Research Update: Stress is Connected to Decreased Brain Volumes in Children

A new study published this month in the Journal of Neuroscience has profound implications for children of divorce. Researchers at the University of Wisconsin, Richard Davidson and Seth Pollak, examined the brains of a group of children using fMRI and compiled a detailed stressful life events history from their parents. Examining the brain scans revealed that both white matter (the connections between brain areas) and the gray matter (the cells that 'do the math') were LOWER in volume in children with greater levels of stress in their life history. This finding was particularly evident in the anterior cingulate portion of pre-frontal cortex, the part of the brain in the very front of the head that is responsible for "working memory". (Journal of Neuroscience , June 6, 2012)

As we know, divorce is a process and not an event. The period of time leading up to the divorce is a very stressful time for families, and the divorce process itself is particularly difficult for children. Children of divorce are frequently observed to be "absent minded" or "distracted" during and after the divorce, and this new research documents the physical changes that are taking place in the brains of these children that are evident in their behavior, particularly changes in their school performance.  The decreases in the volume of both white and gray matter in the brain found in these children with more stressful life histories now provides a neuroscience foundation for the findings of the psychological research on children of divorce. Divorce is one of the most stressful life events for children but it certainly isn't the only one.  Ongoing family violence, substance abuse, and neglect can all have deleterious effects on the brain development of young children, and profound effects on their emotional and intellectual, as well as social development.

The good news is that much of the new research on brain development is also finding that the brains of both children and adults is remarkably plastic, that is, capable of remarkable recovery and re-growth of new tissue when the conditions improve.  The challenge for professionals involved in resolving family disputes and working "in the best interest of the children" is to find solutions that lead to rapid reductions in the stress levels of the family so that the children's brains can begin to grow again and regain the volumes of both gray and white matter that characterize healthy growing brains. For some families that means therapy and reconciliation for the parents that leads to a new pattern of better communication and lower stress levels.

For other families, when untreated mental illness or personality disorders in one or both parents make new behavior patterns in the family unlikely, a quick and low conflict divorce may be the avenue to lower stress that will allow the children to recover their lost brain function most quickly. At this point, we don't know how much stress for how long will lead to permanent and irreversible brain changes in children of divorce, but as this new line of brain scan-driven research develops, we will know more. Stay tuned.

Be sure to check out my book now on sale at Amazon: http://www.amazon.com/Your-Best-Divorce-Now-Tools/

fMRI Research Update: Spousal abuse causes physical changes in the brains of victims

In many high conflict divorce cases, the pattern of conflict that began as a verbal disagreement escalates in a predictable way until one partner is physically assaulting the other. In a previous post, I reviewed the fMRI research that documented the brain changes in the children from merely witnessing domestic violence (DV) in their families. This post is devoted to the spouse/victims of domestic violence and what we know about the effects of DV and treatments for its symptoms.

Few family lawyers would be surprised to learn that many victims of domestic abuse suffer from post-traumatic stress disorder (PTSD), the same malady that afflicts many combat veterans. The experience of talking with one domestic violence victim is usually enough to sensitize most family lawyers to the resulting anxiety and fear-driven symptoms and behaviors that can result from prolonged exposure to the cycle of abuse (most abusive relationships last an average of 7 years before the victim gets out). What we now know is that the damage is not just emotional--domestic abuse, just like combat, causes identifiable and measurable changes in the brain's structure and function that are evident in fMRI scans of victims. That means the damage is physical and the abuse changes both the physical shape of the brain AND affects the way it functions.

Just as the treatment of combat-related PTSD has proven to be challenging and frequently ineffective, the treatment of domestic violence-related PTSD is less than optimal in its effectiveness. A reasonable summary of the available research, using the latest and most effective cognitive behavior therapy (CBT) for trauma for battered women (CTT-BW) suggests that treatment is about 50% effective. It is this documented lack of treatment success in nearly half the victims that led to the fMRI studies to try to identify underlying brain pathology that was interfering with CBT effectiveness.

What the fMRI scans of these traumatized women revealed was identifiable changes in structure and function of three areas of the brain: the amydala, the insula, and the prefrontal cortex. These 3 regions are the same ones identified in the research of the combat PTSD victims and the kids from violent families, and they are dysfunctional in the same ways in all these victims. Brain centers for identifying danger are hyper-activated, and the brain center responsible for self-control and logical thinking (executive functions, as they are called) is not working like it does in normal people. This latest research noted that other brain areas (the anterior cingulate and posterior cingulate) were more active in people who were successfully treated, suggesting that the CBT was successful in activating these brain areas which led to reducing the fear-driven anticipation of something bad happening to them, leading to reductions in anxiety and other PTSD symptoms.

There are clearly family law implications for this growing body of research. Victims of domestic violence have scientifically verifiable physical brain injuries resulting from their abuse. These brain injuries affect how, and how well, the brains of these people function, and how well state of the art treatments will work to return them to normal functioning.  These findings have both child custody and property division implications which should be considered in cases involving document domestic violence.

Victims of domestic violence, both the adults and the children, are more like the victims of car accidents with head injuries than most of us would like to believe. Domestic violence doesn't just make its victims "nervous"; domestic violence causes brain damage to its victims that is very difficult to repair even with the best available treatments. And by the way, there is NO evidence that this kind of damage will "heal itself" when the victims are removed from the violence.

A number of practice tips come to mind as a consequence of these findings:

1. Longer exposure to abuse means greater brain damage for both the adults and the children. There is no "grace period". Getting away from the abuse is the first step, so the abused spouse and children must either leave or be protected by a protective order--now.

2. Effective treatment for the victim is available, may work, and takes a few (3-4) months. Get the victim into a program which offers CBT or CTT-BW as soon as possible while the litigation proceeds. An effectively treated victim is a much more rational and well functioning client (and parent).

3. Emphasize the physical brain damage effects of DV in settlement discussions about property division and visitation.

4. Insist on treatment for the perpetrator before allowing unsupervised visitation to prevent further "brain damage" to the children. (See my earlier post for details.)

Research update: When the speaker is boring, listeners’ brains will fill in the “blanks”; The implications for the courtroom explained.

The world is not made of atoms, it is made of stories. Muriel Rukeyser

For those of us in the communication business, we know first-hand the power of stories.  Nothing can match the story for engaging the audience, and conveying a compelling, emotionally powerful message like a good story. Good stories always contain vivid detail, and they almost always contain dialogue.  Now some new brain research using fMRI (functional magnetic resonance imaging) scanning has provided some new insights into the power of stories.

Scientists at the University of Glasgow’s Institute of Neuroscience and Psychology scanned the brains of study participants as they listened to audio clips of stories: one group of very short stories was read in a monotone and was “boring”, the other was read with more inflection and was “vivid”. While listening to the “boring” stories, the level of brain activity INCREASED in areas of the auditory cortex interested in human speech, and the participants reported that activity was the brain’s “internal dialogue” filling in the missing information in the boring story.  This was particularly evident in stories with no “direct speech quotations” which the researchers interpreted as the brain “talking over” the boring speech with its own internal speech to speed up information processing and to prepare a response.

Direct speech is more engaging because it triggers neural links to facial expressions, other voices, and gestures and therefore conveys more information. It is this same process that makes reading novels so powerful, as the brain supplies cortical activation in a network of brain centers to “fill in” a complete sensory-motor “picture” depicted in the words on the page.  This is the inherent power of a story: it engages the whole brain in creating an internal representation of the message, and keeps the brain engaged in processing that message.

As any seasoned observer knows, the audience in the courtroom, be it judge or jury, frequently faces the challenge of listening to “boring” speakers. It has long been known that when the audience is bored, they “tune out”, but this research highlights the real danger of “boring” courtroom argument or testimony: the audience not only tunes out, they actually SUBSTITUTE their own more interesting internally generated story to “make up” for the boring audio they are actually hearing!! This may help to explain why fact finders report hearing “evidence” that was not presented when they explain decisions which seem so disconnected from the testimony and the issues. Boring is not just a nuisance in court; it’s a danger! Bored brains are not your friends.

The bottom line: The brains of any audience can be both your friend and your enemy. When the message is a story that includes dialogue and is engaging, those brains will be your friend as they are completely involved in processing the information in multiple sensory and motor channels that are activated by a good story. 

On the other hand, when the message is boring, that is, monotonic, monotonous, and lacking in direct speech and dialogue, those bored brains will be busy “filling in” the processing time with a much more interesting but internally generated story which will probably be loosely connected to the message, at best.

Here’s the link to the research report: http://medicalxpress.com/news/2012-03-brain-speech-quotes.html

Narcissism Research Update: new fMRI research can distinguish narcissism from normal

Narcissism is over-represented among people involved in divorces, and in my experience with hundreds of litigated divorce cases, narcissists are involved in a high percentage of litigated divorces. New research has further refined both the public persona and the unique brain characteristics of narcissistic people (NPD).

First, the public persona. Researchers compared narcissists identified by their personality test scores and compared their Facebook pages with more normal people. The results were just what one would expect. Narcissistic people had a greater number of "friends' than those who were not, a confirmation of the NPD tendency to have more but shallower relationships. Their profile photos tended to be more stylized and "glamour shot"-like than less narcissistic people. Finally, their posts tended to be more self-promoting. For more information look here: http://www.science20.com/news_articles/narcissists_can_be_identified_their_facebook_accounts_psychologists-32720

This research is consistent with some other research which compared annual company reports  and other company PR of narcissistic CEOs with those of companies run by normal people. As expected, the text of reports of narcissistic CEOs had more references to "I" and fewer to "we", had larger photos of the CEO on covers and press releases, and were generally more self-promoting than company promoting. There are a notable gap in salary between the CEO and the second in command in these companies as well, unlike companies without narcissistic CEOs.

Both of these findings provide tools for divorce attorneys to do some free discovery on clients or spouses in these public records and get a "heads up" about the personality functioning of these people without a mental health professional evaluation or records (most narcissists NEVER see a shrink, so records are rare).

Now for the look inside the brain of a narcissist. Research investigating the function of the medial prefrontal cortex (MPC) in maintaining self-perception compared normal and narcissistic people on their ability to identify faces after a brief shock. The shock had scrambled the MPC for a fraction of a second and the participants were shown pictures of themselves, friends, and known strangers during the interval when their MPCs were scrambled. Normal people could identify friends and strangers but NOT themselves, confirming the function of the MPC in self recognition. However, even when the MPC was "off-line", narcissists could still identify their own photos. The researchers concluded that narcissists have larger portions of their brains devoted to "ME" (wonderful, glorious, fabulous me, I might add) than do normal people. This research may be another step toward developing an reliable imaging (fMRI) diagnostic tool for identifying NPD. It may also identify the neural underpinnings of this very destructive personality disorder.

For more information about this research and other fMRI research on narcissism, look here: http://www.science20.com/brain_trust_diy_science_today039s_top_minds/definitive_fmri_test_narcissism-87875

NPD is an aggravating factor in a large percentage of very malignant divorces, so better diagnosis, especially of the non-psychological test variety, will be increasingly helpful in future child custody evaluations.

Exposure to Family Violence and Brain Changes in Children--A Research Update

My last post highlighted the neural structures and processes involved in the development of parental alienation. This note summarizes some recent research about the connection between exposure to family violence and changes in brain functioning in children.

Researchers in the UK had noted that fMRI scans of combat veterans showed increased activation (when compared to veterans with NO combat exposure) in two areas of the brain: the amygdala and the anterior insula. These are two deep brain structures known to be active in the detection of threats, fear, survival responses, (amygdala) and of feelings of disgust or empathy, (anterior insula). These two deep brain structures have mirror neuron connections as well, leading to internal brain representation of external events, just like those noted in the post about parental alienation from last week.

This latest research compared the brains of two groups of children, neither of whom had any symptoms of mental health problems. One group of children came from families with documented histories of family violence; the other group of children had no such history. On a task that involved identifying faces as either male or female while in the fMRI scanner, the children with a history of "exposure to family violence" showed brain activation patterns similar to those of the veterans with combat experience--that is, activation of the two brain areas--the anterior insula and amygdala. The children with NO history of such exposure did NOT show similar activation on their fMRI scans.

This ground breaking research suggests that merely witnessing family violence leads to changes in children's brain function similar to those experienced by combat veterans. It is well known that post-traumatic stress disorder, PTSD, is characterized by "hyper-vigilance",  and the chronic over activation of the neural processes involved in detecting threats and reacting to them. PTSD sufferers experience chronic fear and anxiety as a result of the over-activation of these same two brain structures (and some others).

What is not currently known is how much "exposure" is needed to result in these neural changes, nor why some children seem to avoid the long term consequences of anxiety and hypervigilance and distrust that other children experience from their exposure to family violence.

What is clear, even at this early stage, is that children are highly susceptible to measurable changes in brain function from exposure to family violence. The implications for family lawyers and courts would seem to include:

1. Children don't have to be physically injured by family violence to be adversely affected--just witnessing family violence is sufficient to cause adverse brain effects.
2. Intervention in escalating family violence at the early stages and removing potential for children being exposed to such scenes can prevent the emergence of those changes in brain function that increase the risks of development of anxiety  and other maladies.
3. Leaving divorcing spouses together in the same house raises these risks for children since other divorce research has documented that nearly 100% of divorces involve at least one episode of physical violence between spouses. It is in the best interests of the children that their exposure to family violence be prevented.

More on psychopaths: New research show their brains really are different!

Viewers of TV shows like "Criminal Minds" have been saying this for years when viewing episodes of the incredible, sadistic crimes committed by villains identified as 'psychopaths" by the BAU good guys: "There is something wrong with those guys". Well, it turns out, there is.

The new research
New research just completed by researchers from the U of New Mexico MIND institute, and a group from the U of Wisconsin School of Medicine compared the brains of 20 true psychopaths (not antisocial personality disorder) with 20 matched convicted criminals  in the Wisconsin Department of Corrections facility who did not fit the strict criteria for psychopathy. Using two different brain imaging technologies, fMRI and diffusion tensor imaging (DTI),  Dr. Kent Keihl (who I visited last summer in Albuquerque) and Dr. Michael Koenigs found that psychopaths had identifiable structural and functional deficits when compared to regular criminals.

Functional magnetic resonance imaging (fMRI) is like a movie of the brain at work. Diffusion tensor imaging is designed to image the white matter (the connections) deep in the interior of the brain. fMRI analysis demonstrated that "ventromedial prefrontal cortex (vmPFC), the part of the brain responsible for sentiments such as empathy and guilt, and the amygdala, (a small structure deep in the center of the brain) which mediates fear and anxiety,, were NOT as active in psychopaths as in the convicted criminals who were not psychopaths. Further, the DTI images showed that the connections between those two critical brain regions were also less in the psychopath group.

The reason this matters

It has long been known that psychopaths lack empathy and are extreme risk takers, exhibiting abnormally low anxiety and fear. A common description includes the inability to learn from experience, poor impulse control, and a lack of remorse. Until now, these behavioral and character traits have been attributed to family history, substance abuse, and sometimes to "genetics" but without an adequate neuro-scientific foundation. Sentencing and "rehabilitation" decisions have been based on personal beliefs (or biases) and sometimes on psychological testing, which is only marginally better. Now, if  this research is confirmed by larger studies (the Wisconsin project is ongoing-personal communication), there will be a scientific neuro-imaging technology available for identifying the anatomical deficits inherent in psychopathy.  

The application to family law will provide courts and litigants with a non-fakable, reliable imaging technology to identify psychopathy and prevent the emotional and potentially violent damage that these guys (most psychopaths are male) do to children, their own or someone else's. The new research documents why treatment is ineffective and the psychopathic behavior is ongoing--their brains are both anatomically deficient and functionally defective in areas responsible for impulse control and empathy.  Until science advances further so that this kind of brain damage can be treated and corrected, courts will be limited to protecting the past and future victims of these individuals when they are identified.

One additional implication that Dr. Kiehl mentioned during our visit last summer: if these guys really are brain damaged, and now that can be scientifically proven, then can they be held responsible for their criminal acts under traditional criminal legal theory? Interesting cases ahead...

Journal Reference:

1. Julian C. Motzkin, Joseph P. Newman, Kent A. Kiehl, Michael Koenigs. Reduced Prefrontal Connectivity in Psychopathy. Journal of Neuroscience, 2011; 31 (48): 17348-17357 DOI: 10.1523/JNEUROSCI.4215-11.2011

Mirror neurons and parental alienation

"Parental alienation" may be simpler to accomplish than you think.

Some recent leading edge research using fMRI (functional Magnetic Resonance Imaging-a scan of the brain at work) to investigate the patterns of brain activation in observers of sporting events yielded confirmation of a long held belief of neuroscientists: watching an emotionally engaging event is indistinguishable, at the brain level, from actually participating in it. Same neurons fire, same brain regions are activated, same physical sensations are registered. Or, to be more concrete, watching your favorite football team on TV activates your brain just as if you were playing the game yourself. An entire class of brain cells, called mirror neurons, has been discovered, and the their apparent function, documented many times, is to "mirror" in the brain what the senses detect in the world. Great for football fans, potentially hazardous for children living with conflict.

It has long been assumed by many family lawyers that when children exhibit behaviors indicating that they are afraid of, or angry toward, a non-custodial parent, and when those lawyers represent a parent who complains that they are the victim of a campaign of sustained "brainwashing" by the custodial parent, it must be true. How else could the little angel have become such a strangely fearful and angry child? Now we know.

Children are way more interested in the interaction of their parents than the most rabid football fan. Their very existence depends on the outcome of the conflict leading up to and through the divorce. It's safe to say that the children's mirror neurons are activated every time they witness anger, bitterness, verbal insults, and especially violence between their parents.  When one parent is suddenly absent for long periods of time (between periods of possession for the non-custodial parent, for example) and the remaining parent continues to behave in the same angry, resentful, bitter, and critical fashion toward the absent parent, the child's mirror neurons are working overtime, reproducing in the little brains the sensations and emotions that they see, hear, and feel in their crumbling, unstable divorce world.

With this crucial understanding of the underlying neural processes at work, it's easier to understand why a conscious, intentional campaign to "alienate" the child from the non-custodial parent is NOT necessary to create a fearful or angry "alienated" child. All that's required is opportunities for the child to observe the parent with possession to repeatedly talk about or act out the alienating scenario. The child's mirror neurons will do the rest.

This little piece of science also explains why experts who interview children as part of custody evaluations rarely find a "smoking gun" pattern of intentional, pre-meditated parental brainwashing. Children nearly always deny that either parent is actively programming them to dislike a parent. As this research demonstrates, it is not necessary for a parent to "program" the child--all they need to do is act out their disdain, rage, and accusations in the presence of the child. Mirror neurons in the child will do the rest.

One important difference between children of divorce and football fans: children don't have a favorite team--no matter who "wins" in this game, the kids lose, because they are rooting for both "teams".  So if those mirror neurons are firing when cheering for one favorite team, imagine how many more are firing when both of your teams are playing each other! It is this over-activation that has led to the standard instruction to divorcing parents to keep their conflict and the communication AWAY from those little eyes and the mirror neurons they are connected to in those little brains. Those little brains are not only overloaded by this lose-lose scenario they are literally a part of, they are permanently altered by the over-stimulation and trauma.

Parental alienation is not just a social problem; it's an insidious disease with permanent consequences for developing brains.

More on psychopaths and divorce:research update

While most people think about criminals when they see the word "psychopath", psychopaths do appear in family law cases more often than you might expect. Research has established that the incidence of psychopathy in the general population is about 1 in 100, but the rate of psychopathy among corporate executives is nearly 4 times that rate, meaning one of every 25 divorces of corporate executives (at least) has a psychopath as one of the parties.

Several characteristics of psychopaths, well documented through hundreds of research studies are relevant and problematic in family law cases, namely:

• Superficial charm--these guys are VERY likable and convincing
• Lack of conscience--they will do virtually anything to get what they want, regardless of court orders or laws; 
• Lack of empathy--they treat spouses and children like objects, not people, and can be unbelievably cruel and unfeeling
• Chronic, persistent lying--they will lie about anything, anytime

Because most people are not suspicious or skeptical, psychopaths find it easy to manipulate people, even lawyers, into believing their lies. The really good psychopaths haven't been caught. 

New research though is providing tools for detecting psychopaths. A recent study, reviewed here: http://www.livescience.com/16585-psychopaths-speech-language.html highlights some detectable differences in the speech patterns of true psychopaths (they are a subset of the DSM IV Antisocial personality disorder diagnostic group) . They are:

• a lack of emotion in their story telling
• speaking in terms of cause-and-effect when describing their actions
• in their conversation, focusing their attention on basic needs, such as food, drink, and money
• and , most telling, a higher than normal use of "uh" and "um" in their conversations.

This last feature, which reflects the high level of cognitive effort required to manufacture a lie, is supported by the leading edge research using fMRI scans to detect deception. That brain-focused research has clearly established that areas of the brain that are responsible for deception are identifiable and correspond to those areas of the brain known to be responsible for the generation of ideas, rather than memory retrieval, are activated in response to attempts at deception. (Some leading edge research now underway by Dr. Kent Keihl and his colleagues at MIND at the U of New Mexico promises to lead to an fMRI diagnostic test for psychopathy in the near future.) The psychopaths' efforts to generate lies is reflected in the high levels of "ums" and "uhs" in their speech, as well as in the way they justify their behavior through the use of "because" or "so that" in their conversation.

The lessons to be learned for family law practitioners and their clients are these:

• Psychopathy is more likely among successful executives than any other group except career criminals
• Psychopaths, regardless of their success, position, or status, will commit crimes and violate orders without hesitation or remorse during their divorces
• Psychopaths are detectable by paying close attention to their speech patterns
• Children of psychopaths are at risk because the psychopath lacks normal empathy that parents have for their children
• Most mental health professionals are untrained in the recognition of psychopathy, and reluctant to identify it if they see it, sometimes out of fear of retaliation by the psychopath
• Spouses of psychopaths need protective orders in place; when (not if) the PO is violated, contempt proceedings need to be initiated immediately, and lead to jail time, if possible; if not, the spouse needs protection.