Dentistry

People serving prison sentences have a lower than average ability to read facial expressions or guess what others are thinking and feeling, a survey of Scottish prisoners has found.

Dr Louise Robinson, of the Royal Edinburgh Hospital, told the International Congress of the Royal College of Psychiatrists that new research has shown that significantly more prison inmates were deficient in social cognition skills compared to a control group of non-prisoners.

She told delegates: “We have shown that people who are sent to prison find it difficult to make judgements as to whether someone is angry or not.”

Researchers handed a questionnaire measuring social cognition to 6,700 prisoners in all 12 Scottish jails – with a follow up screening of 2457 prisoners. Dr Robinson said: “We don’t know whether this deficit is something people are born with or, as is more likely, is the result of a range of problems that we found that prisoners suffered – such as having a difficult childhood, drug problems and blows to the head’.

The study also revealed showed that autism was no more common in prison populations than in non-prison populations.

References:

International Congress of the Royal College of Psychiatrists, Edinburgh, 21-24 June 2010.

Source:
Royal College of Psychiatrists

A fascinating new study combines snakes with brain imaging in order to uncover neural mechanisms associated with “courage.” The research, published by Cell Press in the June 24 issue of the journal Neuron, provides fascinating insight into what happens in the brain when an individual voluntarily performs an action opposite to that promoted by ongoing fear and may even lead to new treatment strategies for those who exhibit a failure to overcome their fear.

Although there is a substantial body of research examining brain mechanisms associated with fear, far less is known about the brain mechanisms associated with courage, defined here as action in the face of ongoing fear. “By gauging properly defined actions of either overcoming fear or succumbing to it in an acute controllable fearful situation, one can render certain neural substrates of courage amenable to investigation in a brain research laboratory setting,” explains senior study author, Dr. Yadin Dudai from the Weizmann Institute of Science in Rehovot, Israel.

To study the neural mechanisms associated with moments of real-life courage, Dr. Dudai, Uri Nili, and their colleagues devised an experimental paradigm where participants had to choose whether to advance an object closer or farther away from them while their brain was scanned with functional magnetic resonance imaging (fMRI). The objects used in the study were either a toy bear or a live corn snake. Prior to the study, participants were categorized as “fearful” or “fearless” depending on how they responded to a validated snake-fear questionnaire.

As might be expected, the researchers observed that both high subjective fear and high somatic arousal were associated with succumbing to fear and moving the snake farther away. However, somewhat surprisingly, bringing the snake closer was associated with either high somatic arousal (assessed by skin conductance response) accompanied by low subjective fear (assessed by fear self-ratings) or high subjective fear accompanied by low somatic arousal.

Brain imaging during the task revealed that activity in a brain region called the subgenual anterior cingulate cortex (sgACC) correlated positively with the level of subjective fear when choosing to act courageously but not when choosing to succumb to fear. Further, activity in a series of temporal lobe structures was decreased when the level of fear increased and the individual chose to overcome their fear.

“Our results propose an account for brain processes and mechanisms supporting an intriguing aspect of human behavior, the ability to carry out a voluntary action opposite to that promoted by ongoing fear, namely courage,” concludes Dr. Dudai. “Specifically, our findings delineate the importance of maintaining high sgACC activity in successful efforts to overcome ongoing fear and point to the possibility of manipulating sgACC activity in therapeutic intervention in disorders involving a failure to overcome fear.”

The researchers include Uri Nili, Weizmann Institute of Science, Rehovot, Israel; Hagar Goldberg, Weizmann Institute of Science, Rehovot, Israel; Abraham Weizman, Tel-Aviv University, Petah Tikva, Israel, Geha Mental Health Center, Petah Tikva, Israel; and Yadin Dudai, Weizmann Institute of Science, Rehovot, Israel.

Source: Cell Press

The Human Fertilisation and Embryology Authority (HFEA) approved the principle of human-animal embryos being used for medical research.

The BMA welcomes the decision: Dr Tony Calland, chairman of the BMA Medical Ethics Committee, says:

“This kind of research could lead to major breakthroughs in treatments for Alzheimer’s, Parkinson’s and other serious diseases.

“We understand people’s initial resistance to the idea of hybrid embryos, but there would be very strict controls on the way they are used. The law already prevents such embryos being implanted in a woman, and they must be destroyed within 14 days. Individual research projects are highly regulated.”

bma

“Half the money I spend on advertising is wasted; the trouble is I don’t know which half.” – John Wanamaker, 19th-century U.S. department store pioneer

In a study with implications for the advertising industry and public health organizations, UCLA neuroscientists have shown they can use brain scanning to predict whether people will use sunscreen during a one-week period even better than the people themselves can.

“There is a very long history within psychology of people not being very good judges of what they will actually do in a future situation,” said the study’s senior author, Matthew Lieberman, a UCLA professor of psychology and of psychiatry and biobehavioral sciences. “Many people ‘decide’ to do things but then don’t do them.”

The new study by Lieberman and lead author Emily Falk, who earned her doctorate in psychology from UCLA this month, shows that increased activity in a brain region called the medial prefrontal cortex among individuals viewing and listening to public service announcement slides on the importance of using sunscreen strongly indicated that these people were more likely to increase their use of sunscreen the following week, even beyond the people’s own expectations.

“From this region of the brain, we can predict for about three-quarters of the people whether they will increase their use of sunscreen beyond what they say they will do,” Lieberman said. “If you just go by what people say they will do, you get fewer than half of the people accurately predicted, and using this brain region, we could do significantly better.”

“While most people’s self-reports are not very accurate, they do not realize their self-reports are wrong so often in predicting future behavior,” Falk said. “It is surprising to find out that some technique might be able to predict my own behavior better than I can. Yet the brain seems to reveal something important that we may not even realize.”

The study, the first persuasion study in neuroscience to predict behavior change, appears June 23 in the Journal of Neuroscience.

For the study, Falk, Lieberman and their collaborators sought people who did not use sunscreen every day. The study group consisted of 20 participants, mostly UCLA students, 10 female and 10 male. The participants had their brains scanned using functional magnetic resonance imaging (fMRI) at UCLA’s Ahmanson-Lovelace Brain Mapping Center as they saw and heard a series of public service announcements. They were also asked about their intentions to use sunscreen over the next week and their attitudes about sunscreen.

The participants were then contacted a week later and asked on how many days during the week they had used sunscreen.

Lieberman and Falk focused on part of the brain’s medial prefrontal cortex, which is located in the front of the brain, between the eyebrows. This brain region is associated with self-reflection – thinking about what we like and do not like and our motivations and desires.

“It is the one region of the prefrontal cortex that we know is disproportionately larger in humans than in other primates,” Lieberman said. “This region is associated with self-awareness and seems to be critical for thinking about yourself and thinking about your preferences and values.”

The researchers developed a model based on 10 people and tested it on the next 10. They shuffled the 20 people in different ways to test the model. There are more than 180,000 ways to divide the 20 people into groups, Falk said.

“We ran a simulation of the 180,000 combinations, developed our model on the first 10 subjects on each of the 180,000 simulations, and tested it on the second 10,” Falk said. “We saw a very reliable relationship, where for the vast majority of the 180,000 ways to divide the group up, this one region of the brain, the medial prefrontal cortex, does a very good job of predicting sunscreen use in the second group.”

This finding could be relevant to many public health organizations, as well as the advertising industry, Lieberman and Falk said.

“For advertisers, there may be a lot more that is knowable than is known, and this is a data-driven method for knowing more about how to create persuasive messages,” said Lieberman, one of the founders of social cognitive neuroscience.

Neural focus groups

While 19th-century department store pioneer John Wanamaker (quoted at the beginning of this release) advertised effectively for his stores in newspapers, he still said he was wasting half his advertising budget – only he didn’t know which half.

“We’re learning something about which half,” Lieberman said.

While advertising agencies often use focus groups to test commercials and movie trailers, in the future they and public health officials perhaps should add “neural focus groups” to test which messages will be effective while monitoring the brain activity of their subjects.

“A problem with standard focus groups,” Falk said, “is that people are lousy at reporting what they will actually do. We have not had much to supplement that approach, but in the future it may be possible to create what we are calling ‘neural focus groups.’ Instead of talking with people about what they think they will do, a public health or advertising agency can study their brains and learn what they are really likely to do and how an advertisement would be likely to affect millions of other people as well.”

“Given that there are emerging technologies that are relatively portable and approximate some of what fMRI can do at a fraction of the cost, looking to the brain to shape persuasive messages could become a reality,” Lieberman said. “But we’re just at the beginning. This is one of the first papers on anything like this. There will be a series of papers over the next 10 years or more that will tell us what factors are driving neural responses.”

“We hope to build a sophisticated model of persuasion that may incorporate multiple brain regions,” said Falk, who studies the neural basis of persuasion and attitude change. She has been hired by the University of Michigan-Ann Arbor as an assistant professor of communication studies and psychology and a member of the university’s Institute for Social Research, starting in September.

While some people have emphasized reasoning and emotion as key areas on which to base advertising campaigns, a key question may be whether messages and advertisements can be produced that “make people feel, ‘This is about me and is relevant to my preferences and motivations,’” Falk said. “Perhaps effective messages reinforce our values, our self-identity, what motivates us. We will learn much more as we continue this line of research over the years.”

Neuroscientists will learn whether they can predict behavior better and are likely to obtain a more nuanced understanding of the roles played by different parts of brain regions, said Falk, who this March received UCLA’s Charles E. and Sue K. Young Award for outstanding research and teaching. She is interested in how to make more effective health and other public service messages aimed at young adults.

“There is still much we do not know about how to get people to make healthier choices,” Falk said. “We hope to learn much more about what makes messages more or less persuasive.”

Different brain regions may be important for persuading people to tell or e-mail their friends about a health message, product or service; Lieberman and Falk are studying this issue of “creating buzz” as well.

However, the implications of the research go far beyond advertising, Lieberman said.

“There are many applications beyond how you make a good 30-second commercial,” he said, “including how teachers can communicate better so their students won’t tune out or how doctors can convince patients to stick to their instructions. We all use persuasion in some form or another every day.”

Beware of hucksters

Some people are already offering “neuro-marketing,” purporting to help businesses sell their products and help candidates run their advertising campaigns, Lieberman noted. They may, for example, recommend what colors and sounds to use in commercials. Is this effective, or are they claiming expertise they do not possess?

“In general, they are taking simple views of how different parts of the brain work and are saying it is important to turn a particular part of the brain on when advertising, and therefore you should do more of this or that,” Lieberman said. “For instance, they will say you want to activate the amygdala because that is the brain’s emotion center. Typically they are not looking at the relationship between what happens in the brain when someone is exposed to an advertisement and what actually are the outcomes that you care about. For example, do people change their behavior? Does someone spread the message to others? Instead, they are giving generic analysis, and my guess is that the vast majority of the advice they are giving is not accurate.

“To really understand the relationship between the brain’s responses to brands and persuasive materials and desirable outcomes, you actually have to measure the outcomes that are desirable and not just say what should work,” he said. “There are many folks claiming to be neuroscientists who have read a little introductory neuroscience, and that is not enough expertise. It’s almost infinitely more complicated than that.”

Co-authors on the Journal of Neuroscience paper are Elliot Berkman, a UCLA graduate student of psychology in Lieberman’s laboratory who will be an assistant professor of psychology at the University of Oregon this fall; Traci Mann, a professor of psychology at the University of Minnesota-Minneapolis who was formerly on UCLA’s faculty; and Brittany Harrison, a former UCLA undergraduate student.

Source: University of California – Los Angeles

Recovering addicts who avoid coping with stress succumb easily to substance use cravings, making them more likely to relapse during recovery, according to behavioral researchers.

“Cravings are a strong predictor of relapse,” said H. Harrington Cleveland, associate professor of human development, Penn State. “The goal of this study is to predict the variation in substance craving in a person on a within-day basis. Because recovery must be maintained ‘one day at a time,’ researchers have to understand it on the same daily level.”

Cleveland and his colleague Kitty S. Harris, director, Center for the Study of Addiction and Recovery, Texas Tech University, used data from a daily diary study of college students who are recovering addicts to identify the processes that trigger cravings and prevent some addicts from building a sustained recovery.

The researchers found that how addicts cope with stress — either by working through a problem or avoiding it — is a strong predictor of whether they will experience cravings when faced with stress and negative mood.

“Whether you avoid problems or analyze problems not only makes a big difference in your life but also has a powerful impact on someone who has worked hard to stay away from alcohol and other drugs,” explained Cleveland. “When faced with stress, addicts who have more adaptive coping skills appear to have a better chance of staying in recovery.” The findings appeared in a recent issue of Addictive Behaviors.

Researchers supplied Palm Pilots to 55 college students who were in recovery from substance abuse ranging from alcohol to cocaine and club drugs. The students were asked to record the their daily cravings for alcohol and other drugs, as well as the intensity of negative social experiences — hostility, insensitivity, interference, and ridicule — and their general strategies for coping with stress.

“We looked at variations in the number of cravings across days and found that these variations are predicted by stressful experiences,” said Cleveland. “More importantly, we found that the strength of the daily link between experiencing stress and the level of cravings experienced is related to the participants’ reliance on avoidance coping.”

Statistical analyses of the survey data suggests that the magnitude of the link between having a stressful day and experiencing substance use cravings doubles for recovering addicts who cope with stress by avoiding it.

“We found that addicts who deal with stress by avoiding it have twice the number of cravings in a stressful day compared to persons who use problem solving strategies to understand and deal with the stress,” explained Cleveland. “Avoidance coping appears to undercut a person’s ability to deal with stress and exposes that person to variations in craving that could impact recovery from addiction.”

According to Cleveland, the findings suggest the impulse to avoid stress is never going to help recovering addicts because stressful experiences cannot be avoided.

“If your basic life strategy is to avoid stress, then your problems will probably end up multiplying and causing you more problems,” he added.

Source: Penn State

Personality Disorders, also known previously as character disorders is a broad term for a class of personality types and behaviors that describe individuals who have problems dealing with other people. The patient will typically tend to be rigid and inflexible, finding it harder than other people to respond as easily to the changes and demands that occur in life. They are seen as dysfunctional in the way they assess situations and relate to other people.

The American Psychiatric Association (APA) describes a personality disorder as:

“An enduring pattern of inner experience and behavior that deviates markedly from the expectations of the culture of the individual who exhibits it.”

A personality disorder is a mental illness. The patient can become distressed when having to perform everyday functions in the workplace, school or situations involving other people.

It is not uncommon for the person with a personality disorder to believe that their behaviors and interpretations of things around them are normal. However, their thought processes and behaviors may be self-destructive and self-denigrating. In a significant number of cases other people are blamed for any problems or difficulties that occur.

According to Medilexicon’s medical dictionary:

Personality disorder is a “general term for a group of behavioral disorders characterized by usually lifelong ingrained maladaptive patterns of subjective internal experience and deviant behavior, lifestyle, and social adjustment, which patterns may manifest in impaired judgment, affect, impulse control and interpersonal functioning.”
What Is Personality?
Personality is defined as a dynamic and organized set of characteristics each person possesses that uniquely influences their behaviors, motivations and cognitions in varying situations. The English word personality comes from the Latin persona, meaning “mask”. The mask in the ancient Latin-speaking world was used to reflect a character rather than to disguise it.

Each person’s personality defines how they perceive the world about them, their thoughts, attitudes and feelings.

Individuals with what we term healthy personalities are seen to deal with normal stress in a natural way. They are able to form proper relationships with family members, schoolmates, work colleagues and friends.

Medilexicon’s medical dictionary describes personality as:

“1. The unique self, the totality of someone’s conscious and unconscious cognition and interpersonal behavior and related emotional responses; the sum of the integrated and unintegrated personality traits used by an individual to relate to others.

2. Someone with a particular personality pattern.”
What are the signs and symptoms of personality disorders?
According to the National Health Service (NHS), UK, personality disorders are grouped into three broad clusters, A, B and C.

Cluster A personality disorders – the individual has abnormal and somewhat eccentric behavior. Other people are seen as alien. This includes:

Paranoid Personality Disorder – the individual is suspicious and distrustful to the extreme. They might think that they are being lied to or manipulated, friends, associates and colleagues cannot be trusted, they suspect any confidential information about them will be turned against them, they may believe that remarks most people would regard as innocent are laced with hidden meanings. Despite no evidence, they may suspect their partner/spouse is disloyal.
Schizoid Personality Disorder – the person appears aloof, detached and cold, they tend to shy away from making close social contact with others. The individual is seen as a loner and often does not know how to form a personal relationship. Others may see the person as humorless and grim. A person with schizoid personality disorder may seem uncaring because they tend not to show emotion. This is unfortunate, because in most cases the sufferer is sensitive and feels very lonely.

When criticizing an individual with this kind of personality disorder they come over as uninterested. Experts say their ability to experience joy or pleasure is poor.
Schizotypal personality disorder – there is an ongoing pattern in which they distance themselves from interpersonal and social relationships. They feel extremely uncomfortable when they have to relate to other people. There are often cognitive and perceptual distortions. People may find their eccentric behaviors confusing. Many have poor social skills and delusional thoughts.

There are typically brief periods of psychotic episodes. There are delusional thoughts and insignificant daily events. Details take on a misguided significance, for example, they may believe newspaper headlines are really coded messages directed at them. They may think they are telepathic or have extraordinary empathic powers.

Cluster B personality disorder – there is also a problem relating to other people. Their behavior may be seen as disturbing, dramatic and threatening. The following disorders are within Cluster B:

Antisocial Personality Disorder – people with this type of disorder are generally not concerned about the consequences of their actions. They appear to enjoy bullying or intimidating people, and generally see others as easy prey.

An individual with this type of disorder is frequently bored, depressed and agitated. They may be deceitful and cunning and try to manipulate or take advantage of others. There appears to be no remorse or regret regarding how what they do might affect others. The problems in their lives are generally blamed on other people.

Borderline personality disorder – the individual has unstable and often intense relationships with other people. The person may have impulses to harm himself/herself and is emotionally unstable.
Histrionic personality disorder – there is an irresistible urge to be noticed by others and a fear of being ignored. Being at the center of everybody’s attention becomes their main aim.

The individual may seem not to be emotionally sincere, but at the same time displays too much emotion. Behavior may become provocative, flirtatious, inappropriate, and even seductive. There is scant concern for how others may feel. Receiving other people’s approval becomes an obsession.

Individuals with this type of personality disorder may have signs and symptoms that overlap with those of narcissistic personality disorder.
Narcissistic personality disorder – patients have an inflated sense of their own importance while at the same time crave for admiration. There is little regard for the feelings of others. Most believe they are superior to people around them. However, their self-esteem is brittle, and they don’t take kindly to criticism, even if it is slight and well-intended – they are easily hurt and rejected.

Patients tend to fantasize about their attractiveness, success and power. They may overstate their talents or achievements, and will act as if they are special. Others are expected to along with their plans and ideas. They tend to take advantage of people around them. If they feel somebody is inferior they may treat them with scorn. There may be intense jealousy.

The patient typically is unable to maintain a healthy relationship.

Many will try to come over as dispassionate and tough-minded.

Cluster C personality disorder – others typically see people with this type of personality disorder as withdrawn and disinclined to mingle with people or socialize. They fear personal relationships and tend to be anxious when with other people. The following are examples of Cluster C personality disorders:

Avoidant Personality Disorder – the individual avoids social situations and close interpersonal relationships, mainly because they are afraid of rejection. The patient often feels inadequate, has low self-esteem, and mistrusts most people. In other words, they are extremely shy, socially inhibited, extremely fearful of rejections and feel inadequate.

A person with this type of disorder yearns for close relationships with other people. Their problem is a serious lack of confidence and ability to be able to form them.
Dependent Personality Disorder – there is an excessive need to be taken care of, the individual is overly-dependent on other people. The individual is typically submissive and clingy. There is a deep fear of being separated.

Unlike some disorders which display aggression, a person with this type is usually nonassertive, passive and docile. The desire to please others is uttermost in their minds and a great deal of energy is expended on this aim. Disagreeing with others may be so unbearable that they will go to great lengths to win people over. The individual is easier to take advantage of and to influence.

The patient has low self confidence and usually believes his/her intelligence and abilities are low. Undertaking projects on their own or making decisions without help are enormously difficult. They tend to be pessimistic, full of self doubt, and belittle anything they may have achieved. They balk at responsibility. When they are alone they may feel helpless and uncomfortable. As soon as a relationship has ended, they will desperately seek out a new one.
Obsessive compulsive personality disorder – there is excessive concern with perfectionism and work at the expense of close personal relationships. The individual is inflexible and feels an overwhelming need to be in control. Concerns about rules and efficiency undermine the individual’s ability to relax. Others may see them as sanctimonious, uncooperative, obstinate and miserly.

People with an obsessive compulsive personality disorder are worried about issues that appear out of control or messy. They are typically workaholics, are interested in lists and timetables, and have trouble completing tasks because they have to be so perfectly done. Opinions on lifestyle issues, such as ethics, morals and religion are usually extremely rigid.

Delegating tasks to others is extremely difficult for those with this type of disorder.

Unlike those with obsessive compulsive disorder (OCD), individuals with obsessive compulsive personality disorder believe their behavior is normal and will resist attempts at changing them.

Sources: National Health Service, blog internal archives

Christian Nordvist

The portrayal of madness in drama gives the audience a deep insight into what it means to be human – and is such a powerful dramatic device that playwrights return to it time and time again, a leading psychiatrist has claimed.

Dr Ian McClure, a consultant child and adolescent psychiatrist at the Royal Hospital for Sick Children in Edinburgh and also a playwright, said the greatest dramatists produced plays with complex characters who fall into various states of madness.

He told delegates at the Royal College of Psychiatrists’ International Congress in Edinburgh that Shakespeare had explored the dramatic potential of madness more than any other playwright.

Hamlet, a textbook example of bipolar disorder, swung from depression to mania. The bloody duel at the end of the play is fuelled by Hamlet’s manic intensity, as he seeks flight from his depressive insight into the rottenness of the world.

King Lear, who splits his kingdom into three and becomes an outcast, is cleansed of pride and stubbornness by his madness, and Othello’s obsessional jealousy brings about his downfall.

Madness is a calamity to befall any human being, said Dr McClure, and as such is a proper subject for a dramatist to explore. It is a method by which drama became “turbocharged, unpredictable, dangerous, irrational”.

Dramatists often used “neurotic” madness in their works. Lady Macbeth, said Dr McClure, with her continual hand washing to wipe off any trace of the blood of the murdered king, was an example of obsessional disorder. Othello was such a perfect example of obsessive jealousy that the term “Othello Syndrome” is used in psychiatry to describe jealous husbands.

Madness was and is used as a vehicle for change, the driving force in the play with the main protagonist achieving, even in death, an insight into how things really are, delegates heard. Audiences learn what it means to be human through the portrayal of madness – hence its fascination for theatregoers, a fascination all the more powerful because most people are terrified of it, said Dr McClure.

He said that while mental illness affected 1 in 4 people, it has always been a subject of shame and stigma – despite 100 recent years of active scientific progress in uncovering secrets of the brain.

Dr McClure concluded: “There is still a lot of stigma surrounding mental health. There is something unique about madness and the fear of it is greater even that the fear of cancer. At the end of the day it’s about somebody losing their mind and people are absolutely terrified about that. We can accept the exploration of madness on the stage, and that is why dramatists turn to it. If you see the portrayal of madness in a very real way, but at one remove, that is a fantastic way to explore the very thing you are terrified of.”

References:

International Congress of the Royal College of Psychiatrists, Edinburgh, 21-24 June 2010.

Source:
Royal College of Psychiatrists

The idea that alcohol and drugs can stimulate artists, writers and musicians to create great works of art is a “dangerous myth” and can actually stifle creativity, a psychiatrist has said.

Dr Iain Smith, a consultant in addiction psychiatry at Gartnavel Royal Hospital in Glasgow, was speaking at the International Congress of the Royal College of Psychiatrists in Edinburgh.

He said that while many artists and writers, such as the 19th century French poet Baudelaire and American writer Ernest Hemingway, were well known for their use of intoxicating substances (cannabis and alcohol respectively), most produced their greatest works when they were sober.

Dr Smith said: “The reason that this myth is so powerful is the allure of the substances, and the fact many artists need drugs to cope with their emotions. Artists are, in general, more emotional people and the use of substances to deal with their emotions is more likely to happen.”

He added that drugs and alcohol are social substances and many creative people, such as Ernest Hemingway and the French artist Degas, spent a lot of time in Parisian cafes exchanging ideas and imbibing large quantities of absinthe and other types of alcohol.

Dr Smith said that American writers Tennessee Williams and Hemingway were both addicted to alcohol. He said poets Coleridge and Keats favoured opiates, as did writers Proust and Edgar Allan Poe, while Vincent van Gogh drank absinthe. American writers F. Scott Fitzgerald, Eugene O’Neill and William Faulkner were all recipients of the Nobel Prize for Literature, and all were alcoholics.

Dr Smith told the Congress that the American writer Hunter S. Thompson once wrote: “I’d hate to advocate drugs, alcohol or insanity to anyone – but they’ve always worked for me”. Baudelaire also urged fellow poets “to be drunk always”.

But from reviewing the evidence, Dr Smith claims that many of these artists were most productive during times of sobriety. He said: “The idea that drugs and alcohol give artists unique insights and powerful experiences is an illusion. When you try and capture the experiences [triggered by drugs or alcohol], they are often nonsense.”

For example, the strong visual experiences triggered by hallucinogenic drugs, such as LSD, can be captured on canvas – but this is unlikely to happen in other fields such as music and writing. Dr Smith said: “These drugs often wipe your memory, so it’s hard to remember how you were in that state of mind.”

References:

International Congress of the Royal College of Psychiatrists, Edinburgh, 21-24 June 2010.

Source:
Royal College of Psychiatrists

Whether mom’s golden child or her black sheep, siblings who sense that their mother consistently favors or rejects one child over others are more likely to show depressive symptoms as middle-aged adults according to a new study by Cornell University gerontologist Karl Pillemer.

The recent survey of 275 Boston-area families, co-directed by Purdue University sociologist Jill Suitor, is the first to show that such harmful effects persist long into adulthood. Prior research has shown that parental favoritism negatively affects mental health and often triggers behavioral problems in children, teens and young adults.

“Perceived favoritism from one’s mother still matters to a child’s psychological well-being, even if they have been living for years outside the parental home and have started families of their own,” says Pillemer, a professor in the Department of Human Development and associate dean in Cornell’s College of Human Ecology. “It doesn’t matter whether you are the chosen child or not, the perception of unequal treatment has damaging effects for all siblings.”

The study, which controlled for family size, race and other factors, drew on interviews with 275 mothers in their 60s and 70s with at least two living adult children. Researchers also surveyed 671 offspring of the women.

The findings could lead to new therapies for practitioners who work with later-life families, Pillemer says.

“We have a powerful norm in our society that parents should treat kids equally, so favoritism can be something of a taboo topic,” he says. “If counselors can help older parents and adult children bring some of these issues into the open, it may help prevent family conflict from arising.”

Co-authors of the paper include Suitor, professor of sociology at Purdue University; as well as Charles Henderson, senior research associate in human development, and Ph.D. student Seth Pardo, both of Cornell.

Source: Cornell University

A team of researchers led by NewYork-Presbyterian Hospital/Columbia University Medical Center has developed a method to predict post-stroke recovery of language by measuring the initial severity of impairment. Being able to predict recovery has important implications for stroke survivors and their families, as they plan for short and long-term treatment needs. Findings are reported online in the journal Stroke.

“These results indicate that if we know the extent of the initial impairment following stroke, then we can predict with remarkable accuracy how patients will function 90 days later,” said Ronald M. Lazar, Ph.D., professor of clinical neuropsychology in neurology and neurological surgery, Columbia University College of Physicians & Surgeons, and a neuropsychologist at NewYork-Presbyterian Hospital/Columbia University Medical Center. “We have established the first reliable metric of the current standard care for post-stroke language treatment, and a standard against which future treatments can be compared.”

For many years, it was thought that the size of the stroke, patient age and education, and specific characteristics of the type of language deficit were together predictive of recovery but no reliable metric had been established.

Funded by the National Institutes of Health, the NewYork-Presbyterian Hospital/Columbia-led team used the Western Aphasia Battery (WAB) test to assess language function at 24 – 72 hours after stroke onset and then again at 90 days. They found that among patients with mild to moderate aphasia after acute stroke, recovery (defined as the change in WAB score between baseline and 90 days) improved to about 70 percent of their maximum potential recovery, as long as they received some aphasia therapy.

According to the National Institute of Neurological Disorders and Stroke, up to 25 percent of all stroke survivors experience language impairments involving the ability to speak, write, and understand spoken and written language. A stroke-induced injury to any of the brain’s language-control centers can severely impair verbal communication. There are more than one million Americans with aphasia, which is a disorder of language that occurs after brain injury; stroke is the most common injury causing aphasia.

This study involved patients in the Performance and Recovery in Stroke (PARIS) database, which is based at the Neurological Institute of Columbia University Medical Center and NewYork-Presbyterian/Columbia.

Columbia University Medical Center provides international leadership in basic, pre-clinical and clinical research, in medical and health sciences education, and in patient care. The medical center trains future leaders and includes the dedicated work of many physicians, scientists, public health professionals, dentists, and nurses at the College of Physicians and Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. Established in 1767, Columbia’s College of Physicians and Surgeons was the first institution in the country to grant the M.D. degree and is now among the most selective medical schools in the country. Columbia University Medical Center is home to the most comprehensive medical research enterprise in New York City and State and one of the largest in the United States. Columbia University Medical Center is affiliated with NewYork-Presbyterian Hospital, the nation’s largest not-for-profit, non-sectarian hospital provider.

NewYork-Presbyterian Hospital, based in New York City, is the nation’s largest not-for-profit, non-sectarian hospital, with 2,353 beds. The Hospital has more than 1 million inpatient and outpatient visits in a year, including more than 220,000 visits to its emergency departments more than any other area hospital. NewYork-Presbyterian provides state-of-the-art inpatient, ambulatory and preventive care in all areas of medicine at five major centers: NewYork-Presbyterian Hospital/Weill Cornell Medical Center, NewYork-Presbyterian Hospital/Columbia University Medical Center, NewYork-Presbyterian/Morgan Stanley Children’s Hospital, NewYork-Presbyterian/The Allen Hospital and NewYork-Presbyterian Hospital/Westchester Division. One of the most comprehensive health care institutions in the world, the Hospital is committed to excellence in patient care, research, education and community service. NewYork-Presbyterian is the #1 hospital in the New York metropolitan area and is consistently ranked among the best academic medical institutions in the nation, according to U.S.News & World Report. The Hospital has academic affiliations with two of the nation’s leading medical colleges: Weill Cornell Medical College and Columbia University College of Physicians and Surgeons.

Source: Columbia University Medical Center