After having seen Inside Out, I would say that my experience was not as expected. Though the movie tugs at the heat-strings, it was not particularly satisfying. Riley went through a lot of changes in this movie, and in a way progressed and matured emotionally in the span of two hours. But I still felt that she had not learned much by the end of the movie. Riley’s personified emotions learned that Sadness can bring back your emotions when you have gone emotionless, but does Riley know that? What would prevent her from becoming emotionless if another major change happens in her life? What was most frustrating was that we hardly heard Riley’s own thoughts and reflections, as they were reflected from the point of view of her personified emotions. I feel the movie could have benefitted by an ‘inner voice’ where we can hear what Riley is thinking throughout the movie, and then see how her way of thinking and decision-making changes from the beginning of the film to the end.

Furthermore, I took issue with Joy (as I feel I was supposed to). She essentially acts as a bully to Sadness and belittles her through majority of the film. Meanwhile, she is revered as the hero by all the other emotions. Perhaps Joy represents our culture of never revealing our sadness to others. Just as Sandness seems friend-less in the film, we consider sadness as an emotion experienced in solitude. Meanwhile, happiness or joy is most often experienced in the company of others. The main example of this is Riley’s memory of the day her teammates surrounded her to cheer her up after a hockey game. We see Riley alone, and the memory is blue, indicating sadness, then when others come in to the picture to cheer her up, she becomes happy. It’s no coincidence that sadness and loneliness go hand in hand. In sharing our true emotion with others, we can deal with and address negative feelings such as Sadness. Perhaps the reason why Joy has a somewhat dislikable character is to show the adult audience how absurd it is to constantly maintain an outward appearance of happiness. We all have a full range of emotion, but by hiding our sadness from others, it cannot be properly addressed.

Another small issue I took with the film is that Riley got a completely new personality (personality islands) over the course of a day. If anything, her personality islands would be in a constant state of renovation, so that at any point, “Silliness Island” is in the process of becoming “A Good Sense of Humor” island, and so-on. Furthermore, the subconscious should have contained many many memories of her parents, as I feel that a lot of who we are at our core is shaped by our experiences as children (just like subconscious fears). In fact, the personality islands and the bridges that lead to them should be made of her memories. The memories do not sit around living out their shelf-life until they get recycled; they are used to change her brain and therefore personality. We are, in most part, who we were and what we have experienced.

An interesting avenue to explore within the world of Inside Out would be the role of touch. Good touch and bad touch seem to have a huge impact on our memory. For example, Riley’s immediate family always interact with her with ‘good touch’ and I think that facilities their feeling of familial love and closeness. Riley would likely react in a very negative way if her parents suddenly stopped with the good-night kisses, but otherwise kept interacting with her in the same way. We were able to experience what Riley was seeing and hearing, but touch is a major sense that cannot be overlooked when it comes to certain memories.

Overall I think is a good movie for children. Not only will it hopefully spark their interest in Neuroscience, but it will help them better understand their own emotions and hopefully shows them the importance of sharing their emotions, both the positive emotions and especially the negative ones.

By Ali Gold

Finals week is approaching, which means stress levels are rising. Maybe this increase in anxiety manifests itself in bouncing feet, or transforming pens and pencils into drumsticks. Coping skills vary from person to person; though they are habitually employed to alleviate stress, not all coping skills are helpful in the long term. Maladaptive coping skills reduce stress in ways that can ultimately impair, as opposed to aid, daily functioning. However, one must acknowledge that these (detrimental) means of adapting, such as drug or alcohol use, avoidance, social withdrawal, overexercising, or compulsive sex, are typically very effective short-term stress-relievers, which is why they tend to be so addictive- and while these activities regularly carry a negative stigma, their utilization in moderation can sometimes be beneficial and unproblematic. Despite the dichotomy between adaptive and maladaptive coping skills, they both share an identical origin: an effort to reduce the physiological and emotional intolerable feelings of stress (anxiety, anger, fear and the remaining list of “negative/intolerable” emotions).

Commonly, these uncomfortable emotions, such as anxiety, emanate from an unrealistic companionship with control. We want to erase the past or speed up the future. Cognitions are distorted by appraisals (how we interpret experiences) and fear of the unknown: what will happen? What do others think of me? Unfortunately, most of us are pretty talented at catastrophizing and thinking negatively. From an evolutionary standpoint, the anxiety-driven ability to replay events over and over in our head may have allowed us to learn from our mistakes, map the routes to obtain food or avoid predators, and, in general, may have facilitated consolidation of memories. The anxiety-driven mental faculty to envisage and anticipate the infinite possibilities of fate, on the other hand, may have advantageously led to the thorough preparation that increased our likelihood of survival. Yet, the hyperactivity of these facilities can cause us unwarranted concern and distress. In modern day terms, these inordinate dwellings on the past and future are called “rumination” and “worry.”

Though we cannot always control what happens to us, such as the external stressors our environment imposes on our lives, we can control how we respond.  Yet, acceding to this balance is not always easy. Some people, like myself, find it very difficult accept that ruminating about the past and worrying about the future may only cause additional tension, and most definitely will not change or fix the stressors that I’m currently facing. Alcoholics Anonymous, a popular self-help program and community that encourages recovering alcoholics to obtain and maintain sobriety, has adopted an insightful mantra, called the “Serenity Prayer”, which addresses this struggle to both take and relinquish control over the incessant myriad of life’s stressors. It reads: Grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference. If we can let go of uncontrollable worries, such as dreading finals that are three weeks away, or move on from that one time during a high school basketball game that we missed a free throw, we increase our chances of finding inner peace. If we can acquire the bravery to face our daunting obstacles, such as forgiving friends who wronged us, or generating the willingness to use a healthy coping skill instead of surrendering to the intense temptations of addiction, we augment our opportunities to foster relationships, fortify self-efficacy, and promote inner growth. Ultimately, if we keep an open mind and a readiness to learn from our own and others’ experiences, our apprehension can gradually evolve into astuteness.

So, how does one combat stress, or anxiety? How does one overcome the human instinct to suppress, avoid or eliminate these unsettling emotions? My best answer: there isn’t just one solution. Everyone is different, every situation is different; we are changing and the word is changing. Some factors can help reduce the risk of stress and illness (getting an adequate amount of sleep, maintaining proper hygiene, eating nutritious meals, exercising… you’ve heard it all before). As humans, our lives will always involve stressors. But when a stressful situation arises, and our anxiety or anger is approaching or at a ten out of ten, is there anything that will work for 100% of the time? My answer: yes. Fight evolution with evolution.

Cool tip: Try ice diving. Get a big bowl full of ice water and dip your face in, holding it under for 3-5 second intervals (For as many times until you feel better, or until you develop hypothermia. Just kidding.)

Ice diving works because mammals (like us) have what’s called the Diving Reflex. An advantageous evolutionary trait, the reflex allows humans to better endure life-threatening cold, such as falling through ice into freezing waters, by shutting down a number of physiological processes in order to conserve oxygen and energy (it decelerates the body by about 10-25%). In turn, the reaction slows the person’s heart rate and reduces blood pressure, meaning that a secondary effect of the body’s reflex response is a scientifically proven, physiological decrease in anxiety (and anger and other intense emotions!). Ice diving, cold showers, and ice packs allow us to manipulate our body, and, help us regulate those seemingly out-of-control, and unwanted, emotions.

http://dujs.dartmouth.edu/winter-2012/the-mammalian-diving-reflex#.VT57NIc78mw

Theresa Kosch

I was blown away by the research that has been done on yoga, meditation & mindfulness on the brain. I was aware of the physical gains and the calming affects produced by these practices. I was unaware of just how much these practices can change the actual structure of the brain. I went to a showing of a film called, Free the Mind, hosted by Dr. David Vago. The film was directed by Phie Ambo and the research was collected by Dr. Richard Davidson. Dr. Davidson is a neuroscientist who decided after meeting the Dalai Lama to focus his attention on mindfulness practices to aid in disorders such as ADHD, PTSD and depression. The film follows two Iraqi veterans with Post Traumatic Stress Disorder and one young child suffering from Attention Deficit Hyperactivity Disorder and a phobia of elevators. Dr. Davidson uses techniques such as yoga, meditation and breathing. Dr. Davidson also points out that people who perceive stress have a 43% increased risk of dying after 9 years. Dr. Davidson along with others, found that mindfulness, meditation, yoga and breathing trainings can have potential age defying affects and can change grey matter atrophy in your brain. According to the research, structures in a brain can actually grow because of these practices. The grey matter density in the hippocampus can increase, the hippocampus is what we use for learning and memory. Individuals have also been known to show a decrease in grey matter in the amygdala which plays a part in anxiety. Studies have shown that people who do yoga and meditation that their brains were aging slower than non-meditators. People’s moods have also been known to improve because these practices induce an expansion of myelin. By the end of the film the two Iraqi veterans showed positive results. One of the veterans who was taking Ambien for sleep and for his flashbacks from the war, no longer needed it after the experiment. The young child with ADHD seemed calmer and less fearful. At the end he was able to face his fear of the elevator and join the other children. These positive results were seen after only a couple of weeks. If people can do them on a regular basis the results will be even more astounding. All these practices are exercises for the brain that can improve their function. Just like positive results are seen from exercising, one can feel from these mindfulness practices. If you haven’t tried yoga, meditation or breathing exercises I suggest you start today!

Works Cited

Luders, E., Thompson, P. M., & Kurth, F. (2015). Larger hippocampal dimensions in meditation practitioners: differential effects in women and men. Frontiers in Psychology, 6, 186. doi:10.3389/fpsyg.2015.00186

Desbordes, G., Negi, L. T., Pace, T. W. W., Wallace, B. A., Raison, C. L., & Schwartz, E. L. (2012). Effects of mindful-attention and compassion meditation training on amygdala response to emotional stimuli in an ordinary, non-meditative state. Frontiers in Human Neuroscience, 6, 292. doi:10.3389/fnhum.2012.00292

Gard, T., Taquet, M., Dixit, R., Hölzel, B. K., de Montjoye, Y.-A., Brach, N., … Lazar, S. W. (2014). Fluid intelligence and brain functional organization in aging yoga and meditation practitioners. Frontiers in Aging Neuroscience, 6, 76. doi:10.3389/fnagi.2014.00076

Posner, M. I., Tang, Y.-Y., & Lynch, G. (2014). Mechanisms of white matter change induced by meditation training. Frontiers in Psychology, 5, 1220. doi:10.3389/fpsyg.2014.01220

According to the World Health Organization, about 3.2 billion people, or half the world’s population, are at risk for malaria, which is directly linked to poverty. Countries with the highest poverty rates have also been shown to have the highest malaria infection rates. An estimated one percent of victims of malaria develop cerebral malaria (CM), which results in swelling and hemorrhaging in white matter in the corpus collosum and the subcortical rim leading to a thirty percent mortality rate. Of the seventy percent of patients that do survive, about ten to twenty percent have lasting physical and cognitive dysfunction.

Although CM still imposes a large threat to the world’s population, funding for research is largely nonexistent due to the fact that the wealthiest countries are no longer affected. Ideally human research experiments could be conducted, but developing countries rarely have the funds for MRI, MRS, and CT scans needed to properly trace and research the development of CM. It has also been found that peripheral blood information is incomplete and inconclusive and clinical trial networks are largely too time consuming and costly for developing countries.

With no efficient human research model, researchers have focused on the use of mice to study CM. Overall, the murine model is inexpensive and mice brains are relatively comparable to human brains in respect to physiological, parasitological, and immunological features. Most murine model CM papers end with a statement of relevance in regards to cerebral malaria in humans, or fail to differentiate murine CM from human CM.

Unfortunately, it was found that ninety-two percent of successful treatments found using the murine model failed in treatment of humans, because there exists major histopathological differences between human and mouse CM. Murine CM has little or no intracerebral sequestration of parasitized erythrocytes, while human CM has intense intracerebal sequestration. Murine CM has accumulation of leukocytes and platelets and inflammation in the brain, while human CM has neither. These two major differences show that cerebral malaria does not act the same in mice as it does in humans. Also, the treatments proposed in mice are given before the mice develop any symptoms, which is nearly impossible to do with humans.

The failure of the murine model to deliver any conclusive results should lead to the questioning of the effectiveness of it. However, several reasons contribute to the continuing use and validation of the murine model. First, many research institutions already have existing murine laboratory programs, making it an independent and self-sustaining discipline. It also uses genetically homogenous hosts and parasites, and provides high quality histopathology on all subjects. Lastly, it produces positive results, which appeal to a substantial lab based immunological audience.

Written by Elizabeth S. Gromisch, M.A.

When someone has been diagnosed with a degenerative neurological condition or has sustained injury to the brain, such as with a traumatic brain injury (TBI), there is often a concern about changes in cognition. In a degenerative condition such as Alzheimer’s disease (AD), a decline in cognitive functioning can be indicative of disease progression. Identifying disease progression is important not only in clinical settings, but research settings in which new treatments are developed.

In AD drug trials, MRIs of brain atrophy may be used as an outcome, as changes in the volumes of the right and left hippocampi would be associated with changes in memory. Previously, screening measures of cognitive and behavioral status, such as the Clinical Dementia Rating (CDR) and AD Assessment Scale (ADAS) have been used (Cummings, Gould, & Zhong, 2012), but along with other brief measures like the Mini-Mental State Examination (MMSE), they may not be the most reliable (but that is a topic for another blog post!).

Schmand et al.’s (2014) study compared MRIs as an outcome to a neuropsychological battery. If you are not familiar with a neuropsychological battery, it consists of several measures that assess different cognitive domains, such as memory, language, and executive functioning. These measures can be pencil and paper tests, though they can be administered through a computer. In addition to providing a more comprehensive picture of an individual’s cognitive functioning, neuropsychological tests can have stronger psychometric properties than screening measures (Schmand et al., 2014).

Participants in the study (N = 62) were patients at the Academic Medical Centre memory clinic in Amsterdam. They were between the ages of 50 to 85 and had cognitive complaints. At baseline, they underwent a neurological examination and were administered the CDR and MMSE. Participants then underwent a structural MRI scan and neuropsychological evaluation, which included measures of executive functioning, memory, verbal fluency, and effort. Two years later, they had a follow-up MRI and neuropsychological evaluation, with alternative forms of the tests used. With the MRI, they focused on the cortical thickness of the temporal lobe and atrophy of the hippocampus. They found when they used the neurologist’s diagnosis, the neuropsychological assessment was more responsive with patients with MCI and early dementia compared to the MRI. Another benefit found with using this brief neuropsychological battery, which takes about 45 minutes, is intervention trials in AD and mild cognitive impairment which can have a 50% smaller sample size.

Repeat neuropsychological assessment is often used in a clinical setting. For example, an individual who has sustained a TBI may have an assessment early on in the recovery period, and may undergo repeat testing a year later to track changes in cognitive status. However, there are concerns clinicians should keep in mind with repeat testing. A significant issue that may arise is the practice effect, in which an individual’s performance on the follow-up may be better due to previous exposure to the measure. This can occur even when the questions on the test are different or an alternative version of the test is used (Heilbronner et al., 2010). In the official position from the American Academy of Clinical Neuropsychology (AACN), they recommend “change as a measurable construction to be used to inform the clinical descriptive and diagnostic process…consideration may be given to the standard error of measurement for a test manual, empirical findings on the expected magnitudes of score increases over a particular interval, or other relevant research on test operating characteristics for the instruments employed in the neuropsychologist’s battery.”

References

1. Cummings, J., Gould, H., & Zhong, K. (2012). Advances in designs for Alzheimer’s disease clinical trials. American Journal of Neurodegenerative Diseases, 1, 205-216
2. Heilbronner, R.L., Sweet, J.J., Attix, D.K., Krull, K.R., Henry, G.K., & Hart, R.P. (2010). Official position of the American Academy of Clinical Neuropsychology on serial neuropsychological assessment: the utility and challenges of repeat test administrations in clinical and forensic contexts. The Clinical Neuropsychologist, 24, 1267-1278
3. IOS Press. (2014 February). Neuropsychological assessment more efficient than MRI for tracking disease progression in memory clinic patients. Accessed from http://www.iospress.nl/ios_news/neuropsychological-assessment-more-efficient-than-mri-for-tracking-disease-progression-in-memory-clinic-patients/
4. Schmand, B., Rienstra, A., Tamminga, H., Richard, E., van Gool, W.A., Cann, M.W.A., & Majoie, C.B. (2014). Responsiveness of magnetic resonance imaging and neuropsychological assessment in memory clinic patients. Journal of Alzheimer’s Disease, 40, 409-418

Written by Arleigha Cook ’16

In considering the many emotional side-effects of Traumatic Brain Injury (TBI) that can lead to diagnoses such as depression, anxiety, bipolar, etc., one of the central questions I found myself asking is that of whether or not an “addictive personality” exists.

The question of addictive personalities became a topic of discussion in my abnormal psychology class a few days ago.  As the topic was further discussed, turned over, and considered, I began to relate it to TBI.  I thought about how certain survivors—especially former athletes—will say that they feel “more impulsive” or that they “just don’t think” about what they are doing at times.  It became more and more apparent to me that there is probably a considerable connection between addictive personality tendencies and TBI.

There are biological, psychological, and sociocultural factors that determine whether or not one is likely to have addictive personality tendencies.  These three perspectives represent the biopsychosocial model, a theory that posits mental illness (including depression, anxiety, anorexia, and others) is derived from the interaction of biological, psychological, and sociocultural factors.  This post will discuss these three perspectives in detail and how they relate TBI to addictive personality tendencies, with particular emphasis placed on former athletes who have sustained a TBI.

Biological Perspective

Biology is a more influential factor in personality tendencies than previously supposed.  Research shows that temperament is largely heritable (see the 2005 study “Behavioral Genetics and Child Temperament” conducted at Boston University), and by definition it includes traits that dictate how “impulsive,” “sensation-seeking,” and “neurotic” a person is.  In other words, these traits run in families—and sometimes they do not show until they are triggered by a certain event or other psychological or sociocultural factors.  In a TBI patient’s case, the trigger is usually the brain injury itself.  Thus, survivors may already be predisposed to increased impulsivity, the seeking out of certain sensations as a result of said increased impulsivity, and emotional instability.  These traits may only show post-injury, and many TBI survivors I know have told me that they feel like a different person since the onset of these “new” personality traits.  This certainly speaks to the complexity of our genetic makeup and the extent to which a concussion or other TBI can alter genetic expression.

I relate collegiate and professional athletes to these biological causal factors because athletes already seem to be more impulsive, sensation-seeking, and (sometimes) emotionally unstable than other people.  Further postulation led me to consider that one or more of these biological traits may be the reason that a particular athlete plays a sport in the first place.  A young man may be so sensation-seeking that he is driven to partake in an activity where he can get hit, hit people back, sprint, leap, jump, you name it.  Then, a few years later, you learn that this young man receives a full ride to Florida State University because he’s so “aggressive” that he has no problem winning games for his team.  It can be said that athletes who go on to participate in higher levels of a sport are usually the ones who already make risky decisions on the field (specifically soccer and football).  And it’s no stretch to say that making risky decisions on the field—and subsequently finding success—can translate to a proneness to making similar decisions off the field.  If this theory holds true, athletes are particularly vulnerable to the consequences of impulsivity after sustaining a TBI.

Psychological Perspective

It is true that psychological factors or vulnerabilities can increase one’s proclivity for developing an addictive personality.  These include dependent personality characteristics, such as immaturity and praise seeking; depressive personality style, such as consistently “seeing the negative”; and low frustration tolerance.  For high-level athletes, failure is usually not an option.  A commendable performance is required at all times, and those athletes who go on to sustain a TBI struggle with  their low frustration and failure tolerance (because, as we all know, TBI survivors don’t always find success—and we almost never find the kind of “success” for which professional athletes strive).  Many times, an athlete’s emotional state depends on his or her success.  Expectedly, “success” acquires varying definitions for varying athletes and can take the form of perfectionism.  To those who view anything less than perfect as failure, recovery from TBI can be excruciating.

Praise is another conversation.  An athlete is used to receiving praise from coaches, peers, other players, trainers, etc.  With the incurrence of TBI comes a significant decrease or a sharp cut off from praise for former athletic prowess.  Once that source of confidence is gone, a former athlete may choose to seek acceptance or praise from others in different forms.  This often leads to actions such as drinking or gambling, which can be highly addictive.  Also, the loss that former athletes experience is traumatic in itself without the brain injury and can easily create or trigger a depressive personality style, leading them to compare the present to their “former lives.”  Thus, the co-occurrence of these psychological phenomena can become dangerous should they go unmonitored.

Sociocultural Perspective

Family characteristics and rituals are often influential factors on behavior and cognition.  Parental modeling and socioeconomic status (SES) are two sociocultural factors to which I would like to draw particular attention.  Growing up, children often learn coping strategies from their parents.  If, for example, a child’s parent drinks to cope with stress or to feel more at ease, then the child may be more likely to participate in that behavior because it was displayed by a parent or caregiver as a viable coping mechanism.  A lower SES can have an adverse effect on families as well.  It is an added stressor that has the potential to create an unsupportive family environment if the parents are constantly working instead of monitoring the children.  A TBI survivor may or may not be affected by these circumstances, but they can become powerful influences in a person’s recovery and likelihood of developing what some people call an “addictive personality.”

Conclusion

In the end, it is thought that there isn’t actually an addictive personality.  There are, however, specific biological, psychological, and sociocultural factors (as gathered from the biopsychosocial model) that can combine to create addictive tendencies.  My professor’s short answer to the question of whether or not there exists an addictive personality was “yes and no.”  And this is why athletes who sustain TBI are, I believe, particularly prone to developing or fostering previously-existing addictive tendencies.  Then, with a triggering event (likely the onset of TBI), the struggle with addiction begins.  Some people struggle with going “cold turkey” on their addiction to the sport, and others end up developing other addictions, but that’s a topic for another day.