Written By: Daisy Draper Migrant Detention Facilities Are a Humanitarian Crisis The murder of Renee Nicole Good by officer Jonathon Ross, which left two children without their mother, is a clear example of the profound harm of the US Immigration and Customs Enforcement (ICE) on our youth. It’s nothing new that ICE has a documented history of separating children from their families. Whether they are institutionalized in facilities or separated from their parents, the absence of family-based care can result in lifelong consequences (UNICEF, 2024). Thanks to researchers in neuroscience and psychology, we have evidence suggesting what these consequences might be. Various studies demonstrate that children deprived of family care and enriching environments experience distinct neurodevelopmental and mental health challenges (Mackes et al., 2020). Many of these children studied are raised in orphanages or similar institutions, yet reports indicate that young people detained by ICE may endure even more severe conditions. For example, PBS News described a Texas detention facility where migrant children were “essentially warehoused, as many as 300 children in a cell, with almost no adult supervision” (PBS News Hour, 2019). Image Source: The Washington Post Although regulations prohibit holding children in migrant facilities for more than 20 days, multiple reports have documented cases in which hundreds of children were detained for up to 168 days, averaging 5.5 months (Al Jazeera, 2025). This duration is particularly concerning, as research regarding deprivation-related adversity suggests that its detrimental effects are linked to a sensitive developmental window of approximately 6 months (Edwards et al., 2024). While the full impact of ICE detention on children’s brain development remains under investigation, existing evidence indicates that deprivation increases the risk of depression, anxiety, substance abuse, and difficulties achieving independence in adulthood, including financial instability and unemployment (Sonuga-Barke et al., 2017). The Bucharest Early Intervention Project (BEIP) Image Source: The Bucharest Early Intervention Project The Bucharest Early Intervention Project (BEIP) provides a compelling example of the experiences of institutionalized children, including those held in migrant detention facilities. Supported by two decades of longitudinal data, the BEIP offers critical insights into the effects of deprivation on neurodevelopment. The BEIP researchers followed 136 Romanian orphans since the early 2000s to examine the neurodevelopmental outcomes among children who remained institutionalized compared to those adopted into families. The project uses electroencephalography (EEG) to scan participants’ brains and conducts interviews to assess mental health as they transition into young adulthood. What’s helpful is that this dataset is frequently used by other researchers because it has been collected over such a long period. For example, Margaret Sheridan and her colleagues used the BEIP cohort to investigate the consequences of deprivation-related adversity (Sheridan et al., 2022). They compared the following: children adopted before 24 months children adopted after 24 months and children who remained institutionalized Brain scans from ages 9 and 16, as well as follow-up scans at 16, were analyzed to determine potentially permanent outcomes. Each group was also compared with UK children raised in their biological families. These scans assessed the entire brain, with particular focus on the cerebral cortex (the outermost layer of the brain), grey matter volume (which contains most of the brain’s cell bodies), white matter integrity (the health of white matter), and subcortical volume (the sizes of the structures inside the cerebral cortex). So, what did they find? Well, without surprise, children who remained institutionalized had profound neurodevelopmental problems, as their brains did not reflect patterns consistent with typical development. Additionally, those adopted after 24 months revealed neurodevelopmental problems with little improvement by age 16, whereas those adopted before 24 months showed significant improvement! This is important to emphasize because these results demonstrate that family-based care is integral to a human's healthy development. Another important point to discuss from Sheridan’s study is their results regarding white matter. Picture white matter as a substance in the brain that allows it to engage in higher-level cognitive processes. With that in mind, children who remained institutionalized had poor white matter integrity, which meant they were more susceptible to developing problems with executive functioning. This further illustrates why institutionalized children are more likely to experience cognitive issues and negative life trajectories. The English and Romanian Adoptee (ERA) Project The English and Romanian Adoptee (ERA) is another project led by researchers exploring institutionalization and deprivation. Arranged by researchers from my current university, King’s College London (KCL), they also examined Romanian orphans and obtained results similar to those of the BEIP. For example, researcher Christopher Edwards and his colleagues compared children institutionalized for more than 6 months and less than 6 months with children in the UK raised by their families, along with in-home interviews with adoptees and their parents (Sonuga-Barke et al., 2017). Similar to the BEIP cohort, where institutionalized children exhibited cognitive issues, the ERA sample exposed to deprivation for more than 6 months showed traits resembling attention-deficit/hyperactivity disorder (ADHD) and autism. These traits are referred to as “quasi adhd” and “quasi autism’ because they exhibit very similar traits to those diagnosed with these conditions. The main difference is that ADHD and autism are neurodevelopmental conditions, and are often driven by genetic factors. However, these children seem to exhibit these ‘quasi’ traits solely due to environmental factors, as if the environment can induce neurodevelopmental consequences at a very specific time period of around 6 months. Even more shockingly, a group of researchers at KCL conducted a follow-up study of the ERA participants in young adulthood to examine how deprivation affected their lives. Those who were adopted before 6 months didn’t experience persistent symptoms, however, those who remained institutionalized longer than 6 months exhibited much difficulty (Edwards et al., 2024). To make matters worse, these impacts led to their struggles in independent living, making financial decisions, disengagement with treatment, and vulnerability to victimization and abusive relationships. So, given the well-documented consequences of deprivation, it is critical to question why ICE is permitted to detain children in such inhumane conditions. Even further, these practices provoke serious concerns regarding the decisions of current government leaders. Policymakers must consider the consequences of increased substance abuse, unemployment, and reliance on social services, which result in substantial economic costs and, more importantly, the loss of vulnerable lives. These policies seem to undermine the potential for these children to achieve a good quality of life, while simultaneously attributing societal problems to them despite the adversity they face. Americans are Fighting Back Image Source: NPR News In 2026, several reports documented ICE exploiting children to lure the kidnapping of their parents, such as 5-year-old Liam Ramos and his father. ICE has also terrorized elementary schools in Chicago and swept up children from graduation ceremonies in Massachusetts, New York City, Connecticut, Minnesota, and Georgia, many of whom were days away from receiving asylum eligibility. These draconian measures have led families to skip graduation ceremonies, while many high school students across the country have organized walkouts to show solidarity. The bottom line is that children deserve dignity and safety and should not have to miss out on education or pivotal moments because of poor policy. No child should endure life without the support and nurturance of their families. Even further, racially profiling innocent Americans, kidnapping US citizens and legal residents with green cards, avoiding lawful parameters such as due process or signed judicial warrants, and murdering legal observers are all unconstitutional and abhorrent actions. I am calling on science communicators and researchers to take a stand and address the situation. Your contribution matters, and your voice can influence social and public policy. Now more than ever, use your voice, education, and training to serve our community members. Let this be the wake-up call we all need. References: Edwards, C., Kennedy, M., Knights, N., Kovshoff, H., Kreppner, J., Maughan, B., & Sonuga-Barke, E. (2024a). Neurodevelopmental problems in adulthood following severe early deprivation: A qualitative analysis of clinical needs and service user experiences. Adoption & Fostering Journal/Adoption & Fostering, 48(1), 106–125. https://doi.org/10.1177/03085759231212497 “In Focus: Ending the Institutionalization of Children and Keeping Families Together.” Unicef.org, 11 Nov. 2024, www.unicef.org/eca/reports/focus-ending-institutionalization-children-and-keeping-families-together. Jazeera, A. (2025a, December 10). US authorities acknowledge immigrant children held beyond court-set limit. Al Jazeera. https://www.aljazeera.com/news/2025/12/10/us-authorities-acknowledge-immigrant-children-held-beyond-court-set-limit Mackes, N. K., Golm, D., Sarkar, S., Kumsta, R., Rutter, M., Fairchild, G., Mehta, M. A., Sonuga-Barke, E. J. S., & ERA Young Adult Follow-up team (2020). Early childhood deprivation is associated with alterations in adult brain structure despite subsequent environmental enrichment. Proceedings of the National Academy of Sciences of the United States of America, 117(1), 641–649. https://doi.org/10.1073/pnas.1911264116 PBS News Hour. (2019a, June 21). A firsthand report of “inhumane conditions” at a migrant children’s detention facility. PBS NewsHour; PBS NewsHour. https://www.pbs.org/newshour/show/a-firsthand-report-of-inhumane-conditions-at-a-migrant-childrens-detention-facility Sheridan, M. A., Mukerji, C. E., Wade, M., Humphreys, K. L., Garrisi, K., Goel, S., Patel, K., Fox, N. A., Zeanah, C. H., Nelson, C. A., & McLaughlin, K. A. (2022a). Early deprivation alters structural brain development from middle childhood to adolescence. Science Advances, 8(40). https://doi.org/10.1126/sciadv.abn4316 Sonuga-Barke, E. J. S., Kennedy, M., Kumsta, R., Knights, N., Golm, D., Rutter, M., Maughan, B., Schlotz, W., & Kreppner, J. (2017a). Child-to-adult neurodevelopmental and mental health trajectories after early life deprivation: the young adult follow-up of the longitudinal English and Romanian Adoptees study. The Lancet, 389(10078), 1539–1548. https://doi.org/10.1016/s0140-6736(17)30045-4

Written by: Jacinda Taggett Edited by: Hannah Kim Are you interested in learning more about neuroscience or psychology? If you want to understand how the brain works in its full capacity, we have to start smaller. As small as… a microscopic brain cell? The neuron  is the fancy name for this nervous system cell, and is absolutely essential to begin your deep dive into the brain. So, what is a neuron? The neuron is what allows the brain to communicate not only within the different sections of itself, but also with the body as a whole. Each brain contains billions  of neurons; some estimate up to 86,000,000,000! The structure of neurons In order to best understand how communication works, you need to know the structure of the neuron. Let’s dissect Figure 1  below. Figure 1. Anatomy of a neuron, provided by https://byjus.com/biology/diagram-of-neuron/ Dendrite: these extensions of the neuron are responsible for receiving information from other parts of the body. Equipped with receptors (i.e., the neuron’s biological “lock”), the dendrites accept signals via neurotransmitters (i.e., the neuron’s chemical “key”). Soma: the cell body for the neuron that aggregates the information received from the dendrites and sends it to the axon via the axon hillock. If the signal is strong enough to be sent down the axon, we refer to it as an action potential. Axon: the main highway for action potentials to transfer distances across the nervous system. Node of Ranvier: gaps that lie outside of the axon and in between the Schwann cells, this part of the neuron allows the action potential to “jump” across the axon in a quick fashion Axon Terminal:  at the end of the neuron, this part is necessary for transferring information to other neurons via chemical or electrical signals Schwann Cell: insulation for the neuron’s axon, producing the myelin sheath Myelin Sheath: the fatty layer that cover the Schwann cells, allowing for faster propagation of the signal Nucleus: similar to any other cell in biology, this part of the neuron holds the DNA, or genetic material, of the cell However, all of these parts don’t make sense without context. In order to understand, let’s discuss how the brain actually uses the neuron to communicate. The communication between neurons When one neuron wants to communicate with another, it relays information via chemical or electrical signals from its axon terminal to another neuron’s dendrites. This section between two neurons is called the synaptic cleft, and is also termed as part of the overall synapse. This cleft leads neurons to never even physically touch!   Due to the terminology, the neuron with the axon terminal expelling signals is called presynaptic and the neuron receiving the information through its own dendrites is called postsynaptic. The signal of the presynaptic neuron started from receiving a form of stimulation at its own dendrites beforehand, and this stimulation was strong enough to form an action potential. Once the action potential leaves the soma and moves down the neuron, it jumps between schwann cells covering the axon until it reaches the axon terminal. At the terminal, the action potential allows small sacs ( vesicles ) of chemical or electrical messengers ( neurotransmitters ) to merge with the edge of the neuron and release the neurotransmitter into the synaptic cleft ( Figure 2 ). Figure 2. Diagram of synaptic transmission, provided by https://www.geeksforgeeks.org/biology/synaptic-cleft-anatomy-structure-disease-function/ After reaching the synaptic cleft, the neurotransmitter molecules act as keys to the receptors of the postsynaptic neuron. If enough signal from these neurotransmitters excites the postsynaptic neuron, then this new neuron will undergo the same process as the prior one to transmit the signal to any subsequent neurons. Through this process, we have the capability to transmit information from one part of the brain to limbs across the length of our own body within milliseconds. It’s a beautiful process! What to learn next? Before you can get to the nitty gritty of curing Alzheimer’s disease or understanding how AI replicates human intelligence, you need to learn the fundamentals of neuroscience and psychology. If you are a complete beginner, I recommend taking a look at Neuroscientifically Challenged  on YouTube. These videos are what introduced me to neuroscience! If you have reached a point where you can move onto more complex topics, feel free to read the articles by our blog, Academic Memories!

Author: Evelyn Fistler Editor: Martha W Intro— What Is Endometriosis? Endometriosis is known as a chronic inflammatory disease that is estrogen-dependent, affecting individuals with a uterus. This disease occurs when endometrial-like tissue, known as lesions, reside outside the uterine lining. Severe symptoms include pelvic pain, dysmenorrhea, non-menstrual pelvic pain, and dyspareunia, with about 26% of individuals who have it have reported infertility. While it most commonly grows outside of the uterus and resides within the pelvic cavity, endometrial-type tissue can grow to other parts of the body as well (As-Sanie, et al, 2025). Created in biorender.com Endometriosis and Cognition Endometriosis and cognition are an aspects within the field of neurological research that desperately needs further investigation, as there are limited studies and reviews regarding uterine research. With the limited studies provided, evidence does suggest that many individuals with endometriosis self-reported cognition impairment, highlighting difficulties with inhibition, attention, and memory (Berryman & Machado, 2025). Berryman and Machado (2025) also discuss other studies regarding fMRI results in individuals with endometriosis-associated chronic pelvis pain, with structural changes and altered functional connectivity between the insular cortex and central pain networks.Narrowing down to interior structures, there is further evidence that shows there is decreased functional connectivity between the right anterior insula and the middle frontal gyrus in some individuals with endometrioses-associated chronic pelvic pain.  These changes mostly occurred in those who had displayed pain cognition in attention, expectancy, and appraisal. Because the middle front gyrus focuses on reorienting attention to potential pain inputs within the body, such as intense pressure and extreme heat, it seems that disruption to the circuitry may contribute to pain in individuals with endometriosis. Along with decreased functional connectivity between the right anterior insula and the cerebellum, which is known to have a dominant inhibitory role in pain modulation, fMRI research further suggests that because of these disruptions within these brain regions, those with endometriosis experience enhanced pain, which results in negative attention impacts (Berryman & Machado, 2025). Affect on Mental Health Koller (et al, 2023) provides further insight on how deep endometriosis affects the body, specifically mental health. Significant findings suggest chronic pain to be associated with an increased risk for depression and other psychiatric disorders. A clinical study found that 86% of individuals with endometriosis and chronic pelvic pain (sample size of 8,276) were found to have depression. The study also suggests that endometrial effects on brain regions such as hippocampus, amygdala, and insula in mice cause pain sensitization and mood disorders. Li (et al, 2018) provides evidence that endometriosis is associated with a higher likelihood of developing depression and anxiety disorders; consistent with the fact that the affected areas (insula, amygdala, and hippocampus) play key roles in pain, anxiety, and depression. During the behavioral study, mice with endometriosis were observed to display more anxious behavior than those without, suggesting parallels in human behavior. This research provides evidence that endometriosis alters brain gene expression, leading to noticeable changes in mental health. Even though there is a correlation between endometriosis and mental health issues, there is still a lack of expanded research on how endometriosis affects the brain as there are other aspects to consider. Lack of treatment  or education on how severely each individual is affected is a common issue that results in inadequate care towards both physical and mental health. Biological Changes Bashir (et al, 2023), provides evidence for neurological changes in mice with endometriosis, notability observing an increase in microtonal soma size within regions such as the cortex, hippocampus, thalamus, and hypothalamus. Through behavioral assessment, Bashir (et al, 2023) noticed changes in mice behavior, specifically burrowing and food removal from pellets. Further investigation revealed that mice with increased abdominal pain and hyperalgesia refrain from food retrieval and burrowing habits. Analysis of microglia cell bodies suggests that microglia grow larger in size when activated, and that in this study, there was an increase in glial cells, with microglia size observed to be larger in those with endometriosis.  What Are Microglial Cells? Microglia are macrophages that live in the brain, acting as immune cells to remove unwanted substances and dead cells, inducing healing to an injured area. Microglia activate via enlargement after detecting nerve injuries, inflammation, or ischemia. However, further damage can be induced because activated microglia are suggested to promote inflammation and further aggravate neurodegenerative diseases (Nakaso, 2024). The two types of microglia consist of M1 and M2, with M1 being neurotoxic and inducing inflammation, and M2 being  neuroprotective, inducing anti-inflammatory responses. Because endometriosis lesions release inflammatory markers, this causes microglia to activate. Further analysis shows in Bashir (et al, 2023) provides results of the mice study that give evidence of central nervous system-wide glial activation, further demonstrating that microglial enlargement is a critical aspect of pain sensitivity in those with endometriosis through the release of pro-inflammatory cytokines and chemokines.  Endometriosis in Other Organs Interestingly, it seems endometriosis can reside in other places of the body besides the uterus. In another study conducted by Dr. Neisani Samani, within implanted endometrial cells in mice, these cells can migrate to other organs, including the brain which produces central nervous effects ( Endometriosis.org , n.d.). Cerebral Endometriosis is described as an indication of endometrial tissue within the brain, affecting the cerebellum. Although rare, women with endometriosis are known to have a higher chance of experiencing psychiatric conditions, which cerebral endometriosis is suggested to play a role in influencing. Further symptoms besides constant pain would include heightened sensitivity to hormonal changes, modifications in gene activity, and lesions that affect different areas of the brain that play a role in mood regulation. Considering the study that found that glial cells play a major role in endometriosis, it is also notable to analyze how glial cell abnormalities are further involved with mood disorders (such as depression and anxiety) and behavior (Cronkleton, 2023). Conclusion The limited information on how endometriosis affects women cognitively shows the importance of women’s healthcare and research. Because of unknown variables and constant changes in research, studies such as the ones provided above should be well understood to move forward with newer research, where more education on how endometriosis can manifest within other organs and affect the brain can be sought, with in addition to potential treatments for the disease. References As-Sanie S, Mackenzie SC, Morrison L, et al. Endometriosis: A Review. JAMA. 2025;334(1):64–78. doi:10.1001/jama.2025.2975 Bashir, S. T., Redden, C. R., Raj, K., Arcanjo, R. B., Stasiak, S., Li, Q., Steelman, A. J., & Nowak, R. A. (2023). Endometriosis leads to central nervous system-wide glial activation in a mouse model of endometriosis. Journal of neuroinflammation, 20(1), 59. https://doi.org/10.1186/s12974-023-02713-0 Cronkleton, E. (2023, November 14). What is Endometriosis in the Brain (Cerebral Endometriosis)? Healthline. https://www.healthline.com/health/endometriosis-in-the-brain#symptoms Endometriosis.org . (n.d.). ASRM2015: Endometriosis may infiltrate the entire body –  Endometriosis.org . Copyright 2005-2011 endometriosis.org . https://endometriosis.org/news/congress-highlights/asrm2015-endometriosis-may-infiltrate-the-entire-body/ Koller, D., Pathak, G. A., Wendt, F. R., Tylee, D. S., Levey, D. F., Overstreet, C., Gelernter, J., Taylor, H. S., & Polimanti, R. (2023). Epidemiologic and Genetic Associations of Endometriosis With Depression, Anxiety, and Eating Disorders. JAMA network open, 6(1), e2251214. https://doi.org/10.1001/jamanetworkopen.2022.51214 Nakaso K. (2024). Roles of Microglia in Neurodegenerative Diseases. Yonago acta medica, 67(1), 1–8. https://doi.org/10.33160/yam.2024.02.001 Ashlee Berryman, Liana Machado, Cognitive Functioning in Females with Endometriosis-Associated Chronic Pelvic Pain: A Literature Review, Archives of Clinical Neuropsychology, Volume 40, Issue 5, August 2025, Pages 1066–1080,   https://doi.org/10.1093/arclin/acaf003 Li, T., Mamillapalli, R., Ding, S., Chang, H., Liu, Z. W., Gao, X. B., & Taylor, H. S. (2018). Endometriosis alters brain electrophysiology, gene expression and increases pain sensitization, anxiety, and depression in female mice. Biology of reproduction, 99(2), 349–359. https://doi.org/10.1093/biolre/ioy035

Written by: Alondra Alamillo It’s David’s third time breaking curfew, and his parents are unsure what to do next. Lately, he has been arguing, disregarding house rules, and even destroying school property, resulting in repeated disciplinary actions. Although David’s parents had been notified of instances of bullying and stealing in elementary school, they did not think his behavior would escalate throughout middle school. After an assessment of David’s behavior, conduct disorder (CD) interventions were recommended to help prevent the development of additional behavior disorders or possible criminality. While the focus of these interventions is usually the child, caregiver training programs were also recommended as a good fit for improving the overall family dynamic and effectively supporting long-term change. What is Conduct Disorder? The time for onset of conduct disorder (CD) is broken down into three distinct categories: 1) Childhood-onset type, 2) Adolescent-onset type, or 3) Unspecified onset due to a lack of information needed to categorize the onset. These distinctions are helpful in deciding at what point in the child’s development symptoms occurred. There are 15 diagnostic criteria used to determine CD, including aggression toward people and animals, destruction of property, deceit, theft, and violation of rules specific to minors, such as school rules and curfew ordinances. Additionally, the Diagnostic and Statistical Manual of Mental Disorders specifies the need to ask the child to self-report on matters of their emotional functioning; this is to determine if any antisocial characteristics persist in their life (Substance Abuse and Mental Health Services Administration (US), n.d.). Given that a CD diagnosis can be a precursor to Antisocial Personality Disorder, research on the emotional experience perspective is an important factor to consider in interventions.  In the past year, Delamillieure & Collins (2025) considered CD treatment engagement in children in relation to these antisocial factors, including callous and unemotional conduct as a specifier for antisocial behavior. Information on these specific traits sought to offer insight into what kind of treatments are beneficial and what can be predictive of future impairments with higher stakes. Although callous and unemotional (CU) traits are not a priority when drafting a treatment plan for CD, they are vital to consider. Through prosocial skill building and parenting training, they reinforce habits that will ultimately help lower CU traits. What can caregiver-focused training offer when accompanied by proper adolescent-focused interventions?  Caregiver Training  Common Sense Parenting (CSP), a type of Behavioral Parent Training (BPT), is a category of caregiver training specifically aimed toward parents with children receiving treatment for CD who face traits of callousness and unemotion (Substance Abuse and Mental Health Services Administration (US), n.d.) . In Mason et al. (2015), the CSP program was specifically examined to gain insight into its potential indirect effects on a child’s CD behaviors as they transition from middle school to high school. Given the high level of transition in the development of behaviors seen between middle school and high school, the study found that this was the best setting to experiment with this community. Through this intervention, coping emotional-regulatory skills were targeted and supported by parental choices. To ensure the parenting program was meeting the needs of adolescents while also supporting their development, a balance was struck between external and internal control. This was provided through consistent praise and appropriate discipline when needed. Since existing literature supports CSP as a successful caregiver training intervention, a crucial factor in examining the design of the program lied in evaluating whether or not these parenting skills continued to have positive effects on the children after a two-year follow-up (Mason et al., 2015).  Substance use, school suspensions, and general problems of conduct were the information used to categorize whether the parenting program was effective. The two-year follow-up questionnaire for both parents and children revealed significant emotional regulation improvement compared to the time before the training was given. This suggested that the essential coping skills demonstrated at home, along with metacognitive teachings of self-regulation played a significant and long-lasting role in CD interventions (Mason et al., 2015).  References Search for | Clip art Library . (n.d.). https://clipart-library.com/search1/?q=parents#gsc.tab=1&gsc.q=parents&gsc.page=2 Da Silva, D. R., Rijo, D., Brazão, N., Paulo, M., Miguel, R., Castilho, P., Vagos, P., Gilbert, P., & Salekin, R. T. (2021). The efficacy of the PSYCHOPATHY.COMP program in reducing psychopathic traits: A controlled trial with male detained youth. Journal of Consulting and Clinical Psychology , 89 (6), 499–513. https://doi.org/10.1037/ccp0000659 Delamillieure, E., Colins, O.F. Treatment Engagement and Multiple Specifiers among Boys and Girls with Conduct Disorder. Res Child Adolesc Psychopathol  53, 1499–1512 (2025). https://doi.org/10.1007/s10802-025-01353-7 Mason, W. A., January, S. A., Fleming, C. B., Thompson, R. W., Parra, G. R., Haggerty, K. P., & Snyder, J. J. (2015). Parent training to reduce problem behaviors over the transition to high school: Tests of indirect effects through improved emotion regulation skills. Children and Youth Services Review , 61 , 176–183. https://doi.org/10.1016/j.childyouth.2015.12.022 Substance Abuse and Mental Health Services Administration (US). (n.d.). Table 3.37, DSM-IV to DSM-5 Conduct Disorder Comparison - Impact of the DSM-IV to DSM-5 changes on the National Survey on Drug Use and Health - NCBI Bookshelf . https://www.ncbi.nlm.nih.gov/books/NBK519704/table/ch3.t37/ Reil, J., Lambie, I., Horwood, J., & Becroft, A. (2020). Children who offend: Why are prevention and intervention efforts to reduce persistent criminality so seldom applied? Psychology Public Policy and Law , 27 (1), 65–78. https://doi.org/10.1037/law0000286

By: Jacinda Taggett Edited by: Martha Waricoy “PET? You are not going to need to know PET imaging for cognitive neuroscience. Maybe MRI… so I would focus on the MRI at your job.” I was sitting next to a cognitive neuroscientist at a conference in 2023 when this statement struck me. I had been going around telling everyone of my upcoming position as a positron emission tomography (PET) neuroimaging data analyst, and no one was particularly amused. Now, nearly three years later, she was right. My expertise and interest in PET imaging was not super valuable to academia, especially in the realm of memory research in which I had been invested in for the past six years. PET scans take a long time to acquire at such a high expense, for low resolution images of the smallest regions necessary for cognitive neuroscience research questions. Although I knew this going into the job, my experience with this unconventional modality has given me new career ideas to consider… now in healthcare. In order for PET imaging to be conducted, you need a Certified Nuclear Medicine Technologist (CNMT) on your team. This individual is an imaging technologist responsible for injecting radioactive tracers into the patient and then collecting their images via PET scanner. As I currently transition out of the research realm, I spent this past weekend shadowing a nuclear medicine department. Below is what I learned about this hidden healthcare profession. Career Trajectory To become a nuclear medicine technologist, you have to go through roughly two years of schooling (with pre-requisites completed) and complete two or more board certification exams. The main board branches are the American Registry of Radiologic Technologists (AART) ,which is generalized to all modalities (e.g., x-ray, ultrasound, MRI, etc.), and then the Nuclear Medicine Technologist Certification Board (NMCTB)  – specific to nuclear medicine. A key difference between the two board examinations to get certified is that the NMTCB examination additionally allows you to also get certified in imaging diagnostic Computed Tomography (CT; another modality particularly necessary for nuclear medicine technologists). Pay ranges for this radiologic technologist modality differ per location, however, in states like California (where I am from), you can roughly expect a $100k+ starting salary. And the great thing about being in this profession is that after you are certified and working, the main job promotions do not require additional schooling, but prioritize experience level. Courses throughout schooling typically include radiopharmaceutical chemistry, anatomy, radiation physics, healthcare best practices, and clinical rotations across neighboring hospitals– all of which are outside of how to use the machinery and the numerous tests conducted within  the field. I very quickly learned while in the nuclear medicine unit that there are up to 70 different tests conducted within the facility , below are 3 that I witnessed. Diagnostic Test 1: Gastric Emptying My morning consisted of observing four gastric emptying scans, in which patients are monitored and scanned every hour for four hours to see how fast food moves through the gastrointestinal (GI) system. In order for this study to be conducted, 2 minutes worth of low-dose CT scans (1 frontal, 1 posterior) are completed at every hour for four hours, or until 90% of the food has been excreted from the body. To calculate how much food is excreted over time in a standardized approach, the meals containing the radioactive tracer are prepared not only with the same ingredients, but also the same quantity: an egg sandwich with white bread, strawberry jam, and water. This standardized meal is ideal because the calculated uptake of the tracer can be comparable across patients, ranging from those with normal to dysfunctional GI activity. In my one hour of shadowing this study, I was able to observe multiple patients get their secondary scans for the day. My overall impression of this was that general nuclear medicine (i.e., the nuclear medicine technologists handling the GI, bone, lung, and other similar scans) is a faster-paced environment and great for individuals that need constant work to be done. Due to this nature of the task, it was my most preferred workflow. Diagnostic Test 2: Exercise Nuclear Cardiology The afternoon was split into two separate, but related, tests. Chronologically, individuals suspected of having issues with their hearts will undergo an exercise nuclear cardiology test. The test is administered as follows: Patients will exercise for 3 minute intervals with increasing intensity, usually with a nurse leading the procedure. Meanwhile, another technologist monitors the patient’s EKG, heart rate, and blood pressure. Once the patient reaches the 80th percentile of their maximum heart rate, the nuclear medicine technologist will inject the radioactive tracer, 30 seconds before stopping the exercise. There are three main methods of exercise: moving on a treadmill, lifting a 1-lb weight while sitting, or walking around the clinic. Some major considerations to keep in mind are that patient safety and comfort always come first. Therefore, the patient themselves can tap out at any time, or the nurse leading the procedure can call an end to the test if the vital signs are too intense. This is a perfect subspecialty for nuclear medicine technologists who want direct and front-facing patient interaction and who are also comfortable to venipuncture multiple times an hour. Although it is the most intriguing of the three tests, I felt that the specialty is too niche for a career outside of a large metropolitan area like Boston. Diagnostic Test 3: PET/CT Nuclear Cardiology The final test, which is what I originally went into hoping to shadow, is PET/CT imaging. As a secondary to the diagnostic exercise test, I shadowed a nuclear cardiology scan. In this circumstance, medication that increases heart rate is administered after conducting baseline PET scans– this is called the stress test . This scan is also conducted 30-60 minutes after the exercise test, therefore, the radioactive tracer from the prior test is what is measured in the scanner. The stress test scan will be conducted for 6 minutes. My biggest surprise with the PET/CT aspect within nuclear medicine is how much of the process is the technologist waiting for the scans to be completed. There is minimal work to be done during this process, since they must be attentive to any potential problems with the scanner or patient. That being said, this aspect of nuclear medicine was much slower paced than the other tests, which led it to be my least favorite of the three. Career Risks and Limitations Although this profession sounds interesting and fun, there are quite a few risks and limitations of pursuing this field. Setting aside the daily exposure to radioactive tracers, materials, and scanners , there are still career-specific considerations to make before pursuing this path.  Firstly, getting admitted to nuclear medicine programs can be quite challenging, as there are  less than 10 spots per year for each of the zero to two available programs per state. After being admitted, most programs are expecting LOTS of clinical hours to the point where having a job outside of school can be difficult for most . In my opinion, this practice is understandable due to the fast-paced nature of the programs, as well as the ability to work full-time in hospitals immediately after board certification. After schooling, it can also be limiting to get a job if you do not plan to stay in your local area , due to the lack of scanners and cyclotrons nationally. Finally, the job can feel repetitive and slow compared to other healthcare specialties ,particularly in the PET/CT imaging. I personally prefer this “limitation” due to my recent career pivot after being inspired by the lack of work-life balance in academia. I flourish in my extracurriculars and self-care when I am able to clock in and out without stressors keeping me glued to my work station, and radiologic technology is the healthcare field for that. Author’s Future Directions Although there are lots of limitations, these are all perks for me as someone who wants to stay local to cities and desires a competitive but stable career. When I finished shadowing the nuclear medicine department this weekend, I knew it was the path for me. However, it is one of the least understood or even known healthcare professions. Therefore, I hope to document my journey through this process and note my thoughts and revelations along the way.

Written by: Nitya Thakur Borderline Personality Disorder (BPD) affects millions of people worldwide, yet it remains one of the most widely misunderstood mental health conditions. For many, the first encounter with the diagnosis comes through popular culture, most famously in Girl, Interrupted, where young women navigate intense emotions, unstable relationships, and psychiatric confinement. At one point, the protagonist reflects on the ambiguity of her diagnosis, asking whether the problem lies in who she is or how she is perceived. While such portrayals offer a powerful human entry point into BPD, they often stop at the surface of emotional chaos. They show what it looks like to live with BPD but rarely address the deeper question that lingers beneath the narrative: what is happening inside the brain when emotions become overwhelming, and why does regulation fail? At its core, BPD is not about a lack of emotion or awareness. In fact, many individuals with BPD are highly sensitive to their internal states: they feel emotions deeply, notice shifts in mood quickly, and are acutely aware of interpersonal tension or perceived rejection. The difficulty lies not in feeling too little or caring too much, but in regulating those internal experiences once they arise. The history of BPD helps explain why it has been so widely misunderstood. The term ‘borderline’ emerged in the mid-20th century, when clinicians struggled to categorize patients whose symptoms did not fit neatly into existing diagnoses. These individuals appeared to exist on the “border” between neurosis and psychosis, leading to a vague and often stigmatizing label. Early theories focused on unstable identity, intense emotions, and chaotic relationships, but offered little explanation for why these patterns occurred. When BPD later entered diagnostic manuals as a personality disorder, it was often interpreted incorrectly as a problem of character rather than a condition rooted in brain function. Over the past several decades, this view has begun to change. Research across clinical psychology, developmental psychiatry, and cognitive neuroscience increasingly suggests that BPD is best understood as a disorder of self-regulation, rather than personality or intent (Paris, 2007; Chanen & Kaess, 2012). From this perspective, the central question shifts from blame to mechanism: what happens in the brain when emotional signals become overwhelming, and the systems responsible for regulation cannot keep up? Figure 1.   Emotion regulation depends on coordination between limbic regions that generate emotional signals and prefrontal regions that regulate and contextualize those signals. In BPD, this coordination becomes unreliable under stress. When Emotional Signals Overwhelm Regulation: A Neurobiological Account of BPD Symptoms While BPD is associated with diverse and often striking symptoms, research increasingly suggests that these features reflect difficulties regulating intense emotional signals under stress, rather than a lack of awareness, insight, or effort (Paris, 2007). Affective Instability: Heightened Emotional Signals Without Stabilization One of the most central features of BPD is affective instability, marked by rapid shifts in mood, intense emotional reactions, and prolonged emotional distress following interpersonal stressors. Importantly, these emotional shifts are not random. Paris (2007) emphasizes that emotional instability in BPD is highly reactive, emerging in response to environmental and relational triggers rather than reflecting a persistently elevated mood state. This clinical pattern is consistent with neurobiological models reviewed by Chanen and Kaess Figure 2. Heightened amygdala responsivity increases the salience of emotionally threatening or socially relevant cues, contributing to rapid emotional escalation in BPD. (2012), which describe heightened responsivity in neural systems involved in emotional salience and threat detection. Emotional signals, particularly those related to social rejection or interpersonal conflict, are processed as highly significant, escalating rapidly and placing heavy demands on regulatory systems. The lived experience of this process is often one of emotional overload. Holm and Severinsson (2008) describe emotional pain in BPD as intense, persistent, and consciously distressing. Individuals are not disconnected from their emotions; rather, they experience them as overwhelming and difficult to escape. Awareness Without Regulation: When Control Systems Fail Despite intense emotional experience, individuals with BPD are typically aware of their distress and its consequences. This awareness distinguishes BPD from conditions characterized by emotional blunting or lack of insight (Holm & Severinsson, 2008). Neuroscientific research helps explain why awareness does not always translate into control. Qiu et al. (2018) show that the brain systems responsible for detecting internal uncertainty are functionally distinct from those responsible for regulating behavior in response to that information. In their fMRI study, activity in the dorsal anterior cingulate cortex (dACC), a region involved in monitoring conflict, error, and emotional significance, tracked subjective uncertainty. In contrast, effective behavioral adjustment depended on engagement of lateral prefrontal regions, which support top-down control, planning, and inhibition. Applied to BPD, this distinction suggests that emotional distress may be accurately detected, yet regulatory control may fail to engage effectively under high emotional load. Individuals may recognize that their reaction is extreme or harmful, but still feel unable to stop it in the moment. Impulsivity as a State-Dependent Regulatory Failure Impulsivity is another hallmark symptom of BPD, often manifesting as self-harm, substance use, or sudden interpersonal actions. Importantly, impulsivity in BPD is context-dependent rather than stable. Paris (2007) argues that these behaviors arise primarily during periods of acute emotional distress, rather than reflecting enduring traits. This view is reinforced by neurobiological findings reviewed by Silbersweig et al. (2007), which suggest reduced efficiency of frontal control systems during emotionally provocative states. When emotional arousal intensifies, the balance between emotional signaling and regulatory control shifts, making it difficult to inhibit immediate responses or consider long-term consequences. Paris (1997) further distinguishes this pattern from antisocial personality disorder, where impulsivity is less tied to emotional distress and more pervasive across contexts. In BPD, impulsive behavior is best understood as a temporary breakdown of control, not a lack of moral restraint. Disturbances in Self-Concept and Interpersonal Regulation   BPD is also characterized by an unstable sense of self and intense, volatile relationships. Developmental research suggests that these difficulties emerge early and reflect vulnerabilities in self-regulation under interpersonal stress (Chanen & Kaess, 2012). Adolescents who later develop BPD symptoms often show heightened sensitivity to social evaluation and exaggerated interpretations of interpersonal cues.  As emotional arousal increases, maintaining a coherent sense of self becomes more difficult. This instability contributes to rapid shifts in self-evaluation, fear of abandonment, and intense Figure 3. In BPD, emotional signals escalate rapidly while regulatory systems struggle to keep pace, creating a functional gap between awareness and control. relational reactions, particularly when emotional demands exceed regulatory capacity. Chronic Stress and Biological Vulnerability  Finally, chronic emotional distress in BPD is associated with alterations in the brain’s stress-response systems. Chanen and Kaess (2012) describe dysregulation of the hypothalamic–pituitary–adrenal (HPA) axis, the body’s primary stress-response system, particularly among individuals with histories of trauma or self-harm.  Over time, repeated activation may heighten emotional vulnerability and reduce the ability to return to baseline, further undermining emotional regulation. Reframing the Core Question (and the Path forward)                                  Taken together, these findings suggest that Borderline Personality Disorder is best understood as a condition in which emotional signals escalate rapidly while regulatory systems struggle to keep pace. Emotional awareness is often intact, but the neural mechanisms needed to stabilize internal states and guide behavior become unreliable under stress.  This helps explain a painful reality of BPD: people may recognize that a reaction is extreme or harmful, yet feel unable to stop it in the moment. These experiences do not reflect weakness or lack of effort but a brain under chronic regulatory strain, one in which emotional monitoring outpaces control.  Importantly, this framework also points toward hope. If the core difficulty in BPD lies in weakened regulatory “brakes”, then treatment can be understood as strengthening those brakes over time. Therapies such as Dialectical Behavior Therapy (DBT) and Mentalization-Based Treatment (MBT) work by training skills like emotional labeling, distress tolerance, perspective-taking, and impulse control, capacities closely tied to prefrontal regulation.  Recovery, then, is not about dulling emotion or becoming less sensitive. It is about building the ability to pause, reflect, and respond even when emotions run high. Viewed through this neurobiological lens, BPD becomes not a life sentence but a condition where understanding, skill-building, and compassion can meaningfully change outcomes. References  Chanen, A. M., & Kaess, M. (2012). Developmental pathways to borderline personality disorder. Current Psychiatry Reports , 14(1), 45–53. https://doi.org/10.1007/s11920-011-0242-y Holm, A. L., & Severinsson, E. (2008). The emotional pain and distress of borderline personality disorder: A review of the literature.  International Journal of Mental Health Nursing, 17(1), 27–35. https://doi.org/10.1111/j.1447-0349.2007.00508.x Paris, J. (1997). Antisocial and borderline personality disorders: Two separate diagnoses or two aspects of the same psychopathology?  Comprehensive Psychiatry, 38(4), 237–242. https://doi.org/10.1016/S0010-440X(97)90032-8 Paris, J. (2007). The nature of borderline personality disorder: Multiple dimensions, multiple symptoms, but one category. Journal of Personality Disorders, 21(5), 457–473. https://doi.org/10.1521/pedi.2007.21.5.457 Silbersweig, D., Clarkin, J. F., Goldstein, M., Kernberg, O. F., Tuescher, O., Levy, K. N., Brendel, G., Pan, H., Beutel, M., Pavony, M. T., Epstein, J., Lenzenweger, M. F., Thomas, K. M., & Posner, M. I. (2007). Failure of frontolimbic inhibitory function in the context of negative emotion in borderline personality disorder. American Journal of Psychiatry, 164(12), 1832–1841. https://doi.org/10.1176/appi.ajp.2007.06010126 Qiu, L., Su, J., Ni, Y., Bai, Y., Zhang, X., Li, X., & Wan, X. (2018). The neural system of metacognition accompanying decision-making in the prefrontal cortex. PLoS Biology, 16(4), e2004037. https://doi.org/10.1371/journal.pbio.2004037

Written by: Saghi Naghizadeh Edited by: Chimara Anyanwu Introduction During many days of the past year I would wake up already exhausted, and eventually, there were more mornings like that than not. I used to be the kind of person who stayed on top of school, constantly showed up for other people, and pushed through stressful tasks without much complaint. However, gradually, everything started to feel heavier. Assignments that used to take an hour took four. Things that once helped me recharge started feeling like burdens. When people asked if I was okay, my response was, “I think I’m just burnt out”. Burnout felt like a safer word because it sounded temporary, understandable, and even responsible. A more nuanced and loaded term like depression, on the other hand, felt heavier and harder to admit, even to myself.  I kept framing my feelings and experiences as stress, assuming that rest or better time management would fix them. But at times, rest was not helpful. On many days with nothing scheduled, I still felt strangely drained and numb. I felt disconnected from the things I used to care about; I wasn’t just tired from school or work. That is when I started to question whether it was still burnout or something more. Throughout the past few months, I realized that many other college students and professionals under constant pressure struggle with the same question. The words burnout and depression are often used interchangeably, especially among these demographics. However, while they look similar at first, they are not the same, and understanding the difference can determine whether someone needs a break, a change in the environment, or to seek professional mental health care. Burnout “Burnout is generally acknowledged by researchers, clinicians, and the public as a pervasive occupational difficulty ” (Nadon et al., 2022). American social psychologist, Christina Maslach, one of the leading researchers on burnout, describes this phenomenon as having three main components: emotional exhaustion , depersonalization or cynicism , and a  reduced sense of personal accomplishment . Malasch’s 1981 study is widely regarded as the original empirical foundation as this three-component conceptualization of occupational burnout is still referenced in more contemporary research on burnout.  Emotional Exhaustion Depersonalization or Cynicism Reduced Sense of Personal Accomplishment Feeling drained Feeling depleted Unable to give any more Becoming detached Becoming callous toward work, school, and/or the people involved Negative feelings and emotions Feeling ineffective Feeling like nothing one does is impactful or makes a difference Burnout is typically situational and environment-specific . For example, an individual might feel exhausted and cynical at work but still enjoy hobbies and time with family and friends. In this case, taking some time off or a change of environment is likely to improve symptoms. Depression Depression, specifically Major Depressive Disorder (MDD), is a medical mental health condition characterized by a cluster of emotional, cognitive, and physical symptoms that last at least two weeks and interfere with daily life . According to the American Psychiatric Association (APA), this condition can lead to various symptoms like changes in sleep, appetite, and energy levels, as well as the possibility of suicidal ideation or attempts. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), the core symptoms of Major Depressive Disorder include persistent sadness or emptiness and a loss of interest or pleasure in most activities, known as anhedonia . Rest, vacation, or time away from work or school does not reliably resolve depression. Unlike burnout, depression is not limited to simply one area of life, like work or school. It tends to heavily affect mood, motivation, and functioning in many areas of life, including but not limited to work, school, relationships, home life, and personal hobbies or interests. In contrast to burnout, the roots of depression are not only situational but also biological, psychological, and social, which makes it quite difficult to point to a specific event as the cause. Where Burnout and Depression Overlap While burnout and depression are different, feeling chronically overwhelmed, cynical, and emotionally depleted due to burnout can often start to look and feel like a depressive episode. Ample research (e.g. Baka et al., 2025; Gu et al., 2024, Selskii et al., 2023; Osadnik et al., 2023; Baptista et al., 2022) shows that both can involve low energy, persistent fatigue, difficulty concentrating, irritability, withdrawal, and reduced motivation and productivity. These studies illustrate the presence of overlap in the core features between the two. However, it is important to note that this is a correlation, and not a proven causation. Key Differences That Matter The key differences between burnout and depression are in their scope of impact , core emotional experience , response to rest , and diagnostic status , as illustrated below. When Burnout Turns Into Depression As mentioned previously, while burnout and depression are different, if left unresolved, burnout can gradually increase the risk of developing depression. Chronic and unmanaged stress significantly affects sleep, hormone levels, immune function, and brain systems that are heavily involved in mood regulation. Prolonged feelings of inefficacy and emotional depletion, which are characteristics of burnout, can evolve into hopelessness and negative self-belief, which are symptoms of depression. Long-term exposure to high job stress has been associated with a greater likelihood of developing depressive symptoms later on (Sardella et al., 2024; Shoman et al., 2024; Yu et al., 2024). While this overlap is quite common, it is important to note that not everyone with burnout will develop depression, but rather the risk rises when stress is intense and is combined with limited support, personal vulnerability, or a perceived lack of control over one’s situation. It is beneficial to think of burnout as a warning zone . If it continues without relief, the emotional exhaustion and detachment can deepen into more pervasive mood, cognitive, and functional changes, which are often seen in depression. The Importance of This Distinction Mistaking burnout for depression, or vice versa, can delay one’s ability to receive the right kind of help. If someone with depression assumes they are “just burnt out”, they may try to push through, take short breaks, or even keep blaming themselves for not being resilient enough. Meanwhile, symptoms like hopelessness, severe withdrawal, and even thoughts of self-harm and suicidal ideation may go unrecognized and untreated, which can be extremely harmful. On the other hand, if every case of burnout is treated purely as an individual mental health issue, we run into the danger of ignoring systemic factors that cause burnout in the first place. Excessive workloads, lack of control, poor leadership, or emotionally demanding environments that lack support are not things that psychotherapy or medications alone can fix.  Depression calls for clinical evaluation and evidence-based mental health care, while burnout calls for changes in workload, boundaries, and environment. Sometimes, both are necessary, for either a short or long duration, depending on the circumstance. Understanding the difference helps individuals and organizations respond appropriately. Call to Action Schools and workplaces must take burnout seriously as a preventable organizational issue, not a personal weakness. Reducing chronic overload and increasing vital support should not be viewed as luxuries, but rather, protective factors for mental health. As a society, it is also important to move away from oversimplified labels. Statements like “I’m just burnt out” may often be a helpful starting point, but more individuals need to be open to asking deeper questions of themselves. Questions such as: Is this still stress from my environment, or is my mental health being negatively affected more broadly? Acknowledging the similarities and differences between burnout and depression can be life-changing, and in some cases, life-saving. It could change not only how someone feels about their professional life, but also whether they get the care they need to feel like themselves again. References American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders  (5th ed., text rev.; DSM-5-TR). American Psychiatric Association Publishing. Baka, Ł., Prusik, M., & Grala, K. (2025). Burnout or depression? Investigating conceptual and empirical distinctions in a high-stress occupational group . Journal of Clinical Medicine, 14 (12), 4036. https://doi.org/10.3390/jcm14124036 Baptista, M. N., Hauck-Filho, N., & Cardoso, H. F. (2022). The overlap between burnout and depression through a different lens: A multi-method study . Journal of Affective Disorders Reports, 10 , Article 100437.   https://doi.org/10.1016/j.jadr.2022.100437 Gu, M., Wang, S., & Zhang, S. (2024). The interplay among burnout, and symptoms of depression, anxiety, and stress in Chinese clinical therapists . Nature Scientific Reports .   https://www.nature.com/articles/s41598-024-75550-7 Nadon, L., De Beer, L. T., & Morin, A. J. S. (2022). Should burnout be conceptualized as a mental disorder? Behavioral Sciences , 12(3), 82. https://doi.org/10.3390/bs12030082 Osadnik, C. R., & Hijazi, S. J. (2023). Association between anxiety, COVID, burnout and depression: A qualitative study of primary care clinicians’ perceptions of burnout . Journal of General Internal Medicine . https://doi.org/10.1007/s11606-023-08536-2 Sardella, A., Musetti, A., Franceschini, C. et al.  Longitudinal associations of depression, anxiety, and stress among healthcare workers assisting patients with end-stage cancer during the COVID-19 pandemic: the moderator role of emotional exhaustion. BMC Psychol  12, 359 (2024). https://doi.org/10.1186/s40359-024-01851-1 Selskii, A. O., Zaidi, T. H., Ilyas, A., Khan, M., & Naz, R. (2023). Association of burnout, professional depression, and academic training among medical students . Russian Open Medical Journal, 12 (4), e0104. https://doi.org/10.15275/rusomj.2023.0104 Shoman, Y., Ranjbar, S., Strippoli, M.P. (2023). Longitudinal association of exposure to work-related stress with major depressive disorder and the role of occupational burnout . Journal Name . PMID: 39215821.   https://pubmed.ncbi.nlm.nih.gov/39215821/ Yu, S., Zhao, M., Li, Y. et al.  The interaction of occupational stress and job burnout on depressive symptoms in railway workers in Fuzhou city. BMC Public Health  24, 1432 (2024). https://doi.org/10.1186/s12889-024-18902-2 2

Author: Evelyn Fistler Editor: Ellis Mckeown Introduction Cognitive biases are systematic and unconscious  errors that impact thinking, occurring when influences such as the environment impact judgement and decision making, often distorting an individual's perception of reality, resulting in misinformation or poor interpretations of information ( Da Silva, et al, 2023).  Different cognitive biases can impact decision-making and reasoning due to individual beliefs, which can be flawed through influence and reliance on a particular belief, leaving the individual susceptible to flawed reasoning. With the new use of artificial intelligence and chatbots in media platforms and online, people have become more reliant on discussing questions or seeking advice through AI.This article will provide insight into how the modern use of artificial intelligence impacts cognition, potentially affecting critical thinking and reasoning, leading to diminished brain capability. Types of Cognitive Biases Familiarity, availability, and confirmation biases are some of the most common cognitive biases that many individuals are vulnerable to. Familiarity bias, a bias where individuals prefer to follow what is already known, suggests that people can be susceptible to false information because of previous set beliefs. Information can spread quickly, whether true or not, and contributes to familiarity bias because of how often the information is read and heard. Believing in the topics and information most easiest to remember is known as availability bias, and because AI provides individuals with quick information that sounds believable because of its delivery, this leaves many relying on false information because of how believable it was initially obtained.  Utilizing AI, which caters toward “for you” pages and recommendations through shopping and social media apps, can contribute to familiarity and availability bias. Availability bias is a key factor that consumers experience, specifically regarding impulse buying. Frequently encountered products are stored in long term memory, leaving individuals vulnerable to familiarity and therefore a potential purchase ( Li, et al, 2025). Because AI has the capability to bring forth information through different platforms while also handling quick assistance, providing consumers with products recommended based on searches and advice or solutions, availability bias can affect individuals based on the easy influx of information. Through confirmation bias, many seek information that may support personal beliefs and expectations, which reinforces the bias and assumptions. For example, those seeking a health diagnostic based on symptoms may lean toward a self-diagnosis that best describes their personal needs and/or anxieties, leaving them susceptible to confirmation bias. Because AI models have human-like dialogue capabilities and are utilized to cater toward individuals seeking answers, there is a chance for confirmation bias because some individuals may seek health advice. This leaves the individual more vulnerable to misinformation and misinterpretation (Lopez‐Lopez et al., 2025).  Understanding that AI can easily be used to support personal belief through frequency usage depending on how prompts are worded and understood by the user. Familiarity with AI is suggested to potentially empower scientists to utilize AI visualizations, however, audiences could become further susceptible to misinterpretation and distortion. With this, Eom (et al, 2025), suggests that becoming more familiar with AI and the content generated using different softwares is essential for individuals to become less skeptical. AI disclaimers and credibility along with transparency and understanding for generative AI is extremely important to implement through education and communication to the public. What Can Influence Cognitive Biases?  Emotion, personal belief, influenced thoughts and the capability for an individual to process information are all common factors that can influence cognitive bias. Reliance on flawed information, and the perspective of how information is framed, are other considerations for cognitive bias formation, especially with the use of AI (Paulus, et al, 2022).  The use of artificial intelligence is becoming a part of daily life, whether it is to use AI for ideas, to communicate, or to solve problems with, the human capability to make decisions from AI seems to be causing disruption and affecting cognitive abilities like critical thinking, reasoning, and decision making because humans reproduce the same biases displayed by AI (Vicente & Matute, 2023). Decisions made through biased AI recommendations show how impactful AI is on cognition, with AI responses inheriting the  structure of reasoning and evidence formation that change human behavior. Because AI is man-made, there is room for error especially in generative AI models, where displays of human-like cognitive biases are prevalent (Vicente & Matute, 2023).  How the Use of Artificial Intelligence Impacts Cognition AI has the ability to respond quickly because of pre-trained models and pattern recognition through datasets, enabling rapid data processing to summarize data at high speeds.  Promoting cognitive offloading (the act of reducing mental processing requirements), AI responses and continuous usage appears to distort critical thinking, further impacting learning and reasoning, and increases exposure to biased information because Large Language Models (which AI are trained on) can provide narrow ideas that result in superficial analyses (Duke Learning Innovation & Lifetime Education, 2025). Research within a literature review provides evidence for cognitive offloading, suggesting that reliance on AI tool usage reduces critical thinking abilities, while also leading to greater cognitive offloading. For example, Sparrow (et al, 2011), discussed how frequent use of search engines impacted memory, reducing the individual's likelihood of remembering information independently. Another study within Gerlich’s (2025) review found that Zhai (et al, 2024), did a study with students, discovering that students who relied heavily on AI dialogue systems displayed diminished decision-making and critical analysis skills (Gerlich, 2025).  Consistently, AI responses are exaggerated with rigid structures, providing narrow information—though the responses are vulnerable to being biased due to how information is displayed and captured. This provides users with information that may potentially alter the perception of how the individual views the given information due to the systematic exaggeration and rigid structure of response, which means careful consideration of the AI’s interpretation is optimal (Hanna, et al, 2025). One study found that artificial personas generated by large language models (such as ChatGPT) were susceptible to cognitive bias through generating human-like text, which can, in turn, impact how humans make decisions and perceive certain subjects. Cognitive biases like the False Consensus Bias, which refers to individuals believing their views are more common than they actually are, can become particularly prevalent through AI use. For example, considering how social media algorithms utilize AI to cater each individual's “for you” page based on their views and interests, this particular cognitive bias is prevalent to consider (Hanna, et al, 2025).  Another cognitive bias, known as the Anchoring Effect, refers to individuals relying heavily on an initial piece of information when making decisions. Because of this bias, misinformation and misinterpretation can be spread. For example, a study utilizing AI-generated recommended scores on employees overseen by supervisors. Supervisors exposed to high AI-recommended scores rated employee performance much higher than those with low AI- recommended scores. This suggests that AI may amplify or perceive much differently, but still leaves room for more analysis on how AI provides information. Further studies and analyses showed many individuals relied on artificial intelligence to make decisions, which in turn can impact recommendations and influence their final judgements. Using AI as an anchor for decisions and judgements can potentially hinder experiences with the software, such as limitations in data and instead suggests the need for human oversight and additional verification (Carter & Liu, 2025). Biological Changes Cognitive functions like decision-making, impulse control, and emotional regulation are negatively impacted through excessive internet use due to grey matter density changes in the brain, specifically in regions like the prefrontal cortex and the anterior cingulate cortex. These areas of the brain reflect memory retrieval demand and goal-relevant control which is focused on decision making and error detection (Shanmugasundaram & Tamilarasu, 2023). Dergaa (et al., 2024), suggests that the younger generation is especially affected considering their developing brains, leading them to prioritize quick and efficient information instead of promoting critical analysis and deep reflection and comprehension. Instead of cognitive stimulation, they may become overreliant on chatbots, hindering cognitive capabilities and potentially affecting psychological and social impacts. For example, one's mental health may be negatively impacted through erosion of cognitive capabilities leading to reduced self confidence and a sense of helplessness, which may further contribute to cognitive decline. Dergraa (et al, 2024) also mentions that weakened neural pathways, errors in memory retrieval, diminished thinking, decline in ability to apply knowledge, and increased social isolation are some of the other major factors that may occur with AI reliance.  Cognitive bias can lead to misinformation. However, exposure to misinformation, such as through AI usage, also causes changes in cognition, significantly altering reconstructive processes during memory retrieval. Errors in previously encoded events may be replaced by misleading information, increasing risk for false memories (Lentoor, 2023). Knowing this, it is important to consider information provided by artificial intelligence, understanding the cognitive biases that can occur based on information sought. Further research on how AI and cognitive biases can contribute to changes in the brain may help researchers understand how to prevent or decrease cognitive changes.  A Glimpse at Social Media and AI Usage Research has linked the prevalence of AI and social media usage, finding that AI use is positively correlated with social media use. Many social media platforms may rely on AI technology (e.g., recommendations, short descriptions of summaries, tools to ask questions to…etc), which some users may be unaware of. This could cause reliance on AI, potentially unknowingly, and increase the spread of misinformation which can impact cognition (Montag & Elhai, 2025). Pan (et al., (2025) mentions that AI chatbots and GenAI in social media platforms may result in media manipulation, leading to drastic changes in network structures and information. Users should become aware regarding the prevalence of AI chatbots and genAI on social media platforms,  acknowledging  how information is spread and checking sources for accuracy to prevent negative cognitive influence. Conclusion Through increased research on cognitive biases, and how artificial intelligence can impact memory, decision-making, critical thinking skills, and other cognitive functions, researchers can better understand how to utilize artificial intelligence without users being susceptible to bias and misinformation. Because artificial intelligence is programmed by humans, there is room for bias and false information within AI responses. Furthermore, given the discussed issues that arise in frequent reliance on artificial intelligence, and how cognitive biases may occur, striving to minimize misinterpretation and deception is ideal, meaning regulation of AI usage should be heavily considered. References Hanna Campbell, Samantha Goldman, Patrick M. Markey, Artificial intelligence and human decision making: Exploring similarities in cognitive bias, Computers in Human Behavior: Artificial Humans, Volume 4, 2025, 100138, ISSN 2949-8821, https://doi.org/10.1016/j.chbah.2025.100138 . Lemuria Carter, Dapeng Liu, How was my performance? Exploring the role of anchoring bias in AI-assisted decision making, International Journal of Information Management, Volume 82, 2025, 102875, ISSN 0268-4012, https://doi.org/10.1016/j.ijinfomgt.2025.102875 . Da Silva, S., Gupta, R., & Monzani, D. (2023). Editorial: Highlights in psychology: cognitive bias. Frontiers in psychology , 14 , 1242809. https://doi.org/10.3389/fpsyg.2023.1242809 Dergaa, I., Saad, H. B., Glenn, J. M., Amamou, B., Aissa, M. B., Guelmami, N., Fekih-Romdhane, F., & Chamari, K. (2024). From tools to threats: a reflection on the impact of artificial-intelligence chatbots on cognitive health. Frontiers in Psychology , 15 , 1259845. https://doi.org/10.3389/fpsyg.2024.1259845 Duke Learning Innovation & Lifetime Education. (2025, August 13). Does AI harm critical thinking - Duke Center for Teaching and Learning. Duke Center for Teaching and Learning. https://ctl.duke.edu/ai-ethics-learning-toolkit/does-ai-harm-critical-thinking/ Gerlich, M. (2025). AI Tools in Society: Impacts on Cognitive Offloading and the Future of Critical Thinking. Societies, 15(1), 6. https://doi.org/10.3390/soc15010006 Lentoor A. G. (2023). Cognitive and neural mechanisms underlying false memories: misinformation, distortion, or erroneous configuration?. AIMS neuroscience, 10(3), 255–268. https://doi.org/10.3934/Neuroscience.2023020 Li, X., Zhou, T., Hu, C., & Liu, H. (2025). Availability Bias in AI Recommenders: Impacts on Impulse Buying. Journal of Computer Information Systems , 1–13. https://doi.org/10.1080/08874417.2025.2547173 Liming Pan, Chong-Yang Wang, Fang Zhou, Linyuan Lü, Complexity of social media in the era of generative AI, National Science Review, Volume 12, Issue 1, January 2025, nwae323, https://doi.org/10.1093/nsr/nwae323 Lopez‐Lopez, E., Abels, C. M., Holford, D., Herzog, S. M., & Lewandowsky, S. (2025). Generative artificial intelligence–mediated confirmation bias in health information seeking. Annals of the New York Academy of Sciences , 1550 (1), 23–36. https://doi.org/10.1111/nyas.15413 Christian Montag, Jon D. Elhai, The darker side of positive AI attitudes: Investigating associations with (problematic) social media use,mAddictive Behaviors Reports, Volume 22, 2025, 100613, ISSN 2352-8532, https://doi.org/10.1016/j.abrep.2025.100613 . David Paulus, Gerdien de Vries, Marijn Janssen, Bartel Van de Walle, The influence of cognitive bias on crisis decision-making: Experimental evidence on the comparison of bias effects between crisis decision-maker groups, International Journal of Disaster Risk Reduction, Volume 82, 2022, 103379, ISSN 2212-4209, https://doi.org/10.1016/j.ijdrr.2022.103379 . Shanmugasundaram, M., & Tamilarasu, A. (2023). The impact of digital technology, social media, and artificial intelligence on cognitive functions: a review. Frontiers in Cognition, 2. https://doi.org/10.3389/fcogn.2023.1203077 Research guides: Misinformation - Get the Facts: Cognitive Biases. (n.d.). https://guides.lib.uci.edu/Misinfo/bias Vicente, L., & Matute, H. (2023). Humans inherit artificial intelligence biases. Scientific Reports, 13(1), 15737. https://doi.org/10.1038/s41598-023-42384-8

By: Olivia Mickles Friedrich Nietzsche insightfully noted, “Blessed are the forgetful, for they get the better even of their blunders.” This quote encapsulates the emotional core of the film Eternal Sunshine of the Spotless Mind, which depicts the ambivalent process of erasing another person from one’s memory by following Joel Barish on his journey to getting his ex-girlfriend, Clementine Kruczynski, erased from his memory after discovering she had erased him from hers. This is done through the company Lacuna Inc.,  which provides the seemingly impossible possibility to literally erase memories that make one unhappy. Clementine was so unhappy with Joel, and Joel was so distraught by Clementine erasing him, that they both sought out Lacuna’s procedure to experience complete no-trace forgetting (Gondry, 2004). Yet, could someone completely forget a specific individual person like in this film? In the following paper, I will discuss how technology could be developed to target and manipulate memories, similar to the movie, and how we can understand the ways in which the brain can naturally forget someone. Complete no-trace forgetting is not entirely possible, but there have been neuroscientific findings that support the ability to physically manipulate memories, studies done on those with memory degenerative diseases like Alzheimer's, as well as theories debated on the topic of forgetting memories.   Memories leave a physical trace in our brains, and scientists are getting closer and closer to replicating memory manipulation as depicted in the movie. Gross et al. (2013) examined whether memories could be seen forming in real time, and discovered that it is, in fact, possible in mice. They created a recombinant antibody-like protein, Fibronectin intrabodies generated with mRNA display (FingRs), that attach to traceable neural receptors called PSD-95 and Gephyrin. Then, green fluorescent protein from a certain species of jellyfish was injected into the mice, and the scientists could see the proteins collecting around receptors, forming memories. Knowing that PSD-95 is at excitatory sites and Gephyrin is at inhibitory sites within synapses, using FingR technology, researchers can see which proteins hold memory related synapses and observe when the FingRs are expressed, forming a memory. The researchers in this study also hypothesize that FingR can be used to track synaptic strength in the brains of live mice before and after learning a cognitive task or during sleep and wake cycles. Therefore, it could be feasible in the future to associate changes in synaptic structures with activity at the cellular level, such as memory formation.  The neurological process discovered by Gross et al. (2013) proposes a way that memories can be mapped that is similar to the technology at Lacuna Inc. The whole procedure in the film relies on the ability to pinpoint specific cores of memories and their location in the brain.While FingR technology only allows for visualization as of now, it is a foundational step towards this fictional, surgical method of identifying and erasing memories. The movie depicts detailed maps of the brain with specific neural clusters highlighted to signify individual memories in Joel’s brain. This finding demonstrates that memories have physical traces, and provides convincing evidence that the procedure done to Joel and Clementine could one day be feasible.  Going beyond locating and mapping memories, Roy et al. (2016) seek to use optogenetics to retrieve lost memories in mice that were genetically engineered to mimic having Alzheimer’s disease. In the early stages of this disease, memory decline is mainly caused by dysfunction in the hippocampus and episodic memories. In the genetically-altered mice, researchers used optogenetic activation to manipulate the hippocampus’ memory cells. This procedure uses blue light to control the activity of genetically-modified light-sensitive engram cells, which are responsible for storing memories by activating during learning experiences. Their aim was for optogenetic activation to cause the retrieval of forgotten memories in the mice that were proven to be lost in previous long term memory tests. This outcome would demonstrate an impairment in retrieval rather than a problem with encoding or the storage of memories. However, in the later stages of Alzheimer's disease, amyloid plaque deposition takes place, leading to reduced spine density of hippocampal dentate gyrus engram cells. Using optogenetic laser techniques to activate long term potentiation at those cells minimally restored both long term memory and spine density. The authors concluded that restoring spine density in engram cells in the hippocampus could be an effective treatment for restoring memory in Alzheimer's disease patients. This research solidifies the premise that a memory can be isolated, manipulated, and activated using scientific technology. Still, it also provides evidence that complete no trace forgetting of a person is not possible given the mice’s memories had been lost, then recovered. Roy et al.’s (2016) research on memory retrieval using optogenetics validates the premise of the film, even though the scientists in the study restored memory instead of erasing it. In the film, Dr. Mierzwiak informs Joel that the erasure procedure infiltrates the brain to get rid of the emotional core of memories, and likewise Roy et. al were able to isolate and manipulate specific memory engrams, demonstrating that memory can be accessed at its source. For Lacuna to successfully erase memories of a person, they have to be able to pinpoint episodic memories in a similar way. Modern science is getting closer to being able to replicate the procedure done in the film, so if we can bring memories back, then why can we not figure out how to erase them? Dr. Mierzwiak, in Eternal Sunshine of the Spotless Mind, told Joel that the erase procedure can technically be considered as brain damage given that they are infiltrating the brain, finding the emotional core of each memory, and getting rid of the core to start the memory degradation process (Gondry, 2004). While physically manipulating memories themselves would bring us closer to the procedure done in the film, Redondo et al. (2014) found another way to manipulate memories to create an “eternal sunshine”. They identified a brain circuit that links feelings to memories and found that they could change rats' feelings about a memory from negative to positive. Rats were labeled with channelrhodopsin-2, a key tool in optogenetics for controlling neural activity, in either the dorsal dentate gyrus (DG) or the basolateral complex of the amygdala (BLA), and then exposed either to fear or reward conditioning stimuli. Using an optogenetic laser to activate the DG or BLA, the researchers observed that the fear conditioned rats became extremely avoidant. After being subjected to reward conditioning to induce the opposite emotion, the DG group experienced a change in emotion, but the BLA group did not. In the dentate gyrus, the memory engram of a neural context is plastic, so the valence of a conditioned response can be switched by re-associating the previous memory with a new unconditioned stimulus of the opposite emotion. This provides insight into the functional neural pathways that underlie the true plasticity of memory; and at least if we cannot entirely erase a memory, then we can scientifically change the way we feel about it.   The reason Joel underwent the erase procedure was to alter how he feels. But when the memories started to erase, he realized that all he really wanted was to get rid of the unresolved feelings attached to the memories of Clementine, not to forget her completely. If we have the ability to re-valence a memory, as shown to be possible by optogenetics, we could keep the experience of a memory while removing any unwanted feelings. Yet, experiencing, remembering, and moving on from things is what helps us learn and grow as people. The film itself ends with Joel and Clementine hearing the recording of everything that they once said about the other and choosing to stay together to work things out. They are choosing to move forward, so unlike how they ran away from experiencing their emotions in the past. Using optogenetics to the advantage of avoiding emotional struggle is the scientifically feasible achievement of an “eternal sunshine.” Then, the question is should it be used for that purpose given it goes against a necessary human experience? More than that, forgetting a person is also a natural and unfortunate consequence of dementia related diseases, like Alzheimer’s. Parsons-Suhl et al. (2008) explored how Alzheimer’s disease progressed in various different individuals’ cases and how they perceived that experience. They used Heideggerian hermeneutical phenomenology which holds the basic assumptions that humans are always relating to other people and things in the world, and that meaning is always in the context of relationships. The research participants consisted of three men and nine women who had been diagnosed with either early stage Alzheimer’s disease (AD) or mild cognitive impairment. Data was collected from an in-person interview with each participant where they were asked to tell a story that they feel illustrates what it is like to live with AD or mild cognitive impairment, and then they were asked to describe the breakdown of their memory from the initial realization to the debilitating loss. The responses overall mentioned a similar progression of loss, starting off as being aware that they no longer remembered to do small tasks that they normally do daily, such as taking a pot off the stove. Then, the forgetfulness continued and got more severe as time went on until they experienced symptoms like getting disoriented at random or forgetting where they were in a familiar place. Some participants stated that they just had to learn to accept and live with the forgetting, but, without being able to make memories or remember simple information, they felt disconnected from the world and the people around them. If meaning is always in the context of relationships, what meaning does life or relationships have if you cannot hold onto memories? People with Alzheimer’s and other dementias have to deal with the possibility of completely forgetting people in the later stages of their disease. They would develop a, metaphorically speaking, “spotless mind” and may no longer be able to recognize familiar people like friends and family, or even their own reflection (Parsons-Suhl et al., 2008).  Joel and Clementine are experiencing the erasure of only one person and the memories connected with them. They were both still themselves as they went about their daily lives unscathed, with Clementine even getting a new boyfriend, much to Joel’s dismay (Gondry, 2004). Someone with Alzheimer’s, or another form of dementia, loses all of themself to the disease and is experiencing real brain damage unlike the kind of targeted “brain damage” of Joel and Clementine’s treatment. While dementia is a real world form of no-trace forgetting, it is uncontrollable and unsolicited unlike the procedure Joel wanted and regretted. Losing memory so completely and unexpectedly is a loss of self and identity, not a fresh start.  Beyond the neurological and technological possibilities of memory manipulation as seen in the film and scientific research, there are also psychological theories that can offer insight into how to forget painful memories. One theory by Johnson (1994) suggests that people practice segregation, creating a separate representation in their mind for forgotten and remembered information and then suppressing the forgotten information in order to make chosen memories difficult to access. Subjects in this study initially learned a set of items, some they are cued to remember (R-cued) and others they are cued to forget (F-cued). They are told to create a mental representation of the items that connect the information, and then a global forget instruction is given that tells them to forget the whole set of items learned. Representational changes occur in memory when there is segregation of F-cued and R-cued information, disrupting the links between the two. R-cued information was thought to be able to be retrieved without remembering the F-cued material. This would be intentional forgetting; but could it actually be achieved? The researchers found that two postretrieval processes can lead to intentional forgetting. One is rule-based where the subject reviews all items but only produces a response to the R-cued items. The other process is theory-based where one can adjust their response due to how the F-cued items influenced that response, positively or negatively. This study  demonstrated that providing an F-cue to initially learned items decreases interference with R-cued items. This practice is not the same as erasing, but is a non-technical mechanism that can ease suffering caused by remembering through intentionally forgetting specific information. Like all beings, Joel and Clementine have control over their own beliefs and thoughts, for they are the ones having them; therefore they also have control over their memories. Unlike Lacuna’s scientific approach, segregation is an internal and conscious process one can use to manage their own mental environment. This technique draws upon a person’s “duty to forget” mindset that involves self regulation and management (Johnson, 1994), and is a non-invasive way to process painful memories. An individual using segregation can create emotional distance and boundaries to lessen the effects of remembering another person or event without sacrificing their identity or brain structure. Segregating suggests that “eternal sunshine” comes not from physically draining the brain of all memories of a person or event, but from the difficult process of internal memory management. This approach is probably what Joel and Clementine should have tried before jumping straight to total, irreversible erasure that ended up doing more harm than good in the long run. In the real world, if we were one day able to bypass processing emotional information, it would mean so many people would lack the wisdom that comes with learning from life. If Lacuna’s technology in Eternal Sunshine of the Spotless Mind  existed in real life, millions would be able to erase valuable memories of past love that haunt them in the present like Joel and Clementine. Could someone completely forget a specific individual? No, not yet at least, and no one should try to. Using technology to erase memories is a dangerous shortcut that defies what it means to be human, to feel deep emotions, learn from them, and carry them all with you throughout your life. Modern science has been making revolutionary breakthroughs in memory manipulation with some results that could get closer to the procedure of the film, yet, still, researchers have not yet found any true, possible way to completely erase a memory. One cannot naturally and completely forget someone without damage to the brain, but healthier methods exist with theories and practices that can help one ease heartache. Overall, this movie brings to light that eternal sunshine is not found in a spotless mind, but rather in a mind that accepts a painful past, goes through the hard work of learning to let go, and chooses to remember again and again.  References   Gondry, M. (Director). (2004). Eternal Sunshine of the Spotless Mind. Focus Features.   Gross, G. G., Junge, J. A., Mora, R. J., Kwon, H. B., Olson, C. A., Takahashi, T. T., Liman, E. R., Ellis-Davies, G. C. R., McGee, A. W., Sabatini, B. L., Roberts, R. W., & Arnold, D. B. (2013). Recombinant Probes for Visualizing Endogenous Synaptic Proteins in Living Neurons. Neuron , 78 (6), 971–985. https://doi.org/10.1016/j.neuron.2013.04.017    Johnson, H. M. (1994). Processes of Successful Intentional Forgetting. Psychological Bulletin, 116 (2), 274-292. https://doi.org/10.1037/0033-2909.116.2.274    Parsons-Suhl, K., Johnson, M. E., McCann, J. J., & Solberg, S. (2008). Losing One’s Memory in Early Alzheimer’s Disease. Qualitative Health Research, 18 (1), 31-42. https://doi.org/10.1177/1049732307308987   Redondo, R. L., Kim, J., Arons, A. L., Ramirez, S., Liu, X., & Tonegawa, S. (2014). Bidirectional switch of the valence associated with a hippocampal contextual memory engram. Nature, 513 , 426-430. https://doi.org/10.1038/nature13725       Roy, D. S., Arons, A., Mitchell, T. I., Pignatelli, M., Ryan, T. J., & Tonegawa, S. (2016). Memory retrieval by acitivng engram cells in mouse model of early Alzheimer’s disease. Nature, 531, 508-512. https://doi.org/10.1038/nature17172

Author: Evelyn Fistler Editor: Mia R-J Introduction Manifestation is the act of believing something into existence, and we may tell others, or we may claim in secret—positive energy, good grades, an internship—this “something” can be anything that brings us success, we think about, or we want to happen. This belief system is popular on social media platforms, where people participate by writing down affirmations or creating vision boards of their ideal lives. Many claim manifestation to be useful and true, akin to the law of attraction, and so they promote it to manifest success whenever possible, but what is the science behind manifestation? It could certainly be considered a self-fulfilling prophecy, similar to the pygmalion effect, where an individual is provided support and encouragement, such as through academia, and ends up achieving a better performance (Dixon et al., 2025). However, negative aspects of manifestation are less talked about, which is what this article will provide—insight into manifestation, the neuroscience behind it, and underlying factors that could contribute to the thought processes. Brief History  The concept of modern manifestation was first introduced to the public by the New Thought movement in the late 19th century. This was influenced by eastern philosophies, and recognized the law of attraction to be a key fundamental of philosophical belief aligned with the group's ideology. A spiritual philosophical movement founded by Phineas Quimby, a person who provided the concept of the law of attraction, believed that physical disorders could be developed due to bad thoughts or mistaken ideas that could eventually be cured by changing one’s beliefs and mindset (Mehra & Chakravarty, 2024). Cultures previously utilized manifestation in a spiritual sense, hoping to achieve specific outcomes through connection (Dixon et al., 2025). Hinduism, one of the world's oldest religions, focuses heavily on the belief system such as karma, where actions and intentions influence future outcomes. Hindu traditions such as speaking to Lakshmi, the goddess of wealth if in need of money, and participating in the prayer of Ganesh Puja to enhance overall well-being and luck, focuses on the power of bringing wants and needs to life (Dadds, 2025). Because of how powerful cultural influence can be, it is no surprise to see manifestation becoming a popular point of topic in modern times. Cognitive Bias and Manifestation Within the study Dixon (et al., 2025) discusses, participants were found to have an ideology of power to manifest success through positive thoughts, emotions, and symbolic acts, and cosmic collaboration, or partnering with supernatural or universal forces to manifest success. Through surveying the participants' responses to the created survey, the study was able to suggest how people view manifestation and whether they consider affirmations or beliefs to be aligned with their thought process. While some thoughts were considered positive another part of the study shows that through the thought-action fusion scale, belief of having negative thoughts about oneself may increase the likelihood of the events happening is more associated with psychopathology while the positive form observed showed to be associated with manifestation.  Investigating the results, the studies show that individuals who believe in manifestation often perceive themselves as more successful in both regards to the present and future. However, further analysis of overoptimism in relation to success experiences by the individuals who manifest show that there is higher chance of vulnerability to financial or investment opportunities that overall, promote unlikely rewards.These individuals are more likely to be a victim of fraud and to have been bankrupt, suggesting being overconfident could exhibit behaviors that may cause financial harm, and in the end potentially cause career and business decision-making issues (Dixon, et al., 2025). Thought-action fusion is a cognitive distortion that suggests individuals who are thinking of completing an action believe it to be the same as physically doing said action, a type of cognitive bias on believing inner thoughts. This type of cognitive bias could potentially be negative depending on the thought process, known as the psychological phenomenon negativity bias, which is believing initially of an event or action to be negative in itself and curating a focus toward the negative aspects rather than positive. Thought-action fusion can be more associated with manifestation when looking at the individuals who focus on positive thoughts and beliefs rather than the negative (Dixon et al., 2025). Furthermore, manifestation seems to be reinforced by influential individuals, some of which could be role models. Prior beliefs about one individual can subtly cause others to conform to expectations of other observers, as described in the Pygmalion effect (Dixon., et al, 2025). Neuroscience Behind Cognitive Distortion The precuneus is a region of the brain located in the medial parietal lobe and has been found to be associated with cognitive bias through thought-action fusion, most commonly found in mental disorders such as Obsessive Compulsive Disorder (OCD), where negative thoughts, often through moral and likelihood thought-action fusion, occur and increase negative belief that the action will happen through the thought (Jones., et al, 2013). Activations in the fusiform and lingual gyri, midcingulate and superior medial frontal gyri, inferior orbitofrontal gyrus, and temporoparietal junction are shown to be shared in positive and negative thinking, while positive thinking also displayed additional activation in the precuneus, medial frontal pole, superior frontal gyrus, insula, globus pallidus, thalamus, and midbrain. These areas focus heavily on visual association, cognitive motor control, self-processing and mentalizing, and cognitive reappraisal. For negative thought-action fusion, research consistently shows that the precuneus displayed more activation rather than positive thought-action fusion (Lee., et al, 2021). Other regions of the brain such as the inferior frontal lobe, caudate nucleus, and insular gyri are associated with thought-action process due to the linkage in emotional processing, goal directed behavior, and task engagement, as seen within a study that analyzed thought-action fusion in individuals with major depressive disorder (Sang Won Lee., et al, 2024). However, further investigation on positive thought-action fusion should be sought to understand the regions associated particularly with positive manifestation.  Impact On Daily Life Manifestation used in a negative way may occur due to compulsions, anxiety, negative thoughts, and emotions, but the manifestation many people refer to through social media is positive manifestation, where believing success is the same as it occurring rather than believing negative events. Similar to this, cognitive reconstruction on thought processing, such as with cognitive behavioral therapy (CBT), helps people identify negative thoughts and replace them with more positive ones (Institute for Quality and Efficiency in Health Care (IQWiG), 2025). With this in mind, society can practice positive thinking to become more resilient, boost serotonin levels, lower cortisol, activate dopamine neurons, and enhance overall cognitive health (Suhail, et al, 2025). Conclusion Utilizing methods that CBT focuses on and integrating positive thinking instead of negative thinking can change how the individual perceives people and the rest of the world. Because of how similar positive thinking and manifestation methods are, practicing this type of mindset can be beneficial. References Aseem Mehra, Rahul Chakravarty, “Law of Attraction”: A manifestation of psychological disorder or not?, Asian Journal of Psychiatry, Volume 100, 2024, 104155, ISSN 1876-2018, https://doi.org/10.1016/j.ajp.2024.104155 . Dadds, K. (2025, February 27). The ancient origins of ‘manifesting’—and why it’s making a comeback. History. https://www.nationalgeographic.com/history/article/the-ancient-origins-of-manifesting Dixon, L. J., Hornsey, M. J., & Hartley, N. (2025). "The Secret" to Success? The Psychology of Belief in Manifestation. Personality & social psychology bulletin, 51(1), 49–65. https://doi.org/10.1177/01461672231181162 Jones, R., & Bhattacharya, J. (2013). A role for the precuneus in thought-action fusion: evidence from participants with significant obsessive-compulsive symptoms. NeuroImage. Clinical, 4, 112–121. https://doi.org/10.1016/j.nicl.2013.11.008 Neuroanatomy, Cerebral Cortex Kinaan Javed; Vamsi Reddy; Forshing Lui. https://www.ncbi.nlm.nih.gov/books/NBK537247/ Sang Won Lee, Seungho Kim, Hansol Lee, Yongmin Chang, Seung Jae Lee, Neural correlates of thought–action fusion and their associations with rumination in patients with major depressive disorder, Journal of Psychiatric Research, Volume 180, 2024, Pages 169-176, ISSN 0022-3956, https://doi.org/10.1016/j.jpsychires.2024.10.005 . Suhail Ahmad Dar, Krithika Ramakrishna, Yuvraj Singh Shekhawat, Chapter Two - Impact of positive thinking on synapses, Editor(s): Nasrollah Moradikor, Motahareh Haghipanah, Hib Hamdar, Progress in Brain Research, Elsevier, Volume 293, 2025, Pages 17-40, ISSN 0079-6123, ISBN 9780443346002, https://doi.org/10.1016/bs.pbr.2025.03.005 . Lee, S. W., Cha, H., Jang, T. Y., Kim, E., Song, H., Chang, Y., & Lee, S. J. (2021). The Neural Correlates of Positive Versus Negative Thought-action Fusion in Healthy Young Adults. Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology, 19(4), 628–639. https://doi.org/10.9758/cpn.2021.19.4.628

by Kimberly Hall image credit: " Ford and Kennedy Hold Joint Vaccination Evolution to Further Vaccination Effort 210909-N-YW264-1010 " by   NavyMedicine  is marked with   Public Domain Mark 1.0 . In 1998, The Lancet  famously published a study conducted by Andrew Wakefield which claimed links between the Measles-Mumps-Rubella (MMR) vaccine and the development of autism and gastrointestinal problems in children. Though the research was later found to be fraudulent, its results refuted, and the paper eventually retracted, MMR vaccine compliance dropped so much as a result that in 2008, measles was declared endemic in the United Kingdom for the first time in over a decade (Godlee et al., 2011). Vaccine hesitancy, while certainly not a new phenomenon, has become a significant point of discussion within the field of public health. Given the overall shift of COVID-19 from pandemic to endemic, and recent outbreaks of highly-infectious diseases like measles and RSV, full and updated vaccination remains extremely important to general public health. However, the number of people putting off or outright refusing vaccination continues to grow; according to the CDC’s surveillance coverage, for example, MMR vaccination rates among children during the 2024/25 school year dropped to just 92.5% across the United States, well below the necessary threshold for preventing further transmission of measles. In this article, I plan to explore vaccine hesitancy from a social psychological perspective. I will apply elements of social cognition to help analyze and understand the various factors behind increased vaccine rejection–both internal, relating to psychological and emotional processes, and external, relating to various social influences. Finally, I will explore what can be done to challenge this trend. Overview of Social Cognition Social cognition is an approach to social psychology which focuses on the roles that cognitive elements and processes play within social contexts. Advanced by social scientist Albert Bandura, social cognitive theory asserts that learned human behavior is the product of reciprocal relationships between people and their environment–they both shape and are shaped by each other. Related theories and models make similar assertions about the interdependence of thought, action, and environment (Hagger & Hamilton, 2022; Latkin et al., 2022). In health-related research, social cognition theories, like those of planned behavior (Lin et al., 2020; Shiloh et al., 2022) and triadic reciprocal determinism (Zhu et al., 2022), feature prominently in studies aimed at identifying the internal and external mechanisms which help determine health-related behaviors. Research in social cognition has also found success in developing interventions for health-related behavioral change (Keselman et al., 2023; Latkin et al., 2022). Internal Factors Cognitive Dissonance Cognitive dissonance is the phenomenon in which individuals, knowingly or not, hold conflicting cognitions, producing psychological discomfort. Strategies used to relieve cognitive dissonance may be informed by the particular content and social context of the subject. One such relief strategy is rationalization. This strategy relies on individuals’ tendency towards consistency in self-schemas, which are mental frameworks that an individual uses to characterize themselves based on memories, experiences, and patterns of belief and behavior; an individual may consciously or subconsciously edit their beliefs in order to justify (“rationalize”) their behavior, both to themselves and to those around them (Cancino-Montecinos et al., 2020; George et al., 2023; Miller & Cabell, 2023). An unvaccinated person may rationalize their continued decision to reject vaccinations by asserting a preference for alternative treatments, by claiming herd immunity, or questioning the utility of a vaccine (George et al., 2023; Gomes-Ng et al., 2024; Miller & Cabell, 2023). Interestingly, recent research by George et al. suggests that rationalization may be most significant when individuals attempt to minimize feelings of guilt regarding social responsibility. After all, if vaccines are effectively useless, then there is no reason for an unvaccinated person to feel uncomfortable with having potentially exposed others to an infection.          Another common method for alleviating cognitive dissonance is simple avoidance, a cognitive-behavioral strategy known as selective exposure (Cancino-Montecinos et al., 2024; Miller & Cabell, 2023). If a person is already inclined towards vaccine skepticism, they may selectively avoid news reports or social media posts which do not support those beliefs. This process removes the discomfort of conflicting ideas and protects their hesitancy towards vaccination from external challenge (Gomes-Ng et al., 2024; Latkin et al., 2022; Miller & Cabell, 2023). Cognitive Flexibility–Biases and Heuristics Think back to the early days of the COVID-19 pandemic lockdown. How challenging was it to keep track of COVID-related updates? How the disease spread, what steps to take to prevent it, how severe its effects would be? Flexibility in the thinking process helps people react to new information, and incorporate that information into future actions, including vaccination (Gomes-Ng et al., 2024; Latkin et al., 2022). Lower scores on cognitive flexibility tests generally predict greater vaccine hesitancy (Gomes-Ng et al., 2024). In a related vein, lower educational attainment and information literacy skills also predict reduced vaccination rates (Latkin et al., 2022). Cognitive processes and related behaviors are often informed by a number of mental shortcuts which allow us to think quickly, but leave room for errors in judgment. Say, for instance, an emotionally-charged story about a rare side-effect becomes the first thing someone thinks of when the topic of vaccination comes up. The availability heuristic, which is the tendency to attribute greater significance to things that are easier to recall, may leave that person more inclined to question the safety of a vaccine, and subsequently delay or refuse vaccination (Azarpanah et al., 2021).         The process of selective exposure, which has been previously mentioned in this piece, supports and is supported by confirmation bias. Confirmation bias is the psychological tendency towards confirming beliefs which one already holds. For example, a vaccine-hesitant person maintaining that the COVID-19 vaccine is in fact more dangerous than the disease, even when presented with learning tools and evidence to the contrary (Azarpanah et al., 2021; Gomes-Ng et al., 2024; Malthouse, 2023; Miller & Cabell, 2023). The belief perseveres because all new information is evaluated through it, i.e., what can be interpreted to support vaccine skepticism will be, and what cannot be interpreted as such will be questioned or ignored.          All of these processes are prone to reinforcing themselves through feedback loops, which are often perpetuated through one’s particular social environment–but we’ll get into that later. Affect and Attitudes One aspect of cognitive dissonance and cognition in general that does not necessarily get discussed enough is emotion (Cancino-Montecinos et al., 2020; Hagger & Hamilton, 2022). Regarding one’s decision whether or not to vaccinate, affect and attitude can play significant roles (George et al., 2023; Gomes-Ng et al., 2024; Zhu et al., 2022). Of distinct importance is trust–holding negative or mistrustful attitudes towards public health officials or institutions consistently correlates with greater vaccine skepticism and lower intentions to vaccinate (George et al., 2023; Latkin et al., 2022). This trend is particularly pronounced in regards to the COVID-19 vaccine (Keselman et al., 2023; Shiloh et al., 2022). Another important aspect of emotional social cognition is perceived loss. For some, active refusal to vaccinate can operate as a way to regain a sense of personal freedom or autonomy, which many felt was lost during pandemic lockdowns (George et al., 2023). For others, the refusal to vaccinate is fueled by the desire to avert greater loss. Potential loss, like the risk of serious side-effects from a vaccine, tends to hold greater cognitive and emotional weight than potential gain, like lowered risk of serious illness upon infection (Azarpanah et al., 2021; George et al., 2023). Non-vaccination therefore becomes emotionally safer than vaccination. Self-Efficacy This leads into another category of constructs which have demonstrated particular importance to vaccination decisions: self-efficacy, or perceived behavior control. Self-efficacy ties into a person’s self-image, relating to their belief or confidence in their own abilities (Hagger & Hamilton, 2022; Kojan et al., 2022; Lin et al., 2020). Self-efficacy seems to play an interesting moderating role in rates of vaccine uptake. One might expect high levels of risk from infectious disease to lead to increased vaccination rates throughout society. However, when combined with individuals’ perceptions of low self-efficacy, or low belief in one’s own capacity to meaningfully lower that risk, this expected increase does not take place (Kojan et al., 2022; Lin et al., 2020). What appears to actually increase are anxiety-mitigating behaviors, like avoidance of potentially frightening news, or maintenance of familiar schedules and activities (Lin et al., 2020)–if you cannot fix the problem, at least you can make yourself feel better about it. External Factors Social Norms Written or unwritten, social groups generally have rules. Perceived social norms tend to have significant influence on how a person thinks, acts, and makes decisions. There are many possible sources of normative influence: family and friends, coworkers, social clubs, pop culture figures, news media, etc. People who choose not to vaccinate themselves and/or their children generally perceive this as socially normative behavior, expected and acceptable (Latkin et al., 2022; Lin et al., 2020; Shiloh et al., 2022; Zhu et al., 2022). Sometimes, they will even actively distance themselves from attitudes or group-labels on either end of the vaccination-support spectrum that they perceive as abnormal or extreme (George et al., 2023). Identification with particular social categories sets norms both for in-groups (social groups that an individual identifies themselves with) and against out-groups (social groups that an individual does not identify with). Since what is perceived as socially normal is socially learned (Bandura, 1986), non-vaccination in a social context which encourages, or at least does not discourage, vaccine hesitancy perpetuates the collective idea that non-vaccination is normal, whereas encouraging greater vaccination is not. There are two general identity-group factors which seem to play significant roles in setting vaccine-related social norms: religiosity (Gomes-Ng et al., 2024; Shiloh et al., 2022), and political partisanship (Keselman et al., 2023; Latkin et al., 2022; Zhu et al., 2022). More frequent religious participation (Gomes-Ng et al., 2024) and greater orthodoxy (Shiloh et al., 2022) correlate with lower intentions to vaccinate. Political conservatism also correlates with lower intentions (Keselman et al., 2023; Zhu et al., 2022), and lower actual vaccine uptake (Latkin et al., 2022). Social Influence–Family, Friends, and Authorities         When it comes to health, the influence of one’s social circle cannot be overstated, especially in times of heightened stress, like a pandemic (Latkin et al., 2022). Odds are, if someone’s friends or family are not vaccinating, neither are they–vaccine uptake generally positively correlates with the number of close friends or family who have been vaccinated (George et al., 2023; Keselman et al., 2023). Similarly, intentions to vaccinate decrease when individuals believe their family or friends would discourage it or react negatively (Latkin et al., 2022).         Outside of friends and family, the opinions of authority figures tend to hold a lot of weight. A person’s views on vaccination often fall in line with those of people or institutions they believe to be authoritative, be they GPs, religious figures, social media personalities, or politicians (Azarpanah et al., 2021; Keselman et al., 2023). Remember, normative social influence helps dictate not just how an individual should believe and behave, but what they should expect of others. This feature generally helps people operate smoothly within society, interacting with people who are both like and not like them. It can, however, present challenges when the loudest voices trying to set those norms prove divisive, especially in the face of public health crises where that divisiveness is detrimental to the whole of society–again, like a pandemic. Sources of Information          Where someone receives information is often as important as what information is received. The most trusted vaccine information sources are not always the most used (Keselman et al., 2023). At the same time, the most available mainstream sources are not always well-trusted (George et al., 2023; Zhu et al., 2022). News media, that most available information source, is itself a sphere of social influence which demands attention and reactivity. The sociopolitical bent of news which viewers consume contributes to the cognitions they create about vaccination, including vaccine safety, the salience of possible adverse events, and the intentions or trustworthiness of institutions promoting them (Keselman et al., 2023; Latkin et al., 2022; Zhu et al., 2022).  Social media is playing an increasingly popular role as a news source (Keselman et al., 2023). While information spreads quickly, it does not always spread equitably–algorithm-fueled platforms continually feed users ideas they have already chosen to engage with, which both facilitates misinformation and reinforces cognitive biases (Gomes-Ng et al., 2024; Latkin et al., 2022). One’s social media feed may become a closed feedback loop of information that is possibly inaccurate but cognitively consistent. Targets for Challenging Vaccine Hesitancy The combined internal and external factors involved in social cognition highlight some of the difficulties of challenging vaccine hesitancy. For example, providing vaccine-hesitant populations with scientific evidence or hard data about the benefits of vaccination tends not to actually change minds, and may even result in stronger opposition. That is not to say that misinformation should not be actively challenged when possible, but at-large public health campaigns for vaccination may find more success by changing tactics. Rebuilding trust in public health figures and institutions is key. Tailored campaigns based on small-scale interpersonal connections between specific communities may have more luck than a one-size-fits-all sort of movement. Rather than simply refuting misinformation, which could fall prey to a number of cognitive biases, these programs should emphasize behavior which prioritizes community responsibility and open communication with friends and family members. Such program tactics operate in the sphere of normative social influence, helping perceptions of trustworthiness and affording greater emotional weight to the information presented by way of closer source proximity. Additionally, rather than spotlighting threats of harm from disease, campaigns could try to target self-efficacy as it corresponds with disease-preventative behaviors, including vaccination. Conclusion In 2019, the World Health Organization officially characterized widespread vaccine hesitancy as one of the most significant threats to global health. As such, it is continually important that we understand the internal factors contributing to vaccine hesitancy, like biases and heuristics, cognitive dissonance, and perceptions of self-efficacy, as well as the external social influences that facilitate and reinforce them. With greater understanding of these mechanisms, we can hopefully develop more effective methods of challenging vaccine misinformation, rebuilding trust in scientists and public health institutions, and promoting vaccine uptake to foster a safer, more healthy world. References Azarpanah, H., Farhadloo, M., Vahidov, R., & Pilote, L. (2021). Vaccine hesitancy: Evidence from an adverse events following immunization database, and the role of cognitive biases. BMC Public Health, 21 , 1686.   https://doi.org/10.1186/s12889-021-11745-1 Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory.  Prentice Hall. Cancino-Montecinos, S., Björklund, F., & Lindholm, T. (2020). A general model of dissonance reduction: Unifying past accounts via an emotion regulation perspective. Frontiers in Psychology , 11 , 540081.   https://doi.org/10.3389/fpsyg.2020.540081 George, M.F., Rosenberg, B.D., Dale, S.N., Kirkland, L.H., Culross, P.L., & Chen, R. (2023). “They’ll take a gun to me before I take that shot”: Rationalization, emotions, and misinformation in COVID-19 vaccine hesitancy. Social and Personality Psychology Compass, e12815.   https://doi.org/1https://doi.org/10.1111/spc3.128150.1111/spc3.12815 Godlee F., Smith, J., & Markovitch, H. (2011). Wakefield’s article linking MMR vaccine and autism was fraudulent. BMJ, 342 , c7452. https://doi.org/10.1136/bmj.c7452   Gomes-Ng, S., Wood, J.K., & Cowie, S. (2024). Cognitive flexibility predicts attitudes towards vaccination: Evidence from a New Zealand sample. BMC Psychology, 12 , 550.   https://doi.org/10.1186/s40359-024-02048-2 Hagger, M.S., & Hamilton, K. (2022). Social cognition theories and behavior change in COVID-19: A conceptual review. Behaviour Research and Therapy, 154, 104095.   https://doi.org/10.1016/j.brat.2022.104095 Keselman, A., Arnott Smith, C., Wilson, A.J., Leroy, G., & Kaufman, D.R. (2023). Cognitive and cultural factors that affect general vaccination and COVID-19 vaccination attitudes. Vaccines, 11 (1), 94.   https://doi.org/10.3390/vaccines11010094

Written by: Jacinda Taggett Edited by: Chimara Anyanwu Do you have midterms or final exams coming up? We’ll go through a few different types of studying scenarios together to truly answer the question: How can you optimize your study sessions this semester? Spacing Effect: How often you study matters 1. Studying You have your exam coming up in a couple of days, and you realize you need to start hitting the books. You spend Monday evening studying until dinnertime, but now what? 2. Waiting for some time It’s now Tuesday morning. You got some good rest in and you’re ready for the day! However, you realize you signed up for an all-day volunteer shift at the local hospital because you did not consult your class’s syllabus at the beginning of the semester. Are you going to remember what you studied last night during your exam tomorrow? 3. Studying again Figure 1. Ebbinghaus' Forgetting Curve (Credit: LearnUpon) Do not fret, novice student! Psychology research shows that in order to maintain the knowledge you obtained during your prior study session  (Monday night), you need to study again . This is what we refer to as spaced repetition learning , or the “spacing effect.” This phenomenon stems from one of the earliest examples of learning and retention research, proposed by Ebbinghaus in 1885. He claimed that information is continuously forgotten over long periods of time; therefore, you constantly need to remind yourself of information to retain it. This is famously known as Ebbinghaus’ Forgetting Curve ( Figure 1 ). Given this information, you ideally want to study the same information as before, one last time before your exam. You block out a couple of hours on Wednesday morning to get it done before classes, and now you’re golden! 4. Final test Thursday afternoon comes around, and you’re finally ready for your exam. You had two separate–but identical–study sessions over the past few days, and you know all the answers like second nature! At least, that’s the feeling you have! Now, you wait for your grade. + Comparison to studying once A couple of weeks pass, and you get your exam grades back. You did awesome, given your last-minute studying efforts! However, your friend that was also busy and spent all of Wednesday studying did not do too well. Although disappointing, it is not a surprise. Research shows that spaced repetition allows for better memory of the information compared to learning over a continuous and massed period of time , even when there are manipulations of how much time exists between the study sessions (Carpenter, 2020). Testing Effect: How to spend time between study sessions 1. Studying After your prior exam, you want to learn more psychology tricks to optimize your study sessions. You start your studying session a week in advance, but now you’re unsure of how to transition to your break between sessions. Should you go outside for a walk? Start studying for another class? It turns out, you want to do a quick retrieval activity to retain the information you just studied. 2. Retrieval activities In college, I remember being told to do InQuizitive  (mini virtual quiz) activities at the end of every lecture. This was quite annoying to a lot of my classmates, however, there is science to back up this homework assignment. Extensive research shows that immediately recalling the material you have just learned leads to better memory performance . This is called retrieval-based learning , or the “testing effect.” You can achieve this through mini quiz activities (e.g., Kahoot!, Anki, InQuizitive) to make learning a fun and memorable experience for you and your study buddies. 3. Final test After multiple study sessions where you learn the information and then test yourself afterwards, you are ready for your final test at the end of the week. The greatest part about this method? Your memory for the exam material will be retained from anywhere from a few minutes to even several months afterwards  (Carpenter et al., 2009; Larsen et al., 2013; Rowland and DeLosh, 2015; Smith et al., 2013; as cited in Karpicke, 2017).  + Comparison to learning without retrieval activities The testing effect is very robust, and countless studies have tried different control conditions to see if the success of retrieval-based learning is due to spending more time on the material. Their joint findings, however, showcase that testing yourself significantly improves long-term memory compared to other study methods. Pretesting Effect: The study session itself 1. Receive a question or a prompt Okay. Now you have the ideal study routine,  what about the ideal method?  You sit down for your first study session of the week and realize you don’t know where to begin. If you were given a study guide by your professor, this is a great place to start. 2. Guess With whatever knowledge you do have, try to guess the answer to the questions before you look at your lecture slides or notes for the answer . This technique is broadly called  “pretesting,” or otherwise known as errorful learning  in older literature (for a review, see Metcalfe, 2017). 3. Receive answer Once you’ve guessed what the answer is to a question, immediately check how correct you were in your notes. Were you correct? Were you wrong? If you were incorrect, that’s even better! Recent work (by myself and colleagues) highlights that depending on what your initial guess was , it either internally  bridges the question and answer together in memory or corrects the error originally made to strengthen the question-answer connection (Taggett et al., 2025). 4. Final test You take the test and you feel more confident in your answer than before! You combined all of the strategies from this article, and now you’re ready to conquer your hardest exams. + Comparison to learning without guessing The earliest and most remarkable finding in the literature is: pretesting with multiple types of questions  (i.e., trivia and word-pair associations) led to better memory performance than simply studying these prompts with their answers together  (Kornell et al., 2009). Next time you feel inclined to simply read your lecture notes before an exam, think again about how other strategies might benefit you. So… how do we improve our memory? These seemingly related branches of psychology research, intuitively, should be combined into the ultimate study technique . Unfortunately, there is no highly-cited research that supports this claim. Future research on overall learning effects needs to be conducted to further assess whether utilizing multiple or all of these techniques can work together to maximize memorization. Until then, pick and choose which of these methods works best for your personal schedule! References Carpenter, S.  (2020, April 30). Distributed Practice or Spacing Effect. Oxford Research Encyclopedia of Education. Retrieved 2 Oct. 2025, from https://oxfordre.com/education/view/10.1093/acrefore/9780190264093.001.0001/acrefore-9780190264093-e-859 . Carpenter, S. K, Cepeda, N. J., Rohrer, D., Kang, S. H. K., & Pashler, H. (2012). Using spacing to enhance diverse forms of learning: Review of recent research and implications for instruction. Educational Psychology Review, 24, 369-378. Ebbinghaus H. (2013). Memory: a contribution to experimental psychology. Annals of neurosciences, 20(4), 155–156. https://doi.org/10.5214/ans.0972.7531.200408 Larsen, D. P., Butler, A. C., Aung, W. Y., Corboy, J. R., Friedman, D. I., & Sperling, M. R. (2015). The effects of test-enhanced learning on long-term retention in AAN annual meeting courses. Neurology, 84(7), 748–754. https://doi.org/10.1212/WNL.0000000000001264 Metcalfe J. (2017). Learning from Errors. Annual review of psychology, 68, 465–489. https://doi.org/10.1146/annurev-psych-010416-044022 Karpicke, J. D. (2017). Retrieval-based learning: A decade of progress. In J. T. Wixted (Ed.), Cognitive psychology of memory, Vol. 2 of Learning and memory: A comprehensive reference (J. H. Byrne, Series Ed.) (pp. 487-514). Oxford: Academic Press. Kornell, N., Hays, M. J., & Bjork, R. A. (2009). Unsuccessful retrieval attempts enhance subsequent learning. Journal of experimental psychology. Learning, memory, and cognition, 35(4), 989–998. https://doi.org/10.1037/a0015729 Rowland, C. A., & DeLosh, E. L. (2015). Mnemonic benefits of retrieval practice at short retention intervals. Memory, 23(3), 403–419. https://doi.org/10.1080/09658211.2014.889710 Smith, M. A., & Karpicke, J. D. (2014). Retrieval practice with short-answer, multiple-choice, and hybrid tests. Memory (Hove, England), 22(7), 784–802. https://doi.org/10.1080/09658211.2013.831454 Taggett, J. Z., Ranganath, C., Antony, J. W., & Liu, X. L. (2025). Guess quality moderates how semantic relatedness influences the pretesting effect. Journal of Experimental Psychology: Learning, Memory, and Cognition.  Advance online publication. https://doi.org/10.1037/xlm0001543