It is amazing how many people remain resistant to the idea that Attention Deficit Hyperactivity Disorder (ADHD) is a genuine problem. It is likely becoming more common as we live in a progressively more demanding world in which our inner resources can easily become overwhelmed. It is a “real” problem since if it is severe it can cause suffering and second, ADHD can also be associated with a range of other difficulties. There is also more and more evidence that it is associated with robust disturbances in the structure and functioning of the brain.

There is an important study published in Human Brain Mapping that reveals an association between ADHD and a decrease in cortical volume, surface area and folding throughout the brain. Researchers from the Kennedy Krieger Institute in Baltimore, Maryland, found that children with ADHD has decreased total brain volume and decreased volume throughout the cerebral cortex. What is new is that the reduction in cortical volume seems to be the result of decreased folding in the cortex. This in turn suggests that folding – a process that starts around the 14th-16th weeks of pregnancy and continues into infancy - is the key structural brain feature associated with ADHD.

The investigators examined 21 children with ADHD aged 8-12 years, and a control group of 35 unaffected children matched for age and gender. The children with ADHD had more than 7 percent reduction in total cerebral volume compared with the control group.

One of the design problems in human beings is that the brain is encased in a hard skull that moves little. So once the brain has grown to fill the skull, the only way to increase the surface area of the brain is for the cortex to become more folded. The whole process of cortical folding is crucial to increasing the structural and functional capacity of the brain.

This is of great interest, particularly in light of the study just published in the Proceedings of the National Academies of Sciences that indicates that the brain of people with ADHD can catch up later. That study did not look at brain folding, so it will be interesting to see exactly how the brain can catch up, and how we might be able to give it a helping hand.

Humans have a wonderful ability to expect positive events in the future, even when there is no shred of evidence to support them. One of the key components of resilience is optimism. Though there is data to show that there is a genetic contribution to optimism, it is also a psychological attribute that can flow from life experiences as well as attitude that can be developed. Though the motivational coaches who tell us that putting on a happy face will make you happy and optimistic are probably overstating the truth! A lack of optimism is often a sign of clinical depression so learning more about it, is not just an academic exercise.

New research just published in the journal Nature indicates that there are two regions of the brain linked to optimism.

The team from New York University and University College, London, says that the act of imagining a positive future event, for example winning an award or receiving a large sum of money, activates two brain areas: the amygdala and the rostral anterior cingulated cortex (rACC). The finding ties in with earlier studies that suggested that these brain regions malfunction in depression. (1,2)

The investigators first measured how optimistic 15 volunteers were using a standard questionnaire. They were then scanned using functional magnetic resonance imaging (fMRI) while reflecting on one of a number of potential scenarios.

In one part of the trial, subjects followed specific instructions to recall a negative event in the past, such a funeral that they had attended in the past five years. In another experiment they had to imagine what it would be like to be involved in a car crash in the near future. At other points in the study subjects had to reflect on positive events such as winning an award in the past or receiving a large sum of money in the future.

Reflecting on both past and future events activated the amygdala and the rACC regions of the brain. However, positive events, and particularly those imagined in the future, generated a significantly larger response in these regions than reflecting on negative events.

When imagining happy events, the more pessimistic subjects in the trial had less activation of these brain areas than their optimistic counterparts when imagining happy events.

For some time now, many researchers have assumed that the amygdala and rACC are only involved in negative thoughts and negative reactions, but this research indicates that they have an important role in signaling cheerful thoughts. And, what is more, these are also regions of the brain that have been implicated in depression. Previous research has suggested that patients with depression have decreased nerve signaling and fewer cells in the rACC and amygdala.

Is this why people with depression find it so hard to generate positive thoughts?

This is important work that will likely have a great many practical applications.

“Children are born optimists and we slowly educate them out of their heresy.”
–Louise Imogen Guiney (American-born English Poet, 1861-1920)

“Although the world is full of suffering, it is full also of the overcoming of it.”
–Helen Keller (American Blind and Deaf Swedenborgian Philosopher, 1880-1968)

“No man is so old as not to think he can live one year more.”
–Marcus Tullius Cicero (Roman Political Figure and Orator, c.106-43 B.C.E.)

“The way to become happy
Is to think
And to feel
That the very best is yet to come.”
–Sri Chinmoy (a.k.a. Chinmoy Kumar Ghose, Indian Philosopher and Spiritual Teacher, 1931-2007)

There is some research coming out in the December issue of the journal Cancer from some researchers at the University of Pennsylvania School of Medicine and other colleagues. The results surprised me, particular since I know some of the authors, and they are first rate investigators.

For over thirty years, most research studies have claimed to find an association between emotions, attitudes and beliefs, and the chance of survival form several types of cancer. Entire psychological wellness and psychotherapy programs have been designed around that premise.

The study suggests that emotional wellbeing has no effect on the chances of surviving head and neck cancer. People with negative emotions had the same survival rate as people with positive emotions.

Patients from two Radiation Therapy Oncology Group clinical trials completed a quality of life questionnaire known as the Functional Assessment of Cancer Therapy-General (FACT-G) at the start of the trials. So these assessments were added on to studies of different cancer treatments. One trial was looking at what is known as “dose fractionation strategies” and the other was looking at combined chemotherapy and radiation treatments.

The FACT-G questionnaire included a collection of items called the Emotional Wellbeing Scale. This was assessed against overall survival.

There were 1,093 at the start of the trials, of whom 646 died during the period of the study. One of the reasons for trusting the data is that this large sample together with the consistency in the treatment the patients received have made this study one of the most statistically robust ever conducted.

Emotional state did not predict survival, and the results did not change when the researchers took into account possible effects such as interactions between emotional wellbeing and the methods of the study, gender, the primary site of the cancer, or the stage of the cancer.

There are several important points:

• The study only included head and neck cancer patients. These are often very traumatic cancers, but they do not usually involve the endocrine system. Some of the best data on emotions and survival come from studies of breast cancer, which often involves disturbances of hormones that may themselves have an impact on mood and survival. And mood can have a big impact on hormones
• The patients in the study had to keep coming to appointments, and to follow instructions, so they may not be representative of all people with head and neck cancer

But the most important thing is this: before critics jump off the deep end, let’s be very clear.

The study is not saying that having an optimistic or positive emotional outlook does not bring benefits to cancer patients. All it is saying is there is no evidence that it prolongs life.

Psychotherapy, art therapy, bibliotherapy and many others can all provide a great many emotional and social benefits.

They may not add anything to the years that a persons lives, but they may add greatly to the life in those years.

Today being Halloween, I was thinking about some of the deep beliefs that some people across the world still hold about this day.

I’ve just come across an extremely interesting report from Baylor University entitled American Piety in the 21st Century.

It is a survey conducted by the Gallup Organization of 1,721 randomly selected individuals, that examined some of their beliefs and attitudes.

I was particularly drawn to it because of the undoubted relationships between health, faith, religion and spirituality.

Here were some of the key findings:

• 8% of men and 18% of women surveyed thought that psychics fortunetellers. Astrologers and palm readers could foretell the future
• 41% believed that ancient civilizations such as Atlantis once existed
• 37% believed that places could be haunted
• 28% thought that it was possible for the mind to directly influence the physical world
• 25% believed that some UFOs are extraterrestrial spaceships

My first reaction to these figures is just how low they are. Certainly lower than many previous studies of this type.

I was also struck that few of the respondents could have been aware of some of the research that seems to indicate the existence of some form of psychokinesis: the ability of the mind to influence objects in the material world.

Of course this work is controversial, but there really is enough data for us to realize that there is a case to be answered.

If you are interested in looking into this in more detail, I recently compiled a short reading list that you can find on the Amazon website.

It is sometimes very disheartening to read articles that are probably well intentioned, but in which the writer hasn’t done the most basic research.

I was just sent an article on optimism and pessimism, in which the writer extols the benefits of developing an optimistic outlook on life. And yes, it’s nice to be optimistic, but he – at least I think that it’s a he - makes several significant errors.

He gives examples of several well-known people who were supposed to have attained great things by being optimistic rather than realistic. He has clearly not studied the lives Thomas Edison or Henry Ford in any detail. Or Winston Churchill, Mother Teresa or Ted Turner.

He then says that optimism cannot be measured. Yes it can, there are many validated rating instruments. There is also a lot of research on the relationship between optimism, pessimism, temperament and cognitive and personality styles.

He goes on to say that you can learn to have an optimistic outlook on life. That is only half true. There are well-known genetic predispositions to optimism and pessimism. I’ve also written about recent work from Finland that makes it clear that it is very difficult to develop an optimistic mind set if you spent your childhood in a low socioeconomic status family. Special techniques may be needed to help people who were disadvantaged in childhood.

The idea that you can achieve anything by just “thinking it,” is not just wrong but it leads to some people feeling inadequate because they cannot generate enthusiasm and optimism. I have seen countless people feel guilty because they could not feel happy and optimistic the way that the motivational speaker told them to!

An un-researched and unbalanced article does more harm than good. It’s no good saying that it wasn’t meant to be scientific: you, as a reader, deserve better than some generalized nostrums based on wishful thinking. If someone recommends something, you need to know whether you can rely on what you are being told, or if it is just an unsubstantiated opinion. If it’s just an opinion, that’s fine, but you need to be told that, and why you can rely on that opinion, or why the writer has chosen to disregard research and previous experience.

So are you stuck with you genes and your upbringing? No you are not. But it is important to know if you are one of the people who do better with negative cognitions. It is well known in psychology that some people do much better with a constant negative outlook on life. In fact a psychologist – Julie Norem – wrote a first rate book on the subject entitled The Positive Power of Negative Thinking: Using Defensive Pessimism to Harness Anxiety and Perform at Your Peak.

There are techniques from cognitive therapy that can help change a person’s outlook and the newer technique – Attachment and Commitment Therapy – teaches ways of detaching from negative and pessimistic cognitions, rather than trying to stick a smiley face on them.

Best of all are the techniques of Integrated Medicine, that help attitudinal problems with a combination of highly individualized physical, psychological, social, subtle and spiritual techniques.

“If wishes were horses, then beggars would ride.”–Unknown Author