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A Conversation With Antonio Damasio and Siri Hustvedt
Dr. Antonio Damasio is a renowned neuroscientist who direct's the USC Brain and Creativity Institute. Before that he was the Head of Neurology at the University of Iowa Hospitals and Clinics. His research focuses on the neurobiology of mind and behavior, with an emphasis on emotion, decision-making, memory, communication, and creativity. His research has helped describe the neurological origins of emotions and has shown how emotions affect cognition and decision-making. He is the author of a number of books, including "Self Comes to Mind: Constructing the Conscious Brain," which will be published in November, 2010. Dr. Damasio is also the 2010 winner of the Honda Prize, one of the most important international awards for scientific achievement.
Dr. Damasio is a Big Think Delphi Fellow.
Antonio Damasio: I’m Antonio Damasio. I’m a neurologist and a neuroscientist and I’m here, delighted to talk to Siri Hustvedt who is a novelist, but has an enormous knowledge about neuroscience. Very uncommon I must say, and very deeply and very well-researched and thought through and I would like to talk to her about mind and behavior and brain and about how notions such as the notion of consciousness have varied and evolved over the years and how they have an enormous impact on what we understand as society. And also how neuroscience has changed and has changed for reasons of fashion and you know technical ability over the years and how very often with a bit of luck one can make... one can create separations in one’s career and go in different directions that may hopefully tell us novel things about science and the future.
Siri Hustvedt: My name is Siri Hustvedt. I am a novelist and an essayist who has an abiding interest in neuroscience. Today I would like to talk to Antonio about the deep biological realities of what we think of as consciousness, how this relates at least in some way to culture and some of the historical antecedents that are very important to contemporary thinking about the brain and the mind.
I’ve spent a number of years studying neuroscience, reading papers and first the essential aspect of this for me was learning the vocabulary, learning parts of the brain and trying to put it into a larger context in relation to my studies in philosophy, linguistics and various other subjects, which I think has been extremely helpful and we might begin by thinking about the 19th Century roots of neuroscience and I know that in your work you have mentioned both philosophical and scientific origins of certain ideas, for example, homeostasis.
Antonio Damasio: That’s a very, very central idea. Homeostasis is sort of a long word, not terribly beautiful, but it refers… and one good way of giving a synonym of homeostasis is "life regulation." It is something that has been extremely important in the history of neuroscience, and I think it’s going to become even more important as we go forward. In the 19th Century, a number of major physiologists, perhaps most importantly Claude Bernard, a French biologist and physiologist, talked about life regulation and talked about the fact that we have inside ourselves an internal milieu; something which is entirely inside the membrane, the covering of our organism and that of course contains all the roving chemistries that allow life to be inside the boundary of one’s body and he talked about the fact that there were very specific forces and very specific processes that regulated this incredible process and made it compatible with life and actually the word homeostasis only came to be coined...
Siri Hustvedt: It’s canon. Yes, it’s quite late.
Antonio Damasio: Quite late. It’s in the twentieth century. It’s much, much later.
Siri Hustvedt: Yes, but in 1915 Freud talks about something very similar and instincts and their vicissitudes in an essay that is not a late essay of Freud’s really. And he is already talking about something that is very much I think compatible with the idea of homeostasis.
Antonio Damasio: Absolutely. Absolutely and it was something that you know as very often happens in these… with these ideas and with some of these facts. They’re in the air and different investigators, writers, thinkers take them and use them in their work and sometimes with different names, but they’re there. They’re the parts of the thinking style and of the thinking apparatus, and in the vocabulary at that time.
Siri Hustvedt: Absolutely. It’s almost like an atmospheric condition, so that these ideas and we can get to this later, but I’m very interested in how sometimes ideas seem to be absorbed almost by osmosis, so to speak, as you know unconsciously, not necessarily consciously. But Helmholtz for example, also Freud, was highly indebted to biophysics and to people who came before him, so it’s not as if he invented this idea.
Antonio Damasio: No, and of course one always has to think also that people very often change their careers as they go along and Freud is a very good case in point. Freud really begins as a neurologist very much with the same kind of training that I had, except one century before. And it is very interesting that a lot of the formative ideas of neurological training for Freud appear expressed in things that have apparently nothing to do with neurology as such, for example, the sort of tripartite division of one’s mind with the different....
Siri Hustvedt: Yes, the ego, id and uber-ich or superego.
Antonio Damasio: Exactly. All of that matches very well and was probably very much inspired by what Freud knew of neuro-anatomy and if he had not known neuro-anatomy, if he had not had to train with the neurology of the time that might not have come the way it did to him.
Siri Hustvedt: Absolutely, and the fact that somewhat later Freud includes unconsciousness in his idea of the ego I find very interesting and very compatible with your ideas and other ideas that are abroad in neuroscience now, that what we think of as the self or our subjectivity is highly influenced by these unconscious forces, an unconscious part of the self that is not reflective.
Antonio Damasio: Yeah, exactly, yeah and that we are... we are in fact this hodgepodge of non-conscious and conscious processes with some part of our consciousness trying to ride herd over this mess of non-conscious processes and which of course needs to be very clearly spelled out because you have of course the people that listen to something like what we’re saying and say "Oh my God, they’re saying that you have no control over one’s self and one’s behavior and no willpower of any kind." And of course that is false because we do have a measure of control, but it is not true that we have full control and it is not true that when we are executing an action we are necessarily controlling it at that moment consciously.
Siri Hustvedt: Yes, I think this might be an opportunity to talk about a very famous finding that created tremendous uproar among philosophers and neuroscientists, which is Benjamin Libet’s finding—which is very simple for people who don’t know about this—is that... Subjects were asked to move a finger for example, this finger and Libet discovered that something called a readiness potential in the brain that could be measured was going off about a third to a half of a second if I remember correctly, before the subject had any conscious awareness of wanting to move the finger. Now this of course became a free will debate and when I read these findings and read other people talking about them I remember saying to myself, "Does free will necessarily have to be, first of all, a fully conscious action?" I mean if you’re thirsty and you get a glass of water you don’t necessarily have full, subjective linguistic consciousness of getting a glass of water, right, so but also I think you might want to refine this notion of the degree to which a finding like that does not tell us that we have no free will.
Antonio Damasio: Well, it doesn’t because in fact most of the notions that we associate with deliberation and decisions that are important for one’s life are not taken the same way that we move this finger or we pick up the glass. When we think about important decisions in one’s life, when we think about, for example, what we’re going to do with ourselves in terms of one’s career or what we’re going to... you know, how our relationship is going to be, whom we’re going to get married to or live with, those decisions are not taken on the fly. Those decisions are, in fact, deliberated. And I love the word deliberated; it’s a word that has sort of disappeared from the vocabulary of decision making studies. But that is exactly what you’re doing. Sometimes you deliberate for minutes or hours or weeks or months and you do it not in the moment of execution of the action. You do it offline. You take yourself away from the moment and you put yourself in a space that in fact competes with what you’re doing in the moment. One thing that I like to point out is that if you are deliberating, even about something as simple as what you’re going to do this afternoon. For a moment you say, “How am I going to plan this? I need to talk to three different people and I have only certain number or hours. How am I going to organize this?” You don’t do that at the same time that you drive and drink glasses of water and other such. You take yourself away from the perceptual moment and in fact you do that in such a way that others looking at you will get the impression that you are distracted and when somebody says that you are distracted you’re not paying attention. It means you’re not paying attention to me. What you’re paying attention is to what you’re going to do. And it’s a very interesting theory because what that does is also give you an incredible inkling as to how and where these processes are going on in the brain, because it immediately serves notice that there is a competition going on between what is in the perceptual brain...
Siri Hustvedt: Phenomenal reality.
Antonio Damasio: Exactly. And what is in your mind’s eye and ear as you plan stuff and because in fact those two spaces are one in the same, then there is a competition in most brains.
Siri Hustvedt: Spatially, if we want to use the metaphor, in the brain they aren’t necessarily in competition.
Antonio Damasio: They aren’t necessarily in competition, so and that is why for example there are all these things that are very well known that people sort of turn their eyes up and sort of look at the ceiling as their thinking or they close their eyes, they close their eyes as they deliberate because if they don’t their eyes they’re going to have the images of the perceptual moment competing with the images that they’re forming.
Siri Hustvedt: Absolutely and attention is a fairly limited quantity in the human mind. In other words, you can pay attention to something out there or you can pay attention to what I call the internal narrator, but paying attention to both does not work. I mean the interesting experience, for example, reading that we both do a great deal of... And suddenly I realize that I am reading the page, I am taking in the words, but my mind has traveled. This is a familiar experience. My mind has traveled onto some other subject so that I have some cognitive relation to the page, but it’s not one of semantics and understanding.
Antonio Damasio: Right, exactly, yeah and there is… But what is so fascinating is the limitation of this space, is the fact that we don’t have… In other words, our screens. And you know, I’ve been through hating metaphors that have to do with theaters.
At most the prefrontal cortex is guiding the process, but I think there is one, while we are discussing screens, metaphoric screens and different spaces, where the show is going on, auditory, visual and olfactory and tactile and so on. I think what is interesting is to think that those spaces, those performance spaces, are separate. They’re extremely sophisticated. They tend to be, in terms of brain structure, very, very modern in evolution. They tend to have some of the most sophisticated circuitry. Take for example the visual system. Our visual system is an amazing instrument and of course the visual system that allows us to perceive right now something with a fine perception that I can have of your collar and your sweater and so on. All of that is extremely sophisticated, but then surrounding that, let’s consider that like an island in the brain and then surrounding that there is an ocean and that ocean is filled with knowledge of how different parts, different components of past perceptions have been put together in time when they were occurring. And so I think that an interesting analogy is the analogy of strings that pull the puppets that are in the performance spaces and so it’s not that we should privilege the performance spaces as the thing that matters. Of course that matters very much because that is where our consciousness...
Siri Hustvedt: That’s how we live.
Antonio Damasio: Yeah, that’s where our consciousness is actually occurring, quote, unquote, but it is occurring there only by the grace of these strings that are being pulled from the other space, from this elsewhere where you have what I like to call convergence/divergence zones, which are in of themselves...
Siri Hustvedt: Now this is new. I just want to say just pause for a second because this convergence/divergence this is what you’re… You’re making a broader category for parts of the brain that I recognize, but you are putting it together in a larger context as I understand after reading your book yesterday.
Antonio Damasio: Good.
Siri Hustvedt: Okay, just to… I just wanted to give that little info.
Antonio Damasio: Your spirit has enlarged tremendously.
Siri Hustvedt: Anyway.
Antonio Damasio: But, so yeah, that is a… It’s very interesting because from a neural standpoint you could even say that these structures are in of themselves rather dumb. It’s not that they know anything consciously. What they know is they have a sort of internal testimony of the simultaneous occurrence of certain things at a certain point. So for example, if I will tomorrow remember talking to you today I will think of certain words that you have said like for example, the sentence you just said about the book, which I probably will remember in some form and I will remember the fact that you have this sweater that I presume is pink, although I’m not very good with color.
Siri Hustvedt: Very pink.
Antonio Damasio: Is pink okay?
Siri Hustvedt: Yes.
Antonio Damasio: Good, okay.
Siri Hustvedt: Deep pink.
Antonio Damasio: Deep pink and the white shirt and your beautiful blonde hair. So how do I put this thing together? This is occurring right now and I am recording the simultaneity of occurrence of your voice, of certain ideas and of certain garments, but they are in different places, so we need to find in the brain a place where signals about all these different things can come together and can make a record of the proximity and simultaneity of this in time is what counts.
Siri Hustvedt: That’s right, yes. Temporality, we’ll go there next, yes.
Antonio Damasio: And once that happens, once that record is made then it is possible to reactivate the record and to come back into the same regions where this is happening to us right now and reconstruct something that is going to be a paler version of the original, but it’s going to relate to the original and that by the way, gets you into one very important issue, which is the issue that you don’t have a facsimile memory of anything.
Siri Hustvedt: No, this is important, yes.
Antonio Damasio: I don’t have a memory. I’m not going to have a Polaroid picture of you right now talking to me complete with soundtrack. What I’m going to have is all these bits and pieces of information with which I will be allowed to reconstruct something of this moment, but of course the reconstruction is not going to be entirely accurate, and who knows? Maybe then in time I may even make a confusion and I could be asked in court to say what you were wearing and I could say that you were wearing a blue...
Siri Hustvedt: Actually and I think this is quite important, the fact that our brains and our memories are not like recording devices, not like film and that that is how we make sometimes significant errors. And those errors also can be created by an emotion attached to the he experience, so that you can even entirely invert a memory, depending on the motivation in some way—and I don’t mean conscious motivation, but a deeply embodied drive or push sometimes that can have an emotional valence that will change memory.
Antonio Damasio: Right, absolutely and people you know the testimonies in court are very often affected by that and you have all sorts of misattribution errors, inversions of the time sequence and so and that is because we don’t have a filmic medium. We don’t have celluloid with an optic soundtrack attached to it. What we have is this incredibly sophisticated mechanism of transforming… It’s almost like coding. You have these little bits and pieces that are occurring in time and then you have the possibility of reconstruction or reactivation, which is they are very, very, very intriguing and by the way, it is extremely economic. You know the brain whenever it can, does things fuzzily and lazily and you know if there is no need to repeat and reinvent the wheel it won’t.
Siri Hustvedt: Well, and I think this is very important for perception because perception, the way we perceive things has to do with deep learning in the brain and one of my favorite philosophers, who you mentioned a footnote in your most recent book, Maurice Merleau-Ponty talks about perception as something he calls stereotypes and in neuroscience there is a similar idea, which is that the brain also will take in information according to its own expectations.
Antonio Damasio: Absolutely. Yeah, because we don’t… You know it’s not just that we have memory of the things that we have been living through since we were born. We have past memories that we have inherited through a whole history of evolution before us that in fact have memories of things that our forerunners have been doing and I’m not just talking about the human forerunners, but forerunners that go all the way into reptiles and single cells. You know things that have been done in a certain way in life forms and that of course been memorized by the biological systems we inherited.
Siri Hustvedt: Antonio, I’m interested in the fact that you started working on emotion in neuroscience before it was a very popular thing to do. I think the legacy of behaviorism has something to do with that and how did it happen? How did you start working on emotion, long ago now?
Antonio Damasio: That is a very interesting story and it happened largely because of a set of observations in patients curiously with prefrontal damage, patients that we came to realize resembled a lot a very famous, but incompletely studied patient in the history of neuroscience known as Phineas Gage. And the fact that after studying those patients in great detail we could not explain their failures of decision making and their completely disrupted social life in terms of impaired intellect, impaired language, impaired memory and something else needed to figure into the explanation and that something else offered itself very clearly to us, had to do with emotion. And that is when we said "Well, it’s obvious that a very strong hypothesis for why these people fail so miserably in real life, real time when if you put them in the laboratory and you ask them the question of what would you do they turn out to be so normal is that there is something in the execution that is very strongly influenced by emotion or by the lack thereof." And something that was very clear is that these patients were no longer normal in terms of their emotions. Their emotions were attenuated—that’s to say the least.
And there was alt something else, is that there were certain emotions of what we call the social variety of emotions such as compassion, guilt, embarrassment, shame. Those emotions seemed to be lacking, so there was a very, very specific impairment of a range of emotions known as social emotions and at the same time this attenuation of emotions in general, so we turned to that—meaning me and my wife Hannah and the people that were working with us—and people were extremely negative and we’re talking about late '80s, early '90s and people said, “Why on earth are you doing this? Everybody knows what needs to be known about emotion has been done. Everybody knows. You seem to like William James. Everybody knows William James was wrong, which was incredibly pathetic and you’re doing so well with language and memory. You’re going off the deep end.”
You know, I remember actually presenting my first paper on somatic marker hypothesis at the Society of Neuroscience, and there was one person in the first row that just shook his head and said, “How can this poor guy be so wrong?” You know, “Why is he doing this?” Anyway, we did it and we had the only other colleague... Well there were several people that were interested in emotion, but not in a very prominent way. You know someone like [...] who was very interested in emotions both in animals and in humans and there was somebody studying emotions in animals—that was Joe LeDoux—and he was doing beautiful work that had to do with fear and the amygdala. And it is very interesting because we actually organized in 1995 the first symposium on emotion at the Society for Neuroscience. They had never had a symposium on the neuroscience of emotion.
Siri Hustvedt: Well it is extraordinary.
Antonio Damasio: It’s extraordinary and we organized this first symposium, so it’s very interesting. This was one year after I published "Descartes’ Error" and at that time people were sort of warming up more to the idea and of course as you know it has become extremely popular.
Siri Hustvedt: It’s a huge field now.
Antonio Damasio: It’s a huge field. It’s a huge field in neuroscience and everybody talks about it and then of course there was the impact of the studies of emotion on the studies of moral behavior and social behavior in general. The impact in economics; because of course something that is very interesting is that these patients who had all these problems with social behavior and with their emotions and their decisions were very poor at decisions in the area of finances for example and they made a complete mess of their lives.
Siri Hustvedt: They seemed to lack the ability to project themselves into the future in order to plan well and that is so closely related to the psychiatric disorder of psychopathy that this is fascinating. So you know there has to be a neural relation between these two illnesses.
Antonio Damasio: Absolutely, yeah, yeah and of course the big difference here is that for example most of our patients, one might even say practically all of our patients, turned out not to be psychopathic in the criminal sense. Of course we’re talking about patients who had normal development and who grew up until say age 30, 40, 50 as entirely normal human beings, productive members of society and so on.
Siri Hustvedt: And then they have a brain lesion.
Antonio Damasio: And then they have a brain lesion. Now what this… And they normally don’t have criminal behavior. They’re generally not violent and other such and they don’t get into problems with the law. However, we have since discovered and this is now one of the main themes of our work at the Brain Creativity Institute that if you have this damage early on, if you have this damage in your first years of life...
Siri Hustvedt: Yes, I read that paper.
Antonio Damasio: That story is completely different and what happens is that people will become in fact in some cases indistinguishable from psychopaths, and they will never learn the moral system. You know, people try to inculcate that moral system and they don’t learn it. And we think that the lack of emotion is extremely critical there—and this by the way is very interesting because it’s different from most of the consequences of early lesions on the human brain. For example, if you have a lesion at let’s say age three in language areas the brain will compensate for that and you will end up being a normal speaker of your native language and you can learn languages and you will have some linguistic deficiency. You will not become Siri the novelist, but you will speak normally and nobody will think that you are an idiot. If you have something in your visual system you also have these kinds of compensations. You go to the prefrontal cortex and you damage emotion and then you have something that stays there forever and that is not compensated. So it probably is indicating that these systems are very old and relatively singular and not duplicated and there is much less possibility of compensation because you have only... basically only one system serving the entire...
Siri Hustvedt: This whole spectrum.
Antonio Damasio: This whole spectrum. Exactly, whereas, with language you have this… You know it’s very interesting because the older the functions like say emotion or aspects of consciousness the more the operators in the brain are near the midline. They’re near the midline. They sort of look... They look at each other like they’re looking you know across the way to another building and they’re very, very close to the midline and that is of course where you would want them in terms of evolution because these are very old systems that were necessary for life regulation. Once you start going towards the more evolved functions, say language, certain aspects of memory, vision, then you go into the outer aspects of the hemispheres and the structures are separate in the left and in the right hemisphere and, of course, they link functionally, but if you damage one you have some very good hope that the other side will compensate in part at least.
Siri Hustvedt: So the question, which is very interesting, is that in people who develop psychopathy who do not have a lesion, is there some kind of even speculative developmental hypothesis about early traumatic experience possibly or simply a failure to develop?
Antonio Damasio: There is an infinity of possibilities, which is why it is so difficult to research, but, for example, there is could be genetic defects that would influence the development of an area. There can be lots of things that can happen in intra-uterine life or that happened at the time of birth, and that can be very easily missed because there is no patent defect at the beginning. And in fact, one thing that we know now that we’re studying for example, premature babies, which are more and more frequent as you know, in our society. We find that there are numerous small lesions that can be missed and nobody will notice them, but now of course with scans that can be done more invasively like magnetic resonance scanning and that in fact can be done in pregnant...
Siri Hustvedt: You’re able to see them yeah, in utero, I know, yes, yes, yes. This is a new thing. This is great.
Antonio Damasio: You can look at the fetus development. Now we see that there are things happening that may probably be the telltale event that precedes these later developments. And then of course there are many other little lesions that can occur later and there is not much doubt that for example if you take a prison population in our country. Unfortunately we have plenty to pick from. We think that as you study these populations with proper systematic scanning there is a much larger number of lesions than one could have imagined, so in fact, we’re dealing with a mixture of pathologies and then of course when you think about all the social pathologies... that are independent in the brain and have to with poverty and with society and education.
You know it’s very often the case that people tell the story of consciousness as the sort of late development of this property which tends to be seen largely as human, but of course as we know it cannot be human only. It’s very widespread and this process of consciousness is the process that allows us to run our lives personally and in society the way we do. It’s the thing that gives us access to high thinking and high decision-making and very high qualities of reasoning. And that is sort of a late development in evolution and in the brain, and of course of the mind processes. And I think that this is entirely wrong and what I think is that the processes of running life and organizing life have been set from very early on in very simple life forms. In fact, in cells that are as simple as bacterial cells, which when you look at them have the most amazing capacities—they have capacities for example of organizing socially. They have capacity of thinning off individually for themselves and maintaining life and struggling for their existence and in fact they even have the possibility of organizing themselves to the point of doing what is now called by biologists working with bacteria is quorum sensing. They will be able, they the bacteria, without a brain, without a nervous system of any kind, they will be able to sense how many of them are there. “Is this enough to do what we need to do in this process?” “How can we fight for territory?”
Siri Hustvedt: But this is fascinating because it’s not self-reflective self-consciousness, but it has all the underpinnings of human social behavior.
Antonio Damasio: Exactly. And so what I think is happening with us is that little by little we have evolved the ability with our high brains and very complex organization of the nervous system we have evolved the ability to discover that these things exist and they’ve existed all along and to then project the process of consciousness into a completely different dimension, which instead of just running the basic homeostasis, just running the basic life regulation, which largely has been given by our genome, we can now invent something new, which his running what I like to call socio-cultural homeostasis; one in which we can create. We can deal with solutions, but I think the very interesting idea is that those solutions have as a blueprint the solutions that nature gave us, that they allow us to do something different from what nature, which fundamentally is indifferent and callous, ordained us to have and so this allows... I like to when people say, “Well what is social cultural homeostasis?” And I say, “Well do you know about the Supreme Court?” the U.S. Supreme Court is a cauldron for development of socio-culture.
Siri Hustvedt: Absolutely, the balance of powers, homeostasis.
Antonio Damasio: And the organization of financial systems is another such example and the appearance of the arts, the appearance of medicine, the appearance of technology. All of those are developments that have at their root exactly the same origin and the same cause and the same effect. They are related to the homeostatic impulse that can be broken when you are at a loss and they have as a purpose the restoring of lost homeostatic powers and you do that by laws, by moral systems, by medicine, by technology and by the arts to start with.
Siri Hustvedt: Yes and it’s true, but we could not have those things if we didn’t have this relational, this self conscious relational you know I, you or I, it that is represented to ourselves in some kind of symbolic system, so that is the highest result of this homeostatic impulse that is built into the most primitive animals or life forms.
Antonio Damasio: Yeah, so we need to represent something that has to do with the self as organizer of life and the self as knower.
Recorded July 2, 2010
The USC neurobiologist and novelist speak about various topics on neurology and memory.
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Gender and sexual minority populations are experiencing rising anxiety and depression rates during the pandemic.
- Anxiety and depression rates are spiking in the LGBTQ+ community, and especially in individuals who hadn't struggled with those issues in the past.
- Overall, depression increased by an average PHQ-9 score of 1.21 and anxiety increased by an average GAD-7 score of 3.11.
- The researchers recommended that health care providers check in with LGBTQ+ patients about stress and screen for mood and anxiety disorders—even among those with no prior history of anxiety or depression.
Study findings<p>For the study, <a href="https://link.springer.com/article/10.1007/s11606-020-05970-4" target="_blank">published in the Journal of General Internal Medicine</a><em>, </em>Flentje and her team evaluated survey responses from nearly 2,300 individuals who identified as being in the lesbian, gay, bisexual, transgender, and queer (LGBTQ+) community. Most of the participants were white, while nearly 19 percent identified as a racial or ethnic minority. Multiple genders were represented with cisgender women (27.2 percent) and men (24.6 percent) making up a majority of the participants. Sixty-three percent had been assigned female at birth. For the most part, participants identified their sexual orientations as queer (40.3 percent), gay (36.5 percent), and bisexual (30.3 percent).</p><p>The JGIM study participants were recruited from the 18,000-participant <a href="https://pridestudy.org/" target="_blank">PRIDE Study</a> (Population Research in Identity and Disparities for Equality), which is the first large-scale, long-term national study focusing on American adults who identify as LGBTQ+. It conducts annual questionnaires to understand factors related to health and disease in this population. </p><p>Participants filled out an annual questionnaire (starting in June 2019) and a COVID-19 impact survey this past spring. Flentje noted that on an individual level, some people may not have experienced a big change in anxiety or depression levels, but for others there was. Overall, depression increased by a <a href="https://patient.info/doctor/patient-health-questionnaire-phq-9" target="_blank">PHQ-9 score</a> of 1.21, putting it at 8.31 on average. Anxiety went up by a <a href="https://www.mdcalc.com/gad-7-general-anxiety-disorder-7" target="_blank">GAD-7</a> score of 3.11 to an average of 8.89. Interestingly, the average PHQ-9 scores for those who screened positive for depression at the first 2019 survey decreased by 1.08. Those who screened negative for depression saw their PHQ-9 scores increase by 2.17 on average. As for anxiety, researchers detected no GAD-7 change among the study participants who screened positive for anxiety in the first survey, but did see an overall increase of 3.93 among those who had initially been evaluated as negative for the disorder. </p>
Risks among gender and sexual minorities<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="fc3fd1ae68b77bbbf58a6995638d6d65"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/EnUqDjCqg0A?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p>The LGBTQ+ community is a vulnerable population to mental health concerns because of their fear of stigmatization and previous discriminatory experiences.</p> <p>Previous research by the Human Rights Campaign has found "that LGBTQ Americans are more likely than the <a href="https://medicalxpress.com/tags/general+population/" target="_blank">general population</a> to live in poverty and lack access to adequate medical care, paid <a href="https://medicalxpress.com/tags/medical+leave/" target="_blank">medical leave</a>, and basic necessities during the pandemic," said researcher Tari Hanneman, director of the health and aging program at the campaign.</p> <p>"Therefore, it is not surprising to see this increase in anxiety and depression among this population," Hanneman said in the release. "This study highlights the need for <a href="https://medicalxpress.com/tags/health+care+professionals/" target="_blank">health care professionals</a> to support, affirm and provide <a href="https://medicalxpress.com/tags/critical+care/" target="_blank">critical care</a> for the LGBTQ community to manage and maintain their mental health, as well as their physical health, during this pandemic."</p>
What should health care providers do?<p>The authors of the study recommend that health care providers check in with LGBTQ+ patients about stress and screen for mood and anxiety disorders in members of that community—even among those with no prior history of anxiety or depression.</p><p>As cases of COVID-19 continue to mount, the sustained social distancing, potential isolation, economic precariousness, and personal illness, grief, and loss are bound to have increased and varied impacts on mental health. Effective treatments may include individual therapy and medications as well as more large-scale coronavirus support programs like peer-led groups and mindfulness practices. </p><p>"It will be important to find out what happens over time and to identify who is most at risk, so we can be sure to roll out public health interventions to support the mental health of our communities in the best and most effective ways," said Flentje.</p>
What we know about black holes is both fascinating and scary.
- When it comes to black holes, science simultaneously knows so much and so little, which is why they are so fascinating. Focusing on what we do know, this group of astronomers, educators, and physicists share some of the most incredible facts about the powerful and mysterious objects.
- A black hole is so massive that light (and anything else it swallows) can't escape, says Bill Nye. You can't see a black hole, theoretical physicists Michio Kaku and Christophe Galfard explain, because it is too dark. What you can see, however, is the distortion of light around it caused by its extreme gravity.
- Explaining one unsettling concept from astrophysics called spaghettification, astronomer Michelle Thaller says that "If you got close to a black hole there would be tides over your body that small that would rip you apart into basically a strand of spaghetti that would fall down the black hole."
The team caught a glimpse of a process that takes 18,000,000,000,000,000,000,000 years.
- In Italy, a team of scientists is using a highly sophisticated detector to hunt for dark matter.
- The team observed an ultra-rare particle interaction that reveals the half-life of a xenon-124 atom to be 18 sextillion years.
- The half-life of a process is how long it takes for half of the radioactive nuclei present in a sample to decay.
A new study looks at what would happen to human language on a long journey to other star systems.
- A new study proposes that language could change dramatically on long space voyages.
- Spacefaring people might lose the ability to understand the people of Earth.
- This scenario is of particular concern for potential "generation ships".