Become a Creator today!Start creating today - Share your story with the world!
Start for free
00:00:00
00:00:01
Episode 17 with Professor Christian Beste
549 Plays2 months ago
A Fascinating exploration of the idea that event segmentation may be fundamental to the ADHD brain. Prepare to have your mind blown!
Link to the Red Ballloon film- put it on in the background while you listen: The Red Balloon / Le Ballon Rouge (1956) (youtube.com)
Christian's website: Startseite - Christian Beste (christian-beste.de)
Recommended
Transcript
00:00:08
Speaker
Hello.
Welcome Back and Updates
00:00:09
Speaker
Hello. Welcome back to the ADHD Science Podcast. Welcome back. It's been a while hasn't it Tess? I'm Tess Davey. I'm Max Davey. It has been a while Max Davey. Can I remind him how the podcast format goes because it's been a while. Yeah it has been a while. I've been busy. You've been busy. I have been. I've been living out my youth.
00:00:31
Speaker
right You've completed all of your exams and stuff and you've been socialising like nobody's business. Like my business. Like your business. It's entirely your business. Exactly. And now you've got your year off. Yeah. Who knows what kind of business I'm going to be getting up to. Well, we know what business you're going to get up to. Pub business. Pub business. I'm going to be working.
00:00:51
Speaker
Yes, and I continue to just do dad stuff. Yeah, Max does dad stuff. That's exactly
Engaging with the Community
00:00:56
Speaker
it. um So podcast news, we have a Facebook group now so we think it will be helpful for people who want to ask us questions or follow up.
00:01:06
Speaker
or discuss, because it's a bit of a closed environment, it's not like, and it's just, I think people might feel a bit more confident asking stuff. um So do go to Facebook, which we understand is evil and everything, but yeah there isn't anywhere better yeah um for this particular purpose, and do let us know what you think. Just search for ADHD Science Podcast, it's very unimaginably, unimaginatively
Introducing Professor Christian Best
00:01:31
Speaker
ah named. named Right, so today we are going to talk to Professor Christian Best, best who is from Germany, our first German listener, I wouldn't say listener, we've probably got a few listeners. Hello German listeners. Hello, jet well they might have tuned in to listen to Christian of course. Oh yeah. Because he's a big cheese. Oh that's intimidating. Hello. um Big fan of the country. Yeah exactly, we are, he's one of our favourite countries.
00:01:57
Speaker
Really? Well, we went together, didn't we? We did. We went on a father-daughter trip to Germany. Yeah, exactly. We went to Berlin specifically. It was tremendous. So, anyway, Christian has got really interesting perspective on ADHD and the relation... And basically, it's not even the relationship between time perception and ADHD. It's time perception being a fundamental feature of ADHD, which is really, really interesting. And he illustrates it in a beautiful way using a silent film, which we should probably link to as well.
00:02:27
Speaker
Yes, that'd be nice. Yeah, so that's it, basically Christian and the Facebook group, those are the things you need to remember from this intro. Yeah, we won't keep you for any longer. Won't keep you any further, no less further ado. Let's get into it. Let's go. yeah Okay, hello. Hello. So we're delighted to be joined today by Professor Christian Best. Christian, can you just introduce yourself?
Action Control in ADHD
00:02:49
Speaker
Yeah, my name is Christian Best. I'm a professor of cognitive neurophysiology here at U Dresden.
00:02:55
Speaker
By training, I am psychologist and cognitive neuroscientist. We're much interested in um action control processes and all what leads to ah proper unfolding of action and the control of actions.
00:03:10
Speaker
So I'm interested in ADHD, but also many other neuropsychiatric disorders. So basically my research strategy is to try to um yeah explain what's about in different neuropsychiatric disorders through the lens of action control processes and all the different surroundings leading to a successful action control.
00:03:35
Speaker
And this is why I'm not only interested in one disease, because I very much think that taking the lens to different diseases will also help me to better understand, okay, about normal brain functioning, but on the other hand, ah which can lead to some new insights for the different ah new psychiatric disorders. And I think that's what we are talking to about today, in this case ADHD.
00:03:59
Speaker
that's awesome Wow, what an intro. yeah i mean I suppose the the first question is how would you define action control? yes Action control is basically something where you have to integrate ah perceptual processes with motor processes.
00:04:18
Speaker
And only if perceptual processes and motor processes are properly integrated, you can um yeah go for go-directed acting. So when you think about ADHD, for example, you may have problems in inhibiting yourself because there may be an appropriate tendency of Yeah, um waiting for your turn to come and all that stuff. So inhibitory control is one major aspect of action control. But um my ah philosophy behind that is that we need to know about the yeah,
00:04:55
Speaker
building processes of basic motor function, basic perceptual and attentional processes, and how all these get together in what we call goal-directed acting or action control. So action control is not one specific process, it is more that many different processes have to come together, which is attentional processes, which is executive functioning, which is memory processes.
00:05:19
Speaker
And all of these different mechanisms have to come together to um yeah allow a smooth unfolding of action control. And in very, very, very basic lay language, it's action successful action control, as I understand it, is doing the right thing at the right time to get what you want.
00:05:41
Speaker
This, um yeah, you may call it like this, but it's also a sort of strategic thinking ahead. yeah So blending ahead, this is also called action control, but mostly research is done within a given situation where you have different feedback coming in, how you adapt to that feedback, how you select your actions accordingly, and how to behave.
00:06:07
Speaker
appropriately considering also the environmental demand that is in a national action control. Yeah okay I think I mean that makes sense to me is that is that clearer to you Tess? I mean kind of. I don't think I'm ever fully gonna get any of this stuff on the first shot so I usually understand about halfway through the episode. Okay I mean you've got your goals and I suppose what we're saying is it's it's planning and executing the right action in order to achieve those goals. Does that only work for short-term goals or is it possible to do for because I think long-term goals is a lot more complex, would that be a lot more complex?
Event Segmentation Theory Explained
00:06:43
Speaker
Yes, true. um So it also applies for short and long term goals. So when you look into research, especially in cognitive neuroscience, it is more that action control there is conceptualized as being that you're interested in ah not too much in long-term but more on short-term goals which may change in a yeah quite short notice um and um what you were then call about long-term planning is also somehow related to action control
00:07:15
Speaker
But there is nothing to control because it is more about planning. Control is more about, okay, what you are doing in the actual moment. This is action control. Your stuff is planning, ah reasoning, and all that stuff. Okay. Um, one of which is fascinating stuff, but not actually.
00:07:36
Speaker
Well, I'm sure it's related. I'm sure it's kind of the related to the actual paper that we wanted to talk about today, the specific stuff that you wanted to do. I was really kind of struck by, which is your paper on event, is it advanced segmentation theory or so or model? I don't know. Yes, it is. even You can talk about that yeah and and how that applies to ADHD and how that may ah it's been a way of explaining some of what ADHD is. So should we so we jump into that? Yes, first question. What question were you answering? Yeah, we were answering the question or tried to answer the question whether we need a new conception about what we think is ADHD.
00:08:20
Speaker
So when you think about ADHD, ADHD is a neuropsychiatric disorder. And as the name of this disorder already suggests, it is a disorder about attentional processes, so to say.
00:08:33
Speaker
But every one of us um has a different and maybe not mutually in included exclusive conception about what attention is. So everyone has sort of an intuitive idea about what attention is, but this is also kind of the problem for the research in that disorder. Everyone seems to know what attention is. Nobody does really know what attention is.
00:09:00
Speaker
Yeah, but there are so many different conceptions out there. And the other point is that we somehow try to explain an attentional disorder by the same mechanism. So what we try to explain and how we used to explain this is its one at the same and this makes from a scientific point of view, not that much sense. So you cannot ah explain the phenomenon by mechanisms that are at the same time inherent to that phenomenon. So you cannot explain attentional processes or deficits in attention by some construct that are themselves lending to attention. So you cannot pay attention by attention. Yes, exactly. I think that's the really key point is that I think you're really right that people will say, oh, what's attention deficits? like Just we're leaving out the hyperactivity aspect of it. What's an attention deficit? It's when you have a deficit deficit of attention. And they're like, well, what's that? It's when you can't play attention. No, no, but what does that mean? Oh, well, I don't know. And you're right. At some level, it doesn't make sense. It's circular. And then you are also in that problem that you have a kind of a circular argumentation. And this circular argumentation is very much around
00:10:15
Speaker
in adhd hu And also when you think about other problems that these ah patients have, I mean, they have problems in executive functioning cognitive control, for example. So behaving appropriately in a given moment, inhibiting themselves, they may have also difficulties in short-term memory functions long-term memory functions and all what this and then there comes the aspect of concentration so what is concentration about being able to concentrate at a given moment being able to concentrate in a given conversation and all what's about.
00:10:52
Speaker
And when you now think about, okay, ah how is ADHD defined? And when you then look at what's around there in ICD-11 or the DSM, for example, you will see many phenomena that can also or may also be explained by processes that are not that much related. And this was basically the idea of our research project that we said, well, there may be a different concept that may equally well explain the different facets of what ADHD is about. yeah yeah This is the idea behind event segmentation. So in a nutshell, we would think that
00:11:34
Speaker
ADHD is a kind of a disorder of how we segment our environment or the information stream in our environment into meaningful episodes. And that's all. So it is not that much it is attention per se, but how we encapsulate incoming information into meaningful segments, helping us to organize ourselves. Can you give an example of what but ah different sorts of eggs event segmentation, what that looks like in practice. is I mean, maybe we're moving on to the next question, which is, what youve what do you find experimentally when you look at event segmentation?
00:12:16
Speaker
Yeah, of course. um I mean, when you go into a supermarket, for example, yeah, then you go in, then you check for the products, check what you need to buy, check what what you like to buy, and then you end up at the end of the supermarket where you have to pay for all of the articles that are in your trade, for example.
00:12:37
Speaker
But for that, ah you have to may stay in a queue waiting for your turn to come to go to the cashier and all that force. So when you enter the supermarket, you already have an idea about what is to be expected, how to behave in that particular situation, what is likely to come up and what is likely to not come.
00:12:59
Speaker
So you may say that, well, this shopping experience or buying something in your supermarket is one episode and you have a one event segment and you know how these events are usually unfold.
00:13:13
Speaker
However, you could also think about ah situations does not unfold the way you expect it to be. So for example, when you are waiting at a bus stop, the normal expectation is that you have to wait there for the bus to come. However, it can then happen that a friend of you passes by in a car sees you at the bus stop and asks you, well, would you mind jumping in my car instead of waiting for the bus?
00:13:43
Speaker
This is something that you cannot really expect to happen when you are standing at the bus stop. When you are standing at the bus stop, you expect, okay, I have to wait a few minutes until the bus is coming. But you do not really expect that the situation changes that much, that you are allowed to enter another car and therefore have a shortcut in the journey where you want to go to. So there are some expectations that are inherent to a situation and there are some things whereas the expectations in a given situation are violated. And then the question is, how sensitive are you to these different
Experiment: The Red Balloon
00:14:22
Speaker
expectations? yeah And the other point is, how long do you anticipate some situations to evolve? What you could say, for example, I mean people with ADHD have problems
00:14:36
Speaker
in waiting for their turn to come, ah maybe at school, maybe while standing in a queue and all that force and so on. Why is that? Because they may have a different conception about how the events are ah likely to evolve and maybe they have also different conception about when an event or yeah when an when an event in the environment starts and when the episode there is supposed to be closed. So it may be that people with ADHD have much more ah smaller bricks, ah how would they structure the environment, and because they have smaller bricks, time flies by by these people. And because time flies by,
00:15:24
Speaker
They are not really able to wait for their turn to come, for example. They interrupt others because they think it already happened. um That's the idea. But this is nothing that is ah to be connected to being inattentive or whatever or to be impulsive. It is related to it, but the cause of it is a different one. The cause is not that there is an intentional problem per se, the cause is not that they may be impulsive per se, but there is another reason for that, explaining both of these different facets. And this may be the way how they structure the environment.
00:16:05
Speaker
So it's almost, this is probably not a great, so what you're saying in a sense is that the impulsivity and the poor concentration is a surface level sign of a fundamental difference in the way that ADHD people see the world and perceive, almost perceive time. Exactly. And this is one of the biggest problems, at least from my perspective, in ADHD research in general.
00:16:29
Speaker
So ADHD research is very much driven by the phenomenology of the disorder which is completely okay because when you are in a clinic or in an outpatient unit and when you are about to diagnose ADHD it is very much about the phenomena that you need and also deciding about the treatment is very much related to the phenomena because you want to ah reduce the symptoms. The symptoms never are about the phenomena, but the phenomenon and the underlying cause are not necessarily the same. They can be, but in many cases there aren't. So the question is, what could be an overarching mechanism that explains different aspects of ADHD? And we would think that this is the way how people
00:17:23
Speaker
um analyze the environment and segment the environment into meaningful episodes. So yes, um I think I'm vaguely following, but again, my understanding of it could just be wrong. Yeah. um So everybody segments their life into individual episodes, with which we expect to be a different length. Yes. There was some sort of different fundamental difference in the way that ADHD people conceptualize these episodes. Yes.
00:17:49
Speaker
um that means that we perceive time differently, yeah which explains um some of the symptom a lot of ADHD symptoms. And and so the i mean I think the the word phenomenon is a really good one. we know but And I think it kind of covers everything in terms of signs and symptoms, but that's what it, just to but explain to everyone in the audience, phenomenology is basically looking at the surface, what what things look like from the outside rather than what's going on inside. So just to be clear about that.
00:18:19
Speaker
Yeah, exactly. And when you think about, I mean, people with ADHD, they have problems in attention, whatever kind this attention may be. If you focus attention, it could be divided attention. It could also be some sort of difficulties in remembering for sure time period some information. yeah When you have to remember something that you have to buy, you may have forgotten that. So this is also a problem for people with ADHD.
00:18:47
Speaker
They have also cognitive control problems. They may have different um problems in working memory. They may have difficulties in inhibition. They may have difficulties in stringent planning and all that stuff. And the question is why is this is the case. And what is nowadays research strategy that each of these different aspects of ADHD are um treated as mostly yeah independent entities but of course they are not independent. They may have a common core and this core is about um to be detected and we would think now that one at least um yeah promising research strategy or the way to better understand this superficial phenomena could be by how people
00:19:41
Speaker
um segment information in their environment into meaningful events. Okay, so I think it would be really good at this point to dive in and actually think about the specific things that you found. how What was your experiment and and and what the findings of your experiment that you you describe in this paper were? Because I think that might get people a better handle on how you then interpret and how you yeah make that a Yeah. An exploratory framework. So people were to watch a movie. This is a fairly old movie. It is called The Red Balloon. Red Balloon is a movie that was created in the 50s. It's a very famous movie. Extremely. It's a very famous movie. And the special thing about that movie is that there are almost no cuts within that movie.
00:20:32
Speaker
When you think about nowadays movie, you have um a yeah stream of information and a unfolding of scenes and actions that is very much determined by how the cutter cut at the movie. So it is not about you how to make sense of the movie and how far the movie is likely to evolve.
00:20:59
Speaker
but it is very much dictated to you by how the movie is being cut. And that's the idea. People will then say, okay, well, you watched the movie. And whenever you think that a scene in the movie ends and something new is gonna happen, then you press a button. That's all. So the people were in some sense instructed to behave like a cutter in the movie.
00:21:28
Speaker
and whenever they think that the scene ends or some meaningful changes are there, then they had to press the button. That was all. And what's the case is that there is a ah young boy who um lost his red balloon. So the red balloon ah flew away and then he followed this red balloon across the entire city and at the end um it was possible to get this red balloon back. So what happened?
00:21:58
Speaker
No, we were going to watch that. He went through the entire city and then he encountered different obstacles, different people, different objects. yeah yeah This was basically is the point where we were interested in. So how in how far did people with ADHD segment the meaningful information in the movie in a different way than people not having ADHD. Am I right in thinking it doesn't have that much dialogue? It has no dialogue at all. It is simply a black and white film and a young boy is moving through the entire city. There's no dialogue, there's just a bit of music in the back, but there's no dialogue at all. Right. How do you know it's a red balloon?
00:22:53
Speaker
Oh, how do you know it's a red balloon because it's a black and white balloon. The balloon was originally red. and you have to Thank you, Tess. So presumably from what you've been saying, ADHD people segment this film in a different way to other people. Yeah, and they make use of different information.
00:23:21
Speaker
So when you think about, okay, what could determine a change in the scene? It could be that um you are engaging with another person maybe, or it could be that you have to jump across the wall, that you have to cross the street, that you have to change from the inside of your house to the street or whatever it is.
00:23:48
Speaker
So what's possible in this film is that you can And this was tremendous work by ah Jeff Sachs um who did this originally. He yeah sort of evaluated the film according to different changes that are possible. So for example, there are gaps in time or jumps in a place or that you could engage with a different character in the movie. So the movie can be um yeah described by different
00:24:21
Speaker
think how the main character in the movie is going to interact with different objects, other characters, places, and whatever it is. And then you could ask yourself, well, what is the main source of information people are using or not use, determining when a scene in their sense is supposed to end or supposed to stop.
00:24:47
Speaker
yeah What we found there is that especially this social information. So when the boy was about to engage with another person in the street, let's say asking whether that person has also seen the balloon flying, is asking about the direction, where to go and so forth and so on. This is the information where people with ADHD have most problems with.
00:25:15
Speaker
So people with ADHD were not that bad in deciding, well, there is a change in the place, there is a change in time, there is a change um in the object because the boy was supposed to jump from a wall and ran onto a street. But people with ADHD um did not consider the interaction with other characters in the film as being a meaningful information to segment the events. So the interaction with different people is not that much salient to them.
00:25:52
Speaker
And this is why they behave differently. And this is the main outcome of that story that people with ADHD do indeed segment their environment differently, not paying too much attention, you may say, to other people around them. So it is a kind of specific information that people seem to miss out. Right.
00:26:20
Speaker
Okay, so I just have one question. um How did that manifest the difference in ADHD people's segmentation? Did they go sooner or later than other people? Like, what did that look like? Yeah, um it's about the likelihood that they perceive a change in the scene. Yeah. So you could think about, well, how many things are necessary to change before people with ADHD recognize it as such. but And this is a point in the film. So there are very subtle changes in scenes where, for example, only one thing at the screen is changing, for example. Then there could be two things, three things, four things, and five things. And then the question is, in how far does this increase the likelihood
00:27:16
Speaker
that a person judging or who who is supposed to cut the film uses this information. And what we found there is compared to neurotypical people, there are not that much changes when the information is very subtle. So all people are doing hard in that. um But the point is that especially when information is very obvious or already obvious to other people, it is not too obvious for people with ADHD. And this is especially the case when there is some social information in it. So people with ADHD are particularly doing hard
00:28:04
Speaker
when there are otherwise growth changes in a scene and when these growth changes in a scene very much depend on social interactions or changes in the social interaction of the protagonist in the film with other characters that are surrounding that protagonist.
00:28:25
Speaker
That's okay. The obvious question that comes to my mind is, is you've obviously talk about neuro, you know, versus neurotypicals. Have you done the comparison or are you going to do a comparison with people with a more autistic spectrum condition?
Comparing Disorders through Segmentation
00:28:38
Speaker
It's because that's the obvious other group who might. Excellent question. this is Exactly what this research project was about. Yeah. So we are not only interested in ADHD.
00:28:51
Speaker
But we are also interested in other neuropsychiatric disorders as well. For example, autism spectrum disorder, or for example, obsessive compulsive disorder. Why is that? Because first of all, ADHD shows some comorbidities with these different neuropsychiatric disorders. So it is also relevant when you think about dimensional psychiatry.
00:29:18
Speaker
So psychiatrists are not really considering, okay, there is one disorder, the person has that disorder and not the other one. There can also be shadings of different other disorders in one and the same person as well. So a person having symptoms of ADHD can also show symptoms akin to autism spectrum disorder.
00:29:42
Speaker
and can also show symptoms that are related to what you would call obsessive compulsive disorder. And then the question is, and this is ah the question where we are currently working on, how is the pattern that we have now seen further modulated by the degree of specific comorbidities. May it be autism spectrum comorbidities or may it be obsessive compulsive disorder comorbidities? Yeah. Because when you think about obsessive compulsive dis disorder, for example, they may be very rigid in the way how they cut the movie.
00:30:21
Speaker
They may notice every single tiny change there because it is a kind of a mismatch with what they expect to happen. Because they are so close in the event schemes yeah and they have a very rigid application of their schematar how situations have to evolve.
00:30:41
Speaker
ADHD people, however, are very much or are very likely more lenient about that. So you should encounter really gross differences between people with obsessive compulsive disorder and ADHD. And the beauty about that is that you do not really have to change the way how you explain this. So aspects of different um neuropsychiatric disorders become at least to some extent explainable by one and the same mechanism. And that's the beauty about that approach so that we have an overarching concept that can apply to many different neuropsychiatric disorders where you nowadays still have completely distinct and unrelated ways how to explain it.
00:31:36
Speaker
Yeah, our long term goal is to explain not every single facet, but at least a bunch of things ah across different or nominally different disorders. Yeah, you wanted the same theoretical framework. That's about the key. So why I suppose I understand, I understand that you're not necessarily saying that advanced segmentation explains everything about all of these conditions, but it's a fundamental thing about them that is present to some degree in all of them and explains important aspects of yes all of them. Yes, there is some commonality in all of these disorders you may say or at least in some of these disorders that can be explained by event segmentation mechanisms. Other things may not.
00:32:24
Speaker
That's for sure. So we cannot explain the world with that. Definitely not. yeah But what we can do is to provide at least a new promising direction of how to make sense how these different neuropsychiatric disorders relate to each other. Okay.
00:32:46
Speaker
My dad's just underlined the next question so I'm going to ask the next question. um What does this mean for people looking after ADHD people so that can be parents of young children or clinicians? I mean I suppose it's clinical. It might be very early to make any clinical application of this but what are you thinking of in terms of what might be used how it might be useful to a clinician particularly?
Interventions via Event Segmentation
00:33:11
Speaker
Yeah, I think it is of particular relevance when you think about behavioral interventions for ADHD. So what we are currently doing in our project is that we are looking into the effects of drug treatments in ADHD. So Ritalin, for example, we see kind of really promising effects of these first line treatments and the effects on event segmentation. So what we really see is When you administer, for example, a mature fini-date, which is still a kind of a first-line treatment here in Germany, you see that people being administered MPH afterwards show a um performance that is more similar to neurotypical controls than before.
00:34:04
Speaker
hu We have also um data um that, for example, the instruction that you do, and this is particularly relevant for behavioral interventions, can also alter how you segment the movie. So you can, for example, say, well, please segment the movie as sticky or nitpicky as possible.
00:34:30
Speaker
And what you then see is that people are really paying attention in quotation marks to very small and tiny little things in the movie, which is not what they would do if they were to cut the movie at their own pace, for example. So by instruction, you can shift the event segmentation behavior of the people to be either more lenient in the way how they segment their information or be more sticky in how they segment the information. And this is really an important point because you now think that ADHD or people with ADHD have a too lenient way how would they try to transform the incoming stream of information into encapsulated segments.
00:35:21
Speaker
you it It opens a possibility that by some sort of behavioral intervention or self-instruction mechanisms, these people are still able to perform this event segmentation stuff differently. So what we are currently thinking about is, is it possible to translate these cognitive neuroscience findings, what we have, into a novel may be cognitive behavioral intervention for people with ADHD that is then based on the event segmentation concept. So what we try to do is we use the event segmentation concept to try to build a new behavioral intervention for ADHD. This is what is at least at the horizon, because we have shown now, well, event segmentation is different.
00:36:22
Speaker
in these people. And now we can think about how to use this event segmentation theory to now build better intervention. And this is basically what I want to do in my research. I want to take basic cognitive science, cognitive neuroscience, and neurophysiology and transfer it into novel interventions for people with different disorders.
00:36:48
Speaker
So that's fascinating just to kind of translate that into more of a concrete, a more concrete example.
Towards New Diagnostic Tools
00:36:55
Speaker
So what you're saying is that people with ADHD don't realize that they see something like a cue, like cueing up as different, that they see it in a different way, that it plays in a different way to them. So by bringing that difference out, making it explicit to say, look, you see this differently to other people. So this is how you need to approach it. You can actually give either for children, behavioral intervention, or for adults, more of a kind of, well, how do you see this process? Okay, well, this is how other people are seeing this process. How are you going to segment it differently or process it differently in order to cope with it in a way that's more acceptable and so you know to the rest of society? Is it making more sense?
00:37:40
Speaker
um I mean, in your cue example, what would that look like? Like what's that, what you talk about, like the difference of perception, but what. I think we don't know what, it how it looks in particular examples. Okay. yeah As of now, we don't know that because what we have at the moment is that we ah have the first evidence saying that, well, this thinking along the lines of is e of of of event segmentation is at least promising.
00:38:09
Speaker
However, we have to really say that we still um examine people with ADHD in a laboratory setting, not knowing how these people may behave in a real environment and whether behavior in a real environment can still be ah conceptualized along these lines.
00:38:32
Speaker
But at least what we have there is maybe some kind of a new diagnostic instrument or test. Because when you think about neuropsychology in the field of ADHD, so when you test people with ADHD regarding different cognitive functions, may it be focused attention, may it be divided attention, may it be problem solving, may it be a response inhibition, may it be a working memory processes. This is very well done at the moment, but the problem with all of these standard neuropsychological testing is that they have a low ecological validity. So what you find out in these tests does not really say, well, I can predict difficulties in everyday behavior or in specific situations. yeah We now have, for example, is
00:39:29
Speaker
that we have created a new situation where we confront people with ADHD to an at least ecologically more valid or more realistic situation. They are doing things um that are more natural to them. It is less an artificial situation in the you know in a laboratory, for example.
00:39:53
Speaker
So what we could think about is that we apply this sort of red balloon movie and the performance they're in to really put forward a new test system asking, okay, well, we also now want to stress more on how people with ADHD segment an environment and in the way they perform well, or let's say close to neurotypical individuals, we have more information about the um degree or the strengths of changes or difficulties in these patients. So what we can maybe provide is a new diagnostic instrument at the moment. And if we can so, we can also maybe tailor or shape a cognitive behavioral intervention
00:40:52
Speaker
based on the very same graph and that's the idea. So I mean so to take one example if instead of watching so what there's a difference between an ADHD person watching a boy chase a red balloon and a non ADHD person but that doesn't matter in real life no one's going to say well you you know you segmented that sort of avant-garde movie a little bit wrong yeah that's not the point but let's say for example you had an exercise which was about For two young children, for two children who are about 10, one with autism, one with ADHD and one without ADHD, and you have a ah movie of a classroom, a lesson, and they segment it differently. You could then say, okay, well, one of the reasons why you're struggling to listen to your teacher to complete your work is that you're segmenting the what's happening in the classroom differently. You're seeing it differently. It's running differently in your brain.
00:41:46
Speaker
to your neurotypical peer. So you've got two then two ways of do of addressing that and what Christian I think what you're suggesting is that both direct instruction which would need to be adapted to age and to situation works in order to change event segmentation and also medication works to change event segmentation. yeah So potentially you have an in which is quite direct into how people see the world. Exactly. The thing is about direct instruction though is that it's not very practical when you're looking at say a school environment. Oh yeah. it's different If someone says test pay attention, I can do that for a bit. Yes, yes, yes. And then I get tired, I get exhausted because it's it's a lot of mental energy. I can't do that for a whole day of school. And we can't anticipate that this is definitely going to work, can we? But you've got potential for saying not just test pay attention, but test
00:42:38
Speaker
I know you'll see this in a different way. Why don't you see it? Why don't we try and looking at this in in a more, okay, you're segmenting it like this. Could you try segmenting it a little bit? We don't know, but it's got potential. I mean, to be honest, try explain segmentation to a child who's still in primary school. But moving editing is a really good way of explaining it. Yeah, that's true. actually Yeah, because it is a game. And this was also very fascinating for us to see, because at the beginning, we were always yeah a bit of torn between, well, is it useful? Can we really have some reliable insights? Because people are sitting there in front of a black and white movie for half an hour. So what's going to happen? Will they do anything maybe after five or 10 minutes, especially for people with ADHD?
00:43:28
Speaker
But in fact, so wonder if they tolerated a half hour. We had not a single one who said, well, no, I don't want to do that anymore. It was really engaging for them. And that's the point. Yeah. And this is also a very important point when you consider current ah neuropsychological testing. This is ah kind of a clean room situation and these neuropsychological tests.
00:43:55
Speaker
are not engaging at all, they are not motivating. At some point, you measure something, but because they are not really engaging, ah makes it also kind of difficult to extrapolate what you see there into natural situations. This is what I call with the difficulty in ecological validity in current new psychological testing and diagnosis. And this is also one of the points where when you engage in things like this, I mean, it doesn't need to be a red balloon movie. You could also think about creating maybe, for example, in virtual reality, different situations that are standardized and where you can then say, well, okay, parents report that their child has ADHD and showing these ADHD symptoms, particularly at school.
00:44:52
Speaker
Okay, then you create, for example, a virtual environment which is highly um structured, not known to the participant where the structure lies in, and then see how the child or the adolescent behaves in that situation. So you really can mimic the ah situation where difficulties occur.
00:45:16
Speaker
And then you know more about, okay, what are these specific aspects in a given situation that are triggering these problematic behaviors in people with ADHD, for example.
Future Research Directions
00:45:28
Speaker
And then you have a better handle on each individual, um, having ADHD. So this is sort of personalized medicine. This is important.
00:45:39
Speaker
yeah Now you don't do that. I mean, you partly do that in your cognitive behavioral interventions because there the cognitive behavioral intervention is usually closely tailored to the problem of the individual. yeah But nevertheless, the way you diagnose ADHD and the way you treat it are completely two different um aspects. And with the event segmentation stuff, you not only have a new handle on how to diagnose ADHD,
00:46:10
Speaker
But you also have at least a clue about how to tailor novel cognitive behavioral interventions. And this is, I think, pretty cool. Amazing. Shall we go on to our next question? Yes, just about to. So what does this mean for ADHD people themselves? What can we do?
00:46:30
Speaker
Well, this is a difficult question because ah in generally this is the first study out there. So this first study needs to be replicated. We need bigger studies, but um you may say, well, ah when people are maybe better self instruct themselves, okay, I am in this situation. I know it's going to happen this way. I know I have problems. Okay. I have to be.
00:47:00
Speaker
more patient and whatever. This is the point. This is at least what's what's getting around there. yeah But for one study, we cannot make really recommendations for people with ADHD that are ready to be implemented in their daily life. now This is too early. But I think if that I think even at this stage as a person with ADHD, I think it's really helpful for me to go, there's something different about the way I see the world. We don't know what it is yet. We don't know how to apply it, but it's something basic about the fact that I see the world differently. The world plays differently for me. And that's just really powerful because it's better. It's, it's, it's not, I just have, but I had just have poor attention because it doesn't really mean anything it's as again, it's like circular, but this is,
00:47:54
Speaker
The world looks different to me. my My brain sees it differently. So therefore we need to work out what that means. And we are a very early early stage of what that means. But I think I find it really kind of positive to to have that thought. What do you think, Tess? I mean, there's nothing really I can say of them just to agree with you. It's it's really nice.
00:48:14
Speaker
But it's also, it's, it's a bit weird, you know, it's, yeah I do find myself a bit scared by it because it's like, I thought that I just, you know, a few of my chemicals are wrong, but that's like a fundamental difference in my world perception, which is a bit intimidating. Yeah. Yeah. Yeah. Yeah. Interesting. Okay. Well, that's all different perceptions, isn't it? Exactly. the world So shall we ask, shall we go to our last question?
00:48:41
Speaker
but Okay. um What's your next question? What are you hoping to um research in the future? Yeah. As said, so what we have now is kind of a basis. We have now been very much into the role of um yeah drug administration, how drug administration changes event segmentation. We have also done some work which is not yet published um because we're still collecting data.
00:49:11
Speaker
for, for example, neurofeedback treatments or neurofeedback is also a very famous um intervention in ADHD. It's a kind of a computer-based cognitive behavioral intervention where we now try to figure out how does neurofeedback maybe also change event segmentation. And then on the longer run, it is really that we I want to know the interrelation between different neuropsychiatric disorders as said OCD, autism spectrum disorder and ADHD. We want to get to know better in how far the strengths of one or the other comorbidity with ADHD changes event segmentation. Are there specific constellations in symptoms?
00:50:00
Speaker
um making event segmentation even worse or maybe even better, are there then also, let's say, constellations of symptoms that one or the other individual with ADHD may have, ah making it more or less necessary to really look into maybe problems in event segmentation, or are there also people with ADHD not having that much problems?
00:50:30
Speaker
Is it possible, for example, to use event segmentation as a diagnostic tool to say a little bit more about the severity of ADHD? And as we already discussed, is it possible to translate what we found out in our event segmentation experiment um for the one into the direction of another diagnostic tool and for the other into another um behavioral or cognitive behavioral intervention. So this is really lying ahead of us. And this is what we want. Amazing. Just the whole vista opens up, doesn't it? this whole Yes, because I mean, this is a point, it is a new concept now coming into the field of ADHD. And since it is a new concept, it opens a variety of different ah yeah routes to go.
00:51:22
Speaker
Yeah, I think you'll be doing this until you retire. I think this is an hour, this is it now. A huge can of worms. But good worms, nice worms. Yes, not bad worms. I love that phrase, can of worms. What are we all about? I don't know. It's metaphor, isn't it? In it. I'm down. Right.
Episode Conclusion
00:51:44
Speaker
Thank you so much. We've got some point of interest. Yes, thank you very much for the invitation. It was very nice talking to you.
00:51:49
Speaker
Well, that's fire all right that's right. We got to the point where Tess and I start talking about other stuff. Yeah. Which is usually like you trying to use youth lingo. Well, in it, it's not youth lingo. all just so so I was born in London. I'm allowed to say in it. Oh, sorry. Sorry. All right. Anyway, you were also born in London. Right. Anyway, we moved out of there when I was three months old. OK. Thank you so much for joining us. Thank you for being our first guest from the wonderful, beautiful country of Germany.
00:52:18
Speaker
Yeah, jumping in here was very nice. Alright, no worries. And um hopefully we'll we'll spot something from you or contact us when you've got something else you want to come and talk to us about. Fascinating stuff, really put us, it was ah it's a good workout this morning.
00:52:33
Speaker
yeah i woke up like half an hour ago we weren't going to mention that but there you are it's out there all right thank you so much for coming right thank you very much bye okay okay that was christian sure was he's a very clever man isn't he very clever very clever man um anything else to report tess Oh my god, that's pressure. I'm beating you at NFL fantasy at the moment. He is beating me at NFL fantasy at the moment and he will continue to beat me. When I did the draft, I got an email from the company that was like, you've done so well! You've done so well in the draft and I've lost every single week since. Oh and three. Yeah.
00:53:09
Speaker
so it's going well all right this is not going to turn into an nfl fantasy podcast because that would be awful you sure maybe we will give you updates i'd be just as clueless yeah exactly uh i know not mostly you know i have base knowledge yeah base knowledge all right Anyway, that is as may be. We will come back in a few weeks with another episode. It is going to be a bit sporadic in the next well few months because it really depends on Tess's work and my work and how we can kind of
00:53:42
Speaker
Get it all synchronized. So we'll definite sorry about that. We will definitely try and get you some more episodes soon. And we've got some loyal listeners loyal listeners. We have got some more people booked to record. So have a great whatever day you're having. Or night. If you're listening to this at ah three in the morning, please let us know. We want to know what our most unreasonable time of the day listeners we have. Yes. that's You're listening at 4.45 in the morning. Please, please let us know. Yeah. Okay. On the Facebook group. on the Facebook group, indeed. Alright, thank you, bye.