Works in Progress

By Joe Sugarman

silhouette photo of man distressed in deep thought

A glimpse at ongoing faculty research

Mental Illness in Japan

silhouette photo of man distressed in deep thoughtThe concept of mental illness, the idea that something could be biologically wrong with the brain, was slow to catch on in Japan. Up until the mid-20th century, many still believed that people who exhibited “madness” were suffering from an imbalance of “ki,” or life energy, or were possibly possessed by an animal spirit. Villagers dealt with troubled relatives by locking them up in cages or hiring a faith healer to exorcise the offending spirit, says Hayang “Yumi” Kim, an assistant professor in the Department of History.

“In so many ways Japan was a really modern place,” she says. “It was quickly industrialized and it adopted democratic principles, but psychiatry never had that much influence.”

Kim, who arrived at the Krieger School in 2015, is completing a book about the evolution of psychiatry in Japan and how people’s understanding of mental illness, what’s known as seishinbyō in Japanese, eventually penetrated the culture.

Kim says the seeds for the book, which began as an outgrowth of her dissertation, were planted when she spent 15 months in Japan as a doctoral student. Sorting through archives, she came across detailed interviews done by early 20th-century psychiatrists with patients who claimed to have been possessed by animal spirits, often foxes. She also found a trove of photographs from the same era depicting people held in cages within their homes. “They’re really disturbing and gripping because you can’t believe people did it,” she says. “But they made me think, ‘What would compel people to do this?’”

Kim discovered that families, particularly those in isolated villages, had few alternatives when dealing with a potentially violent relative. “If a mentally ill family member committed a crime, the entire family could face criminal charges. You needed to protect your family,” says Kim. “Villagers in the countryside couldn’t—or wouldn’t—go to the [newly built] mental hospitals in big cities like Tokyo.”

Kim says that it wasn’t so much the influence of modern medicine that eventually helped people accept the biological underpinnings of seishinbyō, but “others who grabbed onto this new concept to use it for their own purposes,” she says, like the journalists who wrote about it to sell newspapers, lawyers who used it as a legal defense, or even feminists who used it to explain a series of crimes committed by women in the 1920s.

Still, Kim says even today mental illness is not as accepted in Japan as it is in Western countries. “Only in the past 25 years have people actively sought out help for mental illnesses,” says Kim, who notes that “home confinement” wasn’t banned in Japan until the 1950s. “There remains a huge stigma.”

—Joe Sugarman

Diabetes Detectives

big-ideas-diabetes-1For years, Rejji Kuruvilla, an associate professor in the Department of Biology, has studied the development of the peripheral nervous system and a family of proteins called neurotrophins—of which nerve growth factor (NGF) is the “founding member”—that helps nerve cells grow, navigate, and survive. But her latest research has her looking at connections in an unexpected part of the body: the pancreas.

As it turns out, much of what she and her team have learned over the years about NGF within the nervous system applies to her new research on pancreatic beta cells, the unique cells responsible for producing and releasing insulin into the bloodstream. And her findings could have implications in further understanding how cells function—or malfunction—in people with diabetes.

“For decades it’s been known that neurons and pancreatic beta cells bear a lot of similarities in terms of molecular properties,” says Kuruvilla. “Now, we’re showing they both have this signaling pathway (NGF) that’s shared. And what we have shown in mice is this pathway is absolutely essential to regulating insulin secretion in response to glucose.”

Pancreatic beta cells have a rigid skeletal structure, which normally loosens when glucose is elevated, allowing insulin granules to be released into the bloodstream. For the first time, Kuruvilla and her graduate student, Jessica Houtz, have shown that NGF plays an important role in instructing the skeletal barrier to loosen up.

“I think the excitement for us is taking a pathway that we’ve studied for a long time in neurons and showing that it is physiologically important in insulin secretion,” she says. “What it also suggests is a possible therapeutic potential if we can discover how to use this pathway to help in metabolic disorders. If we can manipulate this pathway, maybe we can improve insulin secretion.”

Kuruvilla says her research on the subject is only just beginning and the role NGF plays on beta cells in people with diabetes remains unclear. “We don’t know if or how this pathway might be affected in the diabetic state or if deficiencies might be early indicators in people with diabetes, but that is certainly something we’d like to find out.”

—Joe Sugarman

A glimpse at ongoing faculty research

teacher at blackboard with class of students with their hands raised to answer a questionWhen evaluating the same black student, white teachers expect significantly less academic success than do black teachers, according to Nicholas Papageorge, an assistant professor in the Department of Economics.

He and his co-authors found that when a black teacher and a white teacher evaluate the same black student, the white teacher is about 30 percent less likely to predict that the student will complete a four-year college degree. White teachers are also almost 40 percent less likely to expect their black students to graduate high school.

In a further study, Papageorge (along with two co-authors, including a Hopkins graduate student) found that these low expectations matter because they affect whether or not a student completes college.

“Teacher expectations matter,” he says. “They have causal impacts on the probability that students complete a four-year college degree. The low expectations of some teachers are not merely accurate forecasts of student potential. In some cases, they become self-fulfilling prophecies.”

He also found that, while all teachers are optimistic about students’ ability to complete college, the degree of optimism is significantly larger for white students than for black students, especially when black students are evaluated by white teachers.

The study went on to explore two hotly debated policy proposals to help narrow racial achievement gaps: hiring more black teachers or training white teachers to have fewer biases. The study shows that both policies can play a role in raising college completion among black students.

Papageorge and his colleagues analyzed data from the Educational Longitudinal Study of 2002, an ongoing study following 8,400 10th-grade public school students.

Papageorge says the work uncovers issues that are relevant to policy-making, which he plans to continue to address in future studies.

—Jill Rosen