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Brains, Black Holes, and Beyond (B Cubed) is a collaborative project between The Daily Princetonian and Princeton Insights. The show releases 3 episodes monthly: one longer episode as part of the Insights partnership, and two shorter episodes independently created by the 'Prince.' This show is produced by Senna Aldoubosh '25 under the 147th Board of the 'Prince.' Insights producers are Crystal Lee, Addie Minerva, and Thiago Tarraf Varella. This show is a reimagined version of the show formerly produced as Princeton Insights: The Highlights under the 145th Board of the 'Prince.'
Please direct pitches and questions to podcast@dailyprincetonian.com, and any corrections to corrections@dailyprincetonian.com.
Aanya Kasera: Hi everyone! Welcome to Brains, Black Holes and Beyond, a collaboration podcast between Princeton Insights newsletter and The Daily Princetonian. From the Prince, my name is Aanya. How do computational processes help us understand mental health disorders and precisely tailor treatments to each individual? Today’s episode focuses on computational psychiatry and its relationship to our understanding of mental illness, which is an exciting new research direction at Princeton in a joint project with Rutgers University through the Rutgers-Princeton Center for Computational Cognitive Neuropsychiatry. Our guest for today’s episode is Dr. Niv, a professor of psychology and neuroscience who received her Ph.D. from the Hebrew University of Jerusalem in 2008. Her research explores the computational processes underlying learning and decision making and their relationship to mental health.
Dr. Niv has actually been on the podcast before, explaining the semi-secret tunnel networks of Princeton. The link to that episode will be in the show notes. Welcome back to the show, Dr. Niv!
Dr. Yael Niv: Hi. Good to be here again, Aanya.
AK: So to start off, could you talk more about the specific topics your research focuses on? What exactly is computational psychiatry, and how does it relate to mental health?
YN: Sure. So, if we think about different kinds of medicine, and many, well, in every kind of medicine, except for psychiatry, we have what’s called medical tests, right? You come to a doctor and you say, well, I have a fever and I’m coughing and maybe some other symptoms, and the doctor is going to perhaps send you to a test, maybe a blood test, maybe count your white blood cells to see if you have an infection or to decide how to treat you. In psychiatry, we have nothing of that sort. So someone will come to a psychiatrist and say, “I’m suffering from low mood and fatigue and I’m not eating well,” and that’s the end of it. There is no test in order to decide what is the underlying problem and how do we treat it? We have treatments, but we don’t have any precise way to figure out what is the right treatment for the right person. And so here comes computational psychiatry. The idea in computational psychiatry is that in the last, maybe 25 years, we’ve made a lot of advances in understanding really important processes in the brain, processes that deal with reward, with learning, with attention, with memory, with cognitive control. These are exactly the processes that go wrong in mental health conditions, and we understand them not only in terms of what brain area is doing what but really what computation is happening in the brain. And that helps us be able to quantify — kind of like in a blood test, like counting white blood cells — we can measure somebody’s learning grade, for instance. We can measure whether they learn more readily, whether they pay attention. And we can measure something like learning grade, whether someone pays attention and learns more readily from negative surprises — something bad happening — or positive surprises — something good happening. And you might already think, well, this might be related to anxiety. For instance, maybe someone who learns a lot from negative events and discounts positive events would develop anxiety. So the idea in this area of research is to develop behavioral measures, behavioral tasks, and computational models that can quantify these different cognitive processes and maybe help us understand both why the person has the mental health condition that they have and what treatment would help them best.
AK: All right, wow, that sounds really interesting. And I was wondering if you could expand on any specific research projects that you have been working on and any interesting discoveries that you have found through this research?
YN: Well, I can tell you about our most recent project because I’m so excited about it, but I should say we finished collecting the data, literally today. Well, actually not finished collecting, we finished recruiting. So this is a really large study. We recruited about 1,400 subjects online. We are looking for people — well we looked until today — for people who suffer from symptoms of depression, and we have them do five different tasks that we develop that measure all kinds of aspects of their learning abilities, their learning tendencies — not so much abilities, and also the potential reasons underlying their depression. And then we have them undergo treatment for their depression through an online self-help tool. So they do six weeks of treatment, all online — this whole experiment is online. And then in the end, we find out whether the treatment helped or not, and then we follow up for a whole year to see whether their symptoms have remained low or have returned. And what we’re trying to do is, with our task, we’re trying to predict who will get better from this treatment, and we’re also dividing people into two types of treatments, so we’re trying to see whether we can predict which treatment would be better for whom. And the idea here is that when people come to get treatment for their condition, if we give them the wrong treatment to start with, not only is that a problem because it won’t help and it will waste their time, that it will waste the doctor’s time or the psychotherapist’s time, and they won’t get better in that time and we know that the longer people are ill, the harder it is for them to get better. But there’s another cost to that. If someone comes to treatment and the first thing that you give them does not work well for them, they might never come back. They might not come back for psychotherapy for 10 years. So, we’re really interested in finding out what is the best treatment that we can give a person when they come in the door, so that we can keep them in treatment, even though you can’t solve these conditions with one session or a very short treatment time. If we give them something that is helpful at the very start, then they’ll stay the course of the treatment. And so that’s what we’re trying to do here. We’re trying to figure out whether our tasks and our computational models can predict which type of cognitive behavioral therapy treatment is going to help which patient.
AK: Yeah, that sounds really interesting, and I’m really happy to see how much of an impact it has had. I just wanted to switch gears a little bit to our own campus on Princeton. Since mental health is a very important topic on our campus and beyond, how is your research relevant to students’ everyday experiences with their mental well-being? Do you have any advice for students regarding their mental well-being that is informed by your research findings?
YN: Yeah. You know, Aanya, when we’re recruiting people online, we find that people out there have a lot of symptoms, a lot of anxiety, a lot of depression. This is a — these are tough times to be living through — and we know that that's also true on campus, that being in college is a stressor. It exacerbates other problems that were maybe there to start with, or it can create problems on its own, and many students on campus have symptoms of mental health. And what I can say is, you know, we’re trying to find out what’s the best treatment for whom, but that is contingent on people coming to get treatment to start with. The biggest barrier these days for people getting better from their mental health conditions is that they don’t seek treatment. So it’s true that our treatments don’t help a hundred percent of people, but they help many, many people. The problem is most people don’t ever come to seek help. And so, I think my advice would be, seek help. We have CPS on campus, but there are also these online tools that can help if you feel that you don’t want to talk to someone in person. In general, we have a study, that I didn’t talk about, a separate study on mental health on campus, and many students reported that although they have mental health symptoms, they don’t go to seek help, maybe because they think their condition is not bad enough. They hear of lots of friends and colleagues that have similar symptoms, so they think maybe this is normal. It’s not necessarily normal. The fact that 40 percent of people on campus have symptoms of anxiety or depression doesn’t mean that those 40 percent of people do not need to get treatment. So I would suggest to people to really seek treatment, seek help. And it doesn’t always work in the very beginning. You have to find a therapist that you connect with. And I would say, you know, to the extent that you can, shop around — if it doesn’t work on the first person, don’t despair from the whole idea that things will get better. Find someone else. Find another type of treatment. There are many types of treatment. But do get help, because, you know, if someone would, I don’t know, break their leg, they wouldn’t think, “oh well, I’ll just walk. It’ll be fine. It’ll get better on its own.” No, I’ll go to the doctor and I’ll get the cast, and I’ll do what it needs, and, you know, I’ll take I’ll rest for a while. I’ll let my leg rest, and my bone will heal. It’s really the same thing with mental health. It feels like it’s all in our brain, and I can just fix it myself. But there’s a lot of expertise out there that can help people get better, and it’s not obvious. I mean, sometimes when you go to therapy — and I’ve been to therapy myself multiple times in life — when you go to therapy, your therapist will tell you something, and you’ll be like, “oh my god, how did I not think about that myself?” But the fact is, I didn’t, and now that they told me, it’s so obvious, and it helps me with so many things in my life that I can’t believe I could have just given up on having that knowledge, and that knowledge comes from someone who is an expert, who has seen not one person like me. You know, I’m unique to myself. They’ve seen hundreds of cases. So they can give advice, and they can really, really help with symptoms of mental health. So that’s my little pitch.
AK: Yes, I agree. I think that the difference between mental and physical health is really interesting to understand. And also, just a follow up question regarding your thoughts on this issue, I was just wondering, you mentioned that it is sometimes a barrier for students to get help because they don’t know whether their symptoms are bad enough. So I was just wondering how do you think that a student can know when to get help and when their symptoms require further treatment?
YN: It’s a good question, and it’s a hard one. I’ve had, recently, a doctor asked me, “Do you have low mood?” And I was like, “Well, you know, some terrible things have happened in my country, for instance, a long war. So yeah, I have low mood.” But is that a mental health problem, or is that just a normative response to what is happening in the world? So it’s hard to know. I would say if you feel that something is lasting longer than it should, so you know, maybe exam period is a period of anxiety. That is normal. But if your anxiety is not going away, if your symptoms of depression are stronger than you expect them to be, and you feel like you’re not pulling out of it, go get help. Worst case, you didn’t waste anybody’s time. Worst case, it’s an easy case, and in a week or two, you’re, you know, back to yourself, but that’s best case scenario, actually. It’s not a worst case scenario. So I don’t think you should be thinking, “am I wasting someone else’s time?” “Is there time better used for someone else?” There are enough resources on campus, and if you feel that maybe external advice can help, then go get help. And I’ll say one more thing. I feel that going to therapy in some sense, is going to learn about myself. And we are all here on a campus. We’re here because we like to learn. We are the people who chose to be somewhere where we learn and where we get to know things and other people. And the first time I went to psychotherapy myself, it was based on my Ph.D. advisor then, who said to me, “you know, you’re so friendly, and you really like to get to know other people. Wouldn’t you like to get to know yourself as well?” And I thought, “Oh my god, yeah. How am I not curious about myself the same way that I’m curious about other people?” So I think the bar could be very low. You can go to psychotherapy just to get to know yourself and your patterns and regain some of the control. So what we find in many mental health conditions is that people have automatic behavioral responses or thought patterns or emotional responses that they’re basically locked into. So something happens, and your response comes automatically, and you basically, you don’t know, but you don’t really have free will at that point, because something is compelling you to act or think or have an emotional response in a specific way and not another. And if those responses are not good for you, what psychotherapy will help you do is regain that control, regain that free will where you can say, “Okay, this thing happened. I don’t have to respond in my automatic way. I have choices. I can still decide to respond the way I did previously, if that is what I think is the best thing to do now, but I have other options.” So psychotherapy really, by getting to know ourselves, we regain control and we gain flexibility and options for different response patterns. So I basically think, I guess it’s pretty obvious from what I’m saying, I basically think psychotherapy is good for everybody.
AK: Yes, I completely agree. I think that mental health and psychotherapy are both very important and that there’s not really any downsides to getting help when you need it, so that if someone needs help, there’s no harm in going and getting a psychotherapy treatment to improve mental health. And just moving back to your research, I was just wondering what direction you see your research moving towards in the future, and are there any specific goals that you are working towards?
YN: Yeah, well, so this whole research area is pretty new for me. I mean, okay, the timelines are maybe different for different people, but about seven years ago, I wasn’t doing anything related to mental health, and my training and the initial kind of research in my lab was not at all related to mental health. So this is all new to me and very exciting. I spent two years training in cognitive behavioral therapy and actually treating people, so I feel really lucky that I was able to do that, and now I can incorporate it into my research. So I’m staying in this subfield for a while. I told you about our ongoing project with looking at symptoms of depression. One of our new projects that I’m really excited about is doing a similar thing for anxiety symptoms, but there, we’re looking not only at who would get better from treatment, but really who would experience relapse in the future. So, half of the people who get better after treatment, after cognitive behavioral therapy treatment for anxiety, within several months, they’ll have relapse of their anxiety symptoms. And we have some really exciting ideas about how to measure in advance, before therapy even starts, if someone is at risk for relapse. And that is useful to do, because there are treatments that have specialized components that, from the start, are aimed at preventing relapse. So if we know who to give that treatment to from the start, hopefully we can give people more long-lasting health.
AK: Yeah, that sounds really exciting, and I’m really looking forward to how this research looks in the future. And thank you so much for taking the time today to talk about your work in computational psychiatry. It was great to hear about your exciting new research efforts, and I can’t wait to see how it continues to go in the future.
YN: Thank you so much.
AK: This episode of B cubed was hosted and sound engineered by me and Senna Aldoubosh and produced under the 148th Managing Board of the ‘Prince.’ To learn more about Dr. Niv’s research, visit the links in the description below. From the ‘Prince,’ my name is Aanya Kasera. Have a lovely rest of your day.