NLM Announces public release of papers of John b. Calhoun, NIH researcher noted social crowding and aggression

The history of Medicine Division, national library of Medicine (NLM) announces the public release of documents from John b. Calhoun (1917-1995), a researcher of behavioral sciences noted at the National Institute of Mental Health (NIMH), a component of the National Institutes of Health. From the 1950s through the 1980s, Dr. Calhoun has studied the behavior of mice and rats in conditions of extreme overcrowding. He, along with other social scientists, politicians and pundits, readily extrapolated his work to comment on Human crowding in urban environments, just as the country was undergoing a massive redevelopment of its urban structures. His conclusions have found a ready audience among those who saw the world's overpopulation as not only a problem of resources, but of social cohesion.

In a statement, Calhoun's work with rats inspired 1971 children's book, Mrs. Frisby and the rats of NIMH by Robert c. O'Brien, which was adapted into an animated film of 1982, the secret of NIMH.

John b. Calhoun was born in Elkton, Tennessee, in 1917. After his undergraduate education at the University of Virginia (B.A., 1939) and postgraduate work in zoology from Northwestern University (PhD, 1943), post-graduate work and Professor at Emory University, Ohio State University and the Johns Hopkins University School of hygiene and public health, studying sociology and ecology of Norway rats. After further work at the Jackson Memorial Laboratory, Bar Harbor, Maine and the army Graduate School at Walter Reed Army Medical Center, in 1954 he joined the section on perception in psychology laboratory at NIMH. He spent the rest of his career.

Study rats in conditions of overcrowding, Calhoun observed what he termed the "behavioural sink". This aberrant behavior as indicated hyperaggression, inability to reproduce normally, infant cannibalism, increased mortality and aberrant sexual models in such situations of overcrowding. His general conclusion was that "the space itself is a necessity". In the 1960s, his research switched in the field of evolution and behavior, which informs the current field of evolutionary psychology. In 1963 he formed and was the first Director of the NIMH for behavioral systems research (URBS) in the laboratory of brain evolution and behavior (LBEB). There he observed the effects of crowding on a community of mice that have been permitted to overpopulate, seeing a complete end to play, with the entire population died. Calhoun coined the term "Autism" to describe the behavior of the Group at that point finale, how I became incapable of social interaction is essential for survival. In the mid-1970s, his research moved to turn to cultural ways that rats acquired to counteract the effects of overcrowding.

Calhoun retired from NIMH in 1984, but continued to work on his research results until his death on September 7, 1995.

The collection, "MS C 586," comprises 196 linear metres of records mostly material from 1954 to 1986. It was donated in 1997, as a gift from Edith Calhoun, his widow. In addition to laboratory notebooks and drafts of articles, the collection is particularly noteworthy for the film, video cassettes and spools audiocassettes that Dr. Calhoun used to document his experiments.

Calhoun cards form one of the collections of research described almost 600 of modern manuscripts of the library program. I am one of a vast number of human development and behavioral sciences; others include the papers of Bertram Brown, Wayne Dennis, Lawrence k. Frank, Paul MacLean, Lois Meek, Lois b. Murphy and Herbert Rowell Stolz, as well as the records of the Society for Research in Child Development and Child Guidance Clinic and child psychiatry movement interview collection.

Calhoun materials can be found in the history of Medicine Division reading room, National Library of Medicine, open Monday to Friday, from 17: 8:30 to 0, except for Federal holidays on the first floor of the building on 38 NIH campus, Bethesda, Maryland. No appointment is necessary. Finding aid for the collection can be found at http://oculus.nlm.nih.gov/cgi/f/findaid/findaid-idx?c=nlmfindaid;idno=calhoun586.

The National Library of Medicine, the largest medical library in the world, is a component of the National Institutes of Health.

Dr. John b. Calhoun points to two injured mice tail on her arm from Universe 17, 102. November 1969.

A view of the universe mouse 33, showing four group cells 01 week 162 of an experiment, study possibly 133. C. 1975.

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Analysis of two Annals papers on benefits of mammography in younger women

Results of two studies published in the Annals of Internal Medicine point to benefits of biennial mammography screening starting age 40 for women at increased risk.

One evaluated data from 66 published articles and from the Breast Cancer Surveillance Consortium.  The authors’ conclusion:

The second study tried to assess “tipping the balance of benefits and harms to favor screening mammography starting at age 40.”  The lead author concluded:

“The evidence suggests that for women at twice the average risk for breast cancer, biennial screening beginning at age 40 has more benefits than harms,” said study lead author Nicolien T. van Ravesteyn, MSc, of the Department of Public Health, Erasmus MC, Rotterdam, The Netherlands. “These results provide important information toward developing more individualized, risk-based screening guidelines.”

Dr. Otis Brawley, chief medical and scientific officer of the American Cancer Society, wrote an accompanying editorial.  Excerpts:

“I worry that the public perceives mammography as a better technology than it actually is. Mammography screening is often promoted for its benefit. Unfortunately, many do not appreciate its limitations. Truth be told, it cannot avert all or even most breast cancer deaths. There are also tradeoffs. Mammography, like every screening test, has a potential for harm, and one must carefully weigh the harm–benefit ratio for a specific woman or a specific population of women (such as those aged 40 to 49 years) before advising use of the test. The harms associated with mammographic screening include false-positive results, false-positive biopsy results, radiation exposure, false-negative results and false reassurance, pain related to the procedure, overdiagnosis (that is, diagnosis of tumors that are of no threat), and overtreatment. False-positive results are the most common and easily quantifiable harm. On the basis of statistics specific to U.S. practice patterns, about half of women getting an annual mammogram for 10 years starting at age 40 years will have at least 1 false-positive result that requires additional testing. More than 5% will get a biopsy during that time.

…These studies also demonstrate that questions about annual versus biennial screening are legitimate but unsettled. The Cancer Intervention and Surveillance Modeling Network consistently shows that annual screening of women in their 40s marginally increases the number of lives saved while substantially increasing harms. This means that patients and their physicians need to make value judgments regarding the harms and benefits.
In the future, more emphasis will be placed on riskbased screening guidelines tailored to the individual. There may be recommendations that some women at very high risk get annual testing, some at intermediate risk get biennial testing, and some at normal risk start screening at a later age. This will be challenging because many health care providers and members of the lay community do not understand screening and the concept of risk. Specific tools designed to educate them need to be developed and rigorously assessed. Ultimately, the preferences of individual women, recognizing the potential for harm and benefit, should be respected.”

For more perspective, I asked Russell Harris, MD, MPH of the University of North Carolina, to analyze the new studies.  He wrote:

“These are well-conducted studies that try to move us toward more efficient screening for breast cancer.  Certainly we are all in favor of that.  At present, our screening is based on the fact that the risk of breast cancer and breast cancer mortality increases with age; thus, we base starting screening on age.  This is the famous “start at age 40 vs start at age 50” debate we have been having for many years.  These investigators suggest that perhaps there are risk factors beyond age that could allow us to better target the women who could benefit from screening.  It is a good idea.

Unfortunately, the first paper (Nelson et al) shows that we just don’t know enough about the factors that increase or decrease the risk of breast cancer to be able to use this proposed strategy.  This causes the second paper (van Ravesteyn) to make some statements that may be misunderstood and confusing.

Nelson (the first paper) systematically reviews studies of the risk of breast cancer, finding that, other than age, extremely dense breasts on mammogram and presence of first-degree family history of breast cancer are the most important risk factors.  It is important to know that dense breasts on mammography may well reduce the ability of mammography to detect breast cancer, and that very few women will have 2 or more first degree relatives who have been diagnosed with breast cancer (which is the group that has a really substantial increased risk).  The problem is that neither of these factors increase risk more than about two-fold.  These factors would be much more useful if they increased risk by 15 or 20-fold.

Van Ravesteyn et al (the second paper) then use their models to find that if we could identify women in their 40s whose risk is more than 3 times usual risk, then the number of lives extended by screening those women in their 40s would be about the same as the number in their 50s whose lives are extended by screening.  (In neither case is this a large number of women.)  Unfortunately, they do not adequately address the issue of the harms of screening, especially including overdiagnosis, a problem that many people far underestimate. Because the models do not adequately address harms, and because we don’t know how much benefit there would be (if any) from screening women in their 40s with dense breasts, and because there are so few women in their 40s with 2 or more first degree relatives, this strategy really doesn’t get us very far toward making screening more efficient.  The best strategy is still what the USPSTF recommended: individual discussions between patient and medical team to develop an individual approach.

Some people who have wanted to start screening mammography at age 40 will read these papers and find a justification for starting early.  A better interpretation of these studies is that we still need better risk tools that help us become more efficient with breast cancer screening – and this means not only finding women whose risk is high enough that screening makes good sense AND also finding women in their 50s and 60s whose risk is low enough that screening doesn’t make sense.  Then we can truly say we are more efficient – screening women more likely to benefit and NOT screening women more likely to be harmed.”

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