'Blade Runner' blows past our ideas of 'disability'

Paul Root Wolpe, director of the Emory Center for Ethics, wrote about Oscar Pistorius, the South African amputee who is running in the 2012 Olympics, as a guest blogger for CNN.com. Dubbed the “Blade Runner,” for his high-tech, carbon-fiber “Cheetah” legs, Pistorius assembled his own legal and scientific team to make a successful bid to compete in the Olympics. But, as Wolpe writes, the story is far from over, with no general guidelines about the future use of “adaptive sports equipment.” An excerpt from the article:

Photo by Elvar Paisson/Wikipedia Commons.

“The issue will have to be revisited by each new athlete who wants to use artificial mechanisms in competition. …

“We do not ultimately know the degree to which technology mimics true physiological function. What if an amputee high jumper wants to use Cheetahs; what level of springiness is "fair" against able-bodied athletes? What about a swimmer who wants to use prosthetic hands or legs? Or an archer whose prosthetic arm does not tremble like an arm of flesh and blood? We do not have metrics that can determine true equivalence with able-bodied athletes.

“Then there is the issue of fairness. In this year's U.S. Olympic trials, Dathan Ritzenhein, the two-time Olympian and 5k American record holder, was eliminated from the marathon team because of leg cramps. Pistorius cannot get cramps in his calves because he does not have any, and so he can never be eliminated based on this criterion.

“The Pistorius case confronts us with two important questions. What is a disability? And what is the rationale for elite sport?”

Read the whole article at CNN.com.

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Former Miss America discusses anorexia

Beauty pageants actually helped her heal from anorexia, says Kirsten Haglund. Photo by Kay Hinton.

By Mary Loftus, Emory Magazine

Kirsten Lora Haglund, Miss America 2008, is now a junior at Emory, majoring in political science. But as a girl growing up in Farmington Hills, Michigan, her dream was to become a ballerina.

And that was how the trouble with food began.

“When I was 12, I went away to a very intensive ballet camp for the summer. I was living away from home for the first time, and my mother had been diagnosed with breast cancer,” Haglund says. “Also, I was going through puberty, and I dreaded that. As a ballet dancer you want to stay thin and graceful and elegant.”

She remembers the day she threw her lunch away for the first time. Everyone else was having a bit of granola, an apple. “I felt like a cow, eating a peanut-butter-and-jelly sandwich,” she says.

Not eating felt like being in complete control—at least of her own body. “I felt above mere mortals, that I could subsist without food. Restricting calories was accomplishing what other people couldn’t. It gave me significance. I was the skinny girl.”

Already tall and slim, Haglund started with the aim of losing five pounds, but that number rapidly escalated. She began severely restricting her food intake to just 900 calories a day, living mostly on Diet Coke, coffee, gum, lettuce, and an occasional spoonful of peanut butter or grilled chicken breast with lemon.

“I started to hate dancing,” she says. “I was tired and had no energy, and you always had to look in mirrors. I was never satisfied; I kept seeing parts of my body I hated more and more.”


Always a straight-A student, she was still excelling in school. But deep down, Haglund knew something was wrong. Her hair started to fall out, her nails became brittle, and she was always cold. She stopped having her period. She isolated, staying away from social functions with food or friends who asked questions. She lost 30 pounds in three years.

When her parents intervened and took her to a doctor, Haglund remembers, “I was so mad. And I hated that doctor. Now we’re friends, so I can say that.”

A physical showed that Haglund’s health, at 15, had already been compromised. She had osteopenia, a precursor to osteoporosis and renal insufficiency. She began seeing an eating disorder specialist, a nutritionist, and a psychologist, multiple times a week throughout high school.

“I can’t even remember now what I saw in the mirror when I was sick, because my eyes have changed,” she says. “But I do remember feeling that my willpower, the restrictions, were never enough. I kept a journal of what I ate and how much I exercised, and had a constant dialogue going on in my brain, whenever I consumed calories, of how and when I was going to burn them off.”

“Genetics loads the gun and environment pulls the trigger,” Haglund adds. “I think I had both a genetic predisposition and also stressors, like ballet.”

But she overcame the disorder before entering her first pageant, Miss Oakland County—a stepping stone to Miss Michigan—at 17. She wanted to attend the University of Cincinnati College-Conservatory of Music, and needed scholarships to afford tuition. Haglund competed in the Miss Michigan pageant in June 2007. She won a preliminary swimsuit award and performed “Adele’s Laughing Song” from the operetta Die Fledermaus.

Haglund believes that pageants, rather than compromising her recovery from anorexia, actually helped her to heal.

“The ideal pageant body is much healthier than the ideal ballet dancer’s body,” she says.

At 19, she went on to represent Michigan in the Miss America 2008 pageant, a newly “modernized” version broadcast for the first time on the network TLC. The youngest of the 53 women vying for the crown, Haglund sang a Broadway-style rendition of “Over the Rainbow,” and her platform was eating disorder awareness.

On January 26, 2008, more than three million TV viewers watched as Haglund was crowned the eighty-third Miss America. With $60,000 in scholarship money, Haglund decided to resume college at Emory, largely because of its location in Atlanta and its top-20 standing.

She has continued to pursue her pageant platform by starting the Kirsten Haglund Foundation to assist girls who need treatment for eating disorders. The foundation has given financial assistance to 13 girls so far and has helped countless others by advocating for their treatment, assisting with insurance, and providing encouragement. Haglund speaks at events all over the country about body image and overcoming anorexia. “Parents can sometimes think it’s just a phase,” she says. “But if you catch it early, like anything else, there’s a much better chance for recovery.”

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Food fight: Colleges still a hot spot for eating disorders

Psychologist Linda Craighead, second from right, with graduate students in the Eating and Weight Concerns Center at Emory, with a "hunger meter" chart. Photo by Todd Deveau.

By Mary Loftus, Emory Magazine

Eating disorders are paradoxical: they are about control more than food, yet thoughts of food pervade almost every waking moment. The substance being abused can’t simply be avoided like drugs or alcohol.

The intent is often to achieve “the perfect body,” but the disorders actually harm, disfigure, even kill. And this all takes place within a culture that simultaneously glorifies eating well and being thin.

No wonder, then, that hot spots for eating disorders include universities, high-level performance sports, and the entertainment industry.

“Southern private schools do have a slightly higher rate, but all universities have more than we would like,” says Emory psychologist Linda Craighead, who specializes in eating disorders and weight concerns and is the author of The Appetite Awareness Workbook: How to Listen to Your Body and Overcome Binge Eating, Overeating and Obsession with Food. “Eating disorders cut across socioeconomic levels and all ethnicities.”

The most severe are anorexia and bulimia—the National Eating Disorder Association estimates that 10 million women and 1 million men in the U.S. struggle with one of these disorders—while millions more engage in binge eating or compulsive overeating. “At Emory’s counseling center, we see a lot of students, even medical students, with eating disorders,” Craighead says.

A person with anorexia typically falls below a certain weight—for adults, a body mass index of 18.5. Their diet is usually very restricted and often vegetarian, Craighead says.

“In many cases,” she says, “people who start with anorexia move on to binging and purging because the biological pressure to eat is so strong it breaks through now and then.”

Bulimia traditionally involves binging followed by a “maladaptive compensatory behavior”— mostly vomiting, but this can also take the form of laxatives, over-exercising, or fasting. “Most bulimics are close to normal weight, since purging is actually one of the least effective ways to compensate—about half the food stays in the body. So we try to teach bulimics in recovery to learn to be satisfied with just eating half the amount.”

Assistant Professor of Family and Preventive Medicine Teresa Beck treats patients with eating disorders and trains residents with a personal perspective. “I developed an eating disorder during medical school and hid it from my family for six years,” she says. “Mine started, just like most, with dieting to lose a few pounds. I use my experiences to help many of my patients with their own problems related to compulsive or emotional eating, obesity, poor body image, perfectionism, and all that goes along with that.”

Often, there’s a migration between all three disorders—anorexia, bulimia, and binging. “The contagion effect is huge,” says Craighead, which explains how eating disorders can run rampant through dorms and sororities. And dangerous new influences exist, like “pro-ana” groups on social media sites that glorify and offer tips about anorexia.

Health problems may not show up until middle age, and the main, irreversible consequence is bone loss. “You only have a window of time, twelve to twenty-three, to lay down all the bone that you’re going to get,” Craighead says. “You have to eat real food and have enough weight on. If your bones are fragile when you’re older, there’s no way to fix it.”

Nadine Kaslow, a professor of psychiatry at Emory and also the psychologist for the Atlanta Ballet, says eating disorders are prevalent among ballerinas. Kaslow has been involved in ballet since she was three, and says the dance culture has always supported extreme thinness.

“We used to have to wear our ideal weight and actual weight pinned to our leotards,” she says. “You weighed in once a week, and if you weren’t thin enough, you were publicly humiliated.”

It’s gotten better, says Kaslow, but “you are still reinforced for being thin, that’s just the normative expectation. A cultural shift is needed.”

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Mirror image: iStockphoto.com

Compassion training benefits foster children

By Kathi Baker, Woodruff Health Sciences Center

Cognitively-Based Compassion Training (CBCT) appears to improve the mental and physical health of adolescents in foster care, a new study shows. CBCT is a therapeutic intervention that uses meditation and other strategies geared to help people develop more compassionate attitudes toward themselves and others.

It is well documented that children in foster care have a high prevalence of trauma in their lives. For many, circumstances that bring them into the foster care system are formidable — sexual abuse, parental neglect, family violence, homelessness and exposure to drugs. In addition, they are separated from biological family and some are regularly moved around from one place to another.

Emory researchers conducted the study in collaboration with the Georgia Department of Human Services and the Division of Family and Child Services. The study was recently published online in the journals Psychoneuroendocrinology and Child and Family Studies.

"Children with early life adversity tend to have elevated levels of inflammation across their lifespan," explains Thaddeus Pace, lead author on the paper in Psychoneuroendocrinology, and assistant professor in the Department of Psychiatry and Behavioral Sciences at Emory.

"Inflammation is known to play a fundamental role in the development of a number of chronic illnesses, including cardiovascular disease, type 2 diabetes, dementia, cancer and depression."

The study finds that adolescents who practiced CBCT showed reductions in the inflammatory marker C-reactive protein (CRP), reduced anxiety and increased feelings of hopefulness. The more the study participants practiced, the greater the improvement observed in these measures.

"The beneficial effects of CBCT on anxiety and feelings of hopelessness suggest that this intervention may provide immediate benefit to foster children," says Charles Raison, a co-author of the study, now at the University of Arizona. "We are even more encouraged by the finding that CBCT reduced levels of inflammation. Our hope is that CBCT may help contribute to the long-term health and well being of foster care children, not only during childhood, but also as they move into their adult years."

Additionally, an article recently published in the journal Pediatrics reported that a high proportion of children in foster care programs across the United States are on psychiatric medications, perhaps inappropriately.

"In light of the increasing concern that we may be over-medicating children in state custody, our findings that CBCT can help with behavioral and physical health issues may be especially timely," says Linda Craighead, senior author for the paper published in Child and Family Studies, and professor of psychology at Emory.

CBCT is a multi-week program developed at Emory by Geshe Lobsang Tenzin Negi, one of the study's co-authors. Although derived from Tibetan Buddhist teachings on compassion, the CBCT program has been designed to be completely secular in nature.

The Georgia Department of Human Services and the Division of Family and Child Services identified 71 adolescents between the ages of 13 and 19 as eligible for study participation. All of the children lived in the greater metropolitan Atlanta area, and were in foster care at the time of the study.

The participants were randomized to six weeks of Cognitvely-Based Compassion Training, or to a wait list control group. Before and after these interventions the adolescents were assessed on various measures of anxiety and hope about the future. They also provided saliva samples for the measurement of C-reactive protein.

The researchers found that within the CBCT group, participation in practice sessions during the study correlated with reduced CRP from baseline to the six-week assessment. The researchers emphasize that further studies will be needed to determine if there are long-term benefits with CBCT.

Images: iStockphoto.com.

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Batman and the psychology of trauma

Some people cope with trauma and devastating loss by becoming a stronger person, working through their pain and using their experiences to help society. But some people who endure severe trauma turn inward, crumple into depression or, even worse, go on to inflict pain onto others.

What is it about the human psyche that sets individuals down such different paths? That question drives everything from modern-day neuroscience to the plots of great literature and comic book super heroes.

In “The Dark Knight Rises,” the third and final installment in a Batman film triology, Bruce Wayne finally confronts the pain of loss that he has kept masked by fighting criminals.

In the above video, taped before the tragic real-life shooting at the film’s opening in Aurora, Colorado, Emory psychologist Jared DeFife discusses the dark themes of pain, anger and fear that shaped the character of Bruce Wayne.

“You can’t really understand Bruce Wayne without understanding the childhood trauma of seeing his parents murdered in front of him,” DeFife says.

On the one hand, Wayne turned his pain into a force for good, by battling for justice for others, Defife says. But in order to fight crime, Bruce Wayne created the alter ego of Batman.

“A split-off identity comes at great cost,” DeFife says, noting that it also happens sometimes in real life. “After a traumatic experience, whether it be combat trauma, motor vehicle accidents or crimes that occur, people can begin to split off aspects of themselves even more so than other people. Because dealing with those events, trying to make sense of those events, can lead people to disassociate. They sort of withdraw from the stimuli going on in the world.”

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