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The Myth of Cognitive Decline: Elderly Know More and Use it Better A steady decline? Experts question whether the human brain really slows down with age.→ Jeremy Dean is a psychologist and author of PsyBlog. His latest book is "Making Habits, Breaking Habits: How to Make Changes That Stick"
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Are all psychological therapies equally effective? Don't ask the dodo | Daniel and Jason Freeman The claim that all forms of psychotherapy for mental illness are winners, known as the Dodo Bird Verdict, has been dealt a blow"Everybody has won and all must have prizes," declared the dodo in Alice in Wonderland when asked to judge the winner of a race around a lake. As judgements go, it is admirably even-handed and optimistic. But in the world of mental health the dodo's decision has come to symbolise a bitter dispute that strikes at the very heart of psychotherapy.The "Dodo Bird Verdict", first suggested in the 1930s by the American psychologist Saul Rosenzweig, proposes that the many and various forms of psychological therapy are all equally effective. It makes no difference whether, for example, a person is being treated with techniques drawn from psychoanalysis, neurolinguistic programming, or cognitive behaviour therapy (CBT). What really helps a patient to recover are straightforward factors such as the opportunity to discuss their worries with a skilled and sympathetic therapist or the degree to which they are prepared to engage with the treatment.Understandably, the Dodo Bird Verdict has ruffled many feathers within the profession, and provoked a slew of studies aiming to corroborate or disprove the idea. Are some types of psychotherapy really more effective than others for particular conditions? There is plentiful data to suggest that the answer to that question – contrary to Rosenzweig's theory – is "yes". But that data tends to come from research conducted by proponents of the ostensibly superior therapy, leaving sceptics to conclude that their conclusions are not impartial.This makes the results of a study of treatments for the eating disorder bulimia nervosa, published this month in the American Journal of Psychiatry, all the more convincing. Bulimia is characterised by binge eating, followed by attempts to compensate by making oneself vomit, taking laxatives or diuretics (water tablets), fasting, and/or exercising frantically. Underlying this behaviour is an intense concern – an obsession, even – with body shape and weight.Bulimia is relatively common. One large US study, for instance, found that almost 1% of adolescents aged 13-18 had experienced the condition at some point in their life. Many of these teenagers reported that their illness made it very difficult for them to have a normal life, and it damaged their relationships with family and friends. The study also found that adolescents with bulimia were more likely to consider, or even attempt, suicide.Given bulimia's prevalence and potentially disastrous consequences, it is clearly important that we understand what treatments work best, which is why researchers at the University of Copenhagen recently compared the efficacy of two popular psychotherapies: CBT and psychoanalysis. The results were remarkable.In the study, 70 patients with bulimia nervosa were randomly assigned either to two years of weekly psychoanalytic therapy or 20 sessions of CBT spread over five months. At the core of the psychoanalytic approach is the idea that bulimic behaviour represents an attempt to control problematic feelings and desires. The therapist helps the client to talk about these buried feelings and to understand how they are related to the bulimia. And when the individual has learned to accept and manage their deepest desires, the theory goes, the distress disappears and with it the symptoms of bulimia.CBT, on the other hand, is targeted at the symptoms themselves: the aim is to stop the binge eating as quickly as possible. For CBT practitioners, bulimia is driven by the belief that one's self worth is determined by one's eating habits, shape and weight. Therapists show the individual how to identify and challenge such beliefs, explain the cycle of binge eating, and promote regular eating patterns and a more flexible and realistic set of dietary guidelines. They work with the patient to devise plans to deal with times when binge eating becomes more likely, and to minimise the likelihood of a relapse.Even though the participants in the Danish trial received vastly unequal amounts of treatment over an extended timespan – with those given psychoanalysis seeing their therapist far more than those allocated CBT – it was CBT that proved more effective. After five months, 42% of the CBT group had stopped binge eating and purging; for those receiving psychoanalysis the figure was just 6%. After two years, the proportion of the psychoanalysis group who were free from bulimia had risen to 15%. But this was still a long way short of the success of the CBT group after two years (44%), despite the fact that by then it was 19 months since the end of their course of treatment.The Danish trial gives real grounds for hope: CBT, it seems, can bring about major improvements for many people with bulimia. But the significance of the study goes further, because its leaders, Stig Poulsen and Susanne Lunn, are not CBT specialists but highly experienced psychoanalysts. Indeed, not only was the research conducted at a clinic devoted to psychoanalysis, the course of treatment was developed by Poulsen and Lunn themselves.Even more remarkably, though the CBT therapists received two days of special training and regular supervision from a world leader in CBT for eating disorders, they were less experienced than those responsible for the psychoanalytic treatment.Despite all this, CBT easily came out on top. As an editorial in the American Journal of Psychiatry commented: "we applaud the candor of the lead investigators for being so forthright in their presentation of the findings. This cannot have been what they hoped to find and indeed was not what they hypothesised."So when it comes to psychotherapy, it seems the dodo was wrong. While short-term treatments may produce similar results for some illnesses, such as depression, we shouldn't assume that the kind of therapy patients receive is essentially inconsequential. Instead we must recognise that some are better for certain conditions than others, redouble our efforts to identify these and improve them, and ensure that the most effective therapies are available to all who need them.Daniel Freeman is a professor of clinical psychology and a Medical Research Council senior clinical fellow in the department of psychiatry, University of Oxford. Jason Freeman is a psychology writer. On Twitter they are @ProfDFreeman and @JasonFreeman100. They are the authors of The Stressed Sex: Uncovering the Truth about Men, Women, and Mental Health PsychologyMedical researchBulimiaMental healthHealthHealth & wellbeingDaniel FreemanJason © 2014 Guardian News and Media Limited or its affiliated companies. 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Can reading make you smarter? There is evidence that reading can increase levels of all three major categories of intelligence. I believe my discovery of Spider-Man and other comic books turned me into a straight-A studentWhen I was eight years old, I still couldn't read. I remember my teacher Mrs Browning walking over to my desk and asking me to read a few sentences from a Dick and Jane book. She pointed to a word. "Tuh-hee," I said, trying to pronounce it. "The," she said, correcting me, and that's when it clicked – the moment when I learned to read the word "the".Growing up in Teaneck, New Jersey, in the 1960s, I was what Mrs Browning called "slow". During a parent-teacher meeting, she told my mother: "Daniel is a slow learner." I sat during lunch in the gymnasium with the – forgive the term – dumb kids. I was grouped with them during reading and maths: the "slow group".And then, a year later, I was rescued by Spider-Man. My best friend Dan, who was reading chapter books by kindergarten, had started reading Spider-Man and other comics with some other kid, and together they began drawing and writing their own comics. In response to this loathsome intruder's kidnapping of my best friend, I began reading comics, too, and then began scrawling and scribbling my own. Soon, Dan and I were happily spending every afternoon on our masterworks, while the interloper was never heard from again. We even convinced Dan's father, Dr. Feigelson (rest his soul), to film a Super-8 movie that we scripted: "Bob Cat and Bat v Disappearo!"By age 11, I was getting straight As. Later in my teens, I took a college admissions course in the US, and scored the equivalent of 136 on an IQ test. So what happened? Was Mrs Browning right – was I actually "slow" when I was eight – and did I somehow become smarter because I immersed myself in reading and writing comic books?In part to answer that question, I spent three years interviewing psychologists and neuroscientists around the world, reviewing their studies and testing new methods they claim can increase intelligence. Bookworms, after all, rarely emerge from their literary cocoons in order to become social butterflies. And while nobody would ever call reading a "new" method for improving the mind, recent scientific studies have confirmed that reading and intelligence have a relationship so close as to be symbiotic.That goes for all three meanings of the word "intelligence" widely recognised by psychologists. First, there is "crystallised intelligence" – the potpourri of knowledge that fills your brain. When you learn how to ride a bicycle, or the name of a new friend, you are gaining not just information but potentially useful knowledge that, in aggregate, forms the backbone of your ability to navigate and thrive in the world. By adding to that storehouse, reading increases your crystallised intelligence. That explains why some IQ tests include vocabulary words, which generally serve as a reliable proxy of how clever you are.But all of us know people with little "book knowledge" who are nonetheless sharp and insightful. "Fluid intelligence" is that ability to solve problems, understand things and detect meaningful patterns. Of course, you can read little or nothing at all and still be brilliant at "reading between the lines" of a conversation. But in today's world, fluid intelligence and reading also go hand in hand. In fact, the increased emphasis on critical reading and writing skills in schools may partly explain why students perform, on average, about 20 points higher on IQ tests than in the early 20th century. The so-called Flynn effect is named after James Flynn, a New Zealand professor who has I much of his career to studying the worldwide phenomena of increasing IQ scores. But if reading can increase fluid intelligence, the converse is also true: increased fluid intelligence also improves reading comprehension, according to studies by Jason Chein of Temple University in Philadelphia. He used "working memory" tasks that train people's ability to juggle and continually update multiple items of attention – to keep track of a moving dot, for instance, and recognise when it lands on a spot it occupied two, three or more moves ago. In papers published in scientific journals in 2010 and 2011, he showed that as both younger and older adults improved their performance on working-memory tasks, they were better able to comprehend reading materials.A third type of intelligence has gained widespread interest of late: "emotional intelligence", the ability to accurately read and respond to your own and others' feelings. It may seem odd to imagine that reading can improve your emotional intelligence. But in October, the journal Science published an extraordinary study showing that reading literary fiction can improve people's theory of mind (ToM) – their ability to understand others' mental states. David Comer Kidd and Emanuele Castano, both of the New School for Social Research in New York, enlisted hundreds of participants online to read examples of either non-fiction, popular fiction or literary fiction, and then to take tests measuring the accuracy of their ToM. In five experiments, they showed that reading literary fiction led to better performance on tests of both emotional and cognitive ToM compared with reading non-fiction, popular fiction or nothing at all.The literary fiction found to increase people's ToM included A Chameleon by Anton Chekhov, The Runner by Don DeLillo, and The Tiger's Wife by Téa Obreht. The study did, however, contain a glaring omission: it failed to measure the extraordinary impact of Spider-Man by that great literary genius, Stan Lee.NeurosciencePsychologyHealth & © 2014 Guardian News and Media Limited or its affiliated companies. All rights reserved. | Use of this content is subject to our Terms & Conditions | More Feeds
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