What Celebrity Case Studies Can Teach about Clinical Formulation of Mental Health Conditions

Abstract

A key challenge in the ‘making of the psychologist’ is how to teach clinical case formulation, which goes beyond just listing the symptoms that make the ‘diagnosis’. One approach which has been both effective and popular among students entails employing case studies of individuals who are celebrities with known mental health conditions and then exploring not only their presenting problems and symptoms, but also a detailed analysis of biopsychosocial predisposing concerns, precipitating events, perpetuating circumstances, and protective factors. Nine cases deemed to be particularly suitable for such psychobiographical instruction are reviewed to illustrate the learning points about case formulation. The cases were chosen because they provide a breadth of presenting symptoms and the individuals under consideration are ones who for the most part have been self-disclosing about their conditions, which makes the clinical material accessible for study; a number have been leaders in the fight against mental illness stigma. The use of celebrity case accounts serves to develop talents in case formulation and appreciation for the complexity of people and the developmental influences in identity formation. Further pedagogic benefits are heightened awareness of mental health stigma issues and the personal and societal barriers individuals face in seeking needed help.     

The effects of musical practice on structural plasticity: The dynamics of grey matter changes

Intensive training and the acquisition of expertise are known to bring about structural changes in the brain. Musical training is a particularly interesting model. Previous studies have reported structural brain modifications in the auditory, motor and visuospatial areas of musicians compared with nonmusicians. The main goal of the present study was to go one step further, by exploring the dynamic of those structural brain changes related to musical experience. To this end, we conducted a regression study on 44 nonmusicians and amateur musicians with 0–26 years of musical practice of a variety instruments. We sought first to highlight brain areas that increased with the duration of practice and secondly distinguish (thanks to an ANOVA analysis) brain areas that undergo grey matter changes after only limited years of musical practice from those that require longer practice before they exhibit changes. Results revealed that musical training results a greater grey matter volumes in different brain areas for musicians. Changes appear gradually in the left hippocampus and right middle and superior frontal regions, but later also include the right insula and supplementary motor area and left superior temporal, and posterior cingulate areas. Given that all participants had the same age and that we controlled for age and education level, these results cannot be ascribed to normal brain maturation. Instead, they support the notion that musical training could induce dynamic structural changes.