Octopi Personalities and Talk Therapy

Here’s my favorite section of an otherwise typically biologically reductionistic article:

As evolutionary theory would predict, you don’t have to be a person to have a personality. Four of the five factors (apart from conscientiousness, a cognitively complex trait) have been identified in more than sixty species, not only in our fellow primates but also in bears, dogs, pigs, hyenas, goats, cats and even the octopus. For anyone wondering how researchers study octopus personality, the answer is simple. They drop dinner (a crab) into a tank of octopuses and watch what they do. Some octopuses will aggressively grab their dinner at once. Some are more passive and wait for the crab to swim near them. And some are devious; they wait and attack the crab when no one is watching. These “personality dispositions” among octopuses can be reliably identified by independent observers.

It certainly calls into question some of the premises of various talk therapies, but (a) doesn’t address the importance of relationship and meaning making in human encounters (b) doesn’t discount possible adjustments made possible by talk therapy (c) overloads praise on cognitive-behavioral therapies (probably because they are more ‘verifiable’.)

Kalea Chapman, Psy.D.

VA Attempts to Cover Up Suicide Rate

Over at PscyhCentral John Grohol is saying the VA is hiding suicide numbers. According to internal memos, veterans are committing suicide at the rate of about 6500 per year. Below are some statistics to put that into the larger context. If the numbers are correct that would put veteran suicides at about 20 percent of the national average.

Some statistics courtesy of the American Foundation for Suicide Prevention.

  • Over 32,000 people in the United States die by suicide every year.
  • In 2005 (latest available data), there were 32,637 reported suicide deaths.
  • Suicide is fourth leading cause of death for adults between the ages of 18 and 65 years in the U.S., with approximately 26,500 suicides.
  • Currently, suicide is the 11th leading cause of death in the United States.
  • A person dies by suicide about every 16 minutes in the United States. An attempt is estimated to be made once every minute.
  • Ninety percent of all people who die by suicide have a diagnosable psychiatric disorder at the time of their death.
  • There are four male suicides for every female suicide, but twice as many females as males attempt suicide.
  • Every day, approximately 80 Americans take their own life, and 1,500 more attempt to do so.

Kalea Chapman, Psy.D.

No End to Deceptive Marketing of Pharmaceuticals

Taken directly from Mind Hacks. More on advertising of drugs. It opens:

We’re so used to drug companies burying data, spinning their results, ghostwriting papers, ‘financially incentivising’ doctors and designing biased studies, you’d just assume that if drug advert cited a research it would back up the claim being made for the medication. According to a new study, you’d often be wrong.

Then continues with some astonishing data:

The Royal Society of Chemistry’s magazine ‘Chemistry World’ has an article on a new study of psychiatric drug ads in medical journals that found that over a third of the total claims made by drug ads are not actually supported by the studies they reference as evidence.

Taken on an advert by advert basis, the results are even more shocking:

42 out of the 53 ads (nearly 80 per cent) the researchers examined made at least one claim the team couldn’t substantiate. 27 made a claim that was not supported by the data source cited by the ad. A further 15 contained claims that couldn’t be verified by the team – usually because the ads provided no sources of data to back up their claims, or made claims that could not be verified because drug firms either failed to respond to the researchers’ requests for trial data, or refused to supply it.

The Mind Hacks take on this: “it seems they can’t even be polite enough to deceive us honestly.”

Kalea Chapman, Psy.D.

Prominent Academic Scientists Begin to Reject Industry Pay

The New York Times ran an article on doctor’s beginning to reject industry pay. The article begins: “With little fanfare, a small number of prominent academic scientists have made a decision that was until recently all but unheard of. They decided to stop accepting payments from food, drug and medical device companies.” Here’s one researcher’s testimony:

Kelly D. Brownell, director of the Rudd Center for Food Policy and Obesity at Yale, made a similar decision. His was to protect his integrity when he began to wonder whether his industry associations were subtly affecting his objectivity. “The money offers started happening about 20 years ago, at the point that I became a visible person in the field,” Dr. Brownell said.

First it was drug companies developing obesity drugs. Then it was food companies. Eventually, Dr. Brownell said, he began to worry. Were his associations unconsciously affecting his objectivity? He said the money could be substantial. He was offered, for example, $50,000 to be on an advisory board.

“It is easy to offer subtle statements that would favor a drug,” Dr. Brownell said. “You do it for two reasons. You’ve got a money stream coming in, and you get to like the people who work for the companies. You feel like you’re on a team.”

Kalea Chapman, Psy.D.

PTSD and Multiple Tours of Duty

Acute PTSD. The Charlotte Sun-Herald has a piece on a “baby-faced” Marine who disappeared and was later found dead. His mother: “My son died a long time ago… He wasn’t the same when he came back.” Of course, where he came back from was Iraq, in 2005. The marine suffered from an acute case of PTSD, according to the article. According to the article the “illness” has been diagnosed in 60,000 veterans of the Iraq and Afghanistan wars. And we can expect to hear a lot more of these stories.

Troop deployments. According to a New York Times article:

Among the 513,000 active-duty soldiers who have served in Iraq since the invasion of 2003, more than 197,000 have been deployed more than once, and more than 53,000 have deployed three or more times, according to a separate set of statistics provided by Army personnel officers. The percentage of troops sent back to Iraq for repeat deployments would have to increase in the months ahead.

The Army study of mental health showed that 27 percent of noncommissioned officers on their third or fourth tour exhibited symptoms commonly referred to as post-traumatic stress disorders. That figure is far higher than the roughly 12 percent who exhibit those symptoms after one tour and the 18.5 percent who develop the disorders after a second deployment, according to the study, conducted by the Army surgeon general’s Mental Health Advisory Team.

VA: PTSD not Mental Illness

From a chief advocate for health care in the Veterans Administration:

“The number of patients who have adjustment reactions to the experience that they have in Afghanistan or Iraq is very important, but we don’t believe that’s mental illness,” Kussman said. “It would be unfair and inappropriate to stigmatize people with a mental health diagnosis when they are having what most people believe are normal reactions to abnormal situations.”

The full treatment at World of Psychology. The headline is: “Undersecretary of Health Reinforces Stigma of Mental Illness.” Here’s another quote from the piece:

Having a depressive, traumatic or anxious reaction to combat is actually not a normal reaction (even if some of us believe it should be). And sadly, war and combat fighting is not an “abnormal situation” for a soldier — it is exactly what is expected of them (and what they signed up for).

Sadly, I don’t think this is entirely fair. Many entering the military (especially via the National Guard) never really thought they’d see combat. For some, it is a way to get a college education. Certainly few dreamed that they would be seeing up to five tours of duty.

A History of Trauma

This piece, originally posted in October, is a backdrop to some of the Veterans Administration’s recent statements about PTSD.

Returning Vietnam veterans.
When Bessel van der Kolk was at the Veteran’s Administration (VA) in 1978, he was one of many clinicians fascinated by the complaints of returning Vietnam veterans. At the time, there was no definition of trauma related to combat, rape, involvement in fatal accidents — none whatsoever. When van der Kolk submitted a grant to do research on trauma symptoms it was denied. “It has never been shown that PTSD is relevant to the mission of the Veterans Administration” the VA stated flatly. (The quote is taken from Mary Sykes Wylie’s excellent profile of van der Kolk and his work “The Limits of Talk” — which you can find here.)

DSM diagnosis.
Van der Kolk is well versed in the limitations of defining trauma in terms of diagnostic category. He helped write the definition. Post-Traumatic Stress Disorder (PTSD) first appeared in the Diagnostic Statical Manual III (DSM-III) in 1980. So what’s so important about a diagnosis? Without one you will not get treatment, or your treatment will not get reimbursed.

The current DSM-IV description begins “…exposure to an extreme traumatic stressor involving direct personal experience of an event that involves death, injury, or a threat to the physical integrity of another person; or learning about unexpected or violent death, seriuos harm, or threat of death or injury experienced by a family member or other close associate.” But at its core, the kernel of the diagnosis is not so much the experience itself as the feeling of helplessness that it arouses in the victim. Another trauma expert, Judith Herman, M.D., describes this in Trauma and Recovery, as “its power to inspire helplessness and terror.” Continue reading “A History of Trauma”