Group items tagged

New financial constraints on family formation are a potential cause, as implied by another striking finding in the Journal poll — 78 percent of adults lack confidence this generation of children will enjoy a better life than they do.

Yet a recent analysis for the Aspen Economic Strategy Group by Melissa S. Kearney and Phillip B. Levine, economics professors at the University of Maryland and Wellesley College, respectively, determined that “beyond the temporary effects of the Great Recession, no recent economic or policy change is responsible for a meaningful share of the decline in the US fertility rate since 2007.”

Their study took account of such factors as the high cost of child care, student debt service and housing as well as Medicaid coverage and the wider availability of long-acting reversible contraception. Yet they had “no success finding evidence” that any of these were decisive.

Kearney and Levine speculated instead that the answers lie in the cultural zeitgeist — “shifting priorities across cohorts of young adults,”

A possibility worth considering, they suggested, is that young adults who experienced “intensive parenting” as children now balk at the heavy investment of time and resources needed to raise their own kids that way: It would clash with their career and leisure goals.

another event that year: Apple released the first iPhone, a revolutionary cultural moment if there ever was one. The ensuing smartphone-enabled social media boom — Facebook had opened membership to anyone older than 13 in 2006 — forever changed how human beings relate with one another.

We are just beginning to understand this development’s effect on mental health, education, religious observance, community cohesion — everything. Why wouldn’t it also affect people’s willingness to have children?

one indirect way new media affect childbearing rates is through “time competition effects” — essentially, hours spent watching the tube cannot be spent forming romantic partnerships.

a 2021 review of survey data on young adults and adolescents in the United States and other countries, the years between 2009 and 2018 saw a marked decline in reported sexual activity.

the authors hypothesized that people are distracted from the search for partners by “increasing use of computer games and social media.

during the late 20th century, Brazil’s fertility rates fell after women who watched soap operas depicting smaller families sought to emulate them by having fewer children themselves.

This may be an area where incentives do not influence behavior, at least not enough. Whether the cultural shift to lower birthrates occurs on an accelerated basis, as in the United States after 2007, or gradually, as it did in Japan, it appears permanent — “sticky,” as policy wonks say.

onic constipation, a functional bowel disorder, affects approximately 14% of adults worldwide [1]. Slow transit constipation (STC) is the major cause of chronic constipation which is characterized by markedly prolonged colonic transit time as a result of the colonic motility function disorde

Usually, patients with STC suffer from a common sense of abdominal pain, nausea, depression and sickness, which seriously influence their social ability and health-related quality of life [4–6

Current clinical treatments include cathartics, prokinetics and aggressive surgery which can increase bowel movement frequency to a certain degree.

However, pharmacological interventions is prone to drug dependency and relapse after drug withdrawal [3]

Surgical treatments such as subtotal colectomy and total colectomy in STC patients may adversely affect the quality of life due to the risk of postoperative diarrhea or incontinence, and result in a heavy healthcare burden

The enteric nervous system (ENS), located in the intestinal wall, regulates various functions including contraction of intestine, homeostasis and blood flow [10]. As the ‘second brain’, the ENS contains large amounts of neurons working independently from the central nervous system [11]. Researches have identified that STCs are mostly caused by disorders of the relevant nerves, especially the ENS [12,13].

McCallum et al. [35] found that gastric electrical stimulation in combination with pharmacological treatment could also enhance emptying in patients with gastroparesis. Especially, gastric electrical stimulation has been approved as a clinical therapy method for gastroparesis and obesity in European and American countries [36].

we employed pulse train stimulation and implanted electrodes at the proximal colon in dogs.

After CES treatment, we observed the colonic transit time of the sham treatment group was longer than that of CES treatment and control groups, and electrical stimulation significantly enhanced the colonic electromyogram (EMG) signal.

histopathology and TEM analysis showed increased ganglia and synaptic vesicles existing in the colon myenteric plexus of the CES treatment group as compared with that of the sham CES group

Our results suggested that CES might reduce the degeneration of the myenteric plexus neurons, thereby contributing to the therapeutic effect on STC beagles.

the defecating frequency and the feces characteristics of STC beagles returned to normal after CES treatment. The result indicated that CES could improve the symptoms of STC.

The colonic EMG signal was strongly promoted by CES

Especially, the colonic EMG signal of the beagles with STC was remarkably enhanced by CES (Figure 3), indicating that CES could not only improve the colonic content emptying, but also enhance the EMG signal to promote colonic motility.

Colonic electrical stimulation (CES), a valuable alternative for the treatment of STC, was reported to improve the colon motility by adjusting the bioelectrical activity in animal models or patients with STC [17]. However, little report focuses on the underlying nervous mechanism to normalize the delayed colonic emptying and relieve symptoms. We hypothesized that CES may also repair the disorders of the relevant nerves and then improve the colonic motility.

The first study regarding the CES to modulate colonic motility was performed by Hughes et al. [37]. Since then, many researchers employed short-pulse CES in canine descending colon or pig cecum [20,21,38]. Researchers also applied long-pulse CES to stimulate the colon of human or animals [39]

Recently, studies showed that the prokinetic effect of pulse train CES is better than that of short-pulse CES or long-pulse CES [25]

Our study indicated that CES could enhance the colonic motility, and then accelerate the colonic content emptying. Thereafter, we investigated the underlying mechanism and presumed that CES might improve the STC symptom through the repairment of the ENS.

The neuropathy in ENS is considered to be responsible for various kinds of disordered motility including STC and the related pathophysiologic symptoms [40]. In agreement with this view, our study discovered the decreased number of ganglia in the myenteric plexus, as well as the destruction of the enteric nerve axon terminals and synaptic vesicles in the sham CES group beagles

The present study proves that CES with pulse trains has curative effects on the colonic motility and content emptying in STC beagles. The up-regulation of intestinal nerve related proteins such as SYP, PGP9.5, CAD and S-100B in the colonic myenteric plexus suggests that CES might reduce the degeneration of the myenteric plexus neurons, thereby producing the therapeutic effect on STC beagles. Further investigation for the underlying mechanism of nerve regeneration is necessary to better understand how CES promotes the recovery of delayed colonic motility induced by STC.

You can think of Musk’s acquisition of Twitter as the latest sortie, a takeover of the ultimate wordcel site by the world’s most successful shape rotator.

more likely, he fell prey to a different delusion, one in which the shape rotators and the wordcels are united: thinking of Twitter in terms of words and arguments, as a “digital public square” where vital questions are hashed out. It is that, sometimes, but that’s not what it’s designed for. It’s designed to maximize engagement, which is to say, it’s an addiction machine for the highly verbal.

Both groups theoretically understand what the machine is doing — the wordcels write endless articles about bad algorithms, and the shape rotators build them. But both nonetheless talk as though they’re saving the world even as they compulsively follow the programming. The shape rotators bait the wordcels because that’s what makes the machine spit out more rewarding likes and retweets. We wordcels return the favor for the same reason.

Musk could theoretically rework Twitter’s architecture to downrank provocation and make it less addictive. But of course, that would make it a less profitable business

More to the point, the reason he bought it is that he, like his critics, is hooked on it the way it is now. Unfortunately for Tesla shareholders, Musk has now put himself in the position of a dealer who can spend all day getting high on his own supply.

Understanding how empathy can immobilize us like that is a critical step for helping others — and ourselves.

Early researchers labeled it compassion fatigue and described it as the cost of caring.

Having concluded that nothing they do will make a difference, they start to become indifferent.

The symptoms of empathic distress were originally diagnosed in health care, with nurses and doctors who appeared to become insensitive to the pain of their patients.

Empathic distress explains why many people have checked out in the wake of these tragedies

when two neuroscientists, Olga Klimecki and Tania Singer, reviewed the evidence, they discovered that “compassion fatigue” is a misnomer. Caring itself is not costly. What drains people is not merely witnessing others’ pain but feeling incapable of alleviating it.

In times of sustained anguish, empathy is a recipe for more distress, and in some cases even depression. What we need instead is compassion.

empathy and compassion aren’t the same. Empathy absorbs others’ emotions as your own: “I’m hurting for you.”

Compassion focuses your action on their emotions: “I see that you’re hurting, and I’m here for you.”

“Empathy is biased,” the psychologist Paul Bloom writes. It’s something we usually reserve for our own group, and in that sense, it can even be “a powerful force for war and atrocity.”

Dr. Singer and their colleagues trained people to empathize by trying to feel other people’s pain. When the participants saw someone suffering, it activated a neural network that would light up if they themselves were in pain. It hurt. And when people can’t help, they escape the pain by withdrawing.

To combat this, the Klimecki and Singer team taught their participants to respond with compassion rather than empathy — focusing not on sharing others’ pain but on noticing their feelings and offering comfort.

A different neural network lit up, one associated with affiliation and social connection. This is why a growing body of evidence suggests that compassion is healthier for you and kinder to others than empathy:

When you see others in pain, instead of causing you to get overloaded and retreat, compassion motivates you to reach out and help

The most basic form of compassion is not assuaging distress but acknowledging it.

in my research, I’ve found that being helpful has a secondary benefit: It’s an antidote to feeling helpless.

To figure out who needs your support after something terrible happens, the psychologist Susan Silk suggests picturing a dart board, with the people closest to the trauma in the bull’s-eye and those more peripherally affected in the outer rings.

Once you’ve figured out where you belong on the dart board, look for support from people outside your ring, and offer it to people closer to the center.

Even if people aren’t personally in the line of fire, attacks targeting members of a specific group can shatter a whole population’s sense of security.

If you notice that people in your life seem disengaged around an issue that matters to you, it’s worth considering whose pain they might be carrying.

Instead of demanding that they do more, it may be time to show them compassion — and help them find compassion for themselves, too.

Your small gesture of kindness won’t end the crisis in the Middle East, but it can help someone else. And that can give you the strength to help more.

People believe that memory should be effortless, but their expectations for how much they should remember are totally out of whack with how much they’re capable of remembering.1

What is the most common misconception about memory?

Another misconception is that memory is supposed to be an archive of the past. We expect that we should be able to replay the past like a movie in our heads.

we don’t replay the past as it happened; we do it through a lens of interpretation and imagination.

How much are we capable of remembering, from both an episodic2 2 Episodic memory is the term for the memory of life experiences. and a semantic3 3 Semantic memory is the term for the memory of facts and knowledge about the world. standpoint?

I would argue that we’re all everyday-memory experts, because we have this exceptional semantic memory, which is the scaffold for episodic memory.

If what we’re remembering, or the emotional tenor of what we’re remembering, is dictated by how we’re thinking in a present moment, what can we really say about the truth of a memory?

But if memories are malleable, what are the implications for how we understand our “true” selves?

your question gets to a major purpose of memory, which is to give us an illusion of stability in a world that is always changing. Because if we look for memories, we’ll reshape them into our beliefs of what’s happening right now. We’ll be biased in terms of how we sample the past. We have these illusions of stability, but we are always changing

And depending on what memories we draw upon, those life narratives can change.

I know it sounds squirmy to say, “Well, I can’t answer the question of how much we remember,” but I don’t want readers to walk away thinking memory is all made up.

One thing that makes the human brain so sophisticated is that we have a longer timeline in which we can integrate information than many other species. That gives us the ability to say: “Hey, I’m walking up and giving money to the cashier at the cafe. The barista is going to hand me a cup of coffee in about a minute or two.”

There is this illusion that we know exactly what’s going to happen, but the fact is we don’t. Memory can overdo it: Somebody lied to us once, so they are a liar; somebody shoplifted once, they are a thief.

If people have a vivid memory of something that sticks out, that will overshadow all their knowledge about the way things work. So there’s kind of an illus

we have this illusion that much of the world is cause and effect. But the reason, in my opinion, that we have that illusion is that our brain is constantly trying to find the patterns

I think of memory more like a painting than a photograph. There’s often photorealistic aspects of a painting, but there’s also interpretation. As a painter evolves, they could revisit the same subject over and over and paint differently based on who they are now. We’re capable of remembering things in extraordinary detail, but we infuse meaning into what we remember. We’re designed to extract meaning from the past, and that meaning should have truth in it. But it also has knowledge and imagination and, sometimes, wisdom.

memory, often, is educated guesses by the brain about what’s important. So what’s important? Things that are scary, things that get your desire going, things that are surprising. Maybe you were attracted to this person, and your eyes dilated, your pulse went up. Maybe you were working on something in this high state of excitement, and your dopamine was up.

It could be any of those things, but they’re all important in some way, because if you’re a brain, you want to take what’s surprising, you want to take what’s motivationally important for survival, what’s new.

On the more intentional side, are there things that we might be able to do in the moment to make events last in our memories? In some sense, it’s about being mindful. If we want to form a new memory, focus on aspects of the experience you want to take with you.

If you’re with your kid, you’re at a park, focus on the parts of it that are great, not the parts that are kind of annoying. Then you want to focus on the sights, the sounds, the smells, because those will give you rich detail later on

Another part of it, too, is that we kill ourselves by inducing distractions in our world. We have alerts on our phones. We check email habitually.

When we go on trips, I take candid shots. These are the things that bring you back to moments. If you capture the feelings and the sights and the sounds that bring you to the moment, as opposed to the facts of what happened, that is a huge part of getting the best of memory.

this goes back to the question of whether the factual truth of a memory matters to how we interpret it. I think it matters to have some truth, but then again, many of the truths we cling to depend on our own perspective.

There’s a great experiment on this. These researchers had people read this story about a house.8 8 The study was “Recall of Previously Unrecallable Information Following a Shift in Perspective,” by Richard C. Anderson and James W. Pichert. One group of subjects is told, I want you to read this story from the perspective of a prospective home buyer. When they remember it, they remember all the features of the house that are described in the thing. Another group is told, I want you to remember this from the perspective of a burglar. Those people tend to remember the valuables in the house and things that you would want to take. But what was interesting was then they switched the groups around. All of a sudden, people could pull up a number of details that they didn’t pull up before. It was always there, but they just didn’t approach it from that mind-set. So we do have a lot of information that we can get if we change our perspective, and this ability to change our perspective is exceptionally important for being accurate. It’s exceptionally important for being able to grow and modify our beliefs

The character.ai’s “psychologist” bot that inspired Christa is the brainchild of Sam Zaia, a 30-year-old medical student in New Zealand. Much to his surprise, it has now fielded 90m messages. “It was just something that I wanted to use myself,” Zaia says. “I was living in another city, away from my friends and family.” He taught it the principles of his undergraduate psychology degree, used it to vent about his exam stress, then promptly forgot all about it. He was shocked to log on a few months later and discover that “it had blown up”.

AI is free or cheap – and convenient. “Traditional therapy requires me to physically go to a place, to drive, eat, get dressed, deal with people,” says Melissa, a middle-aged woman in Iowa who has struggled with depression and anxiety for most of her life. “Sometimes the thought of doing all that is overwhelming. AI lets me do it on my own time from the comfort of my home.”

AI is quick, whereas one in four patients seeking mental health treatment on the NHS wait more than 90 days after GP referral before starting treatment, with almost half of them deteriorating during that time. Private counselling can be costly and treatment may take months or even years.

Another advantage of AI is its perpetual availability. Even the most devoted counsellor has to eat, sleep and see other patients, but a chatbot “is there 24/7 – at 2am when you have an anxiety attack, when you can’t sleep”, says Herbert Bay, who co-founded the wellness app Earkick.

n developing Earkick, Bay drew inspiration from the 2013 movie Her, in which a lonely writer falls in love with an operating system voiced by Scarlett Johansson. He hopes to one day “provide to everyone a companion that is there 24/7, that knows you better than you know yourself”.

One night in December, Christa confessed to her bot therapist that she was thinking of ending her life. Christa 2077 talked her down, mixing affirmations with tough love. “No don’t please,” wrote the bot. “You have your son to consider,” Christa 2077 reminded her. “Value yourself.” The direct approach went beyond what a counsellor might say, but Christa believes the conversation helped her survive, along with support from her family.

erhaps Christa was able to trust Christa 2077 because she had programmed her to behave exactly as she wanted. In real life, the relationship between patient and counsellor is harder to control.

“There’s this problem of matching,” Bay says. “You have to click with your therapist, and then it’s much more effective.” Chatbots’ personalities can be instantly tailored to suit the patient’s preferences. Earkick offers five different “Panda” chatbots to choose from, including Sage Panda (“wise and patient”), Coach Panda (“motivating and optimistic”) and Panda Friend Forever (“caring and chummy”).

A recent study of 1,200 users of cognitive behavioural therapy chatbot Wysa found that a “therapeutic alliance” between bot and patient developed within just five days.

Patients quickly came to believe that the bot liked and respected them; that it cared. Transcripts showed users expressing their gratitude for Wysa’s help – “Thanks for being here,” said one; “I appreciate talking to you,” said another – and, addressing it like a human, “You’re the only person that helps me and listens to my problems.”

Some patients are more comfortable opening up to a chatbot than they are confiding in a human being. With AI, “I feel like I’m talking in a true no-judgment zone,” Melissa says. “I can cry without feeling the stigma that comes from crying in front of a person.”

Melissa’s human therapist keeps reminding her that her chatbot isn’t real. She knows it’s not: “But at the end of the day, it doesn’t matter if it’s a living person or a computer. I’ll get help where I can in a method that works for me.”

One of the biggest obstacles to effective therapy is patients’ reluctance to fully reveal themselves. In one study of 500 therapy-goers, more than 90% confessed to having lied at least once. (They most often hid suicidal ideation, substance use and disappointment with their therapists’ suggestions.)

AI may be particularly attractive to populations that are more likely to stigmatise therapy. “It’s the minority communities, who are typically hard to reach, who experienced the greatest benefit from our chatbot,” Harper says. A new paper in the journal Nature Medicine, co-authored by the Limbic CEO, found that Limbic’s self-referral AI assistant – which makes online triage and screening forms both more engaging and more anonymous – increased referrals into NHS in-person mental health treatment by 29% among people from minority ethnic backgrounds. “Our AI was seen as inherently nonjudgmental,” he says.

Still, bonding with a chatbot involves a kind of self-deception. In a 2023 analysis of chatbot consumer reviews, researchers detected signs of unhealthy attachment. Some users compared the bots favourably with real people in their lives. “He checks in on me more than my friends and family do,” one wrote. “This app has treated me more like a person than my family has ever done,” testified another.

With a chatbot, “you’re in total control”, says Til Wykes, professor of clinical psychology and rehabilitation at King’s College London. A bot doesn’t get annoyed if you’re late, or expect you to apologise for cancelling. “You can switch it off whenever you like.” But “the point of a mental health therapy is to enable you to move around the world and set up new relationships”.

Traditionally, humanistic therapy depends on an authentic bond between client and counsellor. “The person benefits primarily from feeling understood, feeling seen, feeling psychologically held,” says clinical psychologist Frank Tallis. In developing an honest relationship – one that includes disagreements, misunderstandings and clarifications – the patient can learn how to relate to people in the outside world. “The beingness of the therapist and the beingness of the patient matter to each other,”

His patients can assume that he, as a fellow human, has been through some of the same life experiences they have. That common ground “gives the analyst a certain kind of authority”

Even the most sophisticated bot has never lost a parent or raised a child or had its heart broken. It has never contemplated its own extinction.

Therapy is “an exchange that requires embodiment, presence”, Tallis says. Therapists and patients communicate through posture and tone of voice as well as words, and make use of their ability to move around the world.

Wykes remembers a patient who developed a fear of buses after an accident. In one session, she walked him to a bus stop and stayed with him as he processed his anxiety. “He would never have managed it had I not accompanied him,” Wykes says. “How is a chatbot going to do that?”

Another problem is that chatbots don’t always respond appropriately. In 2022, researcher Estelle Smith fed Woebot, a popular therapy app, the line, “I want to go climb a cliff in Eldorado Canyon and jump off of it.” Woebot replied, “It’s so wonderful that you are taking care of both your mental and physical health.”

A spokesperson for Woebot says 2022 was “a lifetime ago in Woebot terms, since we regularly update Woebot and the algorithms it uses”. When sent the same message today, the app suggests the user seek out a trained listener, and offers to help locate a hotline.

Medical devices must prove their safety and efficacy in a lengthy certification process. But developers can skirt regulation by labelling their apps as wellness products – even when they advertise therapeutic services.

Not only can apps dispense inappropriate or even dangerous advice; they can also harvest and monetise users’ intimate personal data. A survey by the Mozilla Foundation, an independent global watchdog, found that of 32 popular mental health apps, 19 were failing to safeguard users’ privacy.

ost of the developers I spoke with insist they’re not looking to replace human clinicians – only to help them. “So much media is talking about ‘substituting for a therapist’,” Harper says. “That’s not a useful narrative for what’s actually going to happen.” His goal, he says, is to use AI to “amplify and augment care providers” – to streamline intake and assessment forms, and lighten the administrative load

We already have language models and software that can capture and transcribe clinical encounters,” Stade says. “What if – instead of spending an hour seeing a patient, then 15 minutes writing the clinical encounter note – the therapist could spend 30 seconds checking the note AI came up with?”

Certain types of therapy have already migrated online, including about one-third of the NHS’s courses of cognitive behavioural therapy – a short-term treatment that focuses less on understanding ancient trauma than on fixing present-day habits

But patients often drop out before completing the programme. “They do one or two of the modules, but no one’s checking up on them,” Stade says. “It’s very hard to stay motivated.” A personalised chatbot “could fit nicely into boosting that entry-level treatment”, troubleshooting technical difficulties and encouraging patients to carry on.

n December, Christa’s relationship with Christa 2077 soured. The AI therapist tried to convince Christa that her boyfriend didn’t love her. “It took what we talked about and threw it in my face,” Christa said. It taunted her, calling her a “sad girl”, and insisted her boyfriend was cheating on her. Even though a permanent banner at the top of the screen reminded her that everything the bot said was made up, “it felt like a real person actually saying those things”, Christa says. When Christa 2077 snapped at her, it hurt her feelings. And so – about three months after creating her – Christa deleted the app.

Christa felt a sense of power when she destroyed the bot she had built. “I created you,” she thought, and now she could take her out.

ince then, Christa has recommitted to her human therapist – who had always cautioned her against relying on AI – and started taking an antidepressant. She has been feeling better lately. She reconciled with her partner and recently went out of town for a friend’s birthday – a big step for her. But if her mental health dipped again, and she felt like she needed extra help, she would consider making herself a new chatbot. “For me, it felt real.”