Richard G. Petty, MD

Violence and Diet

We have talked before about the link between nutrition and violence.

The evidence has continued to mount and I was pleased to see that the Wellcome Trust is funding trials in three British prisons to investigate the link between nutrition and behavior. This is a placebo study that will examine which nutrients are most important and at what dosage.

Volunteers from three young offenders institutions housing male prisoners aged 16 to 21 will take nutritional supplements in addition to their normal choice of food to ensure they receive the necessary vitamins, minerals and essential fatty acids to meet daily guidelines. The investigators will monitor how levels of nutrients affect a range of behaviors including violence, drug-related offences and incidents of self-harm.

The new trials build on previous research published in the British Journal of Psychiatry that was conducted at the then maximum security Young Offenders Institution in Aylesbury, Buckinghamshire. That study was funded by Natural Justice, a research charity that investigates the social and physical causes of offending behavior. Nutritional supplements – 2 grams per day of the omega-3 fatty acids EPA and DHA for three months – were given to ensure that inmates’ diets reached recommended UK dietary standards. The researchers found that the prisoners who consumed the active nutrient capsule committed on average 26% fewer disciplinary offenses overall than those taking the placebo and 37% fewer violent offenses.

The most likely reason why supplements can have such a large effect is because the proper functioning of nerve cell membranes and signaling molecules depends upon adequate amounts of minerals, vitamins and essential fatty acids in the diet.

This is extremely important work. Clearly nutrition is not the only driver of violence but it has been wondered for a long time whether the industrialization of our diets has contributed to the enormous rise in violent crime between the 1950s and 1970s.

“Violence is the last resort of the incompetent.”
Isaac Asimov (Russian-born American Biochemist and Writer, 1920-1992)

“Blessings crown the head of the righteous, but violence overwhelms the mouth of the wicked.”
–The Bible (Proverbs 10:6)

“Peace cannot be achieved through violence, it can only be attained through understanding.”

–Ralph Waldo Emerson (American Poet and Essayist, 1803-1882)

Mindfulness and Depression

Mindfulness meditation has rightly been receiving a lot of attention recently. It is quite simply a technique in which you become intentionally aware of your thoughts and actions in the present moment, non-judgmentally. Though originally a Buddhist technique, it is something that can be practiced by anyone, and there are, in fact, similar techniques that have been developed by Christian mystics and Sufis.

It has recently been discovered that some of the techniques that were developed so that a mystic or meditator could carry on without distraction, may also have value in treating clinical problems. After all, if a group of people has spent a thousand years developing tools and techniques for managing the mind, it might be a good idea to see what they have discovered!

There have recently been several excellent books on the use of mindfulness in the management of depression:
The Mindful Way Through Depression
Relaxation, Meditation and Mindfulness
Mindfulness and Acceptance: Expanding the Cognitive-Behavioral Tradition

This whole field was moved forward by some research from San Francisco (NR822) that was presented at the end of May at the 2007 Annual Meeting of the American Psychiatric Association in San Diego. The researchers used Mindfulness-Based Cognitive Therapy (MBCT) in a group of 53 people with treatment resistant depression.

MBCT is based on the Mindfulness-based Stress Reduction (MBSR) eight-week program that was developed by Jon Kabat-Zinn in 1979 at the University of Massachusetts Medical Center. Research has show that MBSR can be enormously empowering for people with chronic pain, hypertension, heart disease, cancer, and gastrointestinal disorders, as well as for psychological problems such as anxiety and panic.

Mindfulness-based Cognitive Therapy grew from this work. Zindel Segal, Mark Williams and John Teasdale adapted the MBSR program so that it could be used for people who had suffered repeated episodes of depression.

The results of the study presented in San Diego showed that MBCT was effective in reducing depression when compared to treatment as usual: what we call “TAU.” What seems to happen is that MBCT gives people a set of skills for detaching from the stream of depressive thoughts and feelings. As a result the symptoms decrease. Though the study will need to be expanded and replicated, this is clearly a fertile area for research.

This work is also interesting in the light of recent research showing that mindfulness training may improve the activity of some of the subsystems of the brain dedicated to attention, as well as helping some people with mental illness control their aggressive behavior. Mindfulness training may also help to reduce subjective reduces distress and improves positive mood states. It seems to be particularly good at reducing distracting and ruminative thoughts and behaviors.

And just for good measure, mindfulness may help some smokers quit.

“The purpose of meditation is not enlightenment, it is to pay attention even at extraordinary times, to be of the present, nothing-but-in-the-present, to bear this mindfulness of now into each event of ordinary life.”
–Peter Matthiessen (American Naturalist and Writer, 1927-)

“Meditation is not to escape from society, but to come 
back to ourselves and see what is going on. Once there is 
seeing, there must be acting. With mindfulness, we know 
what to do and what not to do to help.”
— Thich Nhat Hanh Vietnamese Buddhist Monk, 1926-)

“Conscious means “having an awareness of one’s inner and outer worlds; mentally perceptive, awake, mindful.” So “conscious business” might mean, engaging in an occupation, work, or trade in a mindful, awake fashion. This implies, of course, that many people do not do so. In my experience, that is often the case. So I would definitely be in favor of conscious business; or conscious anything, for that matter.”
–Ken Wilber (American Philosopher, 1949-)

Aggressive Bullies, Sleep and Breathing

Here is yet another possible problem associated with poor quality sleep and breathing problems during sleep.

Research from the University of Michigan that was presented at SLEEP 2007, the 21st Annual Meeting of the Associated Professional Sleep Societies in Minneapolis this week, suggests a link with aggression.

Aggressive behavior and bullying are common amongst schoolchildren and are likely to have multiple causes. But a new one, and one which may be an undiagnosed, is sleep-related breathing disorder (SRBD).

The study focused on children in the second through fifth grades who attended school in an urban public school district. Parents completed two well-validated rating instruments: the Conners’ Parent Rating ScalePediatric Sleep Questionnaire SDB Scale. Teachers completed the Conners’ Teacher Rating Scale (CPRS) the  (CTRS). The numbers of discipline referrals in the previous 12 months were obtained from the six elementary schools.

A total of 345 CPRS’s and 245 corresponding CTRS’s were completed. The main finding was that schoolchildren who bully may be more likely to have an SRBD than their peers.

An SRBD may be a problem in more than 10 percent of children. It occurs when the airway is partially blocked during sleep. The most common example is snoring. The most severe form of an SRBD is obstructive sleep apnea. It occurs in about one percent to two percent of children.

If you suspect that your child or grandchild might be suffering from an SRBD or, for that matter, any type of sleep disorder, it is a really good idea to consult with your child’s pediatrician, who can see of he or she needs to be referred to a sleep specialist.

We already know that treatment of an SRBD may improve other mood, attention and behaviors in
children. We do not know if treatment might reduce aggression and bullying, and that will be the next research project.

Violence and Nutrition

There is a small but impressive body of evidence about the impact of nutrition on violence. It started with some simple observations concerning nutrient content and behavior in animals. In 1942 the wartime British government was persuaded to supplement the diet of all children with cod-liver oil and orange juice. It was speculated that among other ills, poor diets could lead to antisocial behavior. You humble reporter was still required to take this foul-tasting concoction when he was a child in England very many years after the War.

Over the years evidence has grown to support this link between nutrition and antisocial behavior and a longstanding debate developed about the possible role of nutrition and food additives on the ever-increasing rates of violence in society as a whole. Regular readers may remember the publication several months ago of a report entitled Feeding Minds that implicated nutritional changes in the burgeoning rates of mental illness in the United Kingdom.

Part of the problem with much of the work on nutrition and violence has been that there were vested interested involved. Some people have been trying to prove that all the world’s ills are the result of food additives and others have been trying just as hard to prove that their products are safe. The other problem has been the simplistic notion that it is possible to reduce human behavior to a single nutrient.

Humans are complex creatures. Coffee may make you irritable. If you happen to be a small coffee-drinking furry rodent, you may not be you may not have much choice in the matter. But one of the points about developing frontal lobes is that you should have the ability to override the coffee: you can choose whether or not you want to be irritable. A teenager may not be able to do that: he or she does not yet have fully formed frontal lobes. Alcohol can be such a big problem because not only does the alcohol stimulate some of the emotional regions of the brain but it also suppresses the frontal lobes. Whatever you may have done while under the influence probably seemed like a really good idea at the time!

There have now been a couple of very interesting studies that do suggest that nutritional supplementation may have a significant impact on violent behavior in prisoners.

The first modern experiment was reported in the British Journal of Psychiatry in 2002. 231 young adult prisoners were enrolled in a double blind, placebo-controlled, randomized trial of nutritional supplements comparing disciplinary offences before and during supplementation. The prisoners were given a capsule of “Forceval” as well as a combination of essential fatty acids (A daily dosage of four capsules providing 1260 mg linoleic acid, 160 mg gamma linolenic acid, 80 mg eicosapentaenoic acid and 44 mg docosahexaenoic acid). Those receiving the supplements committed an average of 26.3% fewer offences, which improved yet further with longer supplementation. The conclusion of the study was that, “Antisocial behavior in prisons, including violence, are reduced by vitamins, minerals and essential fatty acids with similar implications for those eating poor diets in the community.”

The British Guardian newspaper recently ran a well-balanced article about some of these research initiatives.

This research is being replicated at various sites because if it is true it has enormous implications for personal well-being and for the whole concept of legal responsibility.

Could it be that some of society’s ills are the result of a failed uncontrolled experiment in force-feeding the population?

Mel's Madness

In the midst of all the furor about Mel Gibson and his self-admittedly foul behavior while under the influence of alcohol, an important point has been missed: when someone is drunk or brain damaged, is their behavior just disinhibition? Are they behaving this way because they’ve lost the cerebral censor that normally maintains our social demeanor? The Romans certainly thought so: in banqueting halls they would have roses carved into columns and the ceiling. The rose – the symbol of secrets – was a reminder to be discrete when alcohol might begin to lossen the tongue.

When the frontal lobes are on strike, does our “true” personality emerge? Or can alcohol, drugs and brain injury produce brand new behaviors that are not just totally out of character, but predictable by the drug or type of injury?

The answer is a mixture of the two. I know a man who is in the running for the Nobel Prize in medicine. But a couple of years ago it was all over the press when he shattered the arm of an innocent man in the middle of an alcohol-fueled frenzy. Was it the alcohol? Yes, I’m sure that it was. But the scientist has had a very long history of anger problems and of bullying younger colleagues. The alcohol was the catalyst to behavior that he normally keeps in check, but which was just waiting to come out of its cage. I’ve treated hundreds of alcohol abusing people, and the amiable ones far outnumber the violent ones. And the majority of the violent ones had also been violent when not drinking.

Some drugs and chronic alcohol abuse can produce stereotyped hallucinations and behaviors. Some alcoholic people really do see bugs and pink elephants, and there are many other examples of predictable perceptual and behavioral disturbances with drugs and with brain injuries.

Students of the healing arts learn that damage to certain regions of the brain is associated with specific behavioral and emotional consequences. This teaching goes back more than a century, and generations of students have been told that, “Damage here causes depression, and damage here causes mania, and over there a lesions will damage one type of language.” Yet for three decades we have known that much of this teaching is fictitious. I was taught brain localization by some of the finest neurologists in the world, and yet each would admit the inaccuracy of their methods. A new study from Brisbane, Australia supports that nihilism. The investigators examined 61 consecutive people admitted to a stroke unit. “Strokes” are either vascular blockage or bleeds affecting the brain.

They could find no significant relationship between the side or location of a lesion and the development of post-stroke depression. But the kinds of people that they were before the stroke had a big impact:  pre-morbid neuroticism and a past history of mental disorder were important predictors of depression following stroke.

So why all the fuss about Mel? Because people are asking if deep down inside he really has been harboring some of the dark, mean spirited thoughts that he expressed to the police, and that the alcohol was the catalyst and not the creator of his diatribe.

“The intoxication of anger, like that of the grape, shows us to others, but hides us from ourselves. We injure our own cause in the opinion of the world when we too passionately defend it.”
— Charles Caleb Colton (English Clergyman and Author, c.1780-1832)

Technorati tags:

Video Games and Violence

For years now, there has been a vigorous debate on both sides of the Atlantic about the impact of violence in the media and the behavior of young people. I’ve seen various statistics indicating that the average teenager, by the time he or she graduates from high school, will have seen thousands of people killed on television. Most professionals have seen young people who no longer have any concept of death: they assume that if someone is killed they will simply get up and play another scene. As bizarre as this sounds, there have been multiple reports of this happening with young people involved in some of the most notorious acts of violence seen in schools.

This month see the publication of an important report from Iowa State University, where a research team has been examining the effects of violence in the media for several years now.

This latest report, "The Effects of Video Game Violence on Physiological Desensitization to Real-Life Violence," was published in the current issue of the Journal of Experimental Social Psychology. Previous research has come to the intuitively sensible conclusion that exposure to violent video games increases aggressive thoughts, angry feelings, physiological arousal and aggressive behaviors and at the same time decreases helpful behaviors. This is very worrying when we discover that more than 85 percent of video games contain some violence, and approximately half of video games include serious violent actions.

The latest research involved 257 college students (124 men and 133 women). First, the investigators made some baseline physiological measurements of heart rate and galvanic skin response, which reflects sweating and blood flow in the skin. They then asked questions to control for the students’ preference for violent video games and general aggression. The participants then played one of eight randomly assigned violent or non-violent video games for 20 minutes.

When viewing real violence, participants who had played a violent video game experienced skin response measurements significantly lower than those who had played a non-violent video game. The participants in the violent video game group also had lower heart rates while viewing the real-life violence compared with the nonviolent video game group.

This research shows that people who play these violent video games get so used to violence that they become desensitized to it: it no longer affects them. Given the numbers of games and the enormous numbers of people playing them, the results are shocking: it could be said that modern entertainment media are systematically desensitizing millions of young people to violence.

Are you happy about that?

Shouldn’t we – both individually and collectively – be doing something about this?

Technorati tags:

logo logo logo logo logo logo