Do you really like it? Social media on the brain.

By Lauren Revie

Social media is something that has become commonplace in most of our lives – we wake up, we scroll the feed, we post throughout the day, like, comment, tweet and share. Most of us are familiar with the concept, despite social media sites such as Instagram and Facebook only coming into popular mainstream use in the last 15 years.

The concept of social media is simple – create an account which allows you to share and connect with friends, family and colleagues across the globe. Many modern-day relationships would cease to exist if it weren’t for the advent of social media, with around 74% of adults connecting on a daily (if not hourly) basis (Meshi, Tamir & Heekeren, 2015). Social media allows us to feel connected, less lonely and can even lead us to feel happier (Mauri et al., 2011).

According to a recent study, the number of friends or followers we acquire on social media also influences the size of different structures related to emotional regulation, and both online and offline social network size, such as the amygdala (Kanai, Bahrami, Roylance & Rees, 2011). This could mean that interaction on social media is linked to our social perception – meaning that if we are more social online, we may also be more socially aware offline.

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However, with the power to connect and reach thousands, if not millions, of people also comes a darker side to social media. Numerous instances of online bullying, fake news, and negative impacts on mental health have been reported in recent years. Despite this, we continue to use these platforms – so what is it about these sites that make them so hard to resist?

Social media provides our brains with positive reinforcement in the form of social approval, which can trigger the same kind of neural reaction as your brain would experience through behaviour such as smoking or gambling. This pathway – the dopamine reward pathway – is associated with behaviours which give us a good feeling, such as food or exercise, leaving us looking for the positive reinforcement or reward. So, in the same way that eating chocolate may release dopamine and lead you to seek more of it, so does social media. Neuroscientists have reported that social media related ‘addictions’ share similar neural activity to substance and gambling addictions (Turel et al., 2014). However, those individuals who used social media sites heavily also showed differences in their brain’s inhibitory control system, which could result in lower focus and attentional abilities (Turel et al., 2014).

Cognitive neuroscientists have also shown that the rewarding behaviour we engage in online, such as sharing images or receiving likes, stimulate behaviour in an area of the brain called the ventral striatum, which is responsible for reward behaviour. However, activity in this area in response to positive social media feedback may be related to the processing of gains in our own reputation (Meshi, Morawetz & Heekeren, 2013). This could mean that we use social media as less of a means to communicate and share with one another, but more to gain social reputation in an attempt to boost our egos.

With around 5% of adolescents considered to have significant levels of addiction-like symptoms (Banyai et al., 2017), it is clear that social media use may be detrimental to our well-being, as well as beneficial for us socially. Moving forward, users can only be mindful of how powerful connecting with contacts can be, as there is a dark addictive side to the likes and shares we interact with every day.

References

Bányai, F., Zsila, Á., Király, O., Maraz, A., Elekes, Z., Griffiths, M. D., … & Demetrovics, Z. (2017). Problematic social media use: Results from a large-scale nationally representative adolescent sample. PLoS One, 12(1).

Kanai, R., Bahrami, B., Roylance, R., & Rees, G. (2012). Online social network size is reflected in human brain structure. Proceedings of the Royal Society B: Biological Sciences, 279(1732), 1327-1334.

Mauri, M., Cipresso, P., Balgera, A., Villamira, M., & Riva, G. (2011). Why is Facebook so successful? Psychophysiological measures describe a core flow state while using Facebook. Cyberpsychology, Behavior, and Social Networking, 14(12), 723-731.

Meshi, D., Morawetz, C., & Heekeren, H. R. (2013). Nucleus accumbens response to gains in reputation for the self relative to gains for others predicts social media use. Frontiers in human neuroscience, 7, 439.

Meshi, D., Tamir, D. I., & Heekeren, H. R. (2015). The emerging neuroscience of social media. Trends in cognitive sciences, 19(12), 771-782.

Turel, O., He, Q., Xue, G., Xiao, L., & Bechara, A. (2014). Examination of neural systems sub-serving Facebook “addiction”. Psychological reports, 115(3), 675-695.

Frauds, fear of failure and finances: The mental health problem in academia

By Lauren Revie

Mental health is a hot topic at the moment – and it is about time. Around 1 in 6 adults will experience anxiety or depression (Mental Health Foundation, 2016), with the number of people recognising suicidal thoughts increasing drastically (McManus et al., 2016). However, as a response to this growing problem, we have also seen a rise in the formation and support for mental health charities and research into different mental health and psychiatric conditions. More and more people are beginning to talk about our mental health openly; how we feel, what is affecting our mental health, and seeking support for problems we might be experiencing. Mental health awareness and advocacy is gaining momentum, and everything *seems* to be heading the right way in working towards normalization of sharing our feelings, emotions and mental state. 

But what about the researchers behind the mental health statistics and the breakthroughs? There is  growing evidence of a mental health epidemic that is often hidden behind academic success, with almost half of PhD students and graduates in academia struggling with mental health. Approximately 41% of PhD students demonstrate moderate to severe symptoms of anxiety and depression – almost threefold that of the general public – meaning mental health issues are rife in researchers (Evans et al., 2018). 

Perhaps, then, we may attribute this to the ‘type’ of person who is attracted to pursuing a career in academia – highly motivated, a perfectionist, and maybe a little hard on themselves. However, research by Levecque et al (2017) compares the incidence of these problems within PhD students to their highly educated counterparts in industry. The findings indicate that one in two PhD students experience psychological distress, and one in three is at risk of developing a common psychiatric disorder – findings which are significantly higher than those within the comparison group.

But why might this be? Why would seemingly driven, motivated and highly successful young individuals be battling with these staggeringly high rates of mental health problems? Levecque and colleagues (2017) attribute these statistics to the effect of their research on work-family life, and found strong predictors of poor mental health to be job demands, lack of job control, and supervisor’s leadership style. Others have attributed these rates to workplace ‘bullying’ of doctoral students (English, Flaherty & English, 2018) and a feeling of disconnection from the research community due to unfamiliar topics or long isolated work (Reeve & Patridge, 2017). 

Academics and postgraduate students alike attribute mental health problems and feelings of being overwhelmed to lack of support and isolation. Further research by Belkhir et al (2018) followed a group of young academics and early career researchers over four years.  It was reported that feelings of loneliness came from social isolation due to workplace culture, meaning individuals weren’t able to make meaningful relationships with those in their immediate groups. In addition to this, they also reported that they felt unable to participate in conversations with their peers and others in their field, as they felt they lacked both cultural and technical knowledge. 

This leads us on to an issue that many postgraduates and early career researchers can related to, known as the ‘Imposter syndrome’. Clance and Imes (1978) first coined the term ‘Imposter syndrome’ in a bid to collectively define the traits of high-achievers who were struggling to accept and internalize their own success. Often, someone struggling with imposter syndrome will claim to be a fraud, or underestimate their own knowledge, attributing their success to luck or circumstance. ‘Imposters’ will often compare themselves to others, and reject praise, leading to anxiety, stress and in some cases, depression. Positive correlations have been observed between imposter syndrome and academic success, neuroticism and perfectionism – all strong traits of a postgraduate student or early career researcher. And it isn’t just them! Many senior faculty members wake up believing they will one day be ‘found out’ Whilst the syndrome is not exclusive to academics, it is rife amongst university staff and students, and is a huge contributor to declining mental health in post graduate education. Watson and Betts (2010) attribute feelings of imposter syndrome to three main themes in an early career researcher’s experience: fear, family and fellowship. The researchers assessed email conversations of graduate researchers, in which a fear of being discovered as a fraud appeared to be one of the main factors driving feelings of imposter syndrome. In addition, this was further exacerbated by feelings of being drawn away from family responsibilities, and a lack of peer support or fellowship during study. 

There are a number of reasons why researchers and students may feel like imposters. Firstly, academia is a competitive world. Postgraduate study attracts the best of the best, and fairly often, those surrounding you are intelligent and also over-achieving. Partnered with the constant pressure to ‘publish or perish’, and the need to justify your project and area of expertise, this can result in stress, anxiety and often burnout (Bothello & Roulet, 2018).

Other factors which may also contribute to poor mental health in academia include difficulty in time management, organizational freedom (van Rijsingen, 2018) and perception of career perspectives, funding opportunities and financial problems. The struggle to manage your own work, produce innovation and progress whilst being largely self-taught can often come at the price of mental health issues. It is suggested that stress may stem from insecurity within this sphere – be it financial insecurity, or insecurity concerning ‘unwritten rules’ within the lab or school – and also from frequent evaluation, and a seemingly unmanageable workload (Pyhalto et al., 2012). 

All in all, the consensus seems to be that postgraduate researchers and academics alike are struggling in the University environment. This issue is beginning to be addressed more readily, however the phenomenon is not new. McAlpine and Norton (2006) note that the calls for action to rectify this growing problem have generally been ad hoc rather than theory driven (ironically!). As such, research which has been conducted has not been broad enough to integrate factors which could influence outcomes in a University context. And so the cycle continues. 

If you have been affected by anything in this article, please talk to a trusted friend or family member, or access help on www.nhs.uk/conditions/stress-anxiety-depression/mental-health-helplines/

www.mind.org.uk

http://www.samaritans.org

References:

Bothello, J., & Roulet, T. J. (2018). The imposter syndrome, or the mis-representation of self in academic life. Journal of Management Studies, 56(4), 854-861.

Clance, P.R., & Imes, S. A. (1978). The impostor phenomenon in high achieving women: Dynamics and therapeutic intervention. Psychotherapy: Theory, Research, and Practice, 15(3), 241-247. 

English, S., Flaherty, A., & English, A. (2018). Gaslit! An examination of bullying on doctoral students. Perspectives on Social Work, 20.

Evans, T. M., Bira, L., Gastelum, J. B., Weiss, L. T., & Vanderford, N. L. (2018). Evidence for a mental health crisis in graduate education. Nature biotechnology, 36(3), 282.

Levecque, K., Anseel, F., De Beuckelaer, A., Van der Heyden, J., & Gisle, L. (2017). Work organization and mental health problems in PhD students. Research Policy, 46(4), 868-879.

McAlpine, L., & Norton, J. (2006). Reframing our approach to doctoral programs: An integrative framework for action and research. Higher Education Research & Development, 25(1), 3-17.

McManus, S., Bebbington, P., Jenkins, R., & Brugha, T. (2016). Mental Health and Wellbeing in England: Adult Psychiatric Morbidity Survey 2014: a Survey Carried Out for NHS Digital by NatCen Social Research and the Department of Health Sciences, University of Leicester. NHS Digital.

Mental Health Foundation. (2016). Fundamental Facts about Mental Health 2015. Mental Health Foundation.

Pyhältö, K., Toom, A., Stubb, J., & Lonka, K. (2012). Challenges of becoming a scholar: A study of doctoral students’ problems and well-being. ISrn Education, 2012.

Reeve, M. A., & Partridge, M. (2017). The use of social media to combat research-isolation. Annals of the Entomological Society of America, 110(5), 449-456.

van Rijsingen. (2018), E. Mind Your Head# 1: Let’s talk about mental health in academia.

Watson, G., & Betts, A. S. (2010). Confronting otherness: An e-conversation between doctoral students living with the Imposter Syndrome. Canadian Journal for New Scholars in Education/Revue canadienne des jeunes chercheures et chercheurs en éducation, 3(1).

Learning to make healthier food choices

By Sophie Waldron

If you haven’t already, read Sophie’s first article ‘Learn, eat, repeat: how food advertising works’!

You are sitting down at a desk and a huge burger comes floating towards you. It gets bigger and bigger as it advances, faster and faster. Luckily, you know what you have to do. Don’t press anything on your computer, and the burger will go away.

This isn’t some dystopian reality where burgers are our new overlords. It’s a computer task that can help people make healthier food choices. In the task, which people can also engage with on their smartphones as an app, participants have to prevent a learnt response to unhealthy food items.

People are first trained to press certain computer keys every time certain images of healthy and unhealthy food come on screen. Then in a subsequent phase participants have to press keys to every picture on screen except to pictures of unhealthy food. Helpfully, a prompt comes with pictures of healthy food, warning people not to respond.

This task may seem simple, but it is designed to help people mentally tackle automatically activated learnt responses to obtain unhealthy food. We live in what scientists call an ‘obesogenic’ environment, where high calorie food is abundant and pushed on us through advertising. Research has shown that learnt associations between pictures (such as a brand logo) and tasty food can make us reach for that food even when we are full (Watson et al., 2014)! In such a world we learn to respond to the attractively colored logo-dripping packets of fast food and eat them, rather than thinking carefully about which foods benefit us. Inhibiting learnt key press responses to food might give us the cognitive skills to think twice about automatically reaching for a chocolate bar.

The unhealthy food inhibition task was designed by Lawrence and her team in 2015. They investigated whether preventing an automatic key press response to unhealthy food pictures would reduce consumption of unhealthy foods in people’s everyday lives. It was found that the task reduced self-reported snacking for up to 6 weeks. This holds many possibilities. If people can make healthier choices based on one lab session, it is likely that they can be healthier for much longer if they could carry on with the task on a regular basis as part of a smartphone app.

Another avenue for treating overeating is mindfulness. Mindfulness practice cultivates experiencing the present external and internal environment, including sensory influx and the thoughts and feelings we have. Mindfulness eating practice focuses on the experiential qualities of food, taste, texture, and our feelings of satiety. There has been evidence that incorporating mindfulness eating into one’s life reduces self reported measures of binge and emotional eating (Alberts et al 2012), consumption of sweets (Mason et al., 2015), and BMI (Tapper et al., 2009).

Currently the mechanism by which mindfulness eating leads to healthier food consumption is unknown. Mindfulness has been found to decrease self-reported body image concern in healthy women with disordered eating (Alberts et al 2012), which may lead these women to eat healthier. However there is a problem that runs through this research: self-report.

Self-report is practical, experimenters could not follow around participants every day for 6 weeks prior to testing and write down exactly what they ate, so instead they ask them to keep a food diary. However self-report studies give an indirect measurement of the dimension experimenters are focusing on, and thus conflate actual changes in behaviour with changes in reporting about a certain behaviour. For example in the study on body image and mindfulness eating, it could be that reduced body image concern actually results in healthier and more natural eating. Yet it also could be that women eat the same but interpret this eating as healthier because of their more positive self-image. Self-report cannot distinguish these possibilities.

Another way in which mindfulness eating may trigger healthier choices is by increasing the flexibility of learning about reward and punishment. It has been claimed that obesity might be due to an inflexibility in this kind of learning, as once people have learned that a food is tasty (and thus rewarding) they may eat too much of it despite the undesirable consequences overeating brings, such as feeling too full or being overweight. In other words, they fail to change their overeating behaviour even when it leads to something unpleasant, a punishment. Janessen and colleagues (2018) found that time invested in mindfulness eating correlated positively with good performance on a task where participants had to quickly learn that a previously rewarded item was now punished, and vice versa. This hints that mindfulness eating could arm people with the cognitive flexibility required to overcome compulsive automatic eating patterns.

Further research will have to look at the long-term health consequences of mindfulness eating practice, and apps that train us to inhibit automatically reaching for unhealthy food. Yet studies so far are promising! Both these tools, and others, will be essential in catching up with the explosion of accessible high calorie food and food advertisement in the modern world.

Interested in the science of obesity and how we can tackle it? A recent BBC documentary ‘The Truth About Obesity‘ covers some strategies, including a study looking at the effectiveness of using apps to train better eating behaviours, filmed at CUBRIC

Interested in the effect of mindfulness on the brain? Check out our previous article: ‘The Neuroscience of Mindfulness: What Happens When We Mediate?’

Edited by Jonathan

References:

Watson, P., Wiers, R. W., Hommel, B., & Wit, S. (2014). Working for food you don’t desire. Cues interfere with goal-directed food-seeking. Appetite, 139 -148.

Lawrence, N. S., O’Sullivan, J., Parslow, D., Javaid, M., Adams, R. C., Chambers, C. D., Kos, K., Verbruggen, F. (2015). Training response inhibition to food is associated with weight loss and reduced energy intake. Appetite, 17-28.

Janssen, L. K., Duif, I., Loon, I., dv Vries, J. H. M., Speckens, A. E. M., Cools, R & Aarts, E. (2018). Greater mindful eating practice is associated with better reversal learning. Scientific Reports, 5702.

Alberts, H. J. E. M., Thewissen, R. & Raes, L. (2012). Dealing with problematic eating behaviour. The effects of a mindfulness-based intervention on eating behaviour, food cravings, dichotomous thinking and body image concern. Appetite 58, 847–851.

Tapper, K. et al. (2009). Exploratory randomised controlled trial of a mindfulness-based weight loss intervention for women. Appetite 52, 396–404.

Mason, A. E. et al. (2015). Effects of a mindfulness-based intervention on mindful eating, sweets consumption, and fasting glucose levels in obese adults: data from the SHINE randomized controlled trial. J. Behav. Med. 1–13.

Learn, eat, repeat: how food advertising works

By Sophie Waldron

You woke up late and ate breakfast late. Thing is, now it’s noon and you are hungry again. How can you be hungry when you only ate an hour ago?

When interacting with our environment, we form associations between items that occur together. This occurs with food, for example if we always eat lunch at 12pm, we will associate that time with food.

What is more, feelings and responses associated with one item can be linked to another by association. The feeling of hunger that is linked to food can become associated with 12pm, so that the time seems to be making you hungry independent of whether you are about to eat or not!

This kind of learning by association is Pavlovian conditioning, discovered by the Russian doctor Ivan Pavlov (hence the name)! He was attempting to study dog’s digestion by measuring their saliva, when he discovered that they would salivate not only to food, but to other stimuli associated with food, such as the experimenter’s footsteps.

Pavlovian conditioning is a gift to advertisers. It provides an avenue to create thoughts or feelings towards a product by associating it with other relevant things. It’s what Coca-Cola are trying to do by sponsoring sporting events – they are hoping that by associating Coke with sports, people will think of it as healthy. Predominantly advertisers attempt to create good feeling towards their products by associating them with stuff their audience likes. They sell Walker’s crisps by associating them with football, new chocolate bars by associating them with old chocolate bars, and even try to sell Pepsi by linking it to Kendall Jenner and social justice movements!

…perhaps think twice about that last one!

It is likely that these associations take charge of our preferences from an early age. We live in an environment teeming with food advertising! A recent study asked 4-6 year old children which of two identical food items they would rather eat, one in plain packaging and one in packaging with a fast food logo. Children overwhelmingly chose the packet with the logo on, despite no differences to how the food inside looks or smells (Robinson et al 2010).

This likely reflects the fact that because of associations between the logo and other pleasant things, established by advertising, children see the food inside as inherently better. The age of the children points to how associations like these form early on in life, and likely determine food choices for many years to come. This learning could contribute to why changing eating behaviour is so hard, as learnt associations have to be revised.

How do these associations influence our behaviour? Pavlovian conditioning only describes the formation of associations between two items, so we must invoke another form of learning if we are to understand how advertising can change which foods we act to obtain. This is instrumental learning, which describes how if a behaviour leads to something pleasant (like tasty food) it is likely to be repeated. My mum used to employ this tactic to stop me being naughty as a child. If I didn’t throw a tantrum the whole way round the supermarket, I got a chocolate cookie.

Pavlovian and instrumental learning interact to influence our actions. Specifically, Pavlovian associations can override and shape learnt behaviours. Watson and colleagues (2014) demonstrated this using a laboratory based computer task. Participants first learned instrumentally that pressing one key got them a piece of chocolate, and another key delivered popcorn. They also learned associations between chocolate and a striped pattern and popcorn and a checked pattern.

Participants then ate lots of chocolate or popcorn. This wasn’t just for fun, the idea was that if a participant eats lots of chocolate they will want to eat it less in future, so not act to obtain it. This was true, participants who had gorged on chocolate pressed on the key associated with chocolate less in the next round of the experiment. These participants were then presented with one of the pictures Pavlovian-associated with chocolate. Experimenters found that even if a participant did not usually want to act to obtain chocolate, when presented with an image associated with chocolate they would press the key to get it!

Think about this in a real world setting. This means that even if we are completely full and don’t want to eat, if we see an advert for pizza on the TV we may quickly find ourselves on the deliveroo website. Furthermore our behaviour may be swayed even by seeing things which are not food, but which are associated with food through advertising. Seeing Gary Lineker’s face might make us reach for a packet of crisps even if we don’t really fancy them. This means that food adverts can control not only what we like to eat, but also tip us towards eating when we do not want to.

Association formation surrounding food is not specific to advertisement. When we interact with an environment in which food is only presented in certain situations, associations (both Pavlovian and instrumental) will form. Going back to the kitchen in the house you grew up in can make you crave cherished childhood foods – fish fingers and smiley faces anyone? It also works the other way round, how often has a certain flavour evoked in you a memory.

This fundamental mechanism just transfers particularly well to advertising. Associations can make us like certain foods in the first place, and also control when and how often we eat them.

Related article: Learning to make healthier food choices.

Edited by Jonathan

References

Robinson, T. N., Borzekowski, D. L. G., Matheson, D. M., & Kraemer, H. C. (2007). Effects of fast food branding on young children’s taste preferences. Archives of Pediatrics & Adolescent Medicine, 161(8), 792e797.

Watson, P., Wiers, R. W., Hommel, B., & Wit, S. (2014). Working for food you dont desire. Cues interfere with goal-directed food-seeking. Appetite, 0195-6663.

Perceptions of mental illness: The media and mental health.

By Rae 

You wouldn’t blame someone with breast cancer or cystic fibrosis for their disease, would you? We know they are caused by impaired biological mechanisms. Lifestyle choices can exacerbate risk but there is less stigma associated with suffering from a ‘physical’ rather than mental illness.  With both types of illness stigma stems from a lack of understanding. If someone walks down the street arguing with themselves you avoid them and think “that person is crazy”. You can’t help it, you avoid their gaze and hurry on by, you don’t want to get involved with something so out of the ordinary. But why? Why should we assign blame to people for something that is not their fault when we wouldn’t do it for other diseases?

The way mental health conditions are portrayed in the media reinforces our mistrust and negative reaction to sufferers. Time and time again they are depicted as evil, deceitful and intending harm, despite this rarely being the case. Empathising with people who suffer from mental illness and commit crime doesn’t detract from what they do, but understanding why they may have behaved in that way is vital to preventing it happening again.

In 2015 a pilot crashed a passenger plane in the Alps in an apparent suicide. It later came out that he had been battling depression for a long time. The majority of the coverage painted him as devious for hiding his illness and, in some reports, just waiting for the opportunity to harm others. What he did was horrible, and heart-breaking for those who lost loved ones, and it reinforces our aversion to dealing with someone with suicidal tendencies. Despite our gut reaction to this we must look at why he was suffering and whether he was he receiving suitable help. This will help us understand why he did it, if it could have been prevented and to stop anyone else from doing it again. The pressure of his job may have played a role in his depression and subsequent suicide. It has been highlighted how stressful a pilot’s life can be, on top of all the usual stresses people deal with, and how difficult and career ending it can be to seek help. If society were more accepting of mental health disorders and there was less attached stigma to a diagnosis people may be more willing to seek help, thus reducing the chance of something like this occurring.

Should we prevent someone doing a job simply because they have a mental health condition? You wouldn’t do the same for someone with a physical illnesses.  There will be some instances where it just isn’t feasible for them to carry out a job, but blanket banning someone from a career due to a mental health diagnosis is unreasonable. This is especially pertinent as although many disorders are given one name they often describe a spectrum of conditions and symptoms. Therefore, not everyone with a condition will behave in the same manner, and those who are more able to cope socially may be penalised for having a related condition. Discounting a proportion of society based on the actions of one person is detrimental to everyone. Cases like this flight, with such negative coverage and discussion of his diagnosis of depression, further fuels mistrust and suspicion. This it in turn makes it harder for those suffering to seek help, increasing the likelihood of it happening again.

Imagine if you were made redundant, or that you just lost someone close to you. You don’t think you cope anymore and all you want to do is stop but it has been drummed into you by friends, family and the media that being depressed, or needing help is weak and pathetic so you try to struggle by alone. It becomes easy to see how people end up in terrible situations, possibly even taking their own life. It will take time to change the public’s opinion but the media could be so powerful in changing our attitudes towards mental health, especially through social media campaigns such as Time to Change and Rethink Mental Illness. The media has been used to provide insight into the lives of sufferers before. A collaboration between Bryan Charnley and a journalist set out to illustrate his experiences of schizophrenia through self-portraits, whilst taking varying degrees of medication. Tragically, it ended with Bryan taking his own life, but his haunting, and increasingly distressing paintings, live on.  Increasing our exposure to messages of support, reminding people that they are not alone and that there is no shame in suffering from mental health conditions, and providing them with information on how to get help is a vital step forward in reducing stigma.

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IMAGE SOURCE.

So why is our gut reaction to mental health generally so negative? Is it purely due to misinformation and fear portrayed by the majority of the media coverage? Can we combat the stigma with our rapidly increasing understanding of the biological basis of these diseases?

If these questions interest you, read on to my next article Perceptions of mental illness: Do biological explanations reduce stigma?’ 

Edited by Jonathan

Sport on the brain; when do the risks outweigh the benefits?

By Catherine Foster

You’re likely to have come across articles citing evidence that physical fitness and sport participation benefits cardiovascular and brain health1. Active lifestyles reduce the risk of high blood pressure, cardiovascular disease, Type 2 Diabetes, and stroke. Physical activity has also been shown to reduce inflammation, depression, cerebral metabolic and cognitive decline and brain atrophy.  The evidence is clear; sport is undeniably a good thing for your brain as well as your ability to fit in your jeans.

Yet, certain sports carry a relatively high risk of concussion, also misleadingly called mild traumatic brain injury (MTBI). American football, wrestling, soccer, ice hockey, boxing and rugby are among the sports with the highest risk of brain injury, though many others involve some risk. The point of this article is not to warn people off playing sport but to highlight the danger of mismanagement of concussion and the long-term effects of repeated impacts. Most research focuses on American Football but concussion is a frequent hazard in all contact and combat sports as well as equestrian and snow-sports.

In the US alone, the estimated annual incidence of sports-related concussions is around 3.8 million with approximately 50% going unreported2. Research and media attention has focused on concussion in American Football, partly due to the popularity of the sport. Another important factor was the diagnosis of chronic traumatic encephalopathy (CTE) by Dr. Bennet Omalu in 2002, in Mike Webster, a former star centre with a 14-year professional career. A form of dementia, CTE causes progressive brain degeneration resulting from an accumulation of the tau protein, which kills brain cells. CTE is now known to be caused by repeated brain trauma such as that suffered by athletes playing contact or collision sports3.

Bennet’s discovery, and ensuing battle with the National Football League (NFL) to have this disease risk acknowledged, was chronicled in the movie Concussion, starring Will Smith as Dr. Omalu. The movie followed the billion-dollar settlement the NFL made to retired players and families of ex-athletes for concealing the effects of repeated concussions. Around $10m of this was dedicated to research into concussion and CTE. Knowledge of the effects of concussion is much improved thanks to Dr. Omalu and others, and it is promising that a small portion of NFL profits will go towards further research. Ideally this would have been the NFL’s own initiative, but that is a separate argument. Increased awareness of concussion has increased reporting. Though, without a solution, the increasing size of players and aggression with which the sport is played is contributing to the rising number of concussions each year4.

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BENNET OMALU (LEFT) & WILL SMITH  WHO PORTRAYED HIM IN
THE 2016 FILM CONCUSSION.  IMAGE SOURCE


How regularly do concussions occur?

The NFL reported 271 concussions in the 2015 season, add this to college and school football and that is a lot of young adults with brain injuries.  It is estimated that a professional football player receives up to 1500 head impacts a season and a Virginia Tech study revealed that the G-force of these hits can reach 150 Gs5, with helmets only absorbing a fraction of the impact. Comparatively, fighter pilots experience a G-force of 9 during a jet roll. This seriousness of concussion is not limited to the NFL: helmetless sports such as soccer, where the impact speed of a ball headed by a player can be 70mph (40mph in children’s games), and rugby where a player’s average weight is around 114kg in the UK and higher internationally. In 2013-14 there were 86 reported concussions in English Rugby alone. So what actually happens to the brain following concussion and can anything be done to reduce the incidence?


What is happening to the brain?

Concussion’s principle causes are the acceleration and deceleration forces caused by a blow to the head or neck6. These forces cause the brain to rotate rapidly and the tissue to stretch and tear, resulting in the death of neuronal cell bodies, dendrites and axons, glia, and blood vessels in both grey matter and white matter connective tissue. Cells downstream of the site of injury are affected due to reduced energy supply or communication from other regions.

In addition, a metabolic cascade characterised by a huge release of neurotransmitters (chemical messengers) attempts to maintain balance following injury. This increase in activity increases glucose requirements and therefore hypermetabolism occurs, even though blood flow in the brain (which carries glucose) is reduced. This “energy crisis” in the brain typically results in a range of symptoms including dizziness or loss of consciousness, confusion, memory loss, headache and mood disturbances.

The good news is that with the correct care, symptoms of concussion typically subside within days or weeks thanks to the brain’s remarkable ability to repair itself, known as ‘brain plasticity’. Unfortunately, concussion is often not dealt with appropriately and individuals go on to develop post-concussion syndrome (PCS), a complex disorder involving physical disability, cognitive and mood disturbances. A second major risk is that of second impact syndrome (SIS) whereby a second injury occurs before the first has resolved. This injury may be extremely minor at first glance but rapidly advances to cerebral oedema, coma and is ultimately fatal.

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What can be done to reduce the incidence and consequences of concussion in sport?

As David Camarillo illustrates in his TED talk, current helmets do not adequately protect the brain and research is aimed at developing a more effective alternative. Senior sports clinicians including Dr. James Robson, Chief Medical Officer for Scotland Rugby Union, have called for changes in the way the game is played to reduce head injuries; it is estimated there is at least one concussion per game in the Six Nations alone. Changing the rules of a sport in a way that dramatically alters the game has huge financial and cultural implications but neuropathology and brain imaging studies have shown the impact of sports concussion on blood flow, metabolism and neurodegeneration in their current form7. Right now, the most effective way to reduce the risk of complications following concussion is to ensure that athletes refrain from playing for an appropriate time following any impact to the head. While it is unclear how many concussions it takes to cause irreversible damage, players and coaches should accept that if an individual continues to play after multiple concussions they are likely to develop neurological problems. One could argue that players should be educated on the risks and allowed to make their own decision on whether to participate in the sport. But, with high incidences of sports-related concussion in children and teenagers this argument becomes more complex and again boils down to; do the many benefits of sport, physical and cultural, outweigh the risks?

Header image source: Getty Images.

Edited by Jonathan and Rachael 

References:

  1. Cotman, C. W., Berchtold, N. C., & Christie, L. A. (2007). Exercise builds brain health: key roles of growth factor cascades and inflammation. Trends in neurosciences30(9), 464-472.
  2.  Harmon, K. G., Drezner, J. A., Gammons, M., Guskiewicz, K. M., Halstead, M., Herring, S. A., … & Roberts, W. O. (2013). American Medical Society for Sports Medicine position statement: concussion in sport. British journal of sports medicine47(1), 15-26.
  3. Omalu, B., Bailes, J., Hamilton, R. L., Kamboh, M. I., Hammers, J., Case, M., & Robert Fitzsimmons, J. D. (2011). Emerging histomorphologic phenotypes of chronic traumatic encephalopathy in American athletes. Neurosurgery69(1), 173-183
  4. Haring, R. S., Canner, J. K., Asemota, A. O., George, B. P., Selvarajah, S., Haider, A. H., & Schneider, E. B. (2015). Trends in incidence and severity of sports-related traumatic brain injury (TBI) in the emergency department, 2006–2011. Brain injury29(7-8), 989-992.
  5. Jenkins, T., J. (2013). Sports Science Part II: Anatomy of a Hit in Football. Retrieved from: http://www.personal.psu.edu/afr3/blogs/siowfa13/2013/10/sports-science-part-ii-anatomy-of-a-hit-in-football.html
  6. McKee, A. C., Daneshvar, D. H., Alvarez, V. E., & Stein, T. D. (2014). The neuropathology of sport. Acta neuropathologica127(1), 29-51.
  7. Henry, L. C., Tremblay, S., & De Beaumont, L. (2016). Long-Term Effects of Sports Concussions Bridging the Neurocognitive Repercussions of the Injury with the Newest Neuroimaging Data. The Neuroscientist, 1073858416651034.

There is more than one scientist

umbrellaThe word ‘scientist’..
Why do we use this umbrella term?

What do the words scientist, physicist, consilience, catastrophism, uniformitarian, ion, anode and cathode all have in common? Well, the late William Whewell, a wordsmith and polymath, created them, often suggesting them to scientists when they had made a discovery. As well as the many scientific disciplines on which he published, he also found time to compose poetry. What a babe. In the 19th century, people we now call ‘Scientists’ were ‘Natural Philosophers’ or ‘Men of Science.’ Whewell first proposed the word scientist anomalously in 1834, and then more seriously in 1840 in ‘The Philosophy of the Inductive Sciences’:

williamwImage source 

“As we cannot use physician for a cultivator of physics, I have called him a physicist. We need very much a name to describe a cultivator of science in general. I should incline to call him a Scientist. Thus we might say, that as an Artist is a Musician, Painter, or Poet, a Scientist is a Mathematician, Physicist, or Naturalist.”

The scientific community initially objected to this term, and it wasn’t until the late 19th/early 20th century that it became established in the United States and Great Britain. (There’s a nice little blog post about it here if you are interested in finding out more about the history of the word). Moving from ‘Man of Science’ to ‘Scientist’ better acknowledges that women actually are capable of scientific pursuit, yet there’s still room for improvement here. Then again, we still have many labels and titles that hark back to older times.  Take ‘PhD’ which stands for Doctorate of Philosophy. The origin of the word philosophy has its roots in the Greek philo– meaning ‘love’ and –sophos meaning wisdom. 

It is difficult to define what a science is. In simple terms, science is a process, whereby you collect enough data in a valid and repeatable way, using the scientific method. The biggest commonality between all scientists is simply that they are studying something in great depth. There are certainly many commonalities between scientists  but there are even more differences. However, in news headlines, we more frequently read ‘Scientists say’ than ‘Physicists says’ or ‘Geneticists says’ which can contribute to a simplification or vagueness of what a specific scientist does, and a lack of appreciation for the diversity of people this term represents.

umbrellaDelving into the diversity

Let’s examine the study of Parkinson’s disease, a neurodegenerative condition that predominantly affects motor function (tremor, rigidity, difficulty with initiating movement), as well as cognitive and emotional functioning.
 greywellyA geneticist might spend their day in a lab, analysing large genetic samples, trying to understand why some people get Parkinson’s disease and others don’t.
greywellyA neurologist might spend their morning in a clinic seeing patients, and the afternoon in a lab carrying out a clinical trials to investigate the effectiveness of a new drug.
greywellyA psychologist might be trying to develop a non-drug based therapy, such as exercise or diet modification, to help alleviate the symptoms of Parkinson’s.
greywellyA radiologist might carry out an MRI scan to investigate changes in activity in specific brain regions, and relate this to behavioural symptoms.

Whilst each one is a neuroscientist, in that they study the brain in one form or another, they have vastly different daily routines, skill sets, and areas of expertise. Yet they are all working towards the same goal: to understand and tackle Parkinson’s disease. This example shows how even a specific scientific title, neuroscientist, can mean many different things.

Diversity of roles needs diversity of people. Science benefits from a diverse group of people, with a diverse set of skills. We shouldn’t  limit the list of people who think they can participate in science, or limit how they can.

umbrellaPerceptions of a ‘Scientist’

The public image of ‘scientist’ has been a concern  for many years and systematic research into this topic goes back as far as Mead & Meatraux’s seminal work (1975). In this study, 35,000 US high school students wrote an essay describing their view of a scientist. Analysis of these essays revealed an elderly or middle-aged man, in a white coat, with glasses, working in a laboratory, performing dangerous experiments.

Image source 
Drawing_from_original_DAST_study.jpg
Another prominent study, Chambers (1983), asked 4,807 children aged 5-11 years to draw scientists. By 7 or 8 years old this stereotype was starting to emerge. The older the child, the more similar the drawing was to the description above. Only 28 female scientists were drawn, and only by girls. This instrument, known as the ‘Draw-A-Scientist Test (DAST)’ has been widely used in research since.  Admittedly, these two studies
were carried out quite some years ago, and you could argue that societal views have changed for the better. A full discussion of that is beyond the scope of this blog post, and I struggled to find studies in the past ten years that had sample sizes as big as these two. Yet some more recent research and commentaries on this stereotype suggest it unfortunately still exists, to some extent. You can find the references for the above two studies, and a few more recent ones, at the end of the article.

umbrella
Does this restrictive perception impact on science itself?

So far we’ve been discussing societal attitudes towards the term scientist.  The restrictive view of what it is to be a scientist has practical consequences, contributing to the demographics of the scientific workplace today.  If people interested in science don’t think they fit into this restrictive view of a scientist, and don’t see people working as scientists they can identify with, they are less likely to  feel they are needed or capable of a career in science.

In 2014, The Royal Society “set out to analyse and understand the composition of the scientific workforce in terms of gender, disability, ethnicity and socio-economic status and background.” They used big samples from three different sources.  Though their results paint a complex picture, clear trends do emerge, highlighting there is a lack of diversity in science. You can read a short summary of the report, or the full report itself, here.

Education and public engagement can go a long way to improving this lack of diversity. In order for people to understand the choices that are available to them, we must avidly teach that there is no particular gender, race, background, or rigid set of skills attached to being a scientist. As well as this, enough scientists should be vocal about what they do, but also who they are and where they’ve come from. This is by no means the magic solution to the problem of lack of diversity in science, and much more funding and opportunities are needed for some individuals to make a scientific career even an option for them. Nonetheless, more communication and transparency will help enable people with different skill sets, and from wider spread of backgrounds, to apply themselves to a worthwhile and satisfying pursuit, and for society to get maximum benefit from this.

Edited by Jonathan Fagg 

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The two main studies I discussed about the ‘Draw A Scientist Test’:
Mead, M.; R. Metraux (1957). “The Image of the Scientist Among High School Students: a Pilot Study”. Science 126 (3270): 384–390
Chambers, D.W. (1983). “Stereotypic Images of the Scientist: The Draw a Scientist Test”. Science Education 67 (2): 255–265.

More recent commentary on the view of scientists:
The Wikipedia page provides a well-sourced background on the DAST, and the study of it over the years!
Frazzetto, G. (2004). The changing identity of the scientist. EMBO reports, 5(1), 18-20.
Schibeci, R. (2006) Student images of scientists : What are they? Do they matter? Teaching Science, 52 (2). pp. 12-16.
Steinke et al (2007). Assessing media influences on middle school–aged children’s perceptions of women in science using the Draw-A-Scientist Test (DAST). Science Communication, 29(1), 35-64.
Losh, S. C., Wilke, R., & Pop, M. (2008). Some methodological issues with “Draw a Scientist Tests” among young children. International Journal of Science Education, 30(6), 773-792.