I can’t tell you how much work this whole thing has been!
Note to anyone hiring postdocs or profs: I identify as a cognitive scientist, not a psychologist. The University of Texas is notating transcripts to reflect their approval of my completion of a program of work via the Ad-Hoc Interdisciplinary PhD, and labeling it as Medical Cognitive Science.
The title is “”Modeling the clinical predictivity of palpitation symptom reports: mapping body cognition onto cardiac and neurophysiological measurements.”
This dissertation models the relationship between symptoms of heart rhythm
fluctuations and cardiac measurements in order to better identify the probabilities of
either a primarily organic or psychosomatic cause, and to better understand cognition of
the internal body. The medical system needs to distinguish patients with actual cardiac
problems from those who are misperceiving benign heart rhythms due to psychosomatic
conditions. Cognitive neuroscience needs models showing how the brain processes
sensations of palpitations. Psychologists and philosophers want data and analyses that
address longstanding controversies about the validity of introspective methods. I
therefore undertake a series of measurements to model how well patient descriptions of
heartbeat fluctuations correspond to cardiac arrhythmias.
First, I employ a formula for Bayesian inference and an initial probability for disease.
The presence of particular phrases in symptom reports is shown to modify the probability
that a patient has a clinically significant heart rhythm disorder. A second measure of body knowledge accuracy uses a corpus of one hundred symptom reports to estimate the
positive predictive value for arrhythmias contained in language about palpitations. This
produces a metric representing average predictivity for cardiac arrhythmias in a
population. A third effort investigates the percentage of patients with palpitations report
actually diagnosed with arrhythmias by examining data from a series of studies.
The major finding suggests that phenomenological reports about heartbeats are as or
are more predictive of clinically significant arrhythmias than non-introspection-based
data sources. This calculation can help clinicians who must diagnose an organic or
psychosomatic etiology. Secondly, examining a corpus of reports for how well they
predict the presence of cardiac rhythm disorders yielded a mean positive predictive value
of 0.491. Thirdly, I reviewed studies of palpitations reporters, half of which showed
between 15% and 26% of patients had significant or serious arrhythmias. In addition,
evidence is presented that psychosomatic-based palpitation reports are likely due to
cognitive filtering and processing of cardiac afferents by brainstem, thalamic, and cortical
neurons. A framework is proposed to model these results, integrating neurophysiological,
cognitive, and clinical levels of explanation. Strategies for developing therapies for
patients suffering from identifiably psychosomatic-based palpitations are outlined.
I don’t think anyone is a psychologist any more. We’re all cognitive scientists or neuroscientists nowadays
For me, when I heard about cog sci as an undergrad, it seemed very exciting in a way that psychology never has. Maybe because psych seemed so far from the perennial philosophical questions about the nature of the mind.
I notice by the way that the few schools that have cognitive science departments are elite institutions. I wonder why more don’t follow their example?