Requisite Skills and the Meaningful Measurement of Cognition Among the Lowly Educated or Non-Medicated Schizophrenics

Requisite Skills and the Meaningful Measurement of Cognition. Richard S. E. Keefe, Michael F. Green, Philip D. Harvey. JAMA Psychiatry. Published online July 8, 2020. doi:10.1001/jamapsychiatry.2020.1618

In 1931, the noted neuropsychologist Alexander Luria, along with his supervisor Lev Vygotsky, led an expedition from Moscow to Uzbekistan with an honorable objective: to understand cognition in a population with low educational levels.1 However, they concluded that the minimal educational background of the population could prevent these individuals from engaging in the basic elements of a cognitive evaluation and that existing cognitive tests were not valid for their study population, so they created specialized tests that would be more appropriate. The study by Stone et al2 shares features of this expedition 90 years ago. Some of our era’s leading scientists have conducted an equally honorable collaborative project in the rural province of Ningxia, China, to assess individuals with chronic schizophrenia who have never received antipsychotic medications. By examining this population, the authors aimed to address the problem of the exclusion of underserved individuals from research on serious mental illness and to examine the longitudinal cognitive trajectory of schizophrenia in its natural untreated condition. The authors found that, in their cross-sectional sample, the duration of untreated psychosis was associated with worse cognitive performance. They specifically reported the association between cognition and the duration of chronic untreated psychosis as having partial Spearman correlation coefficients of 0.35 for the Brief Assessment of Cognition in Schizophrenia, Symbol Coding subtest; 0.24 for the Neuropsychological Assessment Battery, Mazes subtest; and 0.02 for the Brief Visuospatial Memory Test–Revised. These 3 assessments are conceptualized in western cultures as tests of processing speed, reasoning and problem solving, and visual memory. As with the findings of Luria and Vygotsky, given the distinct population in the Stone et al2 study, it is important to consider whether the assessments were suitable to the investigators’ purpose. The most relevant considerations are the validity of the tests for this group of individuals with low educational levels and the consequences of factors that could be associated with the passage of time itself, such as aging and changes in educational quality and opportunity.

To assess cognition in this study sample, the authors chose the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognition Battery (MCCB), which has been used to understand cognitive treatment response in clinical trials of cognition among patients with schizophrenia3 and has been accepted as a criterion-standard measure by the US Food and Drug Administration. The MCCB has been translated into more than 20 languages and has demonstrated reliability and validity in a wide variety of populations with schizophrenia across the world. Stone et al2 properly used a culturally adapted version of the MCCB that had been validated and normed in China and compared the results of participants with chronic untreated schizophrenia with those of a cohort of individuals without mental illness who had similar ages and educational histories. However, as described in standards published by the American Psychological Association,4 one of the important assumptions when administering tests such as the MCCB is that all participants have sufficient experience with the basic elements of testing to understand the intent of the test and perform the test procedures. Based on the educational level of the participants in this study, it is likely that these assumptions were not met, and the study’s primary findings may be associated with changes in education over time.

Any cross-sectional study of the association between longitudinal variables and cognition must recognize that performance on static tests of cognitive ability has been reported to improve (approximately 0.2 SDs per decade) over subsequent generations.5 There are many possible reasons for this improvement, which is called the Flynn effect6; these reasons include improvements in education, knowledge, health, nutrition, poverty, and environmental stimulation, among others.7 While the Flynn effect may be reversing in some western countries,6 it can be substantial in a rapidly evolving culture such as China, especially in the midst of an educational revolution. The median educational level of the participants in the Stone et al2 study was 3 years, and the median age of the participants was 52 years, with a range of 19 to 81 years. The study participants attended school between 1942 and 2004. Over the course of those 62 years, 2 rapid advances in education occurred that outpaced population growth. During the first period, from 1957 to 1960, the number of primary students attending school increased from 55 million to more than 90 million, and the number of middle school students doubled; during the second period, from 1966 to 1976, the number of middle school students increased from less than 15 million to more than 65 million.8 These increases in educational availability and quality were likely even more substantial in underdeveloped regions like Ningxia. Thus, given that the disease onset for most individuals with schizophrenia occurs during a narrow window in late adolescence, the older participants in this study would have been raised in a less advanced educational system. Early education focuses on the basic tenets of reading, writing, and arithmetic. Testing people who lack these fundamental skills creates challenges for the evaluation of cognition.

How, specifically, does the absence of relevant experience create challenges for the validity of a cognitive assessment battery? As an obvious example, consider a processing speed test with quickly moving stimuli that requires respondents to type letters on a smart phone. If test performance were compared between an individual aged 80 years who had no experience with the technology and an individual aged 25 years who had 15 years of experience with the technology, performance differences would likely be associated with the respondent’s experience with that technology, which was substantially different. Few, if any, investigators would consider the test results a valid measure of the participants’ cognition.

To those who received education in societies in which advanced education is the norm, a pencil would not be considered an advanced technology; however, those with limited experience in the use of a pencil will likely have difficulty completing tests that require drawing figures from memory or writing numbers quickly, and such adept use of a pencil is required for 4 of the 10 tests in the MCCB. Previous research on performance-based tests in China reported that, with regard to test performance, the consequences of low educational level were greater than those of a schizophrenia diagnosis, and the most difficult task for test respondents was writing their names using a pencil.9 Measuring the association between the duration of illness and cognition in a cross-sectional study is problematic when older participants have limited experience with the tools required for performance.

Revising the traditional instructions of a test by including additional practice trials and explanations, as done in the Stone et al2 study, may be insufficient. Just as children who are not exposed to human voices during early developmental periods are likely to struggle with language through adulthood, children who do not master fundamental skills, such as writing, during early education are likely to have the remainder of their lives shaped by the absence of those skills, and they may never be able to acquire the skill levels of those who received the requisite training.

The results of the Stone et al2 study illustrate the importance of requisite skills for cognitive assessment. The tests that were associated with duration of illness shared a common feature: all 3 of them required the use of a pencil. Only 1 of the 7 tests that were not associated with illness duration involved pencil use. Those tests mostly involved verbal interaction, which is, of course, a part of everyday life among people with lower and higher educational levels alike, so formal education for that skill was not necessary.

Leading anthropologists have asserted that the neuroanatomy and cognitive capacity of humans as a species have not changed in 30 000 years.10 However, our methods for assessing cognitive ability have changed substantially based on the extent and quality of the education we have received, which has allowed us to perform well on those same assessments, and methods will continue to change as the technologies we use to perform assessments advance. Conducting studies of cognition among people, near and far, who live in regions with underdeveloped educational systems is an important endeavor, but these studies may require special considerations for assessment and the development of specific tests that allow measurement of cognition that is independent of the confounding factor of inexperience with the requisite tools. Cognitive assessments may otherwise remain confounded by variability because of cultural advantages that provide early experience with the requisite tools for only a portion of the population.

From 2015... Reductionist evidence in science debate by laypersons is viewed as more explanatory & conclusive than comparable evidence from macrolevel processes; the preference for reductionist information does not go away with education

From 2015... The Influence of Reductionist Information on Perceptions of Scientific Validity. Rebecca Rhodes. PhD Thesis, Michigan Univ., Psychology, 2015. https://deepblue.lib.umich.edu/bitstream/handle/2027.42/111352/rerhodes_1.pdf?sequence=1&isAllowed=y

ABSTRACT
The ability to reason scientifically about evidence is an important skill for many everyday decisions, ranging from whom to choose in the next presidential election to whether or not to immunize your child. Evidence for the importance of scientific reasoning can be found in continued attempts to improve the teaching of reasoning skills within the educational system. However, in order to develop effective strategies for reasoning about scientific evidence, it is important to understand lay conceptions about what it means for something to be “scientific”. In the present work, I examine the influence that reductionist evidence – that is, evidence that comes from micro-level processes, such as biological or neurological processes – has on perceptions of scientific validity. Across eight experiments, I demonstrate that reductionist evidence tends to be viewed as more explanatory and more conclusive than comparable evidence from macrolevel processes, such as psychological processes. Interestingly, the preference for reductionist information does not go away with education. In fact, people with greater scientific literacy are even more likely to assume that reductionist information is superior to macro-level information. I interpret this finding as evidence that the preference for reductionist information is not irrational, but instead an expected consequence of traditional science curricula. I demonstrate several important implications of reductionist preference. For example, this preference increases the likelihood of making causal inferences from the results of research studies that suggest micro-level – as opposed to macro-level – mechanisms, and it can decrease the size of the sample one needs to feel confident in accepting conclusions from these studies. I relate these findings to current pervasive issues in the scientific community, such as publication biases and the prevalence of underpowered studies utilizing reductionist approaches. I also discuss educational strategies that could encourage holistic thinking about science – specifically, emphasizing science as a tool for thinking strategically about everyday phenomena, regardless of the level of analysis, rather than a collection of discrete facts obtained by the use of technology and equipment.

Blame Crime on Name? People with Bad Names Are More Likely to Commit Crime in Continental China

Bao, Han-Wu-Shuang, Jianxiong Wang, and Huajian Cai. 2020. “Blame Crime on Name? People with Bad Names Are More Likely to Commit Crime.” PsyArXiv. July 9. doi:10.31234/osf.io/txhqg

Abstract: Prior evidence has revealed the interpersonal and intrapersonal costs of bearing “bad” names. The current research examined whether bad names predicted a more serious social outcome: criminal behavior. We found name-crime links based on a large dataset of 981,289 Chinese criminals (as compared to the whole Chinese population and a national representative sample of 1,000,000 non-criminal controls). People whose names were unpopular, negative, or implied lower warmth/morality were more likely to commit property and violent crime, whereas people whose names implied higher competence/assertiveness were more likely to commit violent and economic crime. Critically, lower warmth/morality of name still robustly predicted crime when controlling for demographic confounds and addressing alternative explanations. Furthermore, possessing a less warm/moral name predicted the motive for intentionally committing crime. These findings demonstrate the ethical costs of bearing bad/immoral names and enrich the understanding of how social-cognitive dimensions (warmth–competence) are associated with human behavior.


          “As his name is, so is he; Nabal is his name, and folly is with him.”
                            —Bible (1 Samuel 25:25)

Bad names may invite trouble. As the Bible says, people with a “bad” name may also possess a “bad” trait. Substantial evidence has revealed that bearing a bad (e.g., unpopular, undesirable) name predicted worse interpersonal outcomes (e.g., being unfavorably treated by others; Gebauer, Leary, & Neberich, 2012) and worse intrapersonal outcomes (e.g., poorer mental health; Twenge & Manis, 1998). Some preliminary evidence has even shown that juveniles with a less popular name have a higher tendency toward delinquent or problematic (Kalist & Lee, 2009). In this research, we focused on a possible link between bad names and criminal behavior—a more serious social outcome that hazards both other people and the whole society. Specifically, we investigated the name-crime links comprehensively across seven categories of crime and four dimensions of name. Examining the name-crime links will uncover the ethical costs of bearing bad names beyond its well-documented costs on interpersonal and intrapersonal outcomes.

Baboons (Papio anubis) living in larger social groups have bigger brains

Baboons (Papio anubis) living in larger social groups have bigger brains. Adrien Meguerditchian et al. Evolution and Human Behavior, Jul 9 2020. https://doi.org/10.1016/j.evolhumbehav.2020.06.010

Abstract: The evolutionary origin of Primates' exceptionally large brains is still highly debated. Two competing explanations have received much support: the ecological hypothesis and the social brain hypothesis (SBH). We tested the validity of the SBH in (n = 82) baboons (Papio anubis) belonging to the same research centre but housed in groups with size ranging from 2 to 63 individuals. We found that baboons living in larger social groups had larger brains. This effect was driven mainly by white matter volume and to a lesser extent by grey matter volume but not by the cerebrospinal fluid. In comparison, the size of the enclosure, an ecological variable, had no such effect. In contrast to the current re-emphasis on potential ecological drivers of primate brain evolution, the present study provides renewed support for the social brain hypothesis and suggests that the social brain plastically responds to group size. Many factors may well influence brain size, yet accumulating evidence demonstrates that the complexity of social life is an important determinant of brain size in primates.

Keywords: Social brainGroup sizeBrain sizeBaboon

Helping was facilitated in rats that had previously observed other rats’ helping and were then tested individually; the influence of bystanders on helping behavior in rats seems close to human helping

The bystander effect in rats. View ORCID ProfileJohn L. Havlik et al. Science Advances Jul 8 2020:Vol. 6, no. 28, eabb4205. DOI: 10.1126/sciadv.abb4205

Abstract: To investigate whether the classic bystander effect is unique to humans, the effect of bystanders on rat helping was studied. In the presence of rats rendered incompetent to help through pharmacological treatment, rats were less likely to help due to a reduction in reinforcement rather than to a lack of initial interest. Only incompetent helpers of a strain familiar to the helper rat exerted a detrimental effect on helping; rats helped at near control levels in the presence of incompetent helpers from an unfamiliar strain. Duos and trios of potential helper rats helped at superadditive rates, demonstrating that rats act nonindependently with helping facilitated by the presence of competent-to-help bystanders. Furthermore, helping was facilitated in rats that had previously observed other rats’ helping and were then tested individually. In sum, the influence of bystanders on helping behavior in rats features characteristics that closely resemble those observed in humans.

DISCUSSION

Here, we demonstrate bidirectional effects of bystanders on rat helping. The effect of rat bystanders depends on their capacity to help, with helping antagonized by incompetent helpers and facilitated by additional potential helpers. Recent evidence that naïve human bystanders facilitate or, at the very least, have no negative effect upon helping (9, 15) suggests that human helping may also be bidirectional.

Two incompetent helper rats antagonized helping more than did one. Similarly, helping is progressively more suppressed as the number of human bystanders increases (3). Another similarity between the rat and human versions of the bystander effect is that subjects are only influenced by bystanders of the same in-group (16). These similarities raise the possibility that similar circuits support the classic bystander effect in rats and humans. If this is the case, then either rats have greater cognitive and cultural capacities than currently appreciated or human helping operates independently of rational reasoning and cultural influences. Evidence that the building blocks for helping are fundamental circuits involved in parental care and affiliative interactions are shared across mammals (17) supports the latter possibility.

Incompetent helpers did not prevent or retard the initiation of helping. The first day of opening was the same for rats tested with one additional rat and for control rats and was even earlier for rats tested with two additional rats. It is likely that additional rats, regardless of their competency to help, hasten the initiation of opening by socially buffering potential helpers. Social buffering refers to the improved recovery from stressors afforded by the presence of conspecifics (18, 19). Of particular relevance here, conspecifics reduce the autonomic and behavioral expression of anxiety in response to novel environments (18). In the trapped rat paradigm, social buffering likely reduces the stress of the testing conditions, facilitating proximity to the centrally located restrainer door and thereby increasing opportunities for door-opening. After the first door-opening, however, social buffering can no longer account for the disparate effects on opening elicited by the presence of additional rats of different types. Additional rats that are incompetent to help exert a negative effect on reinforcement, whereas those that are potential helpers appear to facilitate reinforcement, as revealed by the reduction in helping shown by rats tested alone following group testing.

The show of indifference by incompetent helper rats is distinct from, and far more detrimental to, motivating helping than the absence of additional rats in control conditions. In groups, bystanders influence a rat’s interpretation of his own behavior, whereas, when solo, a rat’s own internal assessment of his actions rules. For a rat that has only experienced solo testing, this assessment is enough. Yet, when solo testing follows group testing, the self-reward pales in comparison to the recalled group reinforcement. It is possible then that just as rats tested solo after having the group experience failed to reinforce their behavior, rats tested solo following testing with incompetent helpers may show a positive rebound in reinforcement and helping.

The influence of bystanders promotes conformity, the matching of one’s behavior to that of a group. Conformity need not be limited to helping. Rats who did not eat an unpalatable food when alone ate it in the presence of a “demonstrator rat” who was eating the unpalatable food (20). Thus, the effect of bystanders may be more inclusively imagined as one that promotes conformity in all manner of observable behaviors.