"Screen and intervene": governing risky brains

“It's Just Kind of This Thing That I Need to Navigate”: Young Women's Stories of Recoveries After Domestic Abuse in Childhood

Those who experience parental domestic abuse in childhood are affected in multiple ways, but existing research uses a narrow lens, relying on psychotherapeutic and neuroscientific understandings. This article uses a dialogical theory to explore women's recovery stories. Interviews were conducted with 10 women in England and a voice-centered narrative analysis was used. This article attends to gendered, psychotherapeutic, and neoliberal narrative resources that shaped participants’ stories. It concludes that recoveries after domestic abuse in childhood can be considered as dynamic processes that are individual, as well as shaped by social, political, and relational contexts that shape storytelling practices.

Troubling Neurobiological Vulnerability: Psychiatric Risk and the Adverse Milieu in Environmental Epigenetics Research

In post-genomic science, the development of etiological models of neurobiological vulnerability to psychiatric risk has expanded exponentially in recent decades, particularly since the neuromolecular and biosocial turns in basic research. Among this research is that of McGill Group for Suicide Studies (MGSS) whose work centers on the identification of major risk factors and epigenetic traits that help to identify a specific profile of vulnerability to psychiatric conditions (e.g., depression) and predict high-risk behaviors (e.g., suicidality). Although the MGSS has attracted attention for its environmental epigenetic models of suicide risk over the years and the translation of findings from rodent studies into human populations, its overall agenda includes multiple research axes, ranging from retrospective studies to clinical and epidemiological research. Common to these research axes is a concern with the long-term effects of adverse experiences on maladaptive trajectories and negative mental health outcomes. As these findings converge with post-genomic understandings of health and also translate into new orientations in global public health, our article queries the ways in which neurobiological vulnerability is traced, measured, and profiled in environmental epigenetics and in the MGSS research. Inspired by the philosophy of Georges Canguilhem and by literature from the social studies of risk and critical public health, we explore how the epigenetic models of neurobiological vulnerability tie into a particular way of thinking about the normal, the pathological, and the milieu in terms of risk. Through this exploration, we examine how early life adversity (ELA) and neurobiological vulnerability are localized and materialized in those emerging models while also considering their broader conceptual and translational implications in the contexts of mental health and global public health interventions. In particular, we consider how narratives of maladaptive trajectories and vulnerable selves who are at risk of harm might stand in as a "new pathological" with healthy trajectories and resilient selves being potentially equated with a "new normal" way of living in the face of adversity. By troubling neurobiological vulnerability as a universal biosocial condition, we suggest that an ecosocial perspective may help us to think differently about the dynamics of mental health and distress in the adverse milieu.

Making a murderer: Media renderings of brain injury and Aaron Hernandez as a medical and sporting subject

This paper examines the entanglement of medicine, brain injury, and subjectivity within newspaper discourse and through the case of ex-American footballer Aaron Hernandez. In 2017, two years after being found guilty of murder and five years after scoring in the Super Bowl, Aaron Hernandez died by suicide in his prison cell. Hernandez was posthumously diagnosed with Chronic Traumatic Encephalopathy (CTE), a neurodegenerative disease associated with violence, depression, and dementia-like symptoms. I examine newspaper coverage of the Hernandez case, focusing upon the murder, arrests, conviction, suicide, and diagnosis of CTE in order to examine understandings of Hernandez's subjectivity. I make three conclusions: First, the disease is not mentioned prior to diagnosis with family instability, friendship groups, individual psychology, and the entitlement of celebrity foregrounded. Second, CTE is foregrounded after the diagnosis and is used to explain much of Hernandez's behaviour. Third, the diagnosis of CTE goes someway to normalizing the behaviour of Hernandez, rendering his behaviours comprehensible. I conclude by considering how the specific narrative of CTE-as-acquired-dementia shapes depictions of Hernandez's subjectivity and discuss how this case troubles existing literatures on the neurologization of selfhood.

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CTE is a neurodegenerative disease popularly associated with contact sport.

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Aaron Hernandez was convicted of murder, died by suicide, and diagnosed with CTE.

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Through media analysis, I ask if Hernandez's actions were seen as shaped by CTE.

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CTE is not mentioned prior to suicide and rarely prior to formal diagnosis.

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After diagnosis CTE is used to explain and normalize much of Hernandez's behaviour.

"Even Heroes Get Depressed": Sponsorship and Self-Stigma in Canada's Mental Illness Awareness Week

In 1992, the Canadian Psychiatric Association launched Canada's first national campaign against mental illness, Mental Illness Awareness Week (MIAW). I stress that pharmaceutical sponsorship of the first five years of MIAW (1992-1997) was integral to shaping the trajectory of the campaign and marks a shift in the way stigma is conceived and resisted in Canada: what was an interpersonal process based on social norms becomes refigured as "self-stigma," or an individualized process in which lack of information, education, and self-assessment contribute to an inability to consider oneself as at-risk for a disease, condition, or disorder.

Fraught claims at the intersection of biology and sociality: Managing controversy in the neuroscience of poverty and adversity

In this article, I examine how a subfield of researchers studying the impact of poverty and adversity on the developing brain, cognitive abilities and mental health respond to criticism that their research is racist and eugenicist, and implies that affected children are broken on a biological level. My interviewees use a number of strategies to respond to these resurfacing criticisms. They maintain that the controversy rests upon a fundamental misunderstanding of their work. In addition, they use what I term 'plasticity talk', a form of anti-determinist discourse, to put forth what they believe is a hopeful conception of body and brain as fundamentally malleable. They draw attention to their explicit intentions to use scientific inquiry to mitigate inequality and further social justice - in fact, they believe their studies are powerful evidence that add to the literature on the social determinants of health. Though they may be interested in improving lives, they argue that their aims and means have little in common with programs trying to 'improve' the genetic stock of the population. I argue that theirs is a fraught research terrain, where any claims-making is potentially treacherous. Just as their studies of development refuse dualistic models, so too do their responses defy dichotomous categorization.

Neurolaw and Neuroethics

This short article proposes a conceptual structure for "neurolaw," modeled loosely on the bipartite division of the sister field of neuroethics by Adina Roskies into the "ethics of neuroscience" and the "neuroscience of ethics." As normative fields addressing the implications of scientific discoveries and expanding technological capacities affecting the brain, "neurolaw" and neuroethics have followed parallel paths. Similar foundational questions arise for both about the validity and utility of recognizing them as distinct subfields of law and ethics, respectively. In both, a useful distinction can be drawn between a self-reflexive inquiry (the neuroscience of ethics and law) and an inquiry into the development and use of brain science and technologies (the ethics and law of neuroscience). In both fields, these two forms of inquiry interact in interesting ways. In addition to a proposed conceptual structure for neurolaw, the article also addresses the neurolegal versions of the critiques made against neuroethics, including charges of reductionism, fact/value confusion, and biological essentialism.

Crianças, seus cérebros... e além: Reflexões em torno de uma ética feminista de pesquisa

Resumo: Nesse artigo, em interlocução com autores dos estudos da ciência assim como das teorias feministas de cuidado, reflito sobre dilemas éticos associados à participação do cientista social na arena multidisciplinar das políticas públicas. Construo meu objeto de análise a partir de uma imagem que surge com frequência nos debates sobre políticas de proteção à infância que justapõe dois cérebros infantis -- um etiquetado “normal”, o outro, “negligência extrema”. Ao rastrear, através de atores e situações concretos, a trajetória pouco ortodoxa desse artefato das neurociências, proponho reforçar uma visão crítica sobre os usos populares da ciência que tendem a ofuscar os juízes de valor implícitos em qualquer fato científico. Por outro lado, num exercício autorreflexivo, procuro entender como o “importar-se” da pesquisadora, nas suas diversas manifestações, tem implicações para o devir ético e político dos mundos sob consideração.

Innocent or Intentional?: Interpreting Oppositional Defiant Disorder in a Preschool Mental Health Clinic

Based on 9 months of ethnographic fieldwork in a U.S. mental health clinic focused on the treatment of preschool-aged children who exhibited extremely disruptive behavior, this article examines the contradictions clinicians faced when trying to identify and attribute "intentionality" to very young children. Disruptive, aggressive behavior is one of the central symptoms involved in a wide-range of childhood psychopathology and the number one reason young children are referred to mental health clinics in the United States. In the clinic where I conducted my research, clinicians were especially interested in diagnosing these children with oppositional defiant disorder (ODD), in order to identify those at risk for more serious mental illness later in the lifecourse. In this article, I look at the different strategies clinicians used in interpreting whether aggressive, defiant behavior was a part of the child's "self," a biologically driven symptom of a disease, or a legitimate reaction to problematic social environments. I argue that conceptualizing intentionality as a developmental, interpersonal process may help to make sense of the multiple discourses and practices clinicians used to try to reconcile the contradictions inherent in diagnosing ODD.

Neuroscience in forensic psychiatry: From responsibility to dangerousness. Ethical and legal implications of using neuroscience for dangerousness assessments

Neuroscientific evidence is increasingly being used in criminal trials as part of psychiatric testimony. Up to now, "neurolaw" literature remained focused on the use of neuroscience for assessments of criminal responsibility. However, in the field of forensic psychiatry, responsibility assessments are progressively being weakened, whereas dangerousness and risk assessment gain increasing importance. In this paper, we argue that the introduction of neuroscientific data by forensic experts in criminal trials will be mostly be used in the future as a means to evaluate or as an indication of an offender's dangerousness, rather than their responsibility. Judges confronted with the pressure to ensure public security may tend to interpret neuroscientific knowledge and data as an objective and reliable way of evaluating one's risk of reoffending. First, we aim to show how the current socio-legal context has reshaped the task of the forensic psychiatrist, with dangerousness assessments prevailing. In the second part, we examine from a critical point of view the promise of neuroscience to serve a better criminal justice system by offering new tools for risk assessment. Then we aim to explain why neuroscientific evidence is likely to be used as evidence of dangerousness of the defendants. On a theoretical level, the current tendency in criminal policies to focus on prognostics of dangerousness seems to be "justified" by a utilitarian approach to punishment, supposedly revealed by new neuroscientific discoveries that challenge the notions of free will and responsibility. Although often promoted as progressive and humane, we believe that this approach could lead to an instrumentalization of neuroscience in the interest of public safety and give rise to interventions which could entail ethical caveats and run counter to the interests of the offenders. The last part of this paper deals with some of these issues-the danger of stigmatization for brain damaged offenders because of adopting a purely therapeutic approach to crime, and the impact on their sentencing, in particular.

Survey of Attitudes and Ethical Concerns Related to Gene Therapy Among Medical Students and Postgraduates in China

Gene therapy is becoming an important treatment modality for gravely ill patients, and today's medical students and postgraduates are both potential consumers and future providers of gene therapy. Therefore, their attitudes and concerns about gene therapy may directly influence its long-term development and implementation in the clinic. We performed a cross-sectional survey of medical students and postgraduates at West China Medical School of Sichuan University. A custom-designed questionnaire was distributed to 600 students, and 579 were valid (96.98% response). Most respondents (84.46%) indicated little prior knowledge about gene therapy. The proportion of respondents considering gene therapy as acceptable ranged from 63.73% for serious illness to 17.72% for genetic enhancement. Adverse side effects were the most frequent concern among respondents when asked to imagine that they would receive gene therapy to treat a severe brain-related illness. These results suggest that medical students in China consider gene therapy's acceptability to be rather low, and are most concerned about its adverse side effects.

Social Science and Neuroscience beyond Interdisciplinarity: Experimental Entanglements

This article is an account of the dynamics of interaction across the social sciences and neurosciences. Against an arid rhetoric of 'interdisciplinarity', it calls for a more expansive imaginary of what experiment - as practice and ethos - might offer in this space. Arguing that opportunities for collaboration between social scientists and neuroscientists need to be taken seriously, the article situates itself against existing conceptualizations of these dynamics, grouping them under three rubrics: 'critique', 'ebullience' and 'interaction'. Despite their differences, each insists on a distinction between sociocultural and neurobiological knowledge, or does not show how a more entangled field might be realized. The article links this absence to the 'regime of the inter-', an ethic of interdisciplinarity that guides interaction between disciplines on the understanding of their pre-existing separateness. The argument of the paper is thus twofold: (1) that, contra the 'regime of the inter-', it is no longer practicable to maintain a hygienic separation between sociocultural webs and neurobiological architecture; (2) that the cognitive neuroscientific experiment, as a space of epistemological and ontological excess, offers an opportunity to researchers, from all disciplines, to explore and register this realization.

Infancy, autism, and the emergence of a socially disordered body

Twenty academic psychologists and neuroscientists, with an interest in autism and based within the United Kingdom, were interviewed between 2012 and 2013 on a variety of topics related to the condition. Within these qualitative interviews researchers often argued that there had been a 'turn to infancy' since the beginning of the 21st century with focus moving away from the high functioning adolescent and towards the pre-diagnostic infant deemed to be 'at risk' of autism. The archetypal research of this type is the 'infant sibs' study whereby infants with an elder sibling already diagnosed with autism are subjected to a range of tests, the results of which are examined only once it becomes apparent whether that infant has autism. It is claimed in this paper that the turn to infancy has been facilitated by two phenomena; the autism epidemic of the 1990s and the emergence of various methodological techniques, largely although not exclusively based within neuroscience, which seek to examine social disorder in the absence of comprehension or engagement on the part of the participant: these are experiments done to participants rather than with them. Interviewees claimed that these novel methods allowed researchers to see a 'real' autism that lay 'behind' methodology. That claim is disputed here and instead it is argued that these emerging methodologies other various phenomena, reorienting the social abnormality believed typical of autism away from language and meaning and towards the body. The paper concludes by suggesting that an attempt to draw comparisons between the symptoms of autism in infant populations and adults with the condition inevitably leads to a somaticisation of autism.

Prevailing public perceptions of the ethics of gene therapy

Gene therapy research is advancing rapidly, and hopes of treating a large number of brain disorders exist alongside ethical concerns. Most surveys of public attitudes toward these ethical issues are already dated and the content of these surveys has been researcher-driven. To examine current public perceptions, we developed an online instrument that is responsive and relevant to the latest research about ethics, gene therapy, and the brain. The 16-question survey was launched with the platform Amazon Mechanical Turk and was made available to residents of Canada and the United States. The survey was divided into six themes: (1) demographic information, (2) general opinions about gene therapy, (3) medical applications of gene therapy, (4) identity and moral/belief systems, (5) enhancement, and (6) risks. We received and analyzed responses from a total of 467 participants. Our results show that a majority of respondents (>90%) accept gene therapy as a treatment for severe illnesses such as Alzheimer disease, but this receptivity decreases for conditions perceived as less severe such as attention deficit hyperactivity disorder (79%), and for nontherapeutic applications (47%). The greatest area of concern for the application of gene therapy to brain conditions is the fear of not receiving sufficient information before undergoing the treatment. The main ethical concerns with enhancement were the potential for disparities in resource allocation, access to the procedure, and discrimination. When comparing these data with those from the 1990s, our findings suggest that the acceptability of gene therapy is increasing and that this trend is occurring despite lingering concerns over ethical issues. Providing the public and patients with up-to-date information and opportunities to engage in the discourse about areas of research in gene therapy is a priority.

The Endurance of Uncertainty: Antisociality and Ontological Anarchy in British Psychiatry, 1950–2010

Research into the biological markers of pathology has long been a feature of British psychiatry. Such somatic indicators and associated features of mental disorder often intertwine with discourse on psychological and behavioral correlates and causes of mental ill-health. Disorders of sociality – particularly psychopathy and antisocial personality disorder – are important instances where the search for markers of pathology has a long history; research in this area has played an important role in shaping how mental health professionals understand the conditions. Here, I characterize the multiplicity of psychiatric praxis that has sought to define the mark of antisociality as a form of “ontological anarchy.” I regard this as an essential feature of the search for biological and other markers of an unstable referent, positing that uncertainties endure – in part – precisely because of attempts to build consensus regarding the ontology of antisociality through biomedical means. Such an account is suggestive of the co-production of biomarkers, mental disorder, and psychiatric institutions.

Neural veils and the will to historical critique: why historians of science need to take the neuro-turn seriously

Taking the neuro-turn is like becoming the victim of mind parasites. It's unwilled (although there are those who will it at a superficial level for various strategic reasons). You can't see mind parasites; they make you think things without allowing you to know why you think them. Indeed, they generate the cognitive inability to be other than delighted with the circumstances of your affected cognition. It's not as if you can take off your thinking cap and shoo the pests away. You can't see them--or even know that you could want to. You can't stand on the outside looking in at your cognitive processes. But historically speaking, you are also inside a (broadly postmodern) culture and (broadly neoliberal) socioeconomic order that places the legitimacy of the neuro beyond critique. And the neuro-turn does more: it delegitimizes critique itself, at least as we have known it since Marx. This essay briefly explores how we got here, what the "here" is, and what its implications are for historical critique.

Potential implications of research on genetic or heritable contributions to pedophilia for the objectives of criminal law

In recent years, there has been increasing scientific research on possible genetic or heritable influences to the etiology of pedophilia, driven by national and public concerns about better understanding the disorder in order to reduce children's vulnerabilities to pedophilic and child sex offenders. This research has corresponded to growing academic dialogue on how advances in genetic research, especially concerning the causes and development of particular mental disorders or behaviors, may affect traditional practices of criminal law and how the justice system views, manages, and adjudicates different types of criminal behavior and offenders. This paper strives to supplement this dialogue by exploring several of the many possible effects and implications of research surrounding genetic or heritable contributions to pedophilia for the five widely accepted objectives that enforce and regulate the punishment of criminal law. These include retribution, incapacitation, deterrence, rehabilitation, and restoration. Although still currently in early stages, genetic and heritability research on the etiology of pedophilia may have the potential moving forward to influence the current and established punitive methods and strategies of how the justice system perceives, adjudicates, regulates, and punishes pedophilic and sex offenders, as well as how to best prevent sexual offending against children by pedophilic offenders in the future.

Ethical, Legal and Social Issues Surrounding Research on Genetic Contributions to Anti-Social Behavior

Scientific study of genetic contributions to chronic antisocial behavior has stemmed from many lines of research in recent years. Genetic research involving twin, family, and adoption studies have traditionally been used to compare the health and behavior outcomes of individuals who share the same environment or hereditary lineage; several of these studies have concluded that heredity plays some role in the formation of chronic antisocial behavior, including various forms of aggression and chronic norm-defiance. However, the ethical, social, and legal environment surrounding research on the biological contributions to antisocial behavior in the United States is contentious. Although there has been some discussion in the last few decades regarding the ethical, social, and legal concerns around this type of research within academic and policy circles, analysis and discussion of these concerns rarely appear together. This paper explores the main themes that interact to form the basis of much of the resistance to positing biological contributions to antisocial behavior.

When love meets drugs: pharmaceuticalizing ambivalence in post-socialist China

In this article, I examine the interaction between intimacy and psychiatry to explore the ambivalences in the use of pharmaceuticals in psychiatric practice. Of particular interest is how pharmaceuticals come to constitute in multiple ways what pathology is and what form of life needs to be restored, and how psychiatric medications reconfigure the ambivalence of intimacy in post-socialist China. Following the life of Mei, a female psychiatric patient, for two years, I have made a series of discoveries related to medicine and intimacy in China. Specifically, I show that psychopharmaceuticals indicate a diseased body that threatens the intimate bond. They also highlight a socially suffering subject that is in lack of love from the intimate partner who demands the latter's redemption. I discuss how these multiple and contradicting meanings of psychopharmaceuticals and intimacy are socio-historically situated. Thus, while previous research in medical anthropology criticizes pharmaceuticalization for reducing the socio-political life (bios) to a biological body (zoē), I argue that these life forms co-exist in a pharmaceutical "zone of indistinction" (Agamben, Homo Sacer: Sovereign Power and Bare Life. Stanford University Press, Stanford, 1998), in which they constitute and contradict each other. This discussion warns researchers against falling back into the usual orientation of either biomedicine or the social sciences.

The shortsighted brain: neuroeconomics and the governance of choice in time

The young field of neuroeconomics converges around behavioral deviations from the model of the human being as Homo economicus, a rational actor who calculates his choices to maximize his individual satisfaction. In a historical moment characterized by economic, health, and environmental crises, policymakers have become increasingly concerned about a particular deviation for which neuroeconomics offers a biological explanation: Why do humans value the present at the expense of the future? There is contentious debate within the field over how to model this tendency at the neural level. Should the brain be conceptualized as a unified decision-making apparatus, or as the site of conflict between an impetuous limbic system at perpetual odds with its deliberate and provident overseer in the prefrontal cortex? Scientific debates over choice-making in the brain, we argue, are also debates over how to define the constraints on human reason with which regulative strategies must contend. Drawing on ethnographic and archival research, we explore how the brain and its treatment of the future become the contested terrain for distinct visions of governmental intervention into problems of human choice-making.