Chapter 18. Attention and Higher Cognition
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by Caroline Williams When it comes to making decisions, it seems that the conscious mind is the last to know. We already had evidence that it is possible to detect brain activity associated with movement before someone is aware of making a decision to move. Work presented this week at the British Neuroscience Association (BNA) conference in London not only extends it to abstract decisions, but suggests that it might even be possible to pre-emptively reverse a decision before a person realises they've made it. In 2011, Gabriel Kreiman of Harvard University measured the activity of individual neurons in 12 people with epilepsy, using electrodes already implanted into their brain to help identify the source of their seizures. The volunteers took part in the "Libet" experiment, in which they press a button whenever they like and remember the position of a second hand on a clock at the moment of decision. Kreiman discovered that electrical activity in the supplementary motor area, involved in initiating movement, and in the anterior cingulate cortex, which controls attention and motivation, appeared up to 5 seconds before a volunteer was aware of deciding to press the button (Neuron, doi.org/btkcpz). This backed up earlier fMRI studies by John-Dylan Haynes of the Bernstein Center for Computational Neuroscience in Berlin, Germany, that had traced the origins of decisions to the prefrontal cortex a whopping 10 seconds before awareness (Nature Neuroscience, doi.org/cs3rzv). "It's always nice when two lines of research converge and to know that what we see with fMRI is actually there in the neurons," says Haynes. © Copyright Reed Business Information Ltd.
Link ID: 18021 - Posted: 04.11.2013
By Linda Carroll, Kate Snow and Meghan Frank, NBC News As a little girl, Bonnie Ihme had big plans. Bright and artistically talented, she dreamed of becoming an architect. But the older she got, the more distant that dream seemed. By third grade, school had become a struggle. She felt easily distracted and found it impossible to focus in class. Eventually she abandoned her plan to be an architect. Ihme got married, had two kids and began cleaning houses and helping her husband with his business. But even that simpler life felt impossibly difficult. The Michigan mom had trouble keeping track of all the threads of her life. She’d send her kids to school without sneakers on gym day. She’d forget to bring library books back. She felt more overwhelmed than ever before. “I really would try hard to pull it all together,” Ihme told NBC’s Kate Snow in an interview airing on Rock Center Friday. “But when … you’re late for a Christmas concert that your daughter was really looking forward to going to and we get there and her class is walking back to the classroom and the tears in her eyes… you try harder.” Ihme saw history repeating itself in her 10-year-old son, Jacob, who began struggling with school, just as she had. Jacob would spend hours doing his homework, only to forget to bring it to school the next morning. Ihme’s heart ached for her son. © 2013 NBCNews.com
Link ID: 18001 - Posted: 04.08.2013
Barry Gordon, professor of neurology and cognitive science at the Johns Hopkins University School of Medicine, replies: We are aware of a tiny fraction of the thinking that goes on in our minds, and we can control only a tiny part of our conscious thoughts. The vast majority of our thinking efforts goes on subconsciously. Only one or two of these thoughts are likely to breach into consciousness at a time. Slips of the tongue and accidental actions offer glimpses of our unfiltered subconscious mental life. The intrusive thoughts you may experience throughout the day or before bed illustrate the disconcerting fact that many of the functions of the mind are outside of conscious control. Whether we maintain true control over any mental functions is the central debate about free will. Perhaps this lack of autonomy is to be expected as the foundations for almost all the mind's labors were laid long before our ancestors evolved consciousness. Even deliberate decisions are not completely under our power. Our awareness only sets the start and the end of a goal but leaves the implementation to unconscious mental processes. Thus, a batter can decide to swing at a ball that comes into the strike zone and can delineate the boundaries of that zone. But when the ball comes sailing through, unconscious mental functions take over. The actions required to send him to first base are too complex and unfold too quickly for our comparatively slow conscious control to handle. © 2013 Scientific American
Kerri Smith The experiment helped to change John-Dylan Haynes's outlook on life. In 2007, Haynes, a neuroscientist at the Bernstein Center for Computational Neuroscience in Berlin, put people into a brain scanner in which a display screen flashed a succession of random letters1. He told them to press a button with either their right or left index fingers whenever they felt the urge, and to remember the letter that was showing on the screen when they made the decision. The experiment used functional magnetic resonance imaging (fMRI) to reveal brain activity in real time as the volunteers chose to use their right or left hands. The results were quite a surprise. "The first thought we had was 'we have to check if this is real'," says Haynes. "We came up with more sanity checks than I've ever seen in any other study before." The conscious decision to push the button was made about a second before the actual act, but the team discovered that a pattern of brain activity seemed to predict that decision by as many as seven seconds. Long before the subjects were even aware of making a choice, it seems, their brains had already decided. As humans, we like to think that our decisions are under our conscious control — that we have free will. Philosophers have debated that concept for centuries, and now Haynes and other experimental neuroscientists are raising a new challenge. They argue that consciousness of a decision may be a mere biochemical afterthought, with no influence whatsoever on a person's actions. According to this logic, they say, free will is an illusion. "We feel we choose, but we don't," says Patrick Haggard, a neuroscientist at University College London. © 2013 Nature Publishing Group
Link ID: 17988 - Posted: 04.05.2013
By ALAN SCHWARZ and SARAH COHEN Nearly one in five high school age boys in the United States and 11 percent of school-age children over all have received a medical diagnosis of attention deficit hyperactivity disorder, according to new data from the federal Centers for Disease Control and Prevention. These rates reflect a marked rise over the last decade and could fuel growing concern among many doctors that the A.D.H.D. diagnosis and its medication are overused in American children. The figures showed that an estimated 6.4 million children ages 4 through 17 had received an A.D.H.D. diagnosis at some point in their lives, a 16 percent increase since 2007 and a 53 percent rise in the past decade. About two-thirds of those with a current diagnosis receive prescriptions for stimulants like Ritalin or Adderall, which can drastically improve the lives of those with A.D.H.D. but can also lead to addiction, anxiety and occasionally psychosis. “Those are astronomical numbers. I’m floored,” said Dr. William Graf, a pediatric neurologist in New Haven and a professor at the Yale School of Medicine. He added, “Mild symptoms are being diagnosed so readily, which goes well beyond the disorder and beyond the zone of ambiguity to pure enhancement of children who are otherwise healthy.” And even more teenagers are likely to be prescribed medication in the near future because the American Psychiatric Association plans to change the definition of A.D.H.D. to allow more people to receive the diagnosis and treatment. A.D.H.D. is described by most experts as resulting from abnormal chemical levels in the brain that impair a person’s impulse control and attention skills. © 2013 The New York Times Company
by Audrey Carlsen Plenty of us got our fill of green-colored food on St. Patrick's Day. (Green beer, anyone?) But for some people, associating taste with color is more than just a once-a-year experience. These people have synesthesia — a neurological condition in which stimulation of one sense (e.g., taste) produces experiences in a totally different sense (e.g., sight). According to researcher Sean Day, approximately one in 27 people has some form of synesthesia. We've covered this phenomenon in the past. And I'm a synesthete myself — I see letters and numbers in color, and associate sounds with shapes and textures. But only a very few people — maybe only 1 percent of synesthetes — have sensory crossovers that affect their relationship with food and drink. Jaime Smith is one of those people. He's a sommelier by trade, and he has a rare gift: He smells in colors and shapes. For Smith, who lives in Las Vegas, a white wine like Nosiola has a "beautiful aquamarine, flowy, kind of wavy color to it." Other smells also elicit three-dimensional textures and colors on what he describes as a "projector" in his mind's eye. This "added dimension," Smith says, enhances his ability to appraise and analyze wines. "I feel that I have an advantage over a lot of people, particularly in a field where you're judged on how good of a smeller you are," he says. ©2013 NPR
By Charles Q. Choi and Txchnologist Scientists scanning the human brain can now tell whom a person is thinking of, the first time researchers have been able to identify what people are imagining from imaging technologies. Work to visualize thought is starting to pile up successes. Recently, scientists have used brain scans to decode imagery directly from the brain, such as what number people have just seen and what memory a person is recalling. They can now even reconstruct videos of what a person has watched based on their brain activity alone. Cornell University cognitive neuroscientist Nathan Spreng and his colleagues wanted to carry this research one step further by seeing if they could deduce the mental pictures of people that subjects conjure up in their heads. “We are trying to understand the physical mechanisms that allow us to have an inner world, and a part of that is how we represent other people in our mind,” Spreng says. His team first gave 19 volunteers descriptions of four imaginary people they were told were real. Each of these characters had different personalities. Half the personalities were agreeable, described as liking to cooperate with others; the other half were less agreeable, depicted as cold and aloof or having similar traits. In addition, half these characters were described as outgoing and sociable extroverts, while the others were less so, depicted as sometimes shy and inhibited. The scientists matched the genders of these characters to each volunteer and gave them popular names like Mike, Chris, Dave or Nick, or Ashley, Sarah, Nicole or Jenny. © 2013 Scientific American
by Jennifer Viegas Polly may want a cracker, but when a parrot wants a better deal, it will trade a so-so nut for an even better snack, a new study has found. The discovery, published in the journal Biology Letters, demonstrates that birds can do business in their own way, wheeling and dealing with nuts. It also shows that they can exhibit remarkable self restraint, even performing better than some children. In studies from the 1970s, kids were presented with a marshmallow and were told that they could either eat it now, or wait and receive a second one if they could hold out for a time delay of some minutes. Kids that were able to wait have been more successful now as adults than the other kids (who gulped down the first marshmallow). The ability to strategically wait therefore is very important in the course of human development. Now we can say that it’s important to bird development too. For the new study, Alice Auersperg of the University of Vienna’s Department of Cognitive Biology and colleagues presented an Indonesian cockatoo species, the Goffin’s cockatoo, with food snack options. The best of that bunch, from the bird’s perspective, were pecan nuts. Mirroring the kid-marshmallow experiment, the researchers next offered the birds an even better deal. If the birds did not eat the pecan, they could trade it for a cashew. (Who knew that cockatoos loved cashews so much? Apparently they are the yummiest nut of all, for at least this particular avian species.) © 2013 Discovery Communications, LLC
By Jan Brogan Paula Driscoll had a hard time sitting still as a kid, doodled a lot, and often wrestled with the feeling that she should be accomplishing more. But she made it through high school and college and became an elementary school teacher. With three small children at home, she did not feel she had trouble managing her life. But when her youngest child went to school, she found herself with what felt like too much time on her hands. “I couldn’t get anything done,” she said. “I had one room I started to paint, another I was going to reorganize, and I could never complete a task. I couldn’t stay in the house. I went out on one errand after the next.” Driscoll was 45 when she was diagnosed with attention deficit hyperactivity disorder, or ADHD. ADHD, a neurobiological disorder that makes it difficult to focus and can also include hyperactivity and impulsivity, has historically been viewed as a childhood disease. Over the last couple decades, research has shown that many of those afflicted carry symptoms into adulthood. The latest study, led by a Boston Children’s Hospital researcher and published Monday in the journal Pediatrics, suggests that nearly 30 percent of those with childhood ADHD still have the condition as adults — often after discontinuing treatment. The researchers followed hundreds of children with ADHD into adulthood and reported that the majority had mental health problems such as alcohol or drug dependence, anxiety, depression, or a personality disorder. © 2012 NY Times Co.
Jennifer Raymond I have a bias against women in science. Please don't hold this against me. I am a woman scientist, mentor and advocate for women in science, and an associate dean in my school's Office of Diversity, with a budding field biologist as a daughter. Yet my performance on the Implicit Association Test (https://implicit.harvard.edu/implicit/demo), which measures unconscious associations between concepts, revealed that I have a tendency to associate men with science and career, and women with liberal arts and family. I didn't even need to wait for my score; I could feel that my responses were slower and that I made more mistakes when I had to group science words such as 'astronomy' with female words such as 'wife' rather than male words such as 'uncle'. The results from hundreds of thousands of people indicate that I am not an outlier — 70% of men and women across 34 countries view science as more male than female1. Gender bias is not just a problem in science. A host of studies shows that people tend to rate women as less competent than men across many domains, from musical abilities to leadership2, and that many individuals hold biases about competency on the basis of other irrelevant attributes, such as skin colour, body weight, religion, sexual orientation and parental status. Such biases have important consequences in the workplace. One study showed that mothers are 79% less likely to be hired and are offered US$11,000 less salary than women with no children3. By contrast, the same study shows that parenthood confers an advantage to men in the workplace. © 2013 Nature Publishing Group,
by Trevor Quirk Many smartphones claim to filter out background noise, but they've got nothing on the human brain. We can tune in to just one speaker at a noisy cocktail party with little difficulty—an ability that has been a scientific mystery since the early 1950s. Now, researchers argue that the competing noise of other partygoers is filtered out in the brain before it reaches regions involved in higher cognitive functions, such as language and attention control. Their experiments were the first to demonstrate this process. The scientists didn't do anything as social as attend a noisy party. Instead, Charles Schroeder, a psychiatrist at the Columbia University College of Physicians and Surgeons in New York City, and colleagues recorded the brain activity of six people with intractable epilepsy who required brain surgery. In order to identify the part of their brains responsible for seizures, the patients underwent 1 to 4 weeks of observation through electrocorticography (ECoG), a technique that provides precise neural recordings via electrodes placed directly on the surface of the brain. Schroeder and his team, using the ECoG data, conducted their experiments during this time. The researchers showed the patients two videos simultaneously, each of a person telling a 9- to 12-second story; they were asked to concentrate on just one speaker. To determine which neural recordings corresponded to the "ignored" and "attended" speech, the team reconstructed speech patterns from the brain's electrical activity using a mathematical model. The scientists then matched the reconstructed patterns with the original patterns coming from the ignored and attended speakers. © 2010 American Association for the Advancement of Science.
by Elizabeth Norton The prospect of undergoing surgery while not fully "under" may sound like the stuff of horror movies. But one patient in a thousand remembers moments of awareness while under general anesthesia, physicians estimate. The memories are sometimes neutral images or sounds of the operating room, but occasionally patients report being fully aware of pain, terror, and immobility. Though surgeons scrupulously monitor vital signs such as pulse and blood pressure, anesthesiologists have no clear signal of whether the patient is conscious. But a new study finds that the brain may produce an early-warning signal that consciousness is returning—one that's detectable by electroencephalography (EEG), the recording of neural activity via electrodes on the skull. "We've known since the 1930s that brain activity changes dramatically with increasing doses of anesthetic," says the study's corresponding author, anesthesiologist Patrick Purdon of Massachusetts General Hospital in Boston. "But monitoring a patient's brain with EEG has never become routine practice." Beginning in the 1990s, some anesthesiologists began using an approach called the bispectral (BIS) index, in which readings from a single electrode are connected to a device that calculates, and displays, a single number indicating where the patient's brain activity falls on a scale of 100 (fully conscious) to zero (a "flatline" EEG). Anything between 40 and 60 is considered the target range for unconsciousness. But this index and other similar ones are only indirect measurements, Purdon explains. In 2011, a team led by anesthesiologist Michael Avidan at the Washington University School of Medicine in St. Louis, Missouri, found that monitoring with the BIS index was slightly less successful at preventing awareness during surgery than the nonbrain-based method of measuring exhaled anesthesia in the patient's breath. Of the 2861 patients monitored with the BIS index, seven had memories of the surgery, whereas only two of 2852 patients whose breath was analyzed remembered anything. © 2010 American Association for the Advancement of Science.
By George Johnson In the week since I wrote about Oliver Sacks and the idiot savant twins, I’ve been catching up with Season 2 of “Touch,” the TV series about an autistic boy named Jake who has an inexplicable ability to commune with a secret world of numbers — a buried skein of mathematics in which the Golden Mean, the fibonacci sequence, the genetic code, and the Kabbalah are all mysteriously connected. Jungian synchronicity, quantum entanglement, chaos theory — all turn out to be manifestations of an underlying order in which everything that perplexes us ultimately makes sense. It is the dream of both mystics and scientists, and I had wondered shortly after the show first began how the conceit was going to be sustained through more than a few episodes. The connecting thread has turned out to be a conspiracy by a shadowy corporation called AsterCorp — as secretive and powerful as Massive Dynamic, purveyors of the mind-enhancing medicine Cortexiphan in “Fringe” — to kidnap Jake and others like him in their attempt to control the world. Or the universe. It is too soon to tell. Dr. Sacks’s twins, with their power to see, hear, smell — somehow sense within minutes if a number was prime — would also have been on AsterCorp’s wish list. Something keeps pulling me back to Sacks’s story. That is how enchanting a writer he is. (His memoir, Uncle Tungsten, is my favorite of his books.) There are plenty of accounts in the psychiatric literature of amazing human calculators and mnemonists. Sacks describes some famous cases in his essay. But what he thought he saw in the twins went far beyond that. Somehow, as Sacks described it, they could recognize that a number is prime in the way that one might recognize a face. Something on the surface of 3334401341 told them it was prime while 3334401343 was not.
Link ID: 17867 - Posted: 03.05.2013
by Sheila M. Eldred Picture someone with attention deficit hyperactivity disorder, or ADHD, and you probably conjure up an image of an elementary school-age boy. But an analysis of data from the first large, population-based study to follow kids through to adulthood shows that the neurobehavioral disorder rarely goes away with age. Indeed, as ADHD patients make the transition to adulthood, the issues they face often multiply: they are more likely to have other psychiatric disorders and even commit suicide, reports a new study published online today in Pediatrics. NEWS: ADHD Linked to Missing Genes In fact, researchers found that only 37.5 percent of the adults who had been diagnosed with the disorder as a child were free of other psychiatric disorders, including alcohol and drug dependence, in their late 20s. Very few of the children with ADHD were still being treated as adults -- although neuropsychiatric interviews confirmed that 29 percent still had it. “I think there has been a view that ADHD is a childhood disorder, and it’s only relatively recently that people have been trained to detect it in adults,” said Nathan Blum, a developmental-behavioral pediatrician at Children’s Hospital in Philadelphia, who was not involved in the study. Among the adults who’d had ADHD as a child, 57 percent had at least one other psychiatric disorder, compared with 35 percent of the controls. Just under 2 percent percent had died; of the seven deaths, three were suicides. Of the controls, less than 1 percent had died. Of those 37 deaths, five were from suicide. And 2.7 percent were incarcerated at the time of recruitment for the study. © 2013 Discovery Communications, LLC.
Link ID: 17865 - Posted: 03.04.2013
By Daisy Yuhas It's news chocolate lovers have been craving: raw cocoa may be packed with brain-boosting compounds. Researchers at the University of L'Aquila in Italy, with scientists from Mars, Inc., and their colleagues published findings last September that suggest cognitive function in the elderly is improved by ingesting high levels of natural compounds found in cocoa called flavanols. The study included 90 individuals with mild cognitive impairment, a precursor to Alzheimer's disease. Subjects who drank a cocoa beverage containing either moderate or high levels of flavanols daily for eight weeks demonstrated greater cognitive function than those who consumed low levels of flavanols on three separate tests that measured factors that included verbal fluency, visual searching and attention. Exactly how cocoa causes these changes is still unknown, but emerging research points to one flavanol in particular: (-)-epicatechin, pronounced “minus epicatechin.” Its name signifies its structure, differentiating it from other catechins, organic compounds highly abundant in cocoa and present in apples, wine and tea. The graph below shows how (-)-epicatechin fits into the world of brain-altering food molecules. Other studies suggest that the compound supports increased circulation and the growth of blood vessels, which could explain improvements in cognition, because better blood flow would bring the brain more oxygen and improve its function. Animal research has already demonstrated how pure (-)-epicatechin enhances memory. Findings published last October in the Journal of Experimental Biology note that snails can remember a trained task—such as holding their breath in deoxygenated water—for more than a day when given (-)-epicatechin but for less than three hours without the flavanol. Salk Institute neuroscientist Fred Gage and his colleagues found previously that (-)-epicatechin improves spatial memory and increases vasculature in mice. “It's amazing that a single dietary change could have such profound effects on behavior,” Gage says. If further research confirms the compound's cognitive effects, flavanol supplements—or raw cocoa beans—could be just what the doctor ordered. © 2013 Scientific American
By George Johnson The mystery of whether there is a natural resonance between music and our brains, as I mentioned in a post last week, brings up an even deeper question: whether mathematics itself is neurologically innate, giving the mind (or some minds) direct access to the structure of the universe. Thinking about that recently led me back to one of Oliver Sack’s most astonishing essays. It appeared in his collection The Man Who Mistook His Wife for a Hat, and is about two twins, idiot savants who appeared to have an almost supernatural ability to quickly tell if a number is prime. Prime numbers are those that cannot be broken down into factors — smaller numbers that can be multiplied together to produce the larger one. They have been described as the atoms of the number system. 11 and 13 are obviously prime while 12 and 14 are not. But with larger numbers our brains are quickly flummoxed. Is 7244985277 prime? I just typed the digits by twitching my fingers along the top row of my keyboard. To test the number by hand I would have to start at the beginning of the number system and begin trying out the possible divisors. There are shortcuts to avoid testing every single one. We know 2 can’t be a factor since 7244985277, like all primes, is odd. For the same reason we can rule out all even factors. And you only have to test factors up to the square root of a number. (The factors of 100 are 2 x 50, 4 x 25, 5 x 20, and 10 x 10. Testing beyond 10 would be redundant.)
Link ID: 17847 - Posted: 02.26.2013
by Julia Sklar IT IS a nightmare situation. A person diagnosed as being in a vegetative state has an operation without anaesthetic because they cannot feel pain. Except, maybe they can. Alexandra Markl at the Schön clinic in Bad Aibling, Germany, and colleagues studied people with unresponsive wakefulness syndrome (UWS) – also known as vegetative state – and identified activity in brain areas involved in the emotional aspects of pain. People with UWS can make reflex movements but can't show subjective awareness. There are two distinct neural networks that work together to create the sensation of pain. The more basic of the two – the sensory-discriminative network – identifies the presence of an unpleasant stimulus. It is the affective network that attaches emotions and subjective feelings to the experience. Crucially, without the activity of the emotional network, your brain detects pain but won't interpret it as unpleasant. Using PET scans, previous studies have detected activation in the sensory-discriminative network in people with UWS but their findings were consistent with a lack of subjective awareness, the hallmark of the condition. Now Markl and her colleagues have found evidence of activation in the affective or emotional network too (Brain and Behavior, doi.org/kfs). © Copyright Reed Business Information Ltd.
By Ingrid Wickelgren How many times have you arrived someplace but had no memory of the trip there? Have you ever been sitting in an auditorium daydreaming, not registering what the people on stage are saying or playing? We often spin through our days lost in mental time travel, thinking about something from the past, or future, leaving us oblivious to what is happening right around us right now. In doing so, we miss much of life. We also make ourselves relatively miserable, and prone to poor performance and mishaps. peaceful scene, village by the water. The opposite mental state, mindfulness, is a calm, focused awareness of the present. Cultivating that state is associated with improvements in both mental and physical health, as you will learn from the current cover story of Scientific American Mind (see “Mindfulness Can Improve Your Attention and Health” by Amishi P. Jha). It can even ameliorate mental illness. It turns out that mindfulness training works in large part by training our ability to pay attention. As we learn to focus on the here and now, we also learn to manipulate our mental focus more generally. The ability to direct our own minds at will means we control what we think about. It is no wonder that honing such a skill can make us happier. It can also boost the performance of soldiers, surgeons, athletes and many others who need to maintain a tight focus on what they are doing. Some people are naturally more mindful than others, but it is possible to train yourself to enter this state more often. Simple exercises performed as little as 12 minutes daily can help you become more mindful. For a sample exercise, watch this video “Learn to Live in the Now.” © 2013 Scientific American
Link ID: 17824 - Posted: 02.19.2013
by Nic Halverson By studying a magic trick that has been around for thousands of years, neuroscientists have shed light on human attention and visual systems -- as well as on the trick, itself. "Magicians, in particular, are very intellectual performance artists. They are very interested in the mind and how behavior happens," Dr. Stephen Macknik, director of the Laboratory of Behavioral Neurophysiology at the Barrow Neurological Institute(BNI), told Discovery News. "What scientists are doing when we study perception is pretty much the same thing, except we're using the scientific method." The hope is that magicians' intuitive insight could help instruct the field of neuroscience and perhaps, even be applied in medicine to help people with attention deficit issues. In their study, recently published in the inaugural issue of PeerJ, the researchers focused upon a famous trick by a pair of very famous magicians. Penn & Teller's 10-year run at The Rio All-Suite Hotel & Casino has made them one of the longest-running and most beloved acts in Las Vegas history. Their trick, "Cups and Balls," is a classic illusion performed by Roman magicians as far back as 2,000 years ago when gladiators still battled in the Colosseum. While the trick has many derivatives, the most common uses three brightly colored balls and three opaque cups. Using sleight-of-hand, the magician seemingly makes the balls pass through the bottoms of cups, jump from cup to cup, disappear and reappear elsewhere or turn into entirely different objects. In Penn & Teller's case, that different object is often a potato. © 2013 Discovery Communications, LLC. T
Link ID: 17792 - Posted: 02.13.2013
By melody Yesterday, Alan Schwarz, reporting for the Sunday edition of The New York Times, published an alarmist piece on Adderall abuse. The story chronicles the short life of Richard Fee, a popular young pre-med who, after dabbling in fast-acting stimulants in college, faked his way into an ADHD diagnosis and, within months of filling his first prescription, began heavily abusing the drug, leading to severe addiction and psychosis, and ultimately to his suicide, two years ago, at the age of twenty-four. The story of Richard Fee is a tragic one, and one that highlights both the dangers of prescribing ADHD drugs to neurotypical adults and some of the problems endemic in psychiatric diagnosis. Regrettably, the reporter seems to believe that these problems are somehow specific to amphetamines, signaling “widespread failings in the system through which five million Americans take medication for ADHD”, and that Richard’s harrowing case, while undoubtedly rare, “underscores aspects of ADHD treatment that are mishandled every day with countless patients”. Schwarz is a Pulitzer-prize nominated journalist, renowned for exposing the danger of concussive head injuries in football. More recently, he has cast that same critical eye on how attention-deficit disorder is diagnosed. The question is – to what end? Presumably – in the case of this story – to tighten the restrictions on how amphetamines are prescribed to adults, and to ward against the kind of negligence and lack of oversight that characterized Richard’s case. But there is a delicate balance to be struck here between serving the needs of the ADHD population, many of whom benefit tremendously from the regulated use of stimulants, and potential drug addicts, like Richard. It is also far from clear, given the nature of psychiatric nosology, that there are any surefire ways of stopping con-artists and addicts from gaming the system. © 2013 Scientific American