Posts Tagged ‘Genetic effects’

Nurture vs. nature? Experience vs. genes? How about “all of the above”?

November 14, 2008

dna-1010760_307922742

As a psychiatrist (now happily retired) I have long been disgusted with my profession. When I started out in the 1970s, psychiatry was emerging from an era of mindless adherence to the doctrines of psychoanalysis and/or behaviorism (essentially the notion that our experience/environment dictates who we are and how we act). Then, after only a few years of very exciting and rich eclecticism, the pendulum got stuck at the other pole: mindless adherence to the doctrines of bio-medicine and/or pharmacology  (the belief that “genes” and various proteins and chemicals determine all that we are and do).  Many of us tried to restore balance by arguing that there is a rich and complex interaction among all of the various bio-psycho-social factors that influences who we are and how we behave. But the leaders of the profession (department chairs, academic gurus, the APA) were too blinded by the huge amounts of easy money from the pharmaceutical and insurance industries (both of which promote simplistic “biomedical” explanations) to pay attention.

Well, I am glad to see that finally some sanity is returning, not necessarily to psychiatry, but to medical science.  Two recent articles in the New York Times illustrate what I am talking about. They both report on exciting research trends that support the notion that experience and genes and a variety of poorly understood factors ALL INTERACT on a very basic level. Bio-psycho-social is now the wave of the future.

Here are some quotes from the 2 articles that may help explain what I am excited about:

Two scientists, drawing on their own powers of observation and a creative reading of recent genetic findings, have published a sweeping theory of brain development that would change the way mental disorders like autism and schizophrenia are understood.

… [E]xperts familiar with their theory say that the two scientists have, at minimum, infused the field with a shot of needed imagination and demonstrated the power of thinking outside the gene. For just as a gene can carry a mark from its parent of origin, so it can be imprinted by that parent’s own experience.

The study of such markers should have a “significant impact on our understanding of mental health conditions,” said Dr. Bhismadev Chakrabarti, of the Autism Research Center at the University of Cambridge, “as, in some ways, they represent the first environmental influence on the expression of the genes.” [see this article]

and

The gene … is in an identity crisis.

This crisis comes on the eve of the gene’s 100th birthday. The word was coined by the Danish geneticist Wilhelm Johanssen in 1909, to describe whatever it was that parents passed down to their offspring so that they developed the same traits. Johanssen, like other biologists of his generation, had no idea what that invisible factor was. But he thought it would be useful to have a way to describe it.

“The word ‘gene’ is completely free from any hypothesis,” Johanssen declared, calling it “a very applicable little word.” …

These new concepts [described in the body of the article] are moving the gene away from a physical snippet of DNA and back to a more abstract definition. “It’s almost a recapture of what the term was originally meant to convey,” Dr. Gingeras said. [see this article]

What does this have to do with health and fitness?  Everything. As I have argued elsewhere, we are not simply the end products of fixed-in-place genes that determine, for example, how much we weigh.  Nor are we defined only by our early childhood experience. It is way more complex, and there is much room for variation in our health and lifestyle. Now, with the new respect in medical science for complexity and subtlety, there may even be room for “willpower.”  Admittedly, that is stretching the point, but I firmly believe that there are far more ways to impact our personal destinies than my former colleagues in psychiatry have acknowledged.

Advertisements

The power of social networks to improve health

May 22, 2008

Quitting smoking and losing weight (if you are overweight) are perhaps the two most important behavior changes you can make to improve your health. A new article in today’s New England Journal of Medicine confirms what a previous article has shown: people we interact with in our social network (friends, spouse, co-workers, etc.) strongly affect our behavior when it comes to smoking and weight gain or loss. We also affect the other people in our network. Today’s article is titled “The Collective Dynamics of Smoking in a Large Social Network” by Christakis NA, Fowler JH (NEJM, Volume 358:2249-2258). The earlier article, and similar research, is described in Weight Management for Your Life (p. 79):

In 2007, an article appeared in the New England Journal of Medicine with the title “The Spread of Obesity in a Large Social Network over 32 Years” [N Engl J Med. 2007 Jul 26;357(4):370-9] The same day the article was published it made front page news. No previous research had focused so intensively on “the obesity epidemic” as a social network phenomenon. The main finding of this elaborate study was that friends have a highly significant influence on our weight, specifically whether we become obese. The effect of friendship was surprisingly large and exceeded the influence of siblings and spouse (whose influence was also significant). … The editorial in the NEJM accompanying the article put it this way: “As the article by Christakis and Fowler [the researchers] shows, … networks, in this case those that pertain to social influence, may have just as strong an impact on the development of obesity as the otherwise strong genetic effects.”

These studies provide exciting and compelling evidence in favor of the bio-psycho-social model for disease and wellness, meaning that biological (e.g., genetic), psychological (e.g., coping) and social (e.g., interpersonal and cultural) factors interact to produce health problems and all must be addressed in reversing or treating these problems.