There seems to be something encoded in human genes that turns many parents of young children into documentary filmmakers, that makes them
want to capture the gurgling, crawling, waddling and romping of their offspring for posterity on film or videotape.
On the other hand, there also seems to be something genetic that makes most people loathe to watch, for any length of time at least, home movies of other people`s kids, no matter how cute.
But for science`s sake, a group of researchers at Emory University in Atlanta is not only watching but painstakingly analyzing some of the most prosaic scenes of the home screen.
In an unusual project, researchers are studying the childhoods, via home movies, of people in their 20s, 30s and 40s who developed schizophrenia and other major mental illnesses. By doing so, they hope to better understand the childhood warning signs of mental disorders whose major, unnerving symptoms usually don`t appear until adolescence or early adulthood.
At the recent annual convention of the National Alliance for the Mentally Ill held at the Chicago Hilton, Elaine F. Walker, a psychologist and member of the Emory team, came armed with slides and home movies to give attendees a feeling for the research.
But before launching into a discussion of the film research, she delivered a brief primer on the latest knowledge about schizophrenia, a psychotic illness often called ”split personality” because of the lack of a logical thread between the affected person`s thoughts and feelings. It often produces delusions, like believing oneself to be Napoleon, or hallucinations accompanied by inner voices. The condition affects about 1.5 million Americans.
Some significant points:
– Schizophrenia isn`t as inheritable as once thought. ”I believe the role of genetic factors has been overstated,” Walker said. ”If a first-degree or immediate relative had the disease, researchers assumed there was a 10 to 15 percent chance a child would get it,” she said. ”The standard notation was that if two parents had it, there was a 40 to 50 percent chance. But it`s been shown recently that`s not the case at all. In fact, the risk rate for a child with an affected immediate relative is much lower. The most recent estimate is 5 percent, and some are as low as 3 percent.”
– Some experts are focusing increasingly on obstetrical problems at birth or viral infections in early life as possible culprits. ”In past studies,”
Walker said, ”mothers of schizophrenic children have reported obstetrical problems like prolonged labor, or neonatal abnormalities like low birth weight, or respiratory problems,” which could affect brain development, triggering mental difficulties later. Scientists are also studying chemical imbalances in the brain linked to the illness.
– Studies that have tried to probe the early years of schizophrenics have been faulty, she said. Some, for instance, relied on parents` and teachers`
recollections of the schizophrenic`s childhood, memories that may have been inaccurate or biased. Others tried school and medical records, but they can be spotty. Some theorists have assumed the brain changes behind schizophrenia occur about the same time symptoms do. ”Undoubtedly, the reason for these assumptions is that we know very little about the early development of patients,” Walker said.
That`s where the home movies come in. ”We`re looking for insights,”
Walker told the meeting room filled with health professionals and laypeople.
Specifically, Walker and her colleagues are looking for what they call
”neurological soft signs” that could serve as ”behavioral markers”
before the first real symptoms show up years later. Neuromotor behaviors-the way a child crawls or sits up, for example-are being scrutinized along with the tiniest facial expressions and the level of response to other people as revealed by the movies.
The researchers are coding the behavior in the films in a rigorous, standardized way. To make the results as scientific as possible, those doing the coding aren`t told whether a particular child later became a schizophrenic or is a member of the control group of healthy children.
So painstaking is the frame-by-frame examination of the films, Walker said, that it takes three hours to code a one-minute segment of a home movie for facial activity.
”Fortunately, parents tend to take home movies in a pretty uniform way,” Walker said. ”It`s almost as if a set of instructions on what to shoot came with the camera. There`s always the first-birthday shot where they place the knife in the child`s hand and cut the cake. Also, the quality of home movies is amazing as well as the extent of movies people take of their children.”
To the disappointment of some in the audience, none of the movies she showed on two TV monitors included any of the 60 patients with major mental illnesses in the study. She cited patient confidentiality.
The images of children who didn`t develop mental disorders proved her point about the uniform ways in which parents record their kids. During her talk, numerous movies spliced together formed a silent stream of similar scenes that were filmed by many different parents: children splashing in baths or pools; baby`s-eye views of crawling toddlers; the inevitable first-birthday shots; children opening presents; and tykes mugging for the camera.
Though none of the movies showed children who later developed mental illness, a few of her slides did.
One slide taken from a home-movie frame showed a closeup of an infant boy whose parents had consented to its public use. He was in a blue knitted cap and was cradled in someone`s arms. While his right hand formed a slightly curled fist, his left hand was held out slightly, somewhat in the manner of someone showing off a ring.
”That`s a mild hemiparesis,” or muscle weakness, she said. ”It`s not diagnostic or prognostic but it can be suggestive. We only know that there`s this neuromotor abnormality showing up in this child which can be seen in later movies of him too.”
Another slide showed the same boy at his first birthday party. He sat on a man`s lap in front of a birthday cake. Instead of a wide smile, he appeared sullen and anxious. ”This child shows distress,” she said. She clicked to the next slide; he seemed near tears. ”He continues to show apprehension, not the reaction you`d expect. He`s frightened of cutting his cake. As I recall, he never was able to. A sibling finally had to do it.”
So far, the research seems to indicate that ”preschizophrenic children are distinguishable from their healthy siblings in early childhood,” Walker said. In a preliminary study designed to test whether early visual clues exist, Walker and her colleagues showed 12 mental-health specialists some of the collected movies of children who went on to develop mental illness and those in the control group who didn`t.
More often than not, the experts were able to choose the children who later became mentally ill, although they weren`t always sure how they knew. Some, however, picked up on an apparent lack of emotional activity, an inappropriate impassiveness or some abnormality in muscle tone from the posturing of a child`s hands and arms like the child in the slides, Walker said.
She cautioned, however, that ”we`re not yet seeing diagnosis-specific indicators of any kind,” and urged those in the audience not to try predicting major mental illnesses based on her research group`s very preliminary findings. ”We don`t know exactly what these things mean, only that they were showing up more.”
Walker said she hopes her group`s work allows those at risk to be spotted early so that a preventive regimen might be developed to treat such children, just as has been done with phenylketonuria, an inherited disorder which if left undiscovered can lead to mental retardation.
Walker also expressed interest in home movies of women who developed schizophrenia before age 30 and males with affective disorders such as manic- depressive illness. She can be reached at the department of psychiatry and psychology, Emory University, Atlanta, Ga. 30322.
