Monday, May 05, 2008

Mind and Brain -- Free Will, 'Quichua' Healers, Mind/Body Issues, and More

Lots of interesting posts/articles to mention today. The internets are filled with all manner of blogging and writing on the nature of the mind, in all its definitions.

First up this fine Monday, The Psychogeography of the USA.

Richard Florida is a researcher and author whose column, Where Do All the Neurotics Live?, appears in today’s Boston Globe. The article offers some interesting insights into the potential “psychogeography” of the United States.

Psychologists have shown that human personalities can be classified along five key dimensions: agreeableness, conscientiousness, extroversion, neuroticism, and openness to experience. And each of these dimensions has been found to affect key life outcomes from life expectancy and divorce to political ideology, job choices and performance, and innovation and creativity.

These are referred to as the “Big Five” personality factors by psychologists and can generally be measured by a test called the NEO-FFI, NEO PI-R, or something along those lines (here’s an online version, but it takes forever to complete). Wikipedia’s description of each of these traits is succinct:

The Big Five factors and their constituent traits can be summarized as follows:

Openness - appreciation for art, emotion, adventure, unusual ideas, imagination, curiosity, and variety of experience.

Conscientiousness - a tendency to show self-discipline, act dutifully, and aim for achievement; planned rather than spontaneous behaviour.

Extraversion - energy, positive emotions, surgency, and the tendency to seek stimulation and the company of others.

Agreeableness - a tendency to be compassionate and cooperative rather than suspicious and antagonistic towards others.

Neuroticism - a tendency to experience unpleasant emotions easily, such as anger, anxiety, depression, or vulnerability; sometimes called emotional instability.

Florida’s findings?

Interestingly, America’s psychogeography lines up reasonably well with its economic geography. Greater Chicago is a center for extroverts and also a leading center for sales professionals. The Midwest, long a center for the manufacturing industry, has a prevalence of conscientious types who work well in a structured, rule-driven environment. The South, and particularly the I-75 corridor, where so much Japanese and German car manufacturing is located, is dominated by agreeable and conscientious types who are both dutiful and work well in teams.

Is this a self-fulfilling prophecy? Do people move to a specific area because it’s full of people like themselves, or are these areas simply full of these kinds of people due to age-old immigration patterns? The research can’t really say, but Florida does make some educated guesses.

Read the rest of this interesting post, or go to the original article in the Boston Globe.

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Are there cross-cultural differences when it comes to the notions of free will and moral responsibility? Some philosophers decided to find out. This guest article was hosted at The Splintered Mind.

Crossing Cultures in Free Will (by Guest Blogger Hagop Sarkissian)

Academic philosophers are a fairly homogeneous bunch--mostly male, mostly white. So, when a philosopher proposes a thought experiment and then goes on to make a general claim of the form "in this case, most people would surely say that P" or "in this case, it is clearly the case that P", one might wonder whether the philosopher's intuitions really are so obvious or widely shared. Perhaps only philosophers, or male philosophers, or Western male philosophers, or Western male philosophers who maintain theory x, would find it obvious (or even entertain the idea) "that P".

Indeed, in recent years, experimental philosophers interested in such intuitions about particular cases (and their role in philosophical theories) have discovered that it's not hard to find significant cross-cultural variation. For example, recent studies have shown that Americans, East Asians and Indians may differ considerably in their intuitions concerning key thought experiments in epistemology and philosophy of language.

Some colleagues and I wanted to see whether this phenomenon held true for beliefs concerning free will and moral responsibility. We asked participants in Colombia, Hong Kong, India, and the United States what they thought about the following case. (For a video presentation of these questions, click here.):


Imagine a universe (Universe A) in which everything that happens is completely caused by whatever happened before it. This is true from the very beginning of the universe, so what happened in the beginning of the universe caused what happened next, and so on right up until the present. For example one day John decided to have French Fries at lunch. Like everything else, this decision was completely caused by what happened before it. So, if everything in this universe was exactly the same up until John made his decision, then it had to happen that John would decide to have French Fries.

Now imagine a universe (Universe B) in which almost everything that happens is completely caused by whatever happened before it. The one exception is human decision making. For example, one day Mary decided to have French Fries at lunch. Since a person’s decision in this universe is not completely caused by what happened before it, even if everything in the universe was exactly the same up until Mary made her decision, it did not have to happen that Mary would decide to have French Fries. She could have decided to have something different.

The key difference, then, is that in Universe A every decision is completely caused by what happened before the decision – given the past, each decision has to happen the way that it does. By contrast, in Universe B, decisions are not completely caused by the past, and each human decision does not have to happen the way that it does.

1. Which of these universes do you think is most like ours? (circle one)

Universe A-----Universe B

2. In Universe A, is it possible for a person to be fully morally responsible for their actions?

Read the rest. If you choose not to read it, here are the conclusions:
In all four cultures, the majority of participants responded as indeterminists and incompatibilists! That is, the majority of participants believed our own universe to be indeterministic, and denied that moral responsibility could be compatible with determinism.
Hmmm. . . . Other studies have suggested otherwise. So this is pretty interesting. Their discussion (read the comments) is also quite useful to understanding the results.

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For thousands of years, native healers have been the sole doctors in their communities. Be the illness physical or otherwise, you went to see the healer/shaman. In many cultures, the causes of disease, including mental illness, were thought to be malevolent spirits. We now think of that as magical thinking, but that doesn't mean that these healers are wrong when they diagnose illnesses.
'Quichua' Healers Of The Andes Diagnose Mental Illnesses

Yachactaitas (the Quichua healers of the Andes) may be identifying general psychiatric disorders in their communities, according to a study published in the May 2008 issue of the British Journal of Psychiatry.

Traditional healers' practices are widespread around the world, yet their diagnostic skills have rarely been investigated.

This exploratory study was carried out in Otavalo, in the province of Imbabura in the highlands of Ecuador. For over 18 months, 10 yachactaitas from three rural villages drew patients from the surrounding areas.

They identified 50 of these as having a condition known as llaqui. Each was referred to a Quichua-speaking physician trained in western transcultural psychiatry, and underwent the following investigations:

-- A structured interview, using a Quichua questionnaire on the nature of llaqui
-- A medical evaluation, including personal and medical history, and a physical examination
-- Laboratory tests, including blood, faecal and urine analysis, and an X-ray
-- Psychiatric evaluation and diagnosis, using established western diagnostic criteria
-- An adapted Quichua version of a self-rating depression scale

94% of the people studied lived in the rural villages of the Otavalo area. Most were peasant farmers, artisans or homemakers. 56% were illiterate, and an additional 34% had not completed elementary school education. 54% were male, and 65% married.

The Quichuas themselves (and the yachactaitas in particular) identify llaqui as a cluster of four illness sub-categories comprising a symptom (sadness), the name of an illness, life events and a causal factor of illness.

The first two sub-categories are merged into one, which can be translated as 'victim of malignant spirits.' The person is under attack by natural spirits or spirits under human control that will damage the person's body or soul.

The third sub-category ('heart pain or shattered heart') results from life events and sorcery. Among the Quichuas, land disputes, family conflicts and the death of a relative are the most stressful life events. This condition also resembles the symptoms of typical anxiety or depression.

The fourth sub-category ('victim of sorcery') is believed to result from the aggression of malignant spirits under human control (usually a healer), or by a physical or visual contact with materials used in the treatment of sorcery. People can have symptoms from more than one illness sub-category at the same time.

The western clinical diagnoses of the 50 participants with llaqui showed that 82% had a depressive disorder; 44% medically unexplained symptoms (somatoform disorders); and 40% anxiety disorders. Over 80% of them also had infectious or parasitic diseases.

The researchers comment that it is surprising that the Quichua healers, using supernatural and life events notions, seem to identify people who are psychiatrically ill. Since participants were identified as ill by both the yachactaita and by the biomedically trained doctor, a remarkable overlap is apparent in the diagnostic work of both practitioners.

The findings of this study are in line with those of previous studies in different and remote parts of the world. The results highlight the contribution of yachactaitas in the provision of mental healthcare for Quichua people living in the Andes, for whom government-funded psychiatric services are non-existent, say the researchers.

The yachactaitas' diagnostic abilities could be useful in the screening of patients in psychiatric epidemiological and public health research.

"Efficacy of Quichua healers as psychiatric diagnosticians"
Incayawar M (2008)
British Journal of Psychiatry 192, 5, pages 390-391
Click here to view Abstract online
Very cool. We often think that modern science is the only useful tool, but this study suggests that there are many ways to help people heal.

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One of the rising trends in psychology is mind/body medicine. Many of us are familiar with psychosomatic illnesses -- physical illness that is rooted in psychological issues -- but now researches are beginning to look at psychological illnesses rooted in the body.

From Brain Blogger:
Generalized Anxiety Disorder: The Mind/Body Connection

BioPsychoSocial Health Category

GAD or generalized anxiety disorder is defined as a disorder characterized by irrational, uncontrollable worry about everyday issues and events. While someone without GAD may find themselves anxious in certain scenarios, persons with GAD may be almost paralyzed with anxiety in situations that should not generate that level of fear and worry. This anxiety may manifest itself physically through hot flashes, an accelerated heart beat, sweating, muscle aches, irritability and health issues.

While it has long been known that GAD can affect someone physically, new research is pointing to potential causes for GAD. Reported in Archives of Internal Medicine, researchers are studying the effects of some conditions such as thyroid disease, arthritis, migraine and respiratory disease and their connection to the onset of GAD. They approached this study knowing that physical illness often leads to depression. They wanted to find out if physical illness may cause GAD or other anxiety disorders.


They studied more than 4,000 adults for two years for signs of the GAD mind/body connection. They included all anxiety disorders such as agoraphobia, obsessive-compulsive disorder and panic disorder. Their results thus far show an increased rate of anxiety disorders in patients suffering from physical conditions. They are trying to figure out how and why the connection exists. One thought is that when a person is suffering a physical illness they are faced with increased worry and anxiety, triggering the development GAD.

I would go one step further to say that it seems like the brain gets “stuck” in the worry and anxiety mode, and maybe it can’t get out of it due to the existing stress on the body caused by the illness. It would be interesting to see if GAD patients without illness triggers can recover from their GAD more easily.

It is the hope of researchers that these studies will have the same effect on the medical community as the depression/physical illness studies. As more was learned about depression and physical illness, more doctors watched for the signs in their patients and made treatments available. There may come a day when physical illness automatically leads to a mental health evaluation to help patients circumvent depression and anxiety.

Some doctors may begin to screen for GAD and prescribe antidepressant or anti-anxiety medication for conditions shown most likely to induce depression or anxiety disorders. In some cases this may be handled in a proactive manner if a patient is already an anxious or depressive person.


Sareen, J., Jacobi, F., Cox, B.J., Belik, S., Clara, I., Stein, M.B. (2006). Disability and Poor Quality of Life Associated With Comorbid Anxiety Disorders and Physical Conditions. Archives of Internal Medicine, 166(19), 2109-2116. DOI: 10.1001/archinte.166.19.2109

This is a good article. One of the first things a competent doctor will look at when someone presents with depression is thyroid function. It makes a lot of sense to rule out physical sources of symptoms first, before resorting to psychopharmacology.

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And now a couple of quick hits.

When Is "Tough Love" Torture? -- "At the first round of hearings last October, the GAO had released its initial report, finding "thousands" of allegations of child abuse, medical neglect and "reckless and negligent operating practices," in "boot camps, "wilderness programs" and "academies," which currently hold tens of thousands of American youth. Two additional GAO reports were introduced at the April hearings—with investigators describing the treatment of some of the youth as "torture." One youth was beaten for weeks and denied medical attention after a suicide attempt left him with an exposed bone from a broken arm; others were taunted, then ignored as they lay dying; some were even hooded and had nooses placed around their necks."

Blocking the Transmission of Violence
-- "The traditional response [to gang violence] has been more focused policing and longer prison sentences, but law enforcement does little to disrupt a street code that allows, if not encourages, the settling of squabbles with deadly force. Zale Hoddenbach, who works for an organization called CeaseFire, is part of an unusual effort to apply the principles of public health to the brutality of the streets. CeaseFire tries to deal with these quarrels on the front end. Hoddenbach’s job is to suss out smoldering disputes and to intervene before matters get out of hand. His job title is violence interrupter, a term that while not artful seems bluntly self-explanatory. Newspaper accounts usually refer to the organization as a gang-intervention program, and Hoddenbach and most of his colleagues are indeed former gang leaders. But CeaseFire doesn’t necessarily aim to get people out of gangs — nor interrupt the drug trade. It’s almost blindly focused on one thing: preventing shootings."

Transcendence as Cultural Identity -- "There is growing chorus of voices asserting that full human development cannot be achieved without regard for essential religious values; that achievements in political, social, economic, technical, artistic and scientific realms do not fully exhaust the creativity, beauty, or triumphs human beings are capable of; that a transcendent meaning system can be a powerful developmental force as a complement to secular commitments."

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