Rare Psychophysiological Symptoms; Alien Hand Syndrome and the case of the ‘evil twin…’

Alien Hand Syndrome is a neurological disorder where an individual has no control over their hand and it seems to act independently from the rest of the self.  The hand seems to be out of synch with the rest of the minCaptured and body hence the term ‘alien’.  Some individuals report having to restrain their own hand with their other (reminiscent of Dr Strangelove).  Sufferers have reported a range of experiences from putting a cigarette in the mouth ready to light with one hand for then the  ‘alien hand’ to remove it immediately  Other experiences have been more menacing with the hand punching the self and in one case a woman woke up being choked by her own but alien hand.

Cutting the corpus callosum cured Karen’s epilepsy, but left her with a completely different problem. Karen told me that initially everything seemed to be fine. Then her doctors noticed some extremely odd behaviour.

“Dr O’Connor said ‘Karen what are you doing? Your hand’s undressing you’. Until he said that I had no idea that my left hand was opening up the buttons of my shirt.

“So I start rebuttoning with the right hand and, as soon as I stopped, the left hand started unbuttoning them. So he put an emergency call through to one of the other doctors and said, ‘Mike you’ve got to get here right away, we’ve got a problem’.”

Karen’s problem was caused by a power struggle going on inside her head. A normal brain consists of two hemispheres which communicate with each other via the corpus callosum.

The left hemisphere, which controls the right arm and leg, tends to be where language skills reside. The right hemisphere, which controls the left arm and leg, is largely responsible for spatial awareness and recognising patterns. 

Cited from http://www.bbc.co.uk/news/uk-12225163

The causes seem to be solely down to neurological trauma in certain regions, especially in the connectivity between the two hemispheres, in particular the Corpus Callosum.  Roger Sperry’s research into individuals who had their hemispheres disconnected (known as split brain) as an attempt to significantly reduce symptoms of epilepsy would have been prime candidates for such a phenomenon, but this is not the case, nobody seems  to know why however they did exhibit a range of  behaviours where one side seems to be unaware of what the other was doing.

A similar disorder  is called anarchic hand syndrome.

The woman with the evil twin

Doctors in California have removed a tumour they have described as an “embryologic twin” deep inside the brain of a young woman.

Yamini Karanam, 26, a PhD student in Indiana, had been experiencing difficulties with drowsiness, reading and concentration.

The discovery was made when doctors performed a newly-developed form of surgery to remove the tumour.

The growth, known as a teratoma, had bone and hair.

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Ms Karanam, a student at Indiana University, jokingly described the tumour to KNBC, a California TV station, as her “evil twin sister who’s been torturing me for the past 26 years”.

The tumour was found in Ms Karanam’s corpus callosum.

“This tumour was smack in the middle of that, so extremely deep in the brain,” Dr Hrayr Shahinian told the BBC.

Read the rest of the story from the BBC here…

Ethics in Psychology…….a necessary evil?

The answer is absolutely yes. When you think of controversy in Psychology ethics is often the starting point.  But are we in danger of limiting our ability to validly measure behaviour by imposing too strict ethical principles?  All psychology students are well versed in studies of historical importance but also ethically controversial, Milgram, Zimbardo, Bandura, Freud, Rosenhan, Watson and Rayner  to name a few of the more infamous cases.

Animal behavioural experimentation has also all but long been confined to the history books particularly as the Behaviourist principles fell out of favour in the 1960’s (Behaviourists believed that there was only a quantitative difference between humans and animals and thus pigeons, rats, cats, dogs, etc. were all easily accessible test subjects.  Human participants have been the main focus in the past 50 years however ethical concerns has always been and (always will be the necessary evil).  Psychology today understands that validity has to come second to the protection of harm either psychologically or physically of participants.

The British Psychological Society – has identified 4 core Ethical principles that need to be adhered to.

1) Respect for the autonomy, privacy and dignity of individuals and communities.

Psychologists value the dignity and worth of all persons equally, with sensitivity to the dynamics of perceived authority or influence over others and with particular regard to people’s rights including those of privacy and self-determination’

2) Scientific integrity. 

 Research should be designed, reviewed and conducted in a way that ensures its quality, integrity and contribution to the development of knowledge and understanding. Research that is judged within a research community to be poorly designed or conducted wastes resources and devalues the contribution of the The British Psychological Society participants. At worst it can lead to misleading information being promulgated and can have the potential to cause harm.

3)  Social responsibility.

The discipline of psychology, both as a science and a profession, exists within the context of human society. Accordingly, a shared collective duty for the welfare of human and non-human beings, both within the societies in which psychology researchers live and work, and beyond them, must be acknowledged by those conducting the research.

4) Maximising benefit and minimising harm.

Responsibility of the Code of Ethics and Conduct, psychologists should consider all research from the standpoint of the research participants, and any other persons, groups or communities who may be potentially affected by the research, with the aim of avoiding potential risks to psychological well-being, mental health, personal values, the invasion of privacy or dignity.

Here is an extract from The British Psychological Society website discussing how they deal with key issues pertaining to ethics.

Question: If I wanted to do a small piece of research looking at the general public’s perceptions of risk (about drug taking, offending and outdoor activities), how can I do it independently? I would like to do some research but it won’t be anything to do with the university and hypothetically, would involve asking people on the street to volunteer to take part. The aim would be to have people volunteer through the provision of informed consent. Obviously, I would not like to proceed with research unless it has been reviewed by an Ethics Committee. I have the latest code of ethics and conduct but cannot find information about what to do when there is no obvious ethics committee. It is critical to adhere to the guidelines as I am a professional.

Answer: We would strongly recommend that you submit the research proposal for consideration under your university’s institutional ethics procedure.

There are several reasons why we recommend you to do so:

First, as a protection for the participants, so that your research protocol can be properly reviewed and best advice given as to any modifications to cover eventualities/risks not previously anticipated.

Second, as a protection for yourself. The specifics of this case put you at risk of being in a situation where the fact that confidentiality can never be absolute is activated as the research sets out to canvas ideas/options about potentially illegal activities (drug taking, offending behaviour). This leaves you in a tricky dilemma if participants disclose actual engagement in illegal activity; you may have a legal duty to pass that information on, and if so how does this impact then on informed consent aspects related to confidentiality and anonymity of participants’ disclosures? The duty of care might override any confidentiality clause in consent. It is crucial that a risk management strategy is in place and has been reviewed by a competent body such as an institutional ethics committee. Personal liability insurance may or may not be in place (it perhaps should be), but if it is and there is a claim against you for negligence, if there has not been ethical review, the insurers would have a case for refusing to cover a claim.

Third, as a protection for the institution. Even if the study is done independently, the press are more than happy to link lecturers’ personal behaviour with their professional posts and name the institutions. It is not hard to envisage a situation where this proposed study might be reported in such a way as to bring the institution into disrepute.

The Society’s Code of Ethics and Conduct also provides guidance on the general ethical principles that should be borne in mind.

Informed consent

Question: I am planning some research involving volunteer participants. How do I go about obtaining consent and what form should this take?

Answer: Researchers should ensure that every person from whom data is gathered for the purposes of research consents freely to the process on the basis of adequate information. They should be able, during the data gathering phase, to freely withdraw or modify their consent and to ask for the destruction of all or part of the data that they have contributed.

The way in which consent is sought from people to participate in or otherwise contribute data for research should be appropriate to the research topic and design, and to the ultimate outputs and uses of the analyses. It should recognise in particular the wide variety of data types, collection methods, and the range of people’s possible responses and sensitivities. The principle of proportionality should apply, such that the procedures for consent are proportional to the nature of participation and the risks involved.

For example, for data from existing datasets where consent was properly gained in the initial collection and this consent covers the uses of data proposed, no further consent will normally be needed. For anonymised-at-source, non-sensitive data, consent may appropriately be minimal or may be considered to have been given by the act of participation. Nevertheless, the risks involved in some anonymised-at-source research, for example, web-based research on sensitive topics such as sexual behaviours, will require carefully prepared prior information and clear consent processes.

When research involves the collection of identity capturing data on sensitive material, using video or audio recording, or other methodologies where an individual may be identifiable, it is important to consider additional informed consent procedures. These procedures need to be related to both the nature of the data collected and the ultimate use of the data. Separate informed consent agreements for data collection and the dissemination of the study’s results may be required.

A prior assessment of potential risks should inform the preparation of the information to be given to potential participants and the procedures for seeking consent. The assessment should be used to determine the appropriate form of consent and the nature of any risk management required. When in exceptional circumstances harm, unusual discomfort, or other negative consequences for the individual’s future life might occur, the investigator must inform the participants clearly of these additional risks prior to consent. For all research where risks are present, secure liability insurance should be in place to adequately cover the levels of possible harm identified in the risk analysis.

Giving potential participants sufficient information about the research in an understandable form requires careful drafting of the information sheet. It is recommended that at least one pilot test of the draft documents be carried out with a naive person having a literacy level at the lower end of the range expected in the planned research sample.

In exceptional circumstances the aims of the research may be compromised by giving full information prior to data collection. In such cases, it should be made clear that this is the case in the information sheet and the means by which the withheld information will be given at the conclusion of data collection should be specified. The information withheld and the delay in disclosing the withheld information should be kept to an absolute minimum.

Confidentiality

Question: Does confidentiality really apply in case of teenage research participants? That is, could I  withhold  information from a  parent the contents of the discussions held between his fourteen year old daughter and myself?

Answer: Our guidelines for conducting research with human participants are currently undergoing full review. However, in the meantime, the Society’s Code of Ethics and Conduct provides guidance on the general ethical principles that should be borne in mind. There are also guidelines on the General Medical Council website that may find the guidance of use to you.

The sections on making decisions and principles of confidentiality are particularly straightforward and helpful.

We would also recommend that your research proposal is submitted for consideration by the University’s Research Ethics Committee.

Question: I am a trainee clinical psychologist and am completing my doctoral thesis this year. As part of the project I plan to recruit a control group of University students. This control group will be asked to complete a number of questionnaires including the Hospital Anxiety and Depression Scale and a short evaluation of eating disorders. I had initially planned for the questionnaire responses to be confidential but I am concerned that I may receive questionnaires from control participants which score highly for anxiety, depression and eating disorder. I am aware that I need to balance the need for confidentiality with duty of care to the individual. I could indicate on the information sheet that if the person reveals scores that would indicate I have a concern about their well being that I would contact them but this would be at the expense of confidentiality. I wonder if you would be able to offer some advice?

Answer: We would suggest that you use an appropriate coding system for the questionnaires so that the participants are only identifiable by yourself; and that you are clear about this at the outset. The possibility of follow-up for any concerns over wellbeing could also then be linked to this.

adapted from  http://www.bps.org.uk/what-we-do/ethics-standards/ethics-qa/ethics-qa

Resources 

The BPS Code of Ethics and guidelines (2009)

Here is the latest BPS ethical guidelines fro research (2014)

Predictive Validity? Mind manipulation in the future……

If you have seen either one or both versions of Total Recall…………or better still read the short story (we can remember it for you wholesale) by science fiction writer Philip K Dick, you will know that part of the storyline (no spoilers) consists of implanting memories to an individual of exotic holiday and other exciting adventures which may be usually financially impossible or highly unlikely as a cheaper alternative.

Total-Recall-2012-vs-1990-vs-1966In the future we may never set foot on a tropical beach when we go one holiday, we could just visit them virtually through downloads we place inside our brain, Dr Kaku says

An article in todays mail-online discusses the science behind such processes and the likelihood of them actually occurring….

The article also discusses the notion of false memories which has been studied directly by Loftus and how easily it is to manipulate the mind into believing something actually happened which did not.

Loftus’ research on being lost in a shopping mall is a highly illuminating yet arguably unethical piece of research that proves the point.  See below for what she did and how she did it….can we trust our memory as being a factual recollection of precise events or a malleable reconstruction of internal and external forces?

Now that’s what I call Psychology Vol 2……

On my old blog I ran a fun game where respondents could add  examples of where certain songs seemed to encompass a particular piece of theory or research…..it was fun…so I thought I would start it again…..please feel free to add a comment with the title and reference…as my musical references seem to end in 1996!

let’s get some going……

You have to click on the research/theory to find out what song has been chosen….did you get it right?

The 3 faces of Eve – Thigpen and Cleckley

Freud’s concept of the Id

Freud’s concept of the ego

Freud’s Concept of the Superego

Milgram’s study on obedience

Zimbardo’s Prison study

Rational Non-Adherence to medical advice