Wednesday, April 29, 2020

Beyond Criminal Justice: Implicit Bias Impacting U.S. Healthcare Amidst the COVID-19 Pandemic

In April of 2020, National Public Radio released a story regarding the ongoing coronavirus pandemic. The news outlet reported that alarmingly, African Americans in multiple states were less likely to receive a coronavirus test even when they exhibited symptoms of COVID-19 such as a cough and fever. This is especially harmful to African American populations when taking into consideration the fact that minority groups tend to have higher rates of conditions like high blood pressure, kidney issues, and diabetes, all of which are risk factors for greater severity of COVID-19. Beyond a lesser likelihood of receiving efficient testing from doctors and thus slower essential treatment for the disease, racial and ethnic minority populations and people of lower socioeconomic status are also suffering as communities from biased location of testing at large. In Tennessee, multiple cities (e.g., Nashville and Memphis) have concentrated coronavirus testing in predominantly white, wealthy areas, with limited (if any resources) in lower-income and primarily black neighborhoods. More and more pockets of cases are becoming visible around the country, and many of them are concentrated among black communities. This concerns experts because those groups are the very populations that are at greater statistical risk of contracting worse cases of COVID-19, primarily due to the aforementioned likelihood of people of color suffering from chronic conditions. Poorer and more diverse neighborhoods may also be more vulnerable to COVID-19 because of limited internet access (and therefore important information about the virus) and a potential lack of transportation to increasingly popular drive-through testing sites, so testing access is more limited for these communities as a whole.

            Dr. Yael Granot’s research focuses on implicit racial bias in a different context (primarily in deciding punishments based on visual attention and relating that to the legal system). Her research analyzes the pattern of individuals’ eye tracking when watching ambiguous fight scenes in an attempt to measure visual attention and see its relation to deciding punishments for people in different social groups (relating these punishments to race, which is a highly visible kind of social identification). She found that the kinds of visual attention paid to a member of the social outgroup (i.e., the person in the simulated situation that the participant did not identify with socially) led to a differing severity in punishment. In general, a slight visual focus on the person in the outgroup led to a harsher punishment. So when people pay a bit more attention visually to someone with whom they do not identify in some (primarily visual) social manner, they are more likely to punish that outgroup more harshly, exhibiting their implicit bias for groups that lack a connecting socially identifying component.

            Though Dr. Granot focuses on demonstrating bias in visual attention and punishment, the types of patterns that she is identifying within a criminal justice setting can be more broadly observed in other areas of our society, one of which being in healthcare. Dr. Granot provided evidence of an inherent bias against social outgroups unless a participant was focusing more strongly on that outgroup, so in normal context that outgroup would likely be more harshly punished by that participant. Evidence of a similar inherent bias may be seen in the article described above, detailing doctors’ potential implicit bias against African Americans attempting to be tested for the coronavirus; this bias could potentially stem from a lack of social identification between doctors and African American patients, thus leading to a less understanding and sympathetic attitude toward that patient group. Additionally, those in charge of allocating resources like testing sites in various states may succumb to a similar kind of social identification bias if they come from regions of the state that are more comparable to the predominantly white and wealthy areas than to the poorer, majority-minority neighborhoods of cities. If this bias is present, it would mean that the social identification aspect would be present and preferential toward white and/or wealthier people, and lead to greater priority given to that population than to areas which may empirically need the resources more urgently, but do not have the advantage of positive social identification with those decision-makers and thus could be suffering more due to this possible implicit bias.


Sources:

Granot, Y., Balcetis, E., Schneider, K. E., & Tyler, T. R. (2014). Justice is not blind: Visual attention exaggerates effects of group identification on legal punishment. Journal of Experimental Psychology: General, 143(6), 2196–2208. https://doi.org/10.1037/a0037893

Violent Videogames and Youthful Aggression

           Ever since violent video games like Grand Theft Auto and Call of Duty existed concerns surface whether these genre of video games are encouraging children to perform violent acts on others. Important and powerful figures like Hillary Clinton compared the effects of violent videogames on young children to the effects of smoking and lung cancer in adults. Unfortunate events, like mass shootings where the active shooter was considered youthful, is the starting point in relating video game violence to youthful aggression. With technology being an integral part in today’s society, children are more likely to be exposed to certain things they would otherwise be considered too young for. 
            Laura Stockdale and her colleagues performed an experiment focusing on observing infrequent and frequent videogame players by observing their emotional state while engaging with violent video games. Stockdale and colleagues later conducted another experiment that measured gamers and non-gamers empathy through a self-questionnaire and utilized electroencephalography to determine their emotional state while interacting with violent videogames. The results from Stockdale’s experiment suggested that gamers had on average lower levels of empathy compared to non-gamers. Therefore, this data also suggests the more an individual’s interacts with violent videogames, the more likely they are to exhibit anti-social behavior such as high aggression and low empathy. 
            In the article “The Impact of Degree of Exposure to Violent Video Games, Family Background, and Other Factors on Youth Violence”, Whitney DeCamp and Christopher J. Ferguson were interested in other factors that could also lead to anti-social behavior along with violent videogames such as the degree of exposure to violent videogames and family background. DeCamp and Ferguson distributed questionnaires to students in the fifth, eighth, and eleventh grade at public schools and public-charter schools. Also, just to note informed consent was provided to both the student and their family or legal guardian. The questionnaire possessed questions relating to physical altercations with others, violent video game play propensity, parental attachment, yelling and violence in the household, and if children even been physically hit by an adult. The results in this study were that male and female children who reported playing violent videogames more often than those who did not are more likely to report having hit someone. Also, yelling or violence in the child’s household was associated with a greater risk of hitting others. Additionally, parental attachment and youth disclosure was significantly related to lower risk for hitting others. On the other hand, children who reported being hit by an adult was at a greater risk of hitting others compared to children who reported they did not get physically assaulted by an adult. 
            Both results from both experiments suggests that those who play videogames more often than those who do not are more prone to being aggressive and less empathetic. This should not come as a surprise because first person shooter games like Call of Duty ‘hacks’ into the brain’s reward system because when an individual gets a ‘kill’ it can cause a dopamine overload. On the other hand, when the player gets ‘killed’ rage is likely to accompany their death. Many individuals have fallen victim to this trap especially during these undesirable times of COVID-19. However, with further studies similar to Stockdale and colleagues and DeCamp & Ferguson presenting new information, one can be more cognizant about the possible negative effects of videogaming. 

Link to article:
https://link-springer-com.flagship.luc.edu/content/pdf/10.1007/s10964-016-0561-8.pdf

The Two Sides of Gaming



        With the current COVID-19 pandemic many people agree that life will most likely not be the same as it was at the start of 2020. The negatives out of this outbreak have been strict social distancing rules, many people being stuck at home days at the time, and lastly some people are beginning to suffer from some serious mental problems. According to Verizon one of the many activities that has increased due to the pandemic has been video gaming by nearly 75%. Many people will quickly jump to the assumption that it is a horrible thing. People are constantly hearing that video games cause violence, it’s bad for kid’s brains etc. However, in reality video games are exactly what many people need at times like this and many should consider playing them more. As with many topics there are two sides to the issue and I would like to offer a look into both of them.

        One of the talks our Neuro class had this semester was Dr. Laura Stockdale’s talk “Effects of Media violence on behavior and emotional Processing”. In this talk Dr. Stockdale talked about how herself and her fellow colleagues have done research in the past in regards to the various impacts violent media has on people, more specifically when it comes to behavior. One of the articles given to us was “Cool, callous and in control: superior inhibitory control in frequent players of video games with violent content”. In this article Dr. Stockdale measured the P100 as well as the N200/P300 ERP’s (also known as Event related potentials) of different individuals. Her goal was to measure these different event related potentials for both empathetic emotional responses in frequent video game players as well as non-frequent video game players. This study found that the event-related potential in charge of “happy” facial expressions (N100) was decreased which indicated a lower level of empathy in frequent violent video game players. The general idea here is to demonstrate that frequent usage of violent video games can decrease a person’s emotional output.

        On the other hand we have Time’s article “Don't Feel Bad If Your Kids Are Gaming More Than Ever. In Fact, Why Not Join Them?” by Sean Gregory. In this article Sean talks about how during COVID-19 instead of stressing out about what is going on he has been able to destress and enjoy some time playing video games with his son. Not only is he playing more games but in general everyone is. Nintendo (one of the most popular gaming companies of all time) recently released their long running game of Animal Crossing. They have sold over 3 million copies in Japan alone since it’s release in March of this year. Like previously stated, the majority of people are spending more time behind screens playing games, and according to some research video games actually provide important social, motivational, emotional and a variety of cognitive benefits. Dr. Granic of the developmental psychopathology department of the University of Radboud in the Netherland, as well as leading “Games for Emotional and Mental Health Lab” states “You build your own gardens with other people. You play in teams overcoming other teams and militias and whatever it is. And it’s really checking a lot of those social needs in this time of isolation. And as much as kids need us, they need each other just as much.” Dr. Granic goes on to talk about how instead of not allowing kids to play games that parents should give kids tasks before games. She states how she lets her kids play as many games as they want, as long as they do their homework first, practice playing a musical instrument, do some coding, read part of a novel, and go outside for an hour.

        Dr. Granic is not alone in this type of thinking. In 2016 the Columbia Mailman School of Public Health conducted a study of high video game usage among kids of the ages 6-11. In this study it was found that children with high video game usage showed high intellectual functioning and competence in school as well as fewer relationship problems among their peers. In the Time magazine Dr. Granic goes on to further explain how video games help people grow and develop a wide range of skills. “People learn how to negotiate, collaborate, to take turns, to think critically with others, and so on,” says Granic. “Motivationally, people learn how to persevere in the face of failure. Not only can games help people develop these crucial skills but video games are also helpful for people with mental and or behavioral problems. Dr. Carras has a research paper titled “Connection, meaning, and distraction: A qualitative study of video game play and mental health recovery in veterans treated for mental and/or behavioral health problems” in which she shows the therapeutic benefits of video games among veterans.

        Video games have shown to alleviate mental and behavioral problems in veterans, they provide children with a wide variety of essential skills, help individuals deal with stress and depression but also physically change people's brains. A study back in 2014 by german researchers showed that adults that played Super Mario for around 30 Minutes a day showed an increase of Grey Matter in the right hippocampus, right prefrontal cortex and the cerebellum, regions involved in functions like spatial navigation, memory formation, strategic planning and fine motor skills.

        It is important to understand that like with many things, topics like violence and video games, there are always two sides to the argument. There have been studies that have shown violent video games show an increase in aggression, but there have also been multiple studies that show the opposite. Video games also provide people with important skills as well as a good de-stressor from the things that go on outside our homes. However, there are also many people that suffer from video game addictions and ruin their lives because of this. As with many topics there is no right or wrong answer, one must consider the different things affecting the topic at hand. For people that state video games (not just violent, but video games in general) cause violence I would tell them to take a look at countries like Japan and South Korea. These places are considered the Mecca’s of video games. Virtually everyone in these countries play video games, and they have some of the lowest crime statistics in the world. As previously stated one has to look at the whole picture and also factor in things like environmental factors, pre-existing mental conditions etc.

Work Cited
Colder Carras, Michelle, et al. “Connection, Meaning, and Distraction: A Qualitative Study of Video  Game Play and Mental Health Recovery in Veterans Treated for Mental and/or Behavioral Health Problems.” Social Science & Medicine (1982), U.S. National Library of Medicine, Nov. 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC6193255/.

Gregory, Sean. “Video Games Benefit Quarantined Kids in COVID-19 Pandemic.” Time, Time, 22 Apr. 2020, time.com/5825214/video-games-screen-time-parenting-coronavirus/.

Kühn, S, et al. “Playing Super Mario Induces Structural Brain Plasticity: Gray Matter Changes Resulting from Training with a Commercial Video Game.” Molecular Psychiatry, U.S. National Library of Medicine, Feb. 2014, www.ncbi.nlm.nih.gov/pubmed/24166407.

Stockdale, Laura, et al. “Cool, Callous and in Control: Superior Inhibitory Control in Frequent Players of Video Games with Violent Content.” OUP Academic, Oxford University Press, 4 Oct. 2017, academic.oup.com/scan/article/12/12/1869/4344826.

“Time Spent Playing Video Games May Have Positive Effects on Young Children.” Search the Website, 2 Mar. 2016, www.mailman.columbia.edu/public-health-now/news/time-spent-playing-video-games-may-have-positive-effects-young-children.

Risk Factors and Autism

Autism spectrum disorder (ASD) is a developmental disorder that affects the ability to communicate and interact. Individuals with this disorder process faces differently and this emerges early in development. The New York Times article titled, “What Causes Autism?” talks about different risk factors that are associated with autism. Autism runs in families and there are certain genes that increase the chances of the disorder. There are also certain mutations that could lead to autism. Scientists have identified around hundred different genes that once mutated could cause ASD. The article further talked about different environmental factors that could also lead to ASD. For instance, the use of S.S.R.I could trigger ASD as it affects serotonin which is found in high levels in autistic people. Since autism runs in families having had a previous child with ASD could increase the risk of having another child with the disorder. Additionally, males are three times more likely as females to have the disorder. Overall, these risk factors do not mean that one will get the disorder and autism is very rare with only 1.8 percent of the children in the USA have it.
            In the article “Neural correlates of face processing in etiologically-distinct 12-month-old infants at high-risk of autism spectrum disorder” researchers examined neural correlates of face and object processing in twelve month old infants with high risk ASD with FXS versus ASIBs. They recorded the Event-related potentials to familiar and unfamiliar face and toy stimuli. The results showed that controls expressed greater potentials to new stimuli whereas infants with FXS exhibited opposite patterns and kids with ASIBS did not differentiate between different stimuli. These results show differences in facial specialization across infants with high and low risk for ASD. 
              Even though there is no cure for autism, being able to diagnose it earlier can help people reduce some of the symptoms of autism. There are certain therapies that kids with this disorder can enroll in which can help them participate in typical activities. Both of the articles talked about the risk factors involved with autism. The first article talked about the genetic and the environmental risk factors involved with autism. Whereas, the second article talked about the differences in facial specialization that are associated with autism. If we pay close attention to these risk factors, we can be more prepared to help children suffering with autism.  I am looking forward to learn more about autism and where the research regarding ASD goes in the future. 



Treating Epilepsy with rTMS

            Epilepsy, one of the most common neurological disorders is characterized mainly by seizures. Dr. Hui Ye spoke about this in his lecture and his article, “Neuromodulation with electromagnetic stimulation for seizure suppression: From electrode to magnetic coil” which Ye collaborated on with Dr. Stephanie Kaszuba. In their paper, Ye and Kaszuba highlighted common treatments for epilepsy. While there are anti-epileptic drugs on the market today, not many are very effective. If drugs do not work, there is also the option of surgically removing the part of the brain that causes the seizures to occur, but these procedures are irreversible and have many issues on their own such as losing function in certain areas of the brain (Ye & Kaszuba, 2019).
Aside from these options, there are more effective ways to treat epilepsy. Two options for electrical stimulation is either Deep bran stimulation, which involves implanting an electrode deep into different structures of the brain. This method has been found to be successful in treating and preventing seizures, however, complications from surgery or inflammation around the device can occur which can cause loss of function of structures within the brain. The second electrical stimulation method is Transcranial direct current stimulation. This method is done by placing a cathode and anode on a patient’s head and delivering a weak electric current which decreases cortical excitability. Although this method is safe it is not as effective (Ye & Kaszuba, 2019).
            A new method of treatment that Ye and Kaszuba shed light on is repetitive transcranial magnetic stimulation (rTMS). This treatment works through magnetic stimulation of neurons within the brain. This treatment is effective and does not have adverse effects such as surgical complications or biocompatibility issues (Ye & Kaszuba, 2019).
            In an article published in Scientific American, “Treating Epilepsy’s Toughest Cases” by David Noonan different treatments for epilepsy and their effectiveness is discussed. The ineffectiveness of pharmaceutical treatments was discussed the most. Although there are many different anti-epileptic drugs, many people who suffer from epilepsy do not respond to these drugs. It was also said that new anti-epileptic drugs are not being worked on currently for those who do not respond to the ones out now. Another approach that was discussed was the electrode being implanted as the treatment for those who do not respond to drugs (Noonan, 2017).
            Although transcranial magnetic stimulation was not discussed in this article. The discussion of ineffective drugs helped to enforce the idea that transcranial magnetic stimulation is the way forward for treating epilepsy. This article also talks about implantation of electrodes and these patients having to carry around battery packs for these electrodes to work which highlights the invasiveness of this procedure. With transcranial magnetic stimulation, invasiveness is not a problem, which makes it seem like one of the best options for treating epilepsy.
Ye, H., & Kaszuba, S. (2019). Neuromodulation with electromagnetic stimulation for seizure suppression: From electrode to magnetic coil. IBRO Reports, 7, 26-33. doi: 10.1016/j.ibror.2019.06.001
Noonan, David. Treating Epilepsy’s Toughest Cases. Scientific American, 2017. https://www.scientificamerican.com/article/treating-epilepsy-rsquo-s-toughest-cases/

Rethinking Etiology: Autism Spectrum Disorder



In research conducted by Dr. Maggie Guy and colleagues, the study titled Neural correlates of face processing in etiologically-distinct 12-month-old infants at high-risk of autism spectrum disorder, reports the EEG recordings of infants at high risk of developing Autism Spectrum Disorder (ASD). Data were collected among three groups; infants with siblings diagnosed with ASD (ASIBs), infants with fragile X syndrome (FXS), and a low-risk control group. Their particular focus was on areas of activity associated with face processing, with the primary ERP components being N290 and P400 located in the temporal and occipital regions. Dr. Guy and colleagues averaged the activity levels of the event-related potentials (ERP) across each of the trials. They found that ASIBs showed muted N290 responses, while infants with FXS had higher amplitude responses. Their results suggest that different neural activity patterns in high-risk infants distinguish the two ASD groups and reveal different developmental trajectories.

While very compelling, Dr. Guy’s research brings with it additional questions regarding the neural differences between different high-risk ASD groups. If there are apparent differences in neural activity between ASIBs and individuals with FXS, does the same apply to where precisely in the brain that activity takes place? In a study conducted by Andrew Mckechanie and colleagues, this question is delved into more detail using a functional neuroimaging approach. Like Dr. Guy’s study, the area of interest concerns facial processing and specialization.

Using functional magnetic resonance imaging (fMRI), Mckechanie’s study manages to explore further the differences in brain activation between individuals with idiopathic autism, FXS with no autism diagnosis, and individuals with FXS with a comorbid autism diagnosis. The study recorded the blood-oxygen-level-dependent (BOLD) signals for both groups in response to images of fearful and neutral faces. According to the data produced, they found that there was significantly reduced activation in the left superior temporal gyrus and superior temporal sulcus in individuals with FXS and comorbid autism compared to the participants with FXS alone. Their data suggest that autism in FXS and idiopathic ASD have significant differences compared to those of non-autistic individuals with FXS. With the addition of Dr. Guy’s research, the combination of both studies may suggest altogether that there are further groups that might be included in future research. Autism spectrum disorder does encompass a wide variety of symptoms, but as the research suggests, it overall might have the same neurological basis with regards to facial processing mechanisms.


References


McKechanie, A. G., Campbell, S., Eley, S., & Stanfield, A. C. (2019). Autism in Fragile X Syndrome; A Functional MRI Study of Facial Emotion-Processing. Genes, 10(12), 1052. https://doi.org/10.3390/genes10121052



Guy, M. W., Richards, J. E., Tonnsen, B. L., & Roberts, J. E. (2018). Neural
correlates of face processing in etiologically-distinct 12-month-old infants at high-risk of autism spectrum disorder. Developmental cognitive neuroscience, 29, 61-71. https://doi.org/10.1016/j.dcn.2017.03.002



The Rising Pandemic: Media Violence


With the rapid increase in technological advancements within our society, people of all ages, cultures, and backgrounds have implemented technology into their lifestyle in one way or another. It is common for a child to possess some sort of technological device accessible to the internet. Although there are many benefits to this increase in technology, it also comes with certain repercussions. One of the main issues society is facing is whether or not media violence affects the behavior of individuals in a negative manner. This controversy is especially concerning young children who are constantly learning and adapting to their environment. Because it is unethical to test and determine causation between media violence and violent behavior in children, it is nearly impossible to conduct research giving factual evidence linking these two things. Here, we examine the decorated opinions of Vanessa LoBue and Laura Stockdale who both believe there is a positive correlation between media violence and increased behavioral violence. 

In Psychology Today’s article, “Violent Media and Aggressive Behavior in Children”,
author Vanessa LoBue addresses the issue of why violent media is causing an increase in violent behavior in children. In fact, she explains that there are multiple pieces of evidence linking these two things together leading all the way back to Bandura’s Bobo Doll experiment (LoBue, 2018). She continues to back her claim with a more recent study done by Dillon and Bushman in 2017. In the study, children were either shown a movie with guns or a movie without guns and placed in a room with a hidden and empty 0.38-caliber handgun. The researchers were interested to see what the children would do if they found the handgun. Shockingly, “ the kids who watched the movie that contained gun footage were more likely to pull the trigger of the real gun” (Dillon and Bushman, 2017). Opposingly, they found “almost none of the kids who watched the movie clip without guns ever pulled the trigger” (Dillon and Bushman, 2017). Additionally, LoBue explains “that media violence won’t immediately give someone an aggressive child, however, it is certainly a start”. It is clear from this article published by Psychology Today that there is an ample amount of evidence linking media violence to aggressive behavior in children.

In Laura Stockdale’s article, "Cool, callous and in control: superior inhibitory control in frequent players of video games with violent content”, she discusses how media violence leads to aggressive behavior in individuals as well as a decreased state of empathy. In a broader sense, Stockdale wanted to see the influence of media violence on cognitive and emotional control. She used students from an urban university for her experiments. Using an online questionnaire, LoBue identified and invited thirty-two frequent players of graphically violent video games and thirty-two infrequent players of graphically violent video games to participate in an EEG study. “These participants were then given a 28-item questionnaire that assesses four distinct aspects of empathic responding: perspective taking, fantasy, empathetic concern, and personal distress”. Participants were also given an SST test where they were to identify fearful vs happy faces. After multiple experiments, Stockdale obtained several results. As predicted, results showed that frequent players had significantly lower empathic concern scores than infrequent players (F(1, 59)=7.61, p=0.008; infrequent players M = 28.55 SE = .78; frequent players M = 25.15, SE = .98” (Stockdale, 2017). She also found, “at low levels of empathy, frequent players had reduced P100 amplitudes compared to infrequent players” (Stockdale, 2017). Before her experiments, the P100 response is usually at a higher level with people who express a response to emotions. However, it was clear people who played violent video games had lower P100 levels than people who did not play violent video games as much. Overall, her conclusions supported her hypothesis of the correlation between video games and aggressive behavior in individuals. 

Both of these articles clearly portray the correlation between media violence and aggression in individuals, especially children. However, it is important to note neither these studies nor past studies have shown direct causation between these two topics. Thus, we can come to a consensus on a specific conclusion. Reflecting and analyzing both of these articles can allow us to confidently say media violence is a risk factor and a promoter for aggressive behavior in individuals. Because children learn from their environments, we can also say that media violence may potentially cause aggressive behavior in children. 

This controversial question within our society has floated around for years and will continue to do so until further research links direct causation between media violence and aggressive behavior in children. 

Citations:

LoBue, V. (2018, January 8). Violent Media and Aggressive Behavior in Children. Retrieved from
https://www.psychologytoday.com/us/blog/the-baby-scientist/201801/violent-media-and-aggressive-behavior-in-children

Stockdale, Laura, et al. "Cool, Callous and in Control: Superior Inhibitory Control in Frequent
Players of Video Games with Violent Content." Social Cognitive and Affective Neuroscience,
vol 12, no. 12, April 2017, pp 1869-1880.