The Scientific Journals

By : John Horgan


The first thing one notices on entering New York City’s cavernous Jacob Javits Center, site of the 149th annual meeting of the American Psychiatric Association, is the Eli Lilly exhibit. The golden, shrinelike tower emblazoned with “Prozac” in Day-Glo red stands amid interactive video screens and fiercely cheerful Lilly salespeople touting the wonders of the best-selling antidepressant (sales topped $2 billion last year).

Some 16,000 people—including psychiatrists, psychotherapists, researchers and drug-company representatives—have gathered here in early May for lectures on everything from “Kids Who Kill” and “The Psychobiology of Binge Eating” to emerging markets for psychiatric services. One “area of opportunity,” reveals Melvin Sabshin, medical director of the APA, is forensic psychiatry. “We have more people with psychiatric disorders in jails and prisons than in hospitals,” he explains.


A big buzzword is “parity”—the principle that insurance companies should provide the same coverage for mental disorders as they do for physical ones. A bill calling for mentalhealth parity won approval from the Senate in April after heavy lobbying by the APA but still has to run the gauntlet of the House. “This is about fairness,” declares Marge Roukema—a Republican representative from New Jersey and a fierce advocate of parity—to a cheering audience. Most people who see therapists, argues Roukema (who happens to be married to a psychoanalyst), are not self-absorbed neurotics like the ones depicted in Woody Allen films but people with a real need.

Psychiatrists here voice concern about the encroachment of psychologists and social workers, who usually  charge less than psychiatrists do. On the other hand, psychiatrists are M.D.’s and can prescribe drugs, which are cheaper than protracted talk therapy. And psychiatrists flock to breakfasts and dinners featuring lectures on the latest drugs for insomnia and depression—meals sponsored by Pfizer, SmithKline Beecham and other pharmaceutical firms.

Not every attendee embraces the better-living-through-chemistry philosophy. At a session entitled “The Future of Psychotherapy,” which is attended by only 20 or so people, Gene L. Usdin, a psychiatrist at the Ochsner Clinic in New Orleans, frets that “we are selling our souls” to the drug companies. Another dissenter is a sales rep for Somatics, which has a modest booth in the shadow of the Prozac pavilion. His company, he claims, provides a far more effective treatment for severely depressed patients: electroconvulsive therapy.

By : David Schneider

Linear A, an ancient script, is unearthed in Turkey.

MINOAN POTTERY Recovered from mainland Turkey

Throughout this century, scholars studying the ancient civilizations of the Mediterranean have pondered a vexing puzzle. The mystery unfolded soon after 1900, when the English archaeologist Sir Arthur J. Evans began excavating the buried palace of Minos at Knossos on the island of Crete. Among the many artifacts found were clay tablets bearing two related forms of unintelligible writing that Evans termed Linear A and Linear B script.

Evans, along with many other classicists, struggled for decades to decode the enigmatic symbols. It was an amateur—a young English architect named Michael G. Ventris—who finally deciphered Linear B in 1952, concluding correctly that the language it represented was archaic Greek. The older and more rarely
preserved Linear A code seemed obviously of a different origin, but the identity of that language remained unknown. Now an archaeological discovery in Turkey links the authors of that script—the so-called Minoans—with lands to the east.

There are many thoughts about what language the far-ranging Minoans spoke. Some scholars believe Linear  A inscriptions may be in the language of the Hittites, who some 4,000 years ago dominated what is now Turkey. Others suggest that Linear A transcribes Luwian, a more obscure ancient language of that area. Some have proposed that Linear A symbols spell out Semitic words. It also may be completely possible that the mysterious dialect of the Minoans is not related to any known language at all.

Because there is so little certainty about the origin or extent of Minoan civilization, scholars have been particularly intrigued by the recent findings: Wolf- Dietrich Niemeier of the University of Heidelberg’s Archeological Institute has discovered Minoan artifacts bearing Linear A script on mainland Turkey, marking a strong connection between the ancient inhabitants of Crete and the mainland to the east.

Niemeier’s work began in 1994, at the ruins of Miletus. He had returned to excavations made there by German teams during the 1950s and 1960s. Niemeier installed powerful pumps to lower the water table so that he could explore even deeper levels. Although his initial discovery of Linear A was made during the first season of fieldwork, he did not realize the significance of the find. He thought the curious marks incised on a  shard of pottery were just a graffito, a mere doodle. But in the second year his team uncovered two additional pieces with similar inscriptions. At that point, Niemeier remarks, “I recognized it immediately as Linear A.” He remembered the earlier discovery: “We pulled out the box with the shard, the so-called graffito, and it matched.”

According to Thomas G. Palaima, chairman of the department of classics at the University of Texas at Austin, “There’s absolutely no doubt that this is Linear A.” With only small fragments of pottery bearing three signs found so far, there is not much to read—even if one knew how. Still, this cryptic message helps to paint a picture of the Minoans who lived some 36 centuries ago.

Because Minoan artifacts have been found on several of the Aegean Islands, experts have wondered whether these people presided over a maritime empire that stretched beyond Crete. Did they, for example, rule  overseas colonies, or was it just that they exported their wares? (To make an analogy, one might find Chinese porcelain among items from Victorian England, yet it would be wrong to conclude that China had dominated the British Isles.)

From the type of clay used, it is apparent that the pottery in Miletus was made locally. It is also clear that these Linear A symbols were inscribed before the pot on which they were written was fired. According to  Palaima, these facts (and the observation that one of the signs is rather rare) suggest that Minoan speakers must have been there—probably as members of a Minoan colony.

Greater insight into Minoan society would come from reading Linear A inscriptions, but decoding remains elusive, in part because so few examples have been available to scrutinize. Perhaps archaeologists as determined as Niemeier will eventually recover sufficient text to make decipherment possible. But for the time being, the mystery of Linear A endures.

By : Tim Beardsley in Washington, D.C.

Finding a purpose for sleep has been as elusive as rest to an insomniac, but researchers are getting much closer.

SLEEP RESEARCHERS hope to understand the mechanisms of sleep disorders, which afflict millions of people.

Sleep may well be “a gentle thing, beloved from pole to pole,” as Samuel Taylor Coleridge observed. For physiologists, it remains a biological mystery of the first order. Why should mammals and birds spend such a large part of their lives unresponsive and, worse, vulnerable? Although denying an animal sustenance produces bodily changes that are readily measured, nobody understands what harm is done to an animal—or a person —deprived of sleep. Yet something clearly goes terribly wrong. Researchers have known for more than a decade that a rat prevented from sleeping will lose the ability to maintain body heat and die in about three  weeks, leaving no clues in the form of physiological damage. For humans, sleep deprivation undermines thinking, but science has no explanation.

There are, however, plenty of theories—and thus plenty of enmity in the field. Sleepers lower their metabolic rate, thereby conserving energy. But this does not explain why we lose consciousness. Most researchers believe sleep benefits the brain, perhaps by giving neurons a chance to recuperate. Some, pointing to the fervid neuronal activity during the bouts of REM (rapid-eye movement) sleep that punctuate our nights, suggest we doze to consolidate memories. Others propose that dreams are mental junk being eliminated: we sleep to forget. Although it is too soon to proclaim the conundrum of sleep solved, findings are illuminating processes that seem to control it. At the same time, investigators are refining their ideas about the benefits of slumber for the brain. Understanding its purposes may ultimately help the millions of people who suffer from sleep disorders, which range in severity from the merely irritating to the fatal.

The starting point for many investigations into the control of sleep has been the hypothalamus, a platformlike structure in the brain that has long been known to have an important role. Damage to the back part of the hypothalamus causes somnolence, suggesting that when intact, it maintains alertness. Damage near the front part, in contrast, induces insomnia, indicating that the spur to sleep is there. Investigators have long looked for a controlling circuit for slumber that operates between the two halves of the hypothalamus.

The hypothalamus also plays a part in temperature regulation, and some physiologists have speculated that sleep evolved out of a more primitive thermostat. Last year M. Noor Alam, Dennis McGinty and Ronald Szymusiak of the Department of Veterans Affairs Medical Center in Sepulveda, Calif., found the first evidence of neurons that fill both functions. The team discovered neurons in the front part of the hypothalamus of cats that fire more rapidly when they are warmed by two degrees Celsius—and automatically increase their firing rate while the animal sleeps. The researchers suggest that these neurons are part of the body’s thermostat and that they are responsible for controlling naturally occurring non-REM sleep.

A related discovery was reported earlier this year by Jonathan E. Sherin, Priyattam J. Shiromani, Robert W. McCarley and Clifford B. Saper of Harvard Medical School. These workers uncovered evidence that clusters of neurons in part of the front hypothalamus of rats—a site called the ventrolateral preoptic (VLPO)—seem to be activated when the animal is not awake. The researchers tracked the levels of a gene product that appears to be present whenever a cell is busy: the busy signal in these neurons was greater in animals that had slept more.


Sherin and his colleagues then took another step. They had previously suspected that neurons in the VLPO region send extensions to the rear part of the hypothalamus. By injecting what is called a retrograde tracer into the suspected target region in the rear of the hypothalamus and then following the diffusion of the tracer, they proved that the sleep-active neurons in the VLPO area did indeed project to the back part of the hypothalamus, where they wrap around their target cells. The pathway “probably is playing a major role and may play a critical role in helping sleep,” according to Saper.

Evidence from two quite different avenues of inquiry is consistent with the idea that a crucial piece of the  puzzle resides in that region. One is narcolepsy, which affects 250,000 Americans, causing them suddenly and unpredictably to lose muscle control and fall asleep. Any emotionally laden event—even hearing a joke—can trigger such attacks. Neurologists have supposed that some specific type of brain damage must underlie the condition, but nobody has been able to pinpoint it.

Until now. Jerome M. Siegel of the University of California at Los Angeles studied the brains of narcoleptic Doberman pinschers and found destruction of cells in the amygdala, a region involved in emotional responses. Damage to these areas could explain the symptoms of narcolepsy, Siegel suggests. Moreover, neurons run from the amygdala to the front part of the hypothalamus. It is therefore possible, others observe, that cell death in the amygdala might somehow influence the VLPO, bringing on drowsiness and the loss of muscle control characteristic of REM sleep.

Another VLPO clue comes from studies of circadian rhythms, described roughly as a 24-hour cycle of sleep and waking. Recognized as providing one cue for sleep in animal studies, the circadian clock resides in a part of the hypothalamus called the suprachiasmatic nucleus. And the suprachiasmatic nucleus sends neuronal projections to the VLPO, Saper reports. This pathway could be what directs signals about the time of day from the suprachiasmatic nucleus to the VLPO region.

Details of the neural circuitry that turn on sleep beg the question of what sleep is ultimately for. No damage to the brain prevents sleep indefinitely, notes James M. Krueger of the University of Tennessee. Therefore, Krueger argues, the final explanation must involve a benefit to neural functioning. And he asserts that the benefit is closely linked to the immune system.

Krueger points to experiments conducted by Carol A. Everson, also at Tennessee, showing that rats deprived of sleep have high numbers of bacterial pathogens that are normally suppressed by the immune system. Everson says there is little doubt that the bacteria eventually kill the rats. The exhausted, dying rats fail to develop fever, which would be the normal response to infection. Prolonged sleep deprivation, then, apparently dangerously suppresses the immune system. In humans, even moderate sleep deprivation has a detectable influence on immune system cells.

Further, the effect of sleep on the immune system is not a one-way street: the immune system affects sleep in return. Infections are well known to cause sleepiness, and Krueger has shown that several cytokines, molecules that regulate immune response, can by themselves induce slumber. In addition, cytokines have direct effects on neural development. Krueger and his colleagues have recently demonstrated that in rats, a gene for one cytokine becomes more active in the brain during sleep. He suggests that cytokine activity during sleep reconditions the synapses, the critical junctions between neurons, thereby solidifying memories. The  cytokines also keep the immune system in shape. Neural pathways like the one in the VLPO region, according to Krueger, may simply coordinate a process that arises at the level of small groups of neurons.

Many physiologists still regard Krueger’s ideas as speculative—but later this year Krueger says he will present hard data indicating that cytokines are involved in normal sleep. Genetically engineered mice that lack receptors for two important cytokines, interleukin-1 and tumor necrosis factor, sleep less than usual, Krueger says. So these and related cytokines may well trigger normal sleep in healthy animals, not just the sleepiness of infection and fever.

Whether cytokines, heat-sensitive neurons and the VLPO area indeed hold the key to understanding sleep is a question for the future. But one thing is clear: sleep researchers have never before had so many tantalizing leads or such a full agenda.

by : Uta Frith

SELF-ABSORPTION displayed by this autistic girl is a common feature of the disorder. In the motion picture Rain Man, self-absorption was the key trait of the central character, an autistic adult portrayed by actor Dustin Hoffman.

The old image of the child in the glass shell is misleading in more ways than one. It is incorrect to think that  inside the glass shell is a normal individual waiting to emerge, nor is it true that autism is a disorder of  childhood only. The motion picture Rain Man came at the right time to suggest a new image to a receptive public. Here we see Raymond, a middle-aged man who is unworldly, egocentric in the extreme and all too amenable to manipulation by others. He is incapable of understanding his brother’s double-dealing pursuits, transparently obvious though they are to the cinema audience. Through various experiences it becomes possible for the brother to learn from Raymond and to forge an emotional bond with him. This is not a farfetched story. We can learn a great deal about ourselves through the phenomenon of autism.

Yet the illness should not be romanticized. We must see autism as a devastating handicap without a cure. The autistic child has a mind that is unlikely to develop self-consciousness. But we can now begin to identify the particular types of social behavior and emotional responsiveness of which autistic individuals are capable. Autistic people can learn to express their needs and to anticipate the behavior of others when it is regulated by external, observable factors rather than by mental states. They can form emotional attachments to others. They often strive to please and earnestly wish to be instructed in the rules of person-toperson contact. There is no doubt that within the stark limitations a degree of satisfying sociability can be achieved.

Autistic aloneness does not have to mean loneliness. The chilling aloofness experienced by many parents is not a permanent feature of their growing autistic child. In fact, it often gives way to a preference for company. Just as it is possible to engineer the environment toward a blind person’s needs or toward people with other special needs, so the environment can be adapted to an autistic person’s needs.

On the other hand, one must be realistic about the degree of adaptation that can be made by the limited person. We can hope for some measure of compensation and a modest ability to cope with adversity. We cannot expect autistic individuals to grow out of the unreflecting mind they did not choose to be born with. Autistic people in turn can look for us to be more sympathetic to their plight as we better understand how their minds are different from ours.

by : Uta Frith

BRAIN SCANS show differences in activity between normal and autistic people. In normal persons reading a story that requires inferring the mental state of others, the left medial prefrontal cortex of the brain was active (left). In persons with Asperger syndrome performing the same task, an adjacent lower area was active instead (right). The left medial prefrontal cortex may be a key component of the theory of mind capability.

The astonishing variability in the signs and symptoms of autism is only beginning to be fully appreciated. Some  autistic individuals never develop speech or nonverbal communication, whereas others become fluent and can  pass for normal in social interactions. A screening test that identifies the lack of shared attention, pretend play and eye contact characteristic of autism—developed by Simon Baron-Cohen of the University of Cambridge and his colleagues at Guys Hospital in London—appears to be remarkably successful in predicting autism in children as young as 18 months.

The most severe cases of autism are associated with mental retardation, but IQ does not consistently correlate with abilities and special talents. Some studies report that up to 10 percent of the autistic population has a savant skill—exceptional ability in one area, such as playing the piano, drawing or mathematics. Significantly, almost all savants are diagnosed as autistic.

One of the most important advances in the field has been the growing recognition of a subgroup of autistic individuals who possess high verbal ability and develop a high degree of social awareness by utilizing an acquired, nonintuitive theory of mind. This variant of autism is called Asperger syndrome, and some individuals who exhibit it have successful academic careers in spite of their interpersonal communication problems, obsessive tendencies and restricted interests. Although autistic individuals with normal or higher IQs can show a high degree of social adaptation, even the most compensated have some difficulty in the give and take of everyday conversation and are unlikely to have intimate friends.

The theory of mind—that autistic individuals lack the ability to understand the role of mental states in others —proved to be a crucial step in explaining how the social and communication deficits of autism could coexist with good general abilities. This hypothesis also predicts that there is a specific substrate or pathway in the brain that gives us the ability to conceive of mental states, and recent brain imaging studies indicate that such an area may be located in the left medial prefrontal cortex. Yet the theory of mind is unable to account for all aspects of autism, such as stereotyped behavior and the desire for sameness or the exceptional talents present in a significant proportion of autistic individuals. Two additional hypotheses have been proposed.

FREEHAND DRAWING by E.C., a male autistic savant, was made spontaneously and without any corrections. Although the perspective appears realistic, it is achieved without the “vanishing points” most artists would need. Studies by Laurent Mottron and Sylvie Belleville of the University of Montreal show that E.C.’s ability to integrate parts of visual patterns is impaired; he is unable to reproduce anything resembling a human face but has exceptional ability to remember and draw individual objects and geometric shapes.

Bruce F. Pennington of the University of Denver and others in the U.S., as well as James Russell and his colleagues at the University of Cambridge in the U.K., have put forward the executive dysfunction hypothesis, which proposes that autistic individuals have a deficit in executive functions such as planning and working memory, impulse control, and initiation and monitoring of action. The processing of executive functions is thought to occur in the prefrontal cortex, and poor performance of these functions is directly related to repetitive thought and stereotyped, rigid behavior in autistic individuals.

Francesca Happé of London University and I have proposed the weak central coherence hypothesis as an explanation for the exceptional talents and restricted interests displayed by some autistic individuals. Weak central coherence refers to a preference by autistic individuals for segmental over holistic information processing. How the brain integrates information is obscure, but long-range connections between the hemispheres may well be involved. There is some evidence that people with autism process information in piecemeal fashion—the total attention of the autistic individual often is captured by fragments or selective features usually of little interest to normal persons. Surprisingly, autistic persons tend to be less susceptible to visual illusions, perhaps because they are less affected by the context in which the figure is embedded.

Because it provides a model for the ability to conceive of mental states, research into autism is stimulating philosophical debate on selfconsciousness. Future studies may lead to the identification of subcomponents or precursors of consciousness in other species, which in turn might lead to a better understanding of the development of conscious experience in humans.

Next : Helping The Handicapped
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by : Uta Frith

Lacking a mechanism for a theory of mind, autistic children develop quite differently from normal ones. Most children acquire more and more sophisticated social and communicative skills as they develop other cognitive abilities. For example, children learn to be aware that there are faked and genuine expressions of feeling. Similarly, they become adept at that essential aspect of human communication—reading between the lines. They learn how to produce and understand humor and irony. In sum, our ability to engage in imaginative ideas, to interpret feelings and to understand intentions beyond the literal content of speech are all accomplishments that depend ultimately on an innate cognitive mechanism. Autistic children find it difficult or impossible to achieve any of these things. We believe this is because the mechanism is faulty.

This cognitive explanation for autism is specific. As a result, it enables us to distinguish the types of situations in which the autistic person will and will not have problems. It does not precludethe existence of special assets and abilities that are independent of the innate mechanism my colleagues and I see as defective. Thus it is that autistic individuals can achieve social skills that do not involve an exchange between two minds. They can learn many useful social routines, even to the extent of sometimes camouflaging their problems. The cognitive deficit we hypothesize is also specific enough not to preclude high achievement by autistic people in such diverse activities as musical performance, artistic drawing, mathematics and memorization of facts.

It remains to be seen how best to explain the coexistence of excellent and abysmal performance by autistic people in abilities that are normally expected to go together. It is still uncertain whether there may be additional damage to emotions that prevents some autistic children from being interested in social stimuli. We have as yet little idea what to make of the single-minded, often obsessive, pursuit of certain activities. With the autistic person, it is as if a powerful integrating force—the effort to seek meaning—were missing.

Next : Explaining Autism’s Variability
http://adfoc.us/198212980627

by : Uta Frith

In the second year of life, a particularly dramatic manifestation of the critical component can be seen in normal children: the emergence of pretense, or the ability to engage in fantasy and pretend play. Autistic children cannot understand pretense and do not pretend  when they are playing. The difference can be seen in such a typical nursery game as “feeding” a teddy bear or a doll with an empty spoon. The normal child goes through the appropriate motions of feeding and accompanies the action with appropriate slurping noises. The autistic child merely twiddles or flicks the spoon repetitively. It is precisely the absence of early and simple  communicative behaviors, such as shared attention and make-believe play, that often creates the first nagging doubts in the minds of the parents about the development of their child. They rightly feel that they cannot engage the child in the emotional to-and-fro of ordinary life.

UNUSUAL BEHAVIOR is often displayed by autistic individuals. Autistic children, for example, tend to fixate on making toys and other objects spin and to play repetitively.

My colleague Alan M. Leslie devised a theoretical model of the cognitive mechanisms underlying the key abilities of shared attention and pretense. He postulates an innate mechanism whose function is to form and use what we might call second-order representations. The world around us consists not only of visible bodies and events, captured by first-order representations, but also of invisible minds and mental events, which require second-order representation. Both types of representation have to be kept in mind and kept separate from each other.

Second-order representations serve to make sense of otherwise contradictory or incongruous information. Suppose a normal child, Beth, sees her mother holding a banana in such a way as to be pretending that it is a telephone. Beth has in mind facts about bananas and facts about telephones—first-order representations.  evertheless, Beth is not the least bit confused and will not start eating telephones or talking to bananas. Confusion is avoided because Beth computes from the concept of pretending (a second-order representation) that her mother is engaging simultaneously in an imaginary activity and a real one.

As Leslie describes the mental process, pretending should be understood as computing a three-term relation between an actual situation, an imaginary situation and an agent who does the pretending. The imaginary situation is then not treated as the real situation. Believing can be understood in the same way as pretending. This insight enabled us to predict that autistic children would not be able to understand that someone can have a mistaken belief about the world.

Together with our colleague Simon Baron-Cohen, we tested this prediction by adapting an experiment  originally devised by two Austrian developmental psychologists, Heinz Wimmer and Josef Perner. The test has become known as the Sally-Anne task. Sally and Anne are playing together. Sally has a marble that she puts in a basket before leaving the room. While she is out, Anne moves the marble to a box. When Sally returns, wanting to retrieve the marble, she of course looks in the basket. If this scenario is presented as, say, a puppet show to normal children who are four years of age or more, they understand that Sally will look in the basket even though they know the marble is not there. In other words, they can represent Sally’s erroneous belief as well as the true state of things. Yet in our test, 16 of 20 autistic children with a mean mental age of nine failed the task—answering that Sally would look in the box—in spite of being able to answer correctly a variety of other questions relating to the facts of the episode. They could not conceptualize the possibility that Sally believed something that was not true.

Many comparable experiments have been carried out in other laboratories, largely confirming our prediction:  utistic children are specifically impaired in their understanding of mental states. They appear to lack the innate component underlying this ability. This component, when it works normally, has the most far-reaching consequences for higher-order conscious processes. It underpins the special feature of the human mind: the ability to reflect on itself. Thus, the triad of impairments in autism—in communication, imagination and socialization—is explained by the failure of a single cognitive mechanism. In everyday life, even very able autistic individuals find it hard to keep in mind simultaneously a reality and the fact that someone else may hold a misconception of that reality.

The automatic ability of normal people to judge mental states enables us to be, in a sense, mind readers. With sufficient experience we can form and use a theory of mind that allows us to speculate about psychological motives for our behavior and to manipulate other people’s opinions, beliefs and attitudes. Autistic individuals lack the automatic ability to represent beliefs, and therefore they also lack a theory of mind. They cannot understand how behavior is caused by mental states or how beliefs and attitudes can be manipulated. Hence, they find it difficult to understand deception. The psychological undercurrents of real life as well as literature—in short, all that gives spice to social relations—for them remain a closed book. “People talk to each other with their eyes,” said one observant autistic youth. “What is it that they are saying?”

Next : Theory of Mind
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