When the enemy is invisible... Implicit biases against women in hiring

Photo by NASA on Unsplash

We live in a #HeForShe world of #WonderWoman and #girlpower. Today, more women hold positions of leadership and power than ever before in U.S. history and society is the direct recipient of those changes. Yet, there are still industries where women with the same qualifications as their male colleagues are not given the same opportunities. You could support that statement with factoids, such as the fact that more than 825 men have won a Nobel Prize compared to only 47 women. Or, you could support this statement with science. 

In 2013, Dr. Corinne Moss-Racusin and her colleagues at Yale University published a study testing the question: 

Are scientists biased against female applicants to jobs? 

If so, this may explain the imbalance of male and female scientists. To test this question, they recruited  127 professors in Biology, Chemistry, and Physics at 6 research-intensive universities; 3 were public and 3 were private. These professors were asked to provide feedback on the application materials of an undergraduate science student who wanted to pursue a Ph.D. in their field. What's important is that each faculty member believed that they were providing feedback on a real student who wanted to pursue their career path, and that the student would receive this feedback in order to aid them in reaching this goal. 

The professors were then randomly assigned to receive one of two sets of application materials. These two sets of application materials were identical, in that they included the same exact details of a highly competitive student with some ambiguity with regard to their competence to do independent research. This is by far the most common type of application we get as professors, and is also the type of student whose eventual success will depend largely upon whether a professor is willing to mentor and train them. The difference between the two applications was that one of the applicants was named Jennifer, or a presumably female applicant, and the other was named John, a presumably male applicant. 

The professors were asked to rate the applicant's competence, the likelihood that they would be interested in hiring the student, estimate an annual starting salary of the applicant, and report the amount of mentoring they would provide to the applicant. At the end of the study, these professors were debriefed about the study and none of them knew that the application materials they reviewed were not of a real student. 

From this data, they wanted to test several hypotheses, including the following:  

1) That applications with the name John would be rated as more competent and more likely to be mentored and hired, at higher salaries than the applications with the name Jennifer. 

2) That #1 would not depend on whether the professor rating the applicant was male or female. 

They found that applications for John were rated as significantly more competent,and professors indicated that they were more likely to hire and provide more mentoring to John. Professors also indicated that the starting salary for John should be between $29,000 and $31,000 per year whereas Jennifer's should be between $25,500 and $27,500. This pattern did not vary based on whether the professor rating the applications was male or female, whether they were old or young, nor whether the professor already had tenure. 

Photo by Samantha Sophia on Unsplash

The conclusion from the study was that there is an implicit bias against women applying to positions in science that keeps very competent women from getting entry-level positions. In general, this comes down to the question of whether our society cultivates the perception that women are inherently less competent that men, despite having the same experiences and accomplishments. If so, how to we cultivate a different perception? 

In psychology, we like to drill down into problems like this to determine where they come from and how we can fix them. One way to do this is to test whether and to what degree individuals have an automatic, or implicit bias to associate women with positions of subordinance. It's possible that just knowing that you have such a bias is enough to change your behavior enough to make a difference. 

This is important because there are many ways that a social narrative that women are better suited for positions of subordinance can lead women to behave subordinately and men to treat women as subordinants. The ways women perpetuate this review is expertly outlined in books like Sheryl Sandberg's Lean In. 

If you're interested in knowing whether you are implicitly biased in this particular way, spend just a few minutes to take this test. Knowledge is power people!  If you find that you do, there may be some small ways you can combat these types of bias, especially if you ever operate as a gatekeeper to opportunities for training and jobs. The truth is, only we suffer by biases like this. If we want to solve the problems of the universe, we need the best minds to do it. 

Moss-Racusin, C. A., Dovidio, J. F., Brescoll, V. L., Graham, M. J., & Handelsman, J. (2012). Science faculty’s subtle gender biases favor male students. Proceedings of the National Academy of Sciences, 109(41), 16474-16479.

What works and who benefits: Treating behavioral problems in kids on the Autism Spectrum

Sometimes kids can be challenging. They forget rules they've learned, and don't listen to their parents. These types of problems happen with all children, all over the world, but can be even more challenging for parents with kids on the Autism Spectrum. Luckily, this is a problem that psychology is very good at solving. For decades, leaders in the field of behavioral science have been developing and perfecting intervention programs for children with Autism Spectrum Disorders. 

In clinical psychology and medicine, the best way to show that an intervention works is by conducting a randomized controlled trial (RCT). In this type of clinical trial, a team of researchers recruit a sample of individuals in their target population and randomly assign them to one of two or more interventions. Using this scientific approach is the only way of knowing at the end of the intervention whether the improvements you observed were due to the intervention, rather than differences between the individuals in the treatment groups. 

Very recently,  Karen Bearss, Emory University, and her research team published the results of the largest RCT ever conducted looking at the effectiveness of two active treatment programs for disruptive behavior in children on the Autism Spectrum. They compared Parent Training (PT) and a Parent Education Program (PEP) to determine which program resulted in the greatest improvements in disruptive behaviors. Parent Training is described as follows: 

"The first session taught parents to identify the function of a behavior by analyzing its antecedents (events occurring before the behavior) and consequences (events following the behavior). Subsequent sessions presented strategies for preventing disruptive behavior (eg, visual schedules for routine events), positive reinforcement for appropriate behavior, planned ignoring of inappropriate behavior, and techniques to promote compliance. In the last few sessions, the therapist instructed parents on teaching new skills (eg, communication or daily living skills) and how to maintain improvements over time. This sequence was intended to reduce the child’s disruptive behaviors and foster skill acquisition. The treatment sessions used direct instruction, video examples, practice activities, and rehearsal (role play) with feedback to promote parental skill acquisition. In homework assignments between sessions, parents applied new techniques to specific behaviors. 

The other treatment arm, Parent Education Program, involved having a trained therapist provide "useful information on young children with ASD, including the essentials of evaluation, developmental changes in ASD, educational planning, advocacy, and current treatment options." Each intervention arm included 11 or 12 sessions, and sessions in both treatment arms were 12 60-90 minute sessions. They measured improvements in child defiant behaviors, aggression, irritability, social withdrawal, stereotypy, hyperactivity, and inappropriate speech 24 and 48 weeks after starting the treatment program.  Each of these are core behavioral problems that children on the Autism Spectrum and their families commonly deal with on a daily basis. 

The trial ultimately randomized 180 children (ages 3-7, 158 boys, 22 girls) on the Autism Spectrum to one of the two treatments. Twenty four weeks after starting the treatment program, kids assigned to the PEP showed a 31.8-34.2% decline in behavior problems, depending on the behavior examined. Kids assigned to PT showed a 47.7-55% decline in behavior problems. In other words, both treatments worked in reducing problem behaviors, but the Parent Training program worked much better. Further, the benefit of these treatment programs were still visible at the 48 week follow-up. The research team concluded that Parent Training is an effective program for addressing disruptive behaviors in families with children on the Autism Spectrum. 

More recently, this research team published a study of the moderators of treatment response. Moderators are factors that influence how well the treatment program works. In this study, Luc Lecavalier, Ohio State University, looked at whether the Parent Training intervention works better or worse in kids with different individual or family characteristics. For example, they looked at whether IQ of the child, severity of Autism, presence of another co-occurring disorder such as ADHD or anxiety,  living in a single parent family, or parent income and education were related to treatment outcomes. 

They found that the kids who improved the most from Parent Training were the ones without co-occurring ADHD, low anxiety symptoms, and living in families with a family income above $40,000 per year. In other words, there was no difference in benefit from PT or PEP for kids in the study with ADHD, high symptoms of anxiety, or in low-income families. That being said, the PEP was still associated with a 31-34% decline in disruptive behaviors, so treatment was still somewhat effective. 

To their surprise, the research team did not find that IQ or severity of Autism symptoms were associated with differences in treatment benefits from Parent Training. This is important because many people believe that IQ and symptom severity automatically mean that treatments won't work for them. Here, we see that kids in the study with a range of IQ and symptom severity showed improvements in disruptive behaviors, particularly those enrolled in Parent Training. 

So what does this mean? If you have a child on the Autism Spectrum, Parent Training may significantly improve your and your child's quality of life. In fact, Parent Training is a well-established and effective way of dealing with disruptive behaviors for kids (up to around age 12), regardless of being on the Autism Spectrum. The strategies taught to parents in Parent Training are based in basic behavioral science and apply to all behavior, and in these treatment programs the principles of behavioral theory are simply tailored to the most commonly observed problems in specific populations. 

A final thought on the name "Parent Training." In my work, I've found many parents resistant to going through training in parenting. In many ways, it seems as though parenting should be intuitive and not, yet another, thing that requires a degree or certification. In many ways that's very true. Loving and caring for a child is innate. Teaching a child to regulate their impulses and emotions is something entirely different, and often at odds with the immense loving and caring you feel for them. Think about how often you, as a parent or caregiver, feel conflicted between the short-term relief of "peace and quiet" that is almost immediately gained from giving in to a toddlers request for something at the grocery store and the long-term benefit of not hearing these requests every time you go to the store until the end of time. Behavioral science is an immense field of study that resulted in the training of the modern generation of clinical psychologists who can provide Parent Training that will help reduce the impact of these little moments in your daily life. 

If you're interested in learning more, some Parent Training books I highly recommend for parents looking for behavioral strategies that work: 

For all parents: 

The Everyday Parenting Toolkit: The Kazdin Method for Easy, Step-by-Step, Lasting Change for You and Your Child by Alan E. Kazdin and Carlo Rotella

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For the over-achievers out there, Alan Kazdin has also just completed a course on parenting in Coursera called "Everyday Parenting" which I highly recommend for anyone who has or will ever have kids.   Click here to learn more about that course. 

For parents struggling with child defiance: 

The Kazdin Method for Parenting the Defiant Child by Alan E. Kazdin

Your Defiant Child, Second Edition: Eight Steps to Better Behavior by Russell A. Barkley and Christine M. Benton



References 
Bearss, K., Johnson, C., Smith, T., Lecavalier, L., Swiezy, N., Aman, M., ... & Sukhodolsky, D. G. (2015). Effect of parent training vs parent education on behavioral problems in children with autism spectrum disorder: a randomized clinical trial. Jama, 313(15), 1524-1533.

Lecavalier, L., Smith, T., Johnson, C., Bearss, K., Swiezy, N., Aman, M. G., ... & Scahill, L. (2017). Moderators of parent training for disruptive behaviors in young children with autism spectrum disorder. Journal of abnormal child psychology, 45(6), 1235-1245.

Many thanks to unsplash.com for the lovely photos! 

In defense of humor.

Do you love to laugh? For decades, psychologists have studied the role of positive emotions in health and well-being. So far, it’s pretty clear that positive emotional experiences, including those that make you laugh, are related to better emotional and physical health. Yet, very few of those studies can make causal claims. In other words, they don’t really tell us whether healthier people seek out humor or whether laughter causes better health. Recently, Sarah Wellenzohn, University of Zurich, and colleagues set out to test the causal role of humor in the emotional health of individuals. In short, they designed an experiment to answer the question:  

Does humor increase happiness and decrease symptoms of depression?

To do this, they randomly assigned 632 adults to 1 of 6 interventions to complete daily for 1 week. The interventions were:  

Three funny things: Write down the 3 funniest things you experienced during the day and your feelings during those experiences.

Collecting funny things: Remember 1 of the funniest things you have experienced in the past, write it down with the most possible detail.

Counting funny things: Count all of the funny things that happen throughout the day and write down the number.

Applying humor: Notice the humor experienced throughout the day and add new humorous activities, such as reading comics, telling jokes, watching funny movies.

Solving stressful situations in a humorous way: Think about a stressful experience today and think about how it was or could have been solved in a funny way.

Early memories (placebo control): Write about early memories.

Before starting the intervention, participants completed questionnaires measuring their authentic happiness and symptoms of depression. Authentic happiness is measured using participant agreement to 24 statements such as “My life is filled with joy.”  Depressive symptoms include sad or low mood, loss of interest or pleasure, appetite and weight change, sleep problems, worry, difficulty concentrating, or feelings of hopelessness. Participants also received training in the intervention and were instructed to do their intervention activity each day for one week.

At the end of the 1-week intervention, and then 1-, 3-, and 6-months after completing the intervention, participants again completed the happiness and depression questionnaires. This enabled the research team to look at whether humor interventions led to increases in happiness and declines in depressive symptoms, and also look at how durable those effects are over time.

At the end of 1 week, all of the humor-based interventions were associated with increases in happiness and decreases in depressive symptoms compared to the placebo group. So one important take home message is that humor helps, no matter how you incorporate it into your life.

With respect to increasing happiness, Counting funny things and Applying humor were the most effective, and those effects lasted for up to 6 months! The effects of the Three funny things intervention also lasted through the 6-month time period, but were not as robust. There are a number of reasons that these humor-based interventions had such long-lasting effects on happiness. Most likely, it was because participants continued to engage in the behaviors for longer than just the initial week. Positive emotions are addictive in the same way food and drugs are. So it’s possible that these 1-week interventions were enough to promote a humor-addiction, so to speak.

The effects of these interventions on depressive symptoms were not as durable. Despite all of the humor-based interventions being leading to reductions in depressive symptoms at the end of the 1-week intervention compared with the placebo group, none of these effects remained 3-months after the intervention. This finding isn’t too surprising since there were no individuals with depression in this study. In fact, 250 people were excluded from the study for having elevated symptoms of depression at the baseline assessment. This means that there was very little range in depressive symptoms in the sample to begin with, and thus very little chance that the intervention could have an effect at all. That being said, humor on its own is unlikely to be an effective treatment for depression. Depression is an illness; often initiated in the wake of a major life stressor. With the exception of Solving stressful situations in a funny way, none of the humor-based interventions offered skills that help manage the source of that life stress.

The authors argue that one of the important, active ingredients in humor is the focus on increasing positive emotions in the present moment. Each intervention, particularly the durable ones, accomplished that through increasing daily experiences that involved humor but also increasing individuals’ attention to those experiences over time. You can imagine that just a few days of Counting funny things would cause you to pay more attention to, and enjoy, when funny things are occurring.

Until next time, keep on laughing! Here’s a compilation of funny videos of kids learning about physics: https://youtu.be/-TjtoP6-mcQ

Wellenzohn, S., Proyer, R. T., & Ruch, W. (2016). Humor-based online positive psychology interventions: A randomized placebo-controlled long-term trial. The Journal of Positive Psychology, 11(6), 584-594.

*Many thanks to Unsplash.com for the gorgeous photos. 

How to be curious.

This week marks the launch of The Positivity Project in 33 schools across 12 different states in the US. Each week, the Positivity Project will introduce 1 of the 24 character strengths that make up the fabric of humanity. The team at The Positivity Project will support teachers, educators, parents, and students in learning how to cultivate each of these strengths with the goal of improving relationships between children and their schools, parents, and local communities. The character strength that will kick off the year is CURIOSITY. 

The first step to cultivating a strength is defining it. Curiosity is a fascinating psychological phenomena to say the least. In preparing this article I found that no one I know has the same definition for curiosity, and depending on the definition you use, the result of cultivating curiosity is very different. 

For example, Drs. Christopher Hsee, University of Chicago, and Bowen Ruan, University of Wisconsin-Madison, recently conducted a study examining the role of curiosity in human behavior. In particular, they conducted 4 experiments to address the question: 

Can curiosity be dangerous?

To answer this question, 54 adults (24 women) who were given a box of 10 ballpoint pens that may or may not deliver an electric shock when clicked. Each participant was randomly assigned to one of two conditions: certain or uncertain. In the certain condition, each pen had a sticker indicating whether the pen would shock them or not shock them if clicked. In the uncertain condition, all pens had the same sticker and the participants were told that the pens may or may not have batteries in them. The research team told the participants that they can click the pens if they wanted to "kill time" while waiting for another part of a different experiment, and then counted how many pens each participant clicked. 

People in the uncertain condition clicked more pens than the participants in the certain condition. The researchers interpreted this as evidence that curiosity might be the human desire to resolve uncertainty, and this desire may lead individuals to expose themselves to danger, or at least pain. 

Then, the research team conducted this same study again with 30 new participants. This time, all participants received the uncertain and certain conditions. To do this, some of the pens had red stickers (shock), some had green stickers (no shock), and some had yellow (uncertain). They counted how many of each type of pen each person clicked. 

Again, they found that people clicked more of the yellow sticker-ed pens than the other two types. And again, the researchers interpreted their results as evidence that curiosity may lead people to expose themselves to danger in order to resolve uncertainty. Indeed, the participants rated their experience of the shocks as negative.  

The research team then conducted 2 more follow-up studies. They changed the potential negative outcome to the sound of nails on a chalkboard in order to show that the effect is not specific to electric shocks. They also included measures of participants' feelings. Participants again were more likely to click on uncertain options even though the uncertain options were likely to expose them to negative sounds, and the more exposure they had to these negative sounds, the worse they felt. Yet, if people were given the option of predicting whether clicking the uncertain button would positively or negatively impact their mood, they were less likely to choose to resolve the uncertainty. 


In review, we are driven to resolve uncertainty at the expense of our mood and the potential for danger. This may be the ugly side of curiosity.  

On the other hand, the VIA Institute on Character defines curiosity as being interested in exploring new ideas, activities, and experiences and having a strong desire to increase their own personal knowledge. In short, they advise that the best way to cultivate curiosity is to "ask questions, and lots of them." 

If we think about both definitions, it seems that both highlight the search for information. What may distinguish curiosity of human nature from curiosity as a character strength is the goal of that search. Are you curious to resolve uncertainty or to add to your personal understanding? If you follow-up your curious urges with "why do I want to know/do this?" and the only answer is "because I just want to know," your curiosity may simply be rooted in human nature. This isn't a bad thing. There are a million reasons that the drive to resolve uncertainty was essential to survival. Think about how we know whether we can fly, which plants are poisonous and tasty, that fire causes pain. The tribe benefits from some people being willing to take these risks. 

Now that we have those basics worked out, it is our job to cultivate curiosity as a character strength. Practice the art of understanding why and how new knowledge will improve your understanding of yourself and the world. Teach children to understand what drives their curiosity. It is this nuanced understanding of how to be curious that will make the difference between practicing curiosity that has negative consequences for mood and safety and practicing curiosity that will lead to the good life filled with strong relationships and purpose. 

To learn more about The Positivity Project, click here.  Many thanks to unsplash for the curious photos. 

Hsee, C. K., & Ruan, B. (2016). The Pandora Effect The Power and Peril of Curiosity. Psychological science, 27(5), 659-666.

Does your personality fit your city? Does it matter?

Where do you live? Why do you live there? For most people, choice of where to live comes down to a few obvious and important factors: family, job, money. Have you ever wondered whether your self-esteem takes a hit when you live in a city that doesn't jive with your personality? Psychologists have. 

Just last month, Dr. Weibke Bleidorn, University of California Davis, and colleagues published a study looking at the whether a person's self esteem varies as a function of the fit between a their personality and the personality of their city  To do this, they used data collected online from the Gosling-Potter Internet Personality Project between December 1998 and December 2009. Participants in this study were between the ages of 16-60 and were included in the study if they lived in a city (based on self-reported zip code) that had at least 199 other respondents. The resulting sample included data from 543,934 individuals living in 860 cities in the United States. 

The online questionnaire included measures of personality and self-esteem. Psychologists typically measure personality across 5 dimensions: openness, conscientiousness, extroversion, agreeableness, and emotional stability (also known as neuroticism). Click here for Wikipedia's definition of each of these domains of personality. Each participant answered 44 questions whose answers placed them on a continuum for each of these domains. If you're interested, you can take the test for free here. To measure self-esteem they asked participants to indicate the degree to which they agreed with the statement, "I see myself as someone who has high self-esteem," on a scale from 1 (strongly disagree) to 5 (strongly agree). As simple as it sounds, self-esteem used to be measured in psychology research using more questions, but this single item tends to be all you need to ask. 

With this data, the research team was able to compute scores for the personality of each participant, as well as scores for each of the 860 cities represented. Using these scores, they were then able to disentangle the contributions of an individual's personality, their city's personality, and person-city personality match as predictors of self-esteem. Not surprisingly, the more emotionally stable (less neurotic), extroverted, open, agreeable, and conscientious a person was, the higher their self-esteem. Interestingly, individuals who lived in cites where the average person was higher in emotional stability, lower in openness, higher in agreeableness, and higher in conscientiousness, the higher their self-esteem. However, these weren't necessarily the question the researchers wanted to answer. The research team was more interested in whether fit between an individual and that of others in their city was important for self-esteem. 

As it turns out, it is, but only for openness, agreeableness, and conscientiousness. They found that individuals higher in openness have higher self-esteem when living in cities filled with open people, people higher in agreeableness report higher self-esteem when they live in cities filled with agreeable people, and people higher in conscientiousness report higher self-esteem when living in cities filled with conscientious people. But also, the other side of that coin may be true; less open people may have higher self-esteem in cities with less open people. 

So what might this mean for all of us wherever we live, by chance or by choice, and/or who may have to decide where to live in the future? Well, it means that there are many contributors to our self-esteem. First is our personality, but also the personalities of those around us. As a clinical psychologist, I can't help but point out that this means there are many pathways to higher self-esteem. One can practice emotional stability, conscientiousness, agreeableness, extroversion, and openness. One can seek out cities that promote emotional stability, agreeableness, and conscientiousness in their potential and current residents. Look to their elected officials, their mascots, their city-sponsored events. And as a result of this study, one can learn to appreciate his/her own personality strengths and seek out cities that are matched in those qualities (particularly openness, agreeableness, and conscientiousness). 

There are limitations to the conclusions we can draw from this study. In particular, there is no way to rule out the possibility that having higher self-esteem influences a person's personality and also the cities they choose to live in. Nevertheless, self-esteem is an important psychological resource that psychologists want to understand how to cultivate in individuals and societies alike. So here it is sensible to try and understand what predicts self-esteem, rather than what self-esteem predicts. Hopefully, the next time you consider moving to a new city, you will think about more than just the practicalities of living there but also the personalities of its residents before you sign on the dotted line. It matters. 

Bleidorn, W., Schönbrodt, F., Gebauer, J. E., Rentfrow, P. J., Potter, J., & Gosling, S. D. (2016). To Live Among Like-Minded Others Exploring the Links Between Person-City Personality Fit and Self-Esteem. Psychological science, 27(3), 419-427.

Our gratitude to unsplash  for the beautiful photos. 

Does Google know about a suicide before it happens?

According to the CDC, suicide is in the top 10 leading causes of death for people in the United States between the ages of 10 and 64. Among individuals in age groups 10-14, 15-24, and 25-34, it is the 2nd leading cause of death. In the year 2014 alone, we lost 42,772 Americans to suicide. Truthfully, this is probably somewhat of an underestimate because suicide is often miscategorized by as "unintentional injury," leading to false records.

If you are a clinical psychologist, you spend a lot of time thinking about ways to detect when a patient is entertaining thoughts that life is no longer worth living. Unfortunately, many completed suicides are unpredictable, and occur in moments where extreme hopelessness intersects with impulse and access to means. As a field there are many brilliant scientists and clinicians working on ways to identify and help individuals at this extreme of human suffering.

Among them is Dr. Christine Ma-Kellams, University of La Verne, and colleagues who were interested in understanding whether Google search trends can be used to predict suicide, and whether these trends are more effective in predicting suicide rates than our existing measures.

To answer this question, they pulled together data from several different sources. First, they found data from the CDC National Vital Statistics System on the number of completed suicides in the United States. From the U.S. Census Bureau, she collected demographic data that included information like income, population, home-ownership rates, unemployment, and percent of the population under the poverty line,  age, and racial categories. From the National Survey on Drug Use and Health, they collected nationally representative data on suicide vulnerability as reported on the existing gold-standard, clinical measures for suicide risk. Finally, from Google trends, they recorded the relative frequency of google searches for the terms "suicide," "how to suicide," "how to kill yourself," and "painless suicide" compared to the search term "weather." All of the data used in the study were from the years 2008-2009.

They found that the frequency of these Google search terms was significantly associated with the rate of completed suicides recorded by the CDC. They also found that frequency of these search terms was more predictive of suicide rates than the existing self-report measures we use to estimate suicide risk.

The Google search terms weren't perfect, though. They were less effective at accurately predicting suicide rates in states with lower incomes, higher crime rates, and a larger minority population. Also, it's important to acknowledge the limitations of this study. Even though this data was pulled from many different sources, is nationally representative, and cover two years, there is no way for us to know which direction the effect is going. We think these data mean that people are searching for "how to commit suicide" and then those same people are completing suicide, but it is just as plausible that individuals completed suicide, and then people in their community went online and searched for these terms. It is true that a single suicide in a community can inspire increases in discussions of suicide among the members of that community, but either way the problem to be solved is the same. Find a way to help people who feel like life isn't worth living, and prevent suicide. Google can help us find those people.

So, what does this mean? Google knows where you've been, where you're going, what you want, and how you want it. As it turns out, Google also knows who is thinking of committing suicide. Knowledge is power, and here power is life. Google is already implementing the use of sponsored ads for suicide hotlines that target individuals searching for terms just like the ones in this research study. But we are only at the beginning of understanding how to leverage this type of data in ways that can save lives. For example, can we target specific communities in the wake of a tragedy or disaster when suicide rates increase? Can we create sophisticated programs for online chatting for people going through a moment of hopelessness? Can we use the data to identify communities for whom more mental health resources would prevent these feelings of hopelessness? What ideas do you have about how to harness the power of the internet to reduce suicide rates?

Need Help? Know someone who does? Contact the National Suicide Prevention Lifeline
at 1-800-273-TALK (1-800-273-8255) or use the online Lifeline Crisis Chat.  You’ll be connected to a skilled, trained counselor in your area. Both are free and confidential. For more information, visit National Suicide Prevention Lifeline
Ma-Kellams, C., Or, F., Baek, J. H., & Kawachi, I. (2015). Rethinking Suicide Surveillance Google Search Data and Self-Reported Suicidality Differentially Estimate Completed Suicide Risk. Clinical Psychological Science, 2167702615593475.

Photo credit: Garrett Sears via www.unsplash.com

What works: Anxiety and Depression Treatments

Depression and anxiety are emotional disorders that reduce quality of life, increase suffering, impair our relationships, and endanger our long-term health. What's worse is that they are also extremely common. Depression and anxiety are known to affect 19 and 29% of individuals, respectively, not to mention that depression and anxiety co-occur at a rate of almost 50%. These statistics are particularly astonishing to me as a clinical psychologist because our field has developed a number of effective, non-invasive treatments that just don't seem to get into the lives of the people who need them most. In fact, a large national study recently found that most people suffer with anxiety and depression for about 10 years before they get treatment. A decade of unnecessary suffering. 

There are many reasons for this: some people don't live close enough to mental health providers, many people don't believe they have a problem (after all anything that sticks around for 10 years would just become the new normal), many people don't believe that seeing a psychologist would help, and many people can't afford the time or money it would cost. Luckily, how to effectively treat anxiety and depression is an active area of research, including questions such as what works for whom, and how can these effective treatments be delivered. 

An older approach to treating anxiety and depression was to identify which problem was more pressing and severe, and then treat the disorders sequentially. However, basic psychological science research suggests that underlying brain structures, symptoms, and behaviors for depression and anxiety are the same. This means that they can likely be treated with the same interventions. With this realization, clinical psychological scientists began to test the effectiveness of depression treatments on anxiety disorders, and anxiety treatments on depressive disorders. What emerged from these studies were "transdiagnostic" treatments for depression and anxiety. The transdiagnostic approach to treating emotional disorders is to identify and address the common maladaptive psychological, behavioral, and interpersonal processes that underlie psychological distress and impede well-being. But the million dollar question is, "Do they work?" 

Last year Dr. Jill Newby at the University of New South Wales and her colleagues published a meta-analysis examining the effectiveness across all of the existing clinical trials using transdiagnostic treatments for depression and anxiety. After scouring the published literature, they identified 47 studies that examined the effectiveness of transdiagnostic treatments for depression, anxiety, and quality of life for adults. The 47 studies varied in the type of treatment used (e.g., mindfulness vs cognitive behavioral therapy (CBT)), size (e.g., group vs individual), and delivery (e.g., internet-based vs face-to-face). The results of this meta-analysis represent effectiveness for transdiagnostic treatment for 1,109 patients compared to 992 controls. 

They found that transdiagnostic treatments had a large and significant overall effect on decreasing depression and anxiety symptoms as well as increasing quality of life. They also found that these benefits were maintained for up to 6 months following treatment completion. They also examined delivery characteristics for treatments and found that anxiety symptoms improved the most when treatment was delivered individually or over the internet compared with in a group format. Depression symptoms were most effectively treated over the internet, followed by face-to-face and group formats. They also looked at whether the content and approach to therapy influenced patient outcomes. They found that anxiety symptoms improved more in CBT-based treatments, while there was no difference in effectiveness between CBT- and mindfulness-based treatments for depression symptoms. In other words, both work just as effectively for treating depressive symptoms. 


To summarize, patients with anxiety and depression were better off if they received transdiagnostic treatment than if they didn't. Further, internet-based CBT is likely the best bet for how to effectively treat your symptoms. This is good news because internet-based treatments are wiping out many of the common barriers to getting treatment. They are flexibly scheduled, cost-effective, and accessible. It's not surprising then that internet-based treatments for depression and anxiety are becoming a topic of national discussion. We wrote about it at the launch of Maven, the future of health care, and UCLA's Raphael Rose Ph.D. was featured on the topic in Vogue magazine just this month. Based on the national statistics, one in three of you is struggling with depression and/or anxiety. Getting mental health services used to be nearly impossible and quite stigmatizing to navigate. All of that has changed. The only question now is what are you waiting for? 

Newby, J. M., McKinnon, A., Kuyken, W., Gilbody, S., & Dalgleish, T. (2015). Systematic review and meta-analysis of transdiagnostic psychological treatments for anxiety and depressive disorders in adulthood.Clinical psychology review, 40, 91-110.

Invest in Education

ScienceForWomen.org is has two goals which we describe here. The second goal is to promote the education of women in sciences and reinforce young women who have made an investment in their education.

In a past post, I wrote about telomeres. Telomeres are the caps on our chromosomes, which hold all of our DNA. As we age, telomeres shorten, creating vulnerability to disease and contributing to mortality. As a result, there has been a monsoon of research in the past decade examining the lifestyle and psychological factors that predict telomere length.  More recently, I came across an article that underscores our mission to reward those who have invested in their education.

One of my scientific heroes, Dr. Andrew Steptoe, and his colleagues asked the question:

What is a better predictor of telomere length later in life: how much money you have or how much education you completed?

Study after study after study shows that having low socioeconomic status predicts earlier mortality and greater risk for disease. In fact, some past studies have shown that low SES predicts shortening telomeres which protect the DNA of your cells. Shortening telomeres are a popular marker of biological aging. Yet, socioeconomic status is comprised of many different factors, including household income, occupation, and education. To answer their research question, the team used data from  a large study that followed over 10,000 civil servants living in London between 1985-1988 who were recruited for a longitudinal study on cardiovascular disease risk. Most importantly, recruitment for the study specifically aimed to have participants ranging on socioeconomic background. Among these thousands of individuals, 506 (277 men, 229 women) aged 62.77 years  (range 53–76 years) came to a laboratory between 2006-2008 to provide a blood sample and complete more measures of their current income and occupation.

In this sample,  180 (35.6%) participants had a college/university degree, 153 (30.2%) had obtained "A levels" or an advanced qualification for high school, 132 (26.1%) had obtained "O levels" or a basic qualification in high school, and 41 (8.1%) had no educational qualifications. 

They then looked the association between different education levels and telomere length, and found that as educational attainment increased, so did telomere length. That may not be surprising, but they also found this association after controlling for: age, sex, current occupation, blood pressure, cholesterol, smoking, BMI, physical activity, and current household income. So that means that while it is possible that low educational achievement may contribute negatively to health through lower lifelong income, higher likelihood of smoking, obesity, smoking, and so on, there is still a significant contribution made by educational achievement to the health of your cells, above and beyond those factors.  Even more remarkable was that the association was a gradient, such that there were gains in telomere length with each additional level of educational. 

What might this mean? The authors make two points that warrant further research and consideration. First, it is possible that education sets an individual on a health-promoting trajectory that is more important to late-life health than wealth or occupation when a person is older. It is also possible that education allows an individual to more effectively problem solve around health-related issues. The measures of educational attainment in this study are fairly specific to the UK, whereas educational levels in the United States would likely group the "O"s and "A"s together. Not knowing much about the UK system, I expect that the UK high school qualifications are more highly correlated with IQ than anything else. So, perhaps individuals with higher educational qualifications, have higher IQs, which cause them to seek out and respond to health recommendations and problems differently, resulting in cumulative benefit or damage to the body. 

The take home message here is that investing in a young adult's education will do more for them than increase their potential income, it has the potential to improve their health, reduce their risk for disease, and lengthen their life. Keep in mind that these findings are just correlational, meaning there is no way of knowing whether higher education caused longer telomere lengths for the people in this study. These data are also limited in that they excluded people with heart and inflammatory diseases. These limitations aside, I still can't think of a good reason not to invest in education. 

For more articles on telomeres click here.

Steptoe, A., Hamer, M., Butcher, L., Lin, J., Brydon, L., Kivimäki, M., ... & Erusalimsky, J. D. (2011). Educational attainment but not measures of current socioeconomic circumstances are associated with leukocyte telomere length in healthy older men and women. Brain, behavior, and immunity, 25(7), 1292-1298.

What your body remembers from the first year of life!

Now, normally we cover the work of brilliant psychological scientists from all over the world, but our founder Dr. Kate Ryan Kuhlman's most recent paper was featured last week on the International Society for Traumatic Stress Studies' Trauma Blog so we wanted to share it with you by reposting here. Enjoy!

Exposure to trauma during the first year of life may impair the body’s ability to recover from stress

Childhood adversity exposure has been linked to physical and mental health difficulties, such as asthma, arthritis, cardiovascular disease, depression, and suicidality. These health conditions and/or their risk factors emerge throughout childhood and adolescence, and persist across the lifespan. Research over the past two decades has taught us that exposure to traumatic experiences has the potential to alter the way our body responds to stress. When our body experiences stress, there is a cascade of physiological changes that result in the production of cortisol. Exposure to large quantities of cortisol for extended periods of time has serious negative consequences for our brain and our immune system. More recently, researchers have considered whether there are specific periods of development that are more sensitive to trauma and therefore are more impactful to our long-term health.

In a recent article in the Journal of Traumatic Stress, Dr. Kate Ryan Kuhlman and colleagues in Nestor Lopez-Duran’s laboratory at the University of Michigan conducted a study looking at the way 97 adolescents (ages 9-16) responded to stress in the laboratory, and whether responses to the stressor were different based on when the adolescent was first exposed to trauma. These traumatic experiences were assessed using the Early Trauma Inventory, reported by their parents, and included events that constitute non-intentional traumatic events, sexual, physical, and emotional abuse.

Adolescents in the study who were exposed to trauma before they turned one had a significantly different profile of response to the laboratory stressor. Specifically, adolescents exposed to trauma during their first year of life showed a slower recovery from the acute stressor than their peers who were exposed to the same number of stressors beginning later in childhood.

Several studies have shown that timing of trauma exposure during childhood is linked to distinct alterations in the brain as well as clusters of clinical symptoms. This preliminary finding suggests that exposure to traumatic experiences during infancy may disrupt the physiological capacity to “shut off” the stress response. Thus, the evidence that increased attention to trauma exposure timing is necessary to consider within a developmental framework is growing, and may have profound health implications. Until recently, there were few measures available to reliably gather information regarding the timing of traumatic experiences during youth. Just this year, the Maltreatment and Abuse Chronology of Exposure (MACE; Teicher & Parriger, 2015) was published, and we are excited to use in future studies. More research is needed to identify the cognitive and behavioral symptoms that are associated with delayed recovery from acute stress, how long this pattern of responding lasts, and whether psychosocial and pharmacological interventions can help.

For more insights from the frontlines of science on trauma, check out the ISTSS Trauma Blog.

Kuhlman, K. R., Vargas, I., Geiss, E. G., & Lopez-Duran, N. L. (2015). Age of Trauma Onset and HPA Axis Dysregulation Among Trauma-Exposed Youth. Journal of Traumatic Stress. doi: 10.1002/jts.22054

This is your brain on Facebook.

Social media has revolutionized the way we communicate with one another. Part of the tremendous success of social media platforms, such as Facebook, is that it enables individuals to receive rapid social feedback which is highly rewarding. There is a complex neural network in the human brain that responds to rewards. In particular, the nucleus accumbens is a structure in the brain that has repeatedly been identified as the neural structure that processes rewards that motivate human behavior such as food and money. In fact, the magnitude of activation of this brain structure when viewing photos of food will predict how much a person eats. However, there has long been a debate about whether primary biological needs such as food are motivated by the same neural networks that motivate social needs.

In order to better understand how our brain processes social rewards, a team of psychological scientists from the Freie University in Berlin, Germany conducted a study examining how the brain responds to social and monetary rewards. To do this, the team recruited 31 young adults (ages 19-31). These individuals came into the lab twice. First, they completed a questionnaire describing their regular use of Facebook, including questions about how many friends they have, how many minutes per day they spend on Facebook, and how connected they feel to Facebook. Then, participants were asked to participate in a 15 minute video interview. During this interview the participants briefly introduced themselves, then answered questions such as "Do you like living in Berlin?" and "Please pick one problem facing modern German society and briefly state your opinion on the matter." and "Please think of a creative work, such as a film, book, song or artwork. What is it and why do you like it?" The participants were told that their videos would be evaluated by 10 independent reviewers.

A few weeks later, participants returned to the lab for a brain scan, or fMRI. During this scan, the participants completed two tasks. In the first task, they played a random money game where there were three boxes on a computer screen, A, B, and C. Each box had a different value associated with it. The participant chose a box, and then were told how much money they won. The game required no skill or learning, each value was randomly assigned to a box during each trial, and the research team was only interested in the activation of reward structures in the brain when they saw how much money they won on each trial. In the other task, the participant saw series of photos of either themselves or another individual. In the task they were to indicate whether the photo was their own, or of someone else. Then a word was displayed under the photo. The participants were told that these words were used by the reviewers of their video to describe them. Some of the words were highly positive and complimentary, while others were not. In this task, the research team was interested in the activation of reward structures in the brain when they saw highly positive words about themselves.

They found that the nucleus accumbens activated both when the participant won the most money and when the participant received a positive word describing them. They also found that the magnitude of activation in response to positive social feedback predicted how much the participant used Facebook, while the magnitude of response to winning money did not. For neuroscience nerds like me, this is quite interesting because it shows that the nucleus accumbens responds differently to different types of rewards and stands is opposition to arguments that a reward is a reward is a reward.

The results of this study can be interpreted in a couple of different ways. These data definitely show that, for the average person, positive social feedback activates the neural structure that responds to reward and motivates future behavior, the nucleus accumbens. Further, the activation of this structure in response to social feedback predicted how much the participants used and were connected to Facebook. This is important because it means that any person running a business can benefit from the neural salience of social reward. In the example of Facebook, the masses show their approval by "liking" what others do. More likes = better e-reputation = happier social brain. Another interpretation of the present study's data is that some people are more sensitive to social feedback than others, that sensitivity is rooted in the functioning of the nucleus accumbens, and people who are sensitive to social feedback use Facebook more than those who are not. Either way, we as a field are learning every day, with every new study, how important the social world is to our neurobiology.

Unfortunately, this study is largely limited by issues of causality. Receiving social feedback doesn't cause Facebook use, and also the authors don't directly address comparisons between neural responses to monetary versus social rewards. Wouldn't it be fascinating if someone were to tackle the important marketing question of whether attention or money was more effective as a business strategy. For example, would the average customer prefer 10% off products or 10% more likes on everything they post on social media. This study might suggest that in this digital world, likes might be more valuable than a dollar.


Meshi, D., Morawetz, C., & Heekeren, H. R. (2013). Nucleus accumbens response to gains in reputation for the self relative to gains for others predicts social media use. Frontiers in human neuroscience, 7.