Providentia

How Practical is Brain Training?

Prior researchers have shown that the brain has a remarkable ability for adapting to environmental changes. The positive effects of such neural plasticity include enhanced functioning in specific cognitive domains and shifts in cortical representation following naturally occurring cases of sensory deprivation; however, maladaptive changes in brain function and development owing to early developmental adversity and stress have also been well documented. Researchers examining enriched rearing environments in animals have revealed the potential for inducing positive brain plasticity effects and have helped to popularize methods for training the brain to reverse early brain deficits or to boost normal cognitive functioning. In an article recently published in American Psychologist, two classes of empirically based methods of brain training in children are reviewed and critiqued: laboratory-based, mental process training paradigms and ecological interventions based upon neurocognitive conceptual models. Given the susceptibility of executive function disruption, special attention is paid to training programs that emphasize executive function enhancement. In addition, a third approach to brain training, aimed at tapping into compensatory processes, is postulated. Study results showing the effectiveness of this strategy in the field of neurorehabilitation and in terms of naturally occurring compensatory processing in human aging lend credence to the potential of this approach.

For the abstract.

Off To New York City

I'll be spending a few days in N.Y.C. and likely won't have much time for writing while I'm there.   If you notice a certain New York flavour to some of my upcoming posts, you'll know why.  To tide you nice people over, here are a few blog links that might interest you.

• The ever-fascinating Neuroskeptic blog has a new post up on social anxiety disorder, or is it "social phobia"?
• Karen Franklin at In The News provides up with her new disturbing new series on confidentiality in forensic evaluations.
• Scicurious weighs in on how environmental enrichment can make you sexy, at least if you're a rat..
• How was the most famous bet in the history of brain sciences won and lost?  Christian Jarrett of Brain Myths has the details.
• Disturbed by the recent Times cover picture?  What is the proper time that a child should stop breastfeeding?  Eric Michael Johnson of the Primate Diaries weighs in with his own observations.
• Ferris Jabr of Brainwaves has just launched a new series: titled Know Your NeuronsL The Discovery and Naming of the Neuron.  Here is the first installment.  
• The ever-reliable Vaughn Bell of Mind Hacks has a new post describing an important new article in Nature about the dangers of unreplicated studies in psychology.
• Should therapists be using tough love with their patients? A new post in the Wall Street Journal makes a good case for it.
• How are children affected by their parents' financial instability?  According to this Huffington Post article, the damage is just starting to be recognized.
• Can a patient be charged for not taking medication that might endanger other people?  Here is a news story from USA Today that should raise quite a few questions.
• Will we ever see an end to ex-gay therapy and its advocates?  A new ThinkProgress post finds NARTH's objections to ex-gay therapy restrictions rather easy to refute.
• While we try to understand what people suffering from severe depression, how often do we get to hear about it from the first-person perspective?  Natasha Tracy of Bipolar Burble gives us a gripping account of her own experiences.

Until later.

 

 

Reading The Bumps (Part 1)

One thing you could say about phrenologist and author, Orson Squire Fowler,  he certainly knew how to grab your attention.

Part of my collection of rare psychology books is an 1875 volume by Fowler.  The title certainly leaves little to the imagination: 

"Creative and Sexual Science: or Manhood, Womanhood, and Their Mutual Interrelations;  Love, Its Law, Power, ETC.;  Selection, or Mutual Adaptation; Courtship, Married Life, and PERFECT CHILDREN;  Their Generation, Endowment, Paternity, Maternity, Bearing, Nursing and Rearing; Together with Puberty,, Boyhood, Girlhood, ETC.;  SEXUAL IMPAIRMENTS RESTORED, Male Vigor ad Female Health and Beauty Perpetuated ad Augmented, ETC.,  as Taught By PHRENOLOGY AND PHYSIOLOGY " 

(Fowler was showman enough to make sure that the most important words were carefully capitalized). 

Got all that?  Good.   But more on that later after I provide a little background on the beginnings of phrenology.

Although the idea that mental abilities were linked to specific locations in the brain dates back to Aristotle, true scientific work into the nature of brain functioning didn't begin until the late 18th century.   While early visionaries such as Emmanuel Swedenborg made some inspired guesses about how the brain worked, it was German neuroanatomist Franz Joseph Gall who can properly be considered the father of phrenology (not that he ever used that term).   After establishing his reputation as one of Austria's most prominent physicians, Gall turned his research interests to the human brain and developed the first true theory of cerebral localization.  By 1792, he began lecturing on his idea that the human cerebral cortex was actually a mosaic made up of different specialized organs.  Although many of his ideas were actually correct, including his observations on the significance of cerebral hemispheres and the importance of the frontal lobes in complex thinking, the pseudosciene linked to Gall's name has largely overshadowed his reputation as a medical pioneer.    The premises that Gall laid out in his lectures were that:

1. the brain is the organ of the mind,
2.  the mind is made up of seperate annd discrete faculties,
3. each faculty must have its own "seat" or organ in the brain,
4.   the size of each organ is a direct measure of its relative importance in the mind,
5.   the shape of the brain is determined by how each organ developed,
6. since the skull is formed from the shape of the brain, measuring the skull can provide an accurate assessment of individual aptitudes and tendencies.    

Gall identified nineteen mental faculties which he considered to be essentially animal in nature, these included "reproductive instinct," "love of one's offspring," "affection," "destructiveness or tendency to murder," and "desire to possess things."   In contrast, he also identified a series of exclusively human qualities such as "wisdom", "satire and wit", "sense of metaphysics",  "religious sentiment", and firmness of purpose".  

Public reaction to Gall's lectures were decidedly mixed.   Despite the lectures being popular, conservative Catholic authorities and even some of his medical colleagues accused him of subversion for daring to suggest that the brain was the centre of intellect rather than the soul (the Austrian empire was still Catholic at that time). Although Gall defended himself and his theories as much as he could, he was ordered to stop lecturing in 1801.   Realizing that he would never be allowed to teach freely in Austria, Gall went into exile to could teach and continue his brain research.   Along with giving lectures and public demonstrations of dissections in Denmark, Holland, Switzerland, and France, he took a keen interest in the brains of convicted criminals and gathered further material for his writings on brain functioning.    Settling in Paris in 1807, Gall began writing his masterpiece, ,  The Anatomy and Physiology of the Nervous System in General, and of the Brain in Particular, with Observations upon the possibility of ascertaining the several Intellectual and Moral Dispositions of Man and Animal, by the configuration of their Heads,  which was eventually published in 1819. 

It was Gall's chief supporter, Johann Spurzheim, who helped Gall develop many of his theories after they first met in 1800.   Although he wasn't the first to coin the term "phrenology", Spurzheim  quickly adopted it for the brain science that he and Gall developed.  Their relatively productive relationship end in 1813 over disagreements on how the brain should be classified.    While Gall's research on criminal brains led to his arguing that there were "evil" tendencies in those brains that needed to be suppressed (such as regions of the brain controlling "murder" and "theft"), Spurzheim rejected this completely and argued that criminal behaviour was caused by underdeveloped moral faculties.   He also changed Gall's classification system by adding new organs such as "hope" and "moral sense" to Gall's list.   The total number of organs in Spurzheim's revised list rose to thirty-three from Gall's original twenty-seven.    Spurzheim also rejected Gall's gloomy pessimism over changing human nature and argued that proper upbringing could help overcome criminal tendencies.     After their split, Gall publicly condemned many of Spurzheim's "innovations" in his own books and often denounced him as a plagiarist and a quack. 

And with good reason perhaps.  While Gall tried to link his conclusions to actual brain research, Spurzheim development of "practical phrenology" became extremely popular in England and Scotland (and eventually in the United States as well).   Gall was, well, galled by Spurzheim's success and, despite his refusal to use the term phrenology himself (he preferred to call his own science "organology" or "zoonomy"),  it was Spurzheim's term that won out.  Various critics had no problem linking their names together and one reviewer in 1815 denounced their theories as "a collection of mere absurdities, without truth, connexion, or consistency".   Despite some recognition for his original contributions to brain research, Gall remained bitter over never receiving the eminence he felt he deserved.  He died in 1828 after requesting that his own skull be added to the large collection of skulls that are still on display in the Rollet Museum in Baden bei Wien, Austria.

As fpr Spurzhim and his own chief supporter, George Combe, the practical phrenology that they both advocated had less and less to do with any actual brain science as time went on.   While Spurzheim still had some actual medical credentials and gave public demonstrations of brain dissections, his death in 1832 left George Combe as the chief spokesman for phrenology.  Since Combe had no actual medical training (he was a lawyer),  that also meant that phrenology's tenuous claim to science was weaker than ever.   Still, as phrenology shifted away from brain science towards more"personality-oriented" applications, social reformers, innovators, and criminologists became attracted by its appeal.  Cesare Lombroso incorporated many aspects of Gall and Spurzheim's ideas into his own system of identifying "born criminals".     Educators saw phrenology as a way of classifying students according to their ability to learn while psychiatrists began studying patient skulls to find better ways of dealing with asylum inmates. 

By the time of Johann Spurzheim's death, there were at least twenty-nine different phrenological societies in Great Britain alone (George Combe personally founded the Edinburgh Phrenological Society in 1820).  George Combe's books became international best-sellers and his best-known book, The Constitution of Man, sold more than seventy thousand copies by 1838 alone (and would eventually go on to sell more than three hundred thousand copies).   Even the British royal family consulted Conde since Prince Albert had been worried that one of his sons was a slow learner.   Conde also evaluated Queen Victoria (from a distance) and concluded that her broad and high forehead reflected her "firmness of purpose, great self-control, and awareness of moral principles".   

Despite the controvery over phrenology and increasingly successful attacks by eminent scientists,  phrenology spread across the Atlantic and American phrenological societies sprang up as well.  Still,  phrenology didn't last particularly long as a serious movement in the United States.   Eminent American surgeon John Collins Warren attended many of Spurzheim's lectures and recognized its significance aalthough he never became a member of a phrenological society himself.  He also carried out the autopsy on Johann Spurzheim after his death in Boston during an American tour (leading to Spurzheim's skull being added to the growing Harvard medical collection).    Other eminent medical researchers such as Charles Caldwell and John Bell also attended Spurzheim's lectures and founded Pennsylvania's first phrenological society (Caldwell went to write the first American textbook on phrenology).    Although George Combe visited the United States on lecture tours (and met several American presidents in the process), the movement began fading after 1840 and largely became relegated to a pseudoscience before the decade was out.

Which brings us back to Orson Fowler and his brother...

To be continued.

 

 

 

Adapting to Facial Paralysis

How do people incapable of making facial expressions function in society?  Although there has been little research on the adaptive behavior of people with congenital compared to acquired disability, there is reason to predict that people with congenital conditions may be better adapted because they have lived with their conditions for their entire lives (Smart, 2008).   In a recent paper published in Rehabilitation Psychology, researchers examined whether people with congenital facial paralysis (FP), compared to people with acquired FP, compensate more for impoverished facial expression by using alternative channels of expression (i.e., voice and body).   Participants with congenital (n = 13) and acquired (n = 14) FP were videotaped while recalling emotional events. Expressive verbal behavior was measured using the Linguistic Inquiry Word Count (Pennebaker, Booth, & Francis, 2007). Nonverbal behavior and FP severity were rated by trained coders. Results showed that people with congenital FP, compared to acquired FP, used more compensatory expressive verbal and nonverbal behavior in their language, voices, and bodies. The extent of FP severity had little effect on compensatory expressivity.  This study provides the first behavioral evidence that people with congenital FP use more adaptations to express themselves than people with acquired FP. These behaviors could inform social functioning interventions for people with FP.

For the abstract

Final Public Review for Draft Version of DSM-5 Now Underway

As part of their ongoing review process,  the American Psychiatric Association's DSM-5 Task Force will be soliciting public feedback on the draft fifth edition of the Diagnostic and Statistical Manual of Mental Disorders  (DSM-5) from May 2 through June 15, 2012.    This is the final public review period and follows the previous review period of May-June 2011.   Already the  subject of considerable controversy, the DSM-5 is due for release in May 2013 and is likely to shape mental health policy across North America for years to come.   Along with changes to the diagnostic criteria for many established psychiatric disorders, the DSM-5 will also be introducing new diagnosed such as Suicidal Behavior Disorder,  Non-Suicidal Self-Injury Disorder, and Persistent Complex Bereavement Disorder. Among the significant changes proposed for existing psychiatric diagnoses, the DSM-5 task force is recommending:

• A redefining of current autism diagnoses  into a single diagnosis know as Autism Spectrum Disorder intended to accomodate all of the complex problems faced by children and adults currently diagnosed as autistic.  This is meant to include Asperger's Syndrome, childhood disintegrative disorder, and pervasive development disorder- not otherwise specified (PDD-NOS).    By combining these different diagnoses into a single diagnostic category into a single diagnostic category, the DSM-5 task force is hoping to eliminate potential confusion given the similar symptoms displayed by individuals with the different diagnoses.
• Redefining Major Depressive Disorder to allow for he often devastating consequences of grief.   Since patients dealing with  bereavment often mimic some or all of the diagnostic criteria of Major Depression.  Due to the possibility of misdiagnosis by untrained people using diagnostic checklists, the new DSM-5 will include footnotes to help clinicians recognize how loss reactions can be distinguished from mental illness.
• Due to c0ncerns about the proposed diagnosis of  Attenuated Psychosis Syndrome (which in turn replaces the even more controversial Psychosis Risk Syndrome diagnosis) as well as Mixed Anxiety Depressive Disorder, these two diagnosis have been deferred for further study and possible inclusion in future versions of the DSM. 
• Communication disorders have now been expanded to Language Disorder and Speech Disorder.  A third diagnosis, Social Communication Disorder is proposed (which is distinguished from Autism Spectrum Disorder).  
• Under the general category of Sleep-Wake Disorders  (formerly Sleep Disorders in the DSM-IV-TR) are a range of new diagnoses including Insomnia Disorder, Hypersomnolence Disorders, Obstructive Sleep Hypopnea Syndrome, Nightmare Disorder, Restless Legs Syndrome,  Rapid Eye Movement Sleep Behavior Disorder and Substance-induced Sleep Disorder.
• Trauma and Stressor-Related Disorders will be placed in a separate category and Posttraumatic Stress Disorder will be given a new subtype for preschool children.   This category will also include Acute Stress Disorder,  Reactive Attachment Disorder, Disinhibited Social Engagement Disorder, and Trauma- or Stressor-Related Disorders Not Elsewhere Classified.
• The Sexual and Gender Identity Disorders Work Group has proposed a new diagnostic term Gender Dysphoria with subcategories for children, adolescents and adults.   The new diagnostic label will replace existing categories of Gender Identity Disorder and Transvestic Fetishism and has already generated enormous opposition by transgender activists.
• Existing DSM-IV-TR diagnoses often linked to antisocial behaviour in children and adults including Conduct Disorder, Oppositional Defiant Disorder and Intermittent Explosive Disorder are now categorized under Disruptive, Impulse Control and Conduct Disorders.   Antisocial Personality Disorder (also termed Dyssocial Personality Disorder) is included in this category along with Disruptive Behavior Disorder Not Otherwise Classified.
• The category Substance Use and Addictive Disorder has been expanded to include Gambling Disorder (formerly classified as an Impulse Control Disorder), Tobacco Use Disorder, and Tobacco Withdrawal.   A group of diagnoses linked to Unknown Substance Use are also included for the first time.   As well, Caffeine Use Disorder, Internet Use Disorder, and Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure have been added to Section III of the DSM-5 for further study.
• There is also a radical redefinition of personality disorders proposed for the DSM-5 with a streamlined approach to diagnosis and an extensive guide for implementation.  A series of examples will be included to help clinicians make a proper diagnosis.
• Paraphilic Disorders are now listed in a separate category.  Pedophilic Disorder has been expanded to include a new Hebephilic subtype to reflect sexual attraction to post-pubescent children.    Including hebephilia in the DSM-5 has been extremely controversial with mental health professionals opposing its inclusion on various grounds.   The Sexual and Gender Disorders Work Group are also recommending the inclusion of Hypersexual Disorder and Paraphilic Coercive Disorder for inclusion in Section III of the DSM-5 for further study.

The DSM-5 editors stress that the proposed changes are not final and will undergo further revisions before the end of 2012.  The DSM-5 website will be soliciting comments from the public until June 15th to allow for sufficient feedback.  Anyone with concerns about the current form of the DSM-5 is welcome to  provide feedback.  Given that the importance of ensuring that the DSM-5 will be as fair and unbiased as possible, the time to act is now.

Click here for the link.

 

The Nazi Patient

Adolf Hitler never had much luck with his doctors (not that being a hypochondriac helped).

And he certainly had his share of medical issues.  Along with lingering problems from his World War I injuries (including posttraumatic stress), he also suffered from uncontrollable flatulence. Ever since childhood, the Fuhrer experienced spasmodic stomach cramps, diarrhea, and constipation although medical historians seem divided on whether this was due to physical causes or lifelong stress. 
Whatever the reason, dining with Hitler was often an uncomfortable situation for his supporters due to the digestive attacks that happened after most meals.  Although no one dared comment whenever Hitler jumped up from the table and rushed to his room, his medical issues definitely grew worse over time.  While trying to cure himself by going over medical manuals (including embracing a vegetarian diet where possible), being a rabid hypochondriac left Adolf Hitler acutely self-conscious about his health.  Not only did he examine his stool with elaborate care, but he also experimented with various fad remedies.   Along with camomile enemas (don't ask), he also swore off meat completely after 1931 and only ate heaping plates of vegetables which were carefully prepared for him.  He also refused all cooked foods (which he considered to be cancer-inducing) and only ate a high-fibre diet.  For Adolf Hitler, a daily regimen often involved oatmeal with linseed oil, cauliflower, asparagus tips, and artichoke hearts .  This vegetarian fare did little to cure his digestive problems but der Fuhrer refused to consider anything else.  His mistrust of most medical doctors seemed to stem from the audacity of some of them to suggest that many of his problems were psychosomatic and that his self-diagnosis and treatment were at the root of his problems.

But his health issues only got worse after meeting Dr. Theodor Morell...

Born and raised in a small village in the upper Hesse,  Morell trained as a gynecologist and obstetrician and became a licensed physician in 1913.  Despite his thorough grounding in conventional medicine, he developed a reputation for favouring unconventional medical treatments in his Berlin medical practice.  Which he made various claims to an academic career, including studying under legendary bacteriologist, Elie Metchnikoff and teaching in different universities, the actual historical evidence for his acadamic career seems suspect.  Not that this stopped Morell from labelling himself as a professor at times, or owning shares in several pharmaceutical companies.   Theodor Morell's unlikely rise to prominence only began when he met Adolf Hitler during a party at the Berghof near Berchtesgarden in the Bavarian Alps.   It still isn't clear why Hitler decided to make Morell his personal physician. 

While historians have speculated that he may have treated Hitler for his recurring syphilis, the official story seems to be that Hitler was won over after Morell helped cure a painful case of eczema on his legs and provided temporary relief for his stomach cramps.   The other Nazi doctors had little respect for Morell (aside from his fondness for quack cures, he was also grossly obese with a body odour problem) but, from 1937 onward, Dr. Theodor Morell had complete control over the Fuhrer's medical care.   Although Hitler had another doctor previously, Dr. Karl Brandt, it was Theodor Morell whose medical opinion he relied on (infuriating Brandt and the other doctors).

And it was some care.  While Theodor Morell was probably not a complete quack, the medical treatment that he provided to Adolf Hitler seems bizarre, to put it mildly.   Morell was a firm believer in polypharmacy - treatment with multiple medications  (and the fact that the good doctor owned shares in many of the drug companies likely influenced his medication choices).    He also preferred to administer drugs by injection rather than oral doses.  To deal with the Fuhrer's stomach problems,  Morell chose not to send his star patient for a thorough gastronintestinal examination (despite Germany having some of the best internists in the world).  Instead, he prescribed a generous dose of "Dr. Koester's Anti-Gas Pills" for Hitler's stomach problems.   The Fuhrer took as many as sixteen of these pills a day, which was probably a bad idea since they contained dangerous levels of strychnine and atropine.   Even in small doses, both ingredients are deadly poisons and likely contributed to many of the adverse symptoms Hitler displayed during the last years of World War II (including glazed eyes, sallow skin, attention problems, and mood swings).  

Along with the pills though, Dr. Morell also began giving his patient daily injections of methamphetamine.   It is hard to say when Dr. Morrell first introduced Adolf Hitler to this new medication (or whose idea it was) but the daily injections apparently began by late 1941 or early 1942.  This was in addition to the other medications, including methamphetamine pills that Hitler took by mouth.  Hitler's arms eventually became riddled with injection marks and even Eva Braun grew to despise Morell and referred to him as "that injection quack" as she was talking to her mother.   She also dismissed his office as being a "pig sty" and refused to allow him to give her any more medical care.   By 1942 however, even Hitler's staunchest supporters were noticing that their leader was becoming increasingly bizarre with signs of distrust, irritability, loss of control, and poor decision-making - all signs of methamphetamine addiction.   These symptoms continued right up to the end of the war and Adolf Hitler's suicide on April 30, 1945.  

After their leader developed jaundice in 1944, three other doctors (including Karl Brandt) tried to have Morell fired but Hitler adamantly opposed them.  Whether this was through loyalty to Morell or his own amphetamine addiction is an open question.    Suspicious of the jaundice attack, Heinrich Himmler even went so far as to question Morell's assistant, Richard Weber, over whether the doctor was deliberately poisoning their leader, Weber replied that it was "out of the question.  Morell's too big of a coward for that".  While Hitler's mental deterioration during the last months of his life has been extensively written about and attributed to mental illness and the corrupting influence of absolute power, a more recent book has suggested that the treatment received from Dr. Morell may have played an important role in his downfall.  

As for Theodor Morell, his own downfall was rapid enough.  On April 22, 1945,  a week before his suicide, Adolf Hitler dismissed Morell from his Fuhrenbunker in Berlin and told him that he no longer needed medical care.   In poor health himself, Morell left a large supply of medicine in the bunker for Hitler's needs and managed to catch one of the last German flights out of the city.  He quickly fell into Allied hands however and spent the next two years in an internment camp on the site of the former Buchenwald concentration camp.   While the interrogators were repelled by Morell's lack of personal hygiene (his body odour was as bad as ever), they managed to collect complete details of the astonishing treatment that he provided Hitler.  In addition to the amphetamine injections, Hitler also took more than twenty-eight other kinds of medication including vitamins, testosterone, opiates, liver extracts, laxatives, and sedatives.  That also included some more innovative remedies including cocaine eyedrops (Hitler had ten of these a day), human placenta compounds, and "potency pills" made from ground bull's testicles.  According to Theodor Morell's diaries (now in the National Archives in Washington, D.C.), Hitler still suffered from daily flatulence despite the bizarre range of medications Morell offered.   If Morell hadn't been such an obvious Nazi toady, the Allies might well have pinned him with a medal for his role in Hitler's defeat.   As it was, he was released after two years of internment without ever being charged.   He died on March 26, 1948 of stroke-related problems.

It's easy to dismiss Dr. Theodor Morell as a total quack who was only propelled to the ranks of power because he was willing to provide his star patient with the medical care that more ethical doctors wouldn't.  Still, many of those same "ethical doctors" (including Karl Brandt) were later prosecuted for a range of war crimes involving human medical experimentation and other Nazi extermination policies.  Since there was no evidence that Morell was involved in the same way that other Nazi medical doctors were, he was never charged.  Presumably, Morell wasn't considered competent enough to participate in mass murder.

 If so, being a quack had its advantages

 

How Do Hormones Affect Cognition During Pregnancy?

A longitudinal study recently published in Behavioral Neuroscience investigated the possible influence of estradiol (E₂), progesterone (P), testosterone (T), cortisol (CORT), and prolactin (PRL) levels on cognitive functioning during late pregnancy and the early postpartum period. The performance of 55 pregnant women on a battery of neuropsychological tests, tested once during the third trimester of pregnancy and once during the early postpartum period, was compared with that of 21 nonpregnant controls matched for age and education. Women in the pregnancy group had significantly lower scores than the controls during both the pre- and postpartum visits on tasks of verbal recall and processing speed. CORT levels were significantly associated, in an inverted-U function, with verbal recall scores at both the pregnancy and at postpartum periods and with spatial abilities at postpartum only. During pregnancy, PRL levels were associated in both a linear and an inverted-U function with scores on tests of paragraph recall and in a linear function with scores on tests of executive function. At postpartum, E₂ and CORT were negatively associated in a linear fashion with attention scores. These findings provide new evidence that fluctuating hormone levels during late pregnancy and early postpartum may modulate selected cognitive abilities.

For the abstract.

Celebrating Mental Health Week and National Mental Health Month

The Canadian Mental Health Association (CMHA) has declared May 7 to May 13, 2012 as Mental Health Week.    With the theme "Mental Health For All",  Mental Health Week is an annual national event designed to encourage people to learn, talk, reflect and engage with others on all issues surrounding mental health.    Along with regional and local events, the Assocation is focusing on key topics highlighting the different ways that mental health issues can affect us all.

These topics include :

• "Kids Can Have Stress, Too!"

The Kids Can Have Stress Too! program was developed to boost childrens's ability to handle the normal stress of growing up.   Educating parents, caregivers, and teachers on how to recognize stress in children, the program is also designed to give them the knowledge and insight to help the children in their care cope with stress in healthy ways.  The original program was developed for classroom use with children aged five to nine but a second pre-schooler program has also been developed for pre-school children.   The CMHA is working with social service agences and public health units to bring these programs to every province in Canada.

•   Resiliency: at Home, at School, and at Work

What is resiliency?  It is defined as "a combination of skills and positive attributes that people gain from their life to help them solve problems, cope with challenges and bounce back from disappointments".   As part of their Mental Health Week initiative, CMHA is encouraging adults to develop their resiliency skills to help them function at work and to teach those essential skills to their children.  

•  Mental Health is Everyone's Concern

Although research shows that one in five Canadians will suffer a mental illness at some time in their lives, the stigma surrounding mental illness remains unacceptably strong.   Along with being present in every family, mental illness is also the leading cause of disability in Canada accounting for nearly thirty percent of all disability claims and costs the Canadian economy 50 billion dollars a year in health care costs and lost revenue.  To prevent mental illness from being "swept under the carpet", the CMHA is working to combat many of the myths surrounding mental illness that can prevent people from getting the help that they need or becoming reintegrated into society afterward.   As the fact sheets available on the CMHA site show, most people with mental illness can, and do, get better and return to their normal lives.

Contact the CMHA to learn more about Mental Health Week events in your community or to download the Mental Health Week 2012 Toolkit. 

Also, in the United States,  Mental Health America is celebrating May as "Mental Health Month".    First started in 1949,  marking May as Mental Health Month raises awareness of the one in four Americans who suffer from mental health issues and to improve mental wellness for all.  This year's two main themes are: 

• "Do More for 1 in 4"

Providing a call for action for the one in four Americans who live with diagnosible and treatable mental illnesses.    Download the Do More For 1in4 Toolkit.

• Healing Trauma's Invisible Wounds

Dealing with trauma can often take a lifetime and many trauma sufferers are either unwilling or unable to get the help they need.   Traumatic events can affect entire communities as much as they affect individuals.    Download the Healing Trauma's Invisible Wounds Toolkit.

Contact Mental Health America to learn more about Mental Health Month and their other resources.

 

 

 

 

The Great New York Starvation Challenge

In the summer of 1881, New York City`s Clarendon Hall became the scene of a rather unusual public challenge.  An eccentric Minneapolis physician, Dr. Henry S. Tanner rented the hall to carry out a forty-two day fast.  Not only would Dr. Tanner`s fasting be monitored by New York`s most distinguished medical professionals but anyone outside the medical community would be able to watch for themselves (after paying the twenty-five cents admission fee).  According to Dr. Tanner, the point of his fast was to prove that human beings could go without food far longer than the twelve to fifteen-day limit laid down by the orthodox medical community.   By -passing that limit, Dr. Tanner hoped to prove that that the human mind possessed "untapped powers that modern medicine has yet to understand".  He also hoped to settle one of the great medical mysteries of the late 19^th century:  the mystery of the “fasting girls”.

By the end of the 19^th century, scientific authority had slowly edged out religion as a way of  answering fundamental questions about how the world worked.  Still, spiritualists and their supporters were fighting back vigorously.  Despite the tremendous rise in Victorian-age enthusiasm for scientific discovery and big engineering projects, there was a widespread fascination with spirit mediums, psychics and other fantastic claims of the paranormal.  Was it possible that scientists didn’t have all the answers after all?

Which brings us to “fasting girls” and the how they were able to survive without food...

Although the notion that religious ascetics could overcome the limits of their own bodies through brutal self-denial had been around since the Middle Ages, cases of young women living without food for extended periods of time first appeared in the medical literature only relatively recently.  By 1873,   Sir William Gull presented his now-classic paper “Anorexia Hysterica”  to describe what he insisted was a new medical disorder (which he later renamed anorexia nervosa) and the fasting girls phenomenon had already become front page news on both sides of the Atlantic.    Not long after Sarah Jacob, the “Welsh Fasting Girl”  drew headlines during the late 1860s, similar cases were found in the United States and Canada, including Mollie Fancher (a.k.a. “The Brooklyn Enigma”), Kate Smulsey (a.k.a. “The Fort Plains Fasting Girl”) and Josephine Marie Bedard, a French-Canadian girl living in Maine.   Mollie Fancher became a particular darling of the Spiritualist movement, as much for her supposed psychic powers as her miraculous ability to go without food.

All of which led to an interesting standoff. 

On one side, various scientific authorities insisted that the fasting girls were frauds.  Their defenders, including Spiritualists and family members, denied the accusations that the girls were secretly eating and insisted that the fasting was genuine.  Spiritualists in turn denounced the hardheaded skepticism of the medical doctors and one of them, Joseph Rodes Buchanan, even insisted that “Medical men and schools know no more of the psychic universe than a mole does of astronomy”.   After a controlled study of the most famous case, Sarah Jacob, led to her starvation death in a London hospital in 1869,  nobody felt inclined to try repeating the experiment for fear of more starvation deaths.  The vigorous debate reached its peak in 1881 and a public challenge from Dr. William Hammond of the New York Neurological Society for a formal proof of food abstinence. 

Bringing us back to Dr. Henry S.  Tanner and his public fast.  Although his initial plan was to go without food completely, he altered this slightly by taking “alcohol vapour baths” but otherwise stuck to his fast under the watchful eye of a panel of physicians (who also measured his urine and feces carefully).   Dr. Hammond and his neurologist colleague, Dr. George Beard, didn’t take part in the challenge despite invitations from Dr. Tanner and the media.   Over the course of the forty days that the fast lasted, Dr. Tanner was never caught cheating and insisted on continuing despite becoming extremely emaciated.   Despite expressing hope that his progressive starvation would lead to the sorts of religious visions and other “psychic experiences” that ascetics had reported in the past, Tanner was disappointed  in that.   He just got hungry and weak.

Once the forty day fast ended however, Dr. Tanner's claim to winning his challenge failed to impress his critics.  Neither Dr. Hammond or Dr. Beard considered the test to be valid despite Tanner losing more than forty pounds in his experiment.   As the two neurologists pointed out, the medical panel supervising the fast was made up of “a parcel of doctors whom very few had ever heard of” and that the “alcohol vapour baths” may have invalidated the results since they likely acted as a stimulant.   The New York Times was quick to side with the neurologists and labelled the entire event as “Tanner’s Folly” sinice the doctor had failed to win the challenge or to prove his claim.  The Times also added that "no physiological principle of any importance was deduced from the undertaking". 

Not surprisingly, Dr. Tanner was infuriated and insisted that his successful fast proved his claim about the ability of the mind to overcome the body.  He stated that his fasting demonstrated that humans could live in a state of suspended animation similar to bears going into hibernation.  While Tanner argued that his going without food for forty days proved that humans were capable of "hysterical lowered vitality" (entering a death-like state under extreme circumstances), hardly anyone was persuaded by his argument.  Though fasting girls continued to be studied, it was as examples of mental disorder rather than as being miraculous (despite prominent exceptions).

Although the 20th century would see a far more controlled study of human starvation that was much more useful in learning about the limits of the human body, "Tanner's Folly" earned Henry S. Tanner temporary status as a celebrity (despite his being largely forgotten today).  as well as a place in the writings of Mark Twain who, in his 1897 book, Following the Equator: A Journey Around the World, commented that ""I think that the Dr. Tanners and those others who go forty days without eating do it by resolutely keeping out the desire to eat, in the beginning, and that after a few hours the desire is discouraged and comes no more". 

Food for thought.

 

 

Does Mild Traumatic Brain Injury Increase Suicide Risk in Veterans with PTSD?

Research shows that posttraumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI) independently increase suicide risk; however, scant research has investigated whether mTBI increases suicide risk above and beyond the risk associated with PTSD alone.   A research study published in a recent issue of Rehabilitation Psychology compared suicide risk factors among a matched sample of Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) military personnel and veterans with PTSD alone or PTSD and a history of an mTBI.  Results show that differences in the assessed risk factors were small and suggest that if PTSD and mTBI are associated with elevations in suicide risk relative to PTSD alone, the added risk is likely mediated or confounded by PTSD symptom severity.  This finding highlights the importance of screening and treating military personnel and veterans for PTSD. Future explication of the impact of TBI-related impairments on suicide risk will be critical as we strive to ensure safety and optimize care for our military personnel and veterans.

For the abstract.