Category: Medical anthropology

Parents’ stress, children’s health

Blogging on Peer-Reviewed ResearchTo all the stressed-out parents out there, here, let me just hand you a bit more to worry about. A research team led by Dr. Mary T. Caserta at the University of Rochester (more on her research here) have an article in press at Brain, Behavior, and Immunity entitled, ‘The associations between psychosocial stress and the frequency of illness, and innate and adaptive immune function in children’ (abstract here, unfortunately, I couldn’t find a downloadable version of the whole article). 169 school-aged children and their parents were studied through health diaries and over seven sequential visits, each separated by six months (three years total, by my quick calculation). At these visits, children were tested for human herpesvirus 6 reactivation and general measures of immune function were examined, such as ‘natural killer (NK) cell function and the percentage of CD4 and CD8 cells associated with immune control of cytomegalovirus (CMV).’

The study was to test the relation between parental stress and children’s immune systems:

Family processes have a substantial impact on children’s social and emotional well-being, but little is known about the effects of family stress on children’s physical health. To begin to identify potential links between family stress and health in children, we examined associations between specific aspects of family psychosocial stress and the frequency of illnesses in children, measures of innate and adaptive immune function, and human herpesvirus 6 (HHV-6) reactivation.

The researchers found that parental stress was associated with the illness rates in their children. Although HHV6 activation rates did not increase, the rate of illness in the children (according to the diaries, presumably) and the activation of the children’s immune systems were both elevated. It’s not entirely clear to me from the abstract, so I’ll have to wait for the full write-up to get a sense for the mechanisms involved. The researchers concluded, ‘There is an association between specific psychosocial stress exposure and rates of illness and immune function in normally developing children.’

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Wednesday Round Up #2

On Brains

Susan Greenfield, Bewitched by Bacchae
Meaning, neuronal connections, and Euripides—perfect!

Robert Krulwich and Jad Abumrad, Radio Lab: Into the Brain of a Liar
How big was your fish?  Big-time liars have “more connections in the part of their brains responsible for complex thinking”

Charles Choi, Tiny Brain-Like Computer Created
This chip has dendrites!

Lauran Neergard, Study: Creativity Jazzes Your Brain
Stick a keyboard and a jazz musician in an fMRI, and this is what you get

The Internet

Gamespot, Study Uncovers MMORPG Gender-Swapping Epidemic
“54 percent of all males and 68 percent of all females “gender swap”–or create online personas of their opposite sex”

David Pogue, How Dangerous Is the Internet for Children?
Not as dangerous as the media sometimes says.  Surprise, the context of how you manage the Internet and your children at home makes a big difference in how they interpret what’s online

General Interest

Penepole Green, What’s In a Chair?
Psychiatrists’ offices matter!
Also see Vaughan’s take on this article at Mind Hacks

Nicholas Cristakis, Social Networks Are Like The Eye
The dynamics of social networks

Kevin Lewis, Uncommon Knowledge: Surprising Insights from the Social Sciences
The Boston Globe’s own round up

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Postmodern Medicine

Harvard Magazine has an excerpt from Charles Rosenberg’s new book, Our Present Complaint: American Medicine, Then and Now, in this month’s issue.  I have pasted the entire article below, as I find it a strong evocation of how disease is as much a social entity as a biological phenomenon.  It captures much of what is difficult to understand, that our biology is inevitably and essentially social.

Postmodern Medicine

We are all “medical citizens,” embedded as potential or actual patients, with physicians, in a system of social, moral, and organizational understandings. So writes Monrad professor of the social sciences Charles E. Rosenberg in Our Present Complaint: American Medicine, Then and Now (Johns Hopkins, $50; $19.95 paper), touching on sources of unease.

Disease has become a bureaucratic—and, thus, social and administrative—as well as biological and conceptual—entity.What do I mean when I describe disease as a “social entity”? I refer to a web of practice guidelines, disease protocols, laboratory and imaging results, meta-analyses, and consensus conferences. These practices and procedures have over time come to constitute a seemingly objective and inescapable framework of disease categories, a framework that increasingly specifies diagnostic criteria and dictates appropriate therapeutic choices. In America’s peculiar hybrid health-care system, layers of hospital and managed care administrators enforce these disease-based guidelines. The past generation’s revolution in information technology has only exacerbated and intensified these trends—in parallel with the research and marketing strategies of major pharmaceutical companies…. This web of complex relationships has created a new reality for practitioners and patients alike. Physicians have had their choices increasingly constrained—if, in some ways, enhanced. For the sick, such ways of conceptualizing and treating disease have come to constitute a tangible aspect of their illness experience.

Of course, every society has entertained ideas about disease and its treatment; patients have never been blank slates.…Think of the generations of sufferers who were bled, sweated, puked, or purged to balance their humors. But never has the infrastructure of ideas, practices, thresholds, and protocols that comes between agreed-upon knowledge and the individual patient been so tightly woven and bureaucratically crafted.…

Yet, as I have emphasized, we are left with that inconveniently subjective object, the patient—in whose body these abstract entities manifest themselves. This is the characteristic split screen that faces today’s clinician: the tension between illness in the individual patient and disease as crystallized and made socially real in the laboratory’s and the epidemiologist’s outputs and inscriptions, practice guidelines, and algorithms.…Bedside, clinic, and physician’s office are the points at which the mandates of best—and increasingly most economically rational—practice bump up against the unique reality of the individual patient and challenge the physician’s traditional autonomy.…

It engenders a feeling of paradox, the juxtaposition of a powerful faith in scientific medicine with a widespread discontent at the circumstances in which it is made available. It is a set of attitudes and expectations postmodern as well as quintessentially modern

Glutamate and Schizophrenia

The NY Times has an article, Daring to Think Differently about Schizophrenia, about research on glutamate, schizophrenia, and drug development.  In addiction research, there is also increasing consideration of the role of glutamate, moving beyond the dopamine-centered models.  Glutamate-targeted drugs “might help to treat the cognitive and negative symptoms of schizophrenia. Drugs currently on the market do little to treat those symptoms.”  Here are some early quotes from the article:

“Dr. Schoepp and other scientists had focused their attention on the way that glutamate, a powerful neurotransmitter, tied together the brain’s most complex circuits. Every other schizophrenia drug now on the market aims at a different neurotransmitter, dopamine.”

“Glutamate is a pivotal transmitter in the brain, the crucial link in circuits involved in memory, learning and perception. Too much glutamate leads to seizures and the death of brain cells. Excessive glutamate release is also one of the main reasons that people have brain damage after strokes. Too little glutamate can cause psychosis, coma and death.  ‘The main thoroughfare of communication in the brain is glutamate,’ says Dr. John Krystal, a psychiatry professor at Yale and a research scientist with the VA Connecticut Health Care System.”

Anger and Healing

“Anger slows healing process after injury: study” is one of today’s headlines.  Here’s the main point:

Researchers at the University of Ohio inflicted minor burns on the forearms of 98 volunteers who were then monitored over eight days to see how quickly the skin repaired itself… The results were startlingly clear: individuals who had trouble controlling expressions of anger were four times likelier to need more than four days for their wounds to heal, compared with counterparts who could master their anger.

 Anger, not surprisingly, is more nuanced than an on/off state.  “Subjects described as showing ‘anger out’ (regular outbursts of aggression or hostility) or ‘anger in’ (repressed rage) healed almost as quickly as individuals who ranked low on all anger scales.”  

Indeed only one group had significantly slower healing:

Only those who tried but failed to hold in their feelings of upset and distemper took longer to heal. This same group also showed a higher secretion of the stress hormone cortisol, which could at least partly explain the difference in healing time, the study noted… High levels of cortisol appears to decrease the production at the point of injury of two cytokines crucial to the repair process, suggests the study. Cytokines are proteins released by immune-system cells. They act as signallers to generate a wider immune response.

 So, it is not so much “anger” that matters, but anger management.  Trying and failing is the key variable, not so much anger itself.  That appears to be what is stressful, the lack of control and the uncertainty, rather than experiencing anger itself. 

Here’s the abstract of the original article.

Pattern #2

The current issue of Harvard Magazine has a cover article on autism.  In reading through the piece, I was struck by this one line about Asperger’s syndrome: “they shared key impairments in social interaction, reciprocal communication, and imagination (i.e., repetitive behaviors and interests).”  It many ways this description struck me as presenting a similar dichotomy to addiction, where the repetitive behaviors and interests are linked diagnostically with failed social roles, family difficulties and “denial” in communication. 

I am not saying that addiction and autism are the same, or that biologically or phenomenology they come from similar causes or problems.  But I do wonder if the rush to focus in on singular brain circuits leads us to overlook the human dimensions of imagination, sociality, and behavior.  These abilities and practices are linked in profound ways in everyday life, and thus will drive biology in profound ways. 

Sandy G, who linked to us (thanks!) through his post on The Rat Park, has several posts on autism.  In one on joint attention, he relates Tomasello’s recent work: “The authors concluded that, at least at this developmental period, children with autism seem to understand the social components of situations that call for “helping” behaviors and engage in helping behaviors, but only when such help does not require interpersonal cooperation. However, when cooperation is required to complete the task, these children are less likely to correctly engage with another partner, possibly because the unique “shared” component of cooperation. That is, cooperation requires shared goals, shared attention, and a shared plan of action, processes that seem to be affected in children with autism.” 
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