights into the history of mental illness, and words of encouragement for the future of society’s place for diversity in mental health. Grinker concluded on such a note:

“Stigma decreases when a condition affects us all, when we all exist on a spectrum,” Grinker said. “We see this in the shift away from the categorical to the spectral dimension. Regardless, we might need the differences of neurodiversity to make us, humans, interesting, vital, and innovative.”

Post by Maya Iskandarani

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