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According to an influential and controversial theory, autism is the manifestation of an " Extreme Male Brain". The reasoning goes something like this - the condition is far more prevalent in males than females; people with autism think in a distinctive style that's more commonly observed in men than women (that is, high in systematising and low in empathising); and greater testosterone exposure in the womb appears to go hand in hand with an infant exhibiting more autism-like traits in later childhood.

Simon Baron-Cohen, the psychologist who first proposed the theory, always conjectured that there may also be such a thing as an "Extreme Female Brain". Now in a new paper, a pair of researchers in the USA have made the case that the Extreme Female Brain exists, it's highly empathic, and it comes with its own problematic consequences, in terms of a fear of negative evaluation by others, and related to that, a greater risk of eating disorders (which are known to be far more prevalent in women than men).

Supporting their claims, Jennifer Bremser and Gordon Gallup Jr surveyed hundreds of male and female undergrads and found that men and women with more dysfunctional attitudes towards eating, and more fears of being negatively evaluated by others, also tended to score more highly on self-reported measures of empathising. A fear of being negatively evaluated was also associated with lower scores in systematic thinking.

In other words, people with a thinking style more often observed in women, and opposite to that seen in people with autism (high in empathising, low in systematising), tended to be at greater risk for eating disorders and social anxiety.

The results got a bit messier with objective measures. Among female participants, dysfunctional attitudes towards eating were associated with higher scores on an objective measure of empathising, one that involved interpreting emotions from pictures of people's eyes. But for males, dysfunctional attitudes to eating actually predicted lower scores on the test.

The researchers surmised that perhaps these men were over-interpreting the pictures - "hyper-mentalising" - and seeing emotions that weren't there, which would be consistent with their central thesis about the Extreme Female Brain. Supporting this, further studies found that dysfunctional attitudes towards eating and fear of negative evaluation by others also tended to go hand in hand with higher self-reported scores on schizotypy, including exaggerated suspiciousness, magical thinking and paranoia - arguably all signs of "hyper-mentalising", and the opposite of what's seen in autism.

What about objective measures of systematising? Dysfunctional attitudes toward eating and fear of negative evaluation weren't associated with understanding the laws of physics, but they were associated with poorer mental rotation performance scores.

"Evidence from all four studies converge to show that a combination of disordered eating and negative evaluation anxiety are associated with a cognitive style that Baron-Cohen predicted for the Extreme Female Brain," the researchers concluded.

One last thing - Bremser and Gordon Gallup Jr said their ideas suggested a novel explanation for why vegetarianism is particularly prevalent among people with eating disorders. Previously it's been assumed that vegetarianism is popular for this group as a means of calorie restriction. However, if eating disorders are part of the manifestation of an Extreme Female Brain, one that's associated with exaggerated empathy, then vegetarianism may be a natural consequence of having enhanced empathy for animals.

_________________________________ Bremser JA, and Gallup GG Jr (2012). From one extreme to the other: Negative evaluation anxiety and disordered eating as candidates for the extreme female brain. Evolutionary psychology : an international journal of evolutionary approaches to psychology and behavior, 10 (3), 457-86 PMID:
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Post written by Christian Jarrett for the BPS Research Digest.

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bps research digest: are eating disorders the manifestation of an "extreme female brain"?

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Are eating disorders the manifestation of an "Extreme Female Brain"?

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According to an influential and controversial theory, autism is the manifestation of an " Extreme Male Brain". The reasoning goes something like this - the condition is far more prevalent in males than females; people with autism think in a distinctive style that's more commonly observed in men than women (that is, high in systematising and low in empathising); and greater testosterone exposure in the womb appears to go hand in hand with an infant exhibiting more autism-like traits in later childhood.

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"'Somewhere deep within me is a destructive urge," says Colin. "It's this gremlin in my head that hits me at unexpected moments. Ultimately, complete recovery requires changing my perception of myself. It is going to be a struggle, but it's achievable." Colin is a 50-year-old community development manager, and has battled an eating disorder for more than two decades.

Eating disorders have long been perceived as an issue affecting women and girls, but this idea has been shown to be increasingly warped: the number of men being diagnosed has risen by 27% since 2000.

Typically, this has been interpreted as a stark reflection of increasing pressure on men to care more about their image, but the truth is perhaps more complex. Are cases of male eating disorders really increasing or are we simply getting better at recognising them? Statistics tell us that anorexia, for example, is 10 times more common in women than men, but we are preconditioned not to expect it in the latter. Then there is emotional overeating - far more common than either anorexia or bulimia - but which has only recently become the subject of serious research.

"One of our concerns is that diagnostic criteria for eating disorders are entirely based on female traits," explains Nadia Micali, a senior lecturer at the Behavioural and Brain Sciences Unit at University College London. "To get an anorexia diagnosis, you need to be afraid of getting fat. But masculine concerns can include wanting a lean or defined physique, and males who become fixated with achieving that by excessive use of supplements, hormones or starvation may be dismissed by doctors."

A number of men with eating disorders report reactions ranging from mild disbelief to outward aggression when they seek help. Many are branded as attention seekers, which only hastens a rapid decline in mental health.

"One of the reasons I relapsed was because I still have a continual fear of being a fraud," says Dave, a 25-year-old standup comedian, recovering from anorexia. "When I first went to a GP with heart palpitations and low body temperature, I was told to buy a good jumper and cut down on coffee, and was shown the door. I now have a great doctor, who is understanding, but that constant fear that it was me and that I wasn't anorexic at all, made me try more and more dangerous ways of controlling what I ate and losing weight."

The prevailing stereotype paints a picture of anorexia as largely a 21st-century phenomenon, a disease predominantly affecting white, teenage girls from comfortable, middle-class family backgrounds, with the western luxury of being able to control what they eat. We are led to believe it arises entirely due to the pressures of modern-day image ideals, and our persistent obsession in equating slim with beautiful. The reality is that anorexia is a mental disorder that has existed for centuries.

It is neither gender nor geographically specific, and while it is most common in those aged 15-30, it can occur in older age groups too. And our perception of it as a female disease is, in fact, surprisingly recent. The first recorded case of anorexia was in 1649 when Richard Morton, a London physician, noted the symptoms of a young man. Morton described it as a "nervous consumption" and continued to record cases throughout his life. His notes refer to a "wasting of the body without any remarkable fever, cough or shortness of breath" and speculate on a link to the "cares and passions" of the mind.

Anorexics themselves often reject the concept that their disorder has been triggered by the predominance of certain body types in magazines and adverts. Instead, it is a gradual process, where they slip into an addictive mindset of associating weight loss with both internal and external approval. This acts as a coping mechanism for some underlying trauma, which may range from the end of a relationship, bullying, loneliness, bereavement or general low self-esteem.

The sensationalisation of eating disorders and, in the case of anorexia, creating the idea that you aren't ill unless you are visibly emaciated adds to the problem. "Anorexics don't necessarily have to look skinny, in the same way that you don't have to be in bandages to be genuinely ill," says Dave.

Eating disorders may spring from a combination of nature and nurture, but it is thought that certain personality characteristics predispose people to them. Given that just 30-40% of those with eating disorders receive treatment, there is a growing drive across the US and the UK to collect blood samples and pinpoint genes that may indicate vulnerability.

"Part of the anorexic mindset is the competitive mindset," says Richard, a 24-year-old accounts manager. "It's like a game and when I feel I'm winning at it, controlling my hunger and overcoming the feeling of needing sustenance can become an almost spiritual experience. In my own mind, there is no drug or sensation like it. But it's a game I can never win. "

"We should look at anorexia in the same way that we do bronchitis or sports injuries," Dave says. "During my worst phases, I just wished I could have read something down to earth on the subject, something that said: 'There is nothing to be ashamed of. This is what it is, these are the risks and if you are worried, here is a helpline and how to get treatment.'"
Men Get Eating Disorders Too is a national charity that supports men with eating disorders and their families.

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"'Somewhere deep within me is a destructive urge," says Colin. "It's this gremlin in my head that hits me at unexpected moments. Ultimately, complete recovery requires changing my perception of myself. It is going to be a struggle, but it's achievable." Colin is a 50-year-old community development manager, and has battled an eating disorder for more than two decades.

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When Frances was an infant, she was late to babble, walk and talk. She was three before she would respond to her own name. Although there were hints that something was unusual about her development, the last thing her parents suspected was autism. "She was very social and a very happy, easy baby," says Kevin Pelphrey, Frances's father.

Pelphrey is a leading autism researcher at Yale University's world-renowned Child Study Center. But even he did not recognize the condition in his daughter, who was finally diagnosed at about five years of age. Today Frances is a slender, lightly freckled 12-year-old with her dad's warm brown eyes. Like many girls her age, she is shy but also has strong opinions about what she does and does not want. At lunchtime, she and her little brother, Lowell, engage in some classic sibling squabbling-"Mom, he's kicking me!"

Lowell, seven, received an autism diagnosis much earlier, at 16 months. Their mom, Page, can recall how different the diagnostic process was for her two children. With Lowell, it was a snap. With Frances, she says, they went from doctor to doctor and were told to simply watch and wait-or that there were various physical reasons for her delays, such as not being able to see well because of an eye condition called strabismus that would require surgical treatment at 20 months. "We got a lot of different random little diagnoses," she recalls. "They kept saying, 'Oh, you have a girl. It's not autism.'"

In fact, the criteria for diagnosing autism spectrum disorder (ASD)-a developmental condition that is marked by social and communication difficulties and repetitive, inflexible patterns of behavior-are based on data derived almost entirely from studies of boys. These criteria, Pelphrey and other researchers believe, may be missing many girls and adult women because their symptoms look different. Historically the disorder, now estimated to affect one out of every 68 children in the U.S., was thought to be at least four times more common in boys than in girls. Experts also believed that girls with autism were, on average, more seriously affected-with more severe symptoms, such as intellectual disability. Newer research suggests that both these ideas may be wrong.

Many girls may, like Frances, be diagnosed late because autism can have different symptoms in females. Others may go undiagnosed or be given diagnoses such as attention-deficit/hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD) and even, some researchers believe, anorexia. As scientists study how this disorder plays out in girls, they are confronting findings that could overturn their ideas not only about autism but also about sex and how it both biologically and socially affects many aspects of development. They are also beginning to find ways to meet the unique needs of girls and women on the spectrum.

It's Different for Girls

Scientists in recent years have investigated several explanations for autism's skewed gender ratio. In the process, they have uncovered social and personal factors that may help females mask or compensate for the symptoms of ASD better than males do, as well as biological factors that may prevent the condition from developing in the first place [ see "The Protected Sex" below]. Research has also revealed bias in the way the disorder is diagnosed.

A 2012 study by cognitive neuroscientist Francesca Happ of King's College London and her colleagues compared the occurrence of autism traits and formal diagnoses in a sample of more than 15,000 twins. They found that if boys and girls had a similar level of such traits, the girls needed to have either more behavioral problems or significant intellectual disability, or both, to be diagnosed. This finding suggests that clinicians are missing many girls who are on the less disabling end of the autism spectrum, previously designated Asperger's syndrome.

In 2014 psychologist Thomas Frazier of the Cleveland Clinic and his colleagues assessed 2,418 autistic children, 304 of them girls. They, too, found that girls with the diagnosis were more likely to have low IQs and extreme behavior problems. The girls also had fewer (or perhaps less obvious) signs of "restricted interests"-intense fixations on a particular subject such as dinosaurs or Disney films. These interests are often a key diagnostic factor on the less severe end of the spectrum, but the examples used in diagnosis often involve stereotypically "male" interests, such as train timetables and numbers. In other words, Frazier had found further evidence that girls are being missed. And a 2013 study showed that, like Frances, girls typically receive their autism diagnoses later than boys do.

Pelphrey is among a growing group of researchers who want to understand what biological sex and gender roles can teach us about autism-and vice versa. His interest in autism is both professional and personal. Of his three children, only his middle child is typical. Kenneth, Pelphrey jokes, has classic "middle-child syndrome" and complains that his siblings "get away with murder because they can blame it on their autism."

Pelphrey is now leading a collaboration with researchers at Harvard University, the University of California, Los Angeles, and the University of Washington to conduct a major study of girls and women with autism, which will follow participants over the course of childhood through early adulthood. The researchers want "every bit of clinical information we can get because we do not know what we ought to be looking for," Pelphrey says. Consequently, they are also asking participants and family members to suggest areas of investigation because they know firsthand what is most helpful and most problematic.

Girls in the study will be compared with autistic boys, as well as typically developing children of both sexes, using brain scans, genetic testing and other measures. Such comparisons can help researchers tease out which developmental differences are attributable to autism, as opposed to sex, as well as whether autism itself affects sex differences in the brain and how social and biological factors interact in producing gender-typical behaviors.

Already Pelphrey is seeing fascinating differences in autistic girls in his preliminary research. "The most unusual thing we keep finding is that everything we thought we knew in terms of functional brain development is not true," he says. "Everything we thought was true of autism seems to only be true for boys." For example, many studies show that the brain of a boy with autism often processes social information such as eye movements and gestures using different brain regions than a typical boy's brain does. "That's been a great finding in autism," Pelphrey says. But it does not hold up in girls, at least in his group's unpublished data gathered so far.

Pelphrey is discovering that girls with autism are indeed different from other girls in how their brain analyzes social information. But they are not like boys with autism. Each girl's brain instead looks like that of a typical boy of the same age, with reduced activity in regions normally associated with socializing. "They're still reduced relative to typically developing girls," Pelphrey says, but the brain-activity measures they show would not be considered "autistic" in a boy. "Everything we're looking at, brain-wise, now seems to be following that pattern," he adds. In short, the brain of a girl with autism may be more like the brain of a typical boy than that of a boy with autism.

A small study by Jane McGillivray and her colleagues at Deakin University in Australia, published in 2014, provides behavioral evidence to support this idea. McGillivray and her colleagues compared 25 autistic boys and 25 autistic girls with a similar number of typically developing children. On a measure of friendship quality and empathy, autistic girls scored as high as typically developing boys the same age-but lower than typically developing girls.

Pelphrey is finding that autism also highlights normal developmental differences between girls and boys. Sex hormones, he says, "affect just about every structure you might be interested in and just about every process you might be interested in." Although boys generally mature much later than girls do, the differences in brain development appear to be quite big-far larger than the differences in behavior.

Masking Autism

Jennifer O'Toole, an author and founder of the Asperkids Web site and company, was not diagnosed until after her husband, daughter and sons were found to be on the spectrum. On the outside, she looked pretty much the opposite of autistic. At Brown University, she was a cheerleader and sorority girl whose boyfriend was the president of his fraternity.

But inside, it was very different. Social life did not come at all naturally to her. She used her formidable intelligence to become an excellent mimic and actress, and the effort this took often exhausted her. From the time she started reading at three and throughout her childhood in gifted programs, O'Toole studied people the way others might study math. And then, she copied them-learning what most folks absorb naturally on the playground only through voracious novel reading and the aftermath of embarrassing gaffes.

O'Toole's story reflects the power of an individual to compensate for a developmental disability and hints at another reason females with autism can be easy to miss. Girls may have a greater ability to hide their symptoms. "If you were just judging on the basis of external behavior, you might not really notice that there's anything different about this person," says University of Cambridge developmental psychopathologist Simon Baron-Cohen. "It relies much more on getting under the surface and listening to the experiences they're having rather than how they present themselves to the world."

O'Toole's obsessive focus on reading and finding rules and regularities in social life is far more characteristic of girls with autism than boys, clinical experience suggests. Autistic boys sometimes do not care whether they have friends or not. In fact, some diagnostic guidelines specify a disinterest in socializing. Yet autistic girls tend to show a much greater desire to connect.

In addition, girls and boys with autism play differently. Studies have found that autistic girls exhibit less repetitive behavior than the boys do, and as the 2014 findings from Frazier and his colleagues suggest, girls with autism frequently do not have the same kinds of interests as stereotypical autistic boys. Instead their pastimes and preferences are more similar to those of other girls.

Frances Pelphrey's obsession with Disney characters and American Girl dolls might seem typical, not autistic, for example. O'Toole remembers compulsively arranging her Barbie dolls. Furthermore, although autism is often marked by an absence of pretend play, research finds that this is less true for girls.

Here, too, they can camouflage their symptoms. O'Toole's behavior might have seemed like typical make-believe to her parents because she staged Barbie weddings just like other little girls. But rather than imagining she was the bride, O'Toole was actually setting up static visual scenes, not story lines.

Also, unlike in boys, the difference between typical and autistic development in girls may lie less in the nature of their interests than in its level of intensity. These girls may refuse to talk about anything else or take expected conversational turns. "The words used to describe women on the spectrum come down to the word 'too,'" O'Toole says. "Too much, too intense, too sensitive, too this, too that."

She describes how both her sensory differences-she can be overwhelmed by crowds and is bothered by loud noise and certain textures-and her social awkwardness made her stand out. Her life was dominated by anxiety. Speaking broadly of people on the spectrum, O'Toole says, "There is really not a time when we're not feeling some level of anxiety, generally stemming from either sensory or social issues."

As she grew up, O'Toole channeled her autistic hyperfocus into another area to which culture frequently directs women: dieting and body image, with a big dollop of perfectionism. "I used to have a spreadsheet of how many calories, how many grams of this, that and the other thing [I could eat]," she says. The resulting anorexia became so severe that she had to be hospitalized when she was 25.

In the mid-2000s researchers led by psychiatrist Janet Treasure of King's College London began to explore the idea that anorexia might be one way that autism manifests itself in females, making them less likely to be identified as autistic. "There are striking similarities in the cognitive profiles," says Kate Tchanturia, an eating disorder researcher and colleague of Treasure's at King's College London. Both people with autism and those with anorexia tend to be rigid, detail-oriented and distressed by change.

Furthermore, because many people with autism find certain tastes and food textures aversive, they often wind up with severely restricted diets. Some research hints at the connection between anorexia and autism: in 2013 Baron-Cohen and his colleagues gave a group of 1,675 teen girls-66 of whom had anorexia-assessments measuring the degree to which they had various autism traits. The research found that women with anorexia have higher levels of these traits than typical women do.

No one is suggesting that the majority of women with anorexia also have autism. A 2015 meta-analysis by Tchanturia and her colleagues puts the figure at about 23 percent-a rate of ASD far higher than that seen in the general population. What all of this suggests is that some of the "missing girls" on the spectrum may be getting eating disorder diagnoses instead.

Further, because autism and ADHD often occur together-and because people diagnosed with ADHD tend to have higher levels of autism traits than typical people do-girls who seem easily distracted or hyperactive may get this label, even when autism is more appropriate. Obsessive-compulsive behavior, rigidity and fear of change also occur in both people with autism and those with OCD, suggesting that autistic females might also be hidden in this group.

Double Standards

Even when young women are comparatively "easy" to diagnose, they still face many challenges in the course of development-particularly social ones. This was the case for Grainne. Her mother, Maggie Halliday, had grown up in a large Irish family and could see early on that her third child, Grainne, was different. "I knew from when she was a couple of months old that there was something not right," Halliday says. "She didn't like to be held or cuddled. She could make herself a dead weight and just-you couldn't pick her up."

Although Grainne's IQ tests are in the low normal range, the results do not capture either her abilities or her disabilities well. Today the teenager's intense interests are boy bands and musical theater. Despite being extremely shy, she blooms on stage and loves to sing. "The play she's in, when they deliver the script, within a week, she has everybody's part memorized and every song in the score memorized," Halliday says.

Because of a genetic condition, Grainne is short: 47-and a half, she insists. And although she is laconic and does not tend to initiate conversation, she is also bubbly and smiles frequently, clearly interested in connecting. She weighs what she does say very carefully. For example, when asked whether she thinks autistic girls are more social than boys with autism, Grainne says, "Some might be," not wanting to generalize.

Of course, adolescence is difficult for most kids, but it is especially challenging for autistic girls. Many can cope with the far simpler world of elementary school friendships, but they hit a wall with the "mean girls" of junior high and the subtleties of flirting and dating. Moreover, puberty involves unpredictable changes such as breast development, mood swings and periods-and there are few things that autistic people hate more than change that occurs without warning. "She would like to have a boyfriend-that's why she loves the boy bands," says Halliday, adding that she thinks Grainne may not understand what such a relationship would really mean.

Unfortunately, the autistic tendency to be direct and take things literally can make affected girls and women easy prey for sexual exploitation. O'Toole herself was the victim of an abusive relationship, and she says the problem is "endemic" among women on the spectrum, particularly because so many are acutely aware of their social isolation. "When you feel you're too difficult to love, you'll love for crumbs," she says.

In this way, autism may be more painful for women. Autistic people who do not seem interested in social life probably do not obsess about what they are missing-but those who want to connect and cannot are tormented by their loneliness. A study published in 2014 by Baron-Cohen and his colleagues found that 66 percent of adults with the milder form of ASD (so-called Asperger's) reported suicidal thoughts, a rate nearly 10 times higher than that seen in the general population. The proportion was 71 percent among women, who made up about one third of the sample.

Until very recently, few resources have been available to help autistic girls through these difficulties. Now researchers and clinicians are starting to fill these gaps. For example, Rene Jamison, an assistant clinical professor at the University of Kansas Medical Center, runs a program in Kansas City called Girls Night Out. Aimed at helping affected girls navigate adolescence, it focuses on specific issues such as hygiene and dress. Although this emphasis might seem trivial or a concession to gender stereotypes, in fact, failing to address such "superficial" concerns can cause serious life problems and restrict independence.

Even many highly intelligent girls on the spectrum have difficulties with washing their hair, wearing deodorant and dressing appropriately, Jamison says. Some of this behavior is linked to sensory issues; other aspects of the problem are related to difficulty following the appropriate sequence of behavior when doing something you think is unimportant. "When Grainne was in seventh grade, I had to tell her it was against the law not to wear a bra," Halliday says of her daughter, who found bras uncomfortable. Grainne also did not want to wear deodorant-saying, almost certainly accurately, that the boys smelled worse.

The Girls Night Out group does fun activities, ranging from having manicures to playing sports. Typical girls who get school credit for volunteering provide mentoring and talk about boys and other issues the girls might not want to discuss with adults. "One of the things that we really work on is getting them to try new things to figure out what they might like," Jamison says.

In New York City, Felicity House, which its founders tout as the world's first community center for women on the spectrum, opened in 2015. Funded by the Simons Foundation, it occupies several floors of a spectacular Civil War-era mansion near Gramercy Park and offers classes and social events so autistic women can get to know and support one another. Five of the autistic women who helped to found Felicity House met a few weeks before it opened to talk about life on the spectrum. Only two had been diagnosed as children-one with Asperger's and another with what she said was "ADHD with autistic tendencies." Of the other three women, two had struggled with depression before their diagnosis as adults.

Emily Brooks, 26, is a writer studying for her master's in disability studies at City University of New York. She identifies as gender queer and believes gender norms cause many problems for people on the spectrum. She noted, to broad agreement, that boys are allowed far greater leeway to deviate from social expectations. "If a guy does something that is considered socially inappropriate ... his friends may sometimes encourage some of those behaviors," she said, adding that "teen girls will shut you down if you do anything that's different."

Leironica Hawkins, an artist who has created a comic book about Asperger's, also has to contend with social cues about race. "It's not just because I'm a woman on the spectrum. I'm a black woman on the spectrum, and I have to deal with social cues that [other] people can afford to ignore," she said. She added that she thought women "are probably punished more for not behaving the way we should. I've always heard women are socially aware to the needs of others, and that's not me, most of the time ... I feel like I get pressured to be that way."

Because of these expectations, there is less tolerance for unusual behavior-and not just in high school. Many of the women report having difficulty keeping-but not getting-jobs, despite excellent qualifications. "You can see that in a faculty meeting even at the high-level academic departments," Yale's Pelphrey says. "The guys still get away with much, much more."

As awareness of autism grows, women and girls are already increasingly likely to be diagnosed; this generation clearly has significant advantages over those past. But much more research will need to be done to design better and more gender-appropriate diagnostic tools. Perhaps in the interim, the experiences of women with autism should teach us to be more tolerant of socially inept behavior in women-or less tolerant of it in men. Either way, it is clear that a greater understanding of autism in girls is needed to recognize this condition. And in the process it could illuminate new facets of typical behavior and the way that gender shapes the social world.

The Protected Sex

Simon Baron-Cohen, a professor of developmental psychopathology and director of the University of Cambridge's Autism Research Center, has helped develop several of the major theories that are guiding current thinking about autism. One of these hypotheses, which he is continuing to test, is the "extreme male brain" theory, which first appeared in the literature in 2002. The idea is that autism is caused by fetal exposure to higher than normal levels of male hormones, such as testosterone. This occurrence shapes a mind that is more focused on "systemizing" (understanding and categorizing objects and ideas) than "empathizing" (considering social interactions and other people's perspectives).

In other words, autistic minds may be stronger in areas where male brains, on average, tend to have strengths-and weaker in areas where females, again, speaking broadly, are the superior sex. (When it comes to individuals, of course, these averages do not say anything about a particular man or woman's ability or capacity-nor do the differences necessarily reflect immutable biology rather than culture.)

Numerous recent studies have supported Baron-Cohen's idea. In 2010 he and his colleagues found that male fetuses exposed to higher levels of testosterone in amniotic fluid during pregnancy tend to grow up to have more autism traits. A 2013 study he co-authored, led by his Cambridge colleague MengChuan Lai, found that the brain-scan differences seen in children with autism occurred most often in regions that tend to vary by gender in typical children.

In 2015 Baron-Cohen and his colleagues published results of an analysis of a large group of amniotic fluid samples from Denmark that are linked to population registries of mental health. They found that in boys, having an autism diagnosis was linked with higher levels of fetal testosterone and various other hormones, but the first cohort tested had too few girls with autism, so they are analyzing later births to see if the same results will be found. Further evidence came from a large Swedish study, also published last year, that found a 59 percent increased risk of giving birth to a child with autism among women with polycystic ovary syndrome-an endocrine disorder involving elevated levels of male hormones.

Few scientists-including Baron-Cohen-think that the extreme male brain theory is the whole story. A second idea emerges when looking at the typical strengths of women. If having female hormones and a female-type brain structure increases the ability to read the emotions of others and makes social concerns more salient, it might take a greater number of genetic or environmental "hits" to alter this capacity to the level where autism would be diagnosed. This idea is known as the "female protective" hypothesis.

Along these lines, several studies have shown that in families with affected daughters, there are higher numbers of mutations known as copy-number variations than there are in families where only boys are affected. A 2014 study by geneticist Sbastien Jacquemont of the University of Lausanne in Switzerland and his colleagues found that there was a 300 percent increase in harmful copy-number variants in females with autism, compared with males.

If either-or both-of these hypotheses is correct, then there will always be more boys than girls on the spectrum. "I imagine that once we're very good at recognizing autism in females, there will still be a male bias," Baron-Cohen says. "It just won't be as marked as four to one. It might be more like two to one." -M.S.

Maia Szalavitz is the author of, most recently, Undoing Drugs: The Untold Story of Harm Reduction and the Future of Addiction. She is a contributing opinion writer for the New York Times and author or co-author of seven other books.

More by Maia Szalavitz

This article was originally published with the title "The Invisible Girls" in SA Mind Vol. 27 No. 2 (), p. 48
doi:10.1038/scientificamericanmind0316-48

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New research suggests the disorder often looks different in females, many of whom are being misdiagnosed and missing out on the support they need

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Free Will

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THE BRAIN WITH DAVID EAGLEMAN - Free Will - PBS

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Joscha Bach: Like consciousness, free will is often misunderstood because we know it by reference, but it's difficult to know it by content, what you really mean by free will. A lot of people who immediately feel that free will is related to whether the universe is deterministic or probabilistic. And while physics has some ideas about that-which change every now and then-it's not part of our experience and I don't think it makes a difference if the universe forces you randomly to do things or deterministically.

The important thing seems to me that in free will you are responsible for your actions, and responsibility is a social interface. For instance, if I am told that if I do X I go to prison, and this changes my decision whether or not to do X, I'm obviously responsible for my decision because it was an appeal to my responsibility in some sense. Likewise if I do a certain thing that causes harm to other people and they don't want that harm to happen, that influences my decision. This is a discourse of decision-making that I would call a free will decision.

"Will" is the representation that my nervous system at any level of its functioning has raised a motive to an intention. It has committed to a particular kind of goal that gets integrated into the story of myself, this protocol that I experience as myself in this world. And that was what I experienced as will, as a willed decision, and this decision is free in as much as this decision can be influenced by discourse.

So to me, free will is a social notion. It means that this interface of social interaction, of discourse, of thinking about things, about this interface of knowledge, language, conceptual thought, is relevant for that decision. If you have a decision in which it doesn't play a role, for instance, because you are addicted to something and you cannot stop doing it even if you want to, then this decision I would say is not free.

I grew up in eastern Germany, it was communist eastern Germany and it was a very weird ideological country. A country that believed in stories about how the world works that I, as a nerd, thought obviously not quite true. I had difficultly believing the official stories about how the world works. It was like some weird kind of religion. And then the wall came down and it didn't surprise me in the least. And then we entered a new dream, a new shared model of the world that was not quite true, and I realized that most people now fall for this new model. It was very interesting to see this for me and if you look, for instance, at the U.S., the majority of U.S. Americans do not believe in the theory of evolution despite all the evidence to the contrary.

The majority of people on this planet are religious even though there doesn't seem to be very good evidence for a multitude of creator gods and so on, in my view at least. And if it existed, if a creator god existed, it would be very hard for me to understand why this creator god really does care about whether I worship it or all these things that we attribute to creator gods by religion. So it's very hard for me, in some sense, to intuitively understand why humans are religious and why humans are ideological.

But I think now over the years that this is not a bug, it's a feature. Humans are a programmable species. Religions and ideologies are operating systems for societies. They have been so throughout most of our history, and this idea that we can build society based on rational arguments is very, very recent and very novel. And it's not entirely clear if it really works.
But it's clear that we cannot really build societies on conflicting ideologies that are at war with each other. In the past it has led to situations where the ideology solved the problems by killing the unbelievers or the religions did the same thing, and we all agree this is not what we want to have. We want to have an open society, a pluralistic society, a nonviolent, tolerant society, but still one where people work together and cooperate well. And this ability to wake up into a shared dream in which people believe things because their neighbors believe them has been a very powerful feature that's probably the reason why we were able to build large-scale societies.

We have to understand that when people cooperate they're very often in what we call the Prisoner's Dilemma, a situation in where in order to achieve the greatest good you have to give up something for yourself, even in a situation where that is in some sense a bit irrational, because if everybody else is not doing it you're going to be worse off. And for these Prisoner's Dilemmas we have various solutions. The easiest solution is to have a reputation system. You basically keep track of who did what when, and you make sure that only the good guys get cookies in the future.

And the problem is that these reputation systems do not scale. If you have too many people in your tribe or in your family or in your village you just lose track of who did what when, and you cannot really synchronize it by talking about it. So after a couple hundred individuals the reputation system doesn't work very well. It also doesn't really work if you are not looking. So if nobody is doing the surveillance, how do you make sure that nobody is defecting and stealing stuff from the fridge of your tribe, right? So what do we do? We evolve the ability to be normative: the ability or the need to be good. And this need to be good, this need to follow internalized norms, this need to serve sacred principles is something that is probably a feature that is ingrained into our genetic makeup.

And of course this alone would not be good enough because goodness is like an arbitrary vector in value space. People also have a need to synchronize what's good. So people will try to feel what's good in their in-group. It works by empathy. Empathy is the primary mode in which we transmit norms. If you dress-up somebody as an authority, as a priest, as a professor, as a pop star, as a politician, and this person says a certain thing with conviction and people see that others believe it, they start believing it themselves. And it's obviously very useful to do this. There's almost never a situation where it's useful to have an opinion that is different from the opinion of your boss.

So this is the ability that we got, and it means that people perform the same things, they follow the same rules regardless of the size of the group. This makes it possible to build agricultural societies with hundreds of thousands of individuals and then millions of individuals. It makes it possible that this agricultural society has people that specialize in different foods and different trades and different materials and different crafts and so on, and produce all the multitude of tasks and tools that we need to get an agricultural society to run and be able to compete with the nomadic societies.

And I think the reason why Homo sapiens is the only hominin species that's left is because we outcompeted them all. We were in the same competitive niche and we were a species that was programmable, that was able to coordinate our very large group of individuals. That was very powerful. It just turns out that this mode of tribal organization is not sufficient for the world that we live in now.

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Do We Really Have Free Will, or Are We Programmed by Social Norms?

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Joscha Bach: Like consciousness, free will is often misunderstood because we know it by reference, but it's difficult to know it by content, what you really mean by free will. A lot of people who immediately feel that free will is related to whether the universe is deterministic or probabilistic.

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Amazing podcast on what makes us who we are - free will and determinism

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How much of who we are is biology? How much is learned? And how much can we change? This hour, TED speakers on how genes and experience collaborate - and compete - to make us who we are.

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Examples of Research that can be discussed in culture bias

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Examples of Research that can be discussed in culture bias

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This essential A Level Psychology revision webinar looked at the issue of culture bias from the issues and debates topic. For more help with A Level Psychology visit the tutor2u Psychology channel here: http://www.tutor2u.net/psychology/blog/studying-a-level-psychology and don't forget to join the A Level Psychology Student Group on Facebook https://www.facebook.com/groups/tutor2uALevelPsychStudentGroup/

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AQA Psychology Student Webinar: Gender Bias

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Alpha and Beta Bias

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Psychology Model Answer: A Level SAM 1, Paper 3, Q2 - Alpha and Beta Bias

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This video is just one part of our revision webinar series titled 'The Edge in A Level Psychology'. For full details of future webinars, visit: https://www.tutor2u.net/psychology/events/students In this video, we look at how to answer the following question: Briefly outline one problem associated with alpha bias in psychological research, and one problem associated with beta bias in psychological research.

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Ethical Implications of research studies and theories

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Discuss free will and determinism student handout

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Revision Webinar: Ethical Implications & Social Sensitivity

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This essential A Level Psychology revision webinar looked at the key differences between ethical implications and social sensitivity. For more help with A Level Psychology visit the tutor2u Psychology channel here: http://www.tutor2u.net/psychology/blog/studying-a-level-psychology and don't forget to join the A Level Psychology Student Group on Facebook https://www.facebook.com/groups/tutor2uALevelPsychStudentGroup/

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Guardian newspaper article - biological determinism and crime

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Guardian newspaper article - biological determinism and crime

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Reductionism and Holism in Psychology | Simply Psychology

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This view clearly has implications for treatment. Gender can also be reduced to biological factors (e.g. hormones). Also, language can be reduced to structures in the brain, e.g. Broca's area, Wernicke's area (but holism could state: influence of family, education, social class on language). Another example of biological reductionism is aggression - e.g.

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For every subject you can now access each digital resource as soon as it is ordered. This will always be the latest edition of each resource too (and we'll update you automatically if there is an upgraded version to use).

Simply add the required resources to your cart, checkout using the usual options and your resources will be available to access immediately via your mytutor2u account.

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Issues & Debates: Reductionism & Levels of Explanation | tutor2u Psychology

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Reductionism is the belief that human behaviour can be explained by breaking it down into simpler component parts. Those who take a reductionist position believe that the best way to understand behaviour is to look closely at the parts that make up our systems, and then use the simplest explanations to understand how they work.

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Genetic Factors Associated with Intelligence Test Performance

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Evaluating nature-nurture debate from Tutor2U

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Evaluating nature-nurture debate from Tutor2U

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Recently psychologists have begun to question whether human behaviour is due to heredity factors (nature) or the environment (nurture). It is now widely accepted that heredity and the environment do not act independently and both nature and nurture are essential for almost all behaviour. Therefore, instead of defending extreme nativist or environmentalist views, most researchers are now interested in investigating the ways in which nature and nurture interact. The interactionist approach is the view that both nature and nurture work together to shape human behaviour.

The interactionist approach is best illustrated by the genetic disorder PKU (phenylketonuria). PKU is caused by the inheritance of two recessive genes, one from each parent. People with PKU are unable to break down the amino acid phenylalanine which builds up in the blood and brain causing mental retardation. However, if the child is diagnosed early, they are placed on a low protein diet for the first 12 years, which helps to avert this potentially lifelong disorder. Therefore, the disorder PKU (nature) is not expressed, because of an altered environment (low protein diet - nurture).

In psychopathology, many psychologists argue that both a genetic predisposition and an appropriate environmental trigger are required for a psychological disorder to develop; this is set out in the diathesis-stress model. The diathesis is the biological vulnerability such as being born with a gene that predisposes you to develop a disorder. However, the disorder will only develop if there is an environmental 'stressor' to trigger it. Evidence to support the diathesis-stress model comes from the Finnish Adoption Study w which compared 155 adopted children whose biological mothers had schizophrenia, with a matched group of children with no family history of schizophrenia. The researchers also assessed the quality of parenting through questionnaires and interviews. They found that the group with schizophrenic mothers had a 10% rate of schizophrenia, but they also discovered that all of the reported cases of schizophrenia occurred in families rated as 'disturbed'. When the family environment was rated as 'healthy', even in the high-risk sample (mother with Schizophrenia), the occurrence of schizophrenia was well below the general population rates. However, the environment was not the sole cause, as the low-risk children from 'disturbed' families did not develop Schizophrenia - so the environment alone was not enough to trigger the disorder. This research provides strong evidence that schizophrenia is best explained by looking at an interaction between genetic inheritance and environmental triggers, in this case, family environment.

Neural plasticity is another example of how nature and nurture interact. The brain can reorganise itself by forming new neural connections throughout life. Neuroplasticity is a term which describes the changes in the structure of the brain (nature), as a result of life experience (nurture). For example, Maguire et al. (2000) investigated the hippocampi volume of London taxi drivers' brains. She found that this region of the brain was larger in taxi drivers in comparison to non-taxi drivers. Consequently, Maguire concluded that driving a taxi (nurture) actually had an effect on the size of the hippocampi (nature).

Nature and nurture can interact in a variety of ways, and three separate types of gene-environment interactions have been described by Plomin et al. (1977): passive, evocative/reactive, and active.

1. In passive gene-environment interaction, parents pass on genes and also provide an environment, both of which influence the child's development. For example, highly intelligent parents are likely to pass on genes for intelligence to their children. They are also more likely to provide high levels of cognitive stimulation and a good education. These correlated genetic and environmental influences both increase the likelihood that their child will be highly intelligent.

2. In evocative gene-environment interaction, heritable traits influence the reaction of others and hence the environment provided by others. For example, a shy child (partly genetically influenced) may be less fun to other children, making other children less likely to want to spend time with him or her. This environment may result in the child becoming even more socially withdrawn.

3. In active gene-environment interaction, a child's heritable traits influence his or her choice of environment. For example, an aggressive child may choose to watch violent films and engage in contact sports. This is known as 'niche-picking' and is one reason research has shown that the influence of genes increases as children get older.

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Issues & Debates: Evaluating the Nature-Nurture Debate - Interactionist Approach

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Recently psychologists have begun to question whether human behaviour is due to heredity factors (nature) or the environment (nurture). It is now widely accepted that heredity and the environment do not act independently and both nature and nurture are essential for almost all behaviour.

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Ethical Implications of Brain Scanning - Criminal Minds

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Ethical Implications of Brain Scanning - Criminal Minds

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A team of world-leading neuroscientists has developed a powerful technique that allows them to look deep inside a person's brain and read their intentions before they act.

The research breaks controversial new ground in scientists' ability to probe people's minds and eavesdrop on their thoughts, and raises serious ethical issues over how brain-reading technology may be used in the future.

The team used high-resolution brain scans to identify patterns of activity before translating them into meaningful thoughts, revealing what a person planned to do in the near future. It is the first time scientists have succeeded in reading intentions in this way.

"Using the scanner, we could look around the brain for this information and read out something that from the outside there's no way you could possibly tell is in there. It's like shining a torch around, looking for writing on a wall," said John-Dylan Haynes at the Max Planck Institute for Human Cognitive and Brain Sciences in Germany, who led the study with colleagues at University College London and Oxford University.

The research builds on a series of recent studies in which brain imaging has been used to identify tell-tale activity linked to lying, violent behaviour and racial prejudice.

The latest work reveals the dramatic pace at which neuroscience is progressing, prompting the researchers to call for an urgent debate into the ethical issues surrounding future uses for the technology. If brain-reading can be refined, it could quickly be adopted to assist interrogations of criminals and terrorists, and even usher in a "Minority Report" era (as portrayed in the Steven Spielberg science fiction film of that name), where judgments are handed down before the law is broken on the strength of an incriminating brain scan.

"These techniques are emerging and we need an ethical debate about the implications, so that one day we're not surprised and overwhelmed and caught on the wrong foot by what they can do. These things are going to come to us in the next few years and we should really be prepared," Professor Haynes told the Guardian.

The use of brain scanners to judge whether people are likely to commit crimes is a contentious issue that society should tackle now, according to Prof Haynes. "We see the danger that this might become compulsory one day, but we have to be aware that if we prohibit it, we are also denying people who aren't going to commit any crime the possibility of proving their innocence."

During the study, the researchers asked volunteers to decide whether to add or subtract two numbers they were later shown on a screen.

Before the numbers flashed up, they were given a brain scan using a technique called functional magnetic imaging resonance. The researchers then used a software that had been designed to spot subtle differences in brain activity to predict the person's intentions with 70% accuracy.

The study revealed signatures of activity in a marble-sized part of the brain called the medial prefrontal cortex that changed when a person intended to add the numbers or subtract them.

Because brains differ so much, the scientists need a good idea of what a person's brain activity looks like when they are thinking something to be able to spot it in a scan, but researchers are already devising ways of deducing what patterns are associated with different thoughts.

Barbara Sahakian, a professor of neuro-psychology at Cambridge University, said the rapid advances in neuroscience had forced scientists in the field to set up their own neuroethics society late last year to consider the ramifications of their research.

"Do we want to become a 'Minority Report' society where we're preventing crimes that might not happen?," she asked. "For some of these techniques, it's just a matter of time. It is just another new technology that society has to come to terms with and use for the good, but we should discuss and debate it now because what we don't want is for it to leak into use in court willy nilly without people having thought about the consequences.

"A lot of neuroscientists in the field are very cautious and say we can't talk about reading individuals' minds, and right now that is very true, but we're moving ahead so rapidly, it's not going to be that long before we will be able to tell whether someone's making up a story, or whether someone intended to do a crime with a certain degree of certainty."

Professor Colin Blakemore, a neuroscientist and director of the Medical Research Council, said: "We shouldn't go overboard about the power of these techniques at the moment, but what you can be absolutely sure of is that these will continue to roll out and we will have more and more ability to probe people's intentions, minds, background thoughts, hopes and emotions.

"Some of that is extremely desirable, because it will help with diagnosis, education and so on, but we need to be thinking the ethical issues through. It adds a whole new gloss to personal medical data and how it might be used."

The technology could also drive advances in brain-controlled computers and machinery to boost the quality of life for disabled people. Being able to read thoughts as they arise in a person's mind could lead to computers that allow people to operate email and the internet using thought alone, and write with word processors that can predict which word or sentence you want to type . The technology is also expected to lead to improvements in thought-controlled wheelchairs and artificial limbs that respond when a person imagines moving.

"You can imagine how tedious it is if you want to write a letter by using a cursor to pick out letters on a screen," said Prof Haynes. "It would be much better if you thought, 'I want to reply to this email', or, 'I'm thinking this word', and the computer can read that and understand what you want to do."

What have the scientists developed?
They have devised a system that analyses brain activity to work out a person's intentions before they have acted on them. More advanced versions may be able to read complex thoughts and even pick them up before the person is conscious of them.

How does it work?
The computer learns unique patterns of brain activity or signatures that correspond to different thoughts. It then scans the brain to look for these signatures and predicts what the person is thinking.

How could it be used?
It is expected to drive advances in brain-controlled computers, leading to artificial limbs and machinery that respond to thoughts. More advanced versions could be used to help interrogate criminals and assess prisoners before they are released. Controversially, they may be able to spot people who plan to commit crimes before they break the law.

What is next?
The researchers are honing the technique to distinguish between passing thoughts and genuine intentions.

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The brain scan that can read people's intentions

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A team of world-leading neuroscientists has developed a powerful technique that allows them to look deep inside a person's brain and read their intentions before they act. The research breaks controversial new ground in scientists' ability to probe people's minds and eavesdrop on their thoughts, and raises serious ethical issues over how brain-reading technology may be used in the future.

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The Idiographic and Nomethetic Debate AO1

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Recent research on environmental trauma and brain size

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Recent research on environmental trauma and brain size

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Take a look at the image of two brains above. Although they belong to children of the same age, you'll notice that the one on the left is much bigger and has fewer blurred structures than the one on the right.

This radical difference is not caused by disease or physical injury, it's actually the result of extreme emotional trauma and neglect.

The image comes from a paper by Professor Bruce D Perry, Chief of Psychiatry at Texas Children's Hospital. In his words: "The CT scan on the left is an image from a healthy 3-year-old with an average head size. The image on the right is from a 3-year-old child suffering from severe sensory-deprivation neglect. This child's brain is significantly smaller than average and has enlarged ventricles and cortical atrophy."

It's well established that early childhood years can profoundly affect the rest of a person's life, whether it's through the expression of certain genes or your risk of developing asthma later on. However, it's less well-known that they can also affect the physical structure and size of your brain.

Numerous studies have looked into the startling link between brain development and extreme trauma. A 2007 study found that children with post-traumatic stress disorder and high levels of the stress hormone cortisol were likely to experience a decrease in the size of the hippocampus, a brain region associated with emotions and memory processing.

Towards the final decade of Romania's brutal communist dictatorship, Nicolae Ceausescu outlawed all contraception and abortions, leading to thousands of children being abandoned in so-called "orphanages" where they were left en-mass in cramped conditions with virtually no care and little food. A study in 2015 looked at the brains of 26 children in these horrendous conditions and discovered they had significantly less developed white matter in at least four parts of their brains. Brain regions responsible for emotion were particularly affected, as were areas associated with maintaining attention, executive function, and sensory processing.

Needless to say, all of these insights highlight the irrefutable importance of a caring and loving environment for children in the first few years of their lives.

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Images Show The Shocking Effect Of Emotional Trauma On A Child's Brain

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Take a look at the image of two brains above. Although they belong to children of the same age, you'll notice that the one on the left is much bigger and has fewer blurred structures than the one on the right.

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Discuss the ethical implications of psychological research and theory

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Psychology Model Answer: A Level SAM 1, Paper 3, Q3 - Levels of Explanation

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This video is just one part of our revision webinar series titled 'The Edge in A Level Psychology'. For full details of future webinars, visit: https://www.tutor2u.net/psychology/events/students In this video, we look at how to answer the following question: Briefly outline what psychologists mean by 'levels of explanation'.