Impact of early life adversity on reward processing in young adults (2014)
journals.plos.org
journals.plos.org
They learn that life is completely unpredictable, that opportunities for reward should be taken immediately because they will not be there later, they never learn to spend extended time on learning anything or saving money for the future because they have never seen anyone in their life do those things.
A few manage to figure it out anyway, but most are doomed to repeat all of that as parents with their own kids. It's sad.
Consider, life was far more unpredictable just a few hundred years ago. Literally stubbing your toe in the forest could go septic and then you were dead. Violently so. Bad harvests could happen with no forewarning at all.
You're equating psychological harm and learned patterns of behavior that are unresourceful with physical accidents, without explaining why we should see them as comparable.
Even if they were comparable, who's to say Neanderthal younglings with badly stubbed toes didn't also have skewed reward processing as adults?
My post is specifically in response to the one above me. It is framed with modern events and pushing that they are obviously going to seem unpredictable to people. My assertion is that they can be seen that way, sure; but don't think this is somehow a modern thing.
To your point, I would expect that reward processing is influenced by these events, sure. I would also expect any indoctrination that was happening at the same time to stick. My current bias is to expect indoctrination to stick more effectively than raw experiences. And yes, this is somewhat cheating because the indoctrination is almost certainly done to compliment experiences.
i'd rather think it was the demand for an explanation for those events. and just like any sufficiently advanced technology is indistinguishable from magic, so is any unexplainable event indistinguishable from an act of god.
While I think you can almost make the case that there are some commonalities between origin stories, I think you would be stretching credibility a fair bit there.
This also hits a pretty tough point with regards to other animals. Do they have religions?
given the dominance of monotheistic religions this is actually happening. there is no need for origin stories to have commonalities because the convergence can also happen through replacement. if every group comes up with their own explanation for the different experiences they have, their stories are naturally going to differ, and that is what we see in history. but also, commonalities are there. pretty much all stories have some kind of creator of the universe and many refer to someone who will come and bring salvation.
Yes, you can stretch some stories to say there are commonalities. But you are doing some heavy stretching. And you still don't address other social animals. Do they have religions? Why not?
how are the commonalities a stretch? they are self evident: somehow some entity created the universe. somehow this creator is communicating with us, not just once, but multiple times, and they will communicate again in the future. everything else is the content of that communication, and for that there is no need of any further commonality even though there still are many.
i am not addressing animals because that is completely out of scope. our understanding of the consciousness of animals is still very limited, and even if it is shown that animal are potentially capable of such higher order thinking, as long as we can't actually able to communicate with them, we won't know what they are thinking. the question if animals have a religion is therefore unanswerable for the time being.
Animals have absolutely been shown to be able to communicate. They are unable to persist this teaching in the wild. Which, again, is to my point.
speaking of commonalities, this subthread has diverged from the original topic quite a lot and in an odd way is actually converging with the discussion on "Life is not a story" https://news.ycombinator.com/item?id=41876979
regarding animals, i don't get which point you are making there.
Point on animals is that it isn't just the story telling that propagates religion and similar, but persistent story telling. Writing things down and learning the symbols of previous generations is a fairly uniquely human activity.
to summarize the argument and bring it back to the main topic, i'd like to argue that adversity influenced storytelling which created religion and religion necessitated priests. so yes, without priests religions may not have persisted, but that's like saying without farmers farming would not have taken hold and we would still all be hunter/gatherers.
This is not true at all.
Some survive, but many die from the things you've described. Of those that survive, many fail completely to build a great life afterwards. They succumb to alcoholism, other addictions, and many die later from suicide.
Talk to any therapist and you'll find out that human fragility is the rule rather than the exception. After traumatic events, even those that "still manage to build a great life", as viewed from the outside, are often suffering greatly on the inside. Some of them manage to heal themselves with therapy and loving supportive relationships, but a great many don't. Which is why cycles of trauma unfortunately get passed on.
Certainly, I can be viewed as stereotypically successful by my buddies. Certainly, because the mask we wear should be strong and never come off. But in my nights alone, or even in my therapy sessions, who could possibly see that 'me'?
I have come to realize, though, that most people who didn't suffer much, refuse (implicitly, not explicitly) to empathize with those who have -- perhaps even I may be included in this group which 'refuse implicitly' at time. It's not that big of a deal, though. (Generalized) Empathy is a difficult skill to train.
I don't think we're claiming life isn't "worth living" after adversity. Just that it's somewhat obvious that they will make similar mistakes due to the challenges they face, at least more frequently than those who do not face such adversities.
The way you say 'look at all the people' implies that a lot of people survived and had good lives, but this needs to be weighed against the number of people total that entered concentration camps to know if this is actually a meaningful number of people to validate your assertion or not.
My guess is that someone who went into a concentration camp were much less likely to live a life worth living than people who did not simply because a large number of them lived a life of torture and then death.
That doesn't mean that such factors don't DRASTICALLY reduce the odds of this happening. Moreover, some people being able to build a good life after such trauma doesn't mean that said trauma isn't a hinderance.
The main thing is that people have to learn that, paraphrased for brevity, life in the "ends" requires a different set of skills to life in the more civilised parts of society.
You have to relearn how to function. Some don't.
As someone with pretty much the upbringing you described, I don't think this was the takeaway.
For me personally, I learnt adaptability, how to adjust to new situations and people quickly.
I saw what my parents did and said "I don't want to be like that".
The downside is, it's hard to answer "where are you from?", or to know where home is, and it's especially frustrating as an adult to see your parents continue to make bad decisions, to continue to be broke etc.
I know everyone is different, but anecdotally my sister and brother also seem to be doing relatively well.
In fact in one of the interviews Elon talks about implementing structured adversity.
Don't get me wrong, I fully agree that life experiences are their own teaching. However, it seems clear that a coach/teacher added to the exact same experiences can lead to different learning. Curious if folks have any links to studies that disprove that?
One teacher recognized I had a learning disability at elementary level before teachers were trained on that kind of thing. Was able to work through that over time.
HS counselor nominated me for a program that involved a long weekend trip to a medium sized university city. Never understood why I alone was chosen over peers.
I think it happens to a lot of kids that way, it didn't take a village, curriculum or a coordinated effort. Just one or two educators doing one thing and changing a life completely. I'm sure just one authority figure over time can have a huge impact.
1. Dysfunctional reward processing in parents plausibly causes early life adversity in their children, and
2. Dysfunctional reward processing, like practically every other mental trait, is to some degree heritable.
Without controlling for genetics it would be impossible to distinguish the effect of early life adversity from the effect of being the child of the type of parent who creates an environment of early life adversity.
I think it’s plausible that shared environment plays a role, but papers that don’t even try to address genetic confounding aren’t serious.
What is a dysfunctional reward pathway?
Basically a lower-than-expected response to reward anticipation and a higher-than-expected response upon reward delivery.
I.e. the typical ADHD problem of instant vs delayed gratification and how the brain responds to it.
Neurotypical people’s brains seem to be better at rewarding in anticipation and not just on actual delivery.
IIUC
My whole life I could barely sustain a conversation with someone because the moment they started speaking I'd reflexively begin thinking about something else. But when I tried Adderall I could actually have genuine conversations with people, hearing them and thinking about what they were saying and then responding, doing this repeatedly for many minutes. It felt like a superpower.
sometimes i try to reward myself conscious of something and it works. for example i think conscious about how if i finish a little task it would make me happier. then i kind of force a reward feeling towards the anticipation to have something done. and it works. i feel motivated to do little tasks. and if i do this repeatedly and on bigger and bigger tasks it reduces my adhd symptoms… but then there is suddenly something else to do and then i do this while thinking about the things i should do and what i could do next and suddenly i start 10 things and how the fuck did this happen … where are my keyes? :)
I used to have a little jingle I'd subvocally sing: "Badge, wallet, keys, notes, laptop, phone; Owen's fed, doors locked, leaving home". It was my checklist. It's why I'll throw my backpack in the car even if I'm going to meet friends: It just helps me put aside the preparation anxiety to just do the same thing every time.
Those routines are helpful. I also keep prepacked bags - a backpack for work, a gym bag with copies of keys for gym, etc etc. I even have two or three pre-stocked wallets for those bags or I'll get stuck in optimizing my credit card selection for an activity. My wife laughs, but she's the one who loses her phone, cannot find her wallet, and to this day has no idea where her car keys are.
Atomic Habits was helpful. It's about how to set up your subconcious so you don't have to painfully think about every decision all the time. Maybe it's made me less able, maybe not. But going to the gym at 3 has become so routine that I find myself up in the kitchen before I realize why I left my office.
I'm guessing this is all pre-emergent dementia, honestly.
That utility alone accounts for gambling addiction. Consider that slot machines are a game of random chance against fixed odds. Every time you play the chance of winning is random against the same odds just like the last time. The more a person plays consecutively without winning, a losing streak, the more the brain anticipates winning the next time which builds dopamine anticipation in the brain even though a person is just as likely to continue losing into the future on each iteration.
What's more interesting is that this addiction behavior can be flicked on or off instantly, like a light switch, with medication. What's more strange though is that medically induced gambling addiction, yes that is a very real thing, effects females far more than males. I don't know if the cause of difference in behavior by sex is identified.
I have some addictive/compulsive behaviors that have been hard to shake. GLP-1 agonists look promising, but I'm not sure how to get a prescription since I'm not overweight.
My suggestion, and I am not doctor or providing medical advise, is to make the addictive stimulus inconvenient. Each iteration must include more steps to increase labor of effort and each iteration must also take much longer to complete. This will re-balance the brain from prior established condition. The more painful, disconnected, or costly (in time and not money) an activity becomes the more dedicated you must become about achieving that activity before addiction can set in.
Assumes there is a limit to the amount of effort addicts are willing to put into getting their next dose. Easily disproved by the experience of caring for opioid addicts. Lesser drugs, even. Once upon a time, a seemingly rational benzodiazepine addict got so frustrated with my attempts to get him off of it he rose up from his seat ready to punch me in the face.
There are addicts out there who would sell their own mother for a dose. And I'm not just saying that. One of my former neighbours turned into one of these guys. People wouldn't believe the stories if I told them.
Kind of. The captain of the ship is motivated, but the helmsman needs to get his shit together.
I thought dopamine was both the anticipatory neurotransmitters and the reward. But the reward neurotransmitters are different, they're your endorphins, endogenous opioids.
If dopamine only happened once you received a reward, it would not cause you to get you to actually act before hand.
It's still hacking the brain if you make the perfect Skinner box and take all their life savings and then some
Dysfunctional brain : The reverse.
(Which makes me go hmm)
I would additionally posit the more "potential" the youth were given the perception of having, the dramatically worse the comparative results.
I can distinctly, acutely, remember sondering others' unobservable lives, long before I had any distinct sense of agency; comparing their actions against their words and little affects either had on outcomes.
So few times in my life that I have feared repercussions/punishment, it raises the question if its systematic to a group or just an individual anecdote.
Not any indicator of things to 'do' to help not develop ADHD later? No actions to take?
" In contrast, during reward delivery, activation of the bilateral insula, right pallidum and bilateral putamen increased with EFA. There was a significant association of lifetime ADHD symptoms with lower activation in the left ventral striatum during reward anticipation and higher activation in the right insula during reward delivery."
Reduce early life adversity.
The actions to take would appear to depend upon whether one wishes to have fewer adults with lifetime ADHD symptoms, or more*.
The childhood adversities to affect either way are from [RutterQuinton77] and listed in TFA's Table S1, abbreviated here:
*Low educational level parent with neither school nor training
*Overcrowding more than 1.0 person/room or housing<=50m2
Parental disorder moderate to severe DSM-III-R
Parental history insitutionalised/deliquent/changes of parental figure
Marital discord low partnership in 2 of {harmony,communication,warmth}
*Early parenthood a parent <=18 (birth) or relationship <6 months (conc)
*One-parent family (at birth)
*Unwanted pregnancy an abortion was seriously considered
*Poor social network lack of friends & help in child care
Severe chronic probs affecting a parent for more than 1 year
Poorly coping parent with stressful events of past year
EDIT: TFA uses different measures, discussed in the section "Definition of Rutter’s indicators of adversity (RIA)":
low social class both parents
marital discord parents not at same address
large family size 4+ children
paternal criminality
maternal disorder ICD-8: 290–315 or ICD-10: F00-F99
foster placement
kinda like autism numbers are going up, but that might simply be because of increased diagnosis. or how "gay" isn't a new thing that's just trending -- the romans and greeks (and ottomans, and the tang dynasty, etc.) were also pretty damn gay too.
all super common stuff, just not logged as much
I don't know what the solution is but using government to replace or supplement the kind of support that people traditionally got from their family, friends and network has only reduced the strength of those support streams over the decades.
To call out one well studied example, you can't just do first order stuff like extend bennies to single moms because then people won't get married in the first place and it's easier to split up if you're not married then you've got a legit single mom on your hands with all the poorer outcomes that entails. You can play whack a mole refining the rules forever but that has its own problems.
Refusing to provide support to an person who wants to leave a relationship leads to several other factors, some on this very list. Indeed, staying in a dysfunctional, unwanted, potentially abusive relationship, just because finances force you to, is worse than the alternative.
It's better for society if people get married, (or perform some other socially agreed upon ritual that both requires investment and signals future investment) BEFORE they start cranking out the crotchfruit. Extending more aid to people who skip this step than those who go through it leads to predictable outcomes.
I get that it's really easy to play this off as some sort of pro-woman thing and try and send the discussion careening off into left field by bringing up domestic violence but we both know that's a red herring.
Edit: It was a mistake to reply to this comment at all. This is all a side discussion (ironic considering the subject of TFA). My point wasn't that you can't have government do things. The point was that you can't just pick a metric and turn government loose trying to address it. The goal of historical welfare was to subsidize basic necessities with certain groups getting priority that was generally accomplished (the programs exist, they doll out bennies pursuant to the rules) but it didn't yield the expected improvement on other fronts as intended and in the process we minted a class of people who are all but trapped in a multi-generational cycle of dependance upon the welfare system.
The children of dysfunctional, unwanted, and potentially-abusive relationships speak for themselves: Given a couple with a kid, in a dysfunctional, unwanted, potentially-abusive relationship (marriage or otherwise), it's better for them to end the relationship. Raising a child in such an environment leads to all sorts of disorders (as described in this very article), and is worse than a single parent or separated parents properly raising the child with adequate support, financial and otherwise.
Unfortunately we cannot hand-wave away dysfunctional relationships, unwanted relationships, abusive relationships (to say nothing of domestic violence), and all that comes with them, no matter how easy it is, how much we wish we could, or which fish you wish to change the subject to.
Maybe... just maybe... the US does not have enough social policies to assist the most vulnerable?
While you are being all edgy and misanthropic and childfree or whatever, you do realize that you are included in this definition?
Who says that the welfare programs exacerbate the problems?
Perhaps it is the lack of welfare programs (particularly in the US, the richest country in the world) that causes so much social problems (compared to less rich European countries).
there's a lot of assumption of causation with no backup.
in particular I'd mention that there are countries with far more extensive welfare programs with measurably better social outcomes, so maybe there's something else going on
Also arguing that government support reduces the strength of family networks really needs some serious citation to back it up.
It's logically possible this doesn't reduce single and early parenthood (although I bet someone had measured), but even in that unlikely event I don't see how it would adversely affect family, friends, or networks either.
Though popular reporting on these types of papers will often have speculation from the journalist
Or maybe it presents differently.
Isn't our brain made of chemicals of all kinds, and how we 'feel' is based on many chemical interactions, and so the "a reasonable way to feel given what you've been through", is the brains natural 'reasonable way to feel' as a reaction given some environment it is in.
So this is just measuring that reaction.
Maybe think of it more as analyzing why things are, and not as fixing an error. Like science does. Measure it.
The brain is complicated, that doesn't mean we can't measure it and try and understand it. Right now people are just 'It's impossible, it must be a soul, or something mystical' how else could it be the way it is?
I haven't argued that at all and I'm not saying we can't measure it and understand it. I'm saying reducing it to "just chemicals" is missing the forest for the trees and goes against understanding it better. Might as well reduce it to just atoms, or just protons/electrons, or just quarks... Do you see what I mean? Why are chemicals where you draw the line?
Guess I was just off-hand thinking that 'chemicals' was 'reasonable' cutoff point from going too small, but small enough. It was off the cuff scaling, I have no real evidence where we would stop on the sliding scale from larger emergent properties.
People that go smaller, to quarks, and throw in Quantum Mechanics are usually not super serious. It gets woo-woo.
They diagnose a person with attention defict because he can't tolerate the government's mass education system. Can't sit still and that disrupts class and gets the guy sent to the principal who calls their parents and refers them to a doctor who prescribes medications to make it stop. Before being medicated, that exact same person used to go home and write computer code nonstop. Ten hours straight, he is a machine.
There are organic causes for this, neurodevelopmental causes. There are treatments. But the truth is what everyone truly wants is to make the guy fit into society's mold. It's easier for them that way.
They are not there to teach you how to live a successful life, or find your purpose, or be your own amazing snowflake self, or code more. They have been trained to diagnose specific disorders and treat those disorders with a particular set of tools, which mainly boil down to drugs and a couple of talk therapies. If you experience remission of your symptoms they were successful at their job. Considering how time and expertise intensive the existing non-drug forms of therapy are, there is no realistic version of this discipline where they can personalize the therapy in the manner you seem to be suggesting. In many cases the only realistic option is to drug the patient because they have a high case load, this will reliably make the patient suffer 20% less and that may be enough to prevent suicide.
I'm still not a fan of telling patients that their world view is all wrong, that their brains don't think right and that they need to be fixed. That invalidates their lives and their experiences.
These aren't Alzheimer's patients whose brains are slowly degenerating. Many of these neurodivergents are very capable people when the conditions are right. Society's conditions just aren't right for them.
You simply cannot tell a hyperactive person to sit down and listen to lectures on subjects he couldn't care less about for 5 hours. It's done because things just are that way. Because the government has decreed that children shall be sent to the mass education system we call schools. How do you educate a whole nation? One to many broadcast. One teacher broadcasting knowledge to an infinite number of students. Giving people standardized tests. It's a machine designed to produce educated human beings. Keeps the kids safe and occupied while the adults are working their jobs too, isn't it convenient? It's a system.
Well these patients just aren't compatible with the machine. They get chewed up by it all the same. Then they get treated for ADHD and depression and anxiety.
Maybe, just maybe, it's the ones who need these patients fixed who are in need of some serious fixing of their own. Once I get that out of the way and I make sure they understand this, then I may offer them treatments and medicine. Not before.
You're right, there isn't much freedom to personalize the care we give these people. Truth is health care is yet another machine. A machine that wants to help as many people as humanly possible with the limited resources at its disposal as efficiently as possible. That means standardization. It also means doctors don't have time for this because of "high case load". There must be about a dozen billion humans on this earth by now, you cannot hope to help them all even if you were superman himself.
There's always something that they like. That's always been my experience with these patients. There's always a signal. Always something that just engages their brain like nothing else ever does. One of my patients is on the spectrum and has ADHD. She likes music and plays multiple instruments. Last week her mother was telling me how impressed she was because she just kinda taught herself to play piano out of nowhere. She's nine.
Could we find the right conditions for these people to develop if we used 100% of our will power? I have no doubt in my mind. Whole books could be written about why it is not done.
but in the last few decades we have made quite some progress in better understanding people who are not conforming, and we are adapting society to integrate them. the thing is that this adaption and integration takes decades while convincing the patient that conforming to society is not so bad takes a fraction of that time.
They are not there to teach you how to live a successful life
in my opinion actually they are. being able to lead your life is the whole point of the therapy. otherwise, why even bother?
the only realistic option is to drug the patient because they have a high case load
that is a cop-out. not in your argumentation, but in the responsibility of our healthcare system.
However I don't think that what I am about to say will be very controversial: Psychologists and psychiatrists are professionals who obtain a PhD in a specific field. Their field, education and training relate specifically to understanding the scientific evidence that exists around diseases of the mind, and treating those diseases. The diseases and the treatments are documented in the DSM. So they are at their core, implementers of what is in the DSM, and their approach is fundamentally grounded in the way that orthodox Western medicine is practiced.
Now mental health is a very broad field and you can pursue better mental health in a lot of ways, there are also are a lot of counselors out there who have different backgrounds. But I think the distinction is both significant and valuable - there is the hard science of attempting to treat disease, and that is different from being a life coach. (Well, psychology sometimes struggles to be a hard science and has issues with things like the replicability of studies, but at least the effort is there.)
You might see one or the other based on your individual needs. If you are e.g. severely bipolar and have a high immediate risk for suicide, this is the type of case which may be more likely to end up in the hands of a psychiatrist and very quickly and correctly prescribed a drug intervention. If you have mild PTSD or just want to work on your marriage, perhaps you have the luxury of time and can go talk about life for a few years with a counselor.
Should "the system" include both? To me it is not that black and white. I absolutely think the system should support the former, medical intervention for people suffering serious disease. As afflictions become milder and more about quality of life, support from the system is certainly nice to have but it would be wrong to prioritize resources toward the latter case at the expense of the former.