neurotaylor

Do you have IDS?

For information about IDS, UK politician Iain Duncan Smith, click here.

For information about IBS, Irritable Bowel Syndrome, click here.

What is IDS?

IDS (Irritating Doggerel Syndrome) is a common and hugely under-diagnosed phenomenon. It afflicts all ages, though it may be more common in older people. The causes of IDS are not well understood and there is currently no treatment. However, recent research has opened up some promising avenues for future therapy (see Treatment, below).

Symptoms

IDS is characterised by obtrusive automatic thoughts in response to the perception of certain words or phrases (‘triggers’). These ‘autoresponses’ are similar to those which occur in depression, but they are not necessarily either self-related or negative in content. They are however often linked to negative emotionality, social anxiety and externalising behaviours, though the latter tend to be context-dependent.

The content of autoresponses typically incorporates cultural references such as lines from songs, advertising slogans, political soundbites or poems. (Note that the term ‘doggerel’ should be interpreted not as a judgement of cultural value, but as a reflection of the persistent, involuntary, and often unwanted nature of the thoughts.)

Example (Patient A, male, 52): “My IDS is weather-related. Whenever there’s a thunderstorm, my head’s full of the chorus from that song Knock on Wood that Amii Stewart sang. “It’s like thunder, lightning, the way you love me is frightening.” I don’t even like the wretched song! Lightning sets me off with Queen’s music for Flash Gordon <Patient sings> “Flash! Ah-ah!” When the sun comes out, it’s, “The sun has got his hat on“. When it rains: “The rain it raineth on the just …”

“The trouble is, once it starts, the whole lot goes through my head, as much as I know of it anyhow. Sometimes I find myself saying the words aloud, which is embarrassing. Especially the second verse of “The sun has got his hat on” – it’s terribly incorrect. Thank God I only know that one line from the Amii Stewart song.”

Example (Patient B, female, 45): “I’ve had IDS for years but never knew what it was. It’s such a relief to know it’s a recognised syndrome, even if they can’t cure it yet. Mine’s triggered by all sorts of things. For birds, I get, “Toity poiple boids, a-sitting on da koib, a-choiping, an’ a-boiping, an’ eating doity woims”. For buses, “What is it that roareth thus? Can it be a motor bus?” It does get in the way, because it’s hard to stop until you’ve said the thing through. And you have to be careful not to say it out loud.”

Example (Patient C, male, 33): “I’ve had severe IDS as long as I can remember. I was exposed to a lot of T.S. Eliot as a child, my dad loved his stuff. Not that Eliot wrote doggerel, but you can get a bit cheesed off with anything if it won’t stop. My friends are used to me suggesting we do things with, “Let us go then, you and I,” but it can be awkward with strangers – I’ve been known to greet random women with, “Lady, three white leopards sat under a juniper-tree!” My worst trigger is April. “April is the cruellest month, breeding lilacs out of the dead land …” The Waste Land>.

Causes

There is little research into IDS, but some studies have suggested that it is associated with education, cultural consumption, and with having wider social and cultural networks. Individual factors linked to IDS include the personality factor ‘Openness to Experience’, working in a language-related profession such as academia, and higher-than-average scores on tests of verbal intelligence and fluency. Some IDS patients are also particularly susceptible to ‘ear-worms’ – catchy tunes – but not all. Exposure to bad poetry, especially in youth and young adulthood, is a well-established risk factor. Parental occupation has also been linked to IDS, with children of writers, teachers and academics particularly at risk.

Mechanisms

It is thought that IDS involves over-activation of the brain’s semantic networks. Neuroimaging studies show activation of parietal and temporal brain areas involved in processing language and emotion. There are two major hypotheses of how IDS develops. Some researchers have suggested that the link between trigger and autoresponse is abnormally strengthened by, for example, concurrent strong emotion (the ‘Single Hit’ hypothesis). Others propose a more gradual formation, with weaker positive reinforcement repeatedly serving to strengthen the link (the ‘Slow Burn’ hypothesis). Most studies agree that positive, rather than negative, reinforcement is more likely to be involved in IDS.

Treatment

There is no current treatment for IDS. Studies are underway into whether methods developed to treat post-traumatic stress disorder may be effective. These involve altering intrusive memories, either with drugs, repetitive brain stimulation, or – as a last resort – deep brain stimulation. Anecdotally, some patients have found hypnosis helpful.

In the 1960s it was thought that IDS could be treated with aversion therapy: associating the trigger word with an alternative, highly unpleasant experience such as electric shock. However, this line of research was discontinued, on ethical grounds after some patients suffered serious side-effects, such as anxiety and psychosis.

In short, insufficient evidence currently exists to recommend any of these treatments.

Guidelines

Much clinical attention has therefore focused on prevention, rather than cure. Current guidelines for IDS patients, and for parents wishing to reduce the risk of IDS in their children, are as follows:

• Parents should refrain from teaching their children poetry, or rewarding them if they recite it. Access to poetry books should be restricted. In many households this will already be the case, but Internet access should also be monitored.
• Access to pre-2000 popular music should be restricted. (Much of the more recent music in this genre is entirely concerned with dance and rhythm, so the words tend to be inaudible or unmemorable, posing less of a risk for IDS.)
• Listening to classical music should be encouraged, as any words are often foreign, or complicated, and are thus less easily remembered.
• Media channels which carry advertising should be avoided. Any temporary discomfort will be offset by the increase in viewing quality.
• People with severe IDS should be quarantined where possible, as the condition can be highly contagious.
• If avoidance is not possible, at least try not to smile when someone with IDS says something bizarre. It only makes them worse.