Finally, there exists a causal link between serotonin and impulsivity. The neurotransmitter serotonin is a chemical messenger in the brain that regulates emotions and it has often been associated with social decision-making.

Scientists at the University of Cambridge have shed more light on the ‘myth’ that people tend to become aggressive when they are hungry. Our serotonin levels decline when we do not eat because the essential amino acid used to create serotonin can be found in food, such as tryptophan rich products like poultry and chocolate.

The researchers of the study, funded by the Wellcome Trust and the Medical Research Council, manipulated the subjects’ diet in order to reduce serotonin levels. They then used the ‘Ultimatum game’ to study the subjects’ reactions to unfair behaviours. In this game, a player suggests a manner in which to divide a sum of money into two portions, one for themselves and another for the other player. If the other player agrees on the split they each keep their agreed-upon portion. If the other player disagrees with the split then no one gets paid. Typically, people tend to reject 50% of offers that are less than 20-30% of the total stake. However, with lowered serotonin, rates of rejection increased to over 80%. As per Molly Crockett, PhD student at Cambridge Behavioural and Clinical Neuroscience Institute:

“Our results suggest that serotonin plays a critical role in social decision-making by normally keeping aggressive social responses in check. Changes in diet and stress cause our serotonin levels to fluctuate naturally, so it’s important to understand how this might affect our every day decision-making” - Article

Now that proof exists that serotonin, which is manufactured through diet, affects the impulsivity of decision-making, it would be interesting to examine how this might apply to other situations involving choices, such as how much impact serotonin levels have on decision-making among users of cocaine, a known appetite suppressant.

Dr. Gaby Badre, of Sahlgren’s Academy in Gothenberg, Sweden presented to the Associated Professional Sleep Societies (APSS) that there is a relationship between excessive cell phone use and sleeping problems, such as disrupted sleep, restlessness, stress and fatigue, among youth 14 to 20 years of age.

The study consisted of two groups; those who made less than 5 calls and/or text messages per day (control group) and those who made more than 15 calls and/or text messages per day (experimental group).

The results showed that youth in the experimental group had “increased restlessness with more careless lifestyles, more consumption of stimulating beverages, difficulty in falling asleep and disrupted sleep, more susceptibility to stress and fatigue”. Furthermore, there seems to be a connection between excessive cell phone use and a tendency toward unhealthy habits such as smoking and drinking among youth.

The study suggests that youth are delaying their biological clocks in order to remain in constant connection with the world. The impact on mental health and cognition could be detrimental if youth continue to disrupt their sleep patterns at a period in life where sleep is so critical. It makes me wonder if this trend will hinder the potential of today’s youth.

New research suggests that religious leaders may have been sitting on a potential treatment for depression all along. Even hippies seem to have caught on to the healing powers of incense long before the academic world.

A team of researchers from John Hopkins University and the Hebrew University in Jerusalem studied the psychoactive effects of burning incense. Researcher, Raphael Mechoulam “found that incensole acetate, a Boswellia resin constituent, when tested in mice lowers anxiety and causes antidepressive-like behavior”. Specifically, this constituent activates the TRPV3 protein in areas of the brain that are associated with emotions and nerves. These areas are the same as those already being activated by current medication in use for the treatment of depression and anxiety. Evidently, mice bred without this protein were not affected by the incense.

Although, the idea seems rather harmless in comparison to many of the medications on the market at this time, I have to wonder whether or not this might be a better alternative to medication. I am not convinced that this treatment holds much weight when considering the possible health risks associated with daily doses of incense inhalation in order to sufficiently reduce anxiety and depression.

Researchers of the Layton Aging & Alzheimer’s Disease Center at Oregon Health and Science University (OHSU) in Portland have discovered that brain volume is linked to mental decline in people with Alzheimer’s.

This linkage was discovered while performing autopsies on deceased elderly patients. The entire brain was found to be larger in patients who had not experienced any cognitive impairment. In particular, the hippocampus, a part of the forebrain in the medial temporal lobe that plays a major role in long term memory, has been discovered to be larger in size for those patients with no cognitive impairments. Most surprising, those in both categories had plaques and tangles in the brain as found in typical Alzheimer patients.

The study consisted of 12 patients who did not have Alzheimer’s symptoms before death and 24 who had experienced symptoms of the disease. As per Dr. Deniz Erten-Lyons, the brains of those without symptoms of Alzheimer’s were found to be on average 10% larger.

Dr Jeffrey Kaye, director of the Layton Aging and Alzheimer’s Disease Center and a professor of neurology in the OHSU School of Medicine stated: “We are hopeful that this research will help us further understand the structural and genetic ties to Alzheimer’s disease and perhaps offer clues that may help us develop new drugs or therapies.”

This study could help lead the way to developing better tools for earlier detection rather than relying heavily on evaluations of thought process through mental tests. All studies seem completely worthwhile when up against a degenerative and terminal disease that has no cure and affects millions worldwide every year.

Source

The British Journal of Psychiatry presented a study conducted by Yale School of Medicine regarding the tendency to extract a meaningful message from meaningless noise. The study implies that, over time, this ability could produce a ‘matrix of unreality’ that triggers the initial psychotic phase of schizophrenia-spectrum disorders. The study implies that this ability could be an early sign of schizophrenia.

The study consisted of a measly 43 participants who had already been diagnosed with prodromal symptoms such as social withdrawal, mild perceptual alterations or misinterpretation of social cues.

A medication called olanzapine was used in this study. It is also known as zyprexa, an atypical antipsychotic used to treat schizophrenia and bipolar disorder. Participants were assessed for up to two years after being randomly assigned to either this medication or a placebo.

The participants listened to a reading of a text through headphones, but this text was read by six different people at the same time. The overlap of the words made comprehension virtually impossible. The only words detected with any kind of consistency were increase, children, A-OK, and Republican.

“Eighty percent of the participants who ‘heard’ phrases of four or more words in length went on to develop a schizophrenia-related illness during times that they were not taking olanzapine, said the lead author, Ralph Hoffman, M.D., associate professor of psychiatry. In contrast, only six percent of those in the study converted to schizophrenia-related illness if the phrases ‘heard’ were less than three words in length.” – Article

Clearly this is not sufficient research to conclusively report the effectiveness of this type of screening tool, but it’s an interesting attempt. How long could it be until we are using simple white noise to render a diagnosis.

Detect anything meaningful?

The following is a snippet of a recent paper that I have written regarding a disorder that seriously lacks attention:

“Late at night, I sit at the end of the sofa, pull the shade off the lamp and allow the bright light to expose hundreds of beautiful hairs. My focus is intense and with great concentration, I locate very fine hairs and pluck them. This gives me great pleasure and the sharp pain relaxes me. The concentration takes me away. I love releasing the once buried little hairs and pulling them. With great luck, I find the thick hairs, some with their black sac still attached. I save those hairs like trophies carefully laying them along the arm of the sofa, black against white. […] now I go to bed exhausted but satisfied.” (Penzel, 2003, p. 10)

This scenario depicts the experience of some sufferers of trichotillomania. The term can be traced back to 1889 when it was first defined by French physician Halipeau (Long, Miltenberger & Rapp, 2006, p. 133). The term itself is Greek in origin; trich refers to hair, tillo refers to pull, and mania refers to madness (Penzel, 2003, p. 2). There is a tendency for this disorder to be more common among females and to develop in childhood or early adolescence (Long et al., 2006, p. 137). Trichotillomania is also commonly associated with other disorders such as mood or anxiety (Long et al., 2006, p. 138). Common areas of pulling are the scalp, eyebrows, eyelashes, face, limbs, and pubic area (Penzel, 2003, p. 8). The physical and emotional costs of this disorder can be debilitating. A number of physical consequences may include calluses on finger tips, strain injuries such as in the neck and back, infections such as on the eyelids and pubic area, and the development of gastrointestinal problems from the swallowing of hair or what is called trichophagy (Penzel, 2003, p. 4). Subsequently, “feelings of shame, helplessness, isolation, and frustration can take a tremendous toll on sufferers” (Penzel, 2003, p. 5). Although, it is estimated to affect roughly 2.5 million people in the United States, the actual rate of occurrence is often inaccurate due to misdiagnoses and extraordinary attempts at disguising or concealing the disorder (Kelly, McCormick & White Kress, 2004, p. 2). The fourth edition of The Diagnostic and Statistical Manual of Mental Disorders currently groups trichotillomania with other Axis I impulse control disorders such as pyromania and kleptomania and is defined by the following criterion:

A. Recurrent pulling out of one’s hair resulting in noticeable hair loss.
B. Feeling of tension immediately before pulling hair out or when attempting to pull hair out.
C. Sense of pleasure, gratification, or relief when pulling out hair.
D. Hair pulling is not better explained by the presence of some other disorder.
E. Hair pulling causes significant distress and an impairment of the ability to function in an important area of one’s life. (Penzel, 2003, p. 2)

The assessment of trichotillomania is conducted through several non-standard and standard measures. The initial interview establishes the baseline and allows the clinician to gather a complete picture of the presenting behaviour and its effect on the individual’s life. Standardized tests help to assess the severity of the disorder; however there is an obvious deficiency in strong assessment measures and Breckenridge et al. (1999) suggest that this is in part due to the scales’ context (p. 168). Results from various studies suggest that a multi-method approach is most effective when assessing trichotillomania. “An ideal TM measure would include homogeneous subscales that measure situational variables, affective states, and sensory stimuli associated with hair pulling behaviour in addition to frequency, duration, and interference of symptoms” (Breckenridge et al., 1999, p. 168). To date, trichotillomania lacks answers to such questions as whether the disorder is conceptually related to OCD or more similar to other disorders such as skin picking (Penzel, 2000, p. 1). The controversy with respect to etiology has an extensive impact on assessment methods and tools. Inevitably, assessment influences treatment and treatment affects outcome, so this begs the question: are trichotillomaniacs obtaining appropriate benefits from current methods?

As promised, here are some brief excerpts from my paper regarding the treatment of trichotillomania. This is simply a follow-up to the previous post: Assessment of Trichotillomania.

“Trichotillomania typically presents many challenges to effective treatment. The extant literature suggests that a minority of patients respond to a single intervention, for example, habit reversal or a specific pharmacological agent” (Christenson, Hollander & Stein, 1999, p. 93). Following careful investigation of data pertaining to treatment, findings point toward a high need for long-term controlled studies in order to determine the most appropriate methods for treating trichotillomania. The current research implies that there is no explicit procedure designed to be effective in all cases, rather because individuals have responded differently to various treatments and since studies have produced varied results, the ideal treatment could be some combination of techniques dependent on the individual. Because of this lack in concrete evidence to support the most successful method; this paper will explore the most effective treatment modalities currently in place. Accordingly, the existing appropriate methods are behavioural and pharmacotherapy or some combination of the two. There have been numerous techniques employed over the years; therefore a short review of these other methods will also be presented. [...]

Basically, in some form or another, HRT models consist of the following components: competing reaction training, awareness training, identifying response precursors, identifying habit prone situations, relaxation training, prevention training, habit interruption, positive attention (overcorrection), competing reaction, self-recording, display of improvement, social support and annoyance review (Christenson et al., 1999, p. 156). “Habit reversal training remains the most widely accepted treatment with the most convincing documentation of its efficacy” (Christenson et al., 1999, p. 161). [...]

Similar to behavioural treatment, pharmacotherapy has very little research to confidently support the most useful medications (Christenson et al., 1999, p. 171). Consequently, there has been a great deal of disagreement regarding the most effective medication to treat trichotillomania (Kelly et al., 2004, p. 5). That being said, there have been a multitude of medications prescribed over the years in an attempt to uncover the most effective drug. There is significant variability among medications due to the wide range of the disorder’s symptoms and the lack of long-term studies (Christenson et al., 1999, p. 96). [...]

“Treatment studies are plagued with conflicting results, a lack of large-scale controlled treatment trials, and limited long-term follow-up of patients” (Baer et al., 1998, p. 561). Because of this deficiency in terms of concrete support for the most effective method to treat trichotillomania; this paper has focused on exploring the most successful modalities presently in place. Therefore, behavioural and pharmacotherapy or some combination of the two have been considered as the most appropriate methods of treatment. Specifically, habit reversal treatment has proven to be the most successful form of behavioural treatment, while anti-depressants have been considered the most reliable medications currently being prescribed. In summary, thorough investigation has revealed a critical need for additional research of treatment modalities in order to ensure that the most effective methods are being applied in treating trichotillomania.

In recent news, the Ontario government has managed to save the popular crack pipe program that the city of Ottawa refused to support. Our Mayor, Larry O’Brien cancelled the program back in July 2007. As of yesterday, news has leaked that the Ministry of Health and Long-Term Care will provide $287,000.00 in funding over the next year to the Somerset West Community Health Centre to manage the controversial program.

Many of those who supported the motion to cancel the program may be furious with the province’s overturn; however from the news articles that I’ve read it appears as though the province has always been the main source of funding, while the city only topped up with a small portion of $7,500.00 a year.

The crack pipe program is said to be an essential part of an integrated drug strategy, along with enforcement, treatment and prevention according Jack McCarthy, director of Ottawa’s Somerset West Community Health Centre.

Although, I’m not fully convinced that this “harm-reduction” approach is entirely necessary, at least to the degree of funding awarded, I am open minded about it and not afraid to admit that I am not fully aware of the statistics. On the surface, to the taxpayer, it appears that this program is an unnecessary waste of money. However, the taxpayer may not realize the savings to be had in health care costs to treat diseases, such as Hepatitis C and AIDS, as well as the enormous relief of strain on health services.

Despite some of the more positive aspects, one cannot deny the fact that this program promotes drug use. It gives the impression that this type of behaviour is accepted as normal within our society. Money might be better spent on programs that serve to prevent and treat addiction. It seems that this city and many other cities lack the funding in these areas.

Besides, I’m not sure how partial I am to the image of a city littered with used crack pipes. I’m certainly more interested in helping addicts on their road to recovery.

I stumbled upon an article today regarding addiction, an area of study that has been of interest for many years. The research conducted at Indiana University examined the possibility that structural changes in the amygdala may be responsible for the co-morbidity of addiction and mental illness. Those who are familiar with addiction or have worked with addicts know just how often this combination occurs.

The study compared the behaviour of adult rats that had both undergone surgery on their amygdala during infancy. One group had their amydalas damaged while the control group’s amygdalas were left intact. The control group experienced a type of mock surgery.

Interestingly, those that grew up with damaged amygdalas showed more response to novel stimuli, less fear to elevated mazes, continued social activity in the presence of a predator’s scent, were more sensitive to cocaine after only one exposure, and demonstrated consistency of behaviour changes with repeated cocaine injections. All conditions are stated to have remained constant; therefore results are directly related to the amygdala.

This proposes that the structure of the brain can affect vulnerability to drug addiction. Also, with regards to dual diagnosis it suggests that this vulnerability to addiction more effectively explains the high rates of addicts suffering from other mental illnesses as opposed to drug use causing mental illness.

This seems to suggest that a better response to treat mental illness is to reduce pharmacological treatment, a position that I have held from day one of my studies in psychology.

Full Article

A new study reveals that sex doesn’t have to last hours to be satisfactory. In fact, according to a recent survey, sexual intercourse need only last somewhere along a reasonable continuum of 3 to 13 minutes.

The survey was conducted by researchers Eric Corty and Jenay Guardiani of Penn State Erie. Fifty full members of the Society for Sex Therapy and Research offered their input regarding sexual intercourse satisfaction. Sixty-eight percent of the group responded to the survey. These members consisted of psychologists, physicians, social workers, marriage/family therapists and nurses.

The respondents established adequate sexual intercourse as lasting somewhere between 3 and 7 minutes and desirable intercourse lasted about 7 to 13 minutes. Sexual intercourse was seen as too short when it lasted from 1 to 2 minutes and 10 to 30 minutes was determined to be too long.

Previous research suggests that both men and women perceive sexual satisfaction as long-lasting sex sessions. Therefore, when sex lasts less time than anticipated each party suffers a let down. If only we could re-train our brains to believe that the best sex lasts only a short period of time, we might actually allow ourselves to feel more satisfied with our sex lives.

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