Neurolinguistics

From Wikipedia, the free encyclopedia

https://en.wikipedia.org/wiki/Neurolinguistics 

Surface of the human brain, with Brodmann areas numbered

 

An image of neural pathways in the brain taken using diffusion tensor imaging

Neurolinguistics is the study of the neural mechanisms in the human brain that control the comprehension, production, and acquisition of language. As an interdisciplinary field, neurolinguistics draws methods and theories from fields such as neuroscience, linguistics, cognitive science, communication disorders and neuropsychology. Researchers are drawn to the field from a variety of backgrounds, bringing along a variety of experimental techniques as well as widely varying theoretical perspectives. Much work in neurolinguistics is informed by models in psycholinguistics and theoretical linguistics, and is focused on investigating how the brain can implement the processes that theoretical and psycholinguistics propose are necessary in producing and comprehending language. Neurolinguists study the physiological mechanisms by which the brain processes information related to language, and evaluate linguistic and psycholinguistic theories, using aphasiology, brain imaging, electrophysiology, and computer modeling.

History

Broca's area and Wernicke's area

Neurolinguistics is historically rooted in the development in the 19th century of aphasiology, the study of linguistic deficits (aphasias) occurring as the result of brain damage. Aphasiology attempts to correlate structure to function by analyzing the effect of brain injuries on language processing. One of the first people to draw a connection between a particular brain area and language processing was Paul Broca, a French surgeon who conducted autopsies on numerous individuals who had speaking deficiencies, and found that most of them had brain damage (or lesions) on the left frontal lobe, in an area now known as Broca's area. Phrenologists had made the claim in the early 19th century that different brain regions carried out different functions and that language was mostly controlled by the frontal regions of the brain, but Broca's research was possibly the first to offer empirical evidence for such a relationship, and has been described as "epoch-making" and "pivotal" to the fields of neurolinguistics and cognitive science. Later, Carl Wernicke, after whom Wernicke's area is named, proposed that different areas of the brain were specialized for different linguistic tasks, with Broca's area handling the motor production of speech, and Wernicke's area handling auditory speech comprehension.

The work of Broca and Wernicke established the field of aphasiology and the idea that language can be studied through examining physical characteristics of the brain. Early work in aphasiology also benefited from the early twentieth-century work of Korbinian Brodmann, who "mapped" the surface of the brain, dividing it up into numbered areas based on each area's cytoarchitecture (cell structure) and function; these areas, known as Brodmann areas, are still widely used in neuroscience today.

The coining of the term "neurolinguistics" is attributed to Edith Crowell Trager, Henri Hecaen and Alexandr Luria, in the late 1940s and 1950s; Luria's book "Problems in Neurolinguistics" is likely the first book with Neurolinguistics in the title. Harry Whitaker popularized neurolinguistics in the United States in the 1970s, founding the journal "Brain and Language" in 1974.

Although aphasiology is the historical core of neurolinguistics, in recent years the field has broadened considerably, thanks in part to the emergence of new brain imaging technologies (such as PET and fMRI) and time-sensitive electrophysiological techniques (EEG and MEG), which can highlight patterns of brain activation as people engage in various language tasks; electrophysiological techniques, in particular, emerged as a viable method for the study of language in 1980 with the discovery of the N400, a brain response shown to be sensitive to semantic issues in language comprehension. The N400 was the first language-relevant event-related potential to be identified, and since its discovery EEG and MEG have become increasingly widely used for conducting language research.

Interaction with other fields

Neurolinguistics is closely related to the field of psycholinguistics, which seeks to elucidate the cognitive mechanisms of language by employing the traditional techniques of experimental psychology; today, psycholinguistic and neurolinguistic theories often inform one another, and there is much collaboration between the two fields.

Much work in neurolinguistics involves testing and evaluating theories put forth by psycholinguists and theoretical linguists. In general, theoretical linguists propose models to explain the structure of language and how language information is organized, psycholinguists propose models and algorithms to explain how language information is processed in the mind, and neurolinguists analyze brain activity to infer how biological structures (populations and networks of neurons) carry out those psycholinguistic processing algorithms. For example, experiments in sentence processing have used the ELAN, N400, and P600 brain responses to examine how physiological brain responses reflect the different predictions of sentence processing models put forth by psycholinguists, such as Janet Fodor and Lyn Frazier's "serial" model, and Theo Vosse and Gerard Kempen's "unification model". Neurolinguists can also make new predictions about the structure and organization of language based on insights about the physiology of the brain, by "generalizing from the knowledge of neurological structures to language structure".

Neurolinguistics research is carried out in all the major areas of linguistics; the main linguistic subfields, and how neurolinguistics addresses them, are given in the table below.

Subfield	Description	Research questions in neurolinguistics
Phonetics	the study of speech sounds	how the brain extracts speech sounds from an acoustic signal, how the brain separates speech sounds from background noise
Phonology	the study of how sounds are organized in a language	how the phonological system of a particular language is represented in the brain
Morphology and lexicology	the study of how words are structured and stored in the mental lexicon	how the brain stores and accesses words that a person knows
Syntax	the study of how multiple-word utterances are constructed	how the brain combines words into constituents and sentences; how structural and semantic information is used in understanding sentences
Semantics	the study of how meaning is encoded in language

Topics considered

Neurolinguistics research investigates several topics, including where language information is processed, how language processing unfolds over time, how brain structures are related to language acquisition and learning, and how neurophysiology can contribute to speech and language pathology.

Localizations of language processes

Much work in neurolinguistics has, like Broca's and Wernicke's early studies, investigated the locations of specific language "modules" within the brain. Research questions include what course language information follows through the brain as it is processed, whether or not particular areas specialize in processing particular sorts of information, how different brain regions interact with one another in language processing, and how the locations of brain activation differ when a subject is producing or perceiving a language other than his or her first language.

Time course of language processes

Another area of neurolinguistics literature involves the use of electrophysiological techniques to analyze the rapid processing of language in time. The temporal ordering of specific patterns of brain activity may reflect discrete computational processes that the brain undergoes during language processing; for example, one neurolinguistic theory of sentence parsing proposes that three brain responses (the ELAN, N400, and P600) are products of three different steps in syntactic and semantic processing.

Language acquisition

Another topic is the relationship between brain structures and language acquisition. Research in first language acquisition has already established that infants from all linguistic environments go through similar and predictable stages (such as babbling), and some neurolinguistics research attempts to find correlations between stages of language development and stages of brain development, while other research investigates the physical changes (known as neuroplasticity) that the brain undergoes during second language acquisition, when adults learn a new language. Neuroplasticity is observed when both Second Language acquisition and Language Learning experience are induced, the result of this language exposure concludes that an increase of gray and white matter could be found in children, young adults and the elderly.

Ping Li, Jennifer Legault, Kaitlyn A. Litcofsky, May 2014. Neuroplasticity as a function of second language learning: Anatomical changes in the human brain Cortex: A Journal Devoted to the Study of the Nervous System & Behavior, 410.1016/j.cortex.2014.05.00124996640

Language pathology

Neurolinguistic techniques are also used to study disorders and breakdowns in language, such as aphasia and dyslexia, and how they relate to physical characteristics of the brain.

Technology used

Images of the brain recorded with PET (top) and fMRI (bottom). In the PET image, the red areas are the most active. In the fMRI image, the yellowest areas are the areas that show the greatest difference in activation between two tasks (watching a moving stimulus, versus watching a black screen).

Since one of the focuses of this field is the testing of linguistic and psycholinguistic models, the technology used for experiments is highly relevant to the study of neurolinguistics. Modern brain imaging techniques have contributed greatly to a growing understanding of the anatomical organization of linguistic functions. Brain imaging methods used in neurolinguistics may be classified into hemodynamic methods, electrophysiological methods, and methods that stimulate the cortex directly.

Hemodynamic

Hemodynamic techniques take advantage of the fact that when an area of the brain works at a task, blood is sent to supply that area with oxygen (in what is known as the Blood Oxygen Level-Dependent, or BOLD, response). Such techniques include PET and fMRI. These techniques provide high spatial resolution, allowing researchers to pinpoint the location of activity within the brain; temporal resolution (or information about the timing of brain activity), on the other hand, is poor, since the BOLD response happens much more slowly than language processing. In addition to demonstrating which parts of the brain may subserve specific language tasks or computations, hemodynamic methods have also been used to demonstrate how the structure of the brain's language architecture and the distribution of language-related activation may change over time, as a function of linguistic exposure.

In addition to PET and fMRI, which show which areas of the brain are activated by certain tasks, researchers also use diffusion tensor imaging (DTI), which shows the neural pathways that connect different brain areas, thus providing insight into how different areas interact. Functional near-infrared spectroscopy (fNIRS) is another hemodynamic method used in language tasks.

Electrophysiological

Brain waves recorded using EEG

Electrophysiological techniques take advantage of the fact that when a group of neurons in the brain fire together, they create an electric dipole or current. The technique of EEG measures this electric current using sensors on the scalp, while MEG measures the magnetic fields that are generated by these currents. In addition to these non-invasive methods, electrocorticography has also been used to study language processing. These techniques are able to measure brain activity from one millisecond to the next, providing excellent temporal resolution, which is important in studying processes that take place as quickly as language comprehension and production. On the other hand, the location of brain activity can be difficult to identify in EEG; consequently, this technique is used primarily to how language processes are carried out, rather than where. Research using EEG and MEG generally focuses on event-related potentials (ERPs), which are distinct brain responses (generally realized as negative or positive peaks on a graph of neural activity) elicited in response to a particular stimulus. Studies using ERP may focus on each ERP's latency (how long after the stimulus the ERP begins or peaks), amplitude (how high or low the peak is), or topography (where on the scalp the ERP response is picked up by sensors). Some important and common ERP components include the N400 (a negativity occurring at a latency of about 400 milliseconds), the mismatch negativity, the early left anterior negativity (a negativity occurring at an early latency and a front-left topography), the P600, and the lateralized readiness potential.

Experimental design

Experimental techniques

Neurolinguists employ a variety of experimental techniques in order to use brain imaging to draw conclusions about how language is represented and processed in the brain. These techniques include the subtraction paradigm, mismatch design, violation-based studies, various forms of priming, and direct stimulation of the brain.

Subtraction

Many language studies, particularly in fMRI, use the subtraction paradigm, in which brain activation in a task thought to involve some aspect of language processing is compared against activation in a baseline task thought to involve similar non-linguistic processes but not to involve the linguistic process. For example, activations while participants read words may be compared to baseline activations while participants read strings of random letters (in attempt to isolate activation related to lexical processing—the processing of real words), or activations while participants read syntactically complex sentences may be compared to baseline activations while participants read simpler sentences.

Mismatch paradigm

The mismatch negativity (MMN) is a rigorously documented ERP component frequently used in neurolinguistic experiments. It is an electrophysiological response that occurs in the brain when a subject hears a "deviant" stimulus in a set of perceptually identical "standards" (as in the sequence s s s s s s s d d s s s s s s d s s s s s d). Since the MMN is elicited only in response to a rare "oddball" stimulus in a set of other stimuli that are perceived to be the same, it has been used to test how speakers perceive sounds and organize stimuli categorically. For example, a landmark study by Colin Phillips and colleagues used the mismatch negativity as evidence that subjects, when presented with a series of speech sounds with acoustic parameters, perceived all the sounds as either /t/ or /d/ in spite of the acoustic variability, suggesting that the human brain has representations of abstract phonemes—in other words, the subjects were "hearing" not the specific acoustic features, but only the abstract phonemes. In addition, the mismatch negativity has been used to study syntactic processing and the recognition of word category.

Violation-based

An event-related potential

Many studies in neurolinguistics take advantage of anomalies or violations of syntactic or semantic rules in experimental stimuli, and analyzing the brain responses elicited when a subject encounters these violations. For example, sentences beginning with phrases such as *the garden was on the worked, which violates an English phrase structure rule, often elicit a brain response called the early left anterior negativity (ELAN). Violation techniques have been in use since at least 1980, when Kutas and Hillyard first reported ERP evidence that semantic violations elicited an N400 effect. Using similar methods, in 1992, Lee Osterhout first reported the P600 response to syntactic anomalies. Violation designs have also been used for hemodynamic studies (fMRI and PET): Embick and colleagues, for example, used grammatical and spelling violations to investigate the location of syntactic processing in the brain using fMRI. Another common use of violation designs is to combine two kinds of violations in the same sentence and thus make predictions about how different language processes interact with one another; this type of crossing-violation study has been used extensively to investigate how syntactic and semantic processes interact while people read or hear sentences.

Priming

In psycholinguistics and neurolinguistics, priming refers to the phenomenon whereby a subject can recognize a word more quickly if he or she has recently been presented with a word that is similar in meaning or morphological makeup (i.e., composed of similar parts). If a subject is presented with a "prime" word such as doctor and then a "target" word such as nurse, if the subject has a faster-than-usual response time to nurse then the experimenter may assume that word nurse in the brain had already been accessed when the word doctor was accessed. Priming is used to investigate a wide variety of questions about how words are stored and retrieved in the brain and how structurally complex sentences are processed.

Stimulation

Transcranial magnetic stimulation (TMS), a new noninvasive technique for studying brain activity, uses powerful magnetic fields that are applied to the brain from outside the head. It is a method of exciting or interrupting brain activity in a specific and controlled location, and thus is able to imitate aphasic symptoms while giving the researcher more control over exactly which parts of the brain will be examined. As such, it is a less invasive alternative to direct cortical stimulation, which can be used for similar types of research but requires that the subject's scalp be removed, and is thus only used on individuals who are already undergoing a major brain operation (such as individuals undergoing surgery for epilepsy). The logic behind TMS and direct cortical stimulation is similar to the logic behind aphasiology: if a particular language function is impaired when a specific region of the brain is knocked out, then that region must be somehow implicated in that language function. Few neurolinguistic studies to date have used TMS; direct cortical stimulation and cortical recording (recording brain activity using electrodes placed directly on the brain) have been used with macaque monkeys to make predictions about the behavior of human brains.

Subject tasks

In many neurolinguistics experiments, subjects do not simply sit and listen to or watch stimuli, but also are instructed to perform some sort of task in response to the stimuli. Subjects perform these tasks while recordings (electrophysiological or hemodynamic) are being taken, usually in order to ensure that they are paying attention to the stimuli. At least one study has suggested that the task the subject does has an effect on the brain responses and the results of the experiment.

Lexical decision

The lexical decision task involves subjects seeing or hearing an isolated word and answering whether or not it is a real word. It is frequently used in priming studies, since subjects are known to make a lexical decision more quickly if a word has been primed by a related word (as in "doctor" priming "nurse").

Grammaticality judgment, acceptability judgment

Many studies, especially violation-based studies, have subjects make a decision about the "acceptability" (usually grammatical acceptability or semantic acceptability) of stimuli. Such a task is often used to "ensure that subjects [are] reading the sentences attentively and that they [distinguish] acceptable from unacceptable sentences in the way the [experimenter] expect[s] them to do."

Experimental evidence has shown that the instructions given to subjects in an acceptability judgment task can influence the subjects' brain responses to stimuli. One experiment showed that when subjects were instructed to judge the "acceptability" of sentences they did not show an N400 brain response (a response commonly associated with semantic processing), but that they did show that response when instructed to ignore grammatical acceptability and only judge whether or not the sentences "made sense".

Probe verification

Some studies use a "probe verification" task rather than an overt acceptability judgment; in this paradigm, each experimental sentence is followed by a "probe word", and subjects must answer whether or not the probe word had appeared in the sentence. This task, like the acceptability judgment task, ensures that subjects are reading or listening attentively, but may avoid some of the additional processing demands of acceptability judgments, and may be used no matter what type of violation is being presented in the study.

Truth-value judgment

Subjects may be instructed not to judge whether or not the sentence is grammatically acceptable or logical, but whether the proposition expressed by the sentence is true or false. This task is commonly used in psycholinguistic studies of child language.

Active distraction and double-task

Some experiments give subjects a "distractor" task to ensure that subjects are not consciously paying attention to the experimental stimuli; this may be done to test whether a certain computation in the brain is carried out automatically, regardless of whether the subject devotes attentional resources to it. For example, one study had subjects listen to non-linguistic tones (long beeps and buzzes) in one ear and speech in the other ear, and instructed subjects to press a button when they perceived a change in the tone; this supposedly caused subjects not to pay explicit attention to grammatical violations in the speech stimuli. The subjects showed a mismatch response (MMN) anyway, suggesting that the processing of the grammatical errors was happening automatically, regardless of attention—or at least that subjects were unable to consciously separate their attention from the speech stimuli.

Another related form of experiment is the double-task experiment, in which a subject must perform an extra task (such as sequential finger-tapping or articulating nonsense syllables) while responding to linguistic stimuli; this kind of experiment has been used to investigate the use of working memory in language processing.

Thought disorder

From Wikipedia, the free encyclopedia

https://en.wikipedia.org/wiki/Thought_disorder 

 

Thought disorder
Other names	Formal thought disorder (FTD), thinking disorder
An embroidered cloth produced by a person with schizophrenia, showing the nonsensical associations between words and ideas characteristic of thought disorder
Specialty	Psychiatry

A thought disorder (TD) is any disturbance in cognition that adversely affects language and thought content, and thereby communication. A variety of thought disorders were said to be characteristic of people with schizophrenia. A content-thought disorder is typically characterised by the experience of multiple delusional fragments. The term, thought disorder, is often used to refer to a formal thought disorder.

A formal thought disorder (FTD) is a disruption of the form or structure of thought. Formal thought disorder, also known as disorganised thinking, results in disorganised speech, and is recognised as a major feature of schizophrenia, and other psychoses. FTD is also associated with conditions including mood disorders, dementia, mania, and neurological diseases.

Types of thought disorder include derailment, pressured speech, poverty of speech, tangentiality, repeating things, and thought blocking.

Formal thought disorder is a disorder of the form of thought rather than of content of thought that covers hallucinations and delusions. FTD unlike hallucinations and delusions, is an observable objective sign of psychosis. FTD is a common, and core symptom of a psychotic disorder and may be seen as a marker of its severity, and also as a predictor of prognosis. It reflects a cluster of cognitive, linguistic, and affective disturbances, that has generated research interest from the fields of cognitive neuroscience, neurolinguistics, and psychiatry.

Eugen Bleuler, who named schizophrenia, held that thought disorder was its defining characteristic.

However, disturbances of thinking and speech such as clanging or echolalia may be present in Tourette syndrome, or other symptoms as found in delirium. A clinical difference exists between these two groups. Those with psychoses are less likely to show an awareness or concern about the disordered thinking, while those with other disorders do show awareness and concerns about not being able to think straight.

Content-thought disorder

Content-thought disorder is a thought disturbance in which a person experiences multiple, fragmented delusions, typically a feature of schizophrenia, and some other mental disorders including obsessive–compulsive disorder, and mania. Content-thought disorder is not limited to delusions, other possible abnormalities include preoccupation (centering thought to a particular idea in association with strong affection), obsession (a persistent thought, idea, or image that is intrusive or inappropriate, and is distressing or upsetting), compulsion (the need to perform an act persistently and repetitively—without it necessarily leading to an actual reward or pleasure—to reduce distress), magical thinking (belief that one's thoughts by themselves can bring about effects in the world, or that thinking something corresponds with doing the same thing), overvalued ideas (false/exaggerated belief that is held with conviction but not with delusional intensity), ideas of reference (belief that innocuous or coincident events experienced have strong personal significance) or influence (belief that other people or external agents are covertly exerting powers over oneself), persecutory ideas, phobias (irrational fears of objects or circumstances), suicidal ideas, violent ideas, and homicidal ideas.

The cores of thought content disturbance are abnormal beliefs and convictions, after accounting for the person's culture and backgrounds, and range from overvalued ideas to fixed delusions. Typically, abnormal beliefs and delusions are non-specific diagnostically, even if some delusions are more prevalent in one disorder than another. Also, normal, or neurotypical, thought—consisting of awareness, concerns, beliefs, preoccupations, wishes, fantasies, imagination, and concepts—can be illogical, and can contain beliefs and prejudices/biases that are obviously contradictory. Individuals also have considerable variations, and the same person's thinking also may shift considerably from time to time.

In psychosis, delusions are the most common thought-content abnormalities. A delusion is a firm and fixed belief based on inadequate grounds not amenable to rational argument or evidence to the contrary, and not in sync with regional, cultural and educational background. Common examples in mental status examination include: erotomanic (belief that someone is in love with oneself), grandiose (belief that one is the greatest, strongest, fastest, richest, and/or most intelligent person ever), persecutory (belief that the person, or someone to whom the person is close, is being malevolently treated in some way), reference (belief that insignificant remarks, events, or objects in one's environment have personal meaning or significance), thought broadcasting (belief that others can hear or are aware of one's thoughts), thought insertion (belief that one's thoughts are not one's own, but rather belong to someone else and have been inserted into one's mind), thought withdrawal (belief that thoughts have been 'taken out' of one's mind, and one has no power over this), outside control (belief that outside forces are controlling one's thoughts, feelings, and actions), infidelity (belief that a partner is cheating on oneself), somatic (belief that one has a disease or medical condition), and nihilistic (belief that the mind, body, the world at large, or parts thereof, no longer exist). Delusions are common in people with mania, depression, schizoaffective disorder, delirium, dementia, substance use disorder, schizophrenia, and delusional disorders

Formal thought disorder

Formal thought disorder (FTD), or simply thought disorder, is also known as disorganized speech – evident from disorganized thinking, and is one of the hallmark features of schizophrenia. Formal thought disorder is a disorder of the form of thought rather than of content of thought that covers hallucinations and delusions. FTD, unlike hallucinations and delusions, is an observable objective sign of psychosis. FTD is a common, and core symptom of a psychotic disorder and may be seen as a marker of its severity, and also as a predictor of prognosis. It reflects a cluster of cognitive, linguistic, and affective disturbances, that has generated research interest from the fields of cognitive neuroscience, neurolinguistics, and psychiatry.

FTD is a complex, multidimensional syndrome characterized by deficiencies in the logical organizing of thought needed to achieve goals. FTD can be subdivided into clusters of positive and negative symptoms, as well as objective versus subjective symptoms. Within the scale of positive and negative symptoms they have been grouped into positive formal thought disorder (posFTD) and negative formal thought disorder (negFTD). Positive subtypes were those of pressure of speech, tangentiality, derailment, incoherence, and illogicality. Negative subtypes were those of poverty of speech and poverty of content. The two groups were posited to be at either end of a spectrum of normal speech. However, later studies showed these to be poorly correlated. A comprehensive measure of formal thought disorder is the Thought and Language Disorder (TALD) Scale.

Nancy Andreasen preferred to call the thought disorders collectively as thought-language-communication disorders (TLC disorders). Within the Thought, Language, Communication (TLC) Scale up to seven domains of FTD have been described with most of the variance accounted for by just two or three domains. Some TLC disorders are more suggestive of a severe disorder and given priority by listing them in the first 11 items.

It has been proposed that formal thought disorder relates to neurocognition via semantic memory. Semantic network impairment in people with schizophrenia—measured by the difference between fluency (number of animals' names produced in 60 seconds) and phonological fluency (number of words beginning with "F" produced in 60 seconds)—predicts severity of formal thought disorder, suggesting that verbal information (through semantic priming) is unavailable. Other hypotheses include working memory deficit (being confused about what has already been said in a conversation) and attentional focus.

Signs and symptoms

In the general population there will always be abnormalities in language, and their presence or absence is therefore not diagnostic of any condition. Language abnormalities can occur in schizophrenia and other disorders such as mania or depression, and can also occur in anybody who may simply be tired or stressed. To distinguish thought disorder, patterns of speech, severity of symptoms, their frequency, and resulting functional impairment can be considered.

Symptoms of thought disorder include derailment, pressured speech, poverty of speech, tangentiality, and thought blocking. FTD is a hallmark feature of schizophrenia, but is also associated with other conditions including mood disorders, dementia, mania, and neurological diseases. Impaired attention, poor memory, and difficulty formulating abstract concepts may also reflect thought disorder, and can be observed or assessed with mental status tests such as serial sevens or memory tests.

Types

There are many types of thought disorder. They are also referred to as symptoms of formal thought disorder of which 30 are described including:

• Alogia (also poverty of speech) – A poverty of speech, either in amount or content. Under negative/positive symptom classification of schizophrenia, it is classified as a negative symptom. When classifying symptoms into more dimensions, poverty of speech content—paucity of meaningful content with normal amount of speech—is a disorganization symptom, whereas poverty of speech—loss of speech production—is a negative symptom. Under SANS, thought blocking is considered a part of alogia, and so is increased latency in response.
• Blocking or thought blocking, also called deprivation of thought or obstructive thought – An abrupt stop in the middle of a train of thought which may or not be able to be continued.
• Circumstantial speech (also circumstantial thinking) — An inability to answer a question without giving excessive, unnecessary detail. This differs from tangential thinking, in that the person does eventually return to the original point. For example, the patient answers the question "how have you been sleeping lately?" with "Oh, I go to bed early, so I can get plenty of rest. I like to listen to music or read before bed. Right now I'm reading a good mystery. Maybe I'll write a mystery someday. But it isn't helping, reading I mean. I have been getting only 2 or 3 hours of sleep at night."
• Clanging – A severe form of flight of ideas whereby ideas are related only by similar or rhyming sounds rather than actual meaning. This may be heard as excessive rhyming and/or alliteration. e.g. "Many moldy mushrooms merge out of the mildewy mud on Mondays." "I heard the bell. Well, hell, then I fell." It is most commonly seen in bipolar disorder (manic phase), although it is often observed in patients with primary psychoses, namely schizophrenia and schizoaffective disorder.
• Derailment (also loose association and knight's move thinking) – Thought frequently moves from one idea to another which is obliquely related or unrelated, often appearing in speech but also in writing, e.g. "The next day when I'd be going out you know, I took control, like uh, I put bleach on my hair in California."
• Distractible speech – During mid speech, the subject is changed in response to a nearby stimulus. e.g. "Then I left San Francisco and moved to... Where did you get that tie?"
• Echolalia – Echoing of another's speech that may only be committed once, or may be continuous in repetition. This may involve repeating only the last few words or last word of the examiner's sentences. This can be a symptom of Tourette's Syndrome, e.g. "What would you like for dinner?", "That's a good question. That's a good question. That's a good question. That's a good question."
• Evasion - the next logical idea in a sequence is replaced with another idea closely but not accurately or appropriately related to it. Also called paralogia and perverted logic. Example: "I... er ah... you are uh... I think you have... uh-- acceptable erm... uh... hair."
• Flight of ideas - a form of formal thought disorder marked by abrupt leaps from one topic to another, possibly with discernable links between successive ideas, perhaps governed by similarities between subjects or, in somewhat higher grades, by rhyming, puns, and word plays, or by innocuous environmental stimuli – e.g., the sound of birds chirping. It is most characteristic of the manic phase of bipolar illness.
• Illogicality – Conclusions are reached that do not follow logically (non-sequiturs or faulty inferences). e.g. "Do you think this will fit in the box?" draws a reply like "Well duh; it's brown, isn't it?"
• Incoherence (word salad) – Speech that is unintelligible because, though the individual words are real words, the manner in which they are strung together results in incoherent gibberish, e.g. the question "Why do people comb their hair?" elicits a response like "Because it makes a twirl in life, my box is broken help me blue elephant. Isn't lettuce brave? I like electrons, hello please!"
• Neologisms – forms completely new words or phrases whose origins and meanings are usually unrecognizable. Example is "I got so angry I picked up a dish and threw it at the geshinker." These may also involve elisions of two words that are similar in meaning or in sound. Although neologisms may sometimes refer to words that are formed incorrectly but whose origins are understandable (e.g. "headshoe" for hat), these can be more clearly referred to as word approximations.
• Overinclusion is failure to eliminate ineffective, inappropriate, irrelevant, extraneous details associated with a particular stimulus.
• Perseveration – Persistent repetition of words or ideas even when another person attempts to change the topic. e.g. "It's great to be here in Nevada, Nevada, Nevada, Nevada, Nevada." This may also involve repeatedly giving the same answer to different questions. e.g. "Is your name Mary?" "Yes." "Are you in the hospital?" "Yes." "Are you a table?" "Yes." Perseveration can include palilalia and logoclonia, and can be an indication of organic brain disease such as Parkinson's.
• Phonemic paraphasia – Mispronunciation; syllables out of sequence. e.g. "I slipped on the lice and broke my arm."
• Pressured speech Rapid speech without pauses, difficult to interrupt.
• Self reference – Patient repeatedly and inappropriately refers back to self. e.g. "What's the time?", "It's 7 o'clock. That's my problem."
• Semantic paraphasia – Substitution of inappropriate word. e.g. "I slipped on the coat, on the ice I mean, and broke my book."
• Stilted speech Sentences may be stilted or vague. Speech characterized by the use of words or phrases that are flowery, excessive, and pompous, e.g. "The attorney comported himself indecorously."
• Tangential speech – Wandering from the topic and never returning to it or providing the information requested. For example, in answer to the question "Where are you from?", the person answers "My dog is from England. They have good fish and chips there. Fish breathe through gills."
• Verbigeration – Meaningless and stereotyped repetition of words or phrases replacing understandable speech, as seen in schizophrenia.

Use of term

Some recent (2015, 2017) psychiatric/psychological glossaries defined thought disorder as disturbed thinking or cognition that affects communication, language, or thought content including poverty of ideas, neologisms, paralogia, word salad, and delusions —which are disturbance of both thought content and thought form—and suggested the more specific terms of content thought disorder and formal thought disorder, with content thought disorder defined as a thought disturbance characterized by multiple fragmented delusions, and formal thought disorder defined as disturbance in the form or structure of thinking. For example, DSM-5 (2013) only used the word formal thought disorder, mostly as a synonym of disorganized thinking and disorganized speech. This is in contrast with ICD-10 (1992) which only used the word "thought disorder", always accompanied with "delusion" and "hallucination" separately, and a general medical dictionary (2002) that although generally defined thought disorders similarly to the psychiatric glossaries, but also used the word in other entries as ICD-10 did.

The recent psychiatric text (2017) also mentioned when describing thought disorder as a "disorganization syndrome" within the context of schizophrenia:

"Thought disorder" here refers to disorganization of the form of thought and not content. An older use of the term "thought disorder" included the phenomena of delusions and sometimes hallucinations, but this is confusing and ignores the clear differences in the relationships between symptoms that have become apparent over the past 30 years. Delusions and hallucinations should be identified as psychotic symptoms, and thought disorder should be taken to mean formal thought disorders or a disorder of verbal cognition.

— Phenomenology of Schizophrenia (2017), THE SYMPTOMS OF SCHIZOPHRENIA

The same text also mentioned that some clinicians use the term "formal thought disorder" broadly referring to abnormalities in thought form plus any psychotic cognitive sign or symptom, and that various studies examining cognition and subsymdromes in schizophrenia may refer to formal thought disorder as "conceptual disorganization" or "disorganization factor."

Still, there may be other dissenting opinions, including:

Unfortunately, "thought disorder" is often involved rather loosely to refer to both formal thought disorder and delusional content. For the sake of clarity, the unqualified use of the phrase "thought disorder" should be discarded from psychiatric communication. Even the designation "formal thought disorder" covers too wide a territory. It should always be made clear whether one is referring to derailment or loose associations, flight of ideas, or circumstantiality.

— The Mental Status Examination, The Medical Basis of Psychiatry (2016)

Course, diagnosis, and prognosis

It was believed that thought disorder occurred only in schizophrenia, but later findings indicate it may occur in other psychiatric conditions including mania, and occurs even in people without mental illness. Also, people with schizophrenia don't all exhibit thought disorder, so not having any thought disorder doesn't mean the person doesn't have schizophrenia, i.e. the condition is not very specific to the disease.

When adopting specific definitions of thought disorder subtypes and classifying them as positive and negative symptoms, Nancy Andreasen found that different subtypes of thought disorder occur at different frequencies among those with manic, depression, and schizophrenia. People with mania have pressured speech as the most prominent symptom, but also have relatively high rates of derailment, tangentiality, and incoherence which are as prominent as in those with schizophrenia. They are likelier to have pressured speech, distractibility, and circumstantiality.

People with schizophrenia have more negative thought disorder including poverty of speech and poverty of content of speech, but also have relatively high rates of certain positive thought disorders.

Derailment, loss of goal, poverty of content of speech, tangentiality and illogicality are particularly characteristic of schizophrenia. People with depression have relatively less thought disorders; the most prominent are poverty of speech, poverty of content of speech, and circumstantiality. She found the diagnostic usefulness of dividing the symptoms into subtypes, such as having negative thought disorders without the full affective symptoms highly suggest schizophrenia.

She also found prognostic values of negative/positive symptom divisions. In manic patients, most thought disorders return to normal levels 6 months after evaluation which suggests that thought disorders in this condition, although as severe as in schizophrenia, tend to be recoverable. In people with schizophrenia, however, negative thought disorders remain after six months, and sometimes worsen. Positive thought disorders get better somewhat. Also, negative thought disorder is a good predictor of some outcomes, e.g. patients with prominent negative thought disorders do worse on social functioning six months later. So, in general, having more prominent negative symptoms suggest a worse outcome. Nevertheless, some people may do well, respond to medication, and have normal brain function. The positive symptoms are similar vice versa.

At illness onset, prominent thought disorder also predicts worse prognosis, including:

• illness begins earlier
• increased risk of hospitalization
• decreased functional outcomes
• increased disability rates
• increased inappropriate social behaviors

Thought disorder unresponsive to treatment also predicts worse illness course. In schizophrenia, thought disorders' severity tend to be more stable than hallucinations and delusions. Prominent thought disorders are more unlikely to diminish in middle age compared to positive symptoms. Less severe thought disorder may occur during the prodromal and residual periods of schizophrenia.

DSM-5 include delusions, hallucinations, disorganized thought process (formal thought disorder), and disorganized or abnormal motor behavior (including catatonia) as key symptoms in "psychosis." Although not specific to different diagnoses, some aspects of psychosis are characteristic of some diagnoses. Schizophrenia spectrum disorders (e.g., schizoaffective disorder, schizophreniform disorder) typically consist of prominent hallucinations and/or delusions as well as formal thought disorder—displayed as severe behavioral abnormalities including disorganized, bizarre, and catatonic behavior. Psychotic disorders due to general medical conditions and substance-induced psychotic disorders typically consist of delusions and/or hallucinations. Delusional disorder and shared psychotic disorder, which are more rare, typically consist of persistent delusions. Research found that most formal thought disorders are commonly found in schizophrenia and mood disorders, but poverty of speech content is more common in schizophrenia.

Experienced clinicians may distinguish true psychosis, such as in schizophrenia, and bipolar mania, from malingering, when an individual fakes illness for other gains, by clinical presentations. For example, malingerers feign thought contents with no irregularities in form such as derailment or looseness of associations. Negative symptoms including alogia may not be present. In addition, chronic thought disorder is typically distressing.

Typically, autism spectrum disorders (ASD), whose diagnosis requires onset of symptoms prior to 3 years of age, can be distinguished from early-onset schizophrenia by disease onset occurrence (schizophrenia manifestation under age 10 is extremely rare) and the fact that ASD patients don't display formal thought disorders. However, it has been suggested that individuals with autism spectrum disorders (ASD) display language disturbances like those found in schizophrenia; a 2008 study found that children and adolescents with ASD showed significantly more illogical thinking and loose associations than control subjects. The illogical thinking was related to cognitive functioning and executive control; the loose associations were related to communication symptoms and to parent reports of stress and anxiety.

Criticisms

The concept of thought disorder has been criticized as being based on circular or incoherent definitions. For example, symptoms of thought disorder are inferred from disordered speech, based on the assumption that disordered speech arises because of disordered thought. Incoherence, or word salad, refers to speech that is semantically unconnected and conveys no meaning to the listener.

Furthermore, although thought disorder is typically associated with psychosis, similar phenomena can appear in different disorders, potentially leading to misdiagnosis—for example, in the case of incomplete yet potentially fruitful thought processes.

Another criticism related to the separation of symptoms of schizophrenia into negative/positive symptoms, including thought disorder, is that it oversimplifies the complexity of thought disorder and its relationship with other positive symptoms. Later factor analysis studies found that negative symptoms tend to correlate with one another, while positive symptoms tend to separate into two groups. The three clusters became roughly known as negative symptoms, psychotic symptoms, and disorganization symptoms. Alogia, a thought disorder traditionally classified as a negative symptom, can be separated into two separate groups: poverty of speech content as a disorganization symptom, and poverty of speech, response latency, and thought blocking as negative symptoms. Nevertheless, the efforts that led to the positive/negative symptom diametrics may allow the more accurate characterization of schizophrenia in the later works.

Bystander effect

From Wikipedia, the free encyclopedia
https://en.wikipedia.org/wiki/Bystander_effect

The bystander effect, or bystander apathy, is a social psychological theory that states that individuals are less likely to offer help to a victim when there are other people present. First proposed in 1964, much research, mostly in the lab, has focused on increasingly varied factors, such as the number of bystanders, ambiguity, group cohesiveness, and diffusion of responsibility that reinforces mutual denial. 

The theory was prompted by the murder of Kitty Genovese about which it was wrongly reported that 38 bystanders watched passively. Recent research has focused on "real world" events captured on security cameras, and the coherency and robustness of the effect has come under question. More recent studies also show that this effect can generalize to workplace settings, where subordinates often refrain from informing managers regarding ideas, concerns, and opinions.

Social psychology research

The bystander effect was first demonstrated and popularized in the laboratory by social psychologists John M. Darley and Bibb Latané in 1968 after they became interested in the topic following the murder of Kitty Genovese in 1964. These researchers launched a series of experiments that resulted in one of the strongest and most replicable effects in social psychology. In a typical experiment, the participant is either alone or among a group of other participants or confederates. An emergency situation is staged and researchers measure how long it takes the participants to intervene, if they intervene. These experiments have found that the presence of others inhibits helping, often by a large margin. For example, Bibb Latané and Judith Rodin (1969) staged an experiment around a woman in distress, where subjects were either alone, with a friend, or with a stranger. 70 percent of the people alone called out or went to help the woman after they believed she had fallen and was hurt, but when paired with a stranger only 40 percent offered help.

Philpot et al. (2019) examined over 200 sets of real-life surveillance video recordings from the United Kingdom, the Netherlands, and South Africa to answer "the most pressing question for actual public victims": whether help would be forthcoming at all. They found that intervention was the norm, and in over 90% of conflicts one or more bystanders intervened to provide help. Increased bystander presence can increase the likelihood that someone would intervene, even if the chance of each individual bystander responding is reduced.

Variables affecting bystanders

Emergency versus non-emergency situations

Latané and Darley performed three experiments to test bystander behavior in non-emergency situations. Their results indicated that the way in which the subjects were asked for help mattered. In one condition, subjects asked a bystander for his or her name. More people provided an answer when the students gave their name first. In another condition, the students asked bystanders for a dime. When the student gave an explanation, such as saying that their wallet had been stolen, the percentage of people giving assistance was higher (72%) than when the student just asked for a dime (34%). Additional research by Faul, Mark, et al., using data collected by EMS officials when responding to an emergency, indicated that the response of bystanders was correlated with the health severity of the situation.

According to Latané and Darley, there are five characteristics of emergencies that affect bystanders:

1. Emergencies involve threat of harm or actual harm
2. Emergencies are unusual and rare
3. The type of action required in an emergency differs from situation to situation
4. Emergencies cannot be predicted or expected
5. Emergencies require immediate action

Due to these five characteristics, bystanders go through cognitive and behavioural processes:

1. Notice that something is going on
2. Interpret the situation as being an emergency
3. Degree of responsibility felt
4. Form of assistance
5. Implement the action choice

Notice: To test the concept of "noticing," Latane and Darley (1968) staged an emergency using Columbia University students. The students were placed in a room—either alone, with two strangers or with three strangers to complete a questionnaire while they waited for the experimenter to return. While they were completing the questionnaire, smoke was pumped into the room through a wall vent to simulate an emergency. When students were working alone they noticed the smoke almost immediately (within 5 seconds). However, students that were working in groups took longer (up to 20 seconds) to notice the smoke. Latané and Darley claimed this phenomenon could be explained by the social norm of what is considered polite etiquette in public. In most western cultures, politeness dictates that it is inappropriate to idly look around. This may indicate that a person is nosy or rude. As a result, passers-by are more likely to be keeping their attention to themselves when around large groups than when alone. People who are alone are more likely to be conscious of their surroundings and therefore more likely to notice a person in need of assistance.

Interpret: Once a situation has been noticed, a bystander may be encouraged to intervene if they interpret the incident as an emergency. According to the principle of social influence, bystanders monitor the reactions of other people in an emergency situation to see if others think that it is necessary to intervene. If it is determined that others are not reacting to the situation, bystanders will interpret the situation as not an emergency and will not intervene. This is an example of pluralistic ignorance or social proof. Referring to the smoke experiment, even though students in the groups had clearly noticed the smoke which had become so thick that it was obscuring their vision, irritating their eyes or causing them to cough, they were still unlikely to report it. Only one participant in the group condition reported the smoke within the first four minutes, and by the end of the experiment, no-one from five of eight groups had reported the smoke at all. In the groups that did not report the smoke, the interpretations of its cause, and the likelihood that it was genuinely threatening was also less serious, with no-one suggesting fire as a possible cause, but some preferring less serious explanations, such as the air-conditioner was leaking. Similarly, interpretations of the context played an important role in people's reactions to a man and woman fighting in the street. When the woman yelled, "Get away from me; I don't know you," bystanders intervened 65 percent of the time, but only 19 percent of the time when the woman yelled, "Get away from me; I don't know why I ever married you."

General bystander effect research was mainly conducted in the context of non-dangerous, non-violent emergencies. A study (2006) tested bystander effect in emergency situations to see if they would get the same results from other studies testing non-emergencies. In situations with low potential danger, significantly more help was given when the person was alone than when they were around another person. However, in situations with high potential danger, participants confronted with an emergency alone or in the presence of another person were similarly likely to help the victim. This suggests that in situations of greater seriousness, it is more likely that people will interpret the situation as one in which help is needed and will be more likely to intervene.

Degree of responsibility: Darley and Latané determined that the degree of responsibility a bystander feels is dependent on three things:

1. Whether or not they feel the person is deserving of help
2. The competence of the bystander
3. The relationship between the bystander and the victim

Forms of assistance: There are two categories of assistance as defined by Latané and Darley:

1. Direct intervention: directly assisting the victim
2. Detour intervention. Detour intervention refers to reporting an emergency to the authorities (i.e. the police, fire department)

Implementation: After going through steps 1-4, the bystander must implement the action of choice.

In one study done by Abraham S. Ross, the effects of increased responsibility on bystander intervention were studied by increasing the presence of children. This study was based on the reaction of 36 male undergraduates presented with emergency situations. The prediction was that the intervention would be at its peak due to presence of children around those 36 male undergraduate participants. This was experimented and showed that the prediction was not supported, and was concluded as "the type of study did not result in significant differences in intervention."

A meta-analysis (2011) of the bystander effect reported that "The bystander effect was attenuated when situations were perceived as dangerous (compared with non-dangerous), perpetrators were present (compared with non-present), and the costs of intervention were physical (compared with non-physical). This pattern of findings is consistent with the arousal-cost-reward model, which proposes that dangerous emergencies are recognized faster and more clearly as real emergencies, thereby inducing higher levels of arousal and hence more helping." They also "identified situations where bystanders provide welcome physical support for the potentially intervening individual and thus reduce the bystander effect, such as when the bystanders were exclusively male, when they were naive rather than passive confederates or only virtually present persons, and when the bystanders were not strangers."

An alternative explanation has been proposed by Stanley Milgram, who hypothesized that the bystanders′ callous behavior was caused by the strategies they had adopted in daily life to cope with information overload. This idea has been supported to varying degrees by empirical research.

Timothy Hart and Ternace Miethe used data from the National Crime Victimization Survey (NCVS) and found that a bystander was present in 65 percent of the violent victimizations in the data. Their presence was most common in cases of physical assaults (68%), which accounted for the majority of these violent victimizations and less likely in robberies (49%) and sexual assaults (28%). The actions of bystanders were most frequently judged by victims as "neither helping nor hurting" (48%), followed by "helping" (37%), "hurting" (10%), and "both helping and hurting" (3%). Half of the attacks in which a bystander was present occurred in the evening, where the victim and bystander were strangers.

Ambiguity and consequences

Ambiguity is one factor that affects whether or not a person assists another in need. In some cases of high ambiguity, it can take a person or group up to five times as long before taking action than in cases of low ambiguity. In these cases, bystanders determine their own safety before proceeding. Bystanders are more likely to intervene in low ambiguity, insignificant consequence situations than in high ambiguity, significant consequence situations.

Latané and Rodin (1969) suggested that in ambiguous situations, bystanders may look to one another for guidance, and misinterpret others' lack of initial response as a lack of concern. This causes each bystander to decide that the situation is not serious.

Understanding of environment

Whether or not a bystander intervenes may have to do with their familiarity of the environment where the emergency occurs. If the bystander is familiar with the environment, they are more likely to know where to get help, where the exits are, etc. Bystanders who are in an environment in which they are not familiar with the surroundings are less likely to give help in an emergency situation.

Priming the bystander effect

Research done by Garcia et al. (2002) indicate that priming a social context may inhibit helping behavior. Imagining being around one other person or being around a group of people can affect a person's willingness to help.

Cohesiveness and group membership

Main article: Group cohesiveness

Group cohesiveness is another variable that can affect the helping behaviour of a bystander. As defined by Rutkowski et al., cohesiveness refers to an established relationship (friends, acquaintances) between two or more people. Experiments have been done to test the performance of bystanders when they are in groups with people they have been acquainted with. According to Rutkowski et al., the social responsibility norm affects helping behavior. The norm of social responsibility states that "people should help others who are in need of help and who are dependent on them for it." As suggested by the research, the more cohesive a group, the more likely the group will act in accordance to the social responsibility norm. To test this hypothesis, researchers used undergraduate students and divided them into four groups: a low cohesive group with two people, a low cohesive group with four people, a high cohesive group with two people, and a high cohesive group with four people. Students in the high cohesive group were then acquainted with each other by introducing themselves and discussing what they liked/disliked about school and other similar topics. The point of the experiment was to determine whether or not high cohesive groups were more willing to help a hurt "victim" than the low cohesive groups. The four member high cohesive groups were the quickest and most likely groups to respond to the victim who they believed to be hurt. The four member low cohesive groups were the slowest and least likely to respond to the victim.

Altruism research suggests that helping behaviour is more likely when there are similarities between the helper and the person being helped. Recent research has considered the role of similarity, and more specifically, shared group membership, in encouraging bystander intervention. In one experiment (2005), researchers found that bystanders were more likely to help an injured person if that person was wearing a football jersey of a team the bystander liked as opposed to a team the bystander did not like. However, when their shared identity as football fans was made salient, supporters of both teams were likely to be helped, significantly more so than a person wearing a plain shirt.

The findings of Mark Levine and Simon Crowther (2008) illustrated that increasing group size inhibited intervention in a street violence scenario when bystanders were strangers, but encouraged intervention when bystanders were friends. They also found that when gender identity is salient, group size encouraged intervention when bystanders and victims shared social category membership. In addition, group size interacted with context-specific norms that both inhibit and encourage helping. The bystander effect is not a generic consequence of increasing group size. When bystanders share group-level psychological relationships, group size can encourage as well as inhibit helping.

These findings can be explained in terms of self-categorization and empathy. From the perspective of self-categorization theory, a person's own social identity, well-being is tied to their group membership so that when a group based identity is salient, the suffering of one group member can be considered to directly affect the group. Because of this shared identity, referred to as self-other merging, bystanders are able to empathize, which has been found to predict helping behaviour. For example, in a study relating to helping after eviction both social identification and empathy were found to predict helping. However, when social identification was controlled for, empathy no longer predicted helping behaviour.

Cultural differences

In discussing the case of Wang Yue and a later incident in China, in which CCTV footage from a Shanghai subway showed passengers fleeing from a foreigner who fainted, UCLA anthropologist Yunxiang Yan said that the reactions can be explained not only by previous reports of scamming from older people for helping, but also by historical cultural differences in Chinese agrarian society, in which there was a stark contrast between how individuals associated with ingroup and outgroup members, saying, "How to treat strangers nicely is one of the biggest challenges in contemporary Chinese society...The prevailing ethical system in traditional China is based on close-knit community ties, kinship ties." He continued, "A person might treat other people in the person's social group very, very nicely... But turn around, when facing to a stranger, and (a person might) tend to be very suspicious. And whenever possible, might take advantage of that stranger.". In spite of this, Yan thought Chinese society was moving to a more positive direction, with the younger generation having more inclusive values as a result of growing up in a more globalized society.

In response to these incidents, many government departments and officials looked at punishing bystanders who refused to help people that clearly needed it. On August 1, 2013, a "Good Samaritan" law, was put into effect where people would be penalised for refusing to help in similar situations. This is a duty to rescue law, and is unrelated to the "Good Samaritan laws" in some Western countries that affect liability in situations where a person accidentally injures another while attempting to assist them.

Diffusion of responsibility

Darley and Latané (1968) conducted research on diffusion of responsibility. The findings suggest that in the case of an emergency, when people believe that there are other people around, they are less likely or slower to help a victim because they believe someone else will take responsibility. People may also fail to take responsibility for a situation depending on the context. They may assume that other bystanders are more qualified to help, such as doctors or police officers, and that their intervention would be unneeded. They may also be afraid of being superseded by a superior helper, offering unwanted assistance, or facing the legal consequences of offering inferior and possibly dangerous assistance. For this reason, some legislations, such as "Good Samaritan Laws" limit liability for those attempting to provide medical services and non-medical services in an emergency.

Organizational ombuds practitioners' research

A 2009 study published by International Ombudsman Association in the Journal of the International Ombudsman Association suggests that—in reality—there are dozens of reasons why people do not act on the spot or come forward in the workplace when they see behavior they consider unacceptable. The most important reasons cited for not acting were: the fear of loss of important relationships in and out of the workplace, and a fear of "bad consequences." There also were many reasons given by people who did act on the spot or come forward to authorities.

This practitioners' study suggests that the "bystander effect" can be studied and analyzed in a much broader fashion. The broader view includes not just a) what bystanders do in singular emergencies, b) helping strangers in need, when c) there are (or are not) other people around. The reactions of bystanders can also be analyzed a) when the bystanders perceive any of a wide variety of unacceptable behavior over time, b) they are within an organizational context, and c) with people whom they know. The practitioners' study reported many reasons why some bystanders within organizations do not act or report unacceptable behavior. The study also suggests that bystander behavior is, in fact, often helpful, in terms of acting on the spot to help and reporting unacceptable behavior (and emergencies and people in need.) The ombuds practitioners' study suggests that what bystanders will do in real situations is actually very complex, reflecting views of the context and their managers (and relevant organizational structures if any) and also many personal reasons.

In support of the idea that some bystanders do indeed act responsibly, Gerald Koocher and Patricia Keith Spiegel wrote a 2010 article related to an NIH-funded study which showed that informal intervention by peers and bystanders can interrupt or remedy unacceptable scientific behavior.

What Would You Do?

John Quiñones' primetime show, Primetime: What Would You Do? on ABC, tests the bystander effect. Actors are used to act out (typically non-emergency) situations while the cameras capture the reactions and actions of innocent bystanders. Topics include cheating on a millionaire test, an elderly person shoplifting, racism and homophobia.

Non-computer versus computers: computer mediated intervention

Research suggests that the bystander effect may be present in computer-mediated communication situations. Evidence demonstrates that people can be bystanders even when they cannot see the person in distress. In the experiment, 400 online chat groups were observed. One of two confederates were used as victims in each chat room: either a male victim whose screen name was Jake Harmen or a female victim whose screen name was Suzy Harmen. The purpose of the experiment was to determine whether or not the gender of the victim mattered, if the size of each chat group had any effect and if asking for a person's help by directly using their screen name would have any effect.

Results indicated that the gender of the victim had no effect on whether or not a bystander assisted the victim. Consistent with findings of Latané and Darley, the number of people present in the chat room did have an effect. The response time for smaller chat groups was quicker than in the larger chat groups. However, this effect was nonexistent when the victim (Suzy or Jake) asked for help from a specific person in the chat group. The mean response time for groups in which a specific person was called out was 36.38 seconds. The mean response time for groups in which no screen name was pointed out was 51.53 seconds. A significant finding of the research is that intervention depends on whether or not a victim asked for help by specifying a screen name. The group size effect was inhibited when the victim specifically asked a specific person for help. The group size effect was not inhibited if the victim did not ask a specific person for help.

Children as bystanders

Although most research has been conducted on adults, children can be bystanders too. A study conducted by Robert Thornberg in 2007 came up with seven reasons why children do not help when another classmate is in distress. These include: trivialisation, dissociation, embarrassment association, busy working priority, compliance with a competitive norm, audience modelling, and responsibility transfer.

In a further study, Thornberg concluded that there are seven stages of moral deliberation as a bystander in bystander situations among the Swedish schoolchildren he observed and interviewed: (a) noticing that something is wrong, i.e., children pay selective attention to their environment, and sometimes they do not tune in on a distressed peer if they are in a hurry or their view is obstructed, (b) interpreting a need for help—sometimes children think others are just playing rather than actually in distress or they display pluralistic ignorance, (c) feeling empathy, i.e., having tuned in on a situation and concluded that help is needed, children might feel sorry for an injured peer, or angry about unwarranted aggression (empathic anger), (d) processing the school's moral frames—Thornberg identified five contextual ingredients influencing children's behavior in bystander situations (the definition of a good student, tribe caring, gender stereotypes, and social-hierarchy-dependent morality), (e) scanning for social status and relations, i.e., students were less likely to intervene if they did not define themselves as friends of the victim or belonging to the same significant social category as the victim, or if there were high-status students present or involved as aggressors—conversely, lower-status children were more likely to intervene if only a few other low-status children were around, (f) condensing motives for action, such as considering a number of factors such as possible benefits and costs, and (g) acting, i.e., all of the above coalesced into a decision to intervene or not. It is striking how this was less an individual decision than the product of a set of interpersonal and institutional processes.

Implications of research

South African murder trials

In an effort to make South African courts more just in their convictions, the concept of extenuating circumstances came into being. However, no concrete definition of extenuating circumstances was ever made. The South African courts began using the testimony of expert social psychologists to define what extenuating circumstances would mean in the justice system. Examples include: deindividuation, bystander apathy, and conformity.

In the case of S. vs. Sibisi and Others (1989) eight members of the South African Railways and Harbours Union were involved in the murder of four workers who chose not to join in the SARHWU strike. Psychologists Scott Fraser and Andrew Colman presented evidence for the defense using research from social psychology. Social anthropologist Boet Kotzé provided evidence for the defense as well. He testified that African cultures are characterized by a collective consciousness. Kotzé testified that the collective conscious contributed to the defendants' willingness to act with the group rather than act as individuals. Fraser and Colman stated that bystander apathy, deindividuation, conformity and group polarization were extenuating factors in the killing of the four strike breakers. They explained that deindividuation may affect group members' ability to realize that they are still accountable for their individual actions even when with a group. They also used research on bystander apathy by Latané and Darley to illustrate why four of the eight defendants watched as the other four defendants killed four men. The testimonies of Fraser and Colman helped four of the defendants escape the death penalty.

Laws

Some parts of the world have included laws that hold bystanders responsible when they witness an emergency.

1. The Charter of human rights and freedoms of Quebec states that "[e]very person must come to the aid of anyone whose life is in peril, either personally or calling for aid, unless it involves danger to himself or a third person, or he has another valid reason". It is therefore a legal obligation to assist people in danger in Quebec if it is safe to do so.
2. Likewise, the Brazilian Penal Code states that it is a crime not to rescue (or call emergency services when appropriate) injured or disabled people including those found under grave and imminent danger as long as it safe to do so. This also includes abandoned children.
3. The German penal code makes it a crime for a person to fail to render aid in cases of accidents or other common dangers, unless such person would thereby endanger themselves or it would be contrary to some other important obligation.

In the US, Good Samaritan laws have been implemented to protect bystanders who acted in good faith. Many organizations are including bystander training. For example, the United States Department of the Army is doing bystander training with respect to sexual assault. Some organizations routinely do bystander training with respect to safety issues. Others have been doing bystander training with respect to diversity issues. Organizations such as American universities are also using bystander research to improve bystander attitudes in cases of rape. Examples include the InterAct Sexual Assault Prevention program and the Green Dot program. Others have been critical of these laws for being punitive and criminalizing the problem they are meant to address.

Many institutions have worked to provide options for bystanders who see behavior they find unacceptable. These options are usually provided through complaint systems—so bystanders have choices about where to go. One option that is particularly helpful is that of an organizational ombudsman, who keeps no records for the employer and is near-absolutely confidential.

Notable examples

Kitty Genovese

The murder of Kitty Genovese is the case that originally stimulated social psychological research into the "bystander effect". On March 13, 1964 Genovese was stabbed, sexually assaulted, and murdered while walking home from work at 3 am in Queens, New York. According to a sensationalized article in The New York Times, 38 witnesses watched the stabbings but did not intervene or even call the police until after the attacker fled and Genovese had died. The shocking account drew widespread public attention and many newspaper editorials. Psychology researchers Latané and Darley attributed the lack of help by witnesses to diffusion of responsibility: because each witness saw others witnessing the same event, they assumed that the others would be taking responsibility and calling the police, and therefore did nothing to stop the situation themselves.

An article published in American Psychologist in 2007 found that the story of Genovese's murder had been exaggerated by the media. There were far fewer than 38 eyewitnesses, the police were called at least once during the attack, and many of the bystanders who overheard the attack could not actually see the event. In 2016, The New York Times called its own reporting "flawed", stating that the original story "grossly exaggerated the number of witnesses and what they had perceived".

Jane Doe of Richmond High

On October 24, 2009, a female student of Richmond High School was gang-raped and beaten by a group of boys and men after a classmate invited her to a dark courtyard outside the school's homecoming dance. It was reported that she was treated politely and drank brandy with the group before the assault took place, which lasted two and a half hours before a young woman notified the police. As many as 20 people witnessed the incident, with several reportedly cheering and videotaping it. She was hospitalised for scrapes and bruises all over her face and body, and later sustained scars from cigarette burns on her back, as well as hips that regularly pop out of place. The case drew nationwide outrage.

Raymond Zack

On Memorial Day, 2011, 53-year-old Raymond Zack, of Alameda, California, walked into the waters off Robert Crown Memorial Beach and stood neck deep in water roughly 150 yards offshore for almost an hour. His foster mother, Dolores Berry, called 9-1-1 and said that he was trying to drown himself. (There are conflicting reports about Zack's intentions.) Firefighters and police responded but did not enter the water. The firefighters called for a United States Coast Guard boat to respond to the scene. According to police reports, Alameda police expected the firefighters to enter the water. Firefighters later said that they did not have current training and certifications to perform land-based water rescue. Dozens of civilians on the beach, and watching from their homes across from the beach, did not enter the water, apparently expecting public safety officers to conduct a rescue. Eventually, Zack collapsed in the water, apparently from hypothermia. Even then, nobody entered the water for several minutes. Finally, a good samaritan entered the water and pulled Zack to shore. Zack died afterwards at a local hospital.

Counter examples

In 2019, cultural anthropologist Marie Rosenkrantz Lindegaard led a large international study, analyzing 219 street disputes and confrontations that were recorded by security cameras in three cities in different countries — Lancaster, England; Amsterdam, Netherlands; and Cape Town, South Africa. Contrary to bystander theory, Lindegaard's team found that bystanders intervened in almost every case, and the chance of intervention went up with the number of bystanders. Which she called "a highly radical discovery and a completely different outcome than theory predicts."

This study is the first large-scale test of the bystander effect in real-life. Up until now, this effect was mainly studied in the lab by asking study subjects how they would respond in a particular situation. Another striking aspect of this study is that the observations come from three different countries including the violent country of South Africa where intervening in a street dispute is not without risk. 'That appears to indicate that this is a universal phenomenon', says Lindegaard.