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in Clinical Trials Without Their Consent","publishDate":1540833728,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp class=\"danger-zone\">Minneapolis hospital tested powerful antipsychotics and the potent anesthetic \u003ca href=\"https://www.statnews.com/2018/09/24/ketamine-clinics-severe-depression-treatment/\">ketamine\u003c/a> on emergency room patients without their knowledge or consent, violating regulations on human research, federal inspectors have determined.\u003c/p>\n\u003cp class=\"danger-zone\">Based on those findings\u003cstrong>,\u003c/strong> a health watchdog group on Monday urged federal regulators to suspend all clinical trials at the hospital. In a \u003ca href=\"https://www.citizen.org/our-work/health-and-safety/second-follow-letter-fda-and-ohrp-regarding-unethical-high-risk-clinical-trials-tested-ketamine-management\" target=\"_blank\" rel=\"noopener\">letter\u003c/a> to the Food and Drug Administration and the Department of Health and Human Services office that protects human research subjects, Public Citizen also called for regulators to immediately launch an investigation into the conduct and oversight of the studies and “impose severe sanctions for the serious ethical and regulatory lapses that have occurred in the ketamine clinical trials and other studies” at Minneapolis’s Hennepin County Medical Center.[contextly_sidebar id=\"VBSQOWNGkwEDBdz8APDok0lptMEsHZ3N\"]\u003c/p>\n\u003cp class=\"danger-zone\">The hospital committee that green-lighted the studies, called an institutional review board (IRB), “appears incapable of doing its job,” said Dr. Michael Carome, director of Public Citizen’s Health Research Group, who organized the letter. It acted unethically and placed patients in danger, he said, “including by waiving the requirement for informed consent in situations where that is not allowed.”\u003c/p>\n\u003cp>A hospital spokesperson said the findings by inspectors from the FDA “are neither formal nor conclusory.” Hennepin “has provided formal written responses to each” of the inspectors’ findings, she said, adding that the hospital “has undertaken several reviews by independent experts to evaluate its research and emergency medical practices with the intent to improve our processes. …We understand our mission includes providing the highest standards of medical care, and also conducting studies that help to continuously improve the health and wellness of our patients.”\u003c/p>\n\u003cp>Among other violations identified by FDA inspectors, the IRB ruled that researchers did not need consent to make patients part of a clinical trial in which they were given antipsychotic drugs that they might not receive as part of usual care. The Public Citizen letter said the IRB, which is legally obligated to protect research participants, “appears to lack even a basic understanding of federal regulations for the protection of human subjects and is clearly incapable of fulfilling its obligation” to do so.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In July, Public Citizen and 64 bioethicists, physicians, and other scholars submitted a complaint about two of Hennepin’s ketamine studies to the FDA and HHS’s Office of Human Research Protections. In August, FDA sent inspectors to the hospital.\u003c/p>\n\u003cp>Their report, obtained by Public Citizen through a public records request and shared with STAT, examined additional clinical trials beyond those initially flagged. It found that in four, the hospital IRB “did not determine that informed consent would be sought from each prospective subject” as required by law, while in another five, the IRB granted fast-track review to studies that didn’t qualify for it.\u003c/p>\n\u003cp>At least three of the studies cited by the FDA inspectors involved people brought to the emergency room with “severe” agitation, as assessed by emergency technicians using criteria developed by the researchers. The study leaders apparently persuaded the IRB that such patients could not provide informed consent, and so could be swept into the trial unknowingly.[contextly_sidebar id=\"OXR63kbgFz9mq4tqZdVi1Hy2Rk2yuUa7\"]\u003c/p>\n\u003cp>In fact, such patients are considered “vulnerable,” said bioethicist Leigh Turner of the University of Minnesota, who signed the Public Citizen letter. According to federal law, they are supposed to receive special safeguards, such as having a family member or other representative give or decline consent. That did not happen.\u003c/p>\n\u003cp>Just as concerning, Turner said, it’s not clear that the patients were in fact too agitated to be asked for their consent, as the scientists argued to the IRB. According to the evaluation form’s scoring, “it’s not like they had acute psychosis,” Turner said. “These investigators were basically drugging up individuals with a degree of agitation many of us could experience, like after being pulled over for speeding.”\u003c/p>\n\u003cp>In the first study cited by the FDA inspectors, researchers injected either ketamine or haloperidol into people taken to the ER, to reduce their “agitation.” Ketamine is not approved by the FDA for that use. The unwitting participants were treated not according to clinicians’ best judgment but according to the study’s protocol: Those arriving during certain months got ketamine and those arriving in other months got haloperidol.\u003c/p>\n\u003cp>Among the trial’s \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/27102743\" target=\"_blank\" rel=\"noopener\">results\u003c/a> was that some patients given ketamine suffered breathing problems; 39 percent required intubation, compared to 4 percent given haloperidol. Before the trial began, its leaders had warned in a 2013 \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/23231451\" target=\"_blank\" rel=\"noopener\">paper\u003c/a> that ketamine can impair breathing and so should be reserved for only the most severely agitated patients.\u003c/p>\n\u003cp>The identities of five of the seven studies the FDA report flagged are redacted, but one corresponds to the second ketamine \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT03554915\" target=\"_blank\" rel=\"noopener\">clinical trial\u003c/a> questioned in Public Citizen’s letter. It compared ketamine to midazolam, also in “agitated” ER patients given one or the other drug essentially randomly, not according to which — if any — might help them. The study was suspended by the medical center in June, for unclear reasons, but it also failed to obtain informed consent from participants, the FDA inspectors found.[contextly_sidebar id=\"VDuCmh6PY0M6Ga88zjfyN4sUMUCXdtg4\"]\u003c/p>\n\u003cp>A third clinical \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT03211897?term=hennepin+AND+agitation&rank=1\" target=\"_blank\" rel=\"noopener\">trial\u003c/a> compared the safety and efficacy of four drugs (the antipsychotics olanzapine, haloperidol, and ziprasidone and the sedative midazolam) in agitated patients. The hospital scientists had initially requested an FDA waiver from the informed consent requirement. FDA denied the request. The scientists then requested IRB approval, calling their study observational (meaning patients would be treated according to their doctors’ best judgment rather than receiving drugs as per the trial protocol) and therefore entitled to “expedited review.” The IRB agreed, including giving the okay to forgo consent.\u003c/p>\n\u003cp>In fact the study was not observational: Patients received one of the four drugs based on when they arrived in the ER. They were not informed of this, and so were unwitting participants, the FDA inspectors found.\u003c/p>\n\u003cp>“When the investigators didn’t get FDA clearance, they did an end-run around the agency,” Turner said. “They claimed it was no longer the randomized controlled trial they’d planned, and then pushed it through the IRB as a waiver-of-consent study,” a strategy he called “dodgy.”\u003c/p>\n\u003cp>The FDA inspectors found that “some or all of the subjects [in four studies] were likely to be vulnerable to coercion or undue influence,” yet the IRB did not require the researchers to do anything to safeguard the participants’ safety.\u003c/p>\n\u003cp>In addition to asking HHS to suspend all clinical trials at Hennepin unless doing so would harm participants, Public Citizen called it “imperative” that the hospital disband its current IRB and train a new one, retrain researchers involved in human research, and inform the unwitting participants in past trials of steps “to redress these violations.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">This \u003c/span>\u003c/i>\u003ca href=\"https://www.statnews.com/2018/10/29/er-patients-given-ketamine-powerful-drugs-without-consent/\" target=\"_blank\" rel=\"noopener\">\u003ci>\u003cspan style=\"font-weight: 400\">story\u003c/span>\u003c/i>\u003c/a>\u003ci>\u003cspan style=\"font-weight: 400\"> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/span>\u003c/i>\u003c/p>\n\n","blocks":[],"excerpt":"A Minneapolis hospital tested powerful antipsychotics on emergency room patients without their knowledge or consent, violating regulations on human research, federal inspectors have determined.\r\n","status":"publish","parent":0,"modified":1540833728,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":18,"wordCount":1216},"headData":{"title":"ER Patients Given Ketamine, Other Drugs in Clinical Trials Without Their Consent | KQED","description":"A Minneapolis hospital tested powerful antipsychotics on emergency room patients without their knowledge or consent, violating regulations on human research, federal inspectors have determined.\r\n","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"ER Patients Given Ketamine, Other Drugs in Clinical Trials Without Their Consent","datePublished":"2018-10-29T17:22:08.000Z","dateModified":"2018-10-29T17:22:08.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"445254 https://ww2.kqed.org/futureofyou/?p=445254","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/10/29/er-patients-given-ketamine-other-drugs-in-clinical-trials-without-their-consent/","disqusTitle":"ER Patients Given Ketamine, Other Drugs in Clinical Trials Without Their Consent","nprByline":"Sharon Begley\u003cbr />STAT","path":"/futureofyou/445254/er-patients-given-ketamine-other-drugs-in-clinical-trials-without-their-consent","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp class=\"danger-zone\">Minneapolis hospital tested powerful antipsychotics and the potent anesthetic \u003ca href=\"https://www.statnews.com/2018/09/24/ketamine-clinics-severe-depression-treatment/\">ketamine\u003c/a> on emergency room patients without their knowledge or consent, violating regulations on human research, federal inspectors have determined.\u003c/p>\n\u003cp class=\"danger-zone\">Based on those findings\u003cstrong>,\u003c/strong> a health watchdog group on Monday urged federal regulators to suspend all clinical trials at the hospital. In a \u003ca href=\"https://www.citizen.org/our-work/health-and-safety/second-follow-letter-fda-and-ohrp-regarding-unethical-high-risk-clinical-trials-tested-ketamine-management\" target=\"_blank\" rel=\"noopener\">letter\u003c/a> to the Food and Drug Administration and the Department of Health and Human Services office that protects human research subjects, Public Citizen also called for regulators to immediately launch an investigation into the conduct and oversight of the studies and “impose severe sanctions for the serious ethical and regulatory lapses that have occurred in the ketamine clinical trials and other studies” at Minneapolis’s Hennepin County Medical Center.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp class=\"danger-zone\">The hospital committee that green-lighted the studies, called an institutional review board (IRB), “appears incapable of doing its job,” said Dr. Michael Carome, director of Public Citizen’s Health Research Group, who organized the letter. It acted unethically and placed patients in danger, he said, “including by waiving the requirement for informed consent in situations where that is not allowed.”\u003c/p>\n\u003cp>A hospital spokesperson said the findings by inspectors from the FDA “are neither formal nor conclusory.” Hennepin “has provided formal written responses to each” of the inspectors’ findings, she said, adding that the hospital “has undertaken several reviews by independent experts to evaluate its research and emergency medical practices with the intent to improve our processes. …We understand our mission includes providing the highest standards of medical care, and also conducting studies that help to continuously improve the health and wellness of our patients.”\u003c/p>\n\u003cp>Among other violations identified by FDA inspectors, the IRB ruled that researchers did not need consent to make patients part of a clinical trial in which they were given antipsychotic drugs that they might not receive as part of usual care. The Public Citizen letter said the IRB, which is legally obligated to protect research participants, “appears to lack even a basic understanding of federal regulations for the protection of human subjects and is clearly incapable of fulfilling its obligation” to do so.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In July, Public Citizen and 64 bioethicists, physicians, and other scholars submitted a complaint about two of Hennepin’s ketamine studies to the FDA and HHS’s Office of Human Research Protections. In August, FDA sent inspectors to the hospital.\u003c/p>\n\u003cp>Their report, obtained by Public Citizen through a public records request and shared with STAT, examined additional clinical trials beyond those initially flagged. It found that in four, the hospital IRB “did not determine that informed consent would be sought from each prospective subject” as required by law, while in another five, the IRB granted fast-track review to studies that didn’t qualify for it.\u003c/p>\n\u003cp>At least three of the studies cited by the FDA inspectors involved people brought to the emergency room with “severe” agitation, as assessed by emergency technicians using criteria developed by the researchers. The study leaders apparently persuaded the IRB that such patients could not provide informed consent, and so could be swept into the trial unknowingly.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>In fact, such patients are considered “vulnerable,” said bioethicist Leigh Turner of the University of Minnesota, who signed the Public Citizen letter. According to federal law, they are supposed to receive special safeguards, such as having a family member or other representative give or decline consent. That did not happen.\u003c/p>\n\u003cp>Just as concerning, Turner said, it’s not clear that the patients were in fact too agitated to be asked for their consent, as the scientists argued to the IRB. According to the evaluation form’s scoring, “it’s not like they had acute psychosis,” Turner said. “These investigators were basically drugging up individuals with a degree of agitation many of us could experience, like after being pulled over for speeding.”\u003c/p>\n\u003cp>In the first study cited by the FDA inspectors, researchers injected either ketamine or haloperidol into people taken to the ER, to reduce their “agitation.” Ketamine is not approved by the FDA for that use. The unwitting participants were treated not according to clinicians’ best judgment but according to the study’s protocol: Those arriving during certain months got ketamine and those arriving in other months got haloperidol.\u003c/p>\n\u003cp>Among the trial’s \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/27102743\" target=\"_blank\" rel=\"noopener\">results\u003c/a> was that some patients given ketamine suffered breathing problems; 39 percent required intubation, compared to 4 percent given haloperidol. Before the trial began, its leaders had warned in a 2013 \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/23231451\" target=\"_blank\" rel=\"noopener\">paper\u003c/a> that ketamine can impair breathing and so should be reserved for only the most severely agitated patients.\u003c/p>\n\u003cp>The identities of five of the seven studies the FDA report flagged are redacted, but one corresponds to the second ketamine \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT03554915\" target=\"_blank\" rel=\"noopener\">clinical trial\u003c/a> questioned in Public Citizen’s letter. It compared ketamine to midazolam, also in “agitated” ER patients given one or the other drug essentially randomly, not according to which — if any — might help them. The study was suspended by the medical center in June, for unclear reasons, but it also failed to obtain informed consent from participants, the FDA inspectors found.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>A third clinical \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT03211897?term=hennepin+AND+agitation&rank=1\" target=\"_blank\" rel=\"noopener\">trial\u003c/a> compared the safety and efficacy of four drugs (the antipsychotics olanzapine, haloperidol, and ziprasidone and the sedative midazolam) in agitated patients. The hospital scientists had initially requested an FDA waiver from the informed consent requirement. FDA denied the request. The scientists then requested IRB approval, calling their study observational (meaning patients would be treated according to their doctors’ best judgment rather than receiving drugs as per the trial protocol) and therefore entitled to “expedited review.” The IRB agreed, including giving the okay to forgo consent.\u003c/p>\n\u003cp>In fact the study was not observational: Patients received one of the four drugs based on when they arrived in the ER. They were not informed of this, and so were unwitting participants, the FDA inspectors found.\u003c/p>\n\u003cp>“When the investigators didn’t get FDA clearance, they did an end-run around the agency,” Turner said. “They claimed it was no longer the randomized controlled trial they’d planned, and then pushed it through the IRB as a waiver-of-consent study,” a strategy he called “dodgy.”\u003c/p>\n\u003cp>The FDA inspectors found that “some or all of the subjects [in four studies] were likely to be vulnerable to coercion or undue influence,” yet the IRB did not require the researchers to do anything to safeguard the participants’ safety.\u003c/p>\n\u003cp>In addition to asking HHS to suspend all clinical trials at Hennepin unless doing so would harm participants, Public Citizen called it “imperative” that the hospital disband its current IRB and train a new one, retrain researchers involved in human research, and inform the unwitting participants in past trials of steps “to redress these violations.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">This \u003c/span>\u003c/i>\u003ca href=\"https://www.statnews.com/2018/10/29/er-patients-given-ketamine-powerful-drugs-without-consent/\" target=\"_blank\" rel=\"noopener\">\u003ci>\u003cspan style=\"font-weight: 400\">story\u003c/span>\u003c/i>\u003c/a>\u003ci>\u003cspan style=\"font-weight: 400\"> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/span>\u003c/i>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/445254/er-patients-given-ketamine-other-drugs-in-clinical-trials-without-their-consent","authors":["byline_futureofyou_445254"],"categories":["futureofyou_73"],"tags":["futureofyou_952","futureofyou_1226","futureofyou_204","futureofyou_1224"],"featImg":"futureofyou_444567","label":"futureofyou"},"futureofyou_444933":{"type":"posts","id":"futureofyou_444933","meta":{"index":"posts_1591205157","site":"futureofyou","id":"444933","score":null,"sort":[1539111653000]},"guestAuthors":[],"slug":"how-does-your-brain-construct-your-conscious-reality","title":"How Does Your Brain Construct Your Conscious Reality?","publishDate":1539111653,"format":"aside","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>https://www.youtube.com/watch?v=lyu7v7nWzfo\u003c/p>\n\u003cp>\u003cem>Part 4 of the \u003c/em>TED Radio Hour \u003cem>episode \u003c/em>\u003ca href=\"http://www.npr.org/programs/ted-radio-hour/485704159/what-makes-us-us\" target=\"_blank\" rel=\"noopener\">What Makes Us ... Us\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>About Anil Seth's TED Talk\u003c/strong>\u003c/p>\n\u003cp>When we look around, it feels like we're seeing an objective reality. But neuroscientist Anil Seth says everything we perceive, from objects to emotions, is an act of informed guesswork by the brain.\u003c/p>\n\u003cp>\u003cstrong>About Anil Seth\u003c/strong>\u003c/p>\n\u003cp>\u003ca href=\"http://www.anilseth.com/\">Anil Seth\u003c/a> is a professor of cognitive and computational neuroscience at the University of Sussex, where he studies consciousness and its role in health and disease.\u003c/p>\n\u003cp>He co-directs the \u003ca href=\"http://www.sussex.ac.uk/sackler/\" target=\"_blank\" rel=\"noopener\">Sackler Centre for Consciousness Science\u003c/a> and is the Editor-in-Chief of the academic journal \u003cem>Neuroscience of Consciousness\u003c/em>. Seth was also the 2017 President of the British Science Association (Psychology Section). He is the co-author of \u003ca href=\"http://www.anilseth.com/books\" target=\"_blank\" rel=\"noopener\">\u003cem>30-Second Brain\u003c/em>,\u003c/a> a best-seller that explores how the brain works.\u003c/p>\n\u003cp>Seth is a regular contributor to the \u003cem>New Scientist, The Guardian\u003c/em>, and the BBC.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Anil+Seth%3A+How+Does+Your+Brain+Construct+Your+Conscious+Reality%3F&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n","blocks":[],"excerpt":"When we look around, it feels like we're seeing an objective reality. But neuroscientist Anil Seth says everything we perceive, from objects to emotions, is an act of informed guesswork by the brain.","status":"publish","parent":0,"modified":1539042068,"stats":{"hasAudio":false,"hasVideo":true,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":9,"wordCount":168},"headData":{"title":"How Does Your Brain Construct Your Conscious Reality? | KQED","description":"When we look around, it feels like we're seeing an objective reality. 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Us\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>About Anil Seth's TED Talk\u003c/strong>\u003c/p>\n\u003cp>When we look around, it feels like we're seeing an objective reality. But neuroscientist Anil Seth says everything we perceive, from objects to emotions, is an act of informed guesswork by the brain.\u003c/p>\n\u003cp>\u003cstrong>About Anil Seth\u003c/strong>\u003c/p>\n\u003cp>\u003ca href=\"http://www.anilseth.com/\">Anil Seth\u003c/a> is a professor of cognitive and computational neuroscience at the University of Sussex, where he studies consciousness and its role in health and disease.\u003c/p>\n\u003cp>He co-directs the \u003ca href=\"http://www.sussex.ac.uk/sackler/\" target=\"_blank\" rel=\"noopener\">Sackler Centre for Consciousness Science\u003c/a> and is the Editor-in-Chief of the academic journal \u003cem>Neuroscience of Consciousness\u003c/em>. Seth was also the 2017 President of the British Science Association (Psychology Section). He is the co-author of \u003ca href=\"http://www.anilseth.com/books\" target=\"_blank\" rel=\"noopener\">\u003cem>30-Second Brain\u003c/em>,\u003c/a> a best-seller that explores how the brain works.\u003c/p>\n\u003cp>Seth is a regular contributor to the \u003cem>New Scientist, The Guardian\u003c/em>, and the BBC.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Anil+Seth%3A+How+Does+Your+Brain+Construct+Your+Conscious+Reality%3F&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/444933/how-does-your-brain-construct-your-conscious-reality","authors":["byline_futureofyou_444933"],"categories":["futureofyou_1060","futureofyou_1062","futureofyou_1"],"tags":["futureofyou_56","futureofyou_1576","futureofyou_59","futureofyou_1224"],"collections":["futureofyou_1097"],"featImg":"futureofyou_444934","label":"source_futureofyou_444933"},"futureofyou_444844":{"type":"posts","id":"futureofyou_444844","meta":{"index":"posts_1591205157","site":"futureofyou","id":"444844","score":null,"sort":[1538667576000]},"guestAuthors":[],"slug":"new-smartphone-app-aims-to-monitor-your-mental-health","title":"New Smartphone App Aims to Monitor Your Mental Health","publishDate":1538667576,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp class=\"danger-zone\">In the world of digital health, Silicon Valley-based \u003ca href=\"https://www.statnews.com/2017/08/07/mindstrong-insel-mental-illness/\" target=\"_blank\" rel=\"noopener\">Mindstrong\u003c/a> stands out. It has a star-studded team and tens of millions in venture capital funding, including from Jeff Bezos’ VC firm.[contextly_sidebar id=\"KMLJnak6yPOdRS3TfVoiDTc6a7Cm51Xf\"]\u003c/p>\n\u003cp class=\"danger-zone\">It also has a captivating idea: that its app, based on cognitive functioning research, can help detect troubling mental health patterns by collecting data on a person’s smartphone usage — how quickly they type or scroll, for instance.\u003c/p>\n\u003cp class=\"danger-zone\">The promise of that technology has helped Mindstrong build incredible momentum since it launched last year; already more than a dozen counties in California have agreed to deploy the company’s app to patients.\u003c/p>\n\u003cp class=\"\">Does the app live up to its promise? There’s no way to tell. Almost no one outside the company has any idea whether it works. Most of the company’s key promises or claims aren’t yet backed up by published, peer-reviewed data — leading some experts to wonder if the technology is ready for the real world.\u003c/p>\n\u003cp class=\"\">“I wouldn’t waste all that time and money in the wild until they get sure that some of those things are as specific as they hope they are,” said Rosalind Picard, a researcher at MIT Media Lab who is familiar with Mindstrong’s work and tries to use data from smartphones and wearables to detect a person’s mood.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Even as one of the company’s executives, Dr. Tom Insel, acknowledged to STAT that the app isn’t perfect, the company’s CEO emphasized that Mindstrong could provide unprecedented insight into conditions like depression.[contextly_sidebar id=\"Kw9tNYwAAP3TxDDlzs24FDdim0qufSVP\"]\u003c/p>\n\u003cp>Mindstrong is not alone in pushing the frontiers of smartphone-based digital health. Many companies use so-called digital phenotyping, collecting scientific data on a person’s digital life, to gain insights into his or her physical or mental health.\u003c/p>\n\u003cp>The company’s app collects information about how people are typing and runs it through a machine learning algorithm to determine which data can predict their emotional state. Mindstrong has already used it in controlled clinical settings and trials — including one run by a company developing new antidepressants and another done in a \u003ca href=\"https://www.statnews.com/2018/09/24/ketamine-clinics-severe-depression-treatment/\" target=\"_blank\" rel=\"noopener\">ketamine clinic\u003c/a>. The app is available in Apple’s app store, but requires a participant code to access it.\u003c/p>\n\u003cp>“We’ve done the validation work against the gold-standard clinical tests for depression, for anxiety, for cognitive decline, whether it’s memory or executive function,” said Dr. Paul Dagum, the company’s founder. “We’re confident, we’re already seeing some really exciting results.”\u003c/p>\n\u003cp>In the last year, Mindstrong’s footprint and reach have already grown exponentially. The Palo Alto-based company’s workforce has doubled to 42 employees and it made \u003ca href=\"https://www.hsph.harvard.edu/magazine/magazine_article/philanthropic-impact-digital-phenotyping/\" target=\"_blank\" rel=\"noopener\">a sizable gift\u003c/a> to Harvard’s school of public health. In February, it launched a partnership with Takeda to develop new biomarkers that will be able to aid the pharmaceutical giant’s clinical trials for depression treatments.\u003c/p>\n\u003cp>The idea is to use that data to establish a “normal” pattern — so it can be compared against someone’s typing habits on any given day. If the habits look off, slower or more agitated than normal, the app can alert a health care provider.\u003c/p>\n\u003cp>Abnormal patterns, Mindstrong says, might show up if a person is more depressed or anxious, or if just about anything else about their mental health changes. When asked which disorders Mindstrong might be able to detect, Dagum replied, “all of them.” (Dagum, a data scientist and physician, founded the company in 2017 with Rick Klausner, the founder and director of CAR-T pioneer Juno Therapeutics and \u003ca href=\"https://www.statnews.com/2018/06/02/grail-cancer-blood-test-asco/\" target=\"_blank\" rel=\"noopener\">Grail\u003c/a>, a liquid biopsy company.)[contextly_sidebar id=\"XHhLlvPBCoPTlN54jyme2G0wpse1GITN\"]\u003c/p>\n\u003cp>Mindstrong officials told STAT that among their most encouraging results is that its app can even predict how a person will feel next week, or at least how a person will perform on the Hamilton Rating Scale for depression — kind of like a weather app for your mood.\u003c/p>\n\u003cp>The data behind this claim is being published soon, said Insel, who is the former head of the National Institute of Mental Health and came to the company in 2017 after a short stint at \u003ca href=\"https://www.statnews.com/2016/03/28/google-life-sciences-exodus/\" target=\"_blank\" rel=\"noopener\">Verily\u003c/a>.\u003c/p>\n\u003cp>The app can detect a seven-point change on the Hamilton scale, Insel said. That kind of difference could indicate a patient who is not normally depressed now shows signs of mild or moderate depression, or that a person with moderate depression is now showing signs of a very severe condition.\u003c/p>\n\u003cp>“For a clinician and for someone taking care of a patient, knowing that, it could be very, very powerful,” Dagum said.\u003c/p>\n\u003cp>The company’s momentum has taken it to the cusp of a real-world deployment in California. About 15 counties — including the most populous county in the United States, Los Angeles County — will be spending about $60 million over the next four years to bring companies like Mindstrong and other apps into their health care system.\u003c/p>\n\u003cp>These counties hope apps will help them get better services to people with mental illnesses like depression, schizophrenia, bipolar disorder, and post-traumatic stress disorder.\u003c/p>\n\u003cp>The Mindstrong program itself is limited: Patients can choose voluntarily whether to use the app, which will be free to them, and that decision won’t affect the rest of the mental health services they can access.\u003c/p>\n\u003cp>\u003cstrong>Lack of Public Data\u003c/strong>\u003c/p>\n\u003cp>So far, the Mindstrong app has only been used in controlled clinical settings and trials — including one run by a company developing new antidepressants and another done in a ketamine clinic. The company has also claimed that a “\u003ca href=\"https://mindstronghealth.com/clinical-programs/\" target=\"_blank\" rel=\"noopener\">nationwide employer\u003c/a>” and private substance abuse clinics in D.C. are using the app.[contextly_sidebar id=\"KGoxoWR6m8MUKnLishPvyacpod0HWpt7\"]\u003c/p>\n\u003cp>But other than the change on the Hamilton scale — which hasn’t yet gone through peer review and was disclosed to STAT in an interview — almost no data about how well Mindstrong’s technology works is available to independent observers.\u003c/p>\n\u003cp>The company’s website describes five completed clinical trials, but it has not yet published the results of any. Only a handful of other published works — all from the last year — have hinted at how well it works or its scope with data to back up the claims.\u003c/p>\n\u003cp>The company \u003ca href=\"https://www.nature.com/articles/s41746-018-0018-4\" target=\"_blank\" rel=\"noopener\">published\u003c/a> a 27-person pilot study in the journal npj Digital Medicine earlier this year. Dagum is also an author on a poster \u003ca href=\"https://www.nature.com/articles/npp2017265#t122-assessing-anhedonia-with-quantitative-tasks-digital-and-patient-reported-measures-in-a-multicenter-doubleblind-trial-with-btrx246040-for-the-treatment-of-major-depressive-disorder\" target=\"_blank\" rel=\"noopener\">presentation\u003c/a> given at the American College of Neuropsychopharmacology’s 2017 conference, another \u003ca href=\"https://isctm.org/public_access/Feb2018/PDFs/Smith-poster.pdf\" target=\"_blank\" rel=\"noopener\">poster\u003c/a> that reported results from a very wide variety of digital phenotyping techniques — not just typing — and a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/29074231\" target=\"_blank\" rel=\"noopener\">paper\u003c/a> describing a clinical trial protocol — not results.\u003c/p>\n\u003cp>As Mindstrong steps toward a wider rollout, the scientific studies behind its claims will matter. Federal regulators, for one, have \u003ca href=\"https://www.ftc.gov/news-events/blogs/business-blog/2016/01/mind-gap-what-lumosity-promised-vs-what-it-could-prove\" target=\"_blank\" rel=\"noopener\">cracked down\u003c/a> on \u003ca href=\"https://www.ftc.gov/news-events/press-releases/2016/12/marketers-blood-pressure-app-settle-ftc-charges-regarding\" target=\"_blank\" rel=\"noopener\">commercial apps\u003c/a>that misleadingly reference a study’s conclusions to market their app.\u003c/p>\n\u003cp>Based on her own research, at least one expert in digital health and mood said she’s skeptical that Mindstrong can, in a general population, work as well as the company claims. MIT’s Picard said that while there are ways to predict or detect mood changes, you usually need more than just a single type of data to do so.\u003c/p>\n\u003cp>“I’m suspicious that a single modality like typing is going to be sufficient. It would be like saying there’s a single question [on a screening questionnaire] that a doctor could be using,” said Picard, who is also CEO of a company that works on digital phenotyping, like Mindstrong does.\u003c/p>\n\u003cp>“My guess is that their specificity to depression is going to be relatively low,” Picard said.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Her \u003ca href=\"https://www.jmir.org/2018/6/e210/\" target=\"_blank\" rel=\"noopener\">own\u003c/a> \u003ca href=\"https://ieeexplore.ieee.org/abstract/document/954607\" target=\"_blank\" rel=\"noopener\">research\u003c/a>, for example, relies on temperature and skin conductivity as well as calls and the amount of time spent on a phone to predict mood changes. It is about 80 percent accurate.\u003c/p>\n\u003cdiv class=\"quote-inner\">\n\u003cp>Especially in the field of digital mental health, “we need more peer review,” said Dr. Steven Steinhubl, the director of digital medicine at Scripps Research Translational Institute. (Steinhubl is also the co-editor-in-chief of npj Digital Medicine.) Though he said he strongly believes in the potential of apps like Mindstrong, Steinhubl cautioned that peer review has a purpose.[contextly_sidebar id=\"8bFNH4xsL9O8lTSDRHnxnqtYwxOF2Z5k\"]\u003c/p>\n\u003cp>“[Peer review] is a very imperfect system, but there’s really nothing in the peer-reviewed literature. That means that other experts aren’t able to weigh in,” he said. “If you have committees and other people reviewing something who maybe don’t have the same level of expertise, you’ll have people saying, ‘Yeah, that sounds good.’”\u003c/p>\n\u003cp>Other researchers have also found that neuropsychological tests, more broadly, have relatively low accuracy rates.\u003c/p>\n\u003cp>In a study that examined people who were already being treated for depression, one computerized test could only accurately predict their condition in about 40 percent of cases. Another showed a 44 percent accuracy rate for a similar computerized test used to examine people with major depression.\u003c/p>\n\u003cp>A neuropsychological test — if it’s used as a screening test — is “going to miss a lot of people who are depressed,” said Richard Porter, a psychology researcher based at the University of Otago in New Zealand who conducted one of the studies.\u003c/p>\n\u003cp>And even if depressed people do show some kind of cognitive impairment, it’s impossible to tell what caused it.\u003c/p>\n\u003cp>Many things other than mental illness might cause a person to perform poorly on cognitive tests — like living with another disorder, having a lower baseline performance on cognitive tests, having a drink or taking prescription, over-the-counter, or illegal drugs.\u003c/p>\n\u003cp>Mindstrong’s leaders aren’t worried about that kind of noise in their data. Some of those factors are important to note, both for patients and the health care professionals working with them.\u003c/p>\n\u003cp>“You’re hungover, you didn’t sleep well, you didn’t take your medication, you have a medication side effects, you’re having stress and challenges at work and at home. Those are things that we want to measure,” Dagum said.\u003c/p>\n\u003cp>But even Insel admitted that there are plenty of issues that could affect typing speed — and which Mindstrong hasn’t figured out how to sort out yet. Sticky fingers after lunch, full hands at an airport, wearing gloves during winter, or a broken hand might also plausible affect a person’s typing speed — and, therefore, the app’s performance.\u003c/p>\n\u003cp>“One thing we’ve thought about is how we factor in those unusual environmental issues,” Insel said. “We’re working on that. But I can’t say that we’ve solved all of those possible issues.”\u003c/p>\n\u003cp>\u003cstrong>A Looming Launch in the Golden State\u003c/strong>\u003c/p>\n\u003cp>Insel and others linked with the company are fond of comparing their app to a smoke detector — something that’s intended to enhance humans’ senses to detect danger.\u003c/p>\n\u003cp>But part of the value of a smoke detector is that if it’s functioning properly, we know it isn’t going off at random. It only goes off in certain conditions and carries a specific message: Your house is on fire or about to be. Do something.\u003c/p>\n\u003cp>At least for now, that’s where Mindstrong differs from a smoke detector. There’s no way to tell, yet, how specific it is or how sensitive its algorithm is.\u003c/p>\n\u003cp>Insel said that information is coming. He said the company has the data about the app’s accuracy — but he declined to provide those figures, citing papers pending publication. “[They] square very well with clinically used biomarkers,” he said.\u003c/p>\n\u003cp>California authorities suggest they have been shown some of that data. But they’re nevertheless cautious about how the app will work in their new, different setting.\u003c/p>\n\u003cp>One official said there will be “clear writing” included with the state’s version of the app about what it can do, what it cannot do, and what goals the counties hope it will help them achieve.\u003c/p>\n\u003cp>Those goals are pretty lofty. At least some counties eventually plan to use it not only to supplement the existing system, but potentially to bring more people into its fold.\u003c/p>\n\u003cp>“We might be able to go to colleges, emergency departments, other places,” said Debbie Innes-Gomberg, a deputy director at the Los Angeles County Department of Mental Health. “There’s a process of identifying that they’re symptomatic, but [our target population is] people that are in our system and people who maybe need to be.”\u003c/p>\n\u003cp>And even before the app launched in the original five counties that had signed on, the pilot has expanded. Another 11 counties have recently decided to join.\u003c/p>\n\u003cp>Still, Innes-Gomberg said, it’s going to be rolled out with caution. “We’re not going to oversell this.”\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">This \u003c/span>\u003c/i>\u003ca href=\"https://www.statnews.com/2018/10/04/mindstrong-questions-over-evidence/\" target=\"_blank\" rel=\"noopener\">\u003ci>\u003cspan style=\"font-weight: 400\">story\u003c/span>\u003c/i>\u003c/a>\u003ci>\u003cspan style=\"font-weight: 400\"> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/span>\u003c/i>\u003c/p>\n\u003c/div>\n\n","blocks":[],"excerpt":"The app, based on cognitive functioning research, can help detect troubling mental health patterns by collecting data on a person’s smartphone usage.","status":"publish","parent":0,"modified":1538668957,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":49,"wordCount":2272},"headData":{"title":"New Smartphone App Aims to Monitor Your Mental Health | KQED","description":"The app, based on cognitive functioning research, can help detect troubling mental health patterns by collecting data on a person’s smartphone usage.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"New Smartphone App Aims to Monitor Your Mental Health","datePublished":"2018-10-04T15:39:36.000Z","dateModified":"2018-10-04T16:02:37.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"444844 https://ww2.kqed.org/futureofyou/?p=444844","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/10/04/new-smartphone-app-aims-to-monitor-your-mental-health/","disqusTitle":"New Smartphone App Aims to Monitor Your Mental Health","source":"DIY Health","nprByline":"Kate Sheridan\u003cbr />STAT","path":"/futureofyou/444844/new-smartphone-app-aims-to-monitor-your-mental-health","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp class=\"danger-zone\">In the world of digital health, Silicon Valley-based \u003ca href=\"https://www.statnews.com/2017/08/07/mindstrong-insel-mental-illness/\" target=\"_blank\" rel=\"noopener\">Mindstrong\u003c/a> stands out. It has a star-studded team and tens of millions in venture capital funding, including from Jeff Bezos’ VC firm.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp class=\"danger-zone\">It also has a captivating idea: that its app, based on cognitive functioning research, can help detect troubling mental health patterns by collecting data on a person’s smartphone usage — how quickly they type or scroll, for instance.\u003c/p>\n\u003cp class=\"danger-zone\">The promise of that technology has helped Mindstrong build incredible momentum since it launched last year; already more than a dozen counties in California have agreed to deploy the company’s app to patients.\u003c/p>\n\u003cp class=\"\">Does the app live up to its promise? There’s no way to tell. Almost no one outside the company has any idea whether it works. Most of the company’s key promises or claims aren’t yet backed up by published, peer-reviewed data — leading some experts to wonder if the technology is ready for the real world.\u003c/p>\n\u003cp class=\"\">“I wouldn’t waste all that time and money in the wild until they get sure that some of those things are as specific as they hope they are,” said Rosalind Picard, a researcher at MIT Media Lab who is familiar with Mindstrong’s work and tries to use data from smartphones and wearables to detect a person’s mood.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Even as one of the company’s executives, Dr. Tom Insel, acknowledged to STAT that the app isn’t perfect, the company’s CEO emphasized that Mindstrong could provide unprecedented insight into conditions like depression.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Mindstrong is not alone in pushing the frontiers of smartphone-based digital health. Many companies use so-called digital phenotyping, collecting scientific data on a person’s digital life, to gain insights into his or her physical or mental health.\u003c/p>\n\u003cp>The company’s app collects information about how people are typing and runs it through a machine learning algorithm to determine which data can predict their emotional state. Mindstrong has already used it in controlled clinical settings and trials — including one run by a company developing new antidepressants and another done in a \u003ca href=\"https://www.statnews.com/2018/09/24/ketamine-clinics-severe-depression-treatment/\" target=\"_blank\" rel=\"noopener\">ketamine clinic\u003c/a>. The app is available in Apple’s app store, but requires a participant code to access it.\u003c/p>\n\u003cp>“We’ve done the validation work against the gold-standard clinical tests for depression, for anxiety, for cognitive decline, whether it’s memory or executive function,” said Dr. Paul Dagum, the company’s founder. “We’re confident, we’re already seeing some really exciting results.”\u003c/p>\n\u003cp>In the last year, Mindstrong’s footprint and reach have already grown exponentially. The Palo Alto-based company’s workforce has doubled to 42 employees and it made \u003ca href=\"https://www.hsph.harvard.edu/magazine/magazine_article/philanthropic-impact-digital-phenotyping/\" target=\"_blank\" rel=\"noopener\">a sizable gift\u003c/a> to Harvard’s school of public health. In February, it launched a partnership with Takeda to develop new biomarkers that will be able to aid the pharmaceutical giant’s clinical trials for depression treatments.\u003c/p>\n\u003cp>The idea is to use that data to establish a “normal” pattern — so it can be compared against someone’s typing habits on any given day. If the habits look off, slower or more agitated than normal, the app can alert a health care provider.\u003c/p>\n\u003cp>Abnormal patterns, Mindstrong says, might show up if a person is more depressed or anxious, or if just about anything else about their mental health changes. When asked which disorders Mindstrong might be able to detect, Dagum replied, “all of them.” (Dagum, a data scientist and physician, founded the company in 2017 with Rick Klausner, the founder and director of CAR-T pioneer Juno Therapeutics and \u003ca href=\"https://www.statnews.com/2018/06/02/grail-cancer-blood-test-asco/\" target=\"_blank\" rel=\"noopener\">Grail\u003c/a>, a liquid biopsy company.)\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Mindstrong officials told STAT that among their most encouraging results is that its app can even predict how a person will feel next week, or at least how a person will perform on the Hamilton Rating Scale for depression — kind of like a weather app for your mood.\u003c/p>\n\u003cp>The data behind this claim is being published soon, said Insel, who is the former head of the National Institute of Mental Health and came to the company in 2017 after a short stint at \u003ca href=\"https://www.statnews.com/2016/03/28/google-life-sciences-exodus/\" target=\"_blank\" rel=\"noopener\">Verily\u003c/a>.\u003c/p>\n\u003cp>The app can detect a seven-point change on the Hamilton scale, Insel said. That kind of difference could indicate a patient who is not normally depressed now shows signs of mild or moderate depression, or that a person with moderate depression is now showing signs of a very severe condition.\u003c/p>\n\u003cp>“For a clinician and for someone taking care of a patient, knowing that, it could be very, very powerful,” Dagum said.\u003c/p>\n\u003cp>The company’s momentum has taken it to the cusp of a real-world deployment in California. About 15 counties — including the most populous county in the United States, Los Angeles County — will be spending about $60 million over the next four years to bring companies like Mindstrong and other apps into their health care system.\u003c/p>\n\u003cp>These counties hope apps will help them get better services to people with mental illnesses like depression, schizophrenia, bipolar disorder, and post-traumatic stress disorder.\u003c/p>\n\u003cp>The Mindstrong program itself is limited: Patients can choose voluntarily whether to use the app, which will be free to them, and that decision won’t affect the rest of the mental health services they can access.\u003c/p>\n\u003cp>\u003cstrong>Lack of Public Data\u003c/strong>\u003c/p>\n\u003cp>So far, the Mindstrong app has only been used in controlled clinical settings and trials — including one run by a company developing new antidepressants and another done in a ketamine clinic. The company has also claimed that a “\u003ca href=\"https://mindstronghealth.com/clinical-programs/\" target=\"_blank\" rel=\"noopener\">nationwide employer\u003c/a>” and private substance abuse clinics in D.C. are using the app.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>But other than the change on the Hamilton scale — which hasn’t yet gone through peer review and was disclosed to STAT in an interview — almost no data about how well Mindstrong’s technology works is available to independent observers.\u003c/p>\n\u003cp>The company’s website describes five completed clinical trials, but it has not yet published the results of any. Only a handful of other published works — all from the last year — have hinted at how well it works or its scope with data to back up the claims.\u003c/p>\n\u003cp>The company \u003ca href=\"https://www.nature.com/articles/s41746-018-0018-4\" target=\"_blank\" rel=\"noopener\">published\u003c/a> a 27-person pilot study in the journal npj Digital Medicine earlier this year. Dagum is also an author on a poster \u003ca href=\"https://www.nature.com/articles/npp2017265#t122-assessing-anhedonia-with-quantitative-tasks-digital-and-patient-reported-measures-in-a-multicenter-doubleblind-trial-with-btrx246040-for-the-treatment-of-major-depressive-disorder\" target=\"_blank\" rel=\"noopener\">presentation\u003c/a> given at the American College of Neuropsychopharmacology’s 2017 conference, another \u003ca href=\"https://isctm.org/public_access/Feb2018/PDFs/Smith-poster.pdf\" target=\"_blank\" rel=\"noopener\">poster\u003c/a> that reported results from a very wide variety of digital phenotyping techniques — not just typing — and a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/29074231\" target=\"_blank\" rel=\"noopener\">paper\u003c/a> describing a clinical trial protocol — not results.\u003c/p>\n\u003cp>As Mindstrong steps toward a wider rollout, the scientific studies behind its claims will matter. Federal regulators, for one, have \u003ca href=\"https://www.ftc.gov/news-events/blogs/business-blog/2016/01/mind-gap-what-lumosity-promised-vs-what-it-could-prove\" target=\"_blank\" rel=\"noopener\">cracked down\u003c/a> on \u003ca href=\"https://www.ftc.gov/news-events/press-releases/2016/12/marketers-blood-pressure-app-settle-ftc-charges-regarding\" target=\"_blank\" rel=\"noopener\">commercial apps\u003c/a>that misleadingly reference a study’s conclusions to market their app.\u003c/p>\n\u003cp>Based on her own research, at least one expert in digital health and mood said she’s skeptical that Mindstrong can, in a general population, work as well as the company claims. MIT’s Picard said that while there are ways to predict or detect mood changes, you usually need more than just a single type of data to do so.\u003c/p>\n\u003cp>“I’m suspicious that a single modality like typing is going to be sufficient. It would be like saying there’s a single question [on a screening questionnaire] that a doctor could be using,” said Picard, who is also CEO of a company that works on digital phenotyping, like Mindstrong does.\u003c/p>\n\u003cp>“My guess is that their specificity to depression is going to be relatively low,” Picard said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Her \u003ca href=\"https://www.jmir.org/2018/6/e210/\" target=\"_blank\" rel=\"noopener\">own\u003c/a> \u003ca href=\"https://ieeexplore.ieee.org/abstract/document/954607\" target=\"_blank\" rel=\"noopener\">research\u003c/a>, for example, relies on temperature and skin conductivity as well as calls and the amount of time spent on a phone to predict mood changes. It is about 80 percent accurate.\u003c/p>\n\u003cdiv class=\"quote-inner\">\n\u003cp>Especially in the field of digital mental health, “we need more peer review,” said Dr. Steven Steinhubl, the director of digital medicine at Scripps Research Translational Institute. (Steinhubl is also the co-editor-in-chief of npj Digital Medicine.) Though he said he strongly believes in the potential of apps like Mindstrong, Steinhubl cautioned that peer review has a purpose.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“[Peer review] is a very imperfect system, but there’s really nothing in the peer-reviewed literature. That means that other experts aren’t able to weigh in,” he said. “If you have committees and other people reviewing something who maybe don’t have the same level of expertise, you’ll have people saying, ‘Yeah, that sounds good.’”\u003c/p>\n\u003cp>Other researchers have also found that neuropsychological tests, more broadly, have relatively low accuracy rates.\u003c/p>\n\u003cp>In a study that examined people who were already being treated for depression, one computerized test could only accurately predict their condition in about 40 percent of cases. Another showed a 44 percent accuracy rate for a similar computerized test used to examine people with major depression.\u003c/p>\n\u003cp>A neuropsychological test — if it’s used as a screening test — is “going to miss a lot of people who are depressed,” said Richard Porter, a psychology researcher based at the University of Otago in New Zealand who conducted one of the studies.\u003c/p>\n\u003cp>And even if depressed people do show some kind of cognitive impairment, it’s impossible to tell what caused it.\u003c/p>\n\u003cp>Many things other than mental illness might cause a person to perform poorly on cognitive tests — like living with another disorder, having a lower baseline performance on cognitive tests, having a drink or taking prescription, over-the-counter, or illegal drugs.\u003c/p>\n\u003cp>Mindstrong’s leaders aren’t worried about that kind of noise in their data. Some of those factors are important to note, both for patients and the health care professionals working with them.\u003c/p>\n\u003cp>“You’re hungover, you didn’t sleep well, you didn’t take your medication, you have a medication side effects, you’re having stress and challenges at work and at home. Those are things that we want to measure,” Dagum said.\u003c/p>\n\u003cp>But even Insel admitted that there are plenty of issues that could affect typing speed — and which Mindstrong hasn’t figured out how to sort out yet. Sticky fingers after lunch, full hands at an airport, wearing gloves during winter, or a broken hand might also plausible affect a person’s typing speed — and, therefore, the app’s performance.\u003c/p>\n\u003cp>“One thing we’ve thought about is how we factor in those unusual environmental issues,” Insel said. “We’re working on that. But I can’t say that we’ve solved all of those possible issues.”\u003c/p>\n\u003cp>\u003cstrong>A Looming Launch in the Golden State\u003c/strong>\u003c/p>\n\u003cp>Insel and others linked with the company are fond of comparing their app to a smoke detector — something that’s intended to enhance humans’ senses to detect danger.\u003c/p>\n\u003cp>But part of the value of a smoke detector is that if it’s functioning properly, we know it isn’t going off at random. It only goes off in certain conditions and carries a specific message: Your house is on fire or about to be. Do something.\u003c/p>\n\u003cp>At least for now, that’s where Mindstrong differs from a smoke detector. There’s no way to tell, yet, how specific it is or how sensitive its algorithm is.\u003c/p>\n\u003cp>Insel said that information is coming. He said the company has the data about the app’s accuracy — but he declined to provide those figures, citing papers pending publication. “[They] square very well with clinically used biomarkers,” he said.\u003c/p>\n\u003cp>California authorities suggest they have been shown some of that data. But they’re nevertheless cautious about how the app will work in their new, different setting.\u003c/p>\n\u003cp>One official said there will be “clear writing” included with the state’s version of the app about what it can do, what it cannot do, and what goals the counties hope it will help them achieve.\u003c/p>\n\u003cp>Those goals are pretty lofty. At least some counties eventually plan to use it not only to supplement the existing system, but potentially to bring more people into its fold.\u003c/p>\n\u003cp>“We might be able to go to colleges, emergency departments, other places,” said Debbie Innes-Gomberg, a deputy director at the Los Angeles County Department of Mental Health. “There’s a process of identifying that they’re symptomatic, but [our target population is] people that are in our system and people who maybe need to be.”\u003c/p>\n\u003cp>And even before the app launched in the original five counties that had signed on, the pilot has expanded. Another 11 counties have recently decided to join.\u003c/p>\n\u003cp>Still, Innes-Gomberg said, it’s going to be rolled out with caution. “We’re not going to oversell this.”\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">This \u003c/span>\u003c/i>\u003ca href=\"https://www.statnews.com/2018/10/04/mindstrong-questions-over-evidence/\" target=\"_blank\" rel=\"noopener\">\u003ci>\u003cspan style=\"font-weight: 400\">story\u003c/span>\u003c/i>\u003c/a>\u003ci>\u003cspan style=\"font-weight: 400\"> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/span>\u003c/i>\u003c/p>\n\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/444844/new-smartphone-app-aims-to-monitor-your-mental-health","authors":["byline_futureofyou_444844"],"categories":["futureofyou_1060","futureofyou_1062","futureofyou_1","futureofyou_73"],"tags":["futureofyou_537","futureofyou_56","futureofyou_1224"],"collections":["futureofyou_1093","futureofyou_1097"],"featImg":"futureofyou_18197","label":"source_futureofyou_444844"},"futureofyou_443746":{"type":"posts","id":"futureofyou_443746","meta":{"index":"posts_1591205157","site":"futureofyou","id":"443746","score":null,"sort":[1533330013000]},"guestAuthors":[],"slug":"what-makes-a-leader","title":"What Makes A Leader?","publishDate":1533330013,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>Leaders can have many different styles — just compare President Donald Trump to \u003ca href=\"https://www.malala.org/malalas-story\" target=\"_blank\" rel=\"noopener\">Malala Yousafzai\u003c/a> to your boss or the coach of your kid's soccer team.\u003c/p>\n\u003cp>But a \u003ca href=\"http://science.sciencemag.org/cgi/doi/10.1126/science.aat0036\" target=\"_blank\" rel=\"noopener\">study\u003c/a> published Thursday suggests that people who end up in leadership roles of various sorts all share one key trait: Leaders make decisions for a group in the same way that they make decisions for themselves. They don't change their decision-making behavior, even when other people's welfare is at stake.\u003c/p>\n\u003cp>That may come as a bit of surprise, given that most lists of key leadership qualities focus on things like charisma and communication skills.\u003c/p>\n\u003cp>\"Previous research has mostly focused on these kinds of either personality characteristics of a leader, or situations where individuals are likely to lead,\" says \u003ca href=\"https://www.econ.uzh.ch/en/people/researchers/edelson.html\" target=\"_blank\" rel=\"noopener\">Micah Edelson\u003c/a>, a neuroscientist at the University of Zurich in Switzerland. \"But we don't know much about the cognitive or neurobiological process that is happening when you are choosing to lead or follow — when you're faced with this choice to lead or follow.\"\u003c/p>\n\u003cp>He notes that the decisions of leaders can affect the lives of many others. \"It's not always that easy to make such a choice, and it's something that could be even a little bit aversive to you, to make a choice that impacts other people,\" says Edelson. \"And there are some people that seem to be able to do it; some people don't. So we were interested in looking at that.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>He and his colleagues had volunteers come to the lab, and gave them questionnaires that are widely used to predict whether someone is likely to be in a position of leadership. They also collected information about people's real-world leadership experience, such as what rank they'd achieved in the military (which is compulsory for men in Switzerland) or in the popular Swiss Scouts organization.\u003c/p>\n\u003cp>Then they put the participants into small groups and had them play a series of games in which individuals had to make choices about whether to take a risky action to get a reward.\u003c/p>\n\u003cp>\"These are choices about uncertain gambles that have some probability of success and potential gains and losses,\" Edelson explains.\u003c/p>\n\u003cp>The player could choose to either make the choice alone, or defer the decision to a majority vote.\u003c/p>\n\u003cp>The games were played under two conditions: Sometimes the decision affected only the individual player's winnings and other times the decision affected what the entire group received.\u003c/p>\n\u003cp>What the researchers found is that people in general tended to avoid taking responsibility for what happens to others; deferral rates were the highest when decisions affected other people's pocketbooks.\u003c/p>\n\u003cp>But the people who changed their decision-making behavior the least were the ones who generally served as leaders in the real-world and scored high on leadership questionnaires. Unlike others, they did not require more certainty before being ready to personally make a decision that would affect the whole group.\u003c/p>\n\u003cp>\"On average, people tend to increase the certainty threshold when the choices affect the entire group. But higher-scoring leaders just keep their thresholds almost constant,\" says Edelson, who says preliminary work using MRI brain scanning supports the idea that leaders and followers differ in how their brains process information about gains, losses, and risk in the context of thinking about others.\u003c/p>\n\u003cp>Other neuroscientists say the work, published in the journal \u003cem>Science\u003c/em>, is fascinating.\u003c/p>\n\u003cp>\"It seems a very reasonable finding,\" says \u003ca href=\"http://affectivebrain.com/?page_id=161\" target=\"_blank\" rel=\"noopener\">Tali Sharot\u003c/a>, a cognitive neuroscientist at University College London. \"It works with our intuition, but in the same way it's not something that you'd necessarily think about that distinguishes leadership.\"\u003c/p>\n\u003cp>Sharot cautions that it's not clear whether this decision-making behavior is what led people to their leadership position, or if they've developed it as a result of real-world leadership experience.\u003c/p>\n\u003cp>And this study doesn't say anything about who ends up being a \"good\" leader, either.\u003c/p>\n\u003cp>But Sharot says the researchers have identified something about leadership that can hold true regardless of a leader's style.\u003c/p>\n\u003cp>\"You can have authoritarian leaders who like to have the ultimate control,\" she says. \"You can have democratic leaders who want to lead according to the will of the people. You have leaders who are risk-takers, leaders who are risk-adverse and conservative and so on.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But what's really interesting about this work, she says, is that these different types of leaders' decision-making behavior stays the same regardless of whether the outcome affects only themselves or other people. \"What this paper shows is that all these types of individuals, all these types of leaders, have something in common.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=What+Makes+A+Leader%3F&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"Leaders make decisions for a group in the same way they make choices for themselves, a study suggests. They don't change their decision-making behavior, even when the welfare of others is at stake.","status":"publish","parent":0,"modified":1533254482,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":22,"wordCount":794},"headData":{"title":"What Makes A Leader? | KQED","description":"Leaders make decisions for a group in the same way they make choices for themselves, a study suggests. They don't change their decision-making behavior, even when the welfare of others is at stake.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"What Makes A Leader?","datePublished":"2018-08-03T21:00:13.000Z","dateModified":"2018-08-03T00:01:22.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"443746 https://ww2.kqed.org/futureofyou/?p=443746","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/08/03/what-makes-a-leader/","disqusTitle":"What Makes A Leader?","nprImageCredit":"sorbetto","nprByline":"Nell Greenfieldboyce, NPR","nprImageAgency":"Getty Images","nprStoryId":"634639437","nprApiLink":"http://api.npr.org/query?id=634639437&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"https://www.npr.org/sections/health-shots/2018/08/02/634639437/what-makes-a-leader?ft=nprml&f=634639437","nprRetrievedStory":"1","nprPubDate":"Thu, 02 Aug 2018 14:00:00 -0400","nprStoryDate":"Thu, 02 Aug 2018 14:00:42 -0400","nprLastModifiedDate":"Thu, 02 Aug 2018 14:00:42 -0400","path":"/futureofyou/443746/what-makes-a-leader","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Leaders can have many different styles — just compare President Donald Trump to \u003ca href=\"https://www.malala.org/malalas-story\" target=\"_blank\" rel=\"noopener\">Malala Yousafzai\u003c/a> to your boss or the coach of your kid's soccer team.\u003c/p>\n\u003cp>But a \u003ca href=\"http://science.sciencemag.org/cgi/doi/10.1126/science.aat0036\" target=\"_blank\" rel=\"noopener\">study\u003c/a> published Thursday suggests that people who end up in leadership roles of various sorts all share one key trait: Leaders make decisions for a group in the same way that they make decisions for themselves. They don't change their decision-making behavior, even when other people's welfare is at stake.\u003c/p>\n\u003cp>That may come as a bit of surprise, given that most lists of key leadership qualities focus on things like charisma and communication skills.\u003c/p>\n\u003cp>\"Previous research has mostly focused on these kinds of either personality characteristics of a leader, or situations where individuals are likely to lead,\" says \u003ca href=\"https://www.econ.uzh.ch/en/people/researchers/edelson.html\" target=\"_blank\" rel=\"noopener\">Micah Edelson\u003c/a>, a neuroscientist at the University of Zurich in Switzerland. \"But we don't know much about the cognitive or neurobiological process that is happening when you are choosing to lead or follow — when you're faced with this choice to lead or follow.\"\u003c/p>\n\u003cp>He notes that the decisions of leaders can affect the lives of many others. \"It's not always that easy to make such a choice, and it's something that could be even a little bit aversive to you, to make a choice that impacts other people,\" says Edelson. \"And there are some people that seem to be able to do it; some people don't. So we were interested in looking at that.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>He and his colleagues had volunteers come to the lab, and gave them questionnaires that are widely used to predict whether someone is likely to be in a position of leadership. They also collected information about people's real-world leadership experience, such as what rank they'd achieved in the military (which is compulsory for men in Switzerland) or in the popular Swiss Scouts organization.\u003c/p>\n\u003cp>Then they put the participants into small groups and had them play a series of games in which individuals had to make choices about whether to take a risky action to get a reward.\u003c/p>\n\u003cp>\"These are choices about uncertain gambles that have some probability of success and potential gains and losses,\" Edelson explains.\u003c/p>\n\u003cp>The player could choose to either make the choice alone, or defer the decision to a majority vote.\u003c/p>\n\u003cp>The games were played under two conditions: Sometimes the decision affected only the individual player's winnings and other times the decision affected what the entire group received.\u003c/p>\n\u003cp>What the researchers found is that people in general tended to avoid taking responsibility for what happens to others; deferral rates were the highest when decisions affected other people's pocketbooks.\u003c/p>\n\u003cp>But the people who changed their decision-making behavior the least were the ones who generally served as leaders in the real-world and scored high on leadership questionnaires. Unlike others, they did not require more certainty before being ready to personally make a decision that would affect the whole group.\u003c/p>\n\u003cp>\"On average, people tend to increase the certainty threshold when the choices affect the entire group. But higher-scoring leaders just keep their thresholds almost constant,\" says Edelson, who says preliminary work using MRI brain scanning supports the idea that leaders and followers differ in how their brains process information about gains, losses, and risk in the context of thinking about others.\u003c/p>\n\u003cp>Other neuroscientists say the work, published in the journal \u003cem>Science\u003c/em>, is fascinating.\u003c/p>\n\u003cp>\"It seems a very reasonable finding,\" says \u003ca href=\"http://affectivebrain.com/?page_id=161\" target=\"_blank\" rel=\"noopener\">Tali Sharot\u003c/a>, a cognitive neuroscientist at University College London. \"It works with our intuition, but in the same way it's not something that you'd necessarily think about that distinguishes leadership.\"\u003c/p>\n\u003cp>Sharot cautions that it's not clear whether this decision-making behavior is what led people to their leadership position, or if they've developed it as a result of real-world leadership experience.\u003c/p>\n\u003cp>And this study doesn't say anything about who ends up being a \"good\" leader, either.\u003c/p>\n\u003cp>But Sharot says the researchers have identified something about leadership that can hold true regardless of a leader's style.\u003c/p>\n\u003cp>\"You can have authoritarian leaders who like to have the ultimate control,\" she says. \"You can have democratic leaders who want to lead according to the will of the people. You have leaders who are risk-takers, leaders who are risk-adverse and conservative and so on.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But what's really interesting about this work, she says, is that these different types of leaders' decision-making behavior stays the same regardless of whether the outcome affects only themselves or other people. \"What this paper shows is that all these types of individuals, all these types of leaders, have something in common.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=What+Makes+A+Leader%3F&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/443746/what-makes-a-leader","authors":["byline_futureofyou_443746"],"categories":["futureofyou_1060","futureofyou_1","futureofyou_73"],"tags":["futureofyou_1188","futureofyou_59","futureofyou_1224"],"featImg":"futureofyou_443747","label":"futureofyou"},"futureofyou_443165":{"type":"posts","id":"futureofyou_443165","meta":{"index":"posts_1591205157","site":"futureofyou","id":"443165","score":null,"sort":[1530644426000]},"guestAuthors":[],"slug":"can-zapping-peoples-brains-reduce-violence-controversial-study-sees-potential","title":"Can Zapping People’s Brains Reduce Violence? Controversial Study Sees Potential","publishDate":1530644426,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>The study participants read short accounts of violent behavior: In one, a man smashed a beer bottle over someone’s head; in another, an assailant raped an acquaintance.[contextly_sidebar id=\"gKdycmp0KoVJxcxC1F1K6WdKxrJ9rXZI\"]\u003c/p>\n\u003cp>They were then asked: \u003cem>Would you do that?\u003c/em>\u003c/p>\n\u003cp>The day before, half of them had had the frontmost region of their brains, responsible for such high-level functions as impulse control and moral judgments, electrically stimulated; the other half had not.\u003c/p>\n\u003cp>The people whose prefrontal cortex was stimulated reported roughly half the likelihood of committing a violent act like the ones they watched, scientists at the University of Pennsylvania reported on Monday; they said they found such physical and sexual violence more morally wrong, compared with the control group.\u003c/p>\n\u003cp>The researchers hailed their results as evidence that “increasing activity in the prefrontal cortex can reduce intentions to commit aggression and enhance perceptions of moral judgment,” as they wrote in the Journal of Neuroscience.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Other experts said the results were far less than advertised.\u003c/p>\n\u003cp>“We’re a long way from ‘Clockwork Orange,’” said Dr. Paul Appelbaum, director of the Division of Law, Ethics, and Psychiatry at Columbia University’s Vagelos College of Physicians and Surgeons.\u003c/p>\n\u003cp>For the study, the Penn researchers randomly assigned 81 healthy adults (the average ago was 20) to receive “transcranial direct-current stimulation” of the dorsolateral prefrontal cortex, behind the top of the forehead, for 20 minutes via two scalp electrodes, or to get a low current for 30 seconds and then nothing, also via electrodes. Participants couldn’t tell if they were receiving the stimulation or not.\u003c/p>\n\u003cp>The researchers aimed at the dorsolateral prefrontal cortex because dozens of small neuro-imaging studies have \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2784035/\" target=\"_blank\" rel=\"noopener\">reported\u003c/a> that in people deemed antisocial or aggressive or both, this region is typically smaller and less active than in other people. Such studies can’t tell whether an impaired prefrontal cortex causes aggression or vice versa, so the Penn study, a registered \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT02427672\" target=\"_blank\" rel=\"noopener\">clinical trial\u003c/a>, tried to figure that out.[contextly_sidebar id=\"dnHIsBbKjxIupKuLmg7VYu4mKCZSmb4l\"]\u003c/p>\n\u003cp>The next day, participants read one vignette about the beer-bottle assault and one about the rape, and rated how likely they were (from “no chance” to “definitely”) to act as the assaulter did. The brain-stimulated group reported a 47 percent lower likelihood that they would commit the non-sexual physical assault (1.15 vs. 2.19 on a scale of 0 to 10) and a 70 percent lower likelihood of committing the sexual assault (0.26 vs. 0.86) compared with the control group. The brain-stimulated group also rated the assaults as more morally wrong than the control group did.\u003c/p>\n\u003cp>But while the brain stimulation decreased people’s self-reported likelihood of committing assault, their actions indicated otherwise. In the only assessment of actual behavior, the participants got to stick pins into a computer image of a doll representing a close friend, a common lab test of violent tendencies. Those whose prefrontal cortex was stimulated stuck in slightly more pins than the control group.\u003c/p>\n\u003cp>“What people say they will do with regard to violence and what they actually do may be two different things,” said Appelbaum. “Whether actual violence would be reduced [by brain stimulation] is unknown,” but “the data suggest no impact” on actual aggressive behavior.\u003c/p>\n\u003cp>Olivia Choy, the paper’s lead author and now a psychologist at Nanyang Technological University in Singapore, emphasized that the participants got only one 20-minute stimulation session. “It might be that repeated sessions over a longer time period could produce changes in behavior, but changes in behavior start with changing intent,” she said.\u003c/p>\n\u003cp>“We’re trying to find benign biological interventions [for criminal violence] that society will accept,” Penn psychologist Adrian Raine, who has studied the brain basis of violence and psychopathy for decades, said in a statement. “Transcranial direct-current stimulation is minimal risk. This isn’t a frontal lobotomy.”\u003c/p>\n\u003cp>Robin Mackenzie, a scholar of medical law and ethics at England’s University of Kent, called the study “promising and suggestive,” saying it “advances the field of biological interventions on antisocial and aggressive behavior.”\u003c/p>\n\u003cp>But she, too, noted several concerns. One is that the brain-stimulated group had 24 women and 15 men, compared with 21 and 21 in the control group. That raises the question of whether the zapped group’s lower likelihood of endorsing rape and beer-bottle attacks might be driven by gender differences, especially on what constitutes rape, Mackenzie said: “Asking female participants to identify with a rapist to assess how likely they would be to rape a woman is inherently different from asking male participants to do so….It is at the very least possible that the gender distribution could have skewed the results.”[contextly_sidebar id=\"APQk5r3dfTy6mLZEMSYpZsZfNmt4Z4Oq\"]\u003c/p>\n\u003cp>In addition, the study participants had no history of psychiatric or neurologic disease or injury, all of which are associated with violent tendencies. But the brain mechanisms causing that violence in these groups may differ from the mechanisms in normal people. Results on healthy, non-violent college students therefore might not apply to people with such brain abnormalities. “How far tDCS could affect [such people] is an open question,” Mackenzie said.\u003c/p>\n\u003cp>And even if stimulation of the prefrontal cortex makes people express a heightened sense that violence is wrong, when they are asked their views the next day, it remains to be seen whether any such effect would last, or if people would have to be zapped frequently.\u003c/p>\n\u003cp>Regardless of its shortcomings, the study worries some experts. If governments adopt brain zapping for violent offenders, would it be voluntary or, just as some states and countries mandate chemical castration for some male sex offenders, mandatory? And would governments be tempted to extend its use beyond violence, such as “to induce passivity in politically unruly groups?,” Appelbaum asked.\u003c/p>\n\u003cp>“Neurotechnologies which affect identity, ways of being, and thought processes are particularly tempting for authorities seeking to secure control and cut costs,” Mackenzie said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This\u003ca href=\"https://www.statnews.com/2018/07/02/brain-electric-stimulation-violence/\" target=\"_blank\" rel=\"noopener\"> story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"Study subjects whose prefrontal cortex were stimulated reported roughly half the likelihood of committing a violent act like the ones scientists made them watch.","status":"publish","parent":0,"modified":1530609082,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":23,"wordCount":1057},"headData":{"title":"Can Zapping People’s Brains Reduce Violence? Controversial Study Sees Potential | KQED","description":"Study subjects whose prefrontal cortex were stimulated reported roughly half the likelihood of committing a violent act like the ones scientists made them watch.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Can Zapping People’s Brains Reduce Violence? Controversial Study Sees Potential","datePublished":"2018-07-03T19:00:26.000Z","dateModified":"2018-07-03T09:11:22.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"443165 https://ww2.kqed.org/futureofyou/?p=443165","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/07/03/can-zapping-peoples-brains-reduce-violence-controversial-study-sees-potential/","disqusTitle":"Can Zapping People’s Brains Reduce Violence? Controversial Study Sees Potential","source":"Health","nprByline":"Sharon Begley\u003cbr />STAT","path":"/futureofyou/443165/can-zapping-peoples-brains-reduce-violence-controversial-study-sees-potential","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>The study participants read short accounts of violent behavior: In one, a man smashed a beer bottle over someone’s head; in another, an assailant raped an acquaintance.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>They were then asked: \u003cem>Would you do that?\u003c/em>\u003c/p>\n\u003cp>The day before, half of them had had the frontmost region of their brains, responsible for such high-level functions as impulse control and moral judgments, electrically stimulated; the other half had not.\u003c/p>\n\u003cp>The people whose prefrontal cortex was stimulated reported roughly half the likelihood of committing a violent act like the ones they watched, scientists at the University of Pennsylvania reported on Monday; they said they found such physical and sexual violence more morally wrong, compared with the control group.\u003c/p>\n\u003cp>The researchers hailed their results as evidence that “increasing activity in the prefrontal cortex can reduce intentions to commit aggression and enhance perceptions of moral judgment,” as they wrote in the Journal of Neuroscience.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Other experts said the results were far less than advertised.\u003c/p>\n\u003cp>“We’re a long way from ‘Clockwork Orange,’” said Dr. Paul Appelbaum, director of the Division of Law, Ethics, and Psychiatry at Columbia University’s Vagelos College of Physicians and Surgeons.\u003c/p>\n\u003cp>For the study, the Penn researchers randomly assigned 81 healthy adults (the average ago was 20) to receive “transcranial direct-current stimulation” of the dorsolateral prefrontal cortex, behind the top of the forehead, for 20 minutes via two scalp electrodes, or to get a low current for 30 seconds and then nothing, also via electrodes. Participants couldn’t tell if they were receiving the stimulation or not.\u003c/p>\n\u003cp>The researchers aimed at the dorsolateral prefrontal cortex because dozens of small neuro-imaging studies have \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2784035/\" target=\"_blank\" rel=\"noopener\">reported\u003c/a> that in people deemed antisocial or aggressive or both, this region is typically smaller and less active than in other people. Such studies can’t tell whether an impaired prefrontal cortex causes aggression or vice versa, so the Penn study, a registered \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT02427672\" target=\"_blank\" rel=\"noopener\">clinical trial\u003c/a>, tried to figure that out.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The next day, participants read one vignette about the beer-bottle assault and one about the rape, and rated how likely they were (from “no chance” to “definitely”) to act as the assaulter did. The brain-stimulated group reported a 47 percent lower likelihood that they would commit the non-sexual physical assault (1.15 vs. 2.19 on a scale of 0 to 10) and a 70 percent lower likelihood of committing the sexual assault (0.26 vs. 0.86) compared with the control group. The brain-stimulated group also rated the assaults as more morally wrong than the control group did.\u003c/p>\n\u003cp>But while the brain stimulation decreased people’s self-reported likelihood of committing assault, their actions indicated otherwise. In the only assessment of actual behavior, the participants got to stick pins into a computer image of a doll representing a close friend, a common lab test of violent tendencies. Those whose prefrontal cortex was stimulated stuck in slightly more pins than the control group.\u003c/p>\n\u003cp>“What people say they will do with regard to violence and what they actually do may be two different things,” said Appelbaum. “Whether actual violence would be reduced [by brain stimulation] is unknown,” but “the data suggest no impact” on actual aggressive behavior.\u003c/p>\n\u003cp>Olivia Choy, the paper’s lead author and now a psychologist at Nanyang Technological University in Singapore, emphasized that the participants got only one 20-minute stimulation session. “It might be that repeated sessions over a longer time period could produce changes in behavior, but changes in behavior start with changing intent,” she said.\u003c/p>\n\u003cp>“We’re trying to find benign biological interventions [for criminal violence] that society will accept,” Penn psychologist Adrian Raine, who has studied the brain basis of violence and psychopathy for decades, said in a statement. “Transcranial direct-current stimulation is minimal risk. This isn’t a frontal lobotomy.”\u003c/p>\n\u003cp>Robin Mackenzie, a scholar of medical law and ethics at England’s University of Kent, called the study “promising and suggestive,” saying it “advances the field of biological interventions on antisocial and aggressive behavior.”\u003c/p>\n\u003cp>But she, too, noted several concerns. One is that the brain-stimulated group had 24 women and 15 men, compared with 21 and 21 in the control group. That raises the question of whether the zapped group’s lower likelihood of endorsing rape and beer-bottle attacks might be driven by gender differences, especially on what constitutes rape, Mackenzie said: “Asking female participants to identify with a rapist to assess how likely they would be to rape a woman is inherently different from asking male participants to do so….It is at the very least possible that the gender distribution could have skewed the results.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>In addition, the study participants had no history of psychiatric or neurologic disease or injury, all of which are associated with violent tendencies. But the brain mechanisms causing that violence in these groups may differ from the mechanisms in normal people. Results on healthy, non-violent college students therefore might not apply to people with such brain abnormalities. “How far tDCS could affect [such people] is an open question,” Mackenzie said.\u003c/p>\n\u003cp>And even if stimulation of the prefrontal cortex makes people express a heightened sense that violence is wrong, when they are asked their views the next day, it remains to be seen whether any such effect would last, or if people would have to be zapped frequently.\u003c/p>\n\u003cp>Regardless of its shortcomings, the study worries some experts. If governments adopt brain zapping for violent offenders, would it be voluntary or, just as some states and countries mandate chemical castration for some male sex offenders, mandatory? And would governments be tempted to extend its use beyond violence, such as “to induce passivity in politically unruly groups?,” Appelbaum asked.\u003c/p>\n\u003cp>“Neurotechnologies which affect identity, ways of being, and thought processes are particularly tempting for authorities seeking to secure control and cut costs,” Mackenzie said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This\u003ca href=\"https://www.statnews.com/2018/07/02/brain-electric-stimulation-violence/\" target=\"_blank\" rel=\"noopener\"> story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/443165/can-zapping-peoples-brains-reduce-violence-controversial-study-sees-potential","authors":["byline_futureofyou_443165"],"categories":["futureofyou_1060","futureofyou_1","futureofyou_73","futureofyou_1061"],"tags":["futureofyou_56","futureofyou_1056","futureofyou_204","futureofyou_1224","futureofyou_35","futureofyou_1571"],"collections":["futureofyou_1093","futureofyou_1096"],"featImg":"futureofyou_443168","label":"source_futureofyou_443165"},"futureofyou_443058":{"type":"posts","id":"futureofyou_443058","meta":{"index":"posts_1591205157","site":"futureofyou","id":"443058","score":null,"sort":[1530205524000]},"guestAuthors":[],"slug":"how-family-separation-may-affect-kids-brains","title":"How Family Separation May Affect Kids’ Brains","publishDate":1530205524,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>Doctors have long known that separating families and other traumatic events can damage children’s well-being. More recent research has shed some light on how that may happen: Severe early adversity may cause brain changes and “toxic stress,” resulting in lasting psychological and physical health problems.\u003c/p>\n\u003cp>A “zero-tolerance” immigration policy announced this spring by the Trump Administration has separated 2,300 children from the adults they were traveling with and sent them to shelters and foster homes across the country, according to the government. The administration has 30 days to reunite families, but it remains unclear whether it can meet that deadline.\u003c/p>\n\u003cp>Here’s what evidence shows this kind of separation can do and how some experts think immigrant children may be at risk.\u003c/p>\n\u003cp>\u003cstrong>The Stress Response\u003c/strong>\u003c/p>\n\u003cp>Stress is a normal response to challenging or threatening circumstances that cause the brain to trigger the body’s “fight or flight” mode. Stress hormones and chemicals are released that increase heart rate, blood pressure, alertness and energy levels.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Levels typically return to normal when the threat passes.\u003c/p>\n\u003cp>When the threat is ongoing — a result of things like war, famine, poverty, natural disasters, family discord or neighborhood violence — the stress system may remain on high alert, sometimes triggering anxiety, behavior problems, stomach aches, sleep problems and other mental and physical symptoms.\u003c/p>\n\u003cp>Experts believe that contact with a loving, nurturing parent or caregiver can help children weather stress and reduce chances for lasting ill effects. A recent U.S. study of toddlers from families living in poverty is an example. Youngsters who had a strong parent relationship had lower stress-hormone levels when they arrived at a clinic to get vaccinations than those without that parent buffer.\u003c/p>\n\u003cp>\u003cstrong>What's Toxic Stress? \u003c/strong>\u003c/p>\n\u003cp>Scientists increasingly believe that persistent stress, particularly when there’s no nurturing parent to help kids cope, can cause stress hormones and internal inflammatory markers to smolder at elevated levels, raising risks for later heart disease, diabetes and other health problems.\u003c/p>\n\u003cp>The science is not settled, but some studies also have shown that persistent stress may alter brain structure in regions affecting emotions and regulating behavior. Imaging studies have found these regions are smaller than usual in severely traumatized children.\u003c/p>\n\u003cp>Harvard University neuroscientist Charles Nelson says children younger than 3, with rapidly developing brains, are most at risk for the toxic effects of ongoing stress. In his imaging studies, school-aged Romanian orphans sent to live with foster families had brains with less gray matter than orphans sent to nurturing foster homes before age 2.\u003c/p>\n\u003cp>\u003cstrong>What About Migrant Children \u003c/strong>\u003c/p>\n\u003cp>Central American children arriving with their families at the southern U.S. border have already endured the trauma of leaving their homes, some after violence or other threats, and faced the additional trauma of an arduous journey north, Nelson said Wednesday. “That may increase their susceptibility to the hazards of separation at the border,” he said.\u003c/p>\n\u003cp>Nelson said the images he’s seen of U.S. detention centers housing children remind him of his research with Romanian children. In a recent research newsletter, Nelson wrote, “The lessons we learned then taught us that housing children in institution-like settings, with rotating shifts of caregivers and unfavorable ratios of caregivers to children, may cause severe and permanent damage to their minds and bodies.”\u003c/p>\n\u003cp>“This is what science has taught us about separation,” he said Wednesday.\u003c/p>\n\u003cp>\u003cstrong>What Doctors Say \u003c/strong>\u003c/p>\n\u003cp>In 2017, a year before the separation policy was announced, the American Academy of Pediatrics advised against holding migrant children in detention centers and said they should receive health care and treatment to “support their well-being.”\u003c/p>\n\u003cp>The \u003ca href=\"https://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/AAPStatementOpposingBorderSecurityandImmigrationReformAct.aspx\">academy\u003c/a> and several mental health \u003ca href=\"http://www.apa.org/news/press/releases/2018/06/family-separation-policy.aspx\">groups\u003c/a> recently denounced the separation policy and cautiously supported last week’s executive order to overturn it. Tuesday’s order from a federal judge mandating that thousands of families be reunited within 30 days is an important step, the academy said in a joint statement with UNICEF USA, but it won’t undo the trauma separated children have already faced, said Academy President Dr. Colleen Kraft.\u003c/p>\n\u003cp>Even if they are eventually reunited, these families will need “trauma-informed” care to help them cope, Kraft said.\u003c/p>\n\u003cp>In their statement Wednesday, the academy and UNICEF USA said their organizations “stand ready to assist in reunifying families and supporting their needs. Pediatricians across the country are prepared to provide care for immigrant children as they enter our communities.”\u003c/p>\n\u003cp>Kraft attempted to enter a children’s shelter in McAllen, Texas on Wednesday to see what attempts were being made to reunite children and parents but said authorities turned her away. During an April visit to the same shelter, Kraft saw children who were “eerily quiet” and one who was crying inconsolably while attendants watched.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Staff in the room were not allowed to pick her up and hold her,” Kraft said. It’s that kind of absence of nurturing contact that experts think worsens the effects of traumatic stress.\u003c/p>\n\n","blocks":[],"excerpt":"Severe early adversity may cause brain changes and “toxic stress,” resulting in lasting psychological and physical health problems.","status":"publish","parent":0,"modified":1530853575,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":25,"wordCount":864},"headData":{"title":"How Family Separation May Affect Kids’ Brains | KQED","description":"Severe early adversity may cause brain changes and “toxic stress,” resulting in lasting psychological and physical health problems.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"How Family Separation May Affect Kids’ Brains","datePublished":"2018-06-28T17:05:24.000Z","dateModified":"2018-07-06T05:06:15.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"443058 https://ww2.kqed.org/futureofyou/?p=443058","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/06/28/how-family-separation-may-affect-kids-brains/","disqusTitle":"How Family Separation May Affect Kids’ Brains","source":"Health","nprByline":"Lindsey Tanner\u003cbr />The Associated Press","path":"/futureofyou/443058/how-family-separation-may-affect-kids-brains","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Doctors have long known that separating families and other traumatic events can damage children’s well-being. More recent research has shed some light on how that may happen: Severe early adversity may cause brain changes and “toxic stress,” resulting in lasting psychological and physical health problems.\u003c/p>\n\u003cp>A “zero-tolerance” immigration policy announced this spring by the Trump Administration has separated 2,300 children from the adults they were traveling with and sent them to shelters and foster homes across the country, according to the government. The administration has 30 days to reunite families, but it remains unclear whether it can meet that deadline.\u003c/p>\n\u003cp>Here’s what evidence shows this kind of separation can do and how some experts think immigrant children may be at risk.\u003c/p>\n\u003cp>\u003cstrong>The Stress Response\u003c/strong>\u003c/p>\n\u003cp>Stress is a normal response to challenging or threatening circumstances that cause the brain to trigger the body’s “fight or flight” mode. Stress hormones and chemicals are released that increase heart rate, blood pressure, alertness and energy levels.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Levels typically return to normal when the threat passes.\u003c/p>\n\u003cp>When the threat is ongoing — a result of things like war, famine, poverty, natural disasters, family discord or neighborhood violence — the stress system may remain on high alert, sometimes triggering anxiety, behavior problems, stomach aches, sleep problems and other mental and physical symptoms.\u003c/p>\n\u003cp>Experts believe that contact with a loving, nurturing parent or caregiver can help children weather stress and reduce chances for lasting ill effects. A recent U.S. study of toddlers from families living in poverty is an example. Youngsters who had a strong parent relationship had lower stress-hormone levels when they arrived at a clinic to get vaccinations than those without that parent buffer.\u003c/p>\n\u003cp>\u003cstrong>What's Toxic Stress? \u003c/strong>\u003c/p>\n\u003cp>Scientists increasingly believe that persistent stress, particularly when there’s no nurturing parent to help kids cope, can cause stress hormones and internal inflammatory markers to smolder at elevated levels, raising risks for later heart disease, diabetes and other health problems.\u003c/p>\n\u003cp>The science is not settled, but some studies also have shown that persistent stress may alter brain structure in regions affecting emotions and regulating behavior. Imaging studies have found these regions are smaller than usual in severely traumatized children.\u003c/p>\n\u003cp>Harvard University neuroscientist Charles Nelson says children younger than 3, with rapidly developing brains, are most at risk for the toxic effects of ongoing stress. In his imaging studies, school-aged Romanian orphans sent to live with foster families had brains with less gray matter than orphans sent to nurturing foster homes before age 2.\u003c/p>\n\u003cp>\u003cstrong>What About Migrant Children \u003c/strong>\u003c/p>\n\u003cp>Central American children arriving with their families at the southern U.S. border have already endured the trauma of leaving their homes, some after violence or other threats, and faced the additional trauma of an arduous journey north, Nelson said Wednesday. “That may increase their susceptibility to the hazards of separation at the border,” he said.\u003c/p>\n\u003cp>Nelson said the images he’s seen of U.S. detention centers housing children remind him of his research with Romanian children. In a recent research newsletter, Nelson wrote, “The lessons we learned then taught us that housing children in institution-like settings, with rotating shifts of caregivers and unfavorable ratios of caregivers to children, may cause severe and permanent damage to their minds and bodies.”\u003c/p>\n\u003cp>“This is what science has taught us about separation,” he said Wednesday.\u003c/p>\n\u003cp>\u003cstrong>What Doctors Say \u003c/strong>\u003c/p>\n\u003cp>In 2017, a year before the separation policy was announced, the American Academy of Pediatrics advised against holding migrant children in detention centers and said they should receive health care and treatment to “support their well-being.”\u003c/p>\n\u003cp>The \u003ca href=\"https://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/AAPStatementOpposingBorderSecurityandImmigrationReformAct.aspx\">academy\u003c/a> and several mental health \u003ca href=\"http://www.apa.org/news/press/releases/2018/06/family-separation-policy.aspx\">groups\u003c/a> recently denounced the separation policy and cautiously supported last week’s executive order to overturn it. Tuesday’s order from a federal judge mandating that thousands of families be reunited within 30 days is an important step, the academy said in a joint statement with UNICEF USA, but it won’t undo the trauma separated children have already faced, said Academy President Dr. Colleen Kraft.\u003c/p>\n\u003cp>Even if they are eventually reunited, these families will need “trauma-informed” care to help them cope, Kraft said.\u003c/p>\n\u003cp>In their statement Wednesday, the academy and UNICEF USA said their organizations “stand ready to assist in reunifying families and supporting their needs. Pediatricians across the country are prepared to provide care for immigrant children as they enter our communities.”\u003c/p>\n\u003cp>Kraft attempted to enter a children’s shelter in McAllen, Texas on Wednesday to see what attempts were being made to reunite children and parents but said authorities turned her away. During an April visit to the same shelter, Kraft saw children who were “eerily quiet” and one who was crying inconsolably while attendants watched.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Staff in the room were not allowed to pick her up and hold her,” Kraft said. It’s that kind of absence of nurturing contact that experts think worsens the effects of traumatic stress.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/443058/how-family-separation-may-affect-kids-brains","authors":["byline_futureofyou_443058"],"categories":["futureofyou_1","futureofyou_73"],"tags":["futureofyou_56","futureofyou_491","futureofyou_204","futureofyou_1224"],"label":"source_futureofyou_443058"},"futureofyou_442020":{"type":"posts","id":"futureofyou_442020","meta":{"index":"posts_1591205157","site":"futureofyou","id":"442020","score":null,"sort":[1527188439000]},"guestAuthors":[],"slug":"where-you-live-affects-your-happiness-and-health-but-how-exactly","title":"Diverse, Bike-Friendly Cities Have Happier Residents","publishDate":1527188439,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>Every year, \u003ca href=\"http://news.gallup.com/poll/228314/naples-florida-metro-tops-third-time.aspx\" target=\"_blank\" rel=\"noopener\">Gallup ranks\u003c/a> U.S. cities for well-being, based on how residents feel about living in their communities, and their health, finances, social ties and sense of purpose. Perhaps unsurprisingly, places like Naples, Fla., and Boulder, Col., tend to top the list, while Southern and Midwestern towns including Canton, Ohio, and Fort Smith, Ark., often come in last. But what hard data underpin the differences between these communities?[contextly_sidebar id=\"15QRpQod6Gs06FFQ53JgSZCOIKrWS9aL\"]\u003c/p>\n\u003cp>A study published Wednesday takes a step toward teasing out which attributes might contribute to well-being in communities around the country.\u003c/p>\n\u003cp>A Yale-led team of researchers has identified 12 community factors independently related to well-being. The factors included some obvious ones, such as higher levels of education and income, as well as some surprises, including a higher percentage of black residents, a higher percentage of bicycle commuters, and better access to preventive care, such as mammograms. The results appear in \u003ca href=\"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0196720\" target=\"_blank\" rel=\"noopener\">the journal \u003cem>PLOS ONE\u003c/em>.\u003c/a>\u003c/p>\n\u003cp>Well-being has been associated with \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5150263/\" target=\"_blank\" rel=\"noopener\">longer life expectancy and better health outcomes\u003c/a>. Previous studies \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1448000/\" target=\"_blank\" rel=\"noopener\">have also shown\u003c/a> that where someone lives can improve or diminish well-being.\u003c/p>\n\u003cp>For this study, the researchers compared two types of data: well-being data, gleaned from the \u003ca href=\"https://wellbeingindex.sharecare.com/\" target=\"_blank\" rel=\"noopener\">Gallup-Sharecare Well-Being Index\u003c/a>, based on surveying more than 300,000 Americans; and community attributes that researchers suspected would influence well-being drawn from the Robert Wood Johnson Foundation County Health Rankings, as well as other sources. This data included county-level information on high school graduation rates, percent of children in poverty, and the number of preventable hospital stays, among other things.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Using a statistical model, researchers whittled down more than 75 community attributes to determine which stood out.\u003c/p>\n\u003cp>Many of the potential factors are highly correlated with one another — for example, lower median income is correlated with lower education and less access to healthy food. Researchers wanted to figure out which characteristics measurably affected well-being independent of those other factors.\u003c/p>\n\u003cp>To the researchers' surprise, they discovered that just 12 factors related to demographics, clinical care, social and economic factors, and the physical environment explained over 90 percent of the variation in well-being across the country.[contextly_sidebar id=\"hoO2xlce32NjQsHCOB6fAGcPfegxXuXw\"]\u003c/p>\n\u003cp>\"That's higher than I would have expected,\" says \u003ca href=\"https://medicine.yale.edu/intmed/genmed/people/brita_roy.profile\" target=\"_blank\" rel=\"noopener\">Brita Roy\u003c/a>, assistant professor of medicine at the Yale School of Medicine and lead author of the study.\u003c/p>\n\u003cp>In what Roy called an unexpected but notable result, her team found that communities with higher percentages of black residents reported higher levels of well-being.\u003c/p>\n\u003cp>\"Having something that shows greater diversity is actually better for all of us I think is a really important finding,\" Roy says.\u003c/p>\n\u003cp>\u003ca href=\"https://www.brookings.edu/articles/why-are-black-poor-americans-more-optimistic-than-white-ones/\">Research\u003c/a> by Carol Graham at the Brookings Institution and others has shown high levels of optimism within the black community, which could account for the correlation in the paper.\u003c/p>\n\u003cp>But percentage of black residents is not the same as an overall measure of diversity, says Anita Chandra, director of \u003ca href=\"https://www.rand.org/jie.html\" target=\"_blank\" rel=\"noopener\">RAND Justice, Infrastructure, and Environment\u003c/a>. A better measure of diversity is \u003ca href=\"https://www.rwjf.org/en/cultureofhealth/taking-action/creating-healthier-communities/social-and-economic-environment.html\">diversity exposure\u003c/a>, which calculates how one ethnic or racial group is situated and exposed to all the other groups in a community.\u003c/p>\n\u003cp>Another unexpected finding was the connection between well-being and the percentage of residents commuting by bicycle. People living in places where they could commute to work by bike reported feelings of satisfaction and fulfillment.\u003c/p>\n\u003cp>This could be because places with bike-friendly infrastructure might also support other types of policies that improve living in that area. Or it could be that commuting by bike improves physical health, which in turn improves a sense of well-being; a \u003ca href=\"https://www.bmj.com/content/357/bmj.j1944\">study\u003c/a> in \u003cem>Heart\u003c/em> this week showed walking or cycling to work cut the risk of dying from heart disease or stroke by 30 percent.[contextly_sidebar id=\"d3I8IkqWk8sJqqOWib1G6Ufpur2JF6Nq\"]\u003c/p>\n\u003cp>The researchers hope their findings could lead to future research and even policy applications.\u003c/p>\n\u003cp>\"We are starting to move in the direction of trying to understand at the community level how we can actually work to improve well being for all members of the community,\" says Roy.\u003c/p>\n\u003cp>The study had limitations. It was cross-sectional, meaning researchers used one snapshot in time to see what was linked together, rather than using data over time. \"We can't prove causality at this point,\" Roy says. \"We don't know if we improve these twelve factors, will we actually lead to improved well-being. But it certainly provides us with a first step in understanding what perhaps we should test.\"\u003c/p>\n\u003cp>The study also didn't include psychosocial data, such as levels of trust in community, trust in government and social cohesion. Those data weren't available.\u003c/p>\n\u003cp>Chandra says this study serves as a call for collecting more and better information to help us grasp the full picture of what impacts wellness. \"We collect a lot of data, but we still have these gaps in our understanding of community and individual well-being,\" Chandra says.\u003c/p>\n\u003cp>She says in addition to surveys that measure an individual's sense of well-being, like the Gallup-Sharecare index, researchers need to gather information on larger scale community and civic well-being to bring everything together.\u003c/p>\n\u003cp>\"That's really where policy makers and practitioners can make decisions about resource allocation and where to put time and investment and policies in place,\" she says.\u003c/p>\n\u003cp>Nevertheless, she says this study is another important piece of the puzzle in understanding what drives overall health.\u003c/p>\n\u003cp>\"There are things that communities can do that make it more possible for people to feel more positive about their community,\" she says. \"And some of these things are very much in our control.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Dana Bate is a health and science reporter living in Philadelphia. You can follow her on Twitter: \u003c/em>\u003ca href=\"https://twitter.com/danabate\">\u003cem>@danabate\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Where+You+Live+Affects+Your+Happiness+And+Health%2C+But+How+Exactly%3F+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"Bike commuting, access to health care and racial diversity contribute to higher levels of well-being in communities. ","status":"publish","parent":0,"modified":1527177444,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":27,"wordCount":969},"headData":{"title":"Diverse, Bike-Friendly Cities Have Happier Residents | KQED","description":"Bike commuting, access to health care and racial diversity contribute to higher levels of well-being in communities. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Diverse, Bike-Friendly Cities Have Happier Residents","datePublished":"2018-05-24T19:00:39.000Z","dateModified":"2018-05-24T15:57:24.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"442020 https://ww2.kqed.org/futureofyou/?p=442020","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/05/24/where-you-live-affects-your-happiness-and-health-but-how-exactly/","disqusTitle":"Diverse, Bike-Friendly Cities Have Happier Residents","source":"Health","nprImageCredit":"Amanda Hall / robertharding","nprByline":"Dana Bate, NPR","nprImageAgency":"Getty Images/Robert Harding World Imagery","nprStoryId":"613762326","nprApiLink":"http://api.npr.org/query?id=613762326&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"https://www.npr.org/sections/health-shots/2018/05/23/613762326/where-you-live-affects-your-happiness-and-health-but-how-exactly?ft=nprml&f=613762326","nprRetrievedStory":"1","nprPubDate":"Wed, 23 May 2018 16:10:00 -0400","nprStoryDate":"Wed, 23 May 2018 16:10:42 -0400","nprLastModifiedDate":"Wed, 23 May 2018 16:15:16 -0400","path":"/futureofyou/442020/where-you-live-affects-your-happiness-and-health-but-how-exactly","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Every year, \u003ca href=\"http://news.gallup.com/poll/228314/naples-florida-metro-tops-third-time.aspx\" target=\"_blank\" rel=\"noopener\">Gallup ranks\u003c/a> U.S. cities for well-being, based on how residents feel about living in their communities, and their health, finances, social ties and sense of purpose. Perhaps unsurprisingly, places like Naples, Fla., and Boulder, Col., tend to top the list, while Southern and Midwestern towns including Canton, Ohio, and Fort Smith, Ark., often come in last. But what hard data underpin the differences between these communities?\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>A study published Wednesday takes a step toward teasing out which attributes might contribute to well-being in communities around the country.\u003c/p>\n\u003cp>A Yale-led team of researchers has identified 12 community factors independently related to well-being. The factors included some obvious ones, such as higher levels of education and income, as well as some surprises, including a higher percentage of black residents, a higher percentage of bicycle commuters, and better access to preventive care, such as mammograms. The results appear in \u003ca href=\"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0196720\" target=\"_blank\" rel=\"noopener\">the journal \u003cem>PLOS ONE\u003c/em>.\u003c/a>\u003c/p>\n\u003cp>Well-being has been associated with \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5150263/\" target=\"_blank\" rel=\"noopener\">longer life expectancy and better health outcomes\u003c/a>. Previous studies \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1448000/\" target=\"_blank\" rel=\"noopener\">have also shown\u003c/a> that where someone lives can improve or diminish well-being.\u003c/p>\n\u003cp>For this study, the researchers compared two types of data: well-being data, gleaned from the \u003ca href=\"https://wellbeingindex.sharecare.com/\" target=\"_blank\" rel=\"noopener\">Gallup-Sharecare Well-Being Index\u003c/a>, based on surveying more than 300,000 Americans; and community attributes that researchers suspected would influence well-being drawn from the Robert Wood Johnson Foundation County Health Rankings, as well as other sources. This data included county-level information on high school graduation rates, percent of children in poverty, and the number of preventable hospital stays, among other things.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Using a statistical model, researchers whittled down more than 75 community attributes to determine which stood out.\u003c/p>\n\u003cp>Many of the potential factors are highly correlated with one another — for example, lower median income is correlated with lower education and less access to healthy food. Researchers wanted to figure out which characteristics measurably affected well-being independent of those other factors.\u003c/p>\n\u003cp>To the researchers' surprise, they discovered that just 12 factors related to demographics, clinical care, social and economic factors, and the physical environment explained over 90 percent of the variation in well-being across the country.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"That's higher than I would have expected,\" says \u003ca href=\"https://medicine.yale.edu/intmed/genmed/people/brita_roy.profile\" target=\"_blank\" rel=\"noopener\">Brita Roy\u003c/a>, assistant professor of medicine at the Yale School of Medicine and lead author of the study.\u003c/p>\n\u003cp>In what Roy called an unexpected but notable result, her team found that communities with higher percentages of black residents reported higher levels of well-being.\u003c/p>\n\u003cp>\"Having something that shows greater diversity is actually better for all of us I think is a really important finding,\" Roy says.\u003c/p>\n\u003cp>\u003ca href=\"https://www.brookings.edu/articles/why-are-black-poor-americans-more-optimistic-than-white-ones/\">Research\u003c/a> by Carol Graham at the Brookings Institution and others has shown high levels of optimism within the black community, which could account for the correlation in the paper.\u003c/p>\n\u003cp>But percentage of black residents is not the same as an overall measure of diversity, says Anita Chandra, director of \u003ca href=\"https://www.rand.org/jie.html\" target=\"_blank\" rel=\"noopener\">RAND Justice, Infrastructure, and Environment\u003c/a>. A better measure of diversity is \u003ca href=\"https://www.rwjf.org/en/cultureofhealth/taking-action/creating-healthier-communities/social-and-economic-environment.html\">diversity exposure\u003c/a>, which calculates how one ethnic or racial group is situated and exposed to all the other groups in a community.\u003c/p>\n\u003cp>Another unexpected finding was the connection between well-being and the percentage of residents commuting by bicycle. People living in places where they could commute to work by bike reported feelings of satisfaction and fulfillment.\u003c/p>\n\u003cp>This could be because places with bike-friendly infrastructure might also support other types of policies that improve living in that area. Or it could be that commuting by bike improves physical health, which in turn improves a sense of well-being; a \u003ca href=\"https://www.bmj.com/content/357/bmj.j1944\">study\u003c/a> in \u003cem>Heart\u003c/em> this week showed walking or cycling to work cut the risk of dying from heart disease or stroke by 30 percent.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The researchers hope their findings could lead to future research and even policy applications.\u003c/p>\n\u003cp>\"We are starting to move in the direction of trying to understand at the community level how we can actually work to improve well being for all members of the community,\" says Roy.\u003c/p>\n\u003cp>The study had limitations. It was cross-sectional, meaning researchers used one snapshot in time to see what was linked together, rather than using data over time. \"We can't prove causality at this point,\" Roy says. \"We don't know if we improve these twelve factors, will we actually lead to improved well-being. But it certainly provides us with a first step in understanding what perhaps we should test.\"\u003c/p>\n\u003cp>The study also didn't include psychosocial data, such as levels of trust in community, trust in government and social cohesion. Those data weren't available.\u003c/p>\n\u003cp>Chandra says this study serves as a call for collecting more and better information to help us grasp the full picture of what impacts wellness. \"We collect a lot of data, but we still have these gaps in our understanding of community and individual well-being,\" Chandra says.\u003c/p>\n\u003cp>She says in addition to surveys that measure an individual's sense of well-being, like the Gallup-Sharecare index, researchers need to gather information on larger scale community and civic well-being to bring everything together.\u003c/p>\n\u003cp>\"That's really where policy makers and practitioners can make decisions about resource allocation and where to put time and investment and policies in place,\" she says.\u003c/p>\n\u003cp>Nevertheless, she says this study is another important piece of the puzzle in understanding what drives overall health.\u003c/p>\n\u003cp>\"There are things that communities can do that make it more possible for people to feel more positive about their community,\" she says. \"And some of these things are very much in our control.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Dana Bate is a health and science reporter living in Philadelphia. You can follow her on Twitter: \u003c/em>\u003ca href=\"https://twitter.com/danabate\">\u003cem>@danabate\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Where+You+Live+Affects+Your+Happiness+And+Health%2C+But+How+Exactly%3F+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/442020/where-you-live-affects-your-happiness-and-health-but-how-exactly","authors":["byline_futureofyou_442020"],"categories":["futureofyou_1060","futureofyou_1","futureofyou_73"],"tags":["futureofyou_204","futureofyou_1224","futureofyou_163"],"featImg":"futureofyou_442021","label":"source_futureofyou_442020"},"futureofyou_441207":{"type":"posts","id":"futureofyou_441207","meta":{"index":"posts_1591205157","site":"futureofyou","id":"441207","score":null,"sort":[1525222852000]},"guestAuthors":[],"slug":"americans-are-a-lonely-lot-and-young-people-bear-the-heaviest-burden","title":"Americans Are A Lonely Lot, And Young People Bear The Heaviest Burden","publishDate":1525222852,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>Loneliness isn't just a fleeting feeling, leaving us sad for a few hours to a few days. Research in recent years suggests that for many people loneliness is more like a chronic ache, affecting their daily lives and sense of well-being.[contextly_sidebar id=\"e57r0FGqMOAZghsnjutzZT3UwHbqczQn\"]\u003c/p>\n\u003cp>Now a nationwide survey by the health insurer Cigna underscores that. It finds that loneliness is widespread in America, with nearly 50 percent of respondents reporting that they feel alone or left out always or sometimes.\u003c/p>\n\u003cp>Using one of the best-known tools for measuring loneliness — \u003ca href=\"http://psycnet.apa.org/doiLanding?doi=10.1037%2F0022-3514.39.3.472\" target=\"_blank\" rel=\"noopener\">the UCLA Loneliness Scale\u003c/a> — Cigna surveyed 20,000 adults online across the country ages 18 and above. The UCLA tool uses a series of statements and a formula to calculate a loneliness score based on responses. People scoring between 20 and 80 on the UCLA scale are considered lonely, with a higher score suggesting a greater level of loneliness and social isolation.\u003c/p>\n\u003cp>More than half of survey respondents — 54 percent — said they always or sometimes feel that no one knows them well. Fifty-six percent reported they sometimes or always felt like the people around them \"are not necessarily \u003cem>with\u003c/em> them.\" And 2 in 5 felt like \"they lack companionship,\" that their \"relationships aren't meaningful\" and that they \"are isolated from others.\"\u003c/p>\n\u003cp>The survey found that the average loneliness score in America is 44, which suggests that \"most Americans are considered lonely,\" according to the report released Tuesday by the health insurer.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"Half of Americans view themselves as lonely,\" said \u003ca href=\"https://www.cigna.com/about-us/company-profile/cigna-leadership-team/david-cordani\" target=\"_blank\" rel=\"noopener\">David Cordani\u003c/a>, president and CEO of Cigna Corp. \"I can't help but be surprised [by that].\" (Cigna is an NPR sponsor and a major provider of health insurance for NPR employees.)[contextly_sidebar id=\"Pg3wtSaU0SsTMqBq28e6HhNtWmFiJO0m\"]\u003c/p>\n\u003cp>But the results are consistent with other previous research, says\u003ca href=\"https://fhssfaculty.byu.edu/FacultyPage?id=jh67\" target=\"_blank\" rel=\"noopener\"> Julianne Holt-Lunstad\u003c/a>, a psychologist at Brigham Young University, who studies loneliness and its health effects. She wasn't involved in the Cigna survey. While it's difficult to compare the loneliness scores in different studies, she says, other nationally representative estimates have found between 20 and 43 percent of Americans report feeling lonely or socially isolated.\u003c/p>\n\u003cp>Loneliness has health consequences. \"There's a blurred line between mental and physical health,\" says Cordani. \"Often times, medical symptoms present themselves and they're correlated with mental, lifestyle, behavioral issues like loneliness.\"\u003c/p>\n\u003cp>Several studies in recent years, including ones by Holt-Lunstad, have documented the public health effect of loneliness. It has been linked with a higher risk of \u003ca href=\"http://heart.bmj.com/content/heartjnl/102/13/1009.full.pdf\" target=\"_blank\" rel=\"noopener\">coronary heart disease and stroke\u003c/a>. It has been shown to influence our \u003ca href=\"https://www.npr.org/sections/health-shots/2015/11/29/457255876/loneliness-may-warp-our-genes-and-our-immune-systems\" target=\"_blank\" rel=\"noopener\">genes and our immune systems\u003c/a>, and even \u003ca href=\"https://www.cbsnews.com/news/loneliness-may-sabotage-breast-cancer-survival-study-finds/\" target=\"_blank\" rel=\"noopener\">recovery from breast cancer\u003c/a>.\u003c/p>\n\u003cp>And there's growing evidence that loneliness can kill. \"We have \u003ca href=\"http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1000316\">robust evidence\u003c/a> that it increases risk for premature mortality,\" says Holt-Lunstad. Studies have found that it is a predictor of premature death, not just for the elderly, but \u003ca href=\"http://journals.sagepub.com/doi/abs/10.1177/1745691614568352\" target=\"_blank\" rel=\"noopener\">even more\u003c/a> so for younger people.\u003c/p>\n\u003cp>The latest survey also found something surprising about loneliness in the younger generation. \"Our survey found that actually the younger generation was lonelier than the older generations,\" says Dr. Douglas Nemecek, the chief medical officer for behavioral health at Cigna.\u003c/p>\n\u003cp>Members of Generation Z, born between the mid-1990s and the early 2000s, had an overall loneliness score of 48.3. Millennials, just a little bit older, scored 45.3. By comparison, baby boomers scored 42.4. The Greatest Generation, people ages 72 and above, had a score of 38.6 on the loneliness scale.[contextly_sidebar id=\"VPmLfKEsxWooY6XEkutLxN8Y5ABLBUmT\"]\u003c/p>\n\u003cp>\"Too often people think that this [problem] is specific to older adults,\" says Holt-Lunstad. \"This report helps with the recognition that this can affect those at younger ages.\"\u003c/p>\n\u003cp>In fact, some \u003ca href=\"http://journals.sagepub.com/doi/10.1177/2167702617723376\">research\u003c/a> published in 2017 by psychologist \u003ca href=\"http://www.psychology.sdsu.edu/people/jean-twenge/\" target=\"_blank\" rel=\"noopener\">Jean Twenge\u003c/a> at San Diego State University suggests that more screen time and social media may have caused a rise in depression and suicide among American adolescents. The study also found that people who spend less time looking at screens and more time having face-to-face social interactions are less likely to be depressive or suicidal.\u003c/p>\n\u003cp>However, the Cigna survey didn't find a correlation between social media use and feelings of loneliness. This would on the surface contradict the new findings on screen time, but Holt-Lunstad says that previous research shows that how people use social media determine's its influence on one's sense of isolation.\u003c/p>\n\u003cp>\"If you're passively using it, if you're just scrolling feeds, that's associated with more negative effects,\" she says. \"But if you're using it to reach out and connect to people to facilitate other kinds of [in-person] interactions, it's associated with more positive effects.\"\u003c/p>\n\u003cp>That last finding is also corroborated by the Cigna survey across all age groups. Respondents who said they have more in-person social interactions on a daily basis reported being less lonely.\u003c/p>\n\u003cp>The survey also found that working too little or too much is also associated with the experience of loneliness, suggesting that our workplaces are an important source of our social relationships and also that work-life balance is important for avoiding loneliness.[contextly_sidebar id=\"JkOKxwrLZLl4yCDVrNUiZCYxVTcUUSA6\"]\u003c/p>\n\u003cp>Cigna wants to work with employers to \"help address loneliness in the workplace,\" says Nemecek.\u003c/p>\n\u003cp>Social connection or the lack of it is now considered a social determinant of health. In a \u003ca href=\"http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2014/EHR-Phase-1/EHRdomains.pdf\" target=\"_blank\" rel=\"noopener\">2014 report\u003c/a>, the Institute of Medicine (now the \u003ca href=\"http://www.nationalacademies.org/hmd/About-HMD.aspx\" target=\"_blank\" rel=\"noopener\">Health and Medicine Division of the National Academies of Sciences, Engineering, and Medicine\u003c/a>) suggested that health providers should collect information about patients' \"social connections and social isolation\" along with information on education, employment, lifestyle (diet, exercise, smoking etc) and psychological health.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"But this hasn't happened,\" says Holt-Lunstad. \"I would hope that with a large insurer like Cigna [releasing a report on loneliness], that it would start to be more on the radar of major health organizations but also actual health care providers.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Americans+Are+A+Lonely+Lot%2C+And+Young+People+Bear+The+Heaviest+Burden&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"A nationwide survey by health insurer Cigna finds that loneliness is widespread in America. Millennials and people in Generation Z tend to feel lonelier than retirees.","status":"publish","parent":0,"modified":1525178164,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":23,"wordCount":997},"headData":{"title":"Americans Are A Lonely Lot, And Young People Bear The Heaviest Burden | KQED","description":"A nationwide survey by health insurer Cigna finds that loneliness is widespread in America. Millennials and people in Generation Z tend to feel lonelier than retirees.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Americans Are A Lonely Lot, And Young People Bear The Heaviest Burden","datePublished":"2018-05-02T01:00:52.000Z","dateModified":"2018-05-01T12:36:04.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"441207 https://ww2.kqed.org/futureofyou/?p=441207","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/05/01/americans-are-a-lonely-lot-and-young-people-bear-the-heaviest-burden/","disqusTitle":"Americans Are A Lonely Lot, And Young People Bear The Heaviest Burden","source":"Health","nprImageCredit":"Tara Moore","nprByline":"Rhitu Chatterjee, NPR","nprImageAgency":"Getty Images","nprStoryId":"606588504","nprApiLink":"http://api.npr.org/query?id=606588504&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"https://www.npr.org/sections/health-shots/2018/05/01/606588504/americans-are-a-lonely-lot-and-young-people-bear-the-heaviest-burden?ft=nprml&f=606588504","nprRetrievedStory":"1","nprPubDate":"Tue, 01 May 2018 06:01:00 -0400","nprStoryDate":"Tue, 01 May 2018 06:01:28 -0400","nprLastModifiedDate":"Tue, 01 May 2018 06:01:28 -0400","path":"/futureofyou/441207/americans-are-a-lonely-lot-and-young-people-bear-the-heaviest-burden","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Loneliness isn't just a fleeting feeling, leaving us sad for a few hours to a few days. Research in recent years suggests that for many people loneliness is more like a chronic ache, affecting their daily lives and sense of well-being.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Now a nationwide survey by the health insurer Cigna underscores that. It finds that loneliness is widespread in America, with nearly 50 percent of respondents reporting that they feel alone or left out always or sometimes.\u003c/p>\n\u003cp>Using one of the best-known tools for measuring loneliness — \u003ca href=\"http://psycnet.apa.org/doiLanding?doi=10.1037%2F0022-3514.39.3.472\" target=\"_blank\" rel=\"noopener\">the UCLA Loneliness Scale\u003c/a> — Cigna surveyed 20,000 adults online across the country ages 18 and above. The UCLA tool uses a series of statements and a formula to calculate a loneliness score based on responses. People scoring between 20 and 80 on the UCLA scale are considered lonely, with a higher score suggesting a greater level of loneliness and social isolation.\u003c/p>\n\u003cp>More than half of survey respondents — 54 percent — said they always or sometimes feel that no one knows them well. Fifty-six percent reported they sometimes or always felt like the people around them \"are not necessarily \u003cem>with\u003c/em> them.\" And 2 in 5 felt like \"they lack companionship,\" that their \"relationships aren't meaningful\" and that they \"are isolated from others.\"\u003c/p>\n\u003cp>The survey found that the average loneliness score in America is 44, which suggests that \"most Americans are considered lonely,\" according to the report released Tuesday by the health insurer.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"Half of Americans view themselves as lonely,\" said \u003ca href=\"https://www.cigna.com/about-us/company-profile/cigna-leadership-team/david-cordani\" target=\"_blank\" rel=\"noopener\">David Cordani\u003c/a>, president and CEO of Cigna Corp. \"I can't help but be surprised [by that].\" (Cigna is an NPR sponsor and a major provider of health insurance for NPR employees.)\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>But the results are consistent with other previous research, says\u003ca href=\"https://fhssfaculty.byu.edu/FacultyPage?id=jh67\" target=\"_blank\" rel=\"noopener\"> Julianne Holt-Lunstad\u003c/a>, a psychologist at Brigham Young University, who studies loneliness and its health effects. She wasn't involved in the Cigna survey. While it's difficult to compare the loneliness scores in different studies, she says, other nationally representative estimates have found between 20 and 43 percent of Americans report feeling lonely or socially isolated.\u003c/p>\n\u003cp>Loneliness has health consequences. \"There's a blurred line between mental and physical health,\" says Cordani. \"Often times, medical symptoms present themselves and they're correlated with mental, lifestyle, behavioral issues like loneliness.\"\u003c/p>\n\u003cp>Several studies in recent years, including ones by Holt-Lunstad, have documented the public health effect of loneliness. It has been linked with a higher risk of \u003ca href=\"http://heart.bmj.com/content/heartjnl/102/13/1009.full.pdf\" target=\"_blank\" rel=\"noopener\">coronary heart disease and stroke\u003c/a>. It has been shown to influence our \u003ca href=\"https://www.npr.org/sections/health-shots/2015/11/29/457255876/loneliness-may-warp-our-genes-and-our-immune-systems\" target=\"_blank\" rel=\"noopener\">genes and our immune systems\u003c/a>, and even \u003ca href=\"https://www.cbsnews.com/news/loneliness-may-sabotage-breast-cancer-survival-study-finds/\" target=\"_blank\" rel=\"noopener\">recovery from breast cancer\u003c/a>.\u003c/p>\n\u003cp>And there's growing evidence that loneliness can kill. \"We have \u003ca href=\"http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1000316\">robust evidence\u003c/a> that it increases risk for premature mortality,\" says Holt-Lunstad. Studies have found that it is a predictor of premature death, not just for the elderly, but \u003ca href=\"http://journals.sagepub.com/doi/abs/10.1177/1745691614568352\" target=\"_blank\" rel=\"noopener\">even more\u003c/a> so for younger people.\u003c/p>\n\u003cp>The latest survey also found something surprising about loneliness in the younger generation. \"Our survey found that actually the younger generation was lonelier than the older generations,\" says Dr. Douglas Nemecek, the chief medical officer for behavioral health at Cigna.\u003c/p>\n\u003cp>Members of Generation Z, born between the mid-1990s and the early 2000s, had an overall loneliness score of 48.3. Millennials, just a little bit older, scored 45.3. By comparison, baby boomers scored 42.4. The Greatest Generation, people ages 72 and above, had a score of 38.6 on the loneliness scale.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"Too often people think that this [problem] is specific to older adults,\" says Holt-Lunstad. \"This report helps with the recognition that this can affect those at younger ages.\"\u003c/p>\n\u003cp>In fact, some \u003ca href=\"http://journals.sagepub.com/doi/10.1177/2167702617723376\">research\u003c/a> published in 2017 by psychologist \u003ca href=\"http://www.psychology.sdsu.edu/people/jean-twenge/\" target=\"_blank\" rel=\"noopener\">Jean Twenge\u003c/a> at San Diego State University suggests that more screen time and social media may have caused a rise in depression and suicide among American adolescents. The study also found that people who spend less time looking at screens and more time having face-to-face social interactions are less likely to be depressive or suicidal.\u003c/p>\n\u003cp>However, the Cigna survey didn't find a correlation between social media use and feelings of loneliness. This would on the surface contradict the new findings on screen time, but Holt-Lunstad says that previous research shows that how people use social media determine's its influence on one's sense of isolation.\u003c/p>\n\u003cp>\"If you're passively using it, if you're just scrolling feeds, that's associated with more negative effects,\" she says. \"But if you're using it to reach out and connect to people to facilitate other kinds of [in-person] interactions, it's associated with more positive effects.\"\u003c/p>\n\u003cp>That last finding is also corroborated by the Cigna survey across all age groups. Respondents who said they have more in-person social interactions on a daily basis reported being less lonely.\u003c/p>\n\u003cp>The survey also found that working too little or too much is also associated with the experience of loneliness, suggesting that our workplaces are an important source of our social relationships and also that work-life balance is important for avoiding loneliness.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Cigna wants to work with employers to \"help address loneliness in the workplace,\" says Nemecek.\u003c/p>\n\u003cp>Social connection or the lack of it is now considered a social determinant of health. In a \u003ca href=\"http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2014/EHR-Phase-1/EHRdomains.pdf\" target=\"_blank\" rel=\"noopener\">2014 report\u003c/a>, the Institute of Medicine (now the \u003ca href=\"http://www.nationalacademies.org/hmd/About-HMD.aspx\" target=\"_blank\" rel=\"noopener\">Health and Medicine Division of the National Academies of Sciences, Engineering, and Medicine\u003c/a>) suggested that health providers should collect information about patients' \"social connections and social isolation\" along with information on education, employment, lifestyle (diet, exercise, smoking etc) and psychological health.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"But this hasn't happened,\" says Holt-Lunstad. \"I would hope that with a large insurer like Cigna [releasing a report on loneliness], that it would start to be more on the radar of major health organizations but also actual health care providers.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Americans+Are+A+Lonely+Lot%2C+And+Young+People+Bear+The+Heaviest+Burden&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/441207/americans-are-a-lonely-lot-and-young-people-bear-the-heaviest-burden","authors":["byline_futureofyou_441207"],"categories":["futureofyou_1"],"tags":["futureofyou_61","futureofyou_204","futureofyou_1224","futureofyou_1434"],"featImg":"futureofyou_441208","label":"source_futureofyou_441207"},"futureofyou_440672":{"type":"posts","id":"futureofyou_440672","meta":{"index":"posts_1591205157","site":"futureofyou","id":"440672","score":null,"sort":[1523035067000]},"guestAuthors":[],"slug":"when-daydreaming-gets-in-the-way-of-real-life","title":"When Daydreaming Gets In The Way Of Real Life","publishDate":1523035067,"format":"aside","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>\u003ciframe width=\"640\" height=\"360\" src=\"https://www.youtube.com/embed/ckYSydGYKRU?feature=oembed\" frameborder=\"0\" allow=\"autoplay; encrypted-media\" allowfullscreen>\u003c/iframe>\u003c/p>\n\u003cp>\u003cem>Welcome to \u003c/em>Invisibilia\u003cem> Season 4! The NPR program and \u003c/em>\u003ca href=\"http://www.npr.org/podcasts/510307/invisibilia\" target=\"_blank\" rel=\"noopener\">podcast\u003c/a>\u003cem> explores the invisible forces that shape human behavior, and we here at Shots are joining in to probe the science of why we act the way we do. In Episode 5, they're investigating how it feels to live \"in between,\" to be in two worlds at once. In the episode, and in the animation above, we meet M, a woman who worries that her intense daydreaming is interfering with her actual life.\u003c/em>\u003c/p>\n\u003cp>The story of M begins innocently enough. She was a girl who felt isolated and misunderstood, so she began spending hours at a time on the swings in her backyard, daydreaming.\u003c/p>\n\u003cp>She imagined herself as many characters, blasting off to other planets, fighting crime and just generally saving the day. This made her feel loved, accepted, even understood.\u003c/p>\n\u003cp>[contextly_sidebar id=\"PN5qpfkUkdC6IDaS53jvI12s3Nkk5Y8D\"]M began to realize her daydreaming was not normal when her mother yelled at her and asked her why she was moving her lips. So she kept up her daydreaming in secret, hiding from friends at school, pretending to read a book, plugging in earphones to make it appear as if she was listening to music.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Then one day by chance, M met with a former classmate who drew her out. They fell in love, married and had a child, and for a while, the daydreams subsided.\u003c/p>\n\u003cp>But as life became more middle-class and mundane — dishwasher unloading, toothpaste in the sink — she found herself sneaking back into a world where she was the hero, the boss and every character in between.\u003c/p>\n\u003cp>[contextly_sidebar id=\"0rxdI3CFoOWSBss3ToB6u1S84tVyjhnE\"]M worries that she has a newly diagnosed condition known as \u003ca href=\"https://www.healthline.com/health/mental-health/maladaptive-daydreaming#complications\" target=\"_blank\" rel=\"noopener\">maladaptive daydreaming\u003c/a>. Now, it's not in the mental health bible, aka the \u003cem>Diagnostic and Statistical Manual of Mental Disorders,\u003c/em> and doctors don't know what causes it. There's no official treatment, although \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/19062309\" target=\"_blank\" rel=\"noopener\">one case study\u003c/a> suggests fluvoxamine, an OCD drug, may help control the daydreams.\u003c/p>\n\u003cp>Whatever maladaptive daydreaming is, it can have real effects on a person's daily life. People who say they have the condition report having trouble making friends or even leaving the house. M worries she is one of them. She carves out time to daydream away from her husband and son who know nothing of her secret life. In fact, she says she has never told anyone about it.\u003c/p>\n\u003cp>M loves her never-ending story, yet she acknowledges her secret is isolating.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"As much as I hate the feeling of being torn and being in two places, I'm not ready to give up my daydreaming and I'm not ready to give up my characters and the feelings that those daydreams give me,\" she says.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Invisibilia%3A+When+Daydreaming+Gets+In+The+Way+Of+Real+Life&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"An inside look at 'maladaptive daydreaming,' a newly diagnosed condition that can disrupt actual life.","status":"publish","parent":0,"modified":1523035260,"stats":{"hasAudio":false,"hasVideo":true,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":13,"wordCount":468},"headData":{"title":"When Daydreaming Gets In The Way Of Real Life | KQED","description":"An inside look at 'maladaptive daydreaming,' a newly diagnosed condition that can disrupt actual life.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"When Daydreaming Gets In The Way Of Real Life","datePublished":"2018-04-06T17:17:47.000Z","dateModified":"2018-04-06T17:21:00.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"440672 https://ww2.kqed.org/futureofyou/?p=440672","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/04/06/when-daydreaming-gets-in-the-way-of-real-life/","disqusTitle":"When Daydreaming Gets In The Way Of Real Life","source":"Health","nprByline":"Meredith Rizzo\u003cbr />NPR Shots","nprImageAgency":"Lily Padula for NPR","nprStoryId":"598365217","nprApiLink":"http://api.npr.org/query?id=598365217&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"https://www.npr.org/sections/health-shots/2018/04/05/598365217/invisibilia-when-daydreaming-gets-in-the-way-of-real-life?ft=nprml&f=598365217","nprRetrievedStory":"1","nprPubDate":"Fri, 06 Apr 2018 10:35:00 -0400","nprStoryDate":"Thu, 05 Apr 2018 08:00:00 -0400","nprLastModifiedDate":"Fri, 06 Apr 2018 10:35:30 -0400","nprAudio":"https://ondemand.npr.org/anon.npr-mp3/npr/invsb/2018/04/20180405_invsb_in_between.mp3?orgId=1&topicId=1128&d=2924&story=598365217&ft=nprml&f=598365217","nprAudioM3u":"http://api.npr.org/m3u/1600120047-b0e1d6.m3u?orgId=1&topicId=1128&d=2924&story=598365217&ft=nprml&f=598365217","path":"/futureofyou/440672/when-daydreaming-gets-in-the-way-of-real-life","audioUrl":"https://ondemand.npr.org/anon.npr-mp3/npr/invsb/2018/04/20180405_invsb_in_between.mp3?orgId=1&topicId=1128&d=2924&story=598365217&ft=nprml&f=598365217","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003ciframe width=\"640\" height=\"360\" src=\"https://www.youtube.com/embed/ckYSydGYKRU?feature=oembed\" frameborder=\"0\" allow=\"autoplay; encrypted-media\" allowfullscreen>\u003c/iframe>\u003c/p>\n\u003cp>\u003cem>Welcome to \u003c/em>Invisibilia\u003cem> Season 4! The NPR program and \u003c/em>\u003ca href=\"http://www.npr.org/podcasts/510307/invisibilia\" target=\"_blank\" rel=\"noopener\">podcast\u003c/a>\u003cem> explores the invisible forces that shape human behavior, and we here at Shots are joining in to probe the science of why we act the way we do. In Episode 5, they're investigating how it feels to live \"in between,\" to be in two worlds at once. In the episode, and in the animation above, we meet M, a woman who worries that her intense daydreaming is interfering with her actual life.\u003c/em>\u003c/p>\n\u003cp>The story of M begins innocently enough. She was a girl who felt isolated and misunderstood, so she began spending hours at a time on the swings in her backyard, daydreaming.\u003c/p>\n\u003cp>She imagined herself as many characters, blasting off to other planets, fighting crime and just generally saving the day. This made her feel loved, accepted, even understood.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>M began to realize her daydreaming was not normal when her mother yelled at her and asked her why she was moving her lips. So she kept up her daydreaming in secret, hiding from friends at school, pretending to read a book, plugging in earphones to make it appear as if she was listening to music.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Then one day by chance, M met with a former classmate who drew her out. They fell in love, married and had a child, and for a while, the daydreams subsided.\u003c/p>\n\u003cp>But as life became more middle-class and mundane — dishwasher unloading, toothpaste in the sink — she found herself sneaking back into a world where she was the hero, the boss and every character in between.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>M worries that she has a newly diagnosed condition known as \u003ca href=\"https://www.healthline.com/health/mental-health/maladaptive-daydreaming#complications\" target=\"_blank\" rel=\"noopener\">maladaptive daydreaming\u003c/a>. Now, it's not in the mental health bible, aka the \u003cem>Diagnostic and Statistical Manual of Mental Disorders,\u003c/em> and doctors don't know what causes it. There's no official treatment, although \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/19062309\" target=\"_blank\" rel=\"noopener\">one case study\u003c/a> suggests fluvoxamine, an OCD drug, may help control the daydreams.\u003c/p>\n\u003cp>Whatever maladaptive daydreaming is, it can have real effects on a person's daily life. People who say they have the condition report having trouble making friends or even leaving the house. M worries she is one of them. She carves out time to daydream away from her husband and son who know nothing of her secret life. In fact, she says she has never told anyone about it.\u003c/p>\n\u003cp>M loves her never-ending story, yet she acknowledges her secret is isolating.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"As much as I hate the feeling of being torn and being in two places, I'm not ready to give up my daydreaming and I'm not ready to give up my characters and the feelings that those daydreams give me,\" she says.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Invisibilia%3A+When+Daydreaming+Gets+In+The+Way+Of+Real+Life&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/440672/when-daydreaming-gets-in-the-way-of-real-life","authors":["byline_futureofyou_440672"],"categories":["futureofyou_1060","futureofyou_1"],"tags":["futureofyou_56","futureofyou_61","futureofyou_204","futureofyou_1224"],"collections":["futureofyou_1093"],"featImg":"futureofyou_440673","label":"source_futureofyou_440672"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.","airtime":"SUN 2pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.possible.fm/","meta":{"site":"news","source":"Possible"},"link":"/radio/program/possible","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/possible/id1677184070","spotify":"https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"}},"1a":{"id":"1a","title":"1A","info":"1A is home to the national conversation. 1A brings on great guests and frames the best debate in ways that make you think, share and engage.","airtime":"MON-THU 11pm-12am","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/1a.jpg","officialWebsiteLink":"https://the1a.org/","meta":{"site":"news","source":"npr"},"link":"/radio/program/1a","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=1188724250&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/1A-p947376/","rss":"https://feeds.npr.org/510316/podcast.xml"}},"all-things-considered":{"id":"all-things-considered","title":"All Things Considered","info":"Every weekday, \u003cem>All Things Considered\u003c/em> hosts Robert Siegel, Audie Cornish, Ari Shapiro, and Kelly McEvers present the program's trademark mix of news, interviews, commentaries, reviews, and offbeat features. 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You ask the questions. You decide what Bay Curious investigates. 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Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. 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You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg","imageAlt":"KQED MindShift: How We Will Learn","officialWebsiteLink":"/mindshift/","meta":{"site":"news","source":"kqed","order":"2"},"link":"/podcasts/mindshift","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/mindshift-podcast/id1078765985","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5","npr":"https://www.npr.org/podcasts/464615685/mind-shift-podcast","stitcher":"https://www.stitcher.com/podcast/kqed/stories-teachers-share","spotify":"https://open.spotify.com/show/0MxSpNYZKNprFLCl7eEtyx"}},"morning-edition":{"id":"morning-edition","title":"Morning Edition","info":"\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. 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On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. 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