2014 Winter Workshop
Rethinking Psychosis: Culture, Brain, and Context*
January 10 – 11 (Friday – Saturday), 2014
*Due to the interest this topic has generated we will be posting a summary of our discussions at cbdmh.org. Stay tuned!
Day 1 (Friday, Jan 10, 2014)
Rethinking Psychosis: Overview
Thinking About Psychosis in Context: Steps Toward a Cultural Neurophenomenology / Laurence J. Kirmayer, MD, MD, FRCPC, James McGill Professor and Director, Division of Social and Transcultural Psychiatry, Department of Psychiatry, McGill University; Editor-in-Chief, Transcultural Psychiatry
Endophenotypes for Psychotic Bipolar Disorder in a Genetically Isolated Population / Carrie Bearden, PhD, Associate Professor, Departments of Psychiatry and Biobehavioral Sciences and Psychology, UCLA
This presentation focuses on our study of multi-generational pedigrees genetically enriched for psychotic bipolar disorder in a two closely related Latin American population isolates, located in Antioquia, Colombia and the Central Valley of Costa Rica (CVCR). In the context of these families, we have been investigating neuroanatomic, cognitive, and temperament traits hypothesized to be relevant to disease processes involved in bipolar disorder. I will also discuss our new findings on relationships between the socio-cultural environment, daily stress, and emerging symptoms in adolescent children of adult pedigree members. The long-term goal of these studies is to investigate how genetic and neurobiological factors and the social world inter-relate in the expression and course of the illness, given the high penetrance of psychotic bipolar illness in these pedigrees. Link to related paper in press.
11:00–11:30am Coffee Break
“Living Under the Description of a Psychotic Disorder”
Family Socialization and Neurobiological Processes / Steven R. López, PhD, Professor, Department of Psychology, USC; Member, Board of Directors, Foundation for Psychocultural Research; Mary Helen Immordino-Yang, PhD, Assistant Professor of Psychology, Brain and Creativity Institute; Neuroscience Graduate Program Faculty, USC
We will discuss a line of schizophrenia research that begins to integrate the study of social processes with neurobiological processes. We first present a clinical case that suggests that family caregivers’ efforts to orient the ill relative to the social world is associated with greater social orientation of the ill relative and in turn better social and clinical outcomes. Second, we discuss findings from a pilot study that examines the relationship of the quality of social orientation of ill relatives and its association with both social and clinical functioning. Third, we examine the neural correlates of patients’ social orientation scores, social functioning, and clinical symptoms using fMRI imaging during a specially adapted social emotional processing task. To do so, we adapted Immordino-Yang and colleagues’ (2009) novel methodological approach for inducing two varieties of compassion in the scanner: compassion for social pain, a more abstract, inferential emotion, and compassion for physical pain, a more direct, context dependent and concrete emotion. These emotions are now known to be associated with different neural signatures in regions of the brain related to the so-called “default mode network” (DMN). Because it is known that DMN systems function atypically in schizophrenia, we applied a simplified version of this task to examine the functioning of the default mode network in 11 subjects with schizophrenia. Current analyses focus on testing for correspondences between patients’ real-world social functioning, measured using ecologically valid methods, and patients’ neural responses during the structured compassion induction task. Our overarching aim is to begin to investigate relations between real-world functioning and neural processing. Link to related paper.
12:30–1:30 pm Lunch Break
Psychosis and the Environment
Psychosis and Recovery in Cultural Context / Robert Lemelson, PhD, Adjunct Professor, Department of Anthropology, UCLA; President, The Foundation for Psychocultural Research. Link to related chapter in press.
Psychological anthropology has a long history of providing detailed, person-centered ethnography on thought disorders that have documented both the universality and particularities of these experiences. However, there have been few, if any, visual ethnographies on the subject. This presentation will highlight aspects of a fifteen-year film project on serious mental illness in Indonesia, with a particular focus on the subjective, phenomenological, and psychosocial factors that are salient to the longstanding question of differential outcome for psychotic disorders in the West vs. the “developing” world.
Understanding the Self: A Cultural Neuroscience Approach / Georg Northoff, MD, MA, PhD, EJLB-CIHR Michael Smith Chair in Neurosciences and Mental Health, Canada Research Chair for Mind, Brain Imaging and Neuroethics, Institute of Mental Health Research, University of Ottawa
Schizophrenia is a mutlifaceted disorder where the self of the patient is severely altered. Old psychiatrists like Bleuler or Kraepelin even spoke of schizophrenia as a disorder of the self. My talk will focus on the neural correlates of self and how they are related to resting state activity. This is complemented by recent findings on schizophrenia and its resting state, including the implications of these findings for the self and its relation to the phenomenology of self in schizophrenia.
3:30–4:00 pm Coffee Break / Day 1 Adjourns
Day 2 (Saturday, Jan 11, 2014)
Psychosis and the Self (cont’d)
Evolutionary Psychology of Delusion / Ian Gold, PhD, Associate Professor of Philosophy & Psychiatry, McGill University in Montreal
Contemporary theories of delusion have largely failed to explain the content of the known forms of delusion. In this paper we take an evolutionary perspective in order to try to do so. We argue that the evolution of cooperation would have required human beings to develop the ability to evaluate the trustworthiness of potential cooperative partners. We posit the existence of a hard-wired system for this purpose which we call the “Suspicion System,” and we argue that delusions are states that arise when the Suspicion System is disordered. Link to related chapter in press.
Anthropologists and Neuroscientists Talk Shop
10:00–12:00 pm (with Coffee Break)
This is a minimally structured session for participants to to learn about each other’s methods and the latest technologies; to talk to each other about issues or concerns relevant to fostering a more integrated understanding of psychosis; and to workshop new collaborations between lab and fieldwork.
Boxed Lunch / Workshop Adjourns