Hosted by the Center for Ethics, Neuroethics Program at Emory University

www.theneuroethicsblog.com

The official blog of AJOB Neuroscience

Carlie Hoffman, Volume Editor

The official blog of AJOB Neuroscience

Hosted by the Emory Center for Ethics, Neuroethics Program

The Neuroethics Blog Reader

Featuring the most popular contributions from student fellows and interns,
presented in chronological order

Carlie Hoffman, Volume Editor

AJOB Neuroscience Graduate Editorial Intern

Published by the Neuroethics Program of the Center for Ethics at Emory University
Copyright 2015 by the Neuroethics Program. All rights reserved. No portion of this publication
may be reproduced without the formal consent of the Neuroethics Program.
Address: The Neuroethics Program, Center for Ethics, Emory University, 1531 Dickey Drive,
Atlanta, GA 30322
Website: http://ethics.emory.edu/neuroethics
Blog: http://www.theneuroethicsblog.com
Cover Image: adapted from AJOB Neuroscience

The 2015 Neuroethics Blog Team:

Founder/Editor/Contributor
Karen S. Rommelfanger, PhD
Neuroethics Program Director, Emory University Center for Ethics
Neuroscience Editor-in-Residence, AJOB Neuroscience
Managing Editor/Contributor
Lindsey Grubbs, Emory University, English and Bioethics
Supporting Editors/Contributors and AJOBN Editorial Interns
Carlie Hoffman, Emory University, Neuroscience
Ryan Purcell, Emory University, Pharmacology/Neuroscience
Jonah Queen, Emory University, Neuroscience and Behavioral Biology
Katie Strong, Emory University, Chemistry
Center for Ethics Director, Emory University
Paul Root Wolpe, PhD
Editor-in-Chief, AJOB Neuroscience

Table of Contents

Foreword

Introduction

ii

Oxytocin: Liquid trust and artificial love

Jonah Queen

Drug addiction and sex addiction: Are they real (brain) diseases?

Kristina Gupta

The military and dual use neuroscience

Ross Gordon

Return of the pedophilic brain tumor: Acquired versus innate pedophilia

Cyd Cipolla

Brain-boosting or pulp fiction?

12

Shezza Shagarabi

Why use brain cells in art?

15

Riley Zeller-Townson

Uncovering the neurocognitive systems for Help this Child

17

Julia Haas

The violence of assumed violence: A reflection on reports of Adam Lanzas possible

autism
20
Jennifer Sarrett

Misophonia: Personality quirk, symptom, or neurological disorder?

23

Emily Young

Lumosity: A personal trainer for your brain?

25

Ryan Purcell

Why people's beliefs about free will matter: Introducing the free will inventory

29

Jason Shepard

Should you read more because a neuroscientist said so?

32

Lindsey Grubbs

Pass-thoughts and non-deliberate physiological computing: When passwords and

keyboards become obsolete
35
Katie Strong

So you want to be a successful psychopath?

38

Julia Marshall

The power of a name: Controversies and changes in defining mental illness

41

Carlie Hoffman

Appendix: Where are they now?

A1

Foreword

Dear Readers:
This publication has collected some of the most popular and recent submissions to The
Neuroethics Blog and offers them for your reading pleasure. The Neuroethics Blog (at
www.theneuroethicsblog.com) is published by the Neuroethics Program of the Center for Ethics
at Emory University and is the official blog of the journal AJOB Neuroscience, published quarterly
by Taylor and Francis.
The goal of the blog and the journal is to provide stimulating and cutting edge resources
for scholars, researchers, clinicians, and anyone else interested in ethics and the brain sciences.
As youll see, the blogs in this special collection traverse topics as far-ranging as pedophilic brain
tumors, misophonia, successful psychopathy, and nosology in mental illness. Our quarterly
journal, AJOB Neuroscience, offers a similar range of provocative topics and has the added
advantage of publishing both target articles from the intersection of ethics and neuroscience as
well as open peer commentaries addressing those target articles. Our aspiration with both
publications is to advance the conversation on the ever expanding landscape of neuroethics in
creative, stimulating, and eminently responsible ways.
Neuroscience is challenging us with sometimes startling new findings that have
implications for concepts of selfhood, agency, human enhancement, legal standing, and
neurological orders, among others. A thoughtful public conversation on negotiating these
complicated issues is needed. Where can scholars from related fields and the educated lay public
go for nuanced reflection on such important issues? The Neuroethics Blog is a wonderful starting
place, a reliable and accessible conversation, steeped in scholarship. Truly a singular resource.
We encourage thoughtful and committed scholars in neuroethics to consider submitting
blog posts and target articles or open peer commentaries. Our goal is to inspire and inform
research across the many disciplines that comprise neuroethics, and we look to publications such
as the journal and blog to provide a global forum for advancing that knowledge.

Sincerely,
John Banja, PhD
AJOB Neuroscience Editor
Paul Root Wolpe, PhD
AJOB Neuroscience Editor-in-Chief
Director, Emory University Center for Ethics

Introduction

It is my pleasure to present you with our first edition of The Neuroethics Blog reader. This
reader includes some of the most popular posts on the site and highlights our junior talent.
I created the The Neuroethics Blog in 2011 as a postdoctoral fellow under the mentorship
of Dr. Paul Root Wolpe with the motivation of growing our neuroethics community as well as
increasing my neuroethics knowledge base, and it has been my pleasure to see the blog become
a resource for the larger community. The Neuroethics Blog has now become the premier
international blog on neuroethics and is the official blog of AJOB Neuroscience, boasting a current
dedicated readership in over 40 countries. The blog, which has published weekly since 2011, is
used as an online platform for conversation and discussion, and includes contributions from
neuroethics luminaries such as individuals on the editorial board of AJOB Neuroscience as well
as junior scholars and students.
While the blog showcases cutting-edge debates in neuroethics, it also serves as a
mechanism for mentoring junior scholars and students and providing them with exciting
opportunities to have their pieces featured alongside established scholars in the field. In addition,
the blog allows for community building, inviting scholars from multiple disciplines to participate.
Our contributors have included individuals at various levels of education hailing from fields such
as law, neuroscience, engineering, psychology, english, medicine, philosophy, womens studies,
and religion, to name a few. Each blog post is a collaborative process, read and edited numerous
times by the editorial leadership in partnership with the author.
The blog has also served as a resource for those outside of our immediate community. In
the most recent Gray Matters report to President Obama from the Presidents Commission for the
Study of Bioethical Issues, The Neuroethics Blog was repeatedly cited as an informational
resource for their discussions and was also cited as a resource amongst high impact peerreviewed journals such as the NIH, WHO, and various neurological disease-related foundations.
The cited blog posts were authored by a graduate student, an AJOB Neuroscience editorial board
member, and a mentored junior scholar in neuroethics; the wide range of experience and
neuroethics expertise represented in these cited posts demonstrates that regardless of position
in their careers, The Neuroethics Blog contributors are able to deliver quality neuroethics content
that engages current and future community members in the field of neuroethics.
We aim to continue to mentor and deliver quality posts that serve to cultivate not only our
neuroethics academic community, but also members of the public who may be cultivating their
own interests in neuroethics. Whether for applications in your profession or simply to understand
the world in which we live, we hope the blog will help you navigate the implications of new
neurotechnologies and explore what is knowable about the human brain.
Thank you for taking the time to embark on this journey with us and happy reading!

Sincerely,
Karen S. Rommelfanger, PhD
Neuroethics Program Director, Emory University Center for Ethics
The Neuroethics Blog Founder and Editor-in-Chief
AJOB Neuroscience Editor-in-Residence (Neuroscience)

ii

Oxytocin:
Liquid trust and artificial love
Jonah Queen, Emory Neuroethics Program Intern/AJOB Neuroscience Editorial Intern, Published
October 13, 2011

The website for the company Vero Labs

[1] sells a product called Liquid Trust. It is a
hormone-based spray that, when applied like
a cologne, is supposed to help win the trust
of those around you. According to the
website, the spray contains pure human
Oxytocin, a hormone and neuropeptide that
is involved in emotions such as trust, social
bonding, and even love. The idea of a
commercially available product that can
secretly control the behavior of those nearby
seems too far-fetched to be possible, and, in
fact, it is. But surprisingly, the problem with
Liquid Trust is not the ingredients but the
dosing. In a 2005 Boston Globe article [2],
neuroeconomist Paul Zak explained that the
amount of oxytocin that would be inhaled by
standing next to someone wearing Liquid
Trust is not enough to have any behavioral
effect and called the product totally bogus.
So then, what can oxytocin do if taken in
a high enough dose?
Zak coauthored a study in the journal
Nature [3] that demonstrated the hormones
trust-increasing effects. In an investment
game [4], participants were more likely to
give over money if they had inhaled an
oxytocin nasal spray. Oxytocin also helps
form emotional bonds in relationships
between romantic partners as well as
between parents and their children [5].
Some researchers hope that oxytocin
can be used to treat people with conditions
such as social anxiety and autism who have
trouble feeling comfortable and connected in
social situations [6]. But there is also the
possibility that it could be abused. The
Boston Globe and National Geographic
articles mention the possibilities of oxytocin
being used at political rallies (to gain the trust
of the audience), by businesses (to make
customers feel more comfortable spending
money), or even as a date-rape drug.

Increasing oxytocin levels could also

have undesired side effects. For example,
doses of oxytocin have been shown to
increase ethnocentrism and xenophobia
since the hormone seems to primarily
increase trust towards those in a persons
in-group [7]. While this research seems to
suggest that a dose of oxytocin can instantly
lead to feelings of trust, comfort, connection,
and even love, it is not exactly that simple.
Research conducted by Larry Young at
Emory University showed that oxytocin and
vasopressin (another hormone) can explain
the differences in the mating behaviors of the
monogamous, pair-bonding prairie voles and
the promiscuous meadow voles [8].
When the prairie voles mate, oxytocin
and vasopressin are released in their brains,
leading to lifelong bonding. Giving injections
of these hormones to prairie voles that have
not mated can still cause them to bond. But
giving these hormones to the meadow voles
does not affect their behavior since they also
lack oxytocin and vasopressin receptors in
the regions of the brain involved in reward
processing. Genetic differences in the
expression of the receptors also mean that
even among prairie vole males, some are
more likely to be monogamous than others.
And there is evidence for the existence of
similar genetic differences among humans
[9], meaning that oxytocin will not affect
everyone the same way. Still, this research
has led to talk of using hormone (and even
genetic) therapies to help people stay faithful
to their partners and to keep marriages
stable. And also to do the exact opposite:
creating an anti-love drug to prevent people
from becoming over-invested in their
relationships [10]. These methods of
artificially regulating love bring up additional
questions about the ethics of using medical

technology to change normal behaviors

and to chemically alter our emotions. While
love drugs might, at first, seem like a form
of mind control, how is taking medication to
treat infidelity or infatuation different from
taking them to treat depression or attention
deficit hyperactivity disorder (ADHD)? And
how would using oxytocin be different than
attending therapy to resolve the same
issues? Some of the reluctance towards the
medication route might have to do with the
negative connotations of psychiatric drugs,
but there are deeper issues involved about
freewill, our ability to choose, our sense of
self, and our position in society. These
questions are currently being asked about
existing treatments, and as neuroscience
and neuro-technology continue to advance,
more such issues will arise.

3.

Kosfeld, M, Heinrichs, M, Zak, PJ, Fischbacher, U, &

Fehr, E (2005) Oxytocin increases trust in humans.
Nature 435: 673-676.
4. Lovgren, S. (2005, June). Trust hormones smell
helps us hand over cash, study says. National
Geographic News.
5. Magon, N, & Kalra, S (2011) The orgasmic history of
oxytocin: Love, lust, and labor. Indian J Endocrinol
Metab 15 Suppl 3: S156-161. doi: 10.4103/22308210.84851
6. Allen, J. (2010, February). Love hormone may help
autism symptoms. Reuters.
7. De Dreu, CKW, Greer, LL, Van Kleef, GA, Shalvi, S, &
Handgraaf, MJJ (2011) Oxytocin promotes human
ethnocentrism. Proceedings of the National Academy
of Sciences 108: 1262-1266. doi:
10.1073/pnas.1015316108
8. Zarembo, A. (2004, June). DNA tweak turns vole
mates into soul mates. Los Angeles Times.
9. CNN.com. (2004, June). Scientists find rodent
monogamy gene. CNN.com.
https://younglab.yerkes.emory.edu/media/CNN_com%
20-%20Scientists%20find%20rodent%20
monogamy%20gene%20- %20Jun%2016,
%202004.htm
10. Tierney, J. (2009, January). New anti-love drug may
be ticket to bliss. The New York Times.

References
1.
2.

https://www.verolabs.com/
Goldberg, C. (2005, December). Feeling shy, afraid of
strangers? Hormone under study may help. The
Boston Globe

Drug addiction and sex addiction:

Are they real (brain) diseases?
Kristina Gupta, Emory Neuroethics Scholars Program Fellow, Published April 24, 2012

As Neuroethics Scholars Program

Fellows, Cyd Cipolla and I designed an
interactive discussion-based undergraduate
course Feminism, Sexuality, and Neuroethics, which we taught at Emory in the
spring of 2012. In developing our course, we
decided to devote one week to examining
neuroscientific research on sex addiction.
In recent years, neuroscientists have started
to use imaging technology to explore the
neurobiology of out-of-control sexual
behavior (sometimes called sex addiction)
[1]. In addition, some researchers and
mental health professionals have argued that
the neurobiology of sex addiction is the same
as the neurobiology of drug addiction [2].
However, a number of scholars have
critiqued the category of sex addiction,
arguing that it is a reflection of our cultural
anxieties about high rates of sexual activity
[3, 4]. After our in-class discussions, I was
still left wondering whether it is appropriate to
view excessive sexual interest as an
addiction (and, specifically, as a brain
disease or a mental illness) or as a
sociocultural construct dependent on sexnegative cultural values.
Thus, I was very excited by Dr. Steve
Hymans visit to Emory, as Dr. Hyman is a
leader in thinking about the neurobiology of
drug addiction and in thinking through the
ethical implications of neuroscientific research on drug addiction. During his visit, I
took advantage of the opportunity to ask Dr.
Hyman to share his thoughts about sex
addiction. This blog is a report back on both
his answer and on my further reflections
about whether it is appropriate to use a
disease model to understand sex addiction.

drug addiction is better understood as a

disease than as a moral failing. According to
Hyman, addictive drugs activate dopamine
pathways, leading the individual to imbue
reward-associated cues (e.g. drug paraphernalia) with motivational salience. In
turn, encountering these salient cues leads
the individual to engage in (nearly) automatic
drug-seeking behavior. Hyman sees two
primary ethical implications of this view of
drug addiction: first, it is wrong to see a drugaddicted individual as entirely in control of,
and thus entirely morally responsible for, his
or her behavior; second, the fact that drugaddicted individuals are not entirely in control
of their behavior may lead us to realize that,
in general, humans are not nearly as in
control of their behavior as they often think
[5].
I see some tension in Dr. Hymans work
between embracing a disease model of drug
addiction (which suggests that drug-addicted
individuals are categorically different from
non-drug addicted individuals) and arguing
that drug addiction reveals the extent to
which we are all on mental autopilot most
of the time. For me this tension was highlighted when, during an informal lunchtime
presentation, Dr. Hyman expressed significant reservations about using a disease
model for mental illness. As David Nicholson
discussed in a previous post on this blog [6],
Dr. Hyman described the diagnostic
categories used by psychiatric researchers
as fictive categories, not natural kinds.
Hyman went on to argue that complex
psychopathologies like autism are not
categorical disorders (in other words, there
is not one group of people that has autism
and a separate group of people that does
not) and suggested that the definitions of
mental disorders are culturally and
historically-dependent.

The neurobiology of drug addiction:

implications for voluntary control of
behavior
First, some background on Dr. Hymans
work on drug addiction: Hyman argues that

Does sex addiction equal drug

addiction?
Some background on sex addiction:
Over the years, many different terms have
been used to describe out-of-control sexual
behavior. In the 1980s, the term sex
addiction was popularized in the U.S. to
describe this behavior, but there remains a
great deal of controversy in the mental health
field over whether sex addiction should be
considered a distinct mental disorder and, if
so, how it should be defined and labeled
(other terms in current usage include
hypersexuality, compulsive sexual behavior,
and impulsive sexual behavior) [3, 7].
In our class, we read a brain-imaging
study about compulsive sexual behavior [1]
and a case study about the use of naltrexone
to treat sex addiction [2]. The latter article
is particularly interesting because the
authors draw heavily on Dr. Hymans writings
to argue that the same neurobiological
processes that underlie drug addiction must
underlie sex addiction, and therefore it
makes sense to treat sex addiction with a
drug like naltrexone (naltrexone is an opioid
antagonist that is approved for the treatment
of opioid and alcohol dependence).
We are fortunate to have had an
engaged and intellectually diverse group of
students and our discussions proved to be
thought-provoking for us and our students. In
class, we discussed the cultural assumptions
influencing the scientific research on sex
addiction and the ethical implications of this
research for society. We debated the
following questions:

Is a person with a sex addiction morally

responsible if he or she puts a partner at
risk for contracting a sexually transmitted infection (STI)?
Is sex addiction defined and/or experienced differently for women than for
men?
Are the neurobiological processes
underlying sex addiction the same as
the neurobiological processes underlying drug addiction?
Is it ethically acceptable for doctors to
prescribe naltrexone to individuals with
a sex addiction based on the theory that
sex addiction and drug addiction involve
the same neurobiological processes?
Does conceptualizing out-of-control
sexual behavior as an addiction or a
brain disease or a mental illness reduce
stigma against people with a sex
addiction?
To what extent does our society make
access to treatment, legal protection,
social support, and respect dependent
on taking up a disease label?

Dr. Hymans take on the issue

As you can imagine, class discussion
about these issues was lively. So, when the
opportunity arose, I jumped at the chance to
ask Dr. Hyman whether he thought it was
appropriate to describe out-of-control
sexual behavior as an addiction or to treat
sex addiction with naltrexone. He offered
what I thought was a thoughtful response to
my question, making six main points:
1.

To what extent does the definition of

sex addiction reflect our cultural ambivalence about or even distaste for high
levels of sexual activity?
Will an individual seek treatment if he or
she is distressed primarily because of
our
societys
stigmatization
of
promiscuity?
Will individuals be pressured to seek
treatment by partners who have different
levels of sexual interest?

2.

3.

On the one hand, behavioral addictions

(like sex addiction) do seem to share
phenomenological and phenotypic similarities to drug addiction.
It may make sense to make treatment
and policy decisions about behavioral
addictions based on the knowledge that
people with these addictions are not fully
in control of their behavior.
As in the case of drug addiction, our
society has the tendency to overattribute agency and moral responsibility
to individuals with behavioral addictions.

4.

5.

6.

However, we do not understand the

neurobiological mechanisms involved in
behavioral addictions; we do not know if
they are the same as the mechanisms
involved in drug addictions.
It is probably premature (he used the
word faddish) to treat sex addiction
with naltrexone without further research.
(As in the case of drug addiction?) it is
very tempting for afflicted individuals,
their families, and health care professionals to call something a disease or
an addiction.

all to tread carefully in order to avoid reifying

sex addiction as a natural kind.
So, for me, the real ethical questions
are: can we respect the phenomenological
and (possibly) neurobiological validity of
diagnoses like sex addiction while also
simultaneously recognizing the extent to
which they are sociocultural constructs (in
other words, can we see sex addiction as
both a real and a fictive category)? Can we
develop effective treatments for sex
addiction while also working to challenge our
societys stigmatization of promiscuity and
obsession with achieving normalcy? Can
we accord respect to people who consider
themselves to be sex addicts while
simultaneously undermining the pressure
our society places on people to take up
disease labels?

So, is sex addiction a real (brain)

disease?
Its important to clarify what we mean
when we ask whether sex addiction is a real
disease. If we are asking, are people
consciously faking it?, then the answer is
usually no, although it may be the case that
some celebrities or politicians cynically claim
to have a sex addiction in order to reingratiate themselves with the public after
their sexual misdeeds are exposed. Still, in
the vast majority of cases, people who
consider themselves to be sex addicts are
genuinely distressed by sexual thoughts,
desires, or behaviors that are experienced
phenomenologically as out-of-control, and
these people may benefit from psychological
and/ or physiological treatments. In addition,
although the neurobiological processes
involved in out-of-control sexual behavior
may not yet be well-understand, I am certain
that neuroscientists will be able to shed light
on these processes in the near future.
However, if by asking is it real? we are
asking whether sex addiction should be
conceptualized as a distinct mental illness
around which a clear line can be drawn
separating sex addiction both from other
mental illnesses and from normal sexual
behavior, the answer is probably no. The
placement of any line we draw between sex
addiction and normal sexual behavior (and
between sex addicted brains and normal
brains) will be heavily influenced by
historically contingent sociocultural norms
about what is a proper level of sexual
interest. Thus, I believe it would behoove us

References
1.

2.
3.
4.
5.
6.

7.

Miner, M. H., Raymond, N., Mueller, B. A., Lloyd, M., &

Lim, K. O. (2009). Preliminary investigation of the
impulsive and neuroanatomical characteristics of
compulsive sexual behavior. Psychiatry Research:
Neuroimaging, 174(2), 146-151.
Bostwick, J. M., & Bucci, J. A. (2008). Internet sex
addiction treated with naltrexone. Mayo Clinic
Proceedings, 83(2), 226-230.
Irvine, J. M. (1995). Reinventing perversion: Sex
addiction and cultural anxieties. Journal of the History
of Sexuality, 429-450.
Moser, C. (2001). Paraphilia: A critique of a confused
concept. New directions in sex therapy: Innovations and
alternatives, 91-108.
Hyman, S. E. (2007). The neurobiology of addiction:
implications for voluntary control of behavior. The
American Journal of Bioethics, 7(1), 8-11.
Nicholson, D. (2012, April). Refried serotonin lunch.
The Neuroethics Blog. Retrieved from:
http://www.theneuroethicsblog.com/2012/04/refriedserotonin-lunch.html
Giugliano, J. R. (2009). Sexual addiction: Diagnostic
problems. International journal of mental health and
addiction, 7(2), 283-294.

The military and dual use neuroscience

Ross Gordon, Emory Neuroethics Program Intern, Published August 16, 2012

If theres one thing I learned from the

most recent installment of Christopher
Nolans Batman trilogy, its this: if youre
doing interesting research, it probably has a
military application.

similarly emphasizes the importance of

neuroscientific research, declaring that
emerging neuroscience opportunities have
great potential to improve soldier performance and enable the development of
technologies to increase the effectiveness of
soldiers on the battlefield."
The military applications of neuroscience are vast, but can be divided [3] into
three categories: performance enhancement
and degradation, surveillance and threat
assessment, and neural interface.

Dual Use Technology

The formal name for this is dual-use
technology, and its difficult to find an area
of research in which its not a relevant
concern. Innovations in renewable energy
may avert catastrophic global warming, but
they also promise to significantly lower
military fuel costs and improve the mobility of
forces newly unconstrained by the logistics
of fossil fuel transportation. Research into
nuclear fusion foreshadows essentially
inexhaustible carbon-free energy at the
same time as it provides a technological
foundation for fusion-triggered nuclear
weapons that some believe may lower the
threshold for nuclear weapons use. Even
ostensibly benign anti-obesity campaigns
have military implications, as suggested by a
recent CBS News article ominously titled
Too Fat to Serve: Military Wages War on
Obesity.
Physics and engineering tend to be the
disciplines most readily associated with highprofile military innovations, but it is biology
and neuroscience in particular that has
increasingly captured the interest of the
military research establishment. In 2006s
Mind Wars: Brain Research and National
Defense, University of Pennsylvania bioethicist Jonathan Moreno estimates that
most of DARPAs (Defense Advanced
Research Projects Agency) [1] desired
research proposals directly or indirectly
involve the brain and, a journal article
published in 2012 finds that the fiscal year
2011 budget contained over $350 million in
military neuroscience research [2]. A 2009
Army report entitled Opportunities in Neuroscience for Future Army Applications
nippinnikp

Performance Enhancement and

Degradation
Performance and cognitive enhancement technologies are not new to the military,
though theyve certainly taken on new forms
in recent years. The use of stimulantsmethamphetamine in Germany and Japan,
and amphetamine among the British and
Americans was widespread throughout
militaries during World War II, and the 2009
Army report includes a section on good ol
caffeine as a means to to improve cognitive
functioning
during
sustained
military
operations. Recent military research has
investigated new drugs, most notably
ampakines [4], that attempt to combat the
negative effects of sleep deprivation without
incurring the abuse potential and side effects
often attributed to traditional stimulants. A
2012 report on neuroscience and conflict
published by the UK Royal Society cites a
number of additional substances with
apparent potential for military use notably,
the Parkinsons drug and dopamine precursor L-DOPA for learning enhancement,
the social-behavior-modulating hormone
oxytocin for unit cohesion, and anxietydulling beta-blockers for decision-making
under stressful conditions. Which substances will find an ultimate military
application remains, at this point, unclear.
For all the well-publicized success of
underground chemists in producing euphoric

Surveillance and Threat Assessment

An EEG device marketed as the Veritas
TruthWave helmet has received a fair bit of
media coverage over the past several
months for its supposed mind-reading
properties. Attached to the head of a
suspicious individual, TruthWave uses EEG
to determine if a subject recognizes a given
suspicious visual stimulus [10]. If the suspect
responds with a pattern of brain activity
known as a P300 signal, recognition and
therefore, it is thought, guilt can be inferred.
The CEO of Veritas Scientific, Eric Elbot, has
been about as ominous as any person could
realistically be about a product they hope to
sell, telling the Institute of Electrical and
Electronics Engineers that The last realm of
privacy is your mindthis will invade that.
Veritas research is funded by the U.S.
military, and Elbot claims that a similar
Veritas product has already been deployed
in a border control context.
Along similar lines, a company called No
Lie MRI has marketed fMRI truth detection
technology to the Department of Defense.
While fMRI has demonstrated impressive liedetection capabilities in some studies,
Neuroethics blogger David Nicholson points
out that the current generation of fMRI
machines also take up an entire room and
sound like a dishwasher powered by the
souls of unborn babies [11], a fact which
likely limits their usability in a field context.
TruthWave, which neither takes up an entire
room nor (to my knowledge) sounds anything
like unborn children, may go some way
towards ameliorating these limitations.

knockoffs of popular recreational drugs [5],

however, it seems inevitable that the
militarys best pharmaceutical minds will
eventually develop a set of chemicals
appropriate to the wide variety of tasks faced
by military personnel.
Military interest in performance enhancement extends well beyond chemicals.
Opportunities in Neuroscience for Future
Army Applications recommends mediumterm field deployment of transcranial
magnetic stimulation (TMS), a form of direct
electrical brain stimulation that has been
associated with memory enhancement. The
2009 DARPA Strategic Plan references a
DARPA program intended for intelligence
analysts [6] that aims to develop a
neuroimaging system capable of detecting
visual information below the level of
conscious apprehension. The same strategic
plan cites applications for neuroimaging in
prescreening potential recruits and in
expertise development for high-skill activities
such as marksmanship and language
acquisition.
In addition to the performance enhancement of its own personnel, the military
stands to benefit from the performance
degradation of the enemy. Techniques for
achieving this goal, which might be
categorized broadly as chemical incapacitation, have applications in crowd control,
counter-terrorism, interrogation, and direct
warfighting [7]. Incapacitating substances
include opiates, notably utilized by Russia
during the Moscow Theater hostage crisis for
purposes of mass sedation, as well as other
agents with established or theoretical
sedating properties such as benzodiazepines, alpha-2 adreno-receptor agonists,
and orexin antagonists [8]. The U.S. military
has also conducted research into the
somewhat more science-fiction suggestive
(and, depending on your political preferences, substantially more sinister sounding
[9]) directed energy weapons, concentrated
beams of small particles or electromagnetic
radiation with the ability to cause cognitive
impairment as well as physical incapacitation.

Neural Interface
Of all the neuroscience technologies
currently under investigation by the military,
it is neural interface that may produce the
most far-ranging implications. Civilian
researchers have made remarkable strides
in direct neurological control of limbs and
other objects, including the successful neural
control of prosthetic robotic arms in both
primates and humans [12]. Neural interface
technology has clear short-term applications
in producing high-quality prosthetics for
injured service members, to the point where

the website for DARPAs Revolutionizing

Prosthetics program suggests that service
members with arm loss may one day have
the option of choosing to return to duty.
In the medium-to-long term, it is
conceivable that neural interface systems
may revolutionize warfare in its entirety. The
UK Royal Society report suggests a number
of applications that appear at first glance to
border on science fiction: imagine, for
instance, remote-operated and braincontrolled vehicles for operations in enemy
territory, neurally-interfaced weapons systems that use unconscious brain data to
enhance reaction times, or magnetic
implants in the fingers that, when connected
to the brain, allow the user to feel heat at a
distance. In a fascinating Penn State
interview, Jonathan Moreno is asked which
military neuroscience technologies he feels
are most eye-opening or scary. Dr. Moreno
responds that neural interface technologies
enabling what is essentially a robot army
with the creativity and spontaneity of a
human operator may constitute the ultimate
future of warfare (though perhaps, he
cautions, not in his lifetime). Such warfare
would be conducted not with boots on the
ground, but by military personnel sequestered safely in a bunker dozens or
hundreds of miles away.

privacy, and the legal and ethical implications

of
next-generation
chemical
incapacitants are just some of topics that
have been discussed extensively in this
literature.
In a future post, Ill look more comprehensively at the legal, ethical, and geopolitical implications of novel military
neuroscience technologies, and discuss the
role of neuroscientists in influencing possible
future applications of their research.

Concluding Remarks
A generation ago, a young, patriotic
science student might have aspired to work
at the Lawrence Livermore or Los Alamos
national laboratories, designing multi-megaton nuclear weapons to contain the
Communist threat. Today, that same student perusing a DARPA budget now easily
accessible to him or her online might reasonably conclude that it is neuroscience, not
physics, in which the bulk of future military
research opportunities lie. The implications
of this paradigm shift for present-day
neuroscientists are substantial, a fact which
has increasingly been recognized by publications in the field [2, 13]. The potentially
coercive use of performance enhancing
substances among military service members, the consequences of EEG and fMRI for

10.

References
1.

2.

3.
4.

5.
6.
7.
8.

9.

11.

12.

13.

Defense Advanced Research Projects Agency, the

federal agency responsible for research into militaryrelevant technology.
Tennison, MN, & Moreno, JD (2012) Neuroscience,
ethics, and national security: the state of the art. PLoS
Biol 10: e1001289. doi: 10.1371/journal.pbio.1001289
Imperfectly, and according to a more or less arbitrary
system of personal categorization.
Drugs whose action is mediated, as might be
expected, through the AMPA subtype of glutamate
receptors.
e.g. bath salts and synthetic cannabis, among others.
Neurotechnology for Intelligence Analysts (NIA).
Although many of these applications are either clearly
or ambiguously restricted by international law.
See the UK Royal Society report
(http://royalsociety.org/uploadedFiles/Royal_Society_C
ontent/policy/projects/brain-waves/2012-02-06BW3.pdf) for more information on these and similar
incapacitating substances.
Sinister-sounding enough, in fact, that a Google
search for directed energy weapons conspiracy
yields 58,000 results, the first page of which contains
diverse allegations involving mind control, the antiChrist, 9/11 truth, and a Russian scheme to melt the
polar ice caps.
Its not clear to me what constitutes a suspicious
visual stimulus, but one article
(http://spectrum.ieee.org/biomedical/diagnostics/themindreading-machine/) suggests bomb specs or
Osama bin Ladens face as possible examples.
Nicholson, D. (2012, June). Likin Laken, if he aint
fakin. The Neuroethics Blog. Retrieved from:
http://www.theneuroethicsblog.com/2012/06/likinlaken-if-he-aint-fakin.html
Hochberg, LR, Bacher, D, Jarosiewicz, B, Masse, NY,
Simeral, JD, Vogel, J, Haddadin, S, Liu, J, Cash, SS,
van der Smagt, P, & Donoghue, JP (2012) Reach and
grasp by people with tetraplegia using a neurally
controlled robotic arm. Nature 485: 372-375. doi:
http://www.nature.com/nature/journal/v485/n7398/abs/
nature11076.html#supplementary-information
Silence of the neuroengineers (2003). Nature 423:
787-787.

Return of the pedophilic brain tumor:

Acquired versus innate pedophilia
Cyd Cipolla, Emory Neuroethics Scholars Program Fellow, Published September 11, 2012

Last week, Reuters carried a story by

Kate Kelland about a pediatrician in Italy,
Domenico Mattiello, accused of sexually
abusing his patients [1,2]. His lawyers plan to
present evidence that his pedophilic urges
are the result of a brain tumor and argue that
the judge in the case should be lenient. As
the Reuter's story mentions, this case is very
similar to a US case I blogged about a few
months ago, where a 40 year old man
suddenly developed pedophilic urges and
had to be removed from his home. The US
case was presented at a medical conference, with very little discussion of criminal
charges, while Mattiello's case is presented
by Kelland as an extreme example of the sort
of challenges neuroscience may bring to our
understandings of criminal responsibility. I
want to push back against this framing, and
argue that a tumor such as this poses an
interesting ethical question because it does
not simply challenge ideas about criminal
responsibility, but also serves as a good
example of the different responses to
"acquired" pedophilia and "innate" pedophilia
[3].
For many discussions about these
cases, the newest article by Kelland
included, a brain tumor that causes sexually
criminal behavior functions as a limit test for
neuroscience in the courtroom. It is only
reasonable to ask ourselves, as a society,
how far we are willing to extend lenience to
someone who argues that a crime he or she
committed was beyond his or her control,
and thus we often employ limit tests to
explore these boundaries. Since sexual
crimes against children are, for many people,
the worst possible type of crimes [4],
questions about pedophilic behavior are a
common test for ideas about criminal
responsibility and mental illness [5].
Mattiello's case is used in Kelland's article as
a limit test for the "my brain made me do it"
defense in this way.

But the idea of a brain tumor that causes

sexual impulses is interesting because it
serves as a limit test for our understandings
of the intersection between mental health
and sex crime. Sex crimes occupy a unique
position within United States law not only
because of the abhorrence of the crimes
themselves, but also because of the way sex
crime law both relies on and rejects certain
psychological ideas about mental illness.
Most of the rhetoric around sex offenders is
that they are both incurable and untreatable,
and often sex offenders are treated as
irredeemably bad people rather than people
who have done bad things.
All discussions about sexual crimes,
especially sexual crimes against children,
that have occurred in the United States since
the mid-1990s have taken place under the
umbrella of what are known as "sexual
predator" laws [6]. According to the original
legal definition, a sexual predator is someone who commits violent sexual crimes and
suffers from a mental abnormality that makes
it unlikely that he or she will stop doing so.
The laws as they exist in the United States
state that the mental abnormality does not
have to be treatable, and, in fact, in many
situations must necessarily be untreatable.
This is largely due to the fact that the most
common mental disorders diagnosed in this
type of criminal have been things like
pedophilia, paraphilia not otherwise specified, and anti-social personality disorders, all
of which are extremely difficult to treat.
In this context, the concept of a brain
tumor which causes someone to commit
sexual crimes also serves as a limit test for
gauging moral reactions to a form of
pedophilia that responds to medical treatment. Let me give a more concrete example
of what I mean by moral reaction. Back in
June, Dr. James Cantor wrote an opinion
piece on CNN in response to the Sandusky
trial titled "Do pedophiles deserve sym-

pathy?"
Cantor
argues
for
more
comprehensive mental health care for
people suffering from pedophilia based on a
separation of the mental disorder of
pedophilia from the criminal act of sexually
abusing children. The idea is that although
pedophilia is incurable, not all people who
have pedophilia actually commit sexual
crimes, and thus we could, and should,
extend some measure of sympathy to people
who suffer from pedophilic urges but do not
commit crimes.
His entire argument rests on the
immutability of pedophilia, as he says, and
on the idea that "no one has been able to find
a way to change pedophiles into nonpedophiles." That is not the situation here.
Both of the tumors in these cases were
treatable. In the US case, the patient's
behavior returned to normal after his tumor
was removed (although it returned as the
tumor regrew). Mattiello is currently
undergoing cancer treatment, and doctors
are still waiting to see if the removal of the
tumor has changed his behavior patterns,
although the actions of his lawyers indicate
they are fairly hopeful this will be the case.
Now, I am not saying that these brain
tumors prove all pedophilia is curable- far
from it. The discovery of brain tumors that
make people commit sex crimes could be
seen as further evidence that sexual
predators are fundamentally (or "biologically") different from non-predatory
humans- perhaps because they have
permanent issues in the portion of the brain
where these tumors cause temporary ones
[7]. This sort of trajectory would go right into
the territory of essentialism, and Kristina
Gupta and I have both blogged about the
pitfalls encountered when sexual behavior is
essentialized.
Further, given the current state of sexual
predator laws, I would bet a discovery such
as this would only serve to bolster the
quarantine that is already taking place. This
is why when I read an article about how brain
science is being misused to argue that
pedophilic sex criminals are "not responsible," and which seems to indicate that
lenience towards a man with a brain tumor

such as this will lead towards letting sex

criminals go free, I cannot help but be
skeptical. All the laws we already have in
place seem to indicate quite the opposite:
that these types of criminals are not on the
extreme edge of criminal behavior we
imagine them to be, but are, in fact, in a
category of their own. To me, this means
using Mattiello's case as a limit test for the
forensic use of neuroscience, as the
Kelland's article for Reuters does, is a little
misleading. While it seems entirely plausible
that "my brain made me do it" might work as
a defense for certain types of crimes, it might
never fully excuse sexual crimes and crimes
against children- but that doesn't mean it will
not succeed fully.
A case like Mattiello's, viewed through
the lens of US law and culture, gives us a
situation in which someone commits
unforgiveable crimes due to what might
otherwise be seen as a forgivable situation.
It presents a limit case on the rights of people
who commit these crimes to receive medical
treatment. The ethical question presented by
these particular brain tumors is not, 'Should
we hold these men responsible in terms of
legal guilt,' but rather, 'How does knowing
about the medical cause of their criminal
behavior help us to move towards real,
empathetic solutions even while maintaining
guilt?'
Moving outward from these cases, I offer
the following questions: Could an understanding based on treatability be extended to
someone who commits sex crimes as a
result of a medication, as was discussed a
few months ago on the University of Oxford's
Practical Ethics blog [8]? What about to
medical issues that are not as straightforward as brain tumors or medications, or
disorders that are fully in the realm of
psychology, with no attendant measurable
neurological component? Could we, as
Cantor urges we should, separate out an
incurable disorder from a compulsion to
commit criminal acts, even if those criminal
acts are beyond the limits of forgiveness?

10

References
1.

2.

3.

4.

Kelland, K. (2012, August). Insight- Neuroscience in

court: My brain made me do it. Reuters. Retrieved
from:
http://www.reuters.com/article/2012/08/29/usneuroscience-crime-idUSBRE87S07020120829
It is impossible for me to talk about a pedophilic
pediatrician without thinking of this story:
http://www.theguardian.com/uk/2000/aug/30/childprote
ction.society
Although I am not focusing on it here, the original
article does not really highlight that Italian law differs
significantly from US law in very important areas when
it comes to our understanding of criminal
responsibility: Italian law does not follow the US idea
of mens rea, does not use due process as the US
defines it, and does not allow for a jury trial, for
starters. News articles that jump from one jurisdiction
to another as if "responsibility" were defined the same
within all criminal courts make me grumpy - much as
cavalier uses of "lizard brain" do to David Nicholson.
The innocence of children and the placement of violent
crimes against children in an overall scale of "worst
crimes to commit" are both culturally contingent and
historically variable. See the work of Kathy Stuart and

5.

6.

7.

8.

11

Tyge Krogh (an English version of Krogh's book is

summarized here: http://www.brill.com/lutheranplague)
Pedophilia is often cited as the major argument
against re-instating the "control test" standard for a not
guilty by reason of insanity plea - see Penney, S.,
Impulse control and criminal responsibility: Lessons
from neuroscience. International Journal of Law and
Psychiatry, 2012. 35(2): p. 99-103.
These laws, which allow for civil commitment in some
states and for lifetime surveillance in others, are
designed to target what are perceived to be the worst
types of sexual offenders: people who are compelled
to seek out victims and cannot control this compulsion.
Despite the fact that sexual predators are not
necessarily pedophilic, the concept of the sexual
predator is firmly linked to the victimization of children the television show To Catch a Predator is a good
example.
Schleim, S., Brains in context in the neurolaw debate:
The examples of free will and "dangerous" brains.
International Journal of Law and Psychiatry, 2012.
35(2): p. 104-111.
Practical Ethics blog site: blog.practicalethics.ox.ac.uk

Brain-boosting or pulp fiction?

Shezza Shagarabi, Emory Neuroethics Program Intern, Published September 11, 2012

It comes as no surprise that pulling allnighters comes with the territory of being an
undergraduate. It is the price that most of my
peers and I have paid at one time or another
for trying to get more work completed before
a fast-approaching deadline. The sleepless
nights ramp up during finals week while the
use of caffeine and energy drinks fuels our
self-induced, sleep-deprived zombie states.
Usually, our energy drinks do not purport
to have cognitive-enhancing effects. However, the drink Nawgan claims to be What to
Drink when you want to Think. The label of
the can states that it is powered with
Cognizin, contains caffeine and natural
ingredients, and is under 40 calories. Now
whom would this cleverly-branded Nawgan
drink not appeal to? And how can Nawgan
boast such wonderful claims?
According to the Nawgan website,
Nawgan was co-founded and created by
neuropsychologist Dr. Robert Paul. Dr.
Pauls day job is an adjunct assistant
professor at Brown University. To his credit,
he has had several publications from his
work on cognitive performance and cognitive
decline in subjects who have dementia and
in subjects taking anti-retroviral medication
for HIV. Dr. Paul joined the energy beverage
industry because he decided it was time to
stop advising companies what to do and
simply do it [him]self and make sure it is done
right. But did he accomplish his goal? Do
Nawgan and Cognizin work? Or are the
claims more substantiated in the minds of
consumers because an Ivy League neuroscientist created and branded the drink?
Nawgans key ingredient is Cognizin,
which ostensibly increases the cognitive performance of the user. After doing a little
research, I found that Cognizin is the brand
name for citicoline, a precursor to a neuropeptide known to be a dopamine agonist.
Outside of the U.S., citicoline has been given
to stroke patients in countries such as Japan
and England [1]. However citicoline has not

been administered in the U.S. due to a lack

of clinical data supporting its efficacy in
providing long-term neuroprotection in phase
III clinical trials [2].
The method of administration of any
drug meant to reach the brain is critical, due
to the blood-brain barriers role in insulating
and protecting the brain from pathogens.
One major issue with Nawgans cognitive
enhancing claims is citicolines chemical
structure, which would prevent it from
appreciably crossing the blood- brain barrier.
In 2000, Wurtman et al. found that citicoline
orally administered to humans was metabolized rapidly even before fully circulating in
the body [3]. Yes, citicoline has approx.imately 100% bioavailability when taken
orally; however, studies also show that only
(0.5%) of the original dose is taken into the
brain when citicoline is ingested [1, 4].
Although citicoline has not been found to
have any major side effects when taken
short-term, the long-term effects of
exogenous dosages of this compound are
still not understood.
That said, Nawgan appears to have an
effective marketing campaign. The target
consumer of Nawgan isnt the ischemic
stroke patient or the person with Alzheimers.
Nawgan is continuously sold and distributed
on college campuses as a cognitive enhancer. In fact, on Emorys campus, free
samples of Nawgan were given during finals
week. In 2011, Nawgan received a $3 million
dollar investment from the Japanese beverage company Kirin Holdings, to expand its
distribution in stores such Walgreens. With
the rapid onslaught of neuro-enhancing
products, we need better measures to
protect the consumers. A scientifically
unsophisticated public enticed by scientific
jargon might be convinced by the scientific
evidence provided on the Nawgan website.
Additionally, some consumers might see the
Vitamin B complexes and Vitamin E listed in
the ingredients and not realize the health

12

complications that could come with product

overuse and think the more the merrier.
For an otherwise healthy person, Im not
convinced that Cognizin works in the manner
that Nawgan has reported. As a scientist-intraining, I realize that the dosage and the
method in which a drug is administered is
often equally as important as the compound
itself. In an article in Discover Magazine, Dr.
Paul Wolpe, Director of the Emory Center for
Ethics and Editor-in-Chief of the American
Journal of Bioethics Neuroscience, expresses similar concern for consumers of
beverages boasting neuro-enhancing properties- especially people that may have a
mental health condition.
The underlying issue at hand, then, is
Why are we relying on energy drinks in the
first place? Even though a healthier solution
might be to get a sound nights sleep, there
seems to be a certain appeal, perhaps
especially amongst college students, to
consume energy drinks and supplements is
to keep us alert and focused. Sleep
deprivation, stress, overexertion and poor
nutrition are the real culprits to our fatigue
and poor concentration.
Surveys show that Americans continue
to cut back on sleep to prioritize work and
other obligations. There is even a growing
problem of attention deficit hyperactivity
disorder (ADHD) medication abuse by
women who feel the need to keep pace with
the ever increasing demands of work and
family, as well as college students who feel
the pressure to have an edge over their
fiercely competitive peers. In a society that
devalues sleep for the sake of productivity,
reliance on energy drinks and caffeine, and
other substances can only increase. Yet,
some individuals might ask, Why not
encourage people to enhance their cognitive
abilities?, especially if doing so enhances
their productivity and happiness in their daily
lives as well as their utility to society.
Hypothetically, if a researcher were to
develop a novel drug to cure multiple
sclerosis, and did so with the aid of cognitive
enhancers, is there anything wrong with
that?

With such widespread use of enhancers,

we have to wonder whether current
governing bodies are keeping pace with
regulating technological innovation. Obviously new discoveries in science are being
made daily, and as neuroscience continues
to advance, scientists and entrepreneurs
alike will capitalize on and commercialize this
information to the public. Although currently
Nawgan likely does not provide the cognitive
boosting abilities it reports to have, future
biotechnological innovations may well
provide the possibility of neuro-enhancement
beyond the effects of a cup of coffee.
Bioconservatives such as Dr. Leon
Kass, of President Bushs Bioethics
Commission, hold the belief that enhancements of humans beyond therapeutic purposes can compromise the dignity of an
individual and ultimately affect the welfare of
humanity. Some might suggest that, in the
process of utilizing drinks like Nawgan in
order to feel more productive, students are
dehumanizing themselves and even others.
Other students might look to enhanced
students as an example for how to balance
work and family life, and strive for an ideal
unattainable without the aid of the same or a
similar cognitive/ performance enhancement. While some might say that individuals
should have the right and freedom to access
any enhancer, the students use of drinks like
Nawgan might un-level the playing field and
result in peer pressure for other students to
follow suit.
Overall, I think Nawgan does not deliver
on its claims of being an effective neuroenhancer. Additionally, I believe that the
messages advocated by this product and
products like it are damaging to our views on
health, wellness, and achievement. Until
safe and effective neuro-enhancements are
produced and accessible to consumers, we
will continue to wrestle with the consequences of maintaining habits that contribute
to lack of sleep and alertness, including
obesity, heart disease, and other co-morbid
conditions. Sure, in the short-term you might
get through a hard days work with the aid of
energy drinks, but then what? A chronic
dependence on caffeine and Vitamin B12

13

2.

shots? Ultimately changes in lifestyle habits

such as sleep and a well-balanced diet offer
sustainable and safe measures towards
increased concentration and alertness. Yet
for many, this advice will fall on deaf ears, if
some of the benefits of sleep can be
mimicked from the contents in a can.

3.

4.

References
1.

Adibhatla, RM, & Hatcher, JF (2002) Citicoline

mechanisms and clinical efficacy in cerebral ischemia.
J Neurosci Res 70: 133-139. doi: 10.1002/jnr.10403

14

Cheng, YD, Al-Khoury, L, & Zivin, JA (2004)

Neuroprotection for ischemic stroke: two decades of
success and failure. NeuroRx 1: 36-45. doi:
10.1602/neurorx.1.1.36
Wurtman RJ, Regan M, Ulus I, Yu L. 2000. Eftect of
oral CDP-choline on plasma choline and uridine levels
in humans. Biochem Pharmacol 60: 989992.
Rao Muralikrishna Adibhatla , Hatcher, J. F. and
Dempsey, R. J. (2002), Citicoline: neuroprotective
mechanisms in cerebral ischemia. Journal of
Neurochemistry, 80: 1223. doi: 10.1046/j.00223042.2001.00697.x

Why use brain cells in art?

Riley Zeller-Townson, Emory Neuroethics Scholars Program Fellow, Published September 25, 2012

Bioart refers to the manipulation of

living cells, tissues, or organisms (or their
derivatives) for artistic purposes. While
artists and biologists have collaborated for
centuries to illustrate biological phenomena,
Bioart refers to the practice started in the
early 1990s of artists training in and
performing techniques from the biological
sciences, such as cell culture, genetic
engineering, and surgery. Artists have used
these technologies to create novel living
entities (such as a leather jacket grown in
vitro) or to modify existing living entities (such
as Stelarcs third ear). These tools provide
new options for aesthetic statements (the
ability to radically sculpt living tissue to suit
particular tastes), ethical statements (if we
are growing a small, edible steak in a vat,
should we continue to kill cattle for food?),
and a novel flavor of irony (that victimless
PETA-endorsed cultured steak required an
entire cows worth of fetal bovine serum to
produce [1]).
Some bio-artworks incorporate living
neurons. Early works such as Force and
Intelligence (1998) used cultured neurons for
its aesthetic and, er, cultural significance.
Later however, neural artwork began to
incorporate the functional aspects of neurons
by recording and initiating neural activity.
This bi-directional communication allowed
for cultures of neurons to control robotic art
installations, giving the biological brain a
robotic body [2]. This embodied neural art
is a distinctive subset of bioart much for the
same reason that neuroethics is a distinctive
subset of bioethics- while similar issues can
be addressed (is it alive?), there are a new
set of issues that come up (does it feel
pain?). In many ways, embodied neural art
is the perfect playground for the extrarational side of the neuroethics discussion.
Here, novel neural systems, or novel
presentations of natural living systems, can
be presented to the public in a manner that

encourages both critical thinking and the

development of new intuitions.
As an example of the sorts of ethical
discourse embodied neural art can generate,
let's examine an issue raised by a particular
piece that I just so happen to be familiar with:
Silent Barrage (2009) [3]. For Silent Barrage,
a culture of dissociated rat neurons was
given control (over the internet) of a robotic
installation that is large enough that audience members could actually walk through
it. The culture "observed" the audience
members through overhead cameras, and
"responded" through movement of the
robotics. In this installation, the robotic
"body" was a grid of 32 upright 9-foot poles,
each with mobile spinning carriages. This
robotic grid mapped the installation to the
electrode grid in the microelectrode array,
leading one audience member to report that
the feeling of physically traveling through an
active brain is impossible to escape. One
question that arises from building an active
brain is whether or not said neural system
has an "inner mental life" or "consciousness"
that its creators have a moral obligation
towards, as they might for a "full" rat.
From a neuroscience perspective, if
Silent Barrage was conscious, it was nothing
near (even) rat-level consciousness. Keep
in mind that this "brain" is actual made
entirely of cerebral cortex, and therefore
missing a brainstem- a condition that leads
to coma in vivo (an unconscious state) [4].
Note, however, that the context usually
created by the rest of the brain can in some
ways be approximated using electrical
stimulation. For example, one of the markers
for consciousness (used to determine if
locked-in patients are aware of their
surroundings) is how evenly distributed
electrical activity is in cortex- which can be
tweaked in the culture by altering electrical
stimulation patterns [5]. Does this imply that
Silent Barrage was "conscious" while being
stimulated, but when the exhibit closed for

15

The Neurally Controlled Animat: Biological Brains

Acting with Simulated Bodies. Autonomous Robots 11:
305-310.
3. Zeller-Townson, Riley, et al. "Silent barrage:
interactive neurobiological art."Proceedings of the 8th
ACM conference on Creativity and cognition. ACM,
2011.
4. Saper, CB. (2000) Brain Stem Modulation of
Sensation, Movement, and Consciousness.
Principles of Neural Science, 4th edition. McGraw-Hill
New York.
5. Again (when is this ever not the case?) see Kandel
(reference 3). During non-REM sleep cortex appears
to fire away in correlated sleep-spindles, while both
REM sleep and wakefulness show more distributed
activity. Interestingly enough, in the absence of driving
sensory input cortical tissue naturally develops highly
correlated activity- in the dish this is referred to as
"population bursts," whereas in vivo one can see a
propensity towards seizures in tissue deprived of its
usual afferents [6]. In the dish, this "sleep like" or
"seizure like" activity can be broken up through certain
types of electrical stimulation[7]- in effect, sensory
input brings the tissue out of a "sleep like" state.
6. Nita DA, Ciss Y, Timofeev I, and Steriade M. (2006)
Increased propensity to seizures after chronic cortical
deafferentation in vivo. AJP - JN Physiol February vol.
95: 902-913
7. You can think of this effect as being much like how
small controlled burns can prevent large uncontrolled
forest fires. Wagenaar, D. A. Madhavan, R. Pine, J.
and Potter, S. M. (2005) Controlling bursting in cortical
cultures with closed-loop multi-electrode stimulation. J.
Neuroscience 25: 680-688.
8. What is becoming my favorite definition of
consciousness- Stuart Sutherland (1989).
Consciousness. Macmillan Dictionary of Psychology.
Macmillan. Can be found here:
http://www.consciousentities.com/definitions.htm,
among many others that help to illustrate the problem.
9. Specific structures that play a role in these missing
functions include the amygdala, the locus coeruleus,
and the hippocampus. Note that cortex itself does
play an important part in the regulation of emotion
(specifically the cingulate and prefrontal parts of
cerebral cortex), though in concert with other, missing
structures. What I'm assuming here is that "emotion,"
at its core, requires information about the well-being of
an organism- whether predicted well-being (fear or
hope) or the current state of well-being (happiness or
misery). The neural system in Silent Barrage does not
have direct access to such information.
10. With some scholars going as far to say that the
decisions are governed entirely through intuition.
Haidt, J. (2001) The Emotional Dog and its rational
tail: A social intuitionist approach to moral judgement.
Psychological Review 108:814-834

the evening (and stimulation was switched

off) it fell into a state of "unconsciousness?"
While it is difficult (if not impossible [8])
to definitively answer that question, we can
at least speculate as to what Silent Barrage
might have been conscious of, if it was in fact
conscious of anything. In this case, the only
information that Silent Barrage processes is
the level of movement in its "field of view"much like a T. Rex, Silent Barrage can't see
you if you stay perfectly still. The inner life of
Silent Barrage, if such a thing does exist,
would consist entirely of observation of
audience turbulence, with no emotional,
motivational, or long term historical context.
With no sensation of pain or pleasure and no
ambition toward discernible goals [9], Silent
Barrage begs about as much moral
obligation towards itself as a desktop
computer does.
When deciding for ourselves whether or
not 50,000 cultured rat neurons controlling a
robot in an art exhibition is "conscious" or
not, it is interesting to examine the contrast
between the neuroscientific sketch above,
and the subjective experience of walking
through Silent Barrage and feeling observed.
The first, a mostly objective statement of fact,
can tell us things about the nature of the
hypothesized "mental life" of this strange
entity, and compare it to things we have more
experience with, but stops short of pointing a
finger and doling out responsibility. The
second doesn't necessarily add to the list of
rational arguments that can be made about
the nature of Silent Barrage's mental life,
but it can more readily build a degree of
empathy toward the work, an intuition that
said mental life is real, and worth
protecting. As ethical decisions are made
through intuition as well as reasoning [10],
both sides must be explored to fully
understand the relevant factors behind this
decision.
References
1.

2.

Catts, O and Zurr, I. (2008) The Ethics of Experimental

Engagement with the Manipulation of Life. Tactical
Biopolitics: Art, Activism, and Technoscience. MIT
Press.
A procedure that had just recently begun to be
performed by neuroscientists. DeMarse, T. B.,
Wagenaar, D. A., Blau, A. W. and Potter, S. M. (2001).

16

Uncovering the neurocognitive systems for Help this Child

Julia Haas, AJOB Neuroscience Graduate Editorial Intern, Published December 10, 2012

In their article, Socioeconomic status

and the brain: mechanistic insights from
human and animal research, Daniel A.
Hackman, Martha J. Farah, and Michael J.
Meaney explore how low socioeconomic
status (SES) affects underlying cognitive and
affective neural systems. They identify and
focus on two sets of factors that determine
the relationship between SES and cognitive
development: (1) the environmental factors
or mechanisms that demonstrably mediate
SES and brain development; and (2) those
neurocognitive systems that are most
strongly affected by low SES, including
language processing and executive function.
They argue that these findings provide a
unique opportunity for understanding how
environmental factors can lead to individual
differences in brain development, and for
improving the programs and policies that are
designed to alleviate SES-related disparities
in mental health and academic achievement
[1].
Theoretically, I have no doubt that
neuroscience can make a powerful contribution to early childhood development by
determining whether and which neurocognitive systems appear to be more
extensively affected by low SES.
This is, as the authors themselves point
out, important work, because understanding
which systems are affected can help educators and policy-makers develop programs to target them more directly and
successfully. For example, the work of
DAnguilli et al. demonstrates that low-SES
children pay more attention to unattended
stimuli, and are thereby more susceptible to
becoming distracted and having a harder
time focusing on a given task [2]. A
corresponding, corrective strategy would
consist in introducing games, lessons and
computer-based strategies which explicitly
target executive functions and indeed, just
such a set of measures is being used by the
Tools of the Mind curriculum, which as of

2012, was being implemented in 18,000 prekindergarten and kindergarten classrooms,

in Head Start programs, public schools, and
childcare centers across the nation.
So far, so good. So what am I worried
about?
What do you think?
Im not worried so much as left
wondering about one issue in Hackman et
al.s review that I would now like to explore.
My concern relates to the broader
relationship between scientific knowledge
and our individual and collective moral
motivation to do something about an ongoing
injustice. Allow me to illustrate what I mean
using two diagrams adapted from the
Hackman et al. article. The first represents
the state of our knowledge regarding the
relationship between SES and development,
without
any
concrete
neuroscientific
understanding of the neurocognitive systems
that
mediate
between
them:

Fig. 1: We know that SES affects developmental

outcomes, even if we don't understand the
neurocognitive systems that mediate the relationship.

The second represents the state of our

knowledge regarding the relationship between SES and development, now including
our emerging neuroscientific understanding
of the neurocognitive systems that mediate
between them, outlined in the paper:

Fig. 2: Neuroscience is beginning to elucidate which

neurocognitive systems are most strongly affected by
SES, and thereby influence children's developmental
outcomes

17

My question is this: if sociologists and

psychologists have already firmly established the relationship between SES, specific
environmental mediators, and resulting
developmental outcomes, as in Figure 1,
(and they have, as the evidence cited by
Hackmans et. al. attests to), then can the
addition of a scientific understanding of the
intermediary mechanisms in any way
enhance or strengthen our practical commitment to improving childrens SES and the
corresponding environmental mediators that
affect their development? In other words, if I
already know that SES, and specifically
prenatal influences, directly affect elements
of childrens cognitive and emotional
development, do I need to know anything
before doing something about it? And will
knowing more about it, including understanding the causal sequence mediating the
relationship, prompt me to do anything more
about it than I was doing before?
Again, as mentioned, I fully recognize
and appreciate the potential of neuroscientists and their collaborators to design
more specific and powerful interventions to
prevent and remediate the effects of low
childhood SES [1]. A second, equally
essential neuroscientific question to explore
is whether certain brain propensities increase the likelihood of individuals' living in
low-SES circumstances. Could we say that
certain brain propensities correspond to
developmental diseases, or to a kind of
physical handicap- one that traps people in
poverty and decreases their likelihood of
attaining a better quality of life? If so, would
this oblige us to take action? These are
fundamental questions that need to be
explored further. For my part, I'm not sure I
agree with the statement that neuroscience
can highlight the importance of policies that
shape the broader environments to which
families are exposed with any more clarity or
motivational force than our existing knowledge already does [1].

down the street and see a person bleeding

profusely from his leg [3]. You could rush in
and help this man, but youre wearing your
brand new, $375 J.Crew Ludlow suit jacket,
so you think to yourself, Ok, do I leave him
there? I mean, its terrible, but I guess so,
because I dont want to get blood all over my
beautiful jacket. If you responded to the
situation in this way, we would probably call
you a moral monster.
Now consider a different case. Imagine
that youre watching your favorite episode of
the Walking Dead when a commercial comes
on and reminds you that for $375, you could
pay for and facilitate 8 healthy births, and
thereby help save the lives of several
mothers and their babies. Now you think to
yourself "Well, I guess it would be good to
save those people, but I really just want that
jacket." In this case, our general consensus
would be that while you're no Mother
Theresa, we probably wouldn't want to
condemn for being a moral monster (after all,
that jacket is made from world class wool!).
So what gives? As Singer pointed out in a
series of influential articles, our rational
obligation towards the mothers and their
newborns should be the same as towards
the bleeding man [3]. So how and why do our
intuitions differ?
In his article, From neural is to moral
ought: what are the moral implications of
neuroscientific moral psychology?, the
philosopher Joshua Greene suggests that an
evolutionary perspective may help explain
the differences in our responses. He
proposes, consider that our ancestors did
not evolve in an environment in which total
strangers on opposite sides of the world
could save each others lives by making
relatively modest material sacrifices.
Consider also that our ancestors did evolve
in an environment in which individuals
standing face-to-face could save each
others lives, sometimes only through
considerable personal sacrifice. Given all of
this, it makes sense that we would have
evolved altruistic instincts that direct us to
help others in dire need, but mostly when the
ones in need are presented in an up-closeand-personal way [4]. According to Greene,

I am a neurophile, but
Heres why Im slightly skeptical. To
borrow an example from the philosopher
Peter Singer, imagine that youre driving

18

this makes a sense of why human beings can

be extraordinarily altruistic in their immediate, interpersonal interactions, but still
gobsmackingly selfish in their transnational
relations.
Unfortunately, our relationship to children in lower-SES environments is closer to
the distant pregnant mothers in Singer's
analogy than it is to the bleeding stranger
right in front us. Few of us interact with lowSES children on a daily basis, and so many
of us worry about how they get on in more
abstract, theoretical terms. But if this is right,
then more information, or even more
scientific understanding, will not be enough
to move us toward addressing their developmental issues. Rather, we will need to use
other kinds of knowledge, such as our
emerging understanding of biased moral
motivation, to reflectively increase the
probability of translating our moral principles
into actions. That is, examples like Singer's
bleeding stranger tell us something about
how our moral motivation works, and we
need to use this type of knowledge to try and

make low-SES children seem more like the

man with the leg wound in our moral
imaginations. This would increase the likelihood of our doing something to improve
low-SES children's circumstances. One way
of achieving this would be to ensure that we
interact with low-SES parents and their
children on a more regular basis, e.g., by
doing something as simple as taking public
transportation. This would make us more
likely to put our hard-won neuroscience
research to use.
References
1.

2.

3.
4.

19

Hackman, D. A., Farah, M.J., Meaney, M. J., 2010,

'Socioeconomic status and the brain: mechanistic
insights from human and animal research,' in Nature
11
DAngiulli A, Herdman A, Stapells D, Hertzman C.
2002, 'Childrens event-related potentials of auditory
selective attention vary with their socioeconomic
status.' Neuropsychology 22:293300.
Singer, P., 1972. 'Famine, affluence, and morality.'
Philosophy and Public Affairs 1, 229243.
Greene, J. 2003. ''From neural 'is' to moral 'ought':
what are the moral implications of neuroscientific
moral psychology?' Nature. Available at:
http://www.overcominghateportal.org/uploads/5/4/1/5/5
415260/from_neural_is_to_moral_ought.pdf

The violence of assumed violence:

A reflection on reports of Adam Lanzas possible autism
Jennifer Sarrett, Emory Neuroethics Scholars Program Fellow, Published January 16, 2013

On Friday, December 14th 2012, the

country learned of the mass shooting of 5and 6-year-old children and several adults in
Newtown, CT. By the end of the day, we
learned that Adam Lanza, the perpetrator of
the heinous act, may be autistic. Although we
now know that this is not the case, it has
spurred conversations about the link
between autism and violence. This mental
illness guessing-game has become the norm
in the wake of such tragedies. Jared
Loughner and James Holmes may have
been schizophrenic; Sueng-Hi Cho may
have been depressed, anxious, and also
possibly autistic; Eric Harris and Dylan
Klebold may have been depressed and/or
psychopathic. These speculations are
understandable the public yearns to understand the motives behind such acts and
recognizes that good mental health and
mass shootings are never coupled
however, the way these representations are
presented to the community create stigma
and blames others with similar disabilities.
In Media Madness: Public Images of
Mental Illness, psychologist Otto Walh
explains that the public does not get its
information about mental illness from
evidenced-based, professional sources,
rather, [i]t is far more likely that the publics
knowledge of mental illness comes from
sources closer to home, sources to which we
are all exposed on a daily basisnamely, the
mass media [1]. The media (i.e. news,
television, movies, video games, popular
literature) often provides these links casually
but carefully. Reports may mention Adam
Lanza had autism, but dont make the causal
link between this diagnosis and his crimes.
Yet in the minds of readers, the association
is made.
The link between mental illness and
violence has a long history [2]. In addition to
the news, popular movies and TV shows
contribute by featuring violent characters

with a history of mental illness. Films such as

Psycho, the Halloween series, Misery,
Silence of the Lambs, and Natural Born
Killers center on violent characters with
some kind of mental illness [4-7]. The Law &
Order and Criminal Minds series both
frequently implicate a mentally ill person in
some violent and incomprehensible crime [810]. The majority of these representations
are of individuals with some sort of undefined
psychosis; however, as the country wonders
over Adam Lanzas possible autism
diagnosis it is fair to expect autism as the
next violent scapegoat.
Autistic individuals are represented in
the media as aloof, shy, detached, rigid, and
unpredictable a seeming recipe for apathy
[11]. The first popular portrayal of autism in
America, Rain Man (1988), portrays Raymond Babbit (Dustin Hoffman), an autistic
man who, in one memorable scene, screams
and hits is own head at the prospect of
getting on an airplane and refuses to connect
with his brother, Charlie (Tom Cruise) [12].
He is detached and unpredictable. Mercury
Rising (1998) features a young autistic boy
who does not communicate verbally and who
relates more to numbers than to people, a
skill that eventually saves his and FBI agent
Art Jefferies (Bruce Willis) lives [13].
Beyond these fictional portrayals,
autism is usually portrayed one of two ways
in popular news stories: (1) stories of
amazing abilities or unexpected outcomes
most of which are entirely unremarkable
events for non-disabled people, or (2) the
immense difficulty of life with autism (with
sometimes fatal consequences). While these
stories are written with an underlying sense
of hope or struggle, they all serve to set up
distinct separations in the mind of the public
between us (i.e. the non-autistics) and them
(i.e. the autistics) [14]. The recent reports,
however, come dangerously close to

20

creating a new category of representation

the violent autistic.
Though reports that Adam Lanza did
not, in fact, have autism or Aspergers
syndrome came out days after the shooting,
the damage has been done [15]. Blogs,
articles, and op-eds quickly denounced the
relationship between autism and violence,
but this was simply triage and not nearly as
interesting, memorable, or comforting as the
original reports of psychiatric difference.
What is needed is more responsible reporting of psychiatric and cognitive differences
from the very first mention in place of later,
cursory amendments.
For example, did any initial reports of
Adam Lanza, Sueng-Hui Cho, James
Loughner, James Holmes, or Eric Harris and
Dylan Klebolds possible mental illnesses
mention the fact that people with mental
illness are much more likely to be the victims,
rather than the perpetrators, of violent crime
[16]? Does news of a crime perpetrated by a
person with a severe mental illness, such as
schizophrenia, also report the extremely high
levels of comorbidity between mental illness
and substance abuse in instances of violent
crimes [17]? The lack of a connection
between mental illness and violence has
been reported by the Surgeon General (in a
1999 report) and the National Institute of
Mental Health, who, in a 2006 report, stated
that ...the amount of violence committed by
people with schizophrenia is small, and only
1% of the U.S. population has schizophrenia, yet by comparison, about 2% of
the general population without psychiatric
disorder engages in any violent behavior in a
one-year period [18]
I am not claiming that people who
commit the atrocities like those at Sandy
Hook Elementary are not mentally ill or that
their psychiatric state should be ignored.
What I am proposing is that when these
reports come out, they should come out
alongside accurate information about the
stated mental illness or disability and its
actual relationship to violence. People on the
autism spectrum are not and have never
been clinically associated with premeditated
violence, yet I fear that when Adam Lanza

and Sueng-Hi Cho are linked with autism,

this is an implicit suggestion that autism is
the cause of their violent behavior [19]. Yes,
autism may be part of the profile of a
perpetrator, but it is usually no more a cause
of violence than if they had, for instance,
been diagnosed with heart disease. When a
diagnosis is recklessly implicated in the
reporting of violent crimes, the public tends
to remember this association much more so
than follow-up reports of no diagnosis or
actual levels of violence among diagnosed
individuals. In respect for the majority of the
population of people with psychiatric or
cognitive difference, this context needs to be
presented at the very beginning.
The WHO reports that stigma is the
biggest barrier to overcome for individuals
with mental illness and an association with
violence is among the most common and
damaging representations [20]. In all the talk
of mental health reform, a top priority must
be a reduction of the stigma of violence. This
stigma leads effortlessly into hate crimes,
injustices, and poor care for people with
cognitive and psychiatric differences.
Id like to close with a quote from the
Autistic Self Advocacy Networks statement
on the Newtown, CT shootings that highlights the faulty logic and stigma that follows
these assumptions: Should the shooter in
todays shooting prove to in fact be diagnosed on the autism spectrum or with
another disability, the millions of Americans
with disabilities should be no more implicated
in his actions than the non-disabled population is responsible for those of nondisabled shooters.
To learn more about autism and related
issues, I recommend the following
resources:
Books
Frith, Uta, ed., Autism and Asperger
Syndrome. Cambridge: Cambridge
University Press, 1991.
Grandin, Temple. Different...Not Less:
Inspiring Stories of Achievement and
Successful
Employment, Arlington, TX: Future
Horizons, Inc., 2012.

21

Grinker, Roy R., Unstrange Minds:

Remapping the World of Autism. New
York: Basic Books, 2008.
Murray, Stuart, Autism. New York:
Routledge, 2012.
Offit, Paul. Autisms False Prophets:
Bad Science, Risky Medicine, and The
Search for a Cure. New York: Columbia
University Press, 2010.

12.
13.
14.

15.

Online
Autistic Self Advocacy Network,
http://autisticadvocacy.org/
National Institutes of Health:
Neurological Disorders and Stroke,
Autism Fact Sheet,
http://www.ninds.nih.gov/disorders/autis
m/detail_autism.htm

16.

References
1.

2.

3.
4.

5.
6.
7.
8.
9.

10.

11.

Walh, Otto. Media Madness: Public Images of Mental

Illness. (New Brunswick: Rutgers University Press,
2005), 2.
JC Phelan & BG Link, The growing belief that people
with mental illnesses are violent: The role of the
dangerousness criterion for civil commitment, Social
Psychiatry and Psychiatric Epidemiology, 33 (1998):
S7-S12; Wahl, Media Madness.
Psycho, directed by Alfred Hitchock (1960; Universal
City, CA: Universal Pictures, 1998), DVD.
Halloween, directed by John Carpenter (1978; Los
Angeles, CA: Compass International Pictures, 1978),
video.
Misery, directed by Rob Reiner (1990; Los Angeles,
CA: Columbia Pictures, 1990), video.
Silence of the Lambs, directed by Jonathan Demme
(1991; Los Angeles, CA: Orion Pictures, 1991), video.
Natural Born Killers, directed by Oliver Stone (1994;
Los Angeles, CA: Warner Brothers, 1994), video.
Law & Order (franchise), created by Dick Wolf (1990;
New York, NY: NBC, 1990), television.
Criminal Minds, created by Jeff Davis (2005; Los
Angeles, CA: The Mark Gordon Company, 2005),
television.
Patricia Owens, Portrayals of schizophrenia by
entertainment media: A content analysis of
contemporary movies, Psychiatric Services, 63, no. 7
(2012): 655-659.; Wahl, Media Madness.
There is a conversation over the use of the phrase
autistic person or person with autism. While the
latter follows person first language, often used in
disability advocacy to represent that a person is more
important and, thus, comes first than a disability,
autistic self-advocates are increasingly promoting the
former phrase. Not only is a persons autism often
viewed as an integral component into who they are,
but some argue that the phrase person with autism
seems to suggest the need to remind others that
autistic people are, in fact, people. (Steven Kapp,
personal communication). I choose which phrase to
use based on the representation I am referring to; in
other words, I use autistic person when advocating

17.

18.

19.

20.

22

and person with autism when referring to nonadvocacy based positions.

Rain Man, directed by Barry Levinson (1988; Los
Angeles, CA: United Artists, 1988), video.
Mercury Rising,directed by Harold Becker (1998;
Universal City, CA: Universal Pictures, 1998), video.
For more on this see: Rosemarie Garland-Thomas,
Seeing the disabled: Visual rhetorics of disability in
popular photography, The New Disability History:
American Perspectives, ed. Paul K. Longmore and L.
Umansky (New York: New York University Press,
2001), 335 and Stuart Murray, Representing Autism:
Culture, Narrative, Fascination. (Liverpool: Liverpool
University Press, 2008).
Aspergers syndrome is a diagnosis under the autism
spectrum that is characterized primarily by differences
in social interaction preferences and styles.
KA Hughes, MA Bellis, L Jones, S Wood, G Bates, L
Eckley, E McCoy, C Mikton, T Shakespeare & A
Officer, Prevalence and risk of violence against adults
with disabilities: A systematic review and metaanalysis of observational studies, Lancet, 379, no
9826(2012): 1621-9, doi:10.1016/S01406736(11)61851-5; Patricia Owens, Portrayals of
schizophrenia by entertainment media: A content
analysis of contemporary movies, Psychiatric
Services, 63, no. 7 (2012): 655-659; Katherine
Quarmby, Scapegoat: Why We are Failing Disabled
People, (London: Portobello Books, 2011); LA Teflon,
GM McClelland, KM Abram, et al., Crime victimization
in adults with severe mental illness: Comparison with
the National Crime Victimization Survey, Archives of
General Psychiatry, 62 (2005): 911-931.
Seena Fazel, Guam Gulati, Louise Linsell, John R.
Geddes, & Martin Grann, Schizophrenia and violence:
Systematic review and meta-analysis. PLoS
Medicine, 6, no. 8 (2009): e1000120. doi:
10.1371/journal.pmed.1000120; U.S. Department of
Health and Human Services. Mental Health: A Report
of the Surgeon General. Rockville, MD: U.S.
Department of Health and Human Services,
Substance Abuse and Mental Health Services
Administration, Center for Mental Health Services,
National Institutes of Health, National Institute of
Mental Health, 1999.
JW Swanson, MS Swartz, RA Van Dorn, EB Elbogen,
HR Wagner, RA Rosenheck, TS Stroup, JP McCoy,
JA Lieberman, A national study of violent behavior in
persons with schizophrenia, Archives of General
Psychiatry, 63, no 5 (2006): 490-9; U.S. Department of
Health and Human Services, Mental Health.
Judy Endow, No linkage between autism and planned
violence. Special-Ism. retrieved January 9, 2012
http://special-ism.com/no-linkage-between-autism-andplanned-violence/; Though there is little research on
the subject, the following article concludes: ...a
potential risk for aggression (but not necessarily for
criminal behavior) in this populations and that, when
violence does occur, it is often in distinct ways relevant
to the symptomatology of HFASDs [High-Functioning
Autism Spectrum Disorders]; Matthew D. Lerner,
Omar Sultan Haque, Eli C. Northrop, Lindsay Lawer, &
Harold J. Bursztajn, Emerging perspectives on
adolescents and young adults with high-functioning
autism spectrum disorders, violence, and criminal law,
American Academy of Psychiatry and the Law, 40, no.
2 (2012): 187.
World Health Organization, The World Health Report
2001: Mental Health: New Understanding, New Hope.
Geneva: World Health Organization, 2009.

Misophonia:
Personality quirk, symptom, or neurological disorder?
Emily Young, Emory Neuroethics Program Ambassador, Georgia Institute for Technology, Published
April 2, 2013

When I first learned about misophonia, it

was described as a severe annoyance by
certain specific sounds, most commonly
bodily sounds such as chewing, breathing
and slurping, or repetitive sounds such as
ceiling fans, beeping, etc. A quick Wikipedia
search described it as, a form of decreased
sound tolerancebelieved to be a neurological disorder characterized by negative
experiences resulting only from specific
sounds, whether loud or soft.
Immediately, I had a number of
questions: if misophonia is just a hatred of
certain sounds that leads to annoyance or
anger, how is this classified as a neurological
disorder? Wouldnt everyone have this
disorder to some degree? Everyone has
their pet peeves as far as sound goes; I
cannot stand the sound of people chewing,
and while it is sometimes very irritating, I
would by no means say that I have a
neurological disorder.
The Wikipedia entry also stated,
Intense anxiety and avoidant behavior may
develop, which can lead to decreased
socialization. Some people may feel the
compulsion to mimic what they hear. If
everyone has sounds that they hate, but
some people get uncontrollably angry or
anxious when they hear their hated sounds,
then isnt this disorder a behavioral issue? I
initially had two hypotheses about misophonia: 1) someone who cannot control their
behavior in response to certain sounds
probably has trouble controlling their
behavior in response to other stimuli as well,
and therefore misophonia is the side-effect of
another neurological or psychiatric disease,
not its own one. And 2) misophonia is one of
those disorders that just seems like a
scheme to sell more drugs to hypochondriacs. But this was Wikipedia, so I first
looked to the DSM-IV to learn more about
misophonia.

Misophonia is not classified in the DSMIV, so even in the small pool of research
available on the subject, there seems to be
little agreement on what misophonia actually
is and what causes it. Some papers lump
misophonia into the same category as
tinnitus (hearing ringing sounds that are not
there, usually due to cochlear damage or
hearing loss) and hyperacusis (sensitivity to
sound). In a study of tinnitus patients, Sztuka
et al. [7] found that 10% of the patients they
studied had misophonia. However, other
studies found that while hyperacusis,
tinnitus, and misophonia are related, misophonia is not caused by auditory damage.
Jastreboff and Jastreboff [3, 4], found that
when a trigger sound is played to people with
misophonia, it results in a larger activation of
the limbic and autonomous nervous system,
but not a larger activation of the auditory
system. The limbic system plays a part in
other behavioral disorders such as
obsessive compulsive disorder (OCD), so
this suggests that misophonia could have an
anatomical origin that may cause people with
misophonia to react to sound differently.
Now that I had learned of an actual
neurological difference in people with
misophonia, I felt that my initial reaction- that
misophonia is a ridiculous attempt to label
something normal as a disorder- was false.
However, there is still evidence to support
the position that misophonia is a symptom of
a larger behavioral disorder, so I wondering
about the legitimacy of misophonia as a
stand-alone behavioral disorder.
Another study published in January of
2013 studied 42 patients with misophonia [5].
The triggers for these patients were all
human-generated noises; chewing, breathing, hand sounds, etc. Some patients also
reported visual triggers, simply referred to as
repetitive visual movements. This study
conducted several personality tests and

23

found that of their 42 patients, 35 had a

comorbid disorder including mood disorders,
panic disorders, attention deficit hyperactivity
disorder (ADHD), and OCD, among others.
22 out of 42 patients were found to have
obsessive-compulsive personality disorder
(OCPD), which is characterized by a chronic
non-adaptive pattern of extreme perfectionism, preoccupation with neatness and
detail, and a requirement or need for control
or power over ones environment. Since
OCPD is estimated to occur in 7.88% the
population [1], the extremely high comorbidity of misophonia and OCPD found in
this study cannot be ignored. Interestingly,
in the discussion of this paper, Schrder et
al. call to distinguish misophonia as its own
neurological disorder, explaining how
misophonia is not a symptom of another
disorder [5]. They assert that misophonia,
while similar to social phobia, is not a social
phobia because patients do not feel anxiety,
only anger and disgust. However, other
studies [3, 4, 6] found that misophonia
patients do feel anxiety or fear as well as
anger. This paper also says that misophonia
cannot be caused by OCD, because while
both disorders are marked by obsession and
avoidance, misophonia patients do not
perform compulsions. However, Hadjipavlou
et al. found that misophonia patients will
often mimic compulsively annoying sounds
as a way to reduce the stress caused by
them.
But to me it still remains unclear whether
misophonia is a separate, distinct disorder.
Since misophonia is reported in people with
auditory disorders as well as people with
behavioral and mood disorders, it seems as
though misophonia is a symptom, not its own
disorder. However, this begs the question,
How do we define a disorder? Many
disorders are comorbid with each other, yet
we still classify them separately and we
especially have difficulty with psychiatric
disorders.
Right now, it seems that there are not
many good treatment options for people
suffering from misophonia. Certain therapies
including Cognitive Behavioral Therapy, and
Tinnitus Retraining Therapy are options; but,

while these options may improve symptoms,

they are not a cure for the disorder. In fact,
one story described on a misophonia blog
states that the patients therapist had not
even heard of misophonia. At this point, it
seems that whether misophonia is actually
its own disorder or is caused by something
else is less relevant than the problem that
those suffering from the disorder are not
getting the treatment they need. However, it
seems that providing misophonia with its
own distinct identity might be part of the
solution for helping these patients. Hopefully
the call to recognize misophonia as a
disorder will spark interest in the subject,
which will increase research on the
neurological mechanisms of misophonia and
innovation in treatment, so that patients will
eventually be able to receive the treatment
they need.
References
1.

2.

3.

4.

5.

6.

7.

24

Grant, Bridget F., et al., "Prevalence, Correlates, and

Disability of Personality Disorders in the United States:
Results From the National Epidemiologic Survey on
Alcohol and Related Conditions." The Journal of
Clinical Psychology 65 (2004): 948-58.
Hadjipavlou, G., S. Baer, A. Lau, and A. Howard.
"Selective Sound Intolerance And Emotional Distress:
What Every Clinician Should Hear." Psychosomatic
Medicine70.6 (2008): 739-40. Print.
Jastreboff, Margaret M. "Chapter 2: Decreased Sound
Tolerance." Tinnitus: Theory and Management. By
Pawel J. Jastreboff. Hamilton, Ont.: BC Decker, 2004.
8-15. Print.
Jastreboff, Pawel J., and Jonathan J.P. Hazell. Figure
2.14. N.d. Tinnitus Retraining Therapy: Implementing
the Neurophysiological Model. N.p.: Cambridge UP,
2004. 49. Print.
Schrder, Arjan, Nienke Vulink, and Damiaan Denys.
"Misophonia: Diagnostic Criteria for a New Psychiatric
Disorder." PLoS One 8.1 (2013): n. pag. 23 Jan. 2013.
Web.
Schwartz, Paula, Jason Leyendecker, and Megan
Conlon. "Hyperacusis and Misophonia The LesserKnown Siblings of Tinnitus." Minnesota Medicine
(2011): 42-43. Print.
Sztuka, Aleksandra, Lucyna Pospiech, Wojciech
Gawron, and Krzysztof Dudek. "DPOAE in Estimation
of the Function of the Cochlea in Tinnitus Patients with
Normal Hearing."Auris Nasus Larynx (2009): n. pag.

Lumosity:
A personal trainer for your brain?
Ryan Purcell, AJOB Neuroscience Graduate Editorial Intern, Published March 4, 2014

Is intelligence more like height or

strength? Could high school students
improve their IQs in time for the college
entrance exams with a few weeks of brain
training like college students pump up their
biceps before spring break? For many years,
psychologists believed that intelligence, and
particularly fluid intelligence is, for the most
part, a fixed quantity somewhat like height.
Fluid intelligence, which is thought of as the
ability to perceive patterns amongst noise,
understand meaningful connections, and
analyze information in the moment, is a
strong predictor of future success, yet has
been remarkably resistant to training [1]. In a
way, this sounds strikingly similar to what
neuroscientists once said about the biology
of the brain (i.e. neurons dont regenerate
after injury and they are only lost, not added
throughout life). Now we know that the brain
is incredibly plastic and that new neurons are
produced even into adulthood [2]. So, why
wouldnt an aspect of intelligence, undoubtedly a product of the dynamic brain,
also be mutable? Recently, a lucrative new
industry has aimed to capitalize on this
notion. Web-based programs such as
Lumosity.com have grown rapidly. They
aggressively market their services with the
assertion that they are backed by neuroscience, but with a decidedly fad-diet feel.
Who wouldnt want to unlock your inner
genius?
The human brain may in fact be the
most complex object in the universe. There
are 1011 neurons (not to mention glia) in the
brain which, though once thought to be
static, are quite plastic and modulate their
connections based on activity- in terms of
both structure (anatomy) and function
(connection strength) [3]. These processes
can occur during learning or recovery from
injury. Add to this the relatively recent
discovery that new neurons are produced in

the brain throughout adulthood and it seems

that the possibilities for changing the brain
are nearly limitless [2,3]. The idea that the
brain could be trained like a muscle, in a way,
was born out of this new understanding of
neuroplasticity, along with data from psychologists suggesting that intelligence is not as
fixed as was once thought.
This idea has really caught on. In fact,
the brain training industry is booming.
Lumosity, a company that offers a personal
trainer for your brain, claims to have more
than 50 million users worldwide. Although
the concept of adaptive working memory
training was initially conceived as an
alternative intervention for attention deficit
hyperactivity disorder (ADHD) [4], it is now
very much marketed to professionals for
(workplace) performance enhancement akin
to how Viagra and the like buy up airtime on
ESPN. Lumositys ads promise improved
brain performance after use of their
neuroscience-based games and lately can
be heard after nearly every segment on NPR.
Observers have traced the roots of this
industry back to Torkel Klingbergs 2002
paper in the Journal of Clinical and
Experimental Neuropsychology [4] in which a
cohort of children with ADHD, and also an
unaffected group of young adults, showed
improvements in working memory (working
memory is, for example, the ability to remember a grocery list while youre shopping)
and scored better on Ravens progressive
matrices (a test of general cognitive ability)
after five weeks of regular training with an
adaptive working memory task. Klingberg
went on to found Cogmed, one of the first
brain training companies, which was sold to
Pearson education in 2010. Sharpbrains
.com has estimated that the brain training
market surpassed $1 billion in 2012 and
could reach $6 billion by 2020. So what is all
the hype about?

25

Brain training promises a simple

approach to a complex issue and perhaps
that is why it appeals to so many people.
Essentially, the underlying premise is that
training on specific working memory tasks
will translate to overall improvements in
reasoning ability and general cognitive
performance, just as a basketball player
spends hours lifting weights to improve allaround strength and thereby performance on
the court. With training it is no surprise that
ability with the bench press increases, but
does the brain also work this way? Can
training on specific working memory tasks
weight-lifting in this analogy translate to
improved reasoning ability and general
cognitive performance? The central question
is whether individuals who play these training
games are simply getting better at the
training tasks, through practice, or if these
people are actually getting smarter.
While there is a great deal of interest in
answering this question, the results have
been somewhat inconclusive. Since Klingbergs 2002 study, there have been many
high-profile articles providing support for
both sides. One of the most influential papers
was Jaeggi and Buschkuehls 2008 study
published in PNAS [5] which suggested that
not only could fluid intelligence be improved
with working memory training, but also that
these mental exercises could yield an
increase of nearly a full IQ point per hour.
Recently, however, the enthusiasm has been
tempered somewhat by several prominent
studies with negative results. A group at
Georgia Tech was unable to replicate Jaeggi
and Buschkuels results [6] and some in the
field have even taken to the popular press to
express skepticism of these findings [7].
Perhaps more troubling for the industry, a
large study of more than 11,000 online brain
training users published in Nature found no
effect of these exercises on general cognitive
abilities despite significant improvements on
the training tasks themselves [8]. Finally, a
2013 meta-analysis [9] found that, at this
point, the evidence across the literature is not
sufficient to conclude that adaptive working
memory training improves intelligence or
even training task performance beyond a few

months (and there was no overall effect on

working memory across all studies at the
average 9 month follow-up).
However, in some cases the question of
whether improvements in working memory
generalize to increased intelligence may not
be all that important. For example, Klingbergs original study measured the effects of
working memory training on children with
ADHD [4]. While it would be great if these
training tasks could improve reasoning ability
and fluid intelligence, a significant enhancement in attention span alone would
likely improve school performance and could
make these programs a welcome alternative
to psychostimulant pharmacotherapy. In this
case, increased ability in attention-based
training tasks alone would likely make the
effort worthwhile and IQ gains would essentially be a bonus. It should also be noted that
measurement of intelligence itself is subject
to significant controversy [10]. Ravens
progressive matrices, a standard nonverbal
test of reasoning ability and fluid intelligence
used in Jaeggi and Buschkuels study [5],
certainly does not cover the entire spectrum
of cognitive ability nor does it necessarily
predict school or job performance. One study
using this test found that a cohort of children
diagnosed with Aspergers disorder significantly out-performed typically developing
children with similar IQ scores [11].
Nonetheless, those of us who are
buffeted by the ubiquitous advertising of
brain training companies like Lumosity cant
help but think that there must be something
to this because, after all, these are
neuroscience-based games. What is the
scientific basis for Lumositys claims? Their
website advertises [15] completed studies
but eight of these are posters that may or
may not have been reviewed by a panel
before being presented at conferences. In
some conferences in the biomedical
sciences, at least, conference posters are
very rarely rejected simply because their
presenters are a good source of revenue and
it is thought that the merits of the poster will
be judged by other attendees [12]. Posters
typically present preliminary findings and are
not subject to the same rigorous peer-review

26

as published articles and thus would hardly

be considered complete. Seven of these
eight posters report data collected at Lumos
Labs by Lumosity employees. Still, five peerreviewed papers have been published.
However, one was authored by an internal
research group headed by the senior director
of research at Lumos Labs [13] and
appeared in Mensa Research Journal which,
according to their website, is primarily a
reprint publication and not typically an outlet
for high-impact research. A second was a
pilot study from an Australian group that had
only one significant finding in the Lumositytrained group an improvement in a measure of visual attention [14]. Finally, three
additional papers have been published by a
group at Stanford led by Shelli Kesler
studying effects of these programs in very
specific groups such as post-chemotherapy
cancer patients [15-17]. Two of these were
pilot studies without control groups [16,17],
and a third found significant improvement in
measures of executive function immediately
following Lumosity training compared to an
untrained control group (which received no
mental exercise of any kind) [15]. While
these data may seem promising, the
preliminary nature of these studies and lack
of real controls make it difficult to come to
any conclusions as to what effect the training
actually has.
This is the fundamental problem with the
industry the science simply does not (yet)
back up their claims. By aggressively
advertising an understudied product,
Lumosity is setting high expectations for
users. These exercises may in fact work in
some way for a great number of people, but
if it were as easy as their claims make it
seem, wouldnt the data be much clearer? As
a neuroscientist, it is also difficult not to take
issue with their overuse of the term
neuroscience itself. Unfortunately it is
cheapened when applied to commercial
products like these, which seem to take a
page out of the fad-diet industrys book by
seductively promising that science has found
a new, easy way to a better you. If in 10 years
the idea of brain training becomes laughable
to a critical general public, will neuroscience

as a field be dragged down with it? Clearly,

Lumosity believes that the term neuroscience carries some gravitas, because most
of the research they cite, and most of
literature on brain training, actually comes
from psychology methodology, rather than
biomedical research techniques. There was
indeed a revolution in neuroscience brought
on by the discovery of neuroplasticity (in truth
an abstract term that is more globally applied
to numerous phenomena related to the
brains ability to change and adapt), but that
was decades ago and the neurobiology of
intelligence, at the cellular and molecular
level, is still poorly understood [18].
On the surface it may seem that there is
no harm in using these programs, but there
is always a cost. In this case, it may be time
that could be spent doing something else
that is known to sharpen mental acuity and
brain health, like physical exercise [19]. In
addition, Lumosity researchers collect data
on users performance (and are essentially
paid by users to collect this data, rather than
the other way around) and then share it with
researchers around the world. Is this the
future of big science or are Lumosity users
just paying a for-profit company to collect
(and share) data on their cognitive abilities*?
The scientific literature shows that there is
hardly a consensus as to whether fluid
intelligence can be reliably improved through
training of any kind, and therefore it may in
fact be more analogous to height than
strength. Still, companies like Lumosity
disregard this and offer a personal trainer for
your brain. Perhaps the biggest danger is
that these companies misrepresent how
science actually works, to a very wide
audience, and could undermine the publics
trust of scientific integrity, which is already
enough of a problem. Real progress in
science results from rational, hypothesisdriven research, which is subjected to replication attempts, peer review, and ample
skepticism particularly from the investigator. The hope is that brain training
programs do, in fact, work. Of course, it
would be nice to unlock that inner genius.
However, as consumers and as the primary

27

funders of natural science research, the

public deserves much more of the full story.

9.

* From Lumositys privacy policy: We collect and store

data about the games you play and your performance
in those games. We may also collect and store
information such as your browser type, IP address,
language, operating system, unique device identifier,
the date and time of your visit, the pages you view and
the websites you visited immediately before and after
visiting Lumosity.

10.
11.

12.

13.

References
1.

2.

3.

4.

5.

6.

7.
8.

Shipstead, Z., Redick, T. S. & Engle, R. W. Is working

memory training effective? Psychological bulletin 138,
628-654, doi:10.1037/a0027473 (2012).
Gage, F. H. Neurogenesis in the adult brain. The
Journal of neuroscience : the official journal of the
Society for Neuroscience 22, 612-613 (2002).
Lledo, P. M., Alonso, M. & Grubb, M. S. Adult
neurogenesis and functional plasticity in neuronal
circuits. Nature reviews. Neuroscience 7, 179-193,
doi:10.1038/nrn1867 (2006).
Klingberg, T., Forssberg, H. & Westerberg, H. Training
of working memory in children with ADHD. Journal of
clinical and experimental neuropsychology 24, 781791, doi:10.1076/jcen.24.6.781.8395 (2002).
Jaeggi, S. M., Buschkuehl, M., Jonides, J. & Perrig, W.
J. Improving fluid intelligence with training on working
memory. Proceedings of the National Academy of
Sciences of the United States of America 105, 68296833, doi:10.1073/pnas.0801268105 (2008).
Redick, T. S. et al. No evidence of intelligence
improvement after working memory training: a
randomized, placebo-controlled study. Journal of
experimental psychology. General 142, 359-379,
doi:10.1037/a0029082 (2013).
Hambrick, D. Z. in The New York Times SR4 (2012).
Owen, A. M. et al. Putting brain training to the test.
Nature 465, 775-778, doi:10.1038/nature09042 (2010).

14.

15.

16.

17.

18.

19.

28

Melby-Lervag, M. & Hulme, C. Is working memory

training effective? A meta-analytic review.
Developmental psychology 49, 270-291,
doi:10.1037/a0028228 (2013).
Weinberg, R. A. Intelligence and Iq - Landmark Issues
and Great Debates. Am Psychol 44, 98-104 (1989).
Hayashi, M., Kato, M., Igarashi, K. & Kashima, H.
Superior fluid intelligence in children with Asperger's
disorder. Brain Cognition 66, 306-310, doi:DOI
10.1016/j.bandc.2007.09.008 (2008).
Erren, T. C. & Bourne, P. E. Ten simple rules for a
good poster presentation. PLoS computational biology
3, e102, doi:10.1371/journal.pcbi.0030102 (2007).
Hardy, J. L., Drescher, D., Sarker, K., Kellett, G.,
Scanlon, M. Enhancing visual attention and working
memory with a Web-based cognitive training program.
Mensa Research Journal 42, 13-20 (2011).
Finn, M., McDonald, S. Computerised Cognitive
Training for Older Persons With Mild Cognitive
Impairment: A Pilot Study Using a Randomised
Controlled Trial Design. Brain Impairment 12, 187199
(2011).
Kesler, S. et al. Cognitive training for improving
executive function in chemotherapy-treated breast
cancer survivors. Clinical breast cancer 13, 299-306,
doi:10.1016/j.clbc.2013.02.004 (2013).
Kesler, S. R., Lacayo, N. J. & Jo, B. A pilot study of an
online cognitive rehabilitation program for executive
function skills in children with cancer-related brain
injury. Brain injury : [BI] 25, 101-112,
doi:10.3109/02699052.2010.536194 (2011).
Kesler, S. R., Sheau, K., Koovakkattu, D. & Reiss, A.
L. Changes in frontal-parietal activation and math skills
performance following adaptive number sense training:
preliminary results from a pilot study.
Neuropsychological rehabilitation 21, 433-454,
doi:10.1080/09602011.2011.578446 (2011).
Gray, J. R. & Thompson, P. M. Neurobiology of
intelligence: science and ethics. Nature reviews.
Neuroscience 5, 471-482, doi:10.1038/nrn1405
(2004).
Cook, G. in Elements blog, newyorker.com (2013).

Why peoples beliefs about free will matter:

Introducing the free will inventory
Jason Shepard, Emory Neuroethics Scholars Program Fellow, Published April 22, 2014

Recently, the question of whether our

notions of free will, along with whether our
responsibility-holding practices that appear
to be based on free will, can survive in light
of discoveries from the behavioral and brain
sciences was named as one of the Top Ten
Philosophical Issues of the 21st Century.
The interest in free will and how discoveries
in neuroscience and psychology affect our
beliefs and attitudes about free will extends
well beyond the halls of philosophy
departments. The topic has also attracted a
lot of interest from neuroscientists, biologists,
and psychologists [1]. And, of course, these
very debates are of central interest to
neuroethicists. The wide range of interests in
these debates is a symptom of the fact that
these debates matter. The debate over what
people believe about free will and how
discoveries in the behavioral and brain
sciences might impact these beliefs matters
for a wide range of theoretical, and perhaps
more importantly, practical reasons. Much of
the empirical research in this area also points
to the need for a valid and reliable tool for
measuring peoples beliefs about free will.
Below, I touch on some of the reasons why
peoples belief in free will matters, and I
introduce a new tool for measuring beliefs
about free will, the Free Will Inventory, which
was published in the April 2014 issue of
Consciousness and Cognition [2].
Whether people believe in free will
matters. Peoples beliefs in free will impact
their behaviors. For example, experimental
studies have shown that telling people they
dont have free will increases cheating and
stealing, decreases prosocial behaviors and
increases aggression, increases conformity,
reduces self-control, and impairs the
detection of errors. Other studies have
shown that belief in free will is positively
correlated with job performance of day
laborers, and belief in free will is positively
related to expectations of future occupational

success in college students. These findings

suggest that believing in free will may be
instrumentally valuable from the standpoints
of positive psychology and public morality
[3].
These recent findings also highlight the
importance of having valid and reliable tools
for measuring beliefs in free will and related
constructs. While the gathering data
suggests that diminishing peoples belief in
free will leads to all kinds of changes in
behavior, the validity of these findings
depends in part on the validity and reliability
of the scales used to measure peoples
beliefs about free will and related constructs.
For example, the paradigms used in most of
the above-mentioned experimental research
involve one group of participants reading an
anti-free will passage or reading a series of
anti-free will statements. However, the antifree will primes used in these experiments
make claims that go beyond simple claims
regarding the existence of free will. For
example, some of the anti-free will
statements also make claims that support
belief in determinism (the view that the state
of a system, plus the laws that govern that
system, specify all subsequent states of the
system) and challenge beliefs in dualism (the
view that the mind and body are separate
entities). It remains an open question
whether these changes in behavior are best
explained by changes in beliefs in free will,
by changes in beliefs in determinism, by
changes in believes in dualism, or some
combination of changes in beliefs.
The ability to tease apart these explanations depends, in large part, on having
psychometric tools that have the precision
and specificity necessary to accurately
measure beliefs in free will and related
constructs such as determinism and dualism.
While psychometric tools for measuring
beliefs in free will and determinism exist,
these tools are not without their problems.

29

For example, many of the existing tools

simply assume that free will and determinism
are incompatible with each other, and, worse
yet, often define free will and determinism as
polar opposites of each other. Such an
assumption rules out by fiat the ability of
people to express a pattern of beliefs that is
compatible with the philosophically rich
tradition known as compatibilism, or the view
that free will and determinism are
compatible. As it turns out, this is an
important mistake. There is accumulating
evidence that compatibilist intuitions are
more widespread than philosophers and
psychologists have traditionally assumed [4].
In other words, many of the previous
psychometric tools for measuring beliefs
about free will not only rule out the ability for
people to express agreement with a
theoretically rich philosophical position but
also rule out the ability to express patterns of
beliefs that may actually be common among
non-philosophers (i.e. most of society)!
Though some more recent psychometric
tools for measuring beliefs in free will avoid
this mistake, these more recent tools still fail
to measure these constructs in a way that is
useful for all stakeholders in these debates.
For example, the ways these constructs are
defined and measured often appear theoretically uninteresting (if not theoretically
confused) from the philosophers point of
view. Furthermore, these tools often have
just-barely acceptable psychometric properties from the psychologists point of view,
which again points to the possibility of
problems of definition and measurement.
Furthermore, none of the existing measures
measure peoples beliefs in dualism, which is
itself an important construct that is often
claimed to be relevant for how people think
about free will [e.g., 5].
What people believe about free will
matters. Whether discoveries in science
challenge the existence of free will depends
a great deal on what we believe about free
will. For example, if we believe that free will
requires human behavior to be unpredictable
in principle, and if discoveries in science
provide evidence that all behavior is in
principle fully predictable, then these

discoveries would challenge the existence of

free willor would at least challenge the
existence of the sort of free will that we
believe in. However, if we didnt believe that
free will requires unpredictability in principle,
then these sorts of discoveries would be
irrelevant to the free will debateor would at
least be irrelevant to our beliefs about free
will. In other words, determining what sorts of
discoveries are relevant to free will depends
a lot on what people believe about free will.
Unfortunately, the existing psychometric
tools for free will beliefs primarily measure
the extent to which people believe in free will.
These tools provide very little insight into
what people believe about free will. In other
words, these tools can tell you whether
someone believes in free will a little, a lot, or
not at all; but these tools cannot tell you
whether free will requires unpredictability or
dualism or the ability to act outside the laws
of nature. And this is an important oversight.
We need tools that not only measure how
much people believe in free will, but we also
need tools that measure what people believe
about free will.
Given the importance of having a good
measurement tool that is useful to a wide
range of stakeholders in the debate, a
diverse research team comprised of philosophers and psychologists, compatibilists
and incompatibilists recently set out to
develop a new psychometric tool for measuring beliefs in free will and related constructs. This team was led by the philosopher
Thomas Nadelhoffer and included myself,
Eddy Nahmias, Chandra Sripada, and Lisa
Ross. The new tool, The Free Will Inventory
(FWI), was published in this months issue of
Consciousness and Cognition. The FWI
consists of two parts. The first part consists
of three subscales: one that measures belief
in free will, one that measures belief in
determinism, and one that measures beliefs
in dualism. While part 1 of the FWI measures
peoples beliefs in free will, determinism, and
dualism, part 2 measures peoples beliefs
about free will and these related concepts
(e.g., does free will depend on being
unpredictable, on having an immaterial soul,

30

on being able to act at least partially

independent of the laws of nature).
While no psychometric tool is perfect,
we hope we have developed a tool that
avoids some of the problems that plagued
the earlier tools and that is of interest to a
wider range of stakeholders in the debate,
from the psychologist to the philosopher,
from the neuroscientist to the neuroethicist,
and to anyone else who is interested in
rigorously exploring peoples beliefs in and
about free will.

2.

3.

4.

References
1.

For recent, accessible multi-disciplinary discussion of

how the brain and behavior sciences might inform the
free will debate, see the Chronicle of Higher Education
special series on "Is Free Will an illusion". For a
thorough introduction to some of the best thinking on

5.

31

the topic, see: Sinnott-Armstrong, W. (2014). Moral

Psychology, Vol. 4: Free Will and Moral Responsibility.
Cambridge, MA: MIT Press.
Nadelhoffer, T., Shepard, J., Nahmias, E., Sripada, C.,
& Ross, L.T. (2014). The free will inventory: Measuring
beliefs about agency and responsibility.
Consciousness and Cognition, 25, 27-41.
For recent reviews, see: Baumeister, R.F., & Brewer,
L.E. (2012). Believing versus disbelieving in free will:
Correlated and consequences. Social and Personality
Psychology Compass, 6, 736-745. and Rigoni, D. &
Brass, M. (2014). From intentions to neurons: Social
and neural consequences of disbelieving in free will.
Topoi, 33, 5-12.
A review of much of this research is discussed in the
introduction of the paper on the FWI. See: Nadelhoffer,
T., Shepard, J., Nahmias, E., Sripada, C., & Ross, L.T.
(2014). The free will inventory: Measuring beliefs
about agency and responsibility. Consciousness and
Cognition, 25, 27-41.
Montague, P.R. (2008). Free will. Current Biology, 18,
584-585.

Should you read more because a neuroscientist said so?

Lindsey Grubbs, AJOB Neuroscience Graduate Editorial Intern, Blog Manager, Published June 24, 2014

As neuroscientists begin to approach

topics usually falling under the purview of
other specialties, how can they ethically
incorporate various forms of knowledge
rather than provide simplified metrics that
will, in a data hungry society, be easier for
most to latch onto?
In 2013, we saw the publication of at
least two high profile studies claiming neuroscientific proof for the potential moral
benefits of reading fiction. Greg Berns and
his associates published Short- and LongTerm Effects of a Novel Connectivity in the
Brain in Brain Connectivity [1], and David
Comer Kidd and Emanuele Castano
published Reading Literary Fiction Improves
Theory of Mind in Science [3]. The Berns
article makes a relatively modest claim: the
day after an evening session reading a
novel, test subjects had short-term increased
brain connectivity in areas of the brain
associated with taking perspectives and
understanding narratives. Subjects also had
longer-term connectivity that lasted several
days in the bilateral somatosensory cortex,
which the authors suggest could help explain
the mechanism of embodied semantics, the
idea that there is somatosensory involvement in the processing of language, as
when tactile metaphors like I had a rough
day activate the somatosensory cortex [4].
As suggested by its title, the Kidd and
Castano piece makes a more dramatic claim:
the authors conducted five experiments and
wrote that reading award-winning literary
fiction improves subjects theory of mind both
alone and in comparison to nonfiction or
popular bestselling fiction. The reaction to
these studies in the press follows the trend of
a mania for neuroscientific evidence and
colorful images of the brain*. Why is it
necessary, though, to grant scientific
authority more weight as evidence than other
forms of knowledge?

Our society values information that

seems objective over that which seems
subjective at times a value that makes
sense, but one that is exaggerated in the
case of something like responses to
literature, which are inherently subjective.
Writing for The New York Times, Alissa
Quart writes, The problem isnt solely that
self-appointed scientists often jump to faulty
conclusions about neuroscience. Its also
that they are part of a larger cultural
tendency, in which neuroscientific explanations eclipse historical, political, economic, literary and journalistic interpretations
of experience [6]. The reading studies and
the press reactions to them clarify the need
for interdisciplinary work that truly engages
with, rather than pays lip service to, multiple
sources of knowledge not just scientific
protocol, but also generations of thoughtful
work in the humanities.
Kidd and Castanos study highlights the
need for truly engaged interdisciplinary work,
as it engages with literary topics without full
consideration of the dynamics of reading
they perform what ought to be an
interdisciplinary study without the necessary
expertise, leading to a weaker study compounding the type of media neurohype this
one received. While Kidd and Castano
acknowledge literary theory by employing
literary critic Roland Barthes differentiation
between readerly texts, which encourage
passive reading, and writerly texts, which
engage the reader and require them to
produce their own meanings (a move
demonstrating that theyve done some
homework in literary theory), they use the
terms imprecisely (Barthes likely would have
classed all of the books in the study as
readerly none were weird enough to
garner a writerly diagnosis, which describes text like James Joyces Finnegans
Wake) and perhaps to the point of
inaccuracy. Anyway, the terms originate over
forty years ago, and hardly reflect more

32

contemporary, nuanced understandings of

how texts engage the reader.
More recent literary theory suggests that
the value and substance of a text is not an
inherent quality of a work; rather, the
meaning of a text is created in the relationship between the reader and the page, both
enmeshed in a complex context of race,
class, gender, and other factors. By making
the claim that literary fiction improves
theory of mind while popular fiction does
not a messy distinction framed as though
it were a straightforward one (it seems important to note that the results of Berns
study which used a popular, not literary
novel would suggest that this is wrong, and
that reading need not be literary to improve
empathy), Kidd and Castanos study also
risks propping up class-based distinctions.
Supporting the bias that reading highculture literature, which is undeniably bound
up in classed, racialized, and gendered
inequalities, is more morally salutary than
reading other texts on the basis of one
measure is irresponsible, and shows an
inadequate engagement with the politics of
reading. Despite a brief nod to the classbased distinctions between the two groups,
the authors maintain that the notion of
literary value has ecological validity
because it can be detected by readers. But it
is precisely this ecological validity that
changes how the text will be read: we live in
a culture that values certain types of writing
from certain types of authors (most typically,
dead white men), and this value is
necessarily historically contingent not
objective. Today, we know when we pick up
a mystery or sci-fi novel that we are
supposed to read it easily, quickly, and
probably with a bit of embarrassment. In
contrast, when we pick up serious
literature, we are supposed to engage and
work at meaning which we can easily
imagine
would
impact
the
neural
mechanisms at play.
Incorporating an expert in literary study
could have helped the experiment design
avoid this problem. Consider the work of
Natalie Phillips, an English professor working
with neuroscientists and radiologists on a

study of the neuroscience of reading and

attention. Subjects read Jane Austen in an
MRI and alternated between skimming
casually and reading closely revealing that
the two types of reading produced very
different patterns on the MRI. Her familiarity
with literature allowed her to realize that
there are not simply different types of texts,
but also different types of reading a key
oversight in the Kidd and Castano study.
Future research into the relationship
between reading and the brain would be
more thorough, convincing, and conceptually
and ethically sound if it includes humanities
scholars, who contribute a different kind of
knowledge. Conversely, the growing body of
work in the humanities that incorporates a
cognitive approach must be vigilant about
including science ethically, which is to say
scientifically not pop-scientifically.
As neuroscientists become more deeply
engaged with social questions, as Berns and
Kidd and Castano have done with these
recent studies, we will need to begin sorting
through a complex series of questions.
Julianne Chiaet writes in Scientific American
that Kidd and Castanos study could
influence educational programs, prison
reform, and the treatment of autism. But how
well supported does a scientific claim have to
be before we use it to shape policy? Kidd and
Castano acknowledge that the research is
preliminary, focused on only one of a wide
array of possible benefits of reading, and that
much research remains however, that
doesnt stop them from suggesting potential
policy implications based on the limited
knowledge they propose. They point to the
new Common Core State Standards and
argue that more fiction ought to be included
in the curriculum (at the expense of other
subjects of study). Alternatively, what are the
implications of prescribing reading as a
kind of social medication for those deemed
pathologically asocial? Writing for Slate,
Mark OConnell expresses concern about
looking at reading in a "morally instrumentalist" way. What are the dangers of
suggesting that mandated reading programs
could fix our criminals and children with
autism at the expense of broader social

33

3.

reforms that would reduce the incentives to

commit crimes or the stigma our culture aims
at people with disabilities? Moving forward,
tackling these types of questions will require
the pooled expertise of those in the sciences
and humanities.

4.

5.

* Berns uses neuroimaging, while Kidd and Castano

use measures of theory of mind like reading the mind
in the eyes tests.
6.

References
1.

2.

Berns, G. S., Blaine, K., Prietula, M. J., & Pye, B. E.

(2013). Short- and Long-Term Effects of a Novel on
Connectivity in the Brain. Brain Connectivity, 3(6),
590600. doi:10.1089/brain.2013.0166
Chiaet, J. (2013). Novel Finding: Reading Literary
Fiction Improves Empathy. Scientific American.
Retrieved June 16, 2014, from
http://www.scientificamerican.com/article/novel-findingreading-literary-fiction-improves-empathy/

7.

34

Kidd, D. C., & Castano, E. (2013). Reading Literary

Fiction Improves Theory of Mind. Science, 342(6156),
377380. doi:10.1126/science.1239918
Lacey, S., Stilla, R., & Sathian, K. (2012).
Metaphorically feeling: Comprehending textural
metaphors activates somatosensory cortex. Brain and
Language, 120(3), 416421.
doi:10.1016/j.bandl.2011.12.016
OConnell, M. (2013, October 28). 10 Novels to a
Better You. Slate. Retrieved from
http://www.slate.com/articles/arts/culturebox/2013/10/d
oes_reading_fiction_make_you_a_more_empathic_be
tter_person.2.html
Quart, A. (2012, November 23). Neuroscience: Under
Attack. The New York Times. Retrieved from
http://www.nytimes.com/2012/11/25/opinion/sunday/ne
uroscience-under-attack.html
"This is your brain on Jane Austen, and Stanford
researchers are taking notes." (2012, September 7).
Stanford University. Retrieved June 11, 2014, from
http://news.stanford.edu/news/2012/september/austen
-reading-fmri-090712.html

Pass-thoughts and non-deliberate physiological computing:

When passwords and keyboards become obsolete
Katie Strong, AJOB Neuroscience Graduate Editorial Intern, Published July 1, 2014

Imagine opening your email on your

computer not by typing a number code, a
password, or even by scanning a finger, but
instead by simply thinking of a password.
Physical keys and garage door openers
could also become artifacts of the past once
they are replaced with what could be referred
to as pass-thoughts. In 2013, researchers at
UC Berkley used EEG signals emitted from
subjects as biomarker identifiers to allow
access to a computer. The entire system
the headset, the Bluetooth device, and the
computer had an error rate of less than 1%
[1]. While wearing EEG headsets to open our
devices may seem futuristic, this type of
scenario could become more prevalent in the
future due to advances in physiological
computing (PC). Physiological computing is
a unique form of human computer
interactions because the input device for a
computer is any form of real-time physiological data, such as a heart-rate or EEG
signal. This is in stark contrast to the
peripheral devices that we are familiar with
today, such as a keyboard, remote, or mouse
[2].
The field of physiological computing is
still quite new, but research has suggested
that different physiological computers require
varying degrees of intentionality from the
human user, and that the devices can be
placed on a spectrum [3].
On one end of the spectrum are
technologies where users can deliberately
interact with input devices based on
voluntary muscle movement such as
electrooculography (EOG) to direct the
movement of a cursor [4]. In contrast, braincomputer-interfaces (BCI), such as the
exoskeleton showcased at the recent first
kick for the 2014 World Cup, bypass this step
since BCIs are often developed for those with
diminished movement capacities and
disabilities. However, in both cases the
general principle is the same: the interface is

ultimately translating a neural signal that the

user has specifically and deliberately
directed to complete a task [5].
Non-deliberate PC, on the other hand,
bypasses any voluntary input, and instead
involves a biocybernetic approach where
spontaneous physiological changes, such as
a heart rate or brain electrical signals are
recorded via an electrocardiogram (EKG) or
an electroencephalogram (EEG), respectively. These signals are then correlated to
meaningful information, such as the case
mentioned above where specific EEG
signals act as identifying information to allow
access to a computer. These types of
technologies are able to associate recorded
physiological changes with the motivational,
cognitive or emotional state of the user. Once
the interface determines the users emotional
state, it can often adapt in an attempt to
promote a specific type of positive mentality
or negate a potentially hazardous emotional
state. For example, if a computer calculates
that the user is stressed, it can play soothing
music or offer to help to diffuse the negative
situation. The long-term recording of physiological data usually for learning purposes is
referred to as ambulatory monitoring [6].
Technologies that incorporate aspects
of physiological computing, such as the
recently released Kinect 2 from Microsoft,
have recently become prevalent in consumer
products. Using technology similar to that
developed at MIT and referred to as Eulerian
Video Modification [7], the camera on the
Kinect detects small changes in skin color
pigmentation and monitors heart rate
optically (although pulse rate can be an
indicator for an emotional state, at this time
the Kinect 2 focuses on monitoring heart
rates during physical activity, but does not
correlate this data to an emotional state).
Portable, wireless sensors that are able
to not only record, but also convert raw EEG
signals into some form of meaningful

35

information are currently available. EPOC by

Emotiv and MindWave by NeuroSky have
developed and currently sell wireless
headsets that act as EEG sensors. Since
certain EEG signals could be used as
indicators of a specific emotional state, such
as frustration [8], the interface can label or
adapt to a user in real-time. That said, while
these EEG sensors give the impression that
the user can execute commands with
seemingly only the power of thought, these
technologies are not yet able to comprehend
intentions or mimic emotions. For an
interface to recognize intentions, first a
system, similar to a dictionary, must be
created so that the computer records the
EEG data for a series of tasks that the
interface will be able to recognize later. Not
to mention, intent is still not clearly
understood mechanistically through neuroscience.
Pertinent ethical issues include those
related to ownership and privacy. Raw EEG
or electrocardiogram (ECG) data is powerful
information, especially when linked to
changes in an emotional state. Emotiv will
provide the raw EEG data from its users for
an additional fee, but NeuroSky does not
provide this information. Do we have any
claim over our own (neuro-) physiological
data once it leaves us? Even if raw EEG
signals are worthless without an algorithm to
decipher the meaning, the data still
originated from only one, original source.
Until it was pulled for ownership issues
(NASA wanted to ensure that the data was
no longer federal property), the EKG of Neil
Armstrongs heart as he took the first steps
on the moon was to be auctioned off in 2013
[9]. But did NASA ever have a right to lay
claim to this information, even if without an
algorithm the EKG is seemingly meaningless? Or, does Neil Armstrong (or in this
case, his family) have any right to claim
ownership since NASA paid for and played a
role in developing the technology that enabled this collection? These will be the types
of questions that need to be addressed as
more and more people continue to offer up
their physiological data by using these types

of technologies and popular commercial

venues.
It seems inevitable that one day enough
people will participate in the use of these
EEG sensors and a massive database of
neurological signals will begin to develop.
Having a large dataset of neurological data
that can potentially be correlated to disease
states is already the goal of well established
companies such as Lumosity [10] and BrainResource [11]. Additionally, the United
States government recently launched
PCORnet: The National Patient-Centered
Clinical Network Project with the intention of
building a national health-data system by
combining data from 29 different health data
networks [12]. The United Kingdom has met
ethical conflicts with the introduction of a
similar system, care.data [13], and the
United States already has a history of
alleged National Security Agency privacy
violations, but government backed organizations are moving forward with the massive
collection of medical records and perhaps
one day, extensive physiological data. A
precedent for having a dataset of extensive,
personal information was set by the company 23andMe, which provided information
based on DNA analysis. Nothing protects the
users of 23andMes service from having their
personal information sold [14], but the
Genetic Information Non-discrimination Act
(GINA) passed in 2008 protects people from
having their genetic information interfere with
insurance policies and employment. This
type of law does not exist for neurological
data. Regulations and discussions should be
taking place now before companies like
Emotiv or NeuroSky have 5 years worth of
data from their customers whose privacy is
not protected in the slightest.
Already specific EEG signals can be
used to characterize neurological disorders.
With the collection of more data, we have the
potential to be able to recognize and use
specific signals as brain signatures for
other neurological disorders or even
tendencies toward certain behaviors (the
well-established
company
Brainwave
Science is a proponent of using EEG
technology to test guilt or innocence). This

36

ability, while incredibly powerful, has a high

risk for abuse in terms of covert monitoring of
individuals [15]. Of course, if a patient has
epilepsy, a discrete EEG sensor that has the
power to be predictive for seizure activity
could greatly increase the health, safety, and
quality of life for these patients [16]. But,
would it be appropriate to monitor a person
who has been given a neurological diagnosis
that has rendered them emotionally unstable
if the EEG sensor could detect a very high or
low state? If that EEG sensor means that
they are deemed stable enough for certain
activities they were once denied, such as
driving, does that make the constant
monitoring worth what many would consider
a violation of privacy?

6.

References

12.

1.

2.
3.

4.

5.

7.

8.

9.

10.

11.

New Research: Computers That Can Identify You by

Your Thoughts
http://www.ischool.berkeley.edu/newsandevents/news/
20130403brainwaveauthentication (accessed Jun 26,
2014).
Fairclough, S. H. Fundamentals of Physiological
Computing. Interact. Comput. 2009, 21, 133145.
Physiological Computing F.A.Q. Physiological
Computing Blog.
http://www.physiologicalcomputing.net/?page_id=227
(assessed on June 28, 2014).
Allanson, J.; Fairclough, S. H. A Research Agenda for
Physiological Computing. Interact. Comput. 2004, 16,
857878.
Allison, B. Z.; Wolpaw, E. W.; Wolpaw, J. R. BrainComputer Interface Systems: Progress and Prospects.
Expert Rev. Med. Devices 2007, 4, 463474.

13.
14.

15.
16.

37

Fairclough, S.H., and Gilleade, K. (2014). Meaningful

Interaction with Physiological Computing. In Advances
in Physiological Computing, S.H. Fairclough, and K.
Gilleade, eds. (Springer London), pp. 116.
Wu, H.-Y.; Rubinstein, M.; Shih, E.; Guttag, J.;
Durand, F.; Freeman, W. T. Eulerian Video
Magnification for Revealing Subtle Changes in the
World. ACM Transactions on Graphics (Proc.
SIGGRAPH 2012 2012, 31.
Kapoor, A.; Burleson, W.; Picard, R. W. Automatic
Prediction of Frustration. Int. J. Hum.-Comput. Stud.
2007, 65, 724736.
Pearlman, R. Z. Neil Armstrongs Heartbeat, Apollo
Joystick Pulled from Auction
http://www.space.com/21228-neil-armstrong-apolloartifacts-auction.html (accessed Jun 26, 2014).
Sternberg, D. A.; Ballard, K.; Hardy, J. L.; Katz, B.;
Doraiswamy, P. M.; Scanlon, M. The Largest Human
Cognitive Performance Dataset Reveals Insights into
the Effects of Lifestyle Factors and Aging. Front. Hum.
Neurosci. 2013, 7.
McRae, K.; Rekshan, W.; Williams, L. M.; Cooper, N.;
Gross, J. J. Effects of Antidepressant Medication on
Emotion Regulation in Depressed Patients: An iSPOTD Report. J. Affect. Disord. 2014, 159, 127132.
Collins, F. S.; Hudson, K. L.; Briggs, J. P.; Lauer, M. S.
PCORnet: Turning a Dream into Reality. J. Am. Med.
Inform. Assoc. 2014, amiajnl2014002864.
Callaway, E. UK Push to Open up Patients Data.
Nature 2013, 502, 283283.
Seife, C. 23andMe Is Terrifying, but Not for the
Reasons the FDA Thinks. Scientific American, Nov.
27, 2013.
http://www.scientificamerican.com/article/23andme-isterrifying-but-not-for-reasons-fda/ (accessed Jun 26,
2014).
Deceiving the Law. Nat. Neurosci. 2008, 11, 1231
1231.
Jouny, C. C.; Franaszczuk, P. J.; Bergey, G. K.
Improving Early Seizure Detection. Epilepsy Behav.
EB 2011, 22 Suppl 1, S4448.

So you want to be a successful psychopath?

Julia Marshall, Emory Neuroethics Program Intern, Published May 15, 2015

Within the past two years, the media has

followed the recent turn toward exploring the
characteristics of a successful psychopath.
A simple Google search on successful
psychopathy now renders a slew of attention-grabbing articles ranging from How to
Protect Yourself from a Successful Psychopath to Why Psychopaths are More
Successful to Is Your Boss a Psychopath?
Together, these articles reference some of
Americas more fascinating psychopathic
fictional characters, such as Dexter, Jordan
Belfort from The Wolf of Wall Street, and
Frank Underwood from House of Cards, to
create a case for an adaptive psychopath.
The recent discussion about the successful
psychopathic personality in the media most
certainly raises questions about the nature of
psychopathy and the ethical implications of
concluding that some psychopathic tendencies may be adaptive.
Before delving into the nuances of
successful psychopathy, one must first
understand the basic characteristics of
psychopathy more generally. Psychopathic
personality, or psychopathy, is a disorder
often characterized by a constellation of
affective, interpersonal, and behavioral deficits. Psychopaths have been known to be
especially callous, cold-hearted, impulsive,
and superficially charming. This subset of
people has also often been characterized as
not possessing empathy and as unable to
feel remorse for their actions. Criminal
anthropologist Havelock Ellis (1890) portrayed psychopaths as instinctive criminal[s]
and moral monsters [1]. Furthermore, in his
pioneering work The Mask of Sanity, Hervey
Cleckley (1941) described a psychopath as
unable to accept substantial blame for the
various misfortunes which befall him and
which he brings down upon others [2].
This characterization of psychopaths is
largely negative. It is hard to think about how
an uncaring, impulsive, cold-hearted person
could seemingly flourish in any endeavor in

life. The debate over whether certain

psychopathic qualities could manifest adaptively remains a question that will largely be
decided through refining the measurement
techniques for assessing psychopathy. Of
course, this will not be an easy debate to
resolve. Throughout the history of psychopathy research, there has also been
significant controversy over the criteria
required for a psychopathy diagnosis. In an
effort to elucidate some confusion, Robert
Hare (1991/2003) developed the Psychopathy Checklist (PCL) [3]. The PCL is the
most commonly used method to measure
psychopathy traits. Factor analytic measures
on the PCL have shown that psychopathy is
supported by two factors: (1) interpersonal
and affective traits and (2) disregard for
social conventions. The first factor more
closely aligns with typical conceptions of
psychopathy, whereas the second factor
captures a tendency to engage in maladaptive antisocial and lifestyle behaviors.
Aside from merely discerning the
characteristics of a psychopath, researchers
have also debated whether psychopathy is a
categorical or dimensional construct. More
recent scholarship suggests that there are
not psychopaths and non-psychopaths,
but instead all individuals possess varying
degrees of psychopathic tendencies [4]. In
my opinion, viewing psychopathy on a
continuum helps to frame a case for the
successful psychopath because one
psychopath will vary from another.
People with psychopathic personality
disorder may express certain personality
tendencies to differing degrees and these
differences are usually captured and clarified
though developing more precise measuring
tools and examining different underlying
factors of psychopathy. The range of
characteristics associated with psychopathy
run the gamut from boldness, heightened
levels of focus, superficial charm, intelligence, and carelessness. The quality most

38

closely related to successful psychopathy is

perhaps boldness and fearlessness [5].
Psychopaths that exhibit these qualities may
perform exceedingly well in stressful
business, legal, or academic environments.
Nonetheless, more research is needed to
examine what arrangement of traits is
correlated with adaptive outcomes in
psychopathic individuals.
To better illustrate the theoretical
possibility of a successful psychopath, say
that there exists a type of person that is
especially bold, devoid of anxiety, and
manipulative in a way that helps her advance
in her career. It is not hard to envisage this
type of person succeeding in her professional life because she may more readily
engage in risky yet potentially profitable
business ventures and exude a great deal of
self-confidence in the face of uncertainty.
This combination of traits may even appear
enviable. There are most certainly times in
which I wish I were less anxious about an
important meeting or bolder when making
important decisions. However, the successful psychopathy discussion must be careful
not to venerate the notion of a so-called highfunctioning psychopath. Just because a
successful psychopath may very well exist
does not mean that psychopathy in many
other cases is not associated with highly
problematic behavior.
In discussing successful psychopathy,
we must be clear about what successful
means and who makes that determination.
For instance, a successful psychopath could
be considered adaptive because she hasnt
been caught engaging in inappropriate
actions, but other people may not think of her
as successful if her behaviors were
uncovered. Take Dexter the so-called
Avenging Angel for examplehe could be
considered a very successful psychopath
because he kills people without getting
caught and subsequently punished. I would
argue that he is successful in a sense, but
not in an enviable way. Frank Underwood
from House of Cards serves as another
example: he is an especially astute political
manipulator and lacks remorse for many of
his morally questionable actions. I find these

individuals fascinating, but I am not so sure

many people would want to possess the
characteristics of these individuals.
Alternatively, another conceptualization
of a successful psychopath may stem from
the idea that a psychopath recognizes her
psychopathic tendencies but channels them
in societally appropriate ways, such as acting
in a heroic manner or taking necessary risks
in the face of uncertainty or having great
economic success. For instance, a person
with a variant of psychopathic personality
may find the job of a firefighter fitting for her
fearlessness. Society would likely deem this
persons choice to seek out an occupation
that matches with her interests admirable
and respectable. This existence of such a
person is still contentious and more research
is needed to determine which underlying
factors of psychopathy manifest into adaptive behaviors [5]. In the end, the intentional
firefighter differs from sly, undercover serial
killer, and we must be careful not to throw the
word successful around without defining
what one means by its use.
Regardless, the medias portrayal of
successful psychopathy ought to include a
discussion of these nuances because these
differences in the definitions of successful
psychopathy are distinctions that make a
difference in how the public perceives mental
disorders, such as psychopathy. On one
side, it would be problematic for the media to
perpetuate a stigma against psychopaths or
stigma against mental illness in general. It
would be equally problematic if the media
framed a successful psychopath as having a
desirable personality disorder. The truth of
the matter is that we simply do not know
enough about successful psychopathy to
make any generalizations about successful
psychopathy. Just because a psychopath
need not always be equivalent to Ted Bundy
does not necessarily mean that a noncriminal psychopath is the type of person our
society ought to deem successful.
Or does it? Only further research and
time will begin to shed light on the curious
character of a successful psychopath.

39

Successful Psychopathy Books of

Potential Interest
The Psychopath Inside: A
Neuroscientists Personal Journey into
the Dark Side of the Brain
Snakes in Suits: When Psychopaths
Go To Work
The Psychopath: A Journey Through
the Madness of Industry
The Good Psychopath's Guide to
Success

References
1.
2.

3.
4.

5.

40

Ellis, H. (1916). The criminal (Vol. 7). W. Scott.

Cleckley, H. (1941/1976). The mask of sanity; an
attempt to reinterpret the so-called psychopathic
personality.
Hare, R. D. (1999). The Hare Psychopathy ChecklistRevised: PLC-R. MHS, Multi-Health Systems.
Lilienfeld, S. O. (1998). Methodological advances and
developments in the assessment of psychopathy.
Behaviour Research and Therapy, 36, 99-125.
Smith, S. F., Watts, A. L., & Lilienfeld, S. O. (2014). On
the trail of the elusive successful psychopath.
Psychological Assessment, 15, 340-350.

The power of a name:

Controversies and changes in defining mental illness
Carlie Hoffman, AJOB Neuroscience Graduate Editorial Intern, Published July 14, 2015

The purposes of naming are to help

categorize the world in which we live and to
aid in grouping similar things together.
However, who decides which name is the
correct one? Is a child who often cannot pay
attention to his classwork absent-minded,
or experiencing attention deficit hyperactivity
disorder? Is a person whose moods often
swing from one extreme to the other simply
moody, or living with bipolar disorder?
Naming a lived experience a mental illness
has the ability to change the social realities
of those who receive the diagnosis, altering
not only self-perception, but also influencing
the perceptions and triggering the biases of
others- often in a detrimental manner. So,
who has the power to determine how such a
label is assigned, and what happens if
someone is given the wrong one?
The power affiliated with naming has
caused the diagnosis of mental disorders to
be fraught with controversy. Mental illnesses
are defined by the Diagnostic and Statistical
Manual of Mental Disorders (DSM), which
has been deemed the bible of mental
health. According to Dr. Thomas Insel, the
director of the National Institutes for Mental
Health (NIMH), the goals of the DSM are to
create a common language for describing
mental illness and to ensure that mental
health care providers use the same terms in
the same ways. Thus, when patients visit a
psychiatrist in search of a name that will
define the symptoms they are experiencing,
this name is assigned with the aid of the
DSM.
One controversy affecting the diagnosis
of mental disorders is the growing concern
with medicalization of the normal human
experience. Medicalization is the process of
defining select human experiences or conditions, typically ones that were once considered normal, as medical conditions that
warrant professional medical attention.
Some level critiques against medicalization,

particularly the medicalization of experiences

associated with cognitive and emotional
function, suggesting it can lead to overdiagnosis of mental disorders as individuals
cope with stressors in a typical fashion [5, 11,
13]. A series of controversial changes made
to the newest edition of the DSM, DSM-5,
have provided a foothold for those concerned with medicalization. The addition of
premenstrual dysphoric disorder and the
elimination of the bereavement exclusion
from the criteria for major depressive disorder have increased the apprehension that
typical premenstrual mood and behavioral
changes and the normal grieving process
could be classified as mental disorders [7,
13, 14].
An additional problem arises in the
difficulty of conceptualizing a typical
example of a person with any given disorder.
The high level of heterogeneity present
within individuals with the same mental
illness insinuates that two people diagnosed
with major depressive disorder can experience very different symptoms. Therefore,
being assigned the blanket diagnosis of
depression is relatively uninformative and
consequently, such mental disorders are
difficult to treat and research. Furthermore, a
diagnosis can bring with it social, financial,
and political stigmas that may have a huge
impact on the patients quality of life and selfconcept [3, 4, 16]. These stigmas against the
mentally ill may also be influenced by the
variability present among those diagnosed.
Individuals with mental disorders express a
wide range of symptom type and severity,
which frequently leads to people thinking the
worst of those diagnosed with a mental
illness, often through invalidating someones
lived experience or grossly misunderstanding their symptoms. This misconception leads to further stigma as people
erroneously apply exaggerated stereotypes

41

to all diagnosed individuals, regardless of the

truth of the stereotype.
The DSM has undergone several
revisions since its first publication by the
American Psychiatric Association (APA) in
1952 with the goal of gathering statistical
information from mental hospitals. The first
edition of the DSM (DSM-I) included 106
disorders, called reactions. The use of this
term reflected the influence of the
psychodynamic view held by Adolf Meyer,
who felt mental illness was the byproduct of
the bodys reaction to life circumstances and
emotional distress [2, 8]. The publication of
DSM-II in 1968 saw the addition of 76
disorders and the elimination of the term
reaction, which removed the influence of
psychodynamic theory from mental illness
diagnosis. In 1980, DSM-III expanded to
include 265 disorders and started to become
a tool for clinicians and researchers instead
of simply functioning as a statistical manual.
DSM-IV was published in 1994 and included
more than 300 disorders, and finally the most
recent version of the manual, DSM-5, was
released in 2013 [2, 15].
DSM-5 is perhaps the most controversial edition of the DSM, and sports significant changes to the criteria for several
disorders- to the chagrin of the public, mental
health practitioners, and the field of
psychiatry at large. Prominent controversies
center on the expansion of many diagnostic
criteria seen in previous DSM editions,
including the combination of four separate
disorders (autistic disorder, Aspergers
disorder, child-hood disintegrative disorder,
and pervasive developmental disorder not
otherwise specified) into one diagnosis of
Autism Spectrum Disorder [1, 6], and the
removal of the bereavement exclusion
criteria from the major depressive disorder
diagnosis. This removal allows individuals
coping with the recent loss of a loved one to
be diagnosed with major depression [13, 14].
There is also concern as to the motives
behind these changes, with some critics
claiming conflicts of interest and ties to drug
companies may have driven the alterations
[12, 13]. A 2012 article in The Washington
Post described the increasing shift toward

prescribing anti-depressant medications for

those grieving the loss of a loved one. The
article also stated this shift was largely
instigated by individuals affiliated with
pharmaceutical companies: eight of the
eleven APA members who drove this change
had economic conflicts of interest with drug
companies, and a key advisor of the APA
committee was the first author of a study
evaluating the efficacy of antidepressant
medications on grieving individuals.
While DSM-5 is portrayed as the
objective gold standard all psychiatrists are
expected to utilize, the disorders it describes
are ultimately determined by an educated,
but subjective, collective opinion. In total,
more than 160 individuals were involved in
the creation of DSM-5, including nearly 100
psychiatrists, 47 psychologists, two pediatric
neurologists, three epidemiologists, one pediatrician, one social worker, and one
psychiatric nurse [2]. However, even with
such capable contributing members, the
diagnostic criteria within DSM-5 were still
ultimately decided by subjective opinions,
and not objective definitions. Consequently,
without more objective or qualitative standards for each mental disorder, diagnostic
criteria can, and have, changed over time
from DSM-I to DSM-5. Key examples, as
described in the Los Angeles Times, include
homosexuality, which was considered to be
a mental disorder until it was removed from
the DSM during a revision in 1974; and
PTSD, which was not formally recognized as
a disorder until 1980. This weakness of the
DSM was described by Dr. Thomas Insel as
a lack of validity: diagnoses are based on an
agreement about symptoms and not on any
objective measures. In essence, this would
be equivalent to creating diagnostic systems
based on the nature of chest pain or the
quality of fever [10].
However, the subjectively-defined tides
of mental illness are beginning to change,
and steps are being made to remedy the
variable nature of mental disorder diagnosis.
The NIMH published a Strategic Plan in 2008
with the goals of defining the mechanisms of
complex behaviors, charting the trajectories
of mental illness, striving for cures and

42

prevention, and promoting progress in basic

and clinical research of mental disorders. In
2013, months prior to the release of DSM-5,
Dr. Insel also discredited the DSM and the
symptom-based method of mental disorder
diagnosis, claiming it is critical to realize that
we cannot succeed if we use DSM
categories as the gold standard [10].
Following this comment, he also introduced
a new direction for NIMH-funded research
that aligned with the goals of the Strategic
Plan, called the Research Domain Criteria
(RDoC) project. RDoC is a decade-long
project with the goal of incorporating more
objective tools, such as those offered by
genetics, cognitive science, and brain imaging, into the criteria for mental disorder
diagnosis [9]. While this appears to be a step
in the right direction and the entrance into a
new era for mental illness, RDoC is still in its
infancy. This initiative will hopefully produce
more objective and improved systematic
means for defining mental disorders.
Nevertheless, because mental illnesses
are highly variable and do not have a uniform
cause or course, the diagnosis of many of
our most common mental illnesses will
continue to rely on subjective assessment: at
some point in the diagnostic process, the
decision of whether to assign a diagnosis will
involve the opinion of the health care
professional. Though not ideal, the DSM has
helped standardize this process and
represents a much-needed attempt to
ground the subjectivity of mental illness in the
collective of numerous psychiatrists through
the use of systematic analysis. While RDoC
seeks to create a new standard for the field
and may serve to usher in an era of improved
objectivity and better research targets, it is
likely that subjectivity will remain to some
extent in the diagnosis of the mentally ill. Yet,
the main vice associated with mental illness
diagnosis is not just the subjectivity of the
DSM naming system, but also the misguided
public perception of the mentally ill. While
use of the DSM may lead to an inaccurate
diagnosis, the main negative repercussions
of such a diagnosis arise from uninformed
public opinion and stigma. Thus, the road to
improving the field of mental illness is

twofold: reducing the subjectivity inherent in

the criteria used to define mental disorders,
and improving the appreciation society has
for mental illness to reduce stigma and make
the world more hospitable for those with
mental illness and those in pursuit of mental
health.
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Corrigan PW (2014) Erasing stigma is much more than
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44

Appendix:
Where are they now?
Cyd Cipolla received her PhD in Womens, Gender, and Sexuality Studies from Emory
University in 2013 and is currently a class adviser and Associate Faculty at the Gallatin
School of Individualized Study at New York University and a visiting research fellow in
Psychiatry at Weill Cornell Medical College.
Ross Gordon received his Bachelors degree in Psychology from Emory University in
2012 and is currently a teacher in the Atlanta area.
Lindsey Grubbs is a PhD student in the Emory University department of English and is
currently an AJOB Neuroscience Graduate Editorial Intern.
Kristina Gupta received her PhD from Emory University in 2013 and is currently an
Assistant Professor of Womens, Gender, and Sexuality Studies at Wake Forest
University.
Julia Haas received her PhD in the Philosophy program at Emory University in 2014
and is currently a McDonnell Postdoctoral Research Fellow in the Department of
Philosophys Philosophy-Neuroscience-Psychology Program at Washington University
in St. Louis.
Carlie Hoffman is a PhD student in the Emory University Neuroscience program and is
currently an AJOB Neuroscience Graduate Editorial Intern.
Julia Marshall received her Bachelors degree in Psychology from Emory University in
2015 and is currently a graduate student in the Yale University Psychology department.
Ryan Purcell is a PhD student in the Emory University Neuroscience Program and is
currently an AJOB Neuroscience Graduate Editorial Intern.
Jonah Queen received his Bachelors degree in Neuroscience and Behavioral Biology
from Emory University in 2011 and is currently the STEM program coordinator at the
Atlanta Jewish Academy.
Jennifer Sarrett received her PhD from Emorys Graduate Institute of Liberal Arts in
2014. She is currently a visiting Assistant Professor at Emory Universitys Center for
the Study of Human Health and teaches courses in Bioethics and Disability, Health
Humanities, and Mental Illness and Culture.
Shezza Shagarabi received her Bachelors degree in Neuroscience and Neurobiology
from Emory University in 2014.

A1

Jason Shepard is a graduate student in the Emory University Department of

Psychology.
Katie Strong is a PhD student in the Emory University Chemistry department and is
currently an AJOB Neuroscience Graduate Editorial Intern.
Emily Young received her Bachelors degree in Biology from the Georgia Institute of
Technology.
Riley Zeller-Townson is a PhD student in Biomedical Engineering at the Georgia
Institute of Technology and is a SMART scholar affiliated with SPAWAR Systems
Center Pacific.

A2

A collection of blog posts featured on www.theneuroethicsblog.com. Posts were written by

undergraduate and graduate student scholars who participated as interns and ambassadors for
the Emory Center for Ethics Neuroethics Program and AJOB Neuroscience. Publication edited
by Carlie Hoffman. Cover design and content layout by Carlie Hoffman. Published by the
Emory Center for Ethics Neuroethics Program.