An In Depth Look at a Mindfulness and Stress Study

My former classmate at the University of Hartford, Tonya Jacobs, had an article described in the Huffington Post titled Mindfulness Meditation Could Lower Levels Of Cortisol, The Stress Hormone.  It described her study which originally appeared in the Journal of Health Psychology.  It talks about how a study was conducted of those who participated in a three month meditation retreat where it says mindfulness was measured along with cortisol levels in saliva as a measure of stress.  If found that cortisol (a hormone that strongly indicates stress) levels were decreased from the beginning of the retreat to the end as mindfulness increased.  They warned that there was no control group.

From past experience I know that the news media often leaves out important details of a study and can be bad at interpreting the results of the studies.  I thought I would take a look Jacobs et al. (2013) original article which has a lot more detail to allow one to replicate the study.  In the methods sections they state that there was a treatment group of 30 for those who participated in the retreat and a control group of 30 who were wait listed for the retreat using stratified random sampling to control for any potential confounding variables such as BMI (Body Mass Index which is weight divided by height squared and is a crude measure of obesity), handedness and IQ.  The wait listed group did receive the mindfulness intervention after the treatment group.  

The authors do not discuss if there is a difference between the wait list and non waitlist groups in cortisol or mindfulness levels especially during the time where the wait list group was not receiving the intervention.  This may not have been feasible during the study as the individuals were probably scattered all over the US and measurements of cortisol and mindfulness could not be taken without great cost.  Participants were paid during the retreat.  Three participants had complete data and were excluded from the study.  

The results showed no overall effect of cortisol decrease from pre to post measurements but did significantly decrease for BMI.  Mindfulness significantly increased between the pre and post.  The pre and post cortisol levels were significantly negatively correlated with mindfulness as measured by a 37 item questionnaire which was previously validated.  Negatively correlated means that as mindfulness increases cortisol levels decrease.  This effect was still significant after adjusting for age and BMI.

The authors acknowledge that this study is correlational and does not establish a cause and effect relationship between meditation, mindfulness, and stress.  The article in the Huffington Post seems to suggest the same thing by stating that there is no control group.  Because of the difficulty in doing this type of research, the need for more of theses types of studies is established.  Experimental studies with a well defined control and treatment group with all other confounding variables are adjusted for are ideal for establishing cause and effect relationships.  The ideal of research is seldom met.  When the situation is less than ideal, converging validation with many different methods is needed to accomplish the same cause-effect relationship.  


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Controversy over the New Psychiatric Diagnostic and Statistical Manual

Since 1952, the American Psychiatric Association has published the Diagnostic and Statistical Manual of Mental Disorders (DSM for short) which has spelled out the criteria for diagnosing all of the known psychiatric disorders.  It has undergone four editions and two revisions with the fifth one due out this year.  In the past there were controversies such as whether or not homosexuality should be included in the manual and it was dropped from the DSM in the 1970s.  New changes are made to the manual as new information is brought to light and cultural views of what is and what is not a disorder change.

This year the fifth edition of the DSM proposes changes to 13 current diagnoses.  The most controversial of these is Asperger's Syndrome which is being eliminated as a separate diagnosis and is being placed under the  Autism spectrum of disorders.  Unlike the gay community in the 1970s, has deletion been met with resistance by those who have been previously diagnosed with Aspergers.  Other changes have been made to dyslexia, ADHD and other diagnoses.  At least 10 new diagnoses are included in the DSM such as post-traumatic embitterment disorder, skin picking disorder, and compulsive hoarding (maybe the American Psychiatric Association all watches TLC). 

Previously the DSM has been accepted as the Bible of psychiatric diagnosis but, right before the DSM-V comes out the National Institutes of Mental Health (NIMH) has announced that it will not use it as a standard for diagnosis in their research.  This means that they will not be funding studies that use the DSM-V as a diagnostic criteria.   The reason given by the NIMH is that “Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure."  This suggests a desire for exactness which the behavioral sciences have lacked relative to the physical sciences sometime termed physics envy. 

There have been advances in neuroscience and genetics which shed light on many of these disorders and made many pharmacological treatments possible but the main reliance for diagnosis is still on behavioral symptoms.  The NIMH is creating a Research Domain Criteria for Diagnoses (RDoC) based on biological criteria which it believes are more objective.  The behavioral symptoms are often subject to interpretation and often still not enough is known about the brain and genetics to differentiate between pathologies.  Consider the figure at left.  Is this a rabbit with its head held high or a duck?  This image is subject to interpretation just as all behaviors and incomplete scientific data are.  Science is fundamentally a human endeavor where politics often plays a role.  
  

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How Do You Use and Consume Math?

People often assume that because I am a statistician I am a whiz at high math.  The graph above from a survey by Northeastern University seems to explain why.  The vast majority of Americans do not use any math above fractions (an estimated 78% or 1-22% which is the opposite of the any more advanced category on the graph above).  The graph below shows what type of job uses what type of math with upper blue collar like upper level trades and mechanics using each type except statistics which is upper white collar.

Although an estimated 78% of Americans do not use advanced math on a daily basis, 100% depend on them, often without question, to make decisions everyday.  Below is an example on The Colbert Report of how this blind faith can go seriously wrong.

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Here is an interview with Stephen Colbert by the UMASS grad student who exposed their error in an Excel spreadsheet.  One can learn a lot by simply doing a little digging.  Some say it is not necessary to teach advanced math to our school students if they are not going to use it in their work but the critical thinking skills that are gained can come in handy if we choose to use them in other areas.

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Mathematics above calculus is a different world altogether as can be seen in the BBC documentary from 1984 A Mathematical Mystery Tour which describes how the philosopher Bertrand Russell needed 362 pages to prove that 1+1=2.  I added an online poll to survey users of this blog on their background and comfort level in math.  The polling will be open until May 26.

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New Census Population Clock and Guardian Terrorism Data Graphs.

The census bureau has made it's online US and World population clock available for embedding on other websites.  Above you can see the estimate of the US population (over 315 million) based on the 2010 census, estimates of birth, death and immigration rates.  If you click on the World Population tab you can see the estimate of the world population (over 7 billion) based on the current world wide birth and death rates.  Below you can see Gapminder statistician Hans Rosling give a TED talk on how he forecasts the world population will stabilize at around 10 billion by 2050.

The Guardian Newspaper of London has a data page with lots of valuable graphics of data.  Below is one of terrorist attacks in the lower 48 US states since 1970 until 2011.  Larger circles indicate more deaths.  Below is an embedded interactive graph showing how the total number of attacks has decreased since 1970 while the number of fatalities with the exception of spikes in 1005 and 2001 has remained relatively steady over the same period.

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Get the Lead Out

A new survey by the Centers for disease control or CDC suggests that about 500,000 children in the US have low blood lead levels (defined as 5 micrograms per deciliter) from 2007-2010.  This shows an 8.6% decrease compared to the last survey period in 1999-2002.  The graph at the left shows that there are higher percentages among african americans, the poor, and those who live in housing built before 1950.  

Many buildings built before 1950 still have paint that is lead based and have plumbing with lead pipes.  These paints were phased out but it is very expensive to replace and it is better in the long run just to build new housing to replace the paint.  The paint can flake off and when ingested by children can cause developmental disabilities (the now politically correct term for mental retardation) and or learning disabilities.  

In the lab (on animal studies) and in correlational studies no dosage level of lead has been found that is completely benign on the brain.  It has a negative effect on the blood brain barrier which protects it from other toxins and has many other negative effects on intelligence test scores and brain function.  

The negative effects of lead exposure were recognized by Greek physicians as early as the 2nd century BC.  There is a theory that it contributed to the decline of the Roman Empire though that is controversial.   It was used heavily in the industrial revolution and in gasoline in the 1920s.  A way to test the theory would be to measure residual lead levels in the remains (teeth, bones, and if lucky hair) of the Roman citizens relative to those in the surrounding Barbarian tribes which sacked the empire from AD 410-476.  If the levels were higher in the Roman citizens it would support the theory.

It was phased out starting in 1978 in the US but the effects are still felt with leaded gasoline getting into the atmosphere through auto emissions, then into rain water, and finally the soil where it can remain for many years.  Other countries do not have as strict regulation on lead as the US does now.  

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Explanation of Washington Post Health Care Cost Graphs

The Washington Post has come out with a post in Ezra Klein's blog titled 21 graphs that show America’s health-care prices are ludicrous.  Two of them are posted here showing how the average prices of angiograms and angioplasties are double those of the next highest country.  For example an angiogram costs an average $914 in the US while costing  an average $378 in the next most expensive country, Chile.  The graph also shows the range of costs in the US with the 25 percentile cost being $173 (between Spain and Switzerland, possibly at the Veteran's Administration) and the 95th percentile being $2,430.

Likewise the average cost of an angioplasty in the US is $28,182 while it is $14,366 in the next most expensive country, the United Kingdom of Great Britain.  At the 25th percentile in the US the cost is $16,533 which is close to Great Britain.  The upper end of the scale cost (95th percentile) is $61,649.  This is four times the cost of Great Britain.

There is a similar pattern in the other 19 graphs that are presented in the article.  The range in costs suggests that price gouging does not occur everywhere in the US system.  Stephen Brill has a good expose in Time Magazine on why medical bills are so high.  

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Today's 'Bible' Prophets

John the Baptist baptizing Jesus

The Bible has been a big ratings bonanza for the History Channel and the Lifetime Network.  Over and over it relies on the main characters such as Saul, David, Solomon and Nebuchadnezzar being guided by the prophets like Samuel, Nathan, Isaiah, and Daniel.  Prophets are like fortune tellers in that they are messengers from God about the future to warn others.  In the Bible every time their advice wasn't followed there was trouble.  Other figures such as Abraham, Moses, and Jesus had traits of both leaders and prophets.  Christians believe that John the Baptist (pictured on the right baptizing Jesus) was the last prophet while Muslims of course believe that Muhammad was.

Oracle at Delphi

Other cultures have relied on fortune tellers, soothsayers,  and oracles such as the Oracle at Delphi depicted by Michelangelo at the left.  The miniseries The Bible did not talk about false prophets.  Today scientists often play the role that the prophets used to play to guide our leaders and the masses.  Global warming/climate change is a classic example of the warning that science gives us about the future.  It is based on evidence and probability theory, and then updated with future evidence which so far supports their claims.  Their predictions are adjusted as the evidence dictates.

Reading scientific data is often like reading tea leaves in that your trying to see relevant patterns from seemingly chaotic things.  In the past prophets, oracles and the like received their messages in visions be it in dreams or hallucinations.  Some are thought to have had temporal lobe epilepsy which causes hallucinations.  The Oracle at Delphi was exposed to natural gasses in her temple that caused her to hallucinate.  The good seers were able to interpret the visions in relation to the real events going on around them while the false prophets, like the one who predicted the world would end on May 21, 2011, were not.  Of course scientists are wrong sometimes too for a variety of reasons.  That is why one must be cautious about arriving at conclusions about the data that they see.

The middle episodes of The Bible focus on the Jews wars with the Philistines.  There are many killed in the miniseries at the behest of the prophets by Joshua, Samson, and David.  The word Philistine has the same origin as Palestine though the familial relationship between the two is unclear.  Is this pro zionist propaganda for Isreal's actions in the Palestinean territories today?  Much has been made of the series depiction of Satan looking like Obama but I've heard little discussion of its depiction of war.  The YouTube clip above shows the producers justification for their depiction of David and his killing of Philistines.  I personally liked the miniseries Jesus of Nazareth (though it unrealistically depicts Jesus as having blue eyes) from the 1970's better because it focused on teachings rather than relying on signs and special effects.

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