Thursday, 8 November 2018

Red Hands

Today's post is by Francesco Filippi (pictured below), an Italian director, screenwriter, and animator whose work can be found here. In this post he tells us about his new film, Red Hands, which addresses the theme of domestic violence.

Can an animated film for teenagers have something to say to the readers of this very interesting blog which explores the boundaries of the human mind? Red Hands, an Italian 30' long film in stop-motion and 2D animation, had his premiere at the Rome Film Festival on October 20th, 2018.

As you can see from the trailer above, it's a story of domestic abuse. Ernesto, a 12 year-old boy, discovers that the magnificent red graffiti appeared on the walls of his street are made by Luna, a girl with a mysterious power. She can emit a blood-like liquid from her hands, but her power is a side-effect of her father's violence at home.

Tuesday, 6 November 2018

What Does it Take to Be a Brain Disorder?

In this post, Anneli Jefferson, Leverhulme Early Career Fellow at the University of Birmingham summarizes her paper on the nature of brain disorder, recently published in Synthese.

A long-standing project pursued by some psychiatrists is to show that mental disorders are brain disorders and that mental dysfunction can best be explained as brain dysfunction. But what exactly is the relationship between mental disorders and brain disorders and when is a mental disorder a brain disorder? This is the question I address in my paper. Some psychiatrists believe that it follows from the acceptance of physicalism that all mental disorders are brain disorders. If all mental states are brain states, shouldn’t all disordered mental states be disordered brain states?

Many philosophers have resisted this conclusion, appealing to the hardware/software distinction to argue that even if dysfunctional mental processes are realised in the brain, this does not mean that the underlying brain processes are also disordered. Just as there can be a software problem without there being anything wrong with the hardware, there can in principle be a mental problem without any systematic problem in brain function.

This argument is often supported by appeal to multiple realizability: one mental dysfunction can be realised by many different brain processes in different individuals or in one individual over time. There may not be a stable underlying brain pattern that realises a specific psychological dysfunction.

In the paper, I suggest that when we do find an underlying brain difference that realises psychological dysfunction, we should characterize this as a brain dysfunction because it realises mental dysfunction. This means that in some cases (for example, amygdala hypofunction) the characterisation of brain difference as dysfunctional is derivative of the psychological level, because the reason the brain anomaly is characterized as dysfunctional is purely that it realises psychological dysfunction.

There is no independent, brain-internal criterion that characterizes these differences as dysfunctional, instead the characterization of brain dysfunction depends on the psychological level. This should not worry us, I argue, because the brain is the organ of thought, so it stands to reason that we look at the interaction between disordered processes of thought and feeling and brain anomaly when figuring out which brain differences constitute brain dysfunctions.

Thursday, 1 November 2018

IMH Inaugural Forum

On 15th October the Institute for Mental Health (IMH) had its Inaugural Forum at Hornton Grange at the University of Birmingham. The event was live-tweeted by the Mental Elf and the IMH. The whole project PERFECT team attended the Forum and this report comes from their collective notes.

In the morning session, Eoin Killackey (Orygen) and Paul Burstow (IMH) started the day with two fascinating talks on youth mental health.

Killackey gave a very international talk, analysing a variety of interventions and forms of support available for young people across the world, reflecting on the many lessons those who wish to improve the UK youth mental health system can learn from these programs. 

Two particularly interesting focal points were on how to improve the transition from youth to adult services, and how to better separate services on the basis of demographic and developmental evidence about the prevalence and nature of youth mental health difficulties. 

Burstow spoke of the need not just to increase spending on youth mental health across the UK, but more importantly of the need to reallocate existing funding towards intervening on the causes of mental ill health, rather than simply tackling the consequences.

From Paul Burstow's talk

Before the lunch break, Karen Newbigging (IMH) and Sophie Stammers (Project PERFECT) facilitated a very interactive session asking what makes coproduction successful. Participants were divided into groups and asked to share their experiences of coproduction. 

Key themes were the need for (a) managing expectations in coproduction; (b) making young people participating in research aware of the remit and the constraints of the project they are asked to help with; (c) offering something back to people participating in research (e.g. training skills); (d) offering expertise to support good ideas coming from people with lived experience of mental health services.

Parallel to this session, Maria Michail (IMH) and Anna Lavis (IMH) facilitated a workshop on how the wide range of disciplines involved in mental health research at the IMH could break out of their own ‘silos’ and work together to better understand and prevent self-harming and suicidal behaviours in youth populations. 

Participants were divided into groups and worked together to begin to develop ways of overcoming existing personal and structural barriers to interdisciplinary research.

In the afternoon, Sophie Dix (Director of MQ) talked about the financial cost of mental illness and the cost in terms of loss of life. There is a lot in the press about raising public awareness of mental health, decreasing stigma, and improving services. But there is very little about making treatment better and research is part of the solution.

Sophie Dix

MQ raises money for research into mental illness. There is great disparity between funding for research for cancer and dementia and funding for research for mental health. And in mental health there is too much ‘trial and error’ and not enough prevention. Further, there is a lack of innovation when it comes to finding the best treatments. No huge progression has been made with psychological treatments either: those we have today were developed in the sixties.

MQ is focused on research that is: (1) multidisciplinary, (2) transdiagnostic, (3) international, (4) focused on impact, (5) aimed at investing in the future. MQ thus applauds the creation of multidisciplinary centres such as the IMH, where scientists from different disciplinary backgrounds work together from the start. 

MQ encourages international collaboration and funds the best research, whether it is based in the UK or elsewhere. Examples of the research they fund includes depression in people with HIV in Uganda; whether women are more responsive to psychological treatment for anxiety depending on where they are in their menstrual cycle; effects of folic acid for protecting people against schizophrenia.

One big focus is on youth mental health: it takes too long for people to get help since they show the first symptoms of mental illness. MQ created a consortium to address the challenges youth mental health poses and coproduce research ideas by people in the physical and social sciences. 

MQ used sandpits to attract people who had expertise in public engagement and collaborative projects. The result was people coming up with ideas (developing a screening tool for mental illness, e.g. suicide prevention and risk scores for depression in adolescents).

Tuesday, 30 October 2018

Phenomenology Imported with EASE

Rolf Hvidtfeldt is postdoctoral fellow at the Humanomics Research Centre at Aalborg University in Denmark. His research is mainly focused on the philosophies of science evaluation, scientific communication, and conflicts of perspective. Currently he is working on a project focused on mapping the various ways in which research (in a broad sense) affects (in a broad sense) society at large.

He has recently published the book The Structure of Interdisciplinary Science in which he seeks to develop a method for examining epistemic aspects of interdisciplinary collaborations. The following blogpost briefly summarises key elements of ch. 8 of this book, which is a case study picked from schizophrenia research.

In the The Structure of Interdisciplinary Science I develop a method, approach-based analysis, for studying interdisciplinary science in deep detail. Chapter 8 of the book is a case study in which this method is applied to a case of interdisciplinary research. The case in question is part of an ongoing research programme, EASE – short for Examination of Anomalous Self-Experience, in which philosophical phenomenology is combined with more traditional (psychiatric and psychopathological) approaches to schizophrenia research. The core ambition of EASE is to link schizophrenia to certain disturbances of basic structures of consciousness. Intuitively, this seems reasonable, since schizophrenia seems to involve obviously abnormal subjective experiences.

Capturing the subjective experience of what it is like to suffer from schizophrenia would certainly enrich our best representations of schizophrenia considerably. And further, if specific disturbances in structures of consciousness could be determined, and these could be shown to be causally related to symptoms of schizophrenia, this ought to attract a lot of attention in psychopathological research. There is little doubt, that such a finding would have considerable impact on future developments in psychiatric nosology and diagnostics.

Thursday, 25 October 2018

Delusions in Context

On 15th October at Hornton Grange Matthew Broome, director of the Institute for Mental Health in Birmingham, chaired the book launch of Delusions in Context (Palgrave Pivot, 2018), a collection of four new papers on delusions. The book is truly interdisciplinary, featuring authors with a background in psychiatry, lived experience, psychology, cognitive neuroscience, and philosophy, and is available open access on the Springer website.

I edited the book. At the launch, I explained how the book fits with the work we have been doing as part of project PERFECT. In the project one of the objectives is to examine whether beliefs that we consider as epistemically irrational (either not supported by existing evidence, or resistant to new counter-evidence) can nonetheless have some benefits for the person who adopts such beliefs. Benefits could be cashed out in terms of increased wellbeing or reduced anxiety, enhanced motivation to pursue epistemic goals, or better performance in some contexts. Can delusions play a positive role at all, maybe one often hidden from view?

The book consists of four chapters, written by Rachel Upthegrove and S.A. (chapter 1), Phil Corlett (chapter 2), Richard Bentall (chapter 3), and myself (chapter 4).