Laura’s Psychology Blog

When I introduce the psychological disorders unit in both intro psych and biopsych, I spend quite a bit of time discussing what we mean in psychology by the term “abnormal.” This sometimes seemed like overkill–the students were always anxious to get into the meat of the material. After reading Allen Frances’ commentary on DSM V in the Los Angeles Times, though, I am more than ever convinced that the time spent in the discussion of “abnormal” is time well spent.

If you’re not familiar with Professor Frances, he is an emeritus professor and former department chair in psychiatry at Duke University, and he headed up the DSM IV task force in 1994. Those credentials suggest to me that when he has something to say about DSM V, we should all listen carefully.

I am not a clinician, and I have often been troubled by the DSM’s couching what seems to be very typical behavior to me in terms of disorder. Here are a few of my favorites:

1. “Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework)” from the criteria for Attention Deficit Hyperactivity Disorder. Do we know anybody who doesn’t do this?
2. “Often leaves seat in classroom or in other situations in which remaining seated is expected.” Another gem from the ADHD criteria. Instead of making this a symptom of a mental disorder, why don’t we consider our expectations for young children remaining seated? After all, with current rates of childhood obesity, maybe we shouldn’t let them sit down at all.
3. “Often initiates physical fights” from the DSM criteria for Conduct Disorder, which is the psychologists’ equivalent of juvenile delinquency. I’m not saying physical fights are ideal behavior, but this is what boys do. I attended a very prissy school system, and most of my classmates are college graduates and successful professionals, and I distinctly recall the boys getting about a block away from our elementary school and starting to punch each other. And what about “mean girl” behavior that doesn’t involve physical fighting? There aren’t too many more vicious creatures on the planet than a pack of 7th grade girls, yet the DSM seems to think that relational aggression is just dandy….

But let’s get back to Dr. Frances, who has some stern things to say about the upcoming DSM V. Here are some of my favorite quotes from his article:

1. Our panel tried hard to be conservative and careful but inadvertently contributed to three false “epidemics” — attention deficit disorder, autism and childhood bipolar disorder.
2. This wholesale medical imperialization of normality could potentially create tens of millions of innocent bystanders who would be mislabeled as having a mental disorder. The pharmaceutical industry would have a field day — despite the lack of solid evidence of any effective treatments for these newly proposed diagnoses.
3. …many misidentified teenagers would receive medications that can cause enormous weight gain, diabetes and shortened life expectancy.
4. Defining the elusive line between mental disorder and normality is not simply a scientific question that can be left in the hands of the experts.
5. This is a societal issue that transcends psychiatry. It is not too late to save normality from DSM-V if the greater public interest is factored into the necessary risk/benefit analyses.

The last two points Dr. Frances makes are consistent with continuing to emphasize a general education at the university level, not just career training. We need citizens educated in history, philosophy, ethics, and social sciences to help make wise decisions for how the science we produce is used. I hope the current DSM task force pays attention to Dr. Frances’ comments, or we soon won’t have any normal people left on the planet.

Today was the beginning of week 9 for us dinosaurs still on the quarter system, and you can feel the growing tension as finals week approaches. Everybody could use some anti-anxiety advice right about now. So a recent article about exercise and anxiety caught my attention.

While I typically bring up the issue of exercise in my discussions of depression, I usually do not discuss it in the context of depression’s relatives, the anxiety disorders. However, in a large meta-analysis of over 40 studies and 3000 participants, a University of Georgia team reported that exercise appears to have a very beneficial role in reducing anxiety [1].

What I especially liked about this analysis is that the researchers used real randomized experiments, not correlational studies. It would be too easy to say that anxiety is lowest among exercising adults, but not be able to comment on the causal nature of exercise in these cases. Instead, these experimental studies showed that exercise does in fact reduce anxiety an average of 20 percent in patients with a variety of symptoms, including heart disease, multiple sclerosis, cancer, and chronic arthritis pain.

As the authors point out, exercise is about as low-cost as a “medical” treatment can get. I find it interesting to see how the current discussion of health care costs has spawned a whole new interest in low-cost and preventive approaches. Wellness has always been preferable to having to fix something, and it’s nice to see the medical community go this route.

1.  Matthew P. Herring; Patrick J. O’Connor; Rodney K. Dishman
The Effect of Exercise Training on Anxiety Symptoms Among Patients: A Systematic Review
Arch Intern Med. 2010;170(4):321-331.  

It’s always fun to do research, but it’s even more fun when people find what you do interesting. We have had a lot of attention for the Facebook work that our group of stalwart student researchers have done over the last year and a half or so. The most recent recognition comes from HealthDay’s Alan Mozes, with whom I enjoyed a nice conversation this week about our work. Alan asked me to comment on an article in the 2/17 online version of Psychological Science by UT Austin’s Samuel Gosling and his colleagues. The researchers found that people’s Facebook profiles are actually quite accurate.

Our Student Research Continues to Generate Interest

These results, which Gosling said were surprising to their group, were actually quite consistent with our own, which have focused on the relationships between feelings of loneliness and Facebook use by college students. We have found that the image of people constructing some alter ego online that is vastly different from who they really are just hasn’t worked for social networking sites like Facebook. Our participants who are very lonely are not compensating for that by spending more time online or seeking to amass huge networks of friends. Facebook seems to be WYSIWYG, literally.

I suppose the down side of all this attention is that we have to stop tweaking our data (we’ve improved our questionnaires from last year’s APS presentation and are collecting more data and running more analyses) long enough to finalize our papers for publication.  Sometimes it’s hard to fit that in with midterms and grad school apps, but I want the students to really be involved with all steps of the project. Stay tuned!

Just a quick note (due to some painful publishing deadlines this weekend) to wish everybody a Happy Valentine’s Day and a Happy Chinese New Year!

Daughter Karla drew this picture for the Year of the Tiger. Mr. F and I are dragons, which should come up again in 2012. I can hardly wait to see what Karla draws for that!

Karla's Year of the Tiger

If you want to see more of Karla’s artwork (my favorite is her animation of the Florida Gator kicking a Razorback through the goalposts), she has her own website, VixDojo.com.

Today provided a fun opportunity to discuss our student group’s loneliness and Facebook research with an audience far from home–via Mike Blanchard’s “Calgary Today” show on AM 770 CHQR. Their news producer had asked me to respond to an article in the Atlantic that suggested that the ubiquitous connectedness technology provides today might actually be making us more lonely, rather than less.

I'm the Underlined Part of Mike Blanchard's Show

In my 15 minutes on the air, I tried to explain that the Atlantic had some things correct and others not. Our research confirms the idea that loneliness is highly negatively correlated with the number of self-reported confidants a person has. The fewer the confidants, the higher the person’s score on the UCLA Loneliness Scale (Russell, 1996). We use the full 20 question version, but you can see a short version here. In our regression analysis, the other factor that really pops in predicting loneliness is a person’s total face-to-face time spent with friends and family. Time spent on the cell phone or on Facebook was not significantly correlated with loneliness at all.

Our differences of opinion with the Atlantic occur in the contribution of social media and technology to loneliness. True, during the same decades that people’s reported number of confidants dropped like a stone, there was a steady increase in the use of technology. But our research does not show that people who report high amounts of face-to-face contact are less likely to spend a lot of time on their cell phones and Facebook. This is not an either-or situation. We are dealing with college students of course, and ALL of them seem to spend a lot of time on cell phones and Facebook.

If anything, I suspect that having cellphone conversations and Facebook might actually soften some feelings of loneliness. We just don’t have the data to evaluate this idea yet. One of my daughters just returned from a year’s deployment in Iraq, and felt that Facebook made it much easier for her to feel connected to her friends and family.

One of the callers to the show did make a valid point–some people reduce the quality of their face-to-face time with others by constantly taking cell phone calls in the middle of conversations, etc. But this, to  me, is simply bad manners.

I did enjoy the way Mike moved the conversation along–it was easy, and hopefully entertaining. What really astonished me, as a Californian who bundles up for any temperature under 60 degrees, was the weather report for Calgary that was on while I was on hold before the show. Zero degrees? I just don’t do zero degrees!