Written by: Annette Dao Edited by: Lea Kallo The Human Mind At what point does human cognition no longer become only understandable to us, but to the machines that we build? The intricacies of our mind separate us from the millions of species inhabiting our world. Quite simply, our brain is what makes us, you and me, an anomaly to intelligence. Does our consciousness define us as human or the centuries of behavior we evolved from? René Descartes' describes consciousness in a single statement, “I think, therefore I am.” Human behavior can be simplified to an even larger degree, to a single word: data. Intelligence is a psychological phenomenon: hypothetical, abstract, and unobservable (Gignac and Szodorai, 2024). In our mortal fashion, we try to create what cannot be determined. Our artificial modelling of intelligence, commonly referenced as AI, attempts to comprehend the human mind in heuristics that is beyond mundane pattern recognition. AI knows us, learns us, and reads us through data. What happens when these machines try to predict us? What is Epilepsy? Epilepsy is a neurological disorder that causes recurring seizures in 1.2% of the United States’ population (“Epilepsy: Symptoms”, 2023). Characterized by an assortment of symptoms like muscle convulsions, loss of awareness, or abnormal brain activity, this disorder arises from abnormal electrical discharges in the brain (“Epilepsy: Symptoms”, 2023). Using electroencephalograms (EEG), electrode-based nodal discs in the scalp, we can interpret the mind’s activity as we see fit– especially in seizure monitoring (“EEG”, 2023). However, what humans cannot see, humans cannot deduce. When EEG signalling sources become too convoluted for human analysis, seizure prediction cannot occur. Thus, a different method for understanding epileptic episodes is needed. Machine learning (ML) is focused on enabling computers to use behavior heuristics in imitating human performance (IBM, 2021). The intersection of human limitations to machine adaptability can create an ironic concept of machines understanding humans better than humans do. How do Machines Interpret Human Behavior? To formulate a thought, a connection, humans have a hierarchical structure of deduction that enables us to create a revelation. When we see an action or change in our surroundings, the information from our eyes travels to our mind and tells us what we do not directly observe, a pattern. In a similar manner, machine learning employs this architecture. To understand data is to categorize it, and in this swift action, pre-processing occurs. EEG signals from seizures are split into two classifications: the pre-ictal phase and interictal phase (Engel and Schwartzkroin, 2007). The pre-ictal phase is characterized by the aura, a subjective sensation that begins before an epileptic episode has occurred. On the other hand, the interictal phase is the period between seizures where there is a return to normal brain activity (Engel and Schwartzkroin, 2007). By sectioning the EEG signals into specific sections representing seizures, we can create a Fourier Transform analysis. (Zhu et al., 2024).  Fourier Transform models determine the sinusoidal frequency of EEG signals (Zhu et al., 2024) which reveal the different oscillations and periodicities that make up an original signal. Using this information, the model is converted into a spectrogram– showing changes to frequency content of a signal over time (Zhu et al., 2024). Choosing the Brain: How do Machines “Think”? After raw EEG signals have been preprocessed and segmented, a framework for neural connectivity is needed. Varying neural networks help extract patterns from data mirroring how humans deduce their line of thought. From the processed information, neural structures are used for deep feature extraction and classification of information. Convolutional neural networks (CNN) excel at using layers to detect different spatial hierarchies of features– making them adept at detecting morphologic signatures in EEG plots (“What Is a Convolutional”, n.d.). Conversely, recurrent neural networks (RNN) use sequential data or time-series dependent thinking to track how brain rhythms evolve over time (Stryker, 2024). Since spatial structure and temporal context are necessary in interpreting EEGs, a fusion model can combine CNN and RNN advantages and yields better results in seizure prediction (Zhang, 2024). More recently, transformer networks have advanced the field by reducing the recurrence with self-attention and combining the data processing with model training ideals. Together, these frameworks allow EEG signals to be used for clinical predictions. The Consciousness of Thought The ability for machines to interpret the human mind accurately should not be understated. We reach a point where human cognition no longer becomes only understandable to us, but to the technology that we build. This emerging field of machine learning and artificial intelligence opens doors to greater opportunities in neuroscience: biomarker discoveries, personalized therapies, and revealing brain dynamics that were once hidden from human analysis. We reached a point where human behavior no longer dictates our mortality. Instead, our consciousness is what makes us truly unique. At what point will machines learn “I think, therefore I am?” References Engel J.J., & Schwartzkroin P.A. (2007, May 9).   What should be Modeled?  Journal of Models of Seizures and Epilepsy, 1-14.  Gignac, G. E., & Szodorai, E. T. (2024). Defining intelligence: Bridging the gap between human and artificial perspectives . Intelligence, 104 , Article 101832.   https://doi.org/10.1016/j.intell.2024.101832   ScienceDirect+5EconPapers+5IDEAS/RePEc+5 IBM. (2021, September 22). What is machine learning?   https://www.ibm.com/think/topics/machine-learning MayoClinic. (2023, October 14). Epilepsy: Symptoms and causes . Mayo Clinic . Retrieved August 3, 2025, from   https://www.mayoclinic.org/diseases-conditions/et pilepsy/symptoms-causes/syc-20350093 MayoClinic. (2023, December 8). EEG (electroencephalogram) . Mayo Clinic .   https://www.mayoclinic.org/tests-procedures/eeg/about/pac-20393875 Stryker, C. (2024, October 4). What is a recurrent neural network (RNN)?  IBM Think.   https://www.ibm.com/think/topics/recurrent-neural-networks What Is a Convolutional Neural Network? (n.d.). MathWorks . Retrieved August 4, 2025, from   https://www.mathworks.com/discovery/convolutional-neural-network.html Zhang, X., Zhang, X., Huang, Q., & Chen, F. (2024). A review of epilepsy detection and prediction methods based on EEG signal processing and deep learning. Frontiers in Neuroscience, 18 , Article 1468967. https://doi.org/10.3389/fnins.2024.1468967 Zhu, R., Pan, W.-x., Liu, J.-x., & Shang, J.-l. (2024). Epileptic seizure prediction via multidimensional transformer and recurrent neural network fusion. Journal of Translational Medicine, 22 , Article 895.

Written By: Michelle Zhang  When I first became intrigued by pharmacy, I was drawn more than ever to pill bottles and prescriptions. I was so fascinated by the ways pharmacists work behind the scenes to keep patients safe- especially in hospitals, where the stakes are higher than ever, and mistakes can be fatal. Unlike the perspective of a pharmacist standing over the counter handing out pills, hospital pharmacists are different in every step of a patient’s meds journey, from reviewing orders, checking doses, and ensuring that nothing is missed with patients. Over time, I began to wonder: How often do medication errors start to happen? And how can a pharmacist prevent things from taking a turn for the worse?  So I began to dig deeper into these questions, and one thing became crystal clear: pharmacists are the last line of defense in preventing medication errors in hospitals. Whether it’s counting pills or making a decision, their roles are super crucial for patient safety. What Are Medication Errors?  A medication error is any mistake that happens when prescribing, ordering, or administering. These can include: Giving the wrong dose Prescribing the wrong drug Mislabeling a medication In hospitals, where patients are often severely vulnerable in their state and on multiple drug medications, these errors are life-threatening. That’s why pharmacist plays such a massive role in this steering, since they’re trained to catch these mistakes before they can happen. The Pharmacist’s Role: Behind the Scenes but Frontline  In hospital settings, clinical pharmacists don’t just distribute pills to everyone; they help prevent adverse reactions in real time. Their responsibilities include: Reviewing medication order Consulting with doctors Monitoring the Patient’s lab Educating patients  For example, a 2020 study by Lazaro Cebras et al. showed that when pharmacists met with older patients before discharge, hospital readmission dropped by almost 4%! That’s almost incredible times 4. Even more importantly, high-risk patients saved both health and money (Lazaro Cebas et.al ., 2022). Real-World Evidence: Studies That Prove It Works One way to look at it is through studies published fairly recently that have been conducted across various countries to prove that pharmacists indeed make a measurable difference: According to a 2023 study conducted by Al-Maqbali et al. in Oman, two groups of patients were compared, those who had the entire hospital stay pharmacist-led care, and those who got only some of that support. The patients who got a full "bundle" of care had 73% fewer hospital readmissions within 90 days (Al-Maqbali et al., 2023). The meta-analysis conducted by Wu et al. in 2025, which includes 14 studies, supported pharmacist-led care in reducing hospital readmissions after 30 days and also in lowering adverse drug events (ADEs). That means fewer dangerous side effects from medicines, fewer visits to emergency services, and safer patients overall (Wu et al., 2025). Why It Matters Most don't know that medication errors are among the leading causes of preventable patient harm in hospital settings. While technology and software are certainly keys to a solution, trained humans are the essential piece. Pharmacists bring clinical judgment, deep knowledge about drugs, and patient-focused concepts that simply cannot be put into codes or SOPs. Where hospital systems and overburdening staff trends exist, the safety net that pharmacists bring must be fostered. With the cultivation of more future pharmacists should come an investment in carving out greater space for them in direct-patient care--not so much in the pharmacy anymore, but alongside nursing, in the ICU, and many more settings Looking Ahead: How Can We Make Hospitals Safer? Yet the job is still incomplete. There are hospitals without the adequate number of clinical pharmacists; unlike other doctors, these physicians might not prefer to work side by side with the pharmacists. The more research we collect and the more patients we protect, the clearer are the prospects of pharmacists becoming necessary for the safe, up-to-date care that is given in a hospital. Be it the dangerous dose-high check or a situation where the anxious patient needs explanation on new medicine, pharmacists save a life every day before that life is lost. As a would-be pharmacist, I am proud to enter an esteemed profession that combines knowledge and humane concern for the protection of people when most vulnerable. Reference  Al-Maqbali, J. S., Al-Zakwani, I. S., Al-Kindi, R. M., Al-Muqbali, A., Al-Azri, M., & Al-Busaidi, I. (2023). Impact of clinical pharmacists-driven bundled activities from admission to discharge on 90-day hospital readmissions and ED visits.  Oman Medical Journal, 38(6).   https://doi.org/10.5001/omj.2023.110 Lázaro Cebas, A. L., Caro Teller, J. M., García Muñoz, C., Carpio Gallego, A., Velasco Sánchez, R., Pérez Muñoz, M. A., ... & Martínez Martínez, F. (2022). Intervention by a clinical pharmacist carried out at discharge of elderly patients admitted to the internal medicine department: Influence on readmissions and costs.  BMC Health Services Research, 22(167). https://doi.org/10.1186/s12913-022-07582-6 Wu, L., Wang, Y., Zhang, T., Chen, Q., & Li, J. (2025). Practice guidelines for evaluation of clinical pharmacy services: A meta-analysis of 14 RCTs and observational studies.  Frontiers in Public Health.   https://doi.org/10.3389/fpubh.2024.1472355 Naseralallah, L. M., Hussain, T. A., & Pawluk, S. A. (2020). Impact of pharmacist interventions on medication errors in hospitalized pediatric patients: A systematic review and meta-analysis. International Journal of Clinical Pharmacy, 42 (4), 979–994. https://doi.org/10.1007/s11096-020-00945-y Jaam, M., Naseralallah, L. M., Hussain, T. A., & Pawluk, S. A. (2021). Pharmacist-led educational interventions provided to healthcare providers to reduce medication errors: A systematic review and meta-analysis. PLOS ONE, 16 (6), e0253588. https://doi.org/10.1371/journal.pone.0253588 Weber, C., Meyer-Massetti, C., & Schönenberger, N. (2025). Pharmacist-led interventions at hospital discharge: A scoping review of studies demonstrating reduced readmission rates. International Journal of Clinical Pharmacy, 47 , 15–30. https://doi.org/10.1007/s11096-024-01821-y De Oliveira, G. S., Castro-Alves, L. J., Kendall, M. C., et al. (2021). Effectiveness of pharmacist intervention to reduce medication errors and healthcare resource utilization after transitions of care: A meta-analysis of randomized controlled trials. Journal of Patient Safety, 17 (5), 375–380. https://doi.org/10.1097/PTS.0000000000000283 Jošt, M., Kerec Kos, M., Kos, M., & Knez, L. (2024). Effectiveness of pharmacist-led medication reconciliation on medication errors at hospital discharge. Frontiers in Pharmacology, 15 , 1377781. https://doi.org/10.3389/fphar.2024.1377781

Written by: Saghi Naghizadeh Edited by: Gabriela Castro, Fernando Aguilar (Randall, M. et al., 2011) When the COVID-19 pandemic began, I was right on the cusp of high school, unaware of how deeply those isolated months would shape me. The first two years of high school passed in a fog of Zoom classes, masked conversations, and social distancing. In the years that followed, something quietly shifted. I noticed I was experiencing forgetfulness, both in the short-term and long-term. Studying took more time, tasks that once came naturally started requiring twice the effort, and I found myself grasping for the details that used to stick to me without trying. I have vivid memories from 2019 and before, but the years 2020 to now? They feel compressed, colorless, and almost indistinguishable, blurred together like one long and unmemorable stretch of time. I blamed it on the lingering brain fog of long COVID. I had developed it after the second time I contracted the virus and knew that the inflammation from the illness could affect neurological function, memory loss included. That explanation made sense by itself, but I started hearing the same things from friends and family who never contracted COVID-19 at all. Many people in the diverse communities I am a part of started describing everything since 2020 as a “blur” and admitted to not having the cognitive sharpness that they used to have prior to the lockdown. These were not isolated comments. They were patterns in teenagers as well as adults in their 20s, 30s, 40s, and even 50s, many of whom should have been in their peak cognitive years.  The fact that so many people of different age groups began experiencing memory decline after a shared period of intense social isolation points to something deeper, suggesting that memory loss is a neurological consequence of loneliness and being cut off from the rhythms of human connection. This realization led me to explore how our collective post-pandemic memory loss is due to loneliness. In this analysis, I will examine how loneliness, intensified by the COVID-19 pandemic, is not merely an emotional state but a multifaceted public health crisis with profound neurological, psychological, and societal consequences. It is vital to note that addressing it requires both individual strategies to restore cognitive health through neuroplasticity and systemic interventions that strengthen community connections and prevent isolation. Neurological Effects of Loneliness Social Isolation and Stress  The hippocampus is the region of the brain responsible for the storage and retrieval of memories. Cortisol is the primary stress hormone and has many receptors, primarily glucocorticoid receptors (GR), in the hippocampus. In the biological realm, stress is defined by the environmental forces that bring out a response in an organism. Glucocorticoids, a class of corticosteroids (a type of steroid hormone), play a huge role in controlling the intensity levels of stress responses, as they regulate the amount of stress hormones produced (Randall, M. et al., 2011). Different stress responses in humans include fight, flight, freeze, and fawn. Stress is a natural human response; controllable, acute cases of it are necessary for enabling motivation and addressing threats and challenges in life. However, extreme and chronic stress leads to long-term deficits in the hippocampus and the hypothalamus (the main brain structure regulating stress response). With social isolation comes a lack of meaningful social connections, which is a major psychological stressor. It activates the hypothalamic-pituitary-adrenal axis (HPA axis), a significant communication system involving the hypothalamus, pituitary gland, and adrenal glands. The HPA axis plays a vital role in regulating stress responses, and its continuous activation leads to increased cortisol (Kim, E. et al., 2015). This creates a positive feedback loop in the brain as excessive levels of cortisol damage the hippocampus, further increasing stress levels and thus leading to memory loss and cognitive decline. A positive feedback loop, also known as the vicious cycle of disease, is a biological mechanism where the output reinforces the input, making it more difficult to break out of the cycle (Mitrophanov, A. et al., 2008). Since each loop worsens cognitive function, the initial input (the social isolation) plays a significant role in causing memory loss, and reversing it can be difficult. Neuroplasticity We all have heard of muscle memory and the phrase “use it or lose it.” Just like any other skill, memory is gained or lost based on how much it is used on a daily basis. The human brain, specifically the hippocampus, is super active when we engage in conversations and have to emotionally respond to social situations; the brain’s activity levels decrease as the social interactions are reduced. Since the brain networks controlling memory, communication, and empathy are not being activated as often, we start losing those skills over time. This process is referred to as neuroplasticity, the brain’s ability to reorganize itself based on what we do, say, think, hear, experience, etc. (Puderbaugh, M. et al., 2023). This is done through the brain forming and strengthening connections between the neurons that are being used the most. This is why the content that we feed our brains (books, TV shows, music, etc.) keeps returning to us in the form of our behaviors. During the COVID-19 lockdown, many of us started to unintentionally feed our brains a repetitive diet of scrolling on social media, attending Zoom classes, and talking to the same people everyday. Exposure to in-person conversations and new environments became limited, and as a result, we no longer got to experience the stimulation that would simultaneously activate multiple brain regions, like the hippocampus and the hypothalamus. Being suddenly stripped away from that rich mental input resulted in the weakening of synaptic connections and the removal of unused pathways in the brain and instead the activation of the HPA axis. Overall, our brains started adapting to the constant stress instead of the typical dynamic stimuli. While neuroplasticity occurs at a relatively rapid rate, it still slows down with age and as the neural connections diminish. While it does not completely stop, it may require more specific triggers to engage it (Ivakhnitskaia, E. et al., 2019). This is why even though we are feeding our brains more human connection years after the lockdown, we still do not seem to be able to regain the same memory and mental clarity as the pre-pandemic. Post-Pandemic Loneliness as a Public Health Crisis Public Health focuses on prevention at a community level, using education, data, policy, and public reform, while individualized healthcare tends to focus on treatments of one specific case at a time through medical interventions like diagnosis, medication, and surgeries. Loneliness is a public health issue, as it affects large and diverse populations instead of only some individuals from a niche demographic. While some biological factors like the presence of a rare chronic illness or mental health issue can exacerbate loneliness, the problem mainly stems from social and structural issues, including but not limited to urban design (e.g., the primary presence of walkable streets vs. public transportation vs. personal vehicles), an imbalance between work and personal life caused by unsupportive workplace cultures, and isolated aging infrastructures (nursing homes, senior living, etc.). Even when loneliness appears to stem from the biological factors listed above, it is often the social consequences, such as stigma, exclusion, and a lack of community support and people to relate to, for those individuals, that truly deepens their isolation.  Shortly after the pandemic, the U.S. Surgeon General declared loneliness and social disconnection as urgent public health concerns, with health risks just as high  as obesity and smoking. It has been shown that chronic loneliness increases the risk of heart disease by 29% and the risk of stroke by 32% (Holt-Lunstad, J., 2023). These issues would be otherwise preventable; that is why loneliness should be viewed through a public health lens, a framework that emphasizes disease prevention by focusing on social determinants of health illustrated in figure 1 ( NACCHO Communique, 2023). Figure 1. Social determinants of health. Note: Identification of social determinants of health has contributed greatly to the understanding that it is almost never one singular focus that causes or resolves a public health issue. Figure adapted from NACCHO Aboriginal Health News Alerts. Memory loss is only one of the many problematic results of loneliness. The rise of many other preventable health problems due to social isolation, including but not limited to heart disease, stroke, and depression, increases healthcare costs; it would cost significantly less money to prevent such ailments in the first place than to treat them. This puts even more burden on an already broken healthcare system. The pandemic and the post-pandemic eras have been associated with spikes in Emergency Room visits among adolescents and young adults due to suicidal ideation and even suicide attempts. During 2021, the peak of the pandemic, there was a 43.6% increase in ER visits for suicide attempts and a 120.4% increase in ER visits for eating disorders among 13-17-year-old females (Overhage, L. et al., 2023). Additionally, a New York-based pediatric Psychiatric Emergency Department longitudinal study found that suicidal thoughts, behaviors, and related diagnoses among ages 5-17 increased from 21.2% in 2019 to 26.3% in 2020 and 30.1% in 2021 (Junewicz, A. et al., 2023). Published in the Journal of American Academy of Child and Adolescent Psychiatry, a systematic review involving 51,000 children and adolescents found that even among previously healthy youths, loneliness during the pandemic was consistently associated with increased levels of depression and anxiety, ruling out possible confounding variables and indicating that those spikes in ED visits were direct effects of isolation and not just of already-existing mental health conditions (Wang, J. et al., 2024).  This example showcases one of the many strains that was put on healthcare workers during this time and does not even scratch  the surface of all the moral injury that healthcare workers had to experience during this era. A meta-analysis involving 4,400 nurses across the U.S. and Canada revealed that the nurse turnover rate intention increased from 33% pre-2020 to 53% post-2020, with the evidence of this being clearly tied to the high workloads, staffing shortages, burnout, and moral distress as a result of the pandemic (Ren, H. et al., 2024). Healthcare worker burnout is not an individual failure but a systemic and public health issue; acknowledging and addressing its complex, multidimensional nature is the way to ensure that it is treated as such.  While a lot of the pandemic-era social isolation was inevitable and even necessary, like a slow-moving gas leak, the effects of post-pandemic loneliness are subtle but also very devastating over time if the root cause is not addressed and resolved, at least to some extent. From widespread memory loss to a rise in ER visits as well as healthcare worker burnout and high turnover rates, the aftermath of isolation proves that loneliness affects many layers of society, making it a multifaceted issue that is biological, psychological, and social. The biopsychosocial model of health and disease is a holistic approach to understanding wellness from multiple dimensions (Bolton, D. et al., 2019). This model reinforces that loneliness is an urgent public health concern and not just a feeling or emotional state. Fighting Loneliness and Regaining Memory While isolation and memory loss are occurring on large scales and can lead to downstream consequences, lowering quality of life and negatively impacting communities and the healthcare system, the good news is that we can use the knowledge shared above to our advantage. While a lot of the damage done during the peak of the pandemic was due to a lack of public knowledge and resources, it is not yet too late to learn from our mistakes and implement effective systems in place to fight the loneliness epidemic and even work towards improving our cognitive skills. Fighting the Loneliness Epidemic While loneliness is a public health issue, it does not mean each individual is not able to make a difference in fighting it. The key to fighting the loneliness epidemic is to seek more community. A New York-based community study suggests the importance of having “third places,” places like churches, coffee shops, bars, beauty salons, libraries, recreation centers, etc. (Oldenberg, R., 1989). These are places where community can be found outside of our homes and workplaces, and investing time and collective effort into building connections in these places, like many of us did pre-pandemic, is the key to fighting this public health issue and preventing its devastating results. Additionally, with the rise of social media, many trends have rapidly entered mainstream culture, particularly among youth, who now have earlier and more frequent access to platforms like Instagram and TikTok. While trends such as the “mysterious,” “nonchalant,” and “protect your peace” aesthetics may seem harmless on the surface, they often lack the context needed to promote genuine emotional well-being and instead further perpetuate emotional detachment and social withdrawal. In the absence of critical guidance, these trends can worsen the post-COVID loneliness epidemic, especially among adolescents. Given that public health should prioritize prevention, it is crucial to implement early interventions aimed at fostering healthy social development in the digital age. The data from a Scottish survey, involving 3,000 adolescents, indicate a strong correlation between higher classmate and teacher support plus more in-person interactions and lower loneliness among students (Zheng, Y. et al., 2022). Parents must take a more active role in monitoring and discussing online content with their children, and schools should prioritize community-building initiatives, designed in a way that encourages students to participate without making them feel embarrassed or stigmatized for seeking social connection. Regaining memory and cognitive skills Our brains do not know the difference between a real experience and when we vividly imagine, and they can rewire themselves based on what we tell or show them (Lamb, C., 2022). This is how we can use neuroplasticity to our advantage. Mental rehearsal (the process of repetitively and mentally practicing and experiencing an event without its physical presence), exposure to novel stimuli, and re-engaging in meaningful social and intellectual activities work together to stimulate the brain into rewiring itself. Some examples of what we can do are learning a new instrument, speaking aloud while solving problems or getting chores done, and mentally visualizing our daily tasks. We can accelerate the brain’s capacity to adapt and heal by intentionally creating both internal and external environments that challenge the brain. In addition to being a deeply biological concept, neuroplasticity is a tool for recovery. Just like any other type of healing, this will not be linear, but with consistency, regaining our pre-pandemic memory and cognitive skills is not impossible. References Bolton, D., & Gillett, G. (2019). The Biopsychosocial Model of Health and Disease: New Philosophical and Scientific Developments. In PubMed . Palgrave Pivot. https://www.ncbi.nlm.nih.gov/books/NBK552029/ Combating Loneliness: The Modern Epidemic . (2024). Psychology Today. https://www.psychologytoday.com/us/blog/things-to-consider/202408/combating-loneliness-the-modern-epidemic?msockid=3b003cd325486c142017284824276d9d Evguenia Ivakhnitskaia, Lin, R. W., Hamada, K., & Chang, C. (2017). Timing of neuronal plasticity in development and aging. Wiley Interdisciplinary Reviews Developmental Biology , 7 (2). https://doi.org/10.1002/wdev.305 Hammond, C. (2021, June 15). Covid-19: Has the pandemic harmed our memories?   Www.bbc.com . https://www.bbc.com/future/article/20210614-covid-19-has-the-pandemic-harmed-our-memories Junewicz, A., Wachtel, J. M., Okparaeke, E., Guo, F., Farahmand, P., Lois, R., Li, A., Stein, C. R., & Baroni, A. (2023). The persistent impact of the COVID‐19 pandemic on pediatric emergency department visits for suicidal thoughts and behaviors. Suicide and Life-Threatening Behavior , 54 (1), 38–48. https://doi.org/10.1111/sltb.13016 Kim, E. J., Pellman, B., & Kim, J. J. (2015). Stress effects on the hippocampus: a critical review. Learning & Memory , 22 (9), 411–416. https://doi.org/10.1101/lm.037291.114 Mitrophanov, A. Y., & Groisman, E. A. (2008). Positive feedback in cellular control systems. BioEssays : News and Reviews in Molecular, Cellular and Developmental Biology , 30 (6), 542–555. https://doi.org/10.1002/bies.20769 Lamb, C. (2022, January 2). What is Neuroplasticity and Motor Imagery? Part 1 . Medimap.ca ; Medimap. https://medimap.ca/en/neuroplasticity-and-motor-imagery/?utm_source NACCHO. (2016). Social determinants of health . NACCHO Aboriginal Health News Alerts. https://nacchocommunique.com/tag/social-determinants-of-health/ Office of the Surgeon General (OSG). (2023). Our Epidemic of Loneliness and Isolation: the U.S. Surgeon General’s Advisory on the Healing Effects of Social Connection and Community. In PubMed . US Department of Health and Human Services. https://www.hhs.gov/sites/default/files/surgeon-general-social-connection-advisory.pdf Ren, H., Xue, Y., Li, P., Yin, X., Xin, W., & Li, H. (2024). Prevalence of turnover intention among emergency nurses worldwide: a meta-analysis. BMC Nursing , 23 (1). https://doi.org/10.1186/s12912-024-02284-2 Oldenburg, R. (1989). The Great Good Place . Google Books. https://books.google.com/books?hl=en&lr=&id=o4ZFCgAAQBAJ&oi=fnd&pg=PR7&ots=MN_PE_fS8u&sig=LJ2-Zm3-sjsQufqz9IB0fq459o0#v=onepage&q&f=false The Physiology of Stress: Cortisol and the Hypothalamic-Pituitary-Adrenal Axis – Dartmouth Undergraduate Journal of Science . (2011, February 3). Sites.dartmouth.edu . https://sites.dartmouth.edu/dujs/2011/02/03/the-physiology-of-stress-cortisol-and-the-hypothalamic-pituitary-adrenal-axis/ Youth Emergency Department Visits for Mental Health Increased During Pandemic. (2023, July 19). National Institute of Mental Health (NIMH). https://www.nimh.nih.gov/news/science-updates/2023/youth-emergency-department-visits-for-mental-health-increased-during-pandemic Zheng, Y., Panayiotou, M., Currie, D., Yang, K., Bagnall, C., Qualter, P., & Inchley, J. (2022). The Role of School Connectedness and Friend Contact in Adolescent Loneliness, and Implications for Physical Health. Child Psychiatry & Human Development , 55 (3). https://doi.org/10.1007/s10578-022-01449-x

Written by: Ananya Ganji Throughout my life, stress has been a constant. Whether it be a dance recital, an exam, or a social event, I’d assumed they were just temporary situations, and after, my mind would be at peace. After all these years, it finally became clear that this stress was more than a feeling, this was something more permanent. It changes the way your brain functions. This led me to some serious contemplation. What does it mean to rewire your brain from stress? How does all the pressure one lives under affects things like memory, attention, or emotions? I wasn't sure about all the right answers yet, but I wanted to know more! Research by Lupien et al. (2009) and McEwen (2013) have shown that chronic stress can affect the prefrontal cortex and the hippocampus. Both structures are important in learning and emotional control. Many people aren’t fully aware of the effects. It especially impacts young adults, whose brains are still developing, and have pressure from school, friends, and social media.It is mainly a concern for them as in this generation stress is non-negotiable to most people making this a topic worth learning and taking precautions about.  Introduction to Stress and the Brain Chronic stress has an impact on the brain's ability to store and use information, leading to difficulties in both memory and learning. Before we discuss the impact, let's understand what stress is. Stress is mental strain caused by emotional pressure. Sometimes, stress can be a positive thing, but chronic stress can lead to both structural and functional changes in the brain, both negatively (Lupien et al., 2009).  Cortisol and the Hippocampus When you’re stressed, the brain releases cortisol. It is a hormone that affects memory, focus, and decision making. In low doses, cortisol will temporarily help you maintain your focus, however long term or high doses are harmful to the hippocampus, which is the part of the brain used for all learning and memory tasks (McEwen 2013). Chronic stress will interfere with your ability to remember simple information, maintain focus on the task at hand, and process information when learning new information.  The Prefrontal Cortex Chronic stress is also known for weakening the prefrontal cortex (PFC) of the brain, which is in the front of the frontal lobe and is responsible for decision making, self-control, planning, and behaviour. Chronic stress changes the connections in the PFC and interferes with your ability to concentrate or think logically (Lupien et al., 2009). Therefore, doing anything on a daily basis from what you would typically complete would feel much harder in your head. Simultaneously, chronic stress could cause the amygdala to be more active. The amygdala is located in the temporal lobes of the brain and is known as the brain’s “fear center” (Lupien et al., 2009). Because of the amygdala, your brain is more active than normal and it causes people to be more emotional and impulsive. Chronic Stress’ Longterm Affect Chronic stress can take over your daily life, over time. Stress impacts your thinking, your emotions, and your behavior. It takes over some basic, but certainly important things, like brain block before a big test. It affects you forgetting simple things like where you put your phone or forgetting what you were about to say while you’re talking. This is because your brain is overwhelmed and it is harder to store or think back to information from before clearly. Overall, understanding the impact stress can leave on your brain is extremely important as it affects things people reply on a day to day basis. It will lead to a downturn in enjoying a daily experience because you are stressed 24/7 and under the burden of the tasks you cannot complete or the things you cannot understand. Being aware of how stress alters the brain helps us understand why it is critical to manage stress for both achievement and quality of life (American Brain Foundation, 2023). Emotional Regulation and Decision Making Chronic stress will impact memory and thinking, but it also will impact our ability to regulate emotions and motivation. Neuroplasticity is the brain's ability to grow and change through learning and adjustment from challenges. But, stress lowers neuroplasticity and makes it harder to recover from challenges (McEwen, 2013; Radley & Morrison 2023). As time passes, it will lead to impulsivity, irritability, and reduced motivation. Overall, chronic stress is not desirable to have as its results will cause severe problems for people and it is important to discuss this in this day and age where chronic stress is on the rise.  Strategies for Recovery Although chronic stress has lots of negative impacts, they are not permanent. Research from the American Brain Foundation (2023) and McEwen (2013) shows that  meditation, rest, and social support have all decreased stress hormones and functioned to ignite brain function (American Brain Foundation, 2023). If these habits are consistent, then healthy means of communication can also be returned to the brain and cognitive functioning and emotional regulation can be improved to help people function in day to day life without constant stress and the aftermath of it.  Why It Matters By managing chronic stress and understanding it, you can not only look after your brain health, you will improve decision making and strengthen motivation which will help you live a better life than you did with chronic stress. Managing chronic stress isn't just about appreciating your existing state of being, but about looking after your ability to adapt, grow, and thrive even through challenging or stressful experiences. Chronic stress is a constant alteration of the brain without our knowledge, as we've spoken about. It distracts one from the joy of life, it hampers memory pathways in the hippocampus, it dulls adaptability and emotional control, and so on. These changes are not entirely fixed; the array of evidence supports practical elements like exercise, mindfulness and sleep to recover healthy brain function and to support resilience (American Brain Foundation, 2023). Understanding how stress is changing the brain gives one the capacity to react in early stages, manage the chronic stress, and to protect mental and cognitive health; in addition to, help maintain the human condition. References American Brain Foundation. (2023). How stress affects the brain . American Brain Foundation.   https://www.americanbrainfoundation.org/how-stress-affects-the-brain/ Lupien, S. J., McEwen, B. S., Gunnar, M. R., & Heim, C. (2009). Effects of stress throughout the lifespan on the brain, behaviour and cognition. Nature Reviews Neuroscience, 10 (6), 434–445. https://doi.org/10.1038/nrn2639 McEwen, B. S. (2013). The brain on stress: Toward an integrative approach to brain, body, and behavior. Neuron, 79 (1), 16–29. https://doi.org/10.1016/j.neuron.2013.06.036 Radley, J. J., & Morrison, J. H. (2023). Rewiring the stress response: Implications for behavior. Frontiers in Behavioral Neuroscience, 17 , 1208351. https://doi.org/10.3389/fnbeh.2023.1208351

Written By: Jolyn Le Edited By: Abbie Affum Introduction Have you ever wanted to learn a new language? Perhaps as a way to order the most delicious food off the menu as you travel across the world, or to understand friends and family who primarily speak another language? Applications across the internet have provided accessible opportunities for people to learn languages easily. Though it becomes difficult to maintain progress and to fully immerse yourself in the language and culture. In this article, we explore whether adults can acquire new languages like native speakers and young children fully, and how learning a language impacts cognition. Are you able to learn and acquire new languages like native speakers? Studying a new language is no easy feat, as it requires grit and consistency. It is believed through previous studies that there is a natural advantage in acquiring a language at a young age, or that our brains are unable to learn at the same capacity at a later age. But, this is not true, and it is possible for second language learners, or L2, to acquire new languages just like native speakers.  From performing various tests and assessments on grammar and comprehension, we understand that late acquisition in languages can have similar cognitive effects compared to individuals who acquired two languages early in their childhood (Vega-Mendoza et al., 2015). Numerous studies have shown that second language learners can reach the native speaker level. In comparison to the amount of exposure and practice that many early-acquisition learners have, late-acquisition learners have demonstrated great proficiency despite limited experiences. We can assume that the typical monolingual native speaker is exposed to a language for 8 hours per day with a total of 87,600 hours of exposure by the age of 30 (Dąbrowska et al., 2020). With second language learners, these individuals are typically in the classroom learning for only 2,220 hours, but they have performed with exceptional knowledge of the language. Not only that, there are multilinguals who have performed better than monolinguals on specific assessments like the Elevator Task with Switching (ETS) from the Test of Everyday Attention (TEA) clinical assessment tool. TEA is utilized to better understand the executive functioning of bilinguals, and within the TEA is the ETS that measures attentional switching between high and low pitch tones as cues for directions (Vega-Mendoza et al., 2015).  These are among several that participants demonstrated they could perform just as well or better than their native speaker participants. Cognitive outcomes of language learning among different populations On a biological basis, we have studied numerous neuroimaging studies and concluded “bilinguals did not have higher FA [fractional anisotropy values] than monolinguals after collapsing across all white matter tracts and studies” (John A.E. Anderson et al., 2024). However, when comparing ages, they have shown that when looking into young adults, it was observed that there were higher FA values for bilinguals. It could be suggested that if you are entering young adulthood, this could be a great period for language learning to promote FA. Fractional anisotropy values are studied as an increase in FA values suggests an increase in white matter integrity. The white matter integrity demonstrates brain health and its ability to create more neural connections, crucial for learning new languages.  Various parts of the brain, such as the corpus callosum , left superior longitudinal fasciculus , and uncinate fasciculus , are all integral components of language learning. Studying the temporal portion of the left superior longitudinal fasciculus  (SLF) has shown us that this region is associated with bilingualism. We have observed the white matter from these regions in combination with age and recognized that bilingualism could have an effect on delaying the onset of dementia. Bilingual individuals and their white matter were studied to reveal their ages, “between 2.31 and 4.65 years younger than expected” (John A.E. Anderson et al., 2024). Regardless of brain health, aging significantly impacts people’s cognitive abilities. Studies have shown that bilingualism has positive effects on healthy adults going through normal cognitive aging as well (Kroll & Dussias, 2017). Most importantly, there are no negative effects of bilingualism, which means any population may learn additional languages without worrying about cognitive decline or disadvantages (Bak et al., 2014). Tips on Learning a New Language and Becoming Fluent Let’s debunk some myths regarding multilingualism and its relation to neuroplasticity. Scientists have researched language learning for decades, and over time, they have collected evidence of the most effective methods for studying languages.  A common myth is that second language learners, or L2, are unable to acquire a new language like a native speaker. One of the key factors in the successful attainment of a second language among adults is motivation, particularly integrative motivation (Dąbrowska et al., 2020). Integrative motivation is the strong desire to learn a language to become part of a community or culture. Adult language learners all have different reasons as to why they are studying languages, but that particular reason should be something they are passionate about to achieve the best learning outcomes. Consistency and effort are key influencers of multilingualism and maintaining the language. Language learning is no short-term goal to achieve, but rather it takes around 3 months of intensive learning to see anatomical changes from studying a new language (Li et al., 2014).  Another myth is the neuroplasticity of the brain, making language learning difficult. Though adolescence offers certain advantages to multilingualism and acquisition, our brains are capable of developing over time, even through brain injuries. One research article found that “even when the entire left hemisphere is lost due to perinatal stroke, language can successfully develop in the remaining right hemisphere” (Martin et al., 2022).  Learning a second language can vary from person to person. Early acquisition and late acquisition can affect people differently; for example, those with higher intelligence will benefit from early acquisition more than those with lower intelligence (Bak et al., 2014). Additionally, acquiring a second language has advantages that early language learners do not have, like a greater impact on inhibitory control, a key component in executive functioning (Bak et al., 2014). Conclusion Although this is just the beginning of research on language acquisition and the influence on cognitive abilities, we have already discovered plenty about multilingualism and neuroplasticity. Languages are a powerful way to communicate, offering ways to express and share ideas and cultures. As society learns more about how our brain processes language, the cognitive advantages, and effective methods in acquiring languages, they will become more encouraged to explore new languages, even as an adult. The journey requires determination and perseverance to become successful, but it is never too late to become introduced to a new language.  References or Sources Bak, T. H., Nissan, J. J., Allerhand, M. M., & Deary, I. J. (2014). Does bilingualism influence cognitive aging? Annals of Neurology , 75 (6), 959–963. https://doi.org/10.1002/ana.24158 Dąbrowska, E., Becker, L., & Miorelli, L. (2020). Is Adult Second Language Acquisition Defective? Frontiers in Psychology , 11 . https://doi.org/10.3389/fpsyg.2020.01839 John A.E. Anderson, Asli Yurtsever, Odin Fisher-Skau, Cherep, L. A., MacPhee, I., Luk, G., & Grundy, J. G. (2024). Examining the consistency in bilingualism and white matter research: A meta-analysis. Neuropsychologia , 195 , 108801–108801. https://doi.org/10.1016/j.neuropsychologia.2024.108801 Kroll, J. F., & Dussias, P. E. (2017). The Benefits of Multilingualism to the Personal and Professional Development of Residents of the US. Foreign Language Annals , 50 (2), 248–259. https://doi.org/10.1111/flan.12271   Li, P., Legault, J., & Litcofsky, K. A. (2014). Neuroplasticity as a function of second language learning: Anatomical changes in the human brain. Cortex , 58 (1), 301–324. https://doi.org/10.1016/j.cortex.2014.05.001 Martin, K. D., Ketchabaw, W. T., & Turkeltaub, P. E. (2022). Plasticity of the language system in children and adults. Handbook of Clinical Neurology , 184 , 397–414. https://doi.org/10.1016/b978-0-12-819410-2.00021-7 Masgoret, A.-M. ., & Gardner, R. C. (2003). Attitudes, Motivation, and Second Language Learning: A Meta-Analysis of Studies Conducted by Gardner and Associates. Language Learning , 53 (S1), 167–210. Vega-Mendoza, M., West, H., Sorace, A., & Bak, T. H. (2015). The impact of late, non-balanced bilingualism on cognitive performance. Cognition , 137 , 40–46. https://doi.org/10.1016/j.cognition.2014.12.008 Ware, C., Dautricourt, S., Gonneaud, J., & Chételat, G. (2021). Does Second Language Learning Promote Neuroplasticity in Aging? A Systematic Review of Cognitive and Neuroimaging Studies. Frontiers in Aging Neuroscience , 13 . https://doi.org/10.3389/fnagi.2021.706672

By Abbie Affum.  Edited by: Fernando Aguilar. What if a scar on your face meant a lifetime of being stared at, teased, or even shunned?  In many countries such as Ethiopia, India, Ghana, and Bangladesh, individuals born with cleft lip carry visible scars into adulthood, often due to a lack of access to early surgical care (Global Burden of Disease Study, Kantar et al., 2023; Wydick et al., 2022). These scars, though physical, often invite social judgment and lead to emotional wounds—discrimination, bullying and low self-worth (Chung et al., 2019). While medical advancements in developed nations like the United States allow for early intervention and minimal scarring, patients in underserved regions are left with both untreated deformities and lasting emotional trauma (Chung et al., 2019). Additionally, this contrast reveals how something as visible as a scar can silently shape a person’s entire life. This article explores how access to cleft lip treatment influences not only physical appearances but also emotional and social well-being, shedding light on the often invisible struggles behind cleft lip scars around the world. Occurring in approximately 1 in every 700 births worldwide, cleft lip develops when the tissues forming the upper lip fail to fuse properly during the fourth to seventh weeks of gestation, the period when a baby is developing inside the mother’s womb  (Wydick et al., 2022; Centers for Disease Control and Prevention [CDC], 2024; Children’s Hospital of Philadelphia, n.d.). In high-resource countries, early surgical repair typically reduces visible scarring and mitigates long-term effects. However, in many developing regions, limited access to timely and high-quality care means that children grow up with noticeable scars, physical reminders that often become social targets. These visible differences can lead to harmful experiences such as bullying, discrimination, and social rejection (See Figure 1: Child with visible cleft scar. Source: Adeyemo et al., 2009). Figure 1. A 12-year-old from Nigeria with an incomplete cleft lip, awaiting surgery in a region with limited access to cleft care (Adeyemo et al., 2009). Beyond physical health, individuals with unrepaired or visibly scarred cleft lips frequently face emotional challenges including anxiety, depression, and persistent low self-esteem (Wydick et al., 2022).  According to estimates, individuals in developing countries face significantly higher rates of psychosocial challenges such as low self-esteem, and depression due to untreated or visible cleft lip scars (Hutchinson et al., 2011).  As shown in Figure 2, low self-esteem is nearly twice as prevalent among patients in developing nations compared to those in developed ones. Similarly, peer teasing and exclusion affect over 65% of patients in underserved regions, an outcome not just of untreated conditions but of stigma that continues after surgery. These statistics highlight how scars can have consequences far beyond the physical, shaping emotional well-being and social identity. Figure 2. Estimated prevalence of psychosocial impacts among individuals with cleft lip in developed vs. developing countries. Note: Data are estimated from published studies and synthesized for illustrative purposes. See Al-Namankany et al. (2018); Hunt et al. (2006); Morgan & Taylor (2009). Moreover, during a medical mission trip I joined in Guatemala, I witnessed how patients with various untreated illnesses had to wait months or even years for care from visiting medical teams. Some had traveled for days, desperately hoping that this one opportunity might bring healing. That same sense of waiting, hoping, and suffering in silence reflects the reality for children born with cleft lip in underserved countries. Without access to surgical teams year-round, families of children born with cleft lip often rely on international charities like Smile Train, a nonprofit that provides free cleft surgery in low-resource settings—which may only visit once or twice a year ( Smile Train, n.d.) . Additionally, because of these delays, surgery happens long after the most effective window for minimal scarring has passed. As a result, children grow up with visible scars that act as a social marker—inviting stares, teasing, and rejection. The emotional effects of these scars can be profound, especially without access to follow-up counseling or mental health support (See Figure 2: Psychosocial impact of facial difference. Adapted Al-Namankany et al. (2018); Hunt et al. (2006); Morgan & Taylor (2009) ). To truly address the impact of cleft lip, solutions must go beyond surgical outreach. Thus, local governments and non-governmental organizations (NGOs), such as the Operation Smile and Smile Train, must invest in public education that reduces stigma, train healthcare workers to provide culturally sensitive psychosocial support, and integrate basic counselling services into cleft care programs (Afolabi, 2022). For instance, in Nigeria community-based initiatives have shown success in raising awareness about facial differences and promoting inclusive care (Afolabi, 2022). Additionally, In Ghana, programs like DHL’s surgical outreach have helped transform lives by providing early intervention and post-operative support. These interventions don’t just repair lips—they restore confidence, dignity, and the possibility of a future free from shame. Addressing the emotional burden of visible scarring is essential for ensuring these children do not just heal physically but socially and emotionally as well (See Figure 3: Post-surgical outcome. Source: DHL Ghana, 2024).   Figure 3. A teenager from Ghana holding a photo of herself before her cleft lip surgery, highlighting the life-changing impact of timely treatment. Her surgery was made possible through the nonprofit Operation Smile (Operation Smile, 2024). A cleft lip is more than just a physical condition—it often leaves behind scars that quietly shape a person’s life. In many low-resource countries, delayed access to surgery means the scars are not just internal but etched visibly on the face. These facial scars, though remnants of healing, can lead to teasing, rejection, and lifelong emotional harm. Children with visible scars may grow up believing they are marked, different, or less worthy—especially in cultures that value physical "normalcy." It’s not just the cleft lip that causes pain, but how society reacts to the reminder left behind. If we want to create real change, we must address both the condition and the perception. By ensuring timely access to cleft care, reducing stigma through public education, and offering emotional support alongside surgery, we can give children more than just repaired lips—we can give them confidence, acceptance, and a future free of shame. Because behind every scar, there is not only a story but also a human being who deserves to be seen, understood, and embraced. References Adeyemo, W. L. (2009). Cleft deformities in adults and children aged over six years in Nigeria: Reasons for late presentation and management challenges. Clinical Cosmetic and Investigational Dentistry , Volume 1 , 63–69. https://doi.org/10.2147/ccide.s6686 Al-Namankany, A., & Alhubaishi, A. (2018). Effects of cleft lip and palate on children's psychological health: A systematic review. Journal of Taibah University Medical Sciences , 13 (4), 311–318. https://doi.org/10.1016/j.jtumed.2018.04.007 Children’s Hospital of Philadelphia. (n.d.). Cleft lip and palate: Overview . https://www.chop.edu/conditions-diseases/cleft-lip-and-palate Chung, K. Y., Sorouri, K., Wang, L., Suryavanshi, T., & Fisher, D. (2019). The Impact of Social Stigma for Children with Cleft Lip and/or Palate in Low-resource Areas: A Systematic Review. Plastic and reconstructive surgery. Global open , 7 (10), e2487. https://doi.org/10.1097/GOX.0000000000002487 Afolabi, A. F. (2022). Psychosocial impact of cleft lip and palate among Nigerian adolescents  (Master’s thesis, Cleveland State University). OhioLINK Electronic Theses and Dissertations Center.   https://etd.ohiolink.edu/acprod/odb_etd/ws/send_file/send?accession=csu1624475008242102&disposition=inline Hunt, O., Burden, D., Hepper, P., & Johnston, C. (2006). The psychosocial effects of cleft lip and palate: A systematic review. The Cleft Palate-Craniofacial Journal, 42 (5), 468–475. https://doi.org/10.1597/04-206.1 Hutchinson, J., Paterson, L. Q., & Mulliken, J. B. (2011). The psychosocial effects of cleft lip and palate in non-Anglo populations: A cross-cultural meta-analysis. International Journal of Pediatric Otorhinolaryngology, 75 (1), 1–5. https://doi.org/10.1016/j.ijporl.2010.10.002 Kantar, R. S., Hamdan, U. S., Muller, J. N., Hemal, K., Younan, R. A., Haddad, M., Melhem, A. M., Don Griot, J. P. W., Breugem, C. C., & Mokdad, A. H. (2023). Global prevalence and burden of orofacial clefts: A systematic analysis for the Global Burden of Disease Study 2019 . The Journal of Craniofacial Surgery, 34 (7), 2012–2015. https://doi.org/10.1097/SCS.0000000000009591 Morgan, D. W., & Taylor, C. R. (2009). Anxiety and depression in adolescents with cleft lip and/or palate. Psychology, Health & Medicine, 14 (6), 711–720. https://doi.org/10.1080/13548500903111806 Operation Smile. (2024, March 13). Changing lives in Ghana, one cleft lip repair surgery at a time . LOT by DHL.   https://lot.dhl.com/changing-lives-in-ghana-one-cleft-lip-repair-surgery-at-a-time/ Smile Train. (n.d.). Our model of care .   https://www.smiletrain.org/our-model Sorooshian, P., Holden, J., Stewart, C. J., & Colville, R. J. (2018). Wound management in acute medicine. Journal of Plastic Reconstructive & Aesthetic Surgery , 72 (3), 513–527. https://doi.org/10.1016/j.bjps.2018.12.008   Wydick, B., Zahid, M., Manning, S., Maller, J., Evsanaa, K., Skjoldhorne, S., Bloom, M., Das, A., & Deshpande, G. (2022). The Impact of Cleft Lip/Palate and Surgical Intervention on Adolescent Life Outcomes. Annals of global health , 88 (1), 25. https://doi.org/10.5334/aogh.3679 Yao, C. A., Swanson, J., Chanson, D., Taro, T. B., Gura, B., Figueiredo, J. C., Wipfli, H., Hatcher, K., Vanderburg, R., & Magee, W. P. (2016). Barriers to Reconstructive Surgery in Low- and Middle-Income Countries: A Cross-Sectional study of 453 cleft lip and cleft palate patients in Vietnam. Plastic & Reconstructive Surgery , 138 (5), 887e–895e. https://doi.org/10.1097/prs.0000000000002656

By Fernando Aguilar Edited by: Jacinda Taggett As someone who is interested in becoming a mental health professional, I receive a lot of mental health-related content on social media. When I was scrolling on Instagram, I found a reel that claimed that a bear that was trapped in a cage but had been free was still walking in circles as if it was still stuck in the cage. This was then accompanied with a caption mentioning how this is how people with Complex Post Traumatic Stress Disorder (CPTSD) feel. Wondering what CPTSD was and seeing if the claim was true, I started to do a bit of research on both. What I found was depressing; the bear had been stuck in a small cage with another bear for 20 years before being freed. When the bear was going in circles (as seen in Figure 1 ), it had been seven years of its freedom from the enclosure at the time. Despite its freedom, the bear’s traumatized brain remains trapped in a time when it was not.  Figure 1 shows the freed bear continuing to walk in circles in a sanctuary.  The traumatized bear represents how prolonged trauma, like being caged for twenty years, could fundamentally rewire the way it thinks and behaves. Its actions no longer match its reality but its traumatized mind and conditioned body have yet to register its freedom. It has not mentally repaired from the psychological damage it has endured. Unfortunately, this appears to be the reality of many people who have experienced many forms of traumatic events: despite possibly being free from a toxic environment or abuser(s), their brain and body continue to relive the trauma. In solidifying the diagnosis of CPTSD, it can directly help address trauma and other co-occurring conditions when it comes to other mental health illnesses and challenges and break the cycle of mental health struggle. PTSD vs. CPTSD / US vs. Non-US—Why the difference? PTSD (Post-Traumatic Stress Disorder) PTSD was officially recognized in the DSM-III back in 1980 and has evolved when it comes to the definition and diagnosis of PTSD. According to the fifth text revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), the diagnostic protocol now defines PTSD as an individual who must have been directly or indirectly affected by a traumatic event either by personal experience or witnessing the event that involves “actual or threatened death, serious injury, or sexual violence.” Comparatively, according to the World Health Organization (WHO) International Classification of Diseases 11th Revision (ICD-11), the diagnostic manual defines PTSD as an event or events that were “extremely threatening or horrific.” Despite the differences in definition and criteria, the overlapping similarities between the ICD-11 and the DSM-5 include intrusions or re-experiencing the traumatic event, avoidance, and reactivity or sense of threat. A summary comparing both diagnostic criteria can be found in Figure 2.  Figure 2 summarizes the differences between PTSD in the DSM-5-TR and IDC-11. CPTSD (Complex Post-Traumatic Stress Disorder) According to the ICD-11, the international diagnostic manual defines CPTSD (Complex PTSD) as having three PTSD (Post-Traumatic Stress Disorder) clusters as well as “three additional clusters that reflect Disturbances in Self Organization (DSO)” (Maercker et al., 2013), as seen in Figure 3. In simpler terms, CPTSD is due to several or repeated traumatic events that are often seen in childhood. Figure 3 explains the DSO clusters previously mentioned. CPTSD and its complexities CPTSD within itself has several ways of identifying itself, such as Disorders of Extreme Stress Not Otherwise Specified (DESNOS) and Developmental Trauma Disorder (DTD). However, CPTSD helps encapsulate the complexities of trauma. Even so, CPTSD is a relatively understudied diagnosis, as it was formally introduced in 2018 in the ICD-11. CPTSD’s possible existence was being debated as early as when PTSD was introduced in the 1980s, arguing that PTSD alone does not address the complexities of multiple forms of trauma, especially during childhood. Judith Herman, a US-born psychiatrist and trauma expert, was the first to conceptualize the idea of complex PTSD in her book  Trauma and Recovery: The Aftermath of Violence—From Domestic Abuse to Political Terror . Even so, the DSM-5 does not currently recognize CPTSD as its own separate diagnosis but rather as a subgroup of PTSD. In contrast, the ICD-11 splits the DSM-5 criteria into 2 groups: PTSD with 3 clusters and CPTSD with the remaining 3 clusters, as seen in Figure 4 . Figure 4 displays the difference between PTSD and CPTSD in the ICD-11. There was a study that aimed to assess whether or not the classification for CPTSD differentiates itself from PTSD using the ICD-11 Trauma Questionnaire (ICD-TQ). Not only were PTSD and CPTSD distinguished as two separate yet similar subgroups, but the study also found that childhood trauma and cumulative stressful life events were significant to CPTSD and were harmful to family and social relationships (Karatzias et al., 2017).   Additionally, there was a higher prevalence of CPTSD in certain demographics, which was found in clinical, domestic, and sexual abuse and military samples. For veterans the extremes of war and a lack of immediate access to mental health resources are factors as to why the PTSD symptoms are so severe. Meanwhile, there was a lower prevalence for CPTSD among emergency and healthcare personnel and the general community due to their accessibility to mental health resources. Despite there being no gender difference when it comes to men and women for CPTSD, women are 1.6 times more likely to be diagnosed with CPTSD in a sample of potentially trauma-exposed samples (Huynh et al., 2025). Coping with CPTSD Types of Treatments When dealing with trauma, it is important to address the trauma(s) of an individual so that their brains register that it is time to heal the mind and body. However, due to how novel the concept of CPTSD is, there are limited updates on the treatment plans for the diagnosis. Even so, there have been pilot studies trying to address the bigger questions surrounding CPTSD. When it comes to repeated childhood trauma in CPTSD, how can we go back and heal the person's inner child? That is what a pilot study aimed to oversee by practicing the Ideal Parent Figure (IPF) method to treat CPTSD related to childhood trauma. They looked at 17 adults that had a history of childhood trauma with CPTSD symptoms and underwent a 5-week psychotherapy program focusing on the stabilization phase of the three-phase treatment program for CPTSD as well as an 8-month follow-up assessment of stability. There was statistically significant evidence to show that this method of directly addressing attachment helped to decrease CPTSD symptoms (Parra et al., 2017). Given that CPTSD holds multiple forms of trauma, this pilot program, if applied for a longer time, could possibly yield positive results for addressing trauma and CPTSD symptoms. Speaking of long term, are there any studies that address the possibility of treating CPTSD as a longer-term goal? In yet another pilot study, they took 38 individuals diagnosed with CPTSD and had them participate in a 6-week multimodal psychodynamic inpatient rehabilitation treatment. This treatment focused on four foundations, including how the past and present affect relationships, using internal resources such as the “safe place” imaginative technique, acknowledging emotional dysregulation altered the victim’s way of thinking, and the importance of therapists being aware of their mental health status to avoid burning out or vicarious traumatization (other people’s trauma negatively affects your mental health). The study found that there was a decrease in CPTSD, depression, and anxiety symptoms, as well as an increase in improvement in relationships after a year of the program (Riedl et al., 2025).  Something that had not registered for me was how, outside of telehealth therapy, there is potential to use technology for CPTSD. There was a study on the usage of digital-based interventions (DBIs) for treating mental illnesses post-pandemic. The article compiled 10 papers regarding the efficacy of reducing CPTSD as evidence to see if and how DBIs can treat CPTSD. They explored treatment approaches, the technological modalities used, the level of support needed, targeted symptoms, safety measures, and efficacy of the DBIS. Despite a certain level of efficiency, DBIs are more focused on stabilizing the individual instead of working on their trauma, which is pivotal in treating either form of PTSD and increases the chances of the individual dropping the DBI (Blackie et al., 2024). Even if the results were less than satisfactory, it is always important to try and incorporate technology into mental health spaces and reinforce the importance of tackling the root of the problem rather than trying to pathologize the cause(s). Reparenting the Inner Child Whenever I scroll on social media, I am constantly getting many positive affirmations and self-forgiving content on my feed, which has now evolved into reparenting language. For example, instead of punishing yourself for breaking a dish or spilling milk on the floor, you simply tell yourself that making small accidents is just part of being human. This shift in mindset helps to heal the inner child by validating the hurt while telling your inner child what it should have heard growing up.  But when it comes to psychology, what surprised me was seeing how reparenting is viewed in therapy spaces. In a study it brings up an interesting point classifying a therapeutic relationship as an attachment. The paper would then explore how limited reparenting, which is the attachment-informed approach to schema therapy, can benefit a client’s attachment needs. Not only should therapists be aware of their attachment style and how it can shape the therapeutic experience of a client but it also asks therapists with insecure forms of attachment to also seek therapy so as to not compromise their clients’ healing process (Andrioupoulou, 2022).  CPTSD—A new gateway of addressing trauma Addressing the complexities of trauma in PTSD can help individuals realize the severity of their trauma from a scientific standpoint as well as expand on addressing trauma in itself. Some professionals argue that this new diagnosis would invite more people with CPTSD. That is the point, for only then will more individuals seek the support they need and deserve as well as add value to the argument that society and the systems in place contribute to the production of mental illnesses and worsening conditions. If we factor in racial abuse and homophobic and transphobic laws and rhetoric as examples, it will expose how embedded mental health struggles are in our modern day. The simple step of recognizing CPTSD in the DSM-5 would help bring the US and other countries to work together and figure out CPTSD and how to properly treat it. Trauma will no longer be something taboo but rather something that can be properly explained to improve lives. References Sagebrush psychotherapy . (2019). Sagebrush Psychotherapy. https://www.sagebrushpsychotherapy.com/complex-trauma Huynh, P. A., Kindred, R., Perrins, K., de Boer, K., Miles, S., Bates, G., & Nedeljkovic, M. (2025). Prevalence of Complex Post-Traumatic Stress Disorder (CPTSD): A Systematic Review and Meta-Analysis. Psychiatry Research , 351 , 116586. Science Direct. https://doi.org/10.1016/j.psychres.2025.116586   Karatzias, T., Shevlin, M., Fyvie, C., Hyland, P., Efthymiadou, E., Wilson, D., Roberts, N., Bisson, J. I., Brewin, C. R., & Cloitre, M. (2017). Evidence of distinct profiles of Posttraumatic Stress Disorder (PTSD) and Complex Posttraumatic Stress Disorder (CPTSD) based on the new ICD-11 Trauma Questionnaire (ICD-TQ). Journal of Affective Disorders , 207 , 181–187. https://doi.org/10.1016/j.jad.2016.09.032   Blackie, M., Kathleen De Boer, Seabrook, L., Bates, G., & Nedeljkovic, M. (2024). Digital-Based Interventions for Complex Post-Traumatic Stress Disorder: A Systematic Literature Review. Trauma, Violence & Abuse , 25 (4). Sage Journals. https://doi.org/10.1177/15248380241238760   PTSD and DSM-5 - PTSD: National Center for PTSD . (2023, June 9). Www.ptsd.va.gov . https://www.ptsd.va.gov/professional/treat/essentials/dsm5_ptsd.asp#one   Treatment (US), C. for S. A. (2014). Exhibit 1.3-4, DSM-5 Diagnostic Criteria for PTSD . Www.ncbi.nlm.nih.gov . https://www.ncbi.nlm.nih.gov/books/NBK207191/box/part1_ch3.box16/?ref=quillette.com   U.S. Department of Veteran Affairs. (2014). Complex PTSD - PTSD: National Center for PTSD . Va.gov . https://www.ptsd.va.gov/professional/treat/essentials/complex_ptsd.asp   TraumaDissociation. (2014). Complex Posttraumatic Stress Disorder . Trauma Dissociation.  Riedl, D., Thaler, J., Kirchhoff, C., Kampling, H., Kruse, J., Nolte, T., Campbell, C., Grote, V., Fischer, M. J., & Lampe, A. (2025). Long‐Term Improvements of Complex Post‐Traumatic Stress Disorder (CPTSD) Symptoms After Multimodal Psychodynamic Inpatient Rehabilitation Treatment–An Observational Single Center Pilot Study. Journal of Clinical Psychology , 81 (8), 739–754. Wiley Online Library. https://doi.org/10.1002/jclp.23809   Parra, F., George, C., Kalalou, K., & Januel, D. (2017). Ideal Parent Figure method in the treatment of complex posttraumatic stress disorder related to childhood trauma: a pilot study. European Journal of Psychotraumatology , 8 (1), 1400879. Taylor & Francis Online. https://doi.org/10.1080/20008198.2017.1400879   Andriopoulou, P. (2022). Healing attachment trauma in adult psychotherapy: The role of limited reparenting. European Journal of Psychotherapy & Counselling , 23 (4), 1–15. Taylor & Francis Online. https://doi.org/10.1080/13642537.2021.2000465

By Eliora M. Introduction Imagine attempting to juggle five balls while standing on one foot, only to hear someone proclaim that the key to success is simply “being consistent.”  For many neurodivergent adults, particularly those with ADHD, that advice feels less like wisdom and more like a cruel joke. Consistency may sound ideal, but what if your brain doesn’t interpret “ideal” in the same way every day? When I was first diagnosed with ADHD, I believed the solution was to simply try harder, to wake up earlier, follow a planner, and commit to strict routines. That’s the advice everyone gives, but despite my efforts, it didn’t work. Some days I was utterly focused; other days, even brushing my teeth felt monumental. The suggestion to “just be consistent” started to feel like a punchline. And honestly? I’m not the only one. This essay proposes a decisive shift in perspective: what if success is not rooted in consistency, but in persistency —the ability to adapt, recover, and continue, even when routines collapse? Drawing on research in therapy, workplace productivity, and human resources, I will explore why this model offers a more realistic and empowering path for neurodivergent individuals seeking work–life balance. CBT as a Model for Persistence Cognitive-behavioural therapy (CBT) is one of the most evidence-based approaches for managing ADHD symptoms in adults. A 2017 meta-analysis by Knouse, Teller, and Brooks reviewed 32 empirical studies and found consistent benefits in improving planning, organization, and time management. This suggests CBT creates the psychological infrastructure necessary for lasting behavioural change. Unlike rigid productivity systems, CBT emphasizes flexibility and metacognition. It helps individuals break large tasks into manageable pieces, reframe unhelpful thought patterns, and design schedules that match natural energy rhythms (Knouse, Teller, & Brooks, 2017). These strategies directly counter the unrealistic pressure to deliver flawless performance every day. The same research also found that emotional regulation—a skill closely tied to resilience—enabled participants to stay engaged with their goals after setbacks. In other words, CBT does not aim for perfection; it teaches people to recover quickly and keep going. This focus on adaptability and rebound capacity embodies the very essence of persistence. Rethinking Productivity at Work Even with strong coping tools, many neurodivergent adults still feel misunderstood at work. A 2018 study by Joseph et al., involving over 2,000 adults with ADHD, found that focus, emotional regulation, and task initiation challenges often reduced productivity and job satisfaction. Yet participants who adopted adaptive strategies such as breaking large tasks into smaller steps, using visual reminders, or requesting flexible deadlines reported marked improvements. Notably, those who avoided catastrophizing after a “bad” day recovered faster and returned to tasks sooner (Joseph et al., 2018). This finding reframes productivity: the real measure of success is the ability to recalibrate, not to maintain an unbroken streak of high performance. HR’s Role in Structural Change The 2024 review by Rolnik-Sadowska and Grabinska highlights how traditional human resource (HR) systems are built on neurotypical norms: valuing punctuality, fixed schedules, and uniform workflows, which can inadvertently exclude neurodivergent strengths. They call for sustainable HR models that offer flexible hours, remote work options, individualized performance metrics, and neurodiversity-informed mentorship. One key insight is that creativity and innovation often flourish when employees can work in short bursts of high energy—a style known as “burst working” (Rolnik-Sadowska & Grabinska, 2024). In practice, this might look like a marketing coordinator who arranges her workday into three intense 90-minute sprints, followed by lighter administrative tasks. By aligning her schedule with her natural focus cycles, she not only meets deadlines but consistently produces high-quality, original content. Such examples show that persistence—adjusting methods to sustain long-term output—is not a workaround but an asset. When companies normalize nonlinear work rhythms, they foster adaptability and reduce burnout, benefiting both neurodivergent and neurotypical employees. Conclusion We’ve been asking the wrong question. Instead of “Why aren’t you more consistent?” we should ask, “What supports your persistence?” For neurodivergent adults, persistence is not a consolation prize; rather, it is a legitimate strength. It reflects the capacity to try again after failure, to adapt strategies to changing conditions, and to reject the myth that success must look identical every day. From CBT’s emphasis on adaptability to HR’s move toward flexible structures, the evidence is clear: resilience matters more than routine, effort more than sameness, and recovery more than perfection. In the end, being able to rise after a setback will always be more powerful than never stumbling at all. References Joseph, A., Kosmas, C. E., Patel, C., Hall, H., & Asherson, P. (2018). Health-Related Quality of Life and Work Productivity of Adults with ADHD: A U.K.-U.S. Web-Based Cross-Sectional Survey. Attention Deficit and Hyperactivity Disorders , 231(3), 1160–1623. https://doi.org/10.1177/1087054718799367 Knouse, L. E., Teller, J., & Brooks, M. A. (2017). Meta-analysis of cognitive-behavioral treatments for adult ADHD. Journal of Consulting and Clinical Psychology, 85 (7), 737–750. https://doi.org/10.1037/ccp0000216 Rolnik-Sadowska, E., & Grabinska, V. (2024). Managing Neurodiversity in Workplaces: A Review and Future Research Agenda for Sustainable Human Resource Management. Sustainability, 16 (5), 654. https://doi.org/10.3390/su160516594

Written by: Hannah Ramirez Postpartum depression is a mood disorder that impacts pregnant or postpartum women and affects 10-20% of mothers ( Mavrogiorgou et al., 2012) , leading to symptoms of anxiety and depression. Every mother is susceptible to distress giving birth, yet research often underrepresents the complexity of maternal changes when an infant is born. Maternal research has limited accessibility in culturally responsive interventions for postpartum depression (PD) and overall lack of knowledge as to how PD may influence caregiving as mothers are struggling with their mental clarity. By sharing the challenges mothers experience through not only quantitative but also qualitative methods, it may push for more accessible culturally competent interventions in mental health settings. Physiological Factors in Postpartum Depression Studies have explored how PD influences maternal cognitive functions by analyzing real-time, computer-based, assessments of mother-infant interactions.  They are able to observe real-time caregiving behaviors, alongside looking at biological factors such as measuring cortisol levels , which increase when the body is responding to stress. A study by Beebe et al. (2012a) in particular has depicted 10-13% of mothers with PD observed their own interactions with their infants had been disturbed as a result of the depression. Examples of maternal disturbance included reduced eye contact or decrease in affectionate vocalization (tone of voice) when mothers interact with their infant, measuring cortisol levels to represent maternal disturbance (Mavrogiorgou et al., 2012). When looking deeper into how emotional distress and cognitive disruptions affect infant bonding, Mavrogiorgou et al. (2012) study observed hormonal levels and other biological measures using a computer-based interactions analysis This analysis with biological measures such as observing cortisol levels allows researchers to look at a variety of components when analyzing the participants. Nine out twenty-five of the participants were experiencing behaviors, personality, or anxiety disorders making comorbidity (medical diagnosis that occurs at the same time as another) a factor to consider as symptoms of depression may be expressed differently. Acknowledging comorbidity in the study is an important factor to consider when looking to translate these findings into interventions, in comparison to other studies using participants who are overly filtered for research settings purposes. Henry and Sherwin (2012) conducted a longitudinal study that examined the same individuals across a span of time, strengthening the interpretations of results, while additionally having a control group to compare results to. Focused on looking into the cognitive functions during late pregnancy and postpartum, they explored associations with hormonal levels like estrogen, progesterone, testosterone, cortisol, and prolactin and made observations on the influence of hormones on performance. Prolactin  is known for the role it plays in stimulating milk production and has been linked to bonding and nurturing instincts in those who breastfeed (Henry & Sherwin, 2012). Prolactin (PRL) is a hormone associated with bonding and nurturing infants, with increased levels showing negative associations with paragraph recall and executive function during pregnancy (Henry & Sherwin, 2012). Meaning when one variable goes up the other goes down, an inverse relationship.  Biological and psychological factors play a complex role during pregnancy and the postpartum period impacting maternal functioning, as depicted across studies exploring hormonal disruption and PD. Henry and Sherwin (2012) studies the role of prolactin and cortisol in cognitive performance during late pregnancy up until early postpartum period. Findings discovered elevated prolactin correlated with reduced executive cognitive function (Henry & Sherwin, 2012). This finding implies dysregulation of bonding hormones may lead to impaired skills for responsive caregiving. Cultural & Economic Accessibility to Clinical Interventions Traditional clinical interventions often fail to reach low-income mothers due to systemic barriers. In-home cognitive behavioral therapy (IH-CBT) was designed for low-income mothers and accounted for cultural considerations in community-based care. Cognitive behavioral therapy (CBT) is a psychological treatment meant to change how the patient thinks to reduce stressors. Maternal mental health directly impacts caregiving, responsiveness, and engagement towards their infants during the postpartum period. Ammerman et al. (2013) focuses on examining how in-home cognitive behavioral therapy (IH-CBT) affects social functions and psychological distress. IH-CBT showed significant results in reducing psychological distress . Improving perceived support was an important finding as well because social isolation is a strong predictor of PD . Key Findings in Studies Biological and psychological factors play a complex role during pregnancy and the postpartum period impacting maternal functioning, as depicted across studies exploring hormonal disruption and PD. Henry and Sherwin (2012) studies the role of prolactin and cortisol in cognitive performance during late pregnancy up until early postpartum period. Findings discovered elevated prolactin correlated with reduced executive cognitive function (Henry & Sherwin, 2012). This finding implies dysregulation of bonding hormones may lead to impaired skills for responsive caregiving. As noted before, mothers with depression-diagnosis showed key signs of impaired bonding like reduced eye contact and affect on vocal tone. Ammerman et al. (2013) offered an intervention of IH-CBT, decreasing psychological distress and increasing perceived social support among depressed mothers. While this study did not explore cognitive functions, it suggests improvements in social engagement supporting the mother’s emotional availability. What Future Research Should Look for These studies revealed shared vulnerabilities among mothers particularly those experiencing overlapping systemic stressors. Hormonal instability and psychological distress compromise the health and well-being of mothers while having to learn how to bond and nurture their infant. Future studies are needed to investigate the timeframe of the onset and the duration of changes in cognitive function during pregnancy and the postpartum period that we observed. By expanding the timeframe in longitudinal design to 12 months post-treatment to assess relapse risk and review how participants retained positive progress. Finally, studies should further examine how IH-CBT outcomes vary across race, immigrant status, single parenting, and historical trauma contexts. Overall recruiting participants from minority backgrounds to better understand the impact of systemic stress components and have that representation in research conducted. These populations are historically overlooked adding to the limited generalizability in current research studies, these findings may inspire change in public policy reducing systemic stressors that influence maternal health outcomes through accessible interventions. Cited Resources Ammerman, R. T., Putnam, F. W., Altaye, M., Teeters, A. R., Stevens, J., & Van Ginkel, J. B. (2013). Treatment of depressed mothers in home visiting: Impact on psychological distress and social functioning. Child Abuse & Neglect , 37 (8), 544–554. https://doi.org/10.1016/j.chiabu.2013.03.003 Beebe, B., Lachmann, F., Jaffe, J., Markese, S., Buck, K.A., Chen, H., et al., 2012b. Maternal postpartum depressive symptoms and 4-month mother–infant interaction. Psychoanal. Psychol. 29, 383–407. https://doi.org/10.1037/a0029387 . Henry, J. F., & Sherwin, B. B. (2012). Hormones and Cognitive Functioning During Late Pregnancy and Postpartum: A Longitudinal Study. Behavioral Neuroscience , 126 (1), 73–85. https://doi.org/10.1037/a0025540 Mavrogiorgou, P., Diop, S., Turmes, L., Specht, C., Vanscheidt, S., Seehagen, S., & Juckel, G. (2022). Computer-based mother–infant interaction analysis and mental functioning in postpartum depression. Psychiatry Research , 311 , 114506. https://doi.org/10.1016/j.psychres.2022.114506

Written by: Eva Rong Here’s an interesting question I encountered in Daniel Kahnman’s book  Thinking Fast and Slow : Steve is very shy and withdrawn, invariably helpful but with little interest in people or in the world of reality. A meek and tidy soul, he has a need for order and structure, and a passion for detail. Is Steve more likely to be a librarian or a farmer? (Kahneman, 2011) A librarian, right? At least that was what I thought when I was reading the book; a librarian is meek and tidy, so Steve must be a librarian. But the truth is that there are way more farmers than librarians in this world, therefore, Steve is way more likely to be a farmer rather than a librarian. I learned after that this phenomenon is called a heuristic bias, a shortcut in our thinking process. We immediately connect meek and tidy to a librarian and not a farmer because we more often see a meek and tidy librarian.The human brain tricks itself without consciousness. Guessing an individual’s career may not cause too much harm but it leads to something bigger and proves something bigger: we judge each other and make decisions upon our distorted, biased  thoughts. This is why understanding the effects of cognitive bias in our daily lives and its effect on our choices. It will allow us to view our decisions and surroundings differently, maybe in a way we’ve never seen before. Intro to Cognitive Bias Before we look into the effects of cognitive bias, we must understand what and how these biases are developed in our lives. Cognitive bias is a systematic error in our thought process; they are errors in our judgements and thinking that may change the way we perceive others, the decisions we make, and process information (Ruhl, 2023). And heuristics are simply “shortcuts” the brain takes to make processing information easier for itself. In the context of businesses and in workplaces, overconfidence and the anchoring bias are the most commonly seen examples of biases. Overconfidence and Illusion of Control Do you often think that you’re above an average person in your workplace? Do you often believe that you have the control over the result of a situation? If so, you might have fallen into the overconfidence and illusion of control trap, which is often demonstrated at the same time. As Willows, (2020) reviewed: in an experiment conducted by Nassim Nicholas Taleb, “84% of Frenchmen estimate that they are above average lovers”.  Said in its name, overconfidence is the tendency for individuals to be subjectively overconfident in their abilities or their control of situations. And the illusion of control bias is the tendency for individuals to believe that they have an influence on the outcomes of a situation despite that some outcomes were completely due to chance at times. Anchoring Bias Anchoring bias, in simple terms, “first impression” bias. Individuals who experience the anchoring bias have the tendency to rely on the first piece of information they receive when making a decision. The anchor, or the first piece of information influences our perception of other information. This first piece of information does not necessarily have to be correlated to the following piece of information to anchor our thoughts. For example, you could be told to recall the last two digits of your phone number, and this number could unconsciously alter your following judgement regarding numbers ( Pilat & Krastev, 2021). The causes of anchoring bias are still being debated but psychologists believe that it is because people usually rely on existing information, especially the first, instead of processing new information. Overconfidence and Anchoring Bias in Business  Overconfidence Although we experience bias almost everyday of our lives, workplaces and work-related decisions where we believe to be bias-free, are nonetheless affected by bias. Conducting a systematic literature review, Acciarini et al. (2021) categorized and evaluated 52 journal articles that were published between 1984 and 2019 to highlight the effects of biases on strategic decisions, important decisions that had been evaluated in many ways. It was concluded from these articles that decision-makers often face “cognitive limitations”. Managers in businesses and corporations often make decisions based on their objective interpretations on specific events. For example, being overconfident in short-term accomplishments encourages managers to make risky decisions without carefully considering all factors. The truth is, managers tend to implement decisions that correlate with their value and experiences, often ignoring facts that contradict them. Anchoring Bias Bias is not revealed in business owners, it has also been shown in consumers; the anchoring bias is not rare to see in this setting. In public markets, items are often purposely priced for consumers to experience the anchoring bias. For example, if you see a T-shirt that is $1,000 first, then see a second one that is $100, you’re prone to think the second one is cheap—although it’s probably way less than its worth—thus more prone to purchasing it (Vipond, 2023). It is important for buyers to be conscious of their purchases when considering its intrinsic value (true or fundamental value of the item instead of its current market value). How to Avoid Bias? Completely avoiding bias is difficult, most likely even impossible. But there are many ways you can minimize bias in your decisions to help you view situations clearer. Since bias and heuristics are systematic errors and shortcuts in your brain, critical thinking—the ability to analyze with discipline, interpret, and judge with intellect—will be your best way to avoid bias. Recognizing the different factors, views, and even counterarguments to a situation will encourage a more systematic and organized thinking process. Say you’re about to purchase the $100 shirt mentioned in the last paragraph because you believe it is cheap. But before you purchase it, think about this: Is the shirt itself worth this price? Do I really need this shirt? How much does my other shirt cost? Practicing self-awareness and setting realistic expectations will lead to your truest thoughts, ultimately preventing overconsumption of products. Until now, I have only mentioned the bias we have in our decision making. This may not seem like a big deal, for people like me, “typical” students or adults; after all, we’re not million-dollar corporate owners that make million dollar involved decisions. But this is not true, bias is everywhere, it’s in schools and workplaces, and our daily actions. It’s the underlying cause for inequality, prejudice, poor decisions, misunderstandings, and so much more. We must continuously educate ourselves to make our decision not necessarily right, but true. References Amanda D. Angie, Shane Connelly, Ethan P. Waples & Vykinta Kligyte (2011) The influence of discrete emotions on judgement and decision-making: A meta-analytic review, Cognition & Emotion , 25:8, 1393-1422, https://www.tandfonline.com/doi/abs/10.1080/02699931.2010.550751 Chiara Acciarini, Federica Brunetta, Paolo Boccardelli; Cognitive biases and decision-making strategies in times of change: a systematic literature review. Management Decision 4 May 2021; 59 (3): 638–652. https://doi.org/10.1108/MD-07-2019-1006 Corporate Finance Institute. (2023, September 29). Anchoring bias . Corporate Finance Institute. https://corporatefinanceinstitute.com/resources/career-map/sell-side/capital-markets/anchoring-bias/   Hayes, A. (n.d.). What is overconfidence bias? Can it harm your investment returns? . Investopedia. https://www.investopedia.com/overconfidence-bias-7485796   Michael, B., Kellett, S., & Delgadillo, J. (2023).  Is clinical decision making in stepped-care psychological services influenced by heuristics and biases? Behavioural and Cognitive Psychotherapy , 51(4), 362–373. https://www.cambridge.org/core/journals/behavioural-and-cognitive-psychotherapy/article/abs/is-clinical-decision-making-in-steppedcare-psychological-services-influenced-by-heuristics-and-biases/D8C4D09DB2403BD38ED6FD8D5631EFF4 Pilat D., & Sekoul K. (2021). Anchoring Bias.  The Decision Lab. Retrieved August 3, 2025, from https://thedecisionlab.com/biases/anchoring-bias Ruhl, C. (2023, October 24). What is cognitive bias? types & examples . Simply Psychology. https://www.simplypsychology.org/cognitive-bias.html   Willow, G. (2020, November 1). Mirror, Mirror, on the wall, stop telling me I’m wonderful!  Nudging Financial Behavior. https://www.nudgingfinancialbehaviour.com/overconfidence-bias-in-decision-making/#:~:text=overcome%20overconfidence%20bias-,Overconfidence%20bias%20in%20decision%2Dmaking,the%20illusion%20of%20control%20bias

By: Emmanuel Isaías Guízar Bayardo Imagine waking up one day and being able to use technology with your mind. As Kaylee R. Davis (2022) explains, brain-computer interfaces (BCIs) may one day allow people to control their home lighting, respond to messages, and engage with entertainment; simply by thinking.¹ What was once considered a dream for many people of all ages, is now within reach and ready to transform our lives. However, in the accelerated race towards a neurotechnological future, an essential ethical question emerges: who will have access to these technologies, and who will truly benefit from them? Neurotechnology offers the promise of radically improving the quality of human life in ways that seem unreal.² From restoring mobility to people with paralysis to optimizing our cognitive abilities, these tools could redefine what it means to be human, as we will have a crucial tool for human advancement.¹⁻³ But at the same time, if not properly regulated, they could deepen existing social divides, creating a world in which brain enhancements and neurotechnological rights become an exclusive luxury.⁴ This concern is corroborated by Hain et al. (2023) who showed that “Over 80% of high-impact neuroscience publications are produced by only 10 countries” out of the 195 countries.⁵ By prioritizing this, we will be too focused on understanding the functionality of these new technologies, forgetting to understand old issues such as inequality that should be addressed with newer ideas. Let's consider for a moment the recent history of artificial intelligence (AI). Initially seen as a democratization of knowledge by facilitating access to it, it quickly became a tool of great economic benefit for large technology corporations.⁶ This led to significant inequalities in access to advanced knowledge, employment, and, more recently, accurate and unbiased information. AI made it clear that any powerful technology must be accompanied by robust ethical regulation to ensure that its benefits are widely accessible and fair. Just because it is the most striking technological advance does not mean that it should be exempt from ethical considerations and critical thinking by society. This pattern raises an important question, how can we prevent BCIs from following the same path? In Latin America, from a critical point of view, is a region characterized by significant economic, social, and educational inequalities, neurotechnologies risk dramatically increasing these divisions.⁷ While more developed countries are already exploring advanced neurotechnological treatments, in countries such as Mexico, the majority of the population does not even have equitable access to basic mental health services, let alone neurological treatments, which are a privilege in many areas of the country.⁸⁻¹⁰ This reality, which is not unique to the Americas, forces us to question how to ensure that the neurotechnological revolution does not exclude entire populations for discriminatory social reasons. For example, in rural areas of Chiapas, Mexico, mental health services are limited or non-existent. Here, people have to travel between six and nine hours to access specialists, facing barriers such as extreme poverty and a lack of adequate health infrastructure.⁹ Integrating advanced technologies such as BCIs into these contexts will require significant adaptations and a firm political and economic commitment to ensure universal accessibility. The answer could lie in an emerging framework known as neuro-rights.¹¹⁻¹² Continuing with the Latin American theme, Chile was a pioneer in this area, becoming the first country to legislate specifically on the protection of its citizens' neural rights, including mental privacy, personal autonomy, and equal access to technologies that directly affect the brain.¹³ This model, although still in development, presents a concrete way to protect individuals from potential abuse and prevent the creation of a society divided by unequal access to advanced neural technologies. Above all, it provides a framework of security for those who need to be aware that this is an issue that concerns them.¹⁴ The need for global regulation is also crucial.¹⁵⁻¹⁶ The international community must ensure that neurotechnologies are developed with justice and equity as guiding principles. It is not enough to innovate technologically; it is also essential to innovate in terms of ethics, policy, and governance. BCIs should be considered global public goods, technologies capable of benefiting everyone, regardless of their location or status, with a special focus on closing the gaps between developed and developing countries. This implies international cooperation, knowledge and technology transfer, as well as investment in educational and medical infrastructure. Ethics in neurotechnology development must also consider the dignity and autonomy of individuals. How do we ensure that the use of BCIs is voluntary and informed, especially in vulnerable contexts? How do we prevent abuse in the workplace, education, or the military? The possibility of BCIs being used coercively or manipulatively is real and must be anticipated with clear and strict regulations that protect the mental autonomy and cognitive privacy of all individuals.¹⁷ A practical example can be found in the use of BCIs for neuroeducation.¹⁸ While this technology promises to revolutionize the way we learn and process information, there is a risk that only some private schools or universities will have access to it, further widening existing educational gaps. Guaranteeing universal access to these tools is not only an ethical issue, but also a social necessity that would enable progress toward more equitable and inclusive societies. In conclusion, ethical and equitable implementation of BCIs would not only prevent the creation of additional social divides, as seen in Mexico, but could also contribute to reducing existing inequalities like Chile is actively working to do. By improving the quality of life, autonomy, and opportunities of all people regardless of their social, economic, or geographical situation, neurotechnology could become a powerful social equalizer, offering opportunities for social development that were previously unimaginable.  Finally, brain-computer interfaces and the development of neurotechnology pose a shared responsibility. Scientists, governments, and society at large must commit to ensuring that these technological advances do not become sources of profit and inequality, but rather tools for social justice. Ethically regulating neurotechnology is essential so that progress in the 21st century is measured not only in scientific or economic terms, but in how well it improves the lives of all people, without exception. References 1. Davis, K. R. (2022). Brain-Computer Interfaces: The Technology of Our Future. UC Merced Undergraduate Research Journal, 14(1). http://dx.doi.org/10.5070/M414157331 Retrieved from https://escholarship.org/uc/item/85p587nc 2. Hanslmayr, S. (2024). The promises and challenges of neurotechnology to improve human health and cognition. PLOS Biology, 22(10), e3002903. https://doi.org/10.1371/journal.pbio.3002903 3. Rubin, D. B., & Hochberg, L. R. (2023). BrainGate: An Intracortical Brain-Computer Interface for the Restoration of Communication and Functional Independence for People with Paralysis. 2023 11th International Winter Conference on Brain-Computer Interface (BCI), 1–3. https://doi.org/10.1109/bci57258.2023.10078547 4. Bardon, A. (2024). The Ways BCIs can be Abused and The Necessary Preventative Actions. Journal of Student Research, 13(2). https://doi.org/10.47611/jsrhs.v13i2.6341 5. Hain, D. S., Jurowetzki, R., Squicciarini, M., & Xu, L. (2023). Unveiling the neurotechnology landscape: Scientific advancements, innovations and major trends. 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Living Six Hours Away from Mental Health Specialists: Enabling Access to Psychosocial Mental Health Services Through the Implementation of Problem Management Plus Delivered by Community Health Workers in Rural Chiapas, Mexico. Intervention, 19(1), 75. https://doi.org/10.4103/intv.intv_28_20 11. Ligthart, S., Ienca, M., Meynen, G., Molnar-Gabor, F., Andorno, R., Bublitz, C., Catley, P., Claydon, L., Douglas, T., Farahany, N., Fins, J. J., Goering, S., Haselager, P., Jotterand, F., Lavazza, A., McCay, A., Paz, A. W., Rainey, S., Ryberg, J., & Kellmeyer, P. (2023). Minding rights: Mapping ethical and legal foundations of “neurorights.” ArXiv.org . https://arxiv.org/abs/2302.06281 12. Marcello Ienca, & Andorno, R. (2021). Hacia nuevos derechos humanos en la era de la neurociencia y la neurotecnología. Análisis Filosófico, 41(1), 141–185. https://doi.org/10.36446/af.2021.386 13. Gúzman, L. (2022). El Correo de La UNESCO, 2022(1), 13–14. https://doi.org/10.18356/22202315-2022-1-4 14. 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Tate Madison Abstract This research project aims to investigate the differences in optimism among college students by academic discipline. Optimism, hopefulness and confidence about the future or the successful outcome of something (Oxford Dictionary), has been linked to motivation, resilience, overall well-being, and happiness. College students tend to be an optimistic demographic, but this may drastically differ by their field of study. Certain disciplines, such as Humanities & Social Sciences foster different perspectives on future success compared to STEM, where career paths appear more structured or competitive. Fields like Business also vary given that many business majors aim to go straight into the workforce; compared to other fields, where graduate school is more common or even required for their career interests. This study will examine the possible varying levels of life optimism among students in different academic fields. Introduction Optimism plays a crucial role in shaping a student’s motivation, resilience, and overall well-being. In college, optimism levels can significantly influence a students’ academic experiences, career expectations and goals, and long-term success. However, optimism may not be the same across all fields and collegiate groups, and may vary vastly by academic discipline. Different fields of study equip students with different skill sets, present unique challenges and stressors, and have distinct career and further educational requirements , all which impact a students’ outlook on their current life and future. Certain disciplines, such as Humanities & Social Sciences foster different perspectives on future success compared to STEM, where career paths appear more structured or competitive. Fields like Business also vary given that many business majors aim to go straight into the workforce; compared to other fields where graduate school is more common or even required for their career interests. This study seeks to explore how optimism varies among college students based on their academic discipline. Methodology: optimism among college students by academic discipline  Participants: In this study, participants will be college students between the ages of 18 and 25 years old. Participants filled out a Google Forms survey on the differences in optimism among college students based on academic discipline. This survey will be completed anonymously, but will collect some demographics such as age, race, gender identity, etc., which may show differences in the data. This study received survey responses from 33 participants. Materials: This survey was created through Google Forms. This survey consists of three parts. Part one is Demographics , consisting of 7 demographic questions. Part two is Academics , consisting of 11 questions on academic discipline, along with post-grad plans and academic confidence/stress. Part three is measuring participants' optimism, measured by the Revised Life Orientation Test (LOT-R). The survey should take less than 5 minutes for participants to complete. Procedure:  The survey was provided to participants through various means, including an online discussion board and social media sites. The survey will inform participants that it is voluntary and tell them what the study is about. In the survey, participants will first be asked for their consent to participate.  In the first section, participants will be asked various demographic questions. In the second section, participants will be asked questions related to their academics, gathering information on their academic discipline, post-grad plans, and academic confidence/stress. In the third section, participants will complete the Revised Life Orientation Test (LOT-R), which consists of 10 statements being rated from 0-4. Results This survey received 33 responses from undergraduate students. Their ages ranged from 19-22 and roughly 30% being second, third, and fourth years each. The study assessed optimism using the Life Orientation Test-Revised (LOT-R), which produces a total score ranging from 0 to 24, with higher scores indicating greater optimism. The overall mean LOT-R score across all students was 14.70. Arts & Creatives had the highest mean LOT-R of 16, followed by Engineering & Technology and Health & Medical Sciences being tied with a mean score of 15. The lowest academic discipline was Natural & Physical Sciences with 13 and Economics, Politics, Law with 13.67 as their mean scores. Those with psychology as a major or minor, that being 13 of 33 participants, had a mean score of 14.47, slightly under the overall mean. Academic Discipline Mean LOT-R (Overall Mean = 14.70) Humanities & Social Sciences 14.64 Arts & Creatives 16 Natural & Physical Sciences 13 Engineering & Technology 15 Business 14.5 Economics, Politics, Law 13.67 Health & Medical Sciences 15 ** Psychology Major/Minor 14.57 Discussion This study aimed to explore the differences in optimism levels among college students and how this may vary by academic discipline. There is very little prior research addressing this topic of study. These results showed some drastic varying levels of life optimism among the different academic disciplines. Arts & Creatives showed the highest levels of optimism, while Natural & Physical Sciences had the lowest. Most of the fields stayed relatively near the mean, with four of the seven fields being within 0.3 LOT-R score from the mean. The variability could partially be due to varying levels of stress, academic workload and pressure, and future career or higher education goals. Some limitations of this study include the sample size and disparities between different fields of study. Psychology majors/minors contributed to roughly 40% of the participants overall, largely due to my main source of participation being the students in this course— Psychology 2303, which may have skewed the overall mean optimism score. Arts & Creatives, Business, and Natural & Physical Sciences each only had two participants in the field and Economics, Politics, Law and Engineering & Technology both had three participants. This limited sample and the poor representation of each field may have had an impact on their optimism levels. For future studies, I’d recommend looking more into the different majors and being sure to have a proper representation of each. This could be done globally or by zoning in to specific universities and surveying their different respective colleges and comparing. Possible other methodologies for this study consists of qualitative interviews, allowing for more in depth analysis of different optimism among students, or even a longitudinal study, tracking students' optimism levels during their time in university. References Icekson, T., Kaplan, O., & Slobodin, O. (2019). Does optimism predict academic performance? Exploring the moderating roles of conscientiousness and gender. Studies in Higher Education, 45(3), 635–647. https://doi.org/10.1080/03075079.2018.1564257 Icekson, T., & Slobodin, O. (2024). When is optimistic expectation most beneficial? Optimistic expectations, conscientiousness and academic performance in a sample of freshman students. Current Psychology: A Journal for Diverse Perspectives on Diverse Psychological Issues. https://doi-org.proxy.lib.ohio-state.edu/10.1007/s12144-024-07008-y Li, J., Yang, D., & Hu, Z. (2022). Wuhan college students’ self-directed learning and academic performance: Chain-mediating roles of optimism and mental health. Frontiers in Psychology, 12. https://doi-org.proxy.lib.ohio-state.edu/10.3389/fpsyg.2021.757496 Phung, N. (2021). Between Optimism and Academic Performance: Does the Subject Matter? Department of Psychology, St. Thomas University. DOI: 10.13140/RG.2.2.18608.69125 Popa-Velea, O., Pîrvan, I., & Diaconescu, L. V. (2021). The Impact of Self-Efficacy, Optimism, Resilience and Perceived Stress on Academic Performance and Its Subjective Evaluation: A Cross-Sectional Study. International journal of environmental research and public health, 18(17), 8911. https://doi-org.proxy.lib.ohio-state.edu/10.3390/ijerph18178911 Rand K. L. (2009). Hope and optimism: latent structures and influences on grade expectancy and academic performance. Journal of personality, 77(1), 231–260. https://doi-org.proxy.lib.ohio-state.edu/10.1111/j.1467-6494.2008.00544.x Rand, K. L., et al. (2020). Hope and optimism as predictors of academic performance and subjective well-being in college students. Learning and Individual Differences, 81, 101906. https://doi.org/10.1016/j.lindif.2020.101906 Rand, K. L., et al. (2020). Hope and optimism as predictors of academic performance and subjective well-being in college students. Learning and Individual Differences, 81, 101906. https://doi.org/10.1016/j.lindif.2020.101906 Usán, P., Salavera, C., & Quílez-Robres, A. (2022). Self-Efficacy, Optimism, and Academic Performance as Psychoeducational Variables: Mediation Approach in Students. Children (Basel, Switzerland), 9(3), 420. https://doi-org.proxy.lib.ohio-state.edu/10.3390/children9030420 Vizoso, C., Arias-Gundín, O., & Rodríguez, C. (2019). Exploring coping and optimism as predictors of academic burnout and performance among university students. Educational Psychology, 39(6), 768–783. https://doi.org/10.1080/01443410.2018.1545996