tag:blogger.com,1999:blog-23019994963441587802024-02-20T23:39:02.940-08:00The MacGuffinNeuroPsychhttp://www.blogger.com/profile/10654138293659468787noreply@blogger.comBlogger93125tag:blogger.com,1999:blog-2301999496344158780.post-49195080540097635452014-04-16T08:07:00.000-07:002014-04-16T08:07:40.737-07:00Does Casual Pot Use Cause Brain Abnormalities?First, I'll put all my cards on the table; I believe at most, marijuana should be legal, and at the very least decriminalized.<br />
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If you paid attention to lately, for the first time since the issue has been tracked, the majority of Americans think that marijuana should be legal. (<a href="http://www.gallup.com/poll/165539/first-time-americans-favor-legalizing-marijuana.aspx" target="_blank">1</a>)<br />
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The federal government and the Justice Department think otherwise. So, how do you change public opinion? Two steps: 1) Pay for a study. 2) Lie about the results.<br />
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Pay close attention to the headline:<br />
"<span style="color: purple;">Casual pot use <u><i>causes</i></u> brain abnormalities in the youn: study</span>." (<a href="http://news.yahoo.com/casual-pot-causes-brain-abnormalities-young-study-020709104--finance.html" target="_blank">2</a>)<br />
The opening sentence: (<a href="http://news.yahoo.com/casual-pot-causes-brain-abnormalities-young-study-020709104--finance.html" target="_blank">2</a>)<br />
"<span style="color: purple;">Young, casual marijuana smokers experience <u><i>potentially harmful</i></u> changes to their brains, with the drug altering regions of the mind related to motivation and emotion, researchers found</span>."<br />
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Here is one of the loud mouth authors: "'<span style="color: purple;">This study raises a strong challenge to the idea that casual marijuana use isn't associated with <u><i>bad consequences</i></u></span>,' Breiter said." (<a href="http://www.sfn.org/Press-Room/News-Release-Archives/2014/Brain-Changes-Are-Associated-with-Casual-Marijuana-Use-in-Young-Adults" target="_blank">3</a>)<br />
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If you're at all familiar with this blog, you'll know that one thing to watch out for is quoting someone not affiliated with the research.<br />
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From another article<br />
"<span style="color: purple;">'This study suggests that even light to moderate recreational marijuana use can <u><i>cause</i></u> changes in brain anatomy,' said Carl Lupica, PhD, who studies drug addiction at the National Institute on Drug Abuse, and was not involved with this study.</span>" (<a href="http://www.sfn.org/Press-Room/News-Release-Archives/2014/Brain-Changes-Are-Associated-with-Casual-Marijuana-Use-in-Young-Adults" target="_blank">3</a>)<br />
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So of course, this was a rigorous, well controlled, experimental study, which shows a causal link between marijuana use and a change in brain structure, as well has highlighting the negatives of these changes.<br />
<span style="background-color: white; font-family: Arial, Helvetica, sans-serif; font-size: 13px;">"<span style="color: purple;">The team of scientists compared the size, shape, and density of the nucleus accumbens and the amygdala — a brain region that plays a central role in emotion — in 20 marijuana users and 20 non-users. Each marijuana user was asked to estimate their drug consumption over a three-month period, including the number of days they smoked and the amount of the drug consumed each day. The scientists found that the more the marijuana users reported consuming, the greater the abnormalities in the nucleus accumbens and amygdala. The shape and density of both of these regions also differed between marijuana users and non-users</span>." (3)</span><br />
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Nope, I was wrong. It was a correlation study. You wouldn't know that from the Yahoo! article (or any popular press article) by the use of the word "cause" in the lead title. Here's what we know from this study. The brains of a small sample of participants who casually smoke marijuana are different than non-smokers. Did marijuana cause these changes? maybe, maybe not. This study doesn't come close to showing that, but that doesn't stop people from saying it does.<br />
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When dealing with correlational research, always ask, what else could explain this result? One possibility may be that subjects' brains were different before they smoked marijuana. Maybe their nucleus accumbens or amygdala were already different and that made it more likely that they would use marijuana more than once. I'd be interested to know if the non-users ever smoked marijuana, since only a 3 month history was taken.<br />
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Fact is, this study doesn't address any of these possibilities. Instead, they take a non-generalizable study (very small sample size & limit age range) and turned it into anti-marijuana propaganda. So a big congratulations to the financial backers of this study: the National Institute on Drug Abuse, the Office of National Drug Control Policy, Counterdrug Technology Assessment Center, and the National Institute of Neurological Disorders and Stroke.<br />
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The sad part is, the media machine just regurgitates this garbage verbatim. <br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhyWdFt6fNhEOwwWCoRB421qVCn67hIisAb9V6cF7i0rRuWc49qJrTkwqcxjDGc4EAoKhwSrhwhIbbG9M5LBa-GJeUZjHxeLrLwIdS37Vf_bpkAPlZWURZ6BVmmgv3pXz7ace9izNypiXpZ/s1600/marijuana.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhyWdFt6fNhEOwwWCoRB421qVCn67hIisAb9V6cF7i0rRuWc49qJrTkwqcxjDGc4EAoKhwSrhwhIbbG9M5LBa-GJeUZjHxeLrLwIdS37Vf_bpkAPlZWURZ6BVmmgv3pXz7ace9izNypiXpZ/s1600/marijuana.png" height="320" width="161" /></a></div>
<br />NeuroPsychhttp://www.blogger.com/profile/10654138293659468787noreply@blogger.com0tag:blogger.com,1999:blog-2301999496344158780.post-45333160872293286032012-06-23T11:51:00.001-07:002012-06-23T11:51:19.283-07:00Automaticity, the Stroop, and Human Behavior<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEihhrH7EASJ56dbhyphenhyphenpV6hPU5vXs4lCcYCOJtgxCKxZQawK81JgF0NLKKvJnPq_NHHAH1zK3RMyntcfua1_JCrPyCwuOa_kuJbzswA6SYqLHV6GDA9U68I8rwZr52GZhM1289fXt82MwEvJl/s1600/Stroop-fig1.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="144" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEihhrH7EASJ56dbhyphenhyphenpV6hPU5vXs4lCcYCOJtgxCKxZQawK81JgF0NLKKvJnPq_NHHAH1zK3RMyntcfua1_JCrPyCwuOa_kuJbzswA6SYqLHV6GDA9U68I8rwZr52GZhM1289fXt82MwEvJl/s320/Stroop-fig1.jpg" width="320" /></a></div>Think back to when you learned to tie your shoelaces; you needed to think carefully through each step of the process. Probably, you made errors over the course of multiple attempts. Now you probably do not even think about the steps, but simply initiate a series of movements that proceed without any further influence. There are many behaviors that followed this same pattern of learning: reading, writing, typing, bicycling, piano playing, driving, etc. When a behavior no longer requires direct, deliberate thinking to perform, the behavior is <i>automatized</i>.<br />
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The amazing thing about automatized behaviors is that many people state that they do not consciously know how the behavior is performed, they just can do it. This is typically referred to as unconscious memory or <a href="http://en.wikipedia.org/wiki/Implicit_memory" target="_blank">implicit memory</a>. For example, try explaining how to properly maintain your balance while riding a bike. Difficult, right?<br />
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In some instances, a behavior can be so over learned that we do it automatically. Or, in other words, we do it without thinking. A great example of this is <i>reading</i>. For literate people, it's impossible to not read. What I mean by that is, if a random word were to flash on the screen, you could not stop your self from reading it. Even if the word were flashed on the screen for a fraction of second so that it only appeared as a blip, you would have a better than chance probability of identifying the correct word if it were presented again alongside another random word.<br />
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Not only can behaviors become automatized, some behaviors can be more automatized than others. And when you have automatized behaviors compete against each other, you get <a href="http://en.wikipedia.org/wiki/Interference_theory" target="_blank">interference</a>, or the slowing down of a behavior. This concept was best and most famously demonstrated in what is known as the Stroop effect named at J.R. Stroop. In <a href="http://en.wikipedia.org/wiki/John_Ridley_Stroop" target="_blank">Stroop</a>'s classic experiment, participants were slower to properly identify the ink color when the ink was used to produce color names different from the color of the ink. That is, participants were slower to identify red ink when it spelled the blue. What makes this finding interesting is that participants are <i>specifically instructed</i> not to pay attention to the word names and simply report the color of the ink. However, this seems to be a nearly impossible task, as the word name seems to interfere with the participant's ability to report only the ink color.<br />
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Below is an example of the Stroop task. First read the color-matched words (trial 1) and then name the colors of the X's (trial 2) as quickly as you can. Note how quickly you're able to complete each task. For the third trial, try NOT read the word, but rather name the ink color in which the word is printed.<br />
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<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiElmQ4V9H4sRP8jiyS4CkaLHf74qd-uybVNFtvdRuuepHwhZ9z5DAoXWjLqhGdwze98PHdRrG9q4WEODnaEWHgRpuljHZwxA22G6E2m0Ymm5BGLCpErXc6wTb1UYeoFtnDptO60yvZ-AG2/s1600/stroop.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="143" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiElmQ4V9H4sRP8jiyS4CkaLHf74qd-uybVNFtvdRuuepHwhZ9z5DAoXWjLqhGdwze98PHdRrG9q4WEODnaEWHgRpuljHZwxA22G6E2m0Ymm5BGLCpErXc6wTb1UYeoFtnDptO60yvZ-AG2/s400/stroop.png" width="400" /></a></div>The difficulty you experience completing the third trial relative to the other two is interference. The automaticity of reading is eliciting a response that is different from the one that is required (naming the ink color) and therefore competes with the response that your suppose to make.<br />
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Aside from this being a cool demonstration of automaticity, did you know that you can use automatic behaviors to influences the behavior of others? In an experiment done by <a href="http://psycnet.apa.org/index.cfm?fa=buy.optionToBuy&id=1979-23568-001" target="_blank">Langer and colleagues</a>, it was demonstrated how compliant people will be with a small request as long as they heard what <i>sounded as if</i> they are being given a sound reason, even though no actual reason is given. In the experiment, an individual approached people standing in line to use a copy machine and presented one of three requests:<br />
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1. Excuse me. I have 5 pages. May I use the Xerox machine because I am in a rush? (sound reason)<br />
2. Excuse me. I have 5 pages. May I use the Xerox machine? (no reason)<br />
3. Excuse me. I have 5 pages. May I use the Xerox machine because I need to make some copies? (non-sound reason).<br />
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<span>When given a request plus a sound reason (#1), 94% of subjects complied with the request. However, when given a request with no reason (#2), only 60% of subjects complied. But when given a request plus what sounds like a reason (#3), but actually wasn't a reason, the compliance rate jumped back to 93%!</span><br />
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What people were responding to was not sound reasoning, but to syntactical structure: a request followed by what should be a sound reason. Most of our behavior, it turns out, is automatic. That includes speaking and thinking. In other words, when we are doing something, we are doing it without occupying our minds. This means that our minds are often free to engage in other, higher order, and more meaningful activities; like watching TV.NeuroPsychhttp://www.blogger.com/profile/10654138293659468787noreply@blogger.com1tag:blogger.com,1999:blog-2301999496344158780.post-38034218846998755962012-06-20T13:06:00.001-07:002012-06-20T13:06:58.166-07:00Saccadic Masking, Chronostasis, and Concsiousness<div style="text-align: left;">
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<img height="188" src="http://www.photoshopessentials.com/images/photo-effects/ghosting/image-motion-blur.jpg" width="320" />
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<span>Time. What is it? To some, Time is a </span><a href="http://www.theonion.com/video/time-announces-new-version-of-magazine-aimed-at-ad,17950/" target="_blank">kid-friendly news magazine</a><span> characterized by info-graphics and colorful pictures. To others, Time represents a continuum of continued progress of events from the past, present, and future. While Time is indefinitely continuous, its rate can appear quite variable, at least to humans.</span></div>
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Below is a clock face with an active seconds hand. Focus your gaze on something nearby (e.g., something just above your CPU monitor) then shift your gaze to the clock and watch time elapse for 5 seconds. What you should notice is that the first second to elapse appears to take longer than the subsequent 4 seconds (It's subtle, you may have to try this a few times to notice the illusion).</div>
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<embed height="200" src="http://flash-clocks.com/free-flash-clocks-blog-topics/free-flash-clock-175.swf" type="application/x-shockwave-flash" width="200" wmode="transparent"></embed></div>
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If you did notice time lag, then you just experienced <a href="http://en.wikipedia.org/wiki/Chronostasis" target="_blank">chronostasis</a>. Chronostasis is the experience or illusion that occurs immediately after a saccade that appears to stop time momentarily. This occurs so much that every day we experience 40 minutes of chronostasis, though it goes entirely unnoticed.<br />
<span text-align: -webkit-auto;"><br />So what's going here? When our eyes move, the image reflected on to the retina is also in motion. This creates </span><a href="http://en.wikipedia.org/wiki/Motion_blur" " target="_blank">motion blur</a><span text-align: -webkit-auto;"> (see picture at beginning of this post). A blurred image being utterly incomprehensible (and of no use) to us sighted humans, our brains have a mechanism to circumvent the blur an create a comprehensible image. This phenomenon is known as saccadic masking. During saccadic masking, the blur is suppressed, along with visual processing, and the gap in visual processing that should be experienced as your eyes move from on side to another. The brain then replaces the blur with an image of the very next thing that your eyes fixate on. </span><span text-align: -webkit-auto;"> </span></div>
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This explains chronostasis experienced in the clock illusion. As you shift your gaze to fixate on the clock, instead of seeing a incomprehensible blur, the blur is supplanted with an image of the clock that your currently fixated. That's why that first second to elapse appears longer than all other subsequent seconds.</div>
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The process is depicted below:</div>
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<a href="http://www.experimentation-online.co.uk/imgs/brainz_harrypettit_04.12_1.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="179" src="http://www.experimentation-online.co.uk/imgs/brainz_harrypettit_04.12_1.jpg" width="320" /></a></div>
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<img height="179" src="http://www.experimentation-online.co.uk/imgs/brainz_harrypettit_04.12_2.jpg" width="320" />
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<span>The first figure depicts what actually occurs, but only our subconscious brain perceives. Figure two shows what what we actually see. If you imagine that point two is the image of the clock, our brain then fills in the time that had motion blur with the same image. </span></div>
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If the brain is replacing a past image with a current image, does that mean what I'm seeing is not really in the present but the past? Yes, in fact, human awareness or what we experience as the "present" is actually the very recent past; more specifically <a href="http://blogs.scientificamerican.com/observations/2011/09/15/time-on-the-brain-how-you-are-always-living-in-the-past-and-other-quirks-of-perception/" target="_blank">our consciousness lags 80 milliseconds behind actual events</a>. This is how saccadic masking and chronostasis are possible; before we become aware, our brain has to make sense of stimuli first, which takes just about 80 milliseconds.</div>
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As it turns out, saccadic masking and the 80 millisecond lag in awareness explain many of the visual illusions that many may already be aware of such as the moving snake illusion. As you move your eyes looking at the image below, the illusion of motion is apparent. If you fix your gaze on a black dot, the illusion of motion will cease. </div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj52kI-n4dxqzBqHo5Zwgusl3J0CbnPfdsqdreUTj0YPxDt2tTR2wMrEVbPQ9zSUimMRlp11UmulqyC3rBfTHYSV8eDZwwyI39IZ4WzoekhxOQef3dcDbXodZVRghSIn5DVXUn6m2fJ60fI/s1600/snakes.gif" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj52kI-n4dxqzBqHo5Zwgusl3J0CbnPfdsqdreUTj0YPxDt2tTR2wMrEVbPQ9zSUimMRlp11UmulqyC3rBfTHYSV8eDZwwyI39IZ4WzoekhxOQef3dcDbXodZVRghSIn5DVXUn6m2fJ60fI/s320/snakes.gif" width="320" /></a></div>
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There are other phenomenon as it relates to time perception: Time passing more quickly as we age and time <a href="http://www.scientificamerican.com/article.cfm?id=an-odd-sense-of-timing" target="_blank">slowing down as we become scared</a>. Of course, the latter phenomenon should not be confused with <a href="http://en.wikipedia.org/wiki/Time_dilation" target="_blank">time dilation</a>, which is an actual difference of elapsed time (as opposed to perceived difference) between two events as measured by observers moving relative to each other. </div>
</div>NeuroPsychhttp://www.blogger.com/profile/10654138293659468787noreply@blogger.com1tag:blogger.com,1999:blog-2301999496344158780.post-47510879582392820392012-01-27T12:09:00.000-08:002012-01-27T19:02:46.641-08:00Al Sharpton is an Idiot<div class="separator" style="clear: both; text-align: center;">
<a href="http://i.huffpost.com/gen/478539/thumbs/r-AL-SHARPTON-large570.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="132" src="http://i.huffpost.com/gen/478539/thumbs/r-AL-SHARPTON-large570.jpg" width="320" /></a></div>
<span style="font-family: Arial,Helvetica,sans-serif;">America's Panacea for racial Freudian slips, Al Sharpton, had a "<a href="http://www.huffingtonpost.com/2012/01/26/al-sharptons-tim-huelskamp_n_1233416.html?ref=media" target="_blank">heated clash</a>" with a Republican congressman whose identity isn't important since, if he actually agreed with Sharpton, he wouldn't have been on his program in the first place. </span><span style="font-family: Arial,Helvetica,sans-serif;"><br /><br />What caused Sharpton to contort his face in such unnatural manner was the following exchange: </span><span style="font-family: Arial,Helvetica,sans-serif;">Sharpton:</span><span style="color: purple; font-family: Arial,Helvetica,sans-serif;"> "<span style="background-color: white; line-height: 18px; text-align: left;">Is it fair that </span>billionaires pay a lower tax rate<span style="background-color: white; line-height: 18px; text-align: left;"> than their own secretaries?" To which the Republican replied, "</span><span style="background-color: white; line-height: 18px; text-align: left;">Well they actually don't, according to the IRS." </span></span><span style="background-color: white; font-family: Arial,Helvetica,sans-serif; line-height: 18px; text-align: left;"><br /><br />Now, if two reasonable people were having this discussion, the conversation might proceed like this, Sharpton: </span><span style="background-color: white; color: blue; font-family: Arial,Helvetica,sans-serif; line-height: 18px; text-align: left;">"Will you please show me the IRS data about which you speak? So I may correct myself"; Republican: "Sure Al; and would you like some motherfucking ice tea?" </span><span style="background-color: white; font-family: Arial,Helvetica,sans-serif; line-height: 18px; text-align: left;"><br /><br />Reality turn out differently,<span style="color: purple;"> "</span></span><span style="background-color: white; color: purple; font-family: Arial,Helvetica,sans-serif; line-height: 18px; text-align: left;">Sharpton started to raise his voice and asked the question again. 'Is it fair? Is it fair?' Huelskamp continued to deny the accuracy of Sharpton's question. 'It's not true, Al.' </span><span style="background-color: white; color: purple; font-family: Arial,Helvetica,sans-serif; line-height: 18px; text-align: left;">Sharpton then said 'on the basis of the report—</span><i style="background-color: white; font-family: Arial,Helvetica,sans-serif; line-height: 18px; text-align: left;"><b>if the report is inaccurate, fine, you stipulate that</b></i><span style="background-color: white; color: purple; font-family: Arial,Helvetica,sans-serif; line-height: 18px; text-align: left;">—I'm asking you, is it fair? Is the arrangement fair, in your opinion?'" </span><span style="background-color: white; font-family: Arial,Helvetica,sans-serif; line-height: 18px; text-align: left;"><br /><br />There is only one answer that Sharpton is willing to hear: NO! He's not interested in facts; notice how he continues to seek an answer even after granting that the statement "billionaires pay less than their secretaries" might be false. </span><span style="background-color: white; font-family: Arial,Helvetica,sans-serif; line-height: 18px; text-align: left;"><b><br /><br />1. Warren Buffett's "secretary" is an idiot.</b></span><span style="background-color: white; font-family: Arial,Helvetica,sans-serif; line-height: 18px; text-align: left;"> </span><span style="font-family: Arial,Helvetica,sans-serif; line-height: 18px; text-align: left;">Some time ago, Mr. Buffett claimed that his secretary made $60,000 and paid a 30% tax rate. Here's the problem with that: o</span><span style="font-family: Arial,Helvetica,sans-serif; line-height: 16px; text-align: left;">ur income tax system is <i>progressive</i>, meaning that we pay higher tax rates as our income gets higher. As the table below shows, there are six tax brackets.</span><br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhvHTr7e14YlbyhctVHXXIjHfySRFTt3GtA90LveKCq6bMAcCaRQBffdrKz82cyqUOMHj0AEeaHKqAi_yuIUQXdH82ah4vQkBUb0VvJt6S9DxmrkyQgUBGeY3GDlRgHKKMRucxmFiASTup9/s1600/projected-2009-income-tax-brackets.gif" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><span style="font-family: Arial,Helvetica,sans-serif;"><img border="0" height="311" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhvHTr7e14YlbyhctVHXXIjHfySRFTt3GtA90LveKCq6bMAcCaRQBffdrKz82cyqUOMHj0AEeaHKqAi_yuIUQXdH82ah4vQkBUb0VvJt6S9DxmrkyQgUBGeY3GDlRgHKKMRucxmFiASTup9/s400/projected-2009-income-tax-brackets.gif" width="400" /></span></a></div>
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<span style="font-family: Arial,Helvetica,sans-serif;"><span style="line-height: 16px;"><br />Let's say our income (husband and wife jointly filing) is $112,000. This would put us in the 25% bracket. If the U.S. had a flat rate tax system (and no deduction), we would pay 25 percent of $112,000 in income tax, or $28,000 </span><span style="line-height: 16px;">(a common misunderstanding of how the tax system functions). Under our tax system we pay 10 percent on the first $17,000, or $1,700. We then pay 15 percent on the next band of income up to $69,000, or $7,800. We then pay 25 percent on the marginal amount over $69,000, for another $10,750 in taxes. When we total the taxes paid on these three bands of income it comes to $20,250, for an average (or effective) tax rate of 18.8 percent. The national average is 11% </span></span><span style="font-family: Arial,Helvetica,sans-serif;">(Note that effective tax rate is what was actually paid. It will always be lower than the marginal tax rate).<br /></span></div>
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<span style="font-family: Arial,Helvetica,sans-serif;"><span style="line-height: 16px;"><b><a href="http://taxfoundation.org/blog/show/27911.html" target="_blank">Effective Tax Rates by Income (2009)</a></b> </span></span></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh3bhPLgHdS1R36Ri9RJ0sV0MO_WgMeJapbYY3nuMotnnao8kHfRkaF1fSr_Nxo6wy0UDG_vyQ7oWkzb4x_sUuXy6fgLWnbK5Lkg4s0mqMHot2GPbKFpmZaRC-7Yr-TN060yIJJiNmpsRgW/s1600/effective+tax+rate.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><span style="font-family: Arial,Helvetica,sans-serif;"><img border="0" height="290" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh3bhPLgHdS1R36Ri9RJ0sV0MO_WgMeJapbYY3nuMotnnao8kHfRkaF1fSr_Nxo6wy0UDG_vyQ7oWkzb4x_sUuXy6fgLWnbK5Lkg4s0mqMHot2GPbKFpmZaRC-7Yr-TN060yIJJiNmpsRgW/s400/effective+tax+rate.png" width="400" /></span></a></div>
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<span style="font-family: Arial,Helvetica,sans-serif;"><br />According to the bracket for single filers </span><span style="font-family: Arial,Helvetica,sans-serif;">(let's assume Mr. Buffett's "secretary" is single)</span><span style="font-family: Arial,Helvetica,sans-serif;">, she would have paid $830 on the first $8,300 of her income (10%) and then she would have paid $3,255 for the remaining $21,700 of her income ($30,000 - $8,300). A total of $4,085 would have been paid for an </span><i style="font-family: Arial,Helvetica,sans-serif;">effective tax rate</i><span style="font-family: Arial,Helvetica,sans-serif;"> of 13.6% (This does not include deductions and credits, which would have likely lowered her rate to 7%). Clearly Mr. Buffett needs to educate his "secretary" on how to file tax returns; after which, he should fire her. </span><span style="font-family: Arial,Helvetica,sans-serif;"><br /><b><br />2. Who decides what is fair?</b></span></div>
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<b><b style="text-align: center;"><br />How Much Should the Top 1% Pay Before It's Considered Fair?</b></b></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgj4e73ruIYz4AiEFTicOsWCYk69CN3qnkd73mkH4gVj55Hy8fWMmkQUYryJvkO9FUcSSULCLfbI-nISkcXdQo3V7CS7ipWEKSvg6XK-kKgE1uKW3CwEfqnDuXMhpuiWbJ9XH-epEoXhf8n/s1600/2009+tax+burden.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><span style="font-family: Arial,Helvetica,sans-serif;"><img border="0" height="305" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgj4e73ruIYz4AiEFTicOsWCYk69CN3qnkd73mkH4gVj55Hy8fWMmkQUYryJvkO9FUcSSULCLfbI-nISkcXdQo3V7CS7ipWEKSvg6XK-kKgE1uKW3CwEfqnDuXMhpuiWbJ9XH-epEoXhf8n/s400/2009+tax+burden.jpg" width="400" /></span></a></div>
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<span style="font-family: Arial,Helvetica,sans-serif; line-height: 16px;"><br />The top 1% of income earners (those with incomes of</span><span style="font-family: Arial,Helvetica,sans-serif; line-height: 16px;"> </span><span style="font-family: Arial,Helvetica,sans-serif;"><span style="line-height: 16px;">$343,927 in 2009) paid a larger percentage of the income tax (36.73%) than the bottom 90% combined (29.5%). Also in 2009, the top 1% earned</span><a href="http://www.taxfoundation.org/news/show/250.html" style="line-height: 16px;" target="_blank"> 16.9%</a><span style="line-height: 16px;"> of the adjusted gross income (that's down from 20% before the recession). </span></span><span style="font-family: Arial,Helvetica,sans-serif;"><span style="line-height: 16px;"><br /></span><br />On the other side of the coin are the non-payers. </span><span style="font-family: Arial,Helvetica,sans-serif; line-height: 16px;">A non-payer tax return is one filed by an individual or couple who, thanks to legal credits and deductions, owes nothing.</span><span style="font-family: Arial,Helvetica,sans-serif;"> In 2009, a </span><a href="http://www.taxfoundation.org/news/show/25962.html" style="font-family: Arial,Helvetica,sans-serif;" target="_blank">record number</a><span style="font-family: Arial,Helvetica,sans-serif;"> of individuals (58 million) paid no income tax. That is,</span><a href="http://www.taxfoundation.org/blog/show/27702.html?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+TaxPolicyBlog+%28Tax+Foundation+-+Tax+Foundation%27s+%22Tax+Policy+Blog%22%29&utm_content=Google+Reader" style="font-family: Arial,Helvetica,sans-serif;" target="_blank"> 42%</a><span style="font-family: Arial,Helvetica,sans-serif;"> of tax filers were non-payers.</span><a href="http://www.taxfoundation.org/blog/show/27661.html?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+TaxPolicyBlog+%28Tax+Foundation+-+Tax+Foundation%27s+%22Tax+Policy+Blog%22%29&utm_content=Google+Reader" style="font-family: Arial,Helvetica,sans-serif;" target="_blank"> Only 0.3%</a><span style="font-family: Arial,Helvetica,sans-serif;"> (</span><a href="http://www.irs.gov/taxstats/indtaxstats/article/0,,id=96981,00.html" style="font-family: Arial,Helvetica,sans-serif;" target="_blank">2009 data, table 1.1</a><span style="font-family: Arial,Helvetica,sans-serif;">) </span><span style="font-family: Arial,Helvetica,sans-serif; line-height: 16px;">of those non-payers earn more than $100,000. </span></div>
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<span style="font-family: Arial,Helvetica,sans-serif; line-height: 16px;"><br />I'll repeat that since it's mildly important: 42% of the bottom 85% of income earners (i.e., <$100,000) paid no income tax.</span><span style="font-family: Arial,Helvetica,sans-serif; line-height: 16px;"><br /><br />Moreover, many of these non-payers also receive "refundable" tax credits even though they have no income tax liability. For millions of these non-payers, these refundable credits exceed their total payroll tax (i.e., social security, medicare, unemployment) contributions. In</span><span style="font-family: Arial,Helvetica,sans-serif; line-height: 16px;"> 2008, more than a third of all tax returns resulted in complete nonpayment; that is, people got back every dollar that was withheld from their paychecks during the year. </span><span style="font-family: Arial,Helvetica,sans-serif; line-height: 16px;"><br /><b><br />3. Raising Taxes on Wealthy Won't Fix Anything<br /></b></span></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj0jUnmDbBGIn_fxhh6Vk0rRYk4FcNjYsaIlqQBxMYfIVMHuduy9NCwTdyk4krsNtU81hnG1YwwQNDPUsz7YdzZ0qy1akhdD9r8Bs_IToCbpPq0lllTPykFzXybQCSnfx3bs-_-k2XYXCV1/s1600/public+debt.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><span style="font-family: Arial,Helvetica,sans-serif;"><img border="0" height="70" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj0jUnmDbBGIn_fxhh6Vk0rRYk4FcNjYsaIlqQBxMYfIVMHuduy9NCwTdyk4krsNtU81hnG1YwwQNDPUsz7YdzZ0qy1akhdD9r8Bs_IToCbpPq0lllTPykFzXybQCSnfx3bs-_-k2XYXCV1/s400/public+debt.png" width="400" /></span></a></div>
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<span style="font-family: Arial,Helvetica,sans-serif; line-height: 16px;"><br />Earlier, congress wanted to impose a 5.6% surtax on those with incomes above $1,000,000. According to the CBO, that tax would raise $450 billion over the next 10 years. That's 45 billion a year. Last year's deficit (fiscal year 2011) was 1.3 trillion, the second largest deficit of any nation in the history of the world. After you subtract 450 billion from 1.3 trillion you get 850 billion. If you cut out all non-defense discretionary spending you save $530 billion, leaving our deficit at $320 billion. Only after halving securing spending, will last year's deficit go away.</span><span style="font-family: Arial,Helvetica,sans-serif; line-height: 16px;"><br /><b><br />4. Stop Blaming the Bush Tax Cuts</b></span></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi19bqN029ARSoiZ-LIwU2OexhfYCz6ah6l9wzKYBBxk-mVhFKbrZ_t7XpSbs5H1Hn3O2GbCV9s5xA3qrwKBeYLbCN_75SDckc-8nRQw9f7kh5pWWBTlRn1DMlhv1NbN6hxUaUps2SiiG6B/s1600/CBO_Pie_Chart_May_2011.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><span style="font-family: Arial,Helvetica,sans-serif;"><img border="0" height="301" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi19bqN029ARSoiZ-LIwU2OexhfYCz6ah6l9wzKYBBxk-mVhFKbrZ_t7XpSbs5H1Hn3O2GbCV9s5xA3qrwKBeYLbCN_75SDckc-8nRQw9f7kh5pWWBTlRn1DMlhv1NbN6hxUaUps2SiiG6B/s400/CBO_Pie_Chart_May_2011.png" width="400" /></span></a></div>
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<span style="font-family: Arial,Helvetica,sans-serif;"><span style="line-height: 16px;">The <a href="http://www.cbo.gov/ftpdocs/121xx/doc12187/ChangesBaselineProjections.pdf" target="_blank">CBO</a>, </span><span style="line-height: 16px;"> </span><span style="line-height: 16px;">broke "down the major components of the $11.8 trillion swing from surpluses to deficits over the ten year period 2002 to 2011." Higher spending turns out to be the largest factor erasing those surplus projections.</span></span></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiZw-9sVt5y3rW4Sy2ZC2fin4EKP64g4ZYqTOZWcKa7sqtpko5r_XGosQw2Nh7yniCysUJLgKtQbuPfmt-2xgAk-w_DMHkOK-VkRy-5JlaU_ViQgoKmiBOpThCDl6-JAZQbNCRg8WWWo4MK/s1600/CBO-back-cast-2001-to-2011-May-2011.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><span style="font-family: Arial,Helvetica,sans-serif;"><img border="0" height="353" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiZw-9sVt5y3rW4Sy2ZC2fin4EKP64g4ZYqTOZWcKa7sqtpko5r_XGosQw2Nh7yniCysUJLgKtQbuPfmt-2xgAk-w_DMHkOK-VkRy-5JlaU_ViQgoKmiBOpThCDl6-JAZQbNCRg8WWWo4MK/s400/CBO-back-cast-2001-to-2011-May-2011.png" width="400" /></span></a></div>
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<span style="font-family: Arial,Helvetica,sans-serif; line-height: 16px;"><br /><br />As the chart <a href="http://www.taxfoundation.org/blog/show/27364.html?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+TaxPolicyBlog+%28Tax+Foundation+-+Tax+Foundation%27s+%22Tax+Policy+Blog%22%29" target="_blank">above</a> shows, the Bush Tax cuts have been declining in significance as a contributing factor to the annual deficits while increased spending and recent tax cuts (e.g., payroll tax cut) are larger contributing factors to annual deficits.</span></div>
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<span style="font-family: Arial,Helvetica,sans-serif; line-height: 16px;"><b>5. The Elephant in the Room</b></span></div>
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<span style="font-family: Arial,Helvetica,sans-serif; line-height: 16px;"><a href="http://useconomy.about.com/od/fiscalpolicy/p/Mandatory.htm" target="_blank">Mandatory spending</a> is consumes 60% of the annual budget. That Social Security (761 billion), Medicare (468 billion), and Medicaid (269 billion). And last*, but certainly not least is Defense spending ($660 billion), which is not actually mandatory spending, although it should be since no one wants to touch it. </span></div>
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<span style="font-family: Arial,Helvetica,sans-serif; line-height: 16px;">Until people start focusing on reforming these programs and these programs alone, all other talk is a waist of time. </span></div>
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<span style="line-height: 16px;"><span style="font-family: Arial,Helvetica,sans-serif;">The information is out there, all you have to do is let it in...</span></span></div>
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<span style="font-family: Arial,Helvetica,sans-serif;"><span style="line-height: 16px;"> </span><span style="line-height: 16px;"> </span></span></div>
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<span style="line-height: 16px;"><span style="font-family: Arial,Helvetica,sans-serif;">*All <i>other</i> mandatory spending programs combined (e.g., food stamps, unemployment) total over 600 billion. </span></span>
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<span style="font-family: Helvetica,Arial,sans-serif; font-size: 12px; line-height: 16px;"><br /></span></div>NeuroPsychhttp://www.blogger.com/profile/10654138293659468787noreply@blogger.com0tag:blogger.com,1999:blog-2301999496344158780.post-17159364789039333342011-01-07T12:41:00.000-08:002011-01-07T12:56:10.235-08:00Koo Koo for Four Loko<div class="separator" style="clear: both; text-align: center;"><a href="http://www.splicetoday.com/vault/posts/0001/6293/29094_10100170262324753_2231657_56291146_1060242_n_large.jpg?1290922328" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="240" src="http://www.splicetoday.com/vault/posts/0001/6293/29094_10100170262324753_2231657_56291146_1060242_n_large.jpg?1290922328" width="320" /></a></div>Next time you watch your local news, remember this: News Media = Misses the Entire Point.<br />
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If you have not seen the news about the drink <a href="http://www.neiuindependent.com/opinions/bottoms-down-four-loko-banned-1.1830742">Four Loko being banned</a>, I will bring you up to speed.<br />
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According to various we-have-nothing-else-to-report news organizations, the drink <i>Four Loko</i> is to some, a "<span style="color: purple;">blackout in a can</span>" and to others, it is "<span style="color: purple;">cocaine in a can.</span>" <i>Four Loko</i>, through its "<span style="color: purple;">witch brew</span>" mixture of alcohol and caffeine can, according to research (<a href="http://reason.com/blog/2010/11/11/look-what-nine-drunken-idiots">1a</a>), cause a person to become a "<span style="color: purple;">wide-awake drunk</span>," and thus impair a person's ability to judge his or her level of intoxication. The negative effects of this drink, which has predominately affected college students, are "<span style="color: purple;">spreading like a plague across the country.</span>" (<a href="http://reason.com/archives/2010/11/24/loco-over-four-loko">1b</a>, <a href="http://reason.com/blog/2010/11/11/look-what-nine-drunken-idiots">1c</a>).<br />
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In all, Michigan, Oklahoma, Washington, Utah, and New York have banned the drink. The FDA evaluated the situation and said that caffeine is an "unsafe food additive" (<a href="http://www.fda.gov/Food/FoodIngredientsPackaging/ucm190366.htm">2</a>). Because of this negative publicity, Fusion Projects has removed the caffeine content from their <i>Four Loko</i> brand.<br />
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However, even the removal of caffeine is not enough according to some experts (<a href="http://uwire.com/2010/12/07/experts-say-four-loko-remains-harmful-despite-caffeine-removal/">3</a>). For some strange reason, all of these "experts" reside at Rutgers University:<br />
<blockquote>"<span style="color: purple;">When consulted about the combination of caffeine and alcohol in one 24.5 oz. can, Rutgers U. nutritionist and registered dietitian Peggy Policastro explained the concoction’s effects on the body. 'The natural response of the body to alcohol is sleepiness and fatigue,' she said. 'When a stimulant such as caffeine is added, this response is blocked, allowing for the consumer to engage is riskier behavior for longer.</span>'"</blockquote><blockquote></blockquote>Here is an example of how the news covered this "controversy":<br />
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<div class="separator" style="clear: both; text-align: center;"><object class="BLOGGER-youtube-video" classid="clsid:D27CDB6E-AE6D-11cf-96B8-444553540000" codebase="http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0" data-thumbnail-src="http://1.gvt0.com/vi/WXgm01r_wBU/0.jpg" height="266" width="320"><param name="movie" value="http://www.youtube.com/v/WXgm01r_wBU&fs=1&source=uds" /><param name="bgcolor" value="#FFFFFF" /><embed width="320" height="266" src="http://www.youtube.com/v/WXgm01r_wBU&fs=1&source=uds" type="application/x-shockwave-flash"></embed></object></div><br />
I've transcribed the more hyperbolic parts:<br />
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The created context is about the dangers of <i>Four Loko (i.e., </i>don't blame irresponsible teenage behavior)<br />
<blockquote>Anchor: "<span style="color: purple;">Well, four teens are hospitalized in White Plains, and police say it's all because of a beverage that looks like an energy drink</span>."</blockquote> Exaggerate the affects of the this witch brew (<i>i.e.</i>, It's PCP in a can )<br />
<blockquote>Field Reporter: "<span style="color: purple;">Cops and kids say just one can of </span><i style="color: purple;">Four Loko</i><span style="color: purple;"> can make you do crazy things.</span>"</blockquote>Cue <strike>expert</strike>, er, teenager who can attest to the affects of <i>Four Loko</i><br />
<blockquote>Dumb Teen: "<span style="color: purple;">I've seen people have half of it, and they're gone...and if you have a whole one, you're...way gone.</span>"</blockquote>Cue inappropriate comparison to another beverage <br />
<blockquote>Field Reporter: "<span style="color: purple;">That's because just one can of it has an alcohol content of 12% while the average mixed drink or beer has just 5%.</span>"(Note: Wine also has a 12% alcohol content)</blockquote>Cue Morgan Rolland, a responsible teenager who has never drank <i>Four Loko</i> because "she's 19, and she's diabetic" (I bet she's a virgin too). Also note at the 50 second mark that there is a bunch of alcohol just behind her chair.<br />
<blockquote>Dumb Teen: "<span style="color: purple;">I've seen a man get very drunk off just one, and he's like a hundred and like 95 pounds and he was gone.</span>"</blockquote>Cue stupidity <br />
<blockquote>Field Reporter: "<span style="color: purple;">What's more scary is that you can pretty much buy this anywhere, and in some stores, it's not even listed in the beer section.</span>"</blockquote> Just the Facts:<br />
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<i>Four Loko</i> is an alcoholic-energy drink marketed by <a href="http://www.phusionprojects.com/index.html">Phusion Projects</a> which contains <a href="http://en.wikipedia.org/wiki/Ethanol" title="Ethanol">alcohol</a>, <a href="http://en.wikipedia.org/wiki/Caffeine" title="Caffeine">caffeine</a>, <a href="http://en.wikipedia.org/wiki/Taurine" title="Taurine">taurine</a> (which has no proven energetic affect), and <a href="http://en.wikipedia.org/wiki/Guarana" title="Guarana">guarana</a> (a rich source of caffeine). In all, <i>Four Loko</i> has the equivalent of 80mg of caffeine (<i>i.e.</i>, average cup of coffee). Depending on state law, <i>Four Loko</i> contains either 6%ABV (the equivalent of a Molson beer) or 12%ABV (equivalent to wine, <a href="http://www.montclair.edu/caps/alcoholindrinks.pdf">4</a>). It comes in a 24.5 oz. can (the equivalent of a bottle of wine). <br />
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The Problem is Teenagers, Not <i>Four Loko:</i><br />
<div><div style="background-color: transparent; border: medium none; color: black; overflow: hidden; text-align: left; text-decoration: none;"><blockquote>"<span style="color: purple;">The NIAAA states that approximately 599,000 college students in the United States get accidental alcohol-related injuries, such as alcohol poisoning. Half of them are under the legal drinking age of 21</span>" (<a href="http://www.ehow.com/about_5410509_statistics-teenagers-die-alcohol-poisoning.html">5</a>).</blockquote><blockquote>"<span style="color: purple;">There are 1,742,887 drug-related ED visits nationwide and 7 percent involved alcohol only in individuals under the age of 21.</span>" (<a href="http://www.nida.nih.gov/infofacts/hospitalvisits.html">6</a>).<br />
<div style="background-color: transparent; border: medium none; color: black; overflow: hidden; text-align: left; text-decoration: none;"><span style="font-family: inherit;"></span></div><br />
<div style="background-color: transparent; border: medium none; color: black; font-family: inherit; overflow: hidden; text-align: left; text-decoration: none;"><span style="font-family: inherit;">"<span style="color: purple;">About four in five of all college students drink, including nearly 60 percent of students age 18 to 20.</span>"</span><span style="color: #000099;"></span> </div></blockquote><blockquote><div style="background-color: transparent; border: medium none; color: black; font-family: inherit; overflow: hidden; text-align: left; text-decoration: none;">"<span style="color: purple;">Approximately two of every five college students of all ages—more than 40 percent—have reported engaging in binge drinking at least once during the past 2 weeks. However, colleges vary widely in their binge drinking rates—from 1 percent to more than 70 percent.</span>"<span style="color: black;"></span> </div></blockquote><blockquote><div style="background-color: transparent; border: medium none; color: black; font-family: inherit; overflow: hidden; text-align: left; text-decoration: none;"><span style="color: black;">"<span style="color: purple;">It is estimated that more than 696,000 students between the ages of 18 and 24 are assaulted by another student who has been drinking each year </span></span><span style="color: purple;"> (430,000 of them by a college student under 21).</span>"<span style="color: black;"></span> </div></blockquote><blockquote><div style="background-color: transparent; border: medium none; color: black; font-family: inherit; overflow: hidden; text-align: left; text-decoration: none;"><span style="color: black;"> </span><span style="color: #000099;"></span>"<span style="color: black;"><span style="color: purple;">About 11 percent of college student drinkers report that they have damaged property while under the influence of alcohol.</span>"</span><span style="color: #000099;"></span><span style="color: black;"></span> </div></blockquote><blockquote><div style="background-color: transparent; border: medium none; color: black; font-family: inherit; overflow: hidden; text-align: left; text-decoration: none;"><span style="color: black;">"<span style="color: purple;">It is estimated that more than 97,000 students between the ages of 18 and 24 are victims of alcohol-related sexual assault or date rape each year </span></span><span style="color: purple;"> (about half among students under </span><span style="color: black;"><span style="color: purple;">21).</span>"</span> </div></blockquote><blockquote><div style="background-color: transparent; border: medium none; color: black; font-family: inherit; overflow: hidden; text-align: left; text-decoration: none;"><span style="color: black;">"<span style="color: purple;">It is estimated that more than 400,000 students between the ages of 18 and 24 had unprotected sex as a result of their drinking and more than 100,000 students between the ages of 18 and 24 report having been too intoxicated to know if they consented to having sex each year" </span></span><span style="color: black;">(<a href="http://www.niaaa.nih.gov/AboutNIAAA/NIAAASponsoredPrograms/StatisticalSnapshotCollegeDrinking.htm">7</a>).</span></div></blockquote><span style="color: red;">Fact of the Day</span>: One's <i><b>Belief</b></i> that Alcohol Will Produce Relaxation, Sexual Desire, or Aggression Has More Effect on the Individual's Behavior than the Pharmacological Effects of the Drug (<a href="http://www.jsad.com/jsad/article/The_Alcohol_Expectancy_Questionnaire_An_Instrument_for_the_Assessment_of_A/3732.html">8</a>, <a href="http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WY0-4NN6WM6-9&_user=10&_coverDate=12%2F31%2F1976&_rdoc=1&_fmt=high&_orig=search&_origin=search&_sort=d&_docanchor=&view=c&_searchStrId=1599817492&_rerunOrigin=scholar.google&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=518c1813b6610aba645f1eaff9893b26&searchtype=a">9</a>, <a href="http://scholar.google.com/scholar?q=related:MzxiB2QRVyQJ:scholar.google.com/&hl=en&as_sdt=20000000000">10</a>).<br />
<br />
</div></div>NeuroPsychhttp://www.blogger.com/profile/10654138293659468787noreply@blogger.com3tag:blogger.com,1999:blog-2301999496344158780.post-34877850426915797272010-08-26T16:43:00.000-07:002010-08-26T16:43:59.180-07:00How to Use a Journal Article to Advertise Your Product<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiT8NNpUKCMKsh1CgZfpVLWfDevCkR7DBNMYtE14Jbpm7idDhJ6T4NpZdKryDQDw8Mm0xzkYoSRtgdMbbnv3xQuBnsDsuvUmbkzefy6D_KFjXSjf_23-PjeHWNBfndiGRd311ujcKmhR6Om/s1600/advertise-here.jpg" imageanchor="1" style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" ox="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiT8NNpUKCMKsh1CgZfpVLWfDevCkR7DBNMYtE14Jbpm7idDhJ6T4NpZdKryDQDw8Mm0xzkYoSRtgdMbbnv3xQuBnsDsuvUmbkzefy6D_KFjXSjf_23-PjeHWNBfndiGRd311ujcKmhR6Om/s200/advertise-here.jpg" width="196" /></a></div>From this Month's JAMA (<a href="http://jama.ama-assn.org/cgi/content/abstract/304/8/875">1</a>) "<em>Cognitive Behavioral Therapy vs Relaxation With Educational Support for Medication-Treated Adults With ADHD and Persistent Symptoms</em>" by Safren et al.<br />
<br />
In order to use an article to advertise your product, first you'll need to chose a topic about which people are fairly ignorant and make yourself an expert on it:<br />
<br />
“<span style="color: purple;">Approximately 4.4% of adults in the United States have attention-deficit/hyperactivity disorder (ADHD)</span>.” <br />
<br />
<u>Writing Style Recommendation</u>: If you use the word “approximately,” which means “near or around,” then don’t use a number with a decimal. That’s too much precision. Just say “approximately 4% of adults.”<br />
<br />
The lead author is Steven Safren, Ph.D., ABPP. In case you’re wondering, those initials mean people have to refer to him as “doctor” and believe that he actually knows what he is talking about. Although adult ADHD is rather amorphous, Safren et al. have extensively researched CBT with adult ADHD. This gives Safren et al. a posteriori authority on the topic.<br />
<br />
Second, you'll need to concoct a reason why you're conducting research: <br />
<br />
“<span style="color: purple;">…Medications have been the primary treatment; however, many adults with ADHD cannot or will not take medications while others show a poor medication response. Furthermore, those considered responders to medications may continue to experience significant and impairing symptoms. Thus, there is a need for alternative and next step strategies.</span>”<br />
<br />
<u>Reader Advisory</u>: Don’t be fooled by this “need.” It’s not a real need, it’s a constructed need (hey look at this huge hole in the ground I created! It needs to be filled!). These authors are using the construct of ADHD and the failure of medication (to treat an arbitrary construct) to accomplish their own goal. <br />
<br />
You can read the results in the abstract here (<a href="http://jama.ama-assn.org/cgi/content/abstract/304/8/875">1</a>) as they are only of secondary importance. <br />
<br />
Here is the real importance of this article: “<span style="color: purple;">Cognitive behavioral therapy was delivered consistent with our manuals</span>.” <br />
<br />
The authors of this article are also the authors of these two books (<a href="http://www.amazon.com/Mastering-Your-Adult-ADHD-Cognitive-Behavioral/dp/0195188195/ref=sr_1_1?s=books&ie=UTF8&qid=1282864170&sr=1-1">2</a>, <a href="http://www.amazon.com/Mastering-Your-Adult-ADHD-Cognitive-Behavioral/dp/0195188187/ref=sr_1_2?s=books&ie=UTF8&qid=1282864170&sr=1-2">3</a>). This journal article will serve as a marketing device for these manuals.<br />
<br />
It works like this: First, they will give “talks” touting the results of this research. <br />
<br />
“<span style="color: red;">I am going to show you a bunch of statistics that have no real world relevance…</span>”<br />
<br />
Second, they will conclude that pointless discussion with…<br />
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“<span style="color: red;">Our manual is available in the literature section located in the lobby</span>.” <br />
<br />
Unfortunately, those manuals don’t contain actual cognitive and behavioral material. Sure, they use the jargon, but it’s not actual CBT.<br />
<br />
<u>Writing Style Recommendation</u>: Add words to mundane terms, thus making them appear more important than they actually are.<br />
<br />
“<span style="color: purple;">Sessions were designed specifically to meet the needs of ADHD patients and included things like starting and maintaining calendar and task list <em>systems</em></span>”<br />
<br />
Anybody can use a calendar or task list, but only “doctors” can provide instruction on how to use a calendar system or a task list system. <br />
<br />
Here's a beauty...<br />
<br />
“<span style="color: purple;">The first module focused on psycho-education about ADHD…</span>” <br />
<br />
What’s the difference between psycho-education and regular education you ask?<br />
<br />
If you read an ADHD article on webMD, that’s “education.” When a psychologist prints out that webMD article and hands it to you, that’s “psycho-education.” <br />
<br />
Study CBT protocol (i.e., the important one)<br />
<br />
<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjjRCdqb0N0_SiMcUMzs2ZPHTmQpkmpcHqzJEpyq28AtUiN3HQoRcYZN0LVnwtS9UHpYmMlhpw7XhGNbxHAizMo25OshulgHJVz7bX4oRfmXVYYGzk79eUeHIPssxKWdwB_d0IrHxvTa4XX/s1600/untitled.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" ox="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjjRCdqb0N0_SiMcUMzs2ZPHTmQpkmpcHqzJEpyq28AtUiN3HQoRcYZN0LVnwtS9UHpYmMlhpw7XhGNbxHAizMo25OshulgHJVz7bX4oRfmXVYYGzk79eUeHIPssxKWdwB_d0IrHxvTa4XX/s1600/untitled.JPG" /></a></div><br />
Study Relaxation protocol (i.e., the unimportant one)<br />
<br />
<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgkhUtL1cK4BCki9hDf51UopBt-pbUPEFbO8ez6yuVXGmBUUwL5PM6-V4TmQIdFG2a-1zNIFAnv_HArkDqQBaNL583EN5_1wY-tP0hkB3Dt2m2XppnKRY2sDDYP9mZCqcyOml3hCpf1IL2M/s1600/education.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" ox="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgkhUtL1cK4BCki9hDf51UopBt-pbUPEFbO8ez6yuVXGmBUUwL5PM6-V4TmQIdFG2a-1zNIFAnv_HArkDqQBaNL583EN5_1wY-tP0hkB3Dt2m2XppnKRY2sDDYP9mZCqcyOml3hCpf1IL2M/s1600/education.JPG" /></a></div><br />
Other cutting edge cognitive behavioral techniques include “<span style="color: purple;">setting priorities</span>” and “<span style="color: purple;">breaking large tasks into manageable steps</span>.” Oh snap!<br />
<br />
I argue that this is not CBT but rather a collection of common sense solutions to everyday organizational needs. However, Safren et al. refer to this as a particular “<span style="color: purple;">type of cognitive behavioral therapy</span>,” which was successfully documented to be useful “<span style="color: purple;">as a next-step strategy for patients with ADHD</span>…” <br />
<br />
So you better go buy those books!<br />
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<span style="float: left; padding: 5px;"><a href="http://www.researchblogging.org"><img alt="ResearchBlogging.org" src="http://www.researchblogging.org/public/citation_icons/rb2_large_gray.png" style="border:0;"/></a></span><br />
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<span class="Z3988" title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.jtitle=JAMA+%3A+the+journal+of+the+American+Medical+Association&rft_id=info%3Apmid%2F20736471&rfr_id=info%3Asid%2Fresearchblogging.org&rft.atitle=Cognitive+Behavioral+Therapy+vs+Relaxation+With+Educational+Support+for+Medication-Treated+Adults+With+ADHD+and+Persistent+Symptoms%3A+A+Randomized+Controlled+Trial.&rft.issn=0098-7484&rft.date=2010&rft.volume=304&rft.issue=8&rft.spage=875&rft.epage=80&rft.artnum=&rft.au=Safren+SA&rft.au=Sprich+S&rft.au=Mimiaga+MJ&rft.au=Surman+C&rft.au=Knouse+L&rft.au=Groves+M&rft.au=Otto+MW&rfe_dat=bpr3.included=1;bpr3.tags=Clinical+Research%2CPsychology">Safren SA, Sprich S, Mimiaga MJ, Surman C, Knouse L, Groves M, & Otto MW (2010). Cognitive Behavioral Therapy vs Relaxation With Educational Support for Medication-Treated Adults With ADHD and Persistent Symptoms: A Randomized Controlled Trial. <span style="font-style: italic;">JAMA : the journal of the American Medical Association, 304</span> (8), 875-80 PMID: <a rev="review" href="http://www.ncbi.nlm.nih.gov/pubmed/20736471">20736471</a></span>NeuroPsychhttp://www.blogger.com/profile/10654138293659468787noreply@blogger.com6tag:blogger.com,1999:blog-2301999496344158780.post-78821246868009515332010-05-28T15:53:00.000-07:002010-05-28T15:53:39.088-07:00Cerebellar Agenesis: Life without a Cerebellum<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiYA6LMHC0bVzw0vTt4iftAciJIdiVSoXdhnAL2pyrQPe_jP5SpK0dvM9iUDf-81ERHxuk35uZa3Rzr0uPYWETqwiSevNmuEEZOMnfbCH-ccT6k_CMBP1PGgksJQWeyZAM5HLfp22ecXqsJ/s1600/agenesis.GIF" imageanchor="1" style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" gu="true" height="148" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiYA6LMHC0bVzw0vTt4iftAciJIdiVSoXdhnAL2pyrQPe_jP5SpK0dvM9iUDf-81ERHxuk35uZa3Rzr0uPYWETqwiSevNmuEEZOMnfbCH-ccT6k_CMBP1PGgksJQWeyZAM5HLfp22ecXqsJ/s200/agenesis.GIF" width="200" /></a></div>Many people are familiar with the famous patient <a href="http://en.wikipedia.org/wiki/HM_(patient)">H.M.</a>, the man who, in an attempt to control his intractable epilepsy, underwent surgical resection of both his medial temporal lobes.<br />
<br />
There is another patient who is less famous, known the by initials H.C. He died in 1939 when H.M. was just entering adolescence. Unlike H.M., this patient did not undergo radical resection surgery. In fact, he never underwent brain surgery at all. His contribution to neurology did not begin until after his death at the age of 76. <br />
<br />
In what was supposed to have been a routine autopsy, H.C. was discovered to have had no <a href="http://en.wikipedia.org/wiki/Cerebellum">cerebellum</a> (see pictured brain above). H.C. had a very rare neurological condition known as <a href="http://www.wrongdiagnosis.com/c/cerebellar_agenesis/intro.htm">cerebellar agenesis</a>. When I was in graduate school, I was taught that the <a href="http://en.wikipedia.org/wiki/Neuroplasticity">neuroplasticity</a> of the brain was so remarkable, that even a child born without his or her cerebellum could grow-up to have no deficits and live a normal life. As it turns out, that was only partly true. H.C. was in fact, not without deficits. His tale is recounted briefly in two articles from the March 2010 issue of Brain:<br />
<blockquote>"<span style="color: purple;">It was clear that there were indeed clinical signs included right external</span> <a href="http://en.wikipedia.org/wiki/Strabismus">strabismus</a> (i.e., misaligned eyes), <span style="color: purple;">slow and slurred articulation and an unsteady gait.</span>" (<a href="http://brain.oxfordjournals.org/cgi/content/abstract/133/3/941">1</a>)</blockquote>However, he did live a "normal life":<br />
<blockquote>H.C. "<span style="color: purple;">had employment, that he was able to work in a manual job and that his working life was not curtailed by his cerebellar agenesis.</span>" (<a href="http://brain.oxfordjournals.org/cgi/content/abstract/133/3/941">1</a>)</blockquote>What is interesting about H.C. compared to H.M., is that H.C.'s agenesis was discovered only after he died. Very little clinical history about his life exists, making this story a great neurological detective case. Most of what is known about H.C. comes from hospital notes during his last years of life, just before he developed dementia:<br />
<blockquote>"<span style="color: purple;">The social history describes him as 'single.' The notes contained a record of his assessment by a neurologist, Dr. Jacobson, who described him as 'a simple man with some hearing loss and slow slurred speech; he has a fair memory for recent and remote events concerning himself, but with limited general knowledge. There is no hallucination or delusions nor emotional defect. He is clean in his habits and able to attend to his person. He is able to get around unassisted</span>." (<a href="http://brain.oxfordjournals.org/cgi/content/abstract/133/3/941">1</a>)</blockquote>The human brain is estimated to have approximately 85 billion neurons (<a href="http://brain.oxfordjournals.org/cgi/content/extract/133/3/652">2</a>). The cerebellum, which is typically 1/4 the size of the rest of brain, contains a full 50% of all our neurons. If you pay close attention to the image above, you will notice that, in addition to not having a cerebellum, H.C. was also missing his <a href="http://en.wikipedia.org/wiki/Pons">pons</a>, the bulbous structure that is typically adjacent to the cerebellum and is responsible for arousal and alertness.<br />
<br />
Many of the patients I have seen with cerebellar strokes typically have severe and irreversible deficits. While H.C. did have some cognitive and functional deficits, that he lived a full and functional life is nothing less than remarkable. His case is an example of how extraordinary the human brain actually is.<br />
<br />
I encourage you to read more about the mysterious case of H.C. <a href="http://www.medscape.com/viewarticle/722005">here</a>.<br />
<br />
<span style="float: left; padding: 5px;"><a href="http://www.researchblogging.org"><img alt="ResearchBlogging.org" src="http://www.researchblogging.org/public/citation_icons/rb2_large_gray.png" style="border:0;"/></a></span><br />
<br />
<span class="Z3988" title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.jtitle=Brain&rft_id=info%3Adoi%2F10.1093%2Fbrain%2Fawp265&rfr_id=info%3Asid%2Fresearchblogging.org&rft.atitle=Cerebellar+agenesis+revisited&rft.issn=0006-8950&rft.date=2009&rft.volume=133&rft.issue=3&rft.spage=941&rft.epage=944&rft.artnum=http%3A%2F%2Fwww.brain.oxfordjournals.org%2Fcgi%2Fdoi%2F10.1093%2Fbrain%2Fawp265&rft.au=Boyd%2C+C.&rfe_dat=bpr3.included=1;bpr3.tags=Psychology%2CNeuroscience">Boyd, C. (2009). Cerebellar agenesis revisited <span style="font-style: italic;">Brain, 133</span> (3), 941-944 DOI: <a rev="review" href="http://dx.doi.org/10.1093/brain/awp265">10.1093/brain/awp265</a></span><br />
<br />
<span class="Z3988" title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.jtitle=Brain&rft_id=info%3Adoi%2F10.1093%2Fbrain%2Fawq030&rfr_id=info%3Asid%2Fresearchblogging.org&rft.atitle=Life+without+a+cerebellum&rft.issn=0006-8950&rft.date=2010&rft.volume=133&rft.issue=3&rft.spage=652&rft.epage=654&rft.artnum=http%3A%2F%2Fwww.brain.oxfordjournals.org%2Fcgi%2Fdoi%2F10.1093%2Fbrain%2Fawq030&rft.au=Lemon%2C+R.&rft.au=Edgley%2C+S.&rfe_dat=bpr3.included=1;bpr3.tags=Psychology%2CNeuroscience">Lemon, R., & Edgley, S. (2010). Life without a cerebellum <span style="font-style: italic;">Brain, 133</span> (3), 652-654 DOI: <a rev="review" href="http://dx.doi.org/10.1093/brain/awq030">10.1093/brain/awq030</a></span>NeuroPsychhttp://www.blogger.com/profile/10654138293659468787noreply@blogger.com8tag:blogger.com,1999:blog-2301999496344158780.post-92025507589618396612010-05-16T22:51:00.000-07:002010-05-18T17:22:12.482-07:00Detroit SWAT Team Kill 7 Year-Old GirlThere has to be a better way to do this....full story <a href="http://www.aolnews.com/nation/article/detroit-police-say-7-year-old-shot-in-home-search/19479101">here</a>.<br />
<br />
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<br />
UPDATE: As luck would have it, this particular raid was being filmed for a reality show known as "The First 48." Base on the footage, the family lawyer is alleging a cover up (<a href="http://www.aolnews.com/nation/article/tv-show-videoed-police-raid-in-detroit-that-killed-aiyana-jones/19481558?icid=main%7Cmain%7Cdl1%7Clink3%7Chttp%3A%2F%2Fwww.aolnews.com%2Fnation%2Farticle%2Ftv-show-videoed-police-raid-in-detroit-that-killed-aiyana-jones%2F19481558">1</a>).<br />
<object classid="clsid:D27CDB6E-AE6D-11cf-96B8-444553540000" height="373" id="AOLVP_86303358001" width="427"><param name="movie" value="http://o.aolcdn.com/videoplayer/AOL_PlayerLoader.swf"></param><param name="bgcolor" value="#000000"></param><param name="allowFullScreen" value="true"></param><param name="wmode" value="transparent"/><param name="allowscriptaccess" value="always"></param><param name="flashvars" value="playerid=10032373001&codever=1&videoid=86303358001&stillurl=http%3A%2F%2Fpdl%2Estream%2Eaol%2Ecom%2Fpdlext%2Faol%2Fbrightcove%2Fap%2F5184737001%2F5184737001%5F86337051001%5F0518dv%2Ddetroit%2Dchild%2Dkilled%2D400x300%2Ejpg%3FpubId%3D5184737001&publisherid=1612833736"></param><embed src="http://o.aolcdn.com/videoplayer/AOL_PlayerLoader.swf" type="application/x-shockwave-flash" allowscriptaccess="always" wmode="transparent" allowfullscreen="true" bgcolor="#000000" width="427" height="373" name="AOLVP_86303358001" flashvars="playerid=10032373001&codever=1&videoid=86303358001&stillurl=http%3A%2F%2Fpdl%2Estream%2Eaol%2Ecom%2Fpdlext%2Faol%2Fbrightcove%2Fap%2F5184737001%2F5184737001%5F86337051001%5F0518dv%2Ddetroit%2Dchild%2Dkilled%2D400x300%2Ejpg%3FpubId%3D5184737001&publisherid=1612833736"></embed></object>NeuroPsychhttp://www.blogger.com/profile/10654138293659468787noreply@blogger.com0tag:blogger.com,1999:blog-2301999496344158780.post-86248576574497488682010-05-14T17:43:00.000-07:002010-05-14T17:43:42.046-07:00Draw Muh...er...Comedy Central Executives Day<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhA4rJAFAMHMw6WlmLAa4g216bMUwC3W6S1JXz7Wb20pkRY6k-dyfE34gyaU0iVKza5K1SMphAilxCgA5YLvZ185W7SDhGQx07nvshBtNnipRnMkBpf-kp0BgLLMZRE-i0bBSJKZdHi6Nk5/s1600/alg_south_park_censor.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhA4rJAFAMHMw6WlmLAa4g216bMUwC3W6S1JXz7Wb20pkRY6k-dyfE34gyaU0iVKza5K1SMphAilxCgA5YLvZ185W7SDhGQx07nvshBtNnipRnMkBpf-kp0BgLLMZRE-i0bBSJKZdHi6Nk5/s320/alg_south_park_censor.jpg" width="320" /></a></div>May 20th has been declared "Everybody Draw Muhammad Day" (<a href="http://www.drawmuhammadday.com/">1</a>). By now, many should be aware of the controversy surrounding South Park's 200th and 201st episodes.<br />
<br />
Shortly after the airing of episode 200, a group known as <a href="http://www.revolutionmuslim.com/">Revolution Muslim</a> posted the following message on their site:<br />
<blockquote> "<span style="color: purple;">We have to warn Matt and Trey that what they are doing is stupid and they will probably wind up like Theo Van Gogh for airing this show...this is not a threat, but a warning of the reality of what will likely happen to them.</span>" (<a href="http://www.latimes.com/entertainment/news/tv/la-et-south-park-20100423,0,5940860.story">2</a>).</blockquote>Thereafter, the media got wind of this post and ran with it. All major news networks and outlets had something to say about this "controversy". A week later, the 201st episode aired. It was, against the wishes of Matt Stone and Trey Parker, heavily edited by the douche bags at Comedy Central/Viacom. <br />
<br />
As a result of the ignorant and spineless actions by the douche bags at Comedy Central/Viacom, a self-proclaimed idiot (<a href="http://latimesblogs.latimes.com/washington/2010/04/creators-of-everybody-draw-muhammad-day-abandon-effort-after-it-becomes-controversial.html">3</a>) and artist, Molly Norris, declared May 20th to be "Everybody Draw Muhammad Day." <strong style="font-weight: normal;">She</strong> had created a poster showing many objects, such as a tea cup, claiming to be the likeness of Muhammad. She sent this poster to different media outlets, who took it seriously, and then it went viral.<br />
<br />
Ms. Norris has since distanced her self from "Draw Muhammad Day" and suggested that we should draw Al Gore instead (<a href="http://voices.washingtonpost.com/comic-riffs/2010/04/apologetic_draw_muhammad_carto.html">4</a>).<br />
<br />
After reading and listening to the media, I decided to do some research. To me, all this "controversy" seemed a bit contrived. After all, this was nothing like the Danish cartoon hysteria. If you were paying attention at all, it appears that this "controversy" had fallen on deaf ears in the Muslim world (<a href="http://www.guardian.co.uk/commentisfree/belief/2010/apr/23/muhammad-south-park-censorship">5</a>).<br />
<br />
The true extent of Muslim hysteria was this: one post, by one Islamic group, Revolution Muslim.<br />
<br />
I read about the group on Wikipedia (<a href="http://en.wikipedia.org/wiki/Revolution_Muslim">6</a>). It turned out to be an interesting read:<br />
<blockquote>"<span style="color: purple;">The group of <b>5-10 members</b>....run by Yousef al-Khattab, born Joseph Cohen, an American Jew who converted to Islam in 2000 after living in Israel and attending an orthodox rabbinical school.</span>"</blockquote>More about Joseph Cohen from LoonWatch.com :<br />
<blockquote> "<span style="color: purple;">He was born and raised in the United States as a Jew, and holds both American and Israeli citizenship. In the late eighties, Cohen embraced an ultra-orthodox interpretation of Judaism, and began attending a yeshiva (rabbinical school). In 1998, Cohen hearkened to the Zionist call, and packed up his bags to relocate to the Israeli Occupied Territories where he became an Israeli settler. As an ardent and extreme Zionist, Joseph Cohen fell in with the Jewish fundamentalist group </span><em style="color: purple;">Shas</em><span style="color: purple;">, an extreme right-wing political party that believes in flouting international law based on their religious beliefs. Less than three years later, Cohen 'converted' to Islam, moved back to the United States, and founded the most radical Islamic group in the country.</span>" (<a href="http://www.loonwatch.com/?s=joseph+cohen&x=0&y=0&=Go#refF1">7</a>, <a href="http://www.scribd.com/doc/2901290/Brother-Yousef-al-Khattabs-Reversion-to-Islam-A-Former-Jew#about">8</a>)</blockquote>A radical in one religion will be a radical in another religion.<br />
<br />
Maybe, just maybe, it was not the Muslims who were over reacting, but rather, the American Media. Now many people across this country are angry, and on May 20th, people will take pencil to paper and draw the Prophet Muhammad.<br />
<br />
Perhaps this anger is misplaced. After all, it was Comedy Central/Viacom that censored the cartoon. It was also Comedy Central/Viacom that censored people who criticized their spineless behavior (<a href="http://www.youtube.com/user/Thunderf00t#p/u/3/6OWaZVMBw1E">9</a>). Perhaps the true enemies of free speech are the people responsible for actual censorship: the executives/lawyers at Comedy Central/Viacom.NeuroPsychhttp://www.blogger.com/profile/10654138293659468787noreply@blogger.com3tag:blogger.com,1999:blog-2301999496344158780.post-84280991305747045182010-05-13T09:25:00.000-07:002010-05-13T09:25:18.362-07:00Woman Hospitalized Following Botched Raid<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiyCgKaHoU38GJCmAQzeDoKM34ghydMYgzsjZSyG81IKGDoIp8LtWnREEO-O2xvMw1Nc5AD6AK8_ZdT2tiH_bBP3i1bTYsa-IfEmXKTxjl3QbjtcaGCXomczFw4uWU5WhE4ZuUnq009-aX3/s1600/swat.jpg" imageanchor="1" style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="196" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiyCgKaHoU38GJCmAQzeDoKM34ghydMYgzsjZSyG81IKGDoIp8LtWnREEO-O2xvMw1Nc5AD6AK8_ZdT2tiH_bBP3i1bTYsa-IfEmXKTxjl3QbjtcaGCXomczFw4uWU5WhE4ZuUnq009-aX3/s200/swat.jpg" width="200" wt="true" /></a></div>How many armed, anonymous, men does it take to give an old woman a heart attack? The answer:<br />
<blockquote>"<span style="color: purple;">An elderly Polk County woman is hospitalized in critical condition after suffering a heart attack when drug agents swarm the wrong house. Machelle Holl tells WSB her 76-year-old mother, Helen Pruett, who lives alone, was at home when nearly a DOZEN local and federal agents swarmed her house, thinking they were about to arrest suspected drug dealers</span>." (<a href="http://wsbradio.com/localnews/2010/05/woman-hospitalized-following-b.html">1</a>)</blockquote>NeuroPsychhttp://www.blogger.com/profile/10654138293659468787noreply@blogger.com0tag:blogger.com,1999:blog-2301999496344158780.post-73847807485603084802010-05-05T14:21:00.000-07:002010-05-05T14:23:16.215-07:00There Are 40,000 of These Each Year<object height="3000" width="400"><param name="movie" value="http://www.youtube.com/v/RbwSwvUaRqc&color1=0xb1b1b1&color2=0xd0d0d0&hl=en_US&feature=player_embedded&fs=1"></param><param name="allowFullScreen" value="true"></param><param name="allowScriptAccess" value="always"></param><embed src="http://www.youtube.com/v/RbwSwvUaRqc&color1=0xb1b1b1&color2=0xd0d0d0&hl=en_US&feature=player_embedded&fs=1" type="application/x-shockwave-flash" allowfullscreen="true" allowScriptAccess="always" width="400" height="300"></embed></object><br />
<br />
Here's what happened (<a href="http://reason.com/blog/2010/05/05/video-of-swat-raid-on-missouri">1</a>):<br />
<blockquote>"<span style="color: purple;">SWAT team breaks into home, fires seven rounds at family's pit bull and corgi (?!) as a seven-year-old looks on.</span></blockquote><blockquote><span style="color: purple;">They found a "small amount" of marijuana, enough for a misdemeanor charge. The parents were then charged with child endangerment.</span></blockquote><blockquote><span style="color: purple;">So smoking pot = "child endangerment." Storming a home with guns, then firing bullets into the family pets as a child looks on = necessary police procedures to ensure everyone's safety.</span></blockquote><blockquote><span style="color: purple;">Just so we're clear.</span>"</blockquote>NeuroPsychhttp://www.blogger.com/profile/10654138293659468787noreply@blogger.com3tag:blogger.com,1999:blog-2301999496344158780.post-30017811086184107632010-05-05T11:49:00.000-07:002010-05-05T11:52:14.722-07:00Transcranial Magnetic Stimulation: Does it Live Up to the Hype?<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiIPIyWBVqT1kTh0DvveC44LzcSdB4jb3XS4IkZiL5ydYHAkh2QQwaOUtS73RdJcrFbYqp_WIajpKP9sXtMA4doGZ2BblAq-Xk4gIrQ77G_cFT5uGDUVnYGhSkk3_oC2Ey-89q_YIXlDTYz/s1600/tms.JPG" imageanchor="1" style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiIPIyWBVqT1kTh0DvveC44LzcSdB4jb3XS4IkZiL5ydYHAkh2QQwaOUtS73RdJcrFbYqp_WIajpKP9sXtMA4doGZ2BblAq-Xk4gIrQ77G_cFT5uGDUVnYGhSkk3_oC2Ey-89q_YIXlDTYz/s1600/tms.JPG" tt="true" /></a></div>Repetitive Transcranial Magnetic Stimulation (<a href="http://en.wikipedia.org/wiki/RTMS">rTMS</a>) is a treatment for depression that was approved by the FDA in October of 2008 (<a href="http://thecarlatreport.com/article/transcranial-magnetic-stimulation-approved-now-what-1">1</a>). Repetitive TMS involves a device (pictured right), which is noninvasive, that excites the neurons in the brain. When this done over the left <a href="http://en.wikipedia.org/wiki/Dorsolateral_prefrontal">dorsolateral prefrontal cortex</a> (an area of the brain supposedly less active in depressed patients), brain activity increases. The major selling point is that it has very few side-effects compared to standard antidepressant treatment (most common effects are headache and tingling at the stimulation site).<br />
<br />
The FDA approval of this device has been controversial (<a href="http://clinpsyc.blogspot.com/2009/10/transcranial-magnetic-stimulation-for.html">2</a>). The initial study submitted to the FDA was rejected. The folks at Neurostar (the manufacturers of the device) did a post-hoc analysis of that data. They discovered that patients, who failed to respond to only 1 antidepressant, subsequently responded to rTMS greater than sham (27.3% versus 10.5%). Based on this analysis, the FDA approved rTMS for the treatment of MDD in patients who have failed only 1 antidepressant trial. <br />
<br />
In this month's <em>Archives of General Psychiatry</em>, is an article titled "Daily Left Prefrontal Transcranial Magnetic Stimulation Therapy for Major Depressive Disorder" (<a href="http://archpsyc.ama-assn.org/cgi/content/full/67/5/507">3</a>). This study was funded by the NIMH and is the first nonindustry funded multisite study of rTMS (though some of the researchers are paid consultants of the TMS manufacturer). It involved 190 people.<br />
<br />
What supposedly separates this study from all others, is the sham treatment. One major criticism of the previous TMS research is that the sham treatment was not convincing enough to prevent unblinding (for example, sham did not cause scalp irritation or facial twitching). The researchers went to great lengths to develop a sham treatment which produced the similar physical sensations of rTMS to prevent unblinding. <br />
<div align="center"><strong>(Click to Enlarge)</strong></div><br />
<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj8zMd2SegveM3Z6vV_O30iYS9xpUnMqh2ztBhQPqNZgFOV_kC1xCzTN8qqUuwrnvMprSp1UXdZO3JwF5NcDUCtRD-q5amejTMX6rsBgtGx8TfmmMzG5LqCp-PifCCkpklOIRgX0gXHpVcN/s1600/guess.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="122" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj8zMd2SegveM3Z6vV_O30iYS9xpUnMqh2ztBhQPqNZgFOV_kC1xCzTN8qqUuwrnvMprSp1UXdZO3JwF5NcDUCtRD-q5amejTMX6rsBgtGx8TfmmMzG5LqCp-PifCCkpklOIRgX0gXHpVcN/s400/guess.JPG" tt="true" width="400" /></a></div><br />
Unfortunately, approximately 50% of the active treatment group correctly guessed which treatment condition they were in. A full 66% of placebo participants correctly guessed their condition. In truth, the level of unblinding is not a whole lot different from standard antidepressant drug trials (since placebos are inactive). The patients, on average, were similar to the patients in the Neurostar post-hoc analysis. The participants failed 1.51 antidepressant trials. <br />
<br />
The primary outcome was remission, defined as a score of 3 or less on the HAM-D or 2 consecutive HAM-D scores less than 10 during phase 1 of the study. Phase 1 was three weeks in duration. Patients received rTMS once a day for 50 minutes (5 days a week). <br />
<div style="text-align: center;"><strong>(Click to Enlarge)</strong> </div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhzmHlUKXDubkiufuLHJIrN914XwZW4O937D0I37sW1UNFr9REcjYPj4cQL8o33Ah7URRnIz7fvQZ38m7wc46gPWFboAbHxhQD2jSQ20H6a89NfOceKTLzyzY7-sirJ-RpRdd3pkTUzosfB/s1600/result.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="175" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhzmHlUKXDubkiufuLHJIrN914XwZW4O937D0I37sW1UNFr9REcjYPj4cQL8o33Ah7URRnIz7fvQZ38m7wc46gPWFboAbHxhQD2jSQ20H6a89NfOceKTLzyzY7-sirJ-RpRdd3pkTUzosfB/s400/result.JPG" tt="true" width="400" /></a></div>Unfortunately, the results were negative. During the three week period (the right side of the chart) only 6 patients (11%) met criteria for remission. The average drop in HAM-D score for active treatment was only 5 points (26 to 21). The researchers then extended the the length of phase 1 by two weeks. The number of patients who went into remission during this extension phase was 13 (14%). By increasing the length of the phase 1, they obtained statical significance. Sounds fishy to me, but at least they provide all the data. <br />
<br />
Similar to the Neurostar analysis, those who did remit were less treatment resistance (i.e., failed only 1 antidepressant trial). The number needed to treat (NNT) was 12. That means, 12 people will need to be treated with rTMS before another person, who otherwise would have not remitted without intervention, finally does remit. That's not very good. However, that number is not far off from standard antidepressant drug trials. <br />
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Does rTMS have any practical value as a future treatment for depression? Based on these results, one will need to attend a 50 minutes session everyday (excluding weekends) for 3-5 weeks to see some sort of result. That is in stark contrast to attending psychotherapy 1-2 times a week or visiting a psychiatrist once every 4-6 weeks. As Daniel Carlat points out in his monthly report (<a href="http://thecarlatreport.com/article/transcranial-magnetic-stimulation-approved-now-what-1">1</a>), each treatment session would cost approximately $400. Insurance companies do not currently cover this treatment (and probably never will). Moreover, the group of patients who did remit (i.e., those who failed only 1 antidepressant trial) is not very marketable. Odds are they will try a second antidepressant instead. According to the Star-D results, the odds of improvement are 30% on a second antidepressant compared to 14% of rTMS. Presently, rTMS just does not make economic sense.<br />
<br />
<span style="float: left; padding-bottom: 5px; padding-left: 5px; padding-right: 5px; padding-top: 5px;"><a href="http://www.researchblogging.org/"><img alt="ResearchBlogging.org" src="http://www.researchblogging.org/public/citation_icons/rb2_large_gray.png" style="border-bottom: 0px; border-left: 0px; border-right: 0px; border-top: 0px;" /></a></span><br />
<br />
<span class="Z3988" title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.jtitle=Archives+of+general+psychiatry&rft_id=info%3Apmid%2F20439832&rfr_id=info%3Asid%2Fresearchblogging.org&rft.atitle=Daily+left+prefrontal+transcranial+magnetic+stimulation+therapy+for+major+depressive+disorder%3A+a+sham-controlled+randomized+trial.&rft.issn=0003-990X&rft.date=2010&rft.volume=67&rft.issue=5&rft.spage=507&rft.epage=16&rft.artnum=&rft.au=George+MS&rft.au=Lisanby+SH&rft.au=Avery+D&rft.au=McDonald+WM&rft.au=Durkalski+V&rft.au=Pavlicova+M&rft.au=Anderson+B&rft.au=Nahas+Z&rft.au=Bulow+P&rft.au=Zarkowski+P&rft.au=Holtzheimer+PE+3rd&rft.au=Schwartz+T&rft.au=Sackeim+HA&rfe_dat=bpr3.included=1;bpr3.tags=Psychology%2CHealth%2CNeuroscience">George MS, Lisanby SH, Avery D, McDonald WM, Durkalski V, Pavlicova M, Anderson B, Nahas Z, Bulow P, Zarkowski P, Holtzheimer PE 3rd, Schwartz T, & Sackeim HA (2010). Daily left prefrontal transcranial magnetic stimulation therapy for major depressive disorder: a sham-controlled randomized trial. <span style="font-style: italic;">Archives of general psychiatry, 67</span> (5), 507-16 PMID: <a href="http://www.ncbi.nlm.nih.gov/pubmed/20439832" rev="review">20439832</a></span>NeuroPsychhttp://www.blogger.com/profile/10654138293659468787noreply@blogger.com12tag:blogger.com,1999:blog-2301999496344158780.post-28914304148703697942010-05-04T17:36:00.000-07:002010-05-05T13:30:20.101-07:00Psychosis Among Substance Users<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhbCtyp5SqNOELzIRCIX3O0tPVljfly1KV-V37TtLX8tJPkE3B_V-JSxPfGrzcQil2Tr49YKbUp6mjzBrWcHkrXuxxT7hvCo-nqo11rYTI1OPBj_YZyc4xI6EfjxdV85boiO6gBpA5rufG6/s1600/mad_scientist.gif" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhbCtyp5SqNOELzIRCIX3O0tPVljfly1KV-V37TtLX8tJPkE3B_V-JSxPfGrzcQil2Tr49YKbUp6mjzBrWcHkrXuxxT7hvCo-nqo11rYTI1OPBj_YZyc4xI6EfjxdV85boiO6gBpA5rufG6/s200/mad_scientist.gif" tt="true" width="150" /></a></div><a href="http://en.wikipedia.org/wiki/Psychosis">Psychosis</a> among drug users is quite common. Often, it is difficult to determine which came first, substance use or psychosis. Frequently, they co-occur. In cases where drugs are causally related (i.e., <a href="http://en.wikipedia.org/wiki/Substance-induced_psychosis">substance-induced psychosis</a>), the condition is typically transient with a duration of 1 month or less. In rare cases, the length of psychosis can last longer. And in even rarer cases, symptoms such as hallucinations can be permanent.<br />
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Psychosis can be associated with the use many legal (e.g., <a href="http://en.wikipedia.org/wiki/Ethanol">alcohol</a>) or illicit substance such as stimulants (<a href="http://en.wikipedia.org/wiki/Amphetamine">amphetamines</a> and <a href="http://en.wikipedia.org/wiki/Cocaine">cocaine</a>), <a href="http://en.wikipedia.org/wiki/Marijuana">cannabis</a>, and <a href="http://en.wikipedia.org/wiki/Hallucinogen">hallucinogens</a>. An article by Thirthalli and Benegal (<a href="http://journals.lww.com/co-psychiatry/Abstract/2006/05000/Psychosis_among_substance_users.3.aspx">1</a>) reviews the evidence that these drugs can cause psychosis in nonpsychotic persons. <br />
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<b>Alcohol</b><br />
<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi_gGa2nnr6A6CkJq5wJG-S1m6NyfVDp5ePPr0UzZIviBTeohq4M3QftLYHxloEVw5IhzNhUi8liYoXj6D0iQUCgKbcqEsHTbIOz06nAQTp7qY3Pw4ZCoSPn6ZV0v7cm2Zk9-HucvxhJ9x2/s1600/alcohol.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="150" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi_gGa2nnr6A6CkJq5wJG-S1m6NyfVDp5ePPr0UzZIviBTeohq4M3QftLYHxloEVw5IhzNhUi8liYoXj6D0iQUCgKbcqEsHTbIOz06nAQTp7qY3Pw4ZCoSPn6ZV0v7cm2Zk9-HucvxhJ9x2/s200/alcohol.jpg" tt="true" width="200" /></a></div>The neurochemical effects of alcohol are complex. "Common knowledge" states that alcohol acts in a similar fashion to other sedatives (e.g., diazepam). In other words, it is an <a href="http://en.wikipedia.org/wiki/Agonist">agonist</a> of <a href="http://en.wikipedia.org/wiki/GABA">GABA</a> receptors. In reality, the alcohol molecule is very simple. It has the ability to cross cell membranes (e.g., <a href="http://en.wikipedia.org/wiki/Blood_brain_barrier">blood-brain barrier</a>) easily and can exert its effects on the brain within minutes. Alcohol also influences the <a href="http://en.wikipedia.org/wiki/Phospholipid_bilayer">phospholipid bilayer</a> that make up <a href="http://en.wikipedia.org/wiki/Cell_%28biology%29#Cell_membrane:_A_cell.27s_defining_boundary">cell membranes</a>. This ability has a widespread impact on normal cell functions and also enables alcohol to modify the action of many <a href="http://en.wikipedia.org/wiki/Neurotransmitter">neurotransmitter</a> systems, such <a href="http://chekhovsgun.blogspot.com/2010/01/schizophrenia-treatment-future.html">glutamate</a>, <a href="http://en.wikipedia.org/wiki/Dopamine">dopamine</a>, and <a href="http://en.wikipedia.org/wiki/Norepinephrine">norepinephrine</a> in addition to GABA. <br />
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Alcohol-induced psychosis can occur during different drug states such intoxication or withdrawal (e.g., <a href="http://en.wikipedia.org/wiki/Delirium_tremens">delirium tremens</a>, <a href="http://en.wikipedia.org/wiki/Alcoholic_hallucinosis">alcoholic hallucinosis</a>). In general, the risk of psychosis is two-fold greater than in the general adult population. <br />
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<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjRNVpVY-ftomTUDixFYekMYGOl4aXteVYBNARAJh43h-92g-RgNtop8ypzczLi-elmoaCcdIRqkPe8BExJnvpyz4xtcJ9DeEyVQtKUWwj1Aa0lBd_30pC-P_JuA2JyCJXGFwf8uhS2KmEC/s1600/Drug_amphet_high.png" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjRNVpVY-ftomTUDixFYekMYGOl4aXteVYBNARAJh43h-92g-RgNtop8ypzczLi-elmoaCcdIRqkPe8BExJnvpyz4xtcJ9DeEyVQtKUWwj1Aa0lBd_30pC-P_JuA2JyCJXGFwf8uhS2KmEC/s200/Drug_amphet_high.png" tt="true" width="178" /></a></div><b>Stimulants</b> (click to enlarge picture; <a href="http://images.google.com/imgres?imgurl=http://www.cnsforum.com/content/pictures/imagebank/hirespng/Drug_amphet_high.png&imgrefurl=http://www.cnsforum.com/imagebank/item/Drug_amphet_high/default.aspx&usg=__Q0gHjf_Zm2L91G4Z24tD5oNwjDA=&h=1761&w=1570&sz=641&hl=en&start=7&sig2=0ZwbG_O886wNu9ZL-l16GQ&um=1&itbs=1&tbnid=HYrAOoSzseDp4M:&tbnh=150&tbnw=134&prev=/images%3Fq%3Damphetamine%26um%3D1%26hl%3Den%26tbs%3Disch:1&ei=L6ngS9CPIqiOtgPytOzFBA">2</a>)<br />
Cocaine and Amphetamines are widely known to lead to psychosis. The psychosis produced by both cocaine and amphetamines is similar to schizophrenia. The risk of psychosis from amphetamine use is quite high; greater than 70% in chronic users. Users who develop first episode psychosis use an average of 20 times years. Psychosis typically lasts for the duration the drug is in the system. However, it can last more than a month in more severe cases. <br />
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For cocaine, typically 50% of chronic users experience paranoia and hallucinations. Cocaine-induced psychosis has a stereotypical form; Users believe that their drug use is being watched and that they are being followed. This paranoia is typically accompanied by hallucinations. Cocaine-induced psychosis also shows sensitization; that is, psychosis becomes more severe and occurs more rapidly with continued use. Unlike amphetamine-induced psychosis, cocaine induced-persistent psychosis is very rare.<br />
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<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjli0fpmhJfd9_fvcJbDrK_fYlQxPZCa0WdHk3F_rW-jmLffmDvD39b-z6feTWSniqXfcEQsfGA8QXo1nplkmoJ4IMVnSJJWPqk724BgxignAT47u1K4nismJslQoYlExq2HXZKfJDsFExE/s1600/effexor.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjli0fpmhJfd9_fvcJbDrK_fYlQxPZCa0WdHk3F_rW-jmLffmDvD39b-z6feTWSniqXfcEQsfGA8QXo1nplkmoJ4IMVnSJJWPqk724BgxignAT47u1K4nismJslQoYlExq2HXZKfJDsFExE/s200/effexor.jpg" tt="true" width="165" /></a></div>Cocaine has the highest affinity and binds most strongly to the <a href="http://en.wikipedia.org/wiki/Serotonin">serotonin</a> (5HT)reuptake pump, followed by the dopamine (DA) reuptake pump, then the norepinephrine (NE) reuptake pump (FYI-Effexor is cocaine with a PG-rating; effexor's affinities are for serotonin, then NE, and then DA). Contrary to popular belief, amphetamines do not act by blocking the dopamine reuptake pump. Amphetamines are <a href="http://en.wikipedia.org/wiki/Indirect_agonist">indirect agnonist</a> of the <a href="http://en.wikipedia.org/wiki/Catecholamine">catecholaminergic</a> systems (i.e., dopamine and norepinephrine). First, amphetamines go inside the neuron and release both DA and NE from their vesicles into the cell cytoplasm (i.e., catecholamins are released inside the neurone). Second, The catecholamines are subsequently transported outside of the neuron by a reversal of the reuptake pumps. This results in a MASSIVE increase in synaptic DA and NE. Lastly, at higher doses, amphetamines inhibit catecholamine metabolism, leading to even higher concentrations in the synapse. <br />
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<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj3C1B3LnANO4GUfAo82sfznBiJwi-E7yri0Vy7978kSuHZEZH6FRjrlb_sfiYYuyLP879xVjZSADURWzFxXUYblFI9jHDsSg-kXGEy2fsvgRhX_WBrYONux0bP297OKXUlxN2xxCbOddJk/s1600/cannabis_2.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="120" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj3C1B3LnANO4GUfAo82sfznBiJwi-E7yri0Vy7978kSuHZEZH6FRjrlb_sfiYYuyLP879xVjZSADURWzFxXUYblFI9jHDsSg-kXGEy2fsvgRhX_WBrYONux0bP297OKXUlxN2xxCbOddJk/s200/cannabis_2.jpg" tt="true" width="200" /></a></div><b>Cannabis</b><br />
There has been a boom in the current research of cannabis and psychosis. There appears to be a temporal correlation between early cannabis use and onset of schizophrenia. This association is stronger than for any other substance. Why the association exists is unclear. In general, cannabis has the same risk of inducing psychosis as alcohol (i.e., two-fold). <br />
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There are two cannabinoid receptors in the human body: <a href="http://en.wikipedia.org/wiki/Cannabinoid_receptor_1">CB1</a> and <a href="http://en.wikipedia.org/wiki/Cannabinoid_receptor_2_%28macrophage%29">CB2</a>. The CB2 receptor is not expressed in the brain, and is primarily found in the immune system. The CB1 receptor is typically found in the basal ganglia, cerebellum, hippocampus, and the cortex. CB1 receptors exist on the <a href="http://en.wikipedia.org/wiki/Axon_terminal">axon terminal</a> instead of the <a href="http://en.wikipedia.org/wiki/Post-synaptic">post-synaptic</a> cell. In others words, CB1 receptors are <a href="http://en.wikipedia.org/wiki/Autoreceptors">autoreceptors</a> that can inhibit the release of many different neurotransmitters.<br />
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<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiombKPgr0NcAOjYJJOG8VQjOAU_tJqW4kZM89HvViFImcnBvRz9fVnnjSmUqf1lHVQE78tosuFZq929a8qNNdm_KhS_jP-hPnYYtMmGHzpX9DfwA8MymZhQ8aDCmytAM8osN1xQ2H-RqnZ/s1600/Mushroom.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiombKPgr0NcAOjYJJOG8VQjOAU_tJqW4kZM89HvViFImcnBvRz9fVnnjSmUqf1lHVQE78tosuFZq929a8qNNdm_KhS_jP-hPnYYtMmGHzpX9DfwA8MymZhQ8aDCmytAM8osN1xQ2H-RqnZ/s320/Mushroom.jpg" tt="true" width="193" /></a></div><b>Hallucinogens</b><br />
Many different drugs fall under this category: mushrooms, <a href="http://en.wikipedia.org/wiki/Peyote">peyote</a> buttons, and <a href="http://en.wikipedia.org/wiki/LSD">LSD</a>, for example. Many hallucinogenic drugs are either synthesized by plants or are based on plant-derived compounds. The main active compound in peyote is<a href="http://en.wikipedia.org/wiki/Mescaline"> mescaline</a>, while <a href="http://en.wikipedia.org/wiki/Psilocin">psilocin</a> in found mushrooms. LSD is actually a synthetic compound, but is based on a fungal alkaloid taken from <a href="http://en.wikipedia.org/wiki/Ergot">ergot</a>.<br />
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Hallucinogenic compounds have a catecholamine-like structure (most are similar in shape to serotonin). Hallucinogens are primarily 5-HT2a receptor agonists. While these drugs do not lead to dependence, withdrawal, or cravings, they still can lead to serious problems for some users. Some people experience acute anxiety or panic attacks in responses to the drugs' hallucinogenic effects. There is a disorder known as hallucinogen persisting perception disorder (HPPD), which is the fancy name for "flashbacks." The most severe reactions, of course, are psychotic breakdowns. However, similar to the above mentioned drugs, psychosis is typically transient. Most prolonged episodes of hallucinogen-induced psychosis involve individuals who have already been diagnosed with a psychotic disorder or who have manifested prepsychotic (e.g., prodromal) symptoms before taking these drugs.<br />
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<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhIeZ5jK3rrfu6u1tt2meP3tLRkQjoQsgP1vkqwJLDlocWfvQHlJboe98aBZ8tDb-0eEd0hXSbJFDaQAv-DvnmQrdppWn75WY3tb1kf2LsvqD_tx5Z629AeOJTsIL7zUzS0ew8cok7KlEhi/s1600/tb_atypicals_450_18990a.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="133" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhIeZ5jK3rrfu6u1tt2meP3tLRkQjoQsgP1vkqwJLDlocWfvQHlJboe98aBZ8tDb-0eEd0hXSbJFDaQAv-DvnmQrdppWn75WY3tb1kf2LsvqD_tx5Z629AeOJTsIL7zUzS0ew8cok7KlEhi/s200/tb_atypicals_450_18990a.jpg" tt="true" width="200" /></a></div><b>Treatment</b><br />
In most cases, substance induced psychosis does not need medical treatment per se. It usually disappears when the drug's affects are gone. However, there are cases when treatment is necessary. Alcohol dependent individuals in withdrawal do need medical treatment because <a href="http://en.wikipedia.org/wiki/Alcohol_withdrawal">alcohol withdrawal</a> can be lethal. Typically, sedatives (<a href="http://en.wikipedia.org/wiki/Benzodiazepines">benzodiazepines</a>) are the drugs of choice. For either cocaine or amphetamine induced psychosis, <a href="http://en.wikipedia.org/wiki/Typical_antipsychotic">first</a> or <a href="http://en.wikipedia.org/wiki/Atypical_antipsychotic">second generation antipsychotics</a> are the drugs of choice because of their potent <a href="http://en.wikipedia.org/wiki/Dopamine_receptor_D2">D2</a> receptor antagonism. In general, it is common for anyone presenting with psychotic symptoms to be prescribed antipsychotics. Occasionally, patients who are addicted to amphetamines will be prescribed antipsychotics in hopes that they will reduce the risk of subsequent psychosis or reduce euphoria, making the drug less reinforcing. Drugs that antagonize the 5HT2a receptor such as <a href="http://en.wikipedia.org/wiki/Risperidone">risperidone</a> (or any second generation antipsychotic), <a href="http://en.wikipedia.org/wiki/Ketanserin">ketanserin</a>, and <a href="http://en.wikipedia.org/wiki/Ritanserin">ritanserin</a> have been shown to reverse hallucinogenic-induced psychosis. <br />
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In rare cases when psychosis persists, there are a few things to consider, such as, is their another cause for the psychosis? For example, does the person have schizophrenia or is there a physical cause for the psychosis (e.g., tumor, metabolic, etc)? Often times, doctors not knowing what to do, will double down on the antipsychotics. This is unlikely to work because the mechanism of action (D2 or 5HT2a blockade) does not necessarily increase with the addition of a second drug. Simply upping the does of the current drug should suffice. Side effects, however, are always additive. Antipsychotics with higher affinities for both D2 and 5HT2a receptors are preferable (e.g., risperidone). <br />
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<b>Risk Factors</b><br />
The risk factors for substance-induced psychosis are similar across all substances. Pre-morbid psychiatric history or a family history of schizophrenia put an individual at risk. Also, the longer a substance is consumed and the larger the quantities consumed are also risk factors. Polysubstance use or consuming drugs that contain other compounds increases the risk of psychosis too. Unfortunately, the research into the neurobiological and genetic underpinnings is substance-related psychosis are quite poor. A useful theory for substance-related psychosis which could lead to better acute treatment is lacking.<br />
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<span style="float: left; padding-bottom: 5px; padding-left: 5px; padding-right: 5px; padding-top: 5px;"><a href="http://www.researchblogging.org/"><img alt="ResearchBlogging.org" src="http://www.researchblogging.org/public/citation_icons/rb2_large_gray.png" style="border-bottom: 0pt; border-left: 0pt; border-right: 0pt; border-top: 0pt;" /></a></span><br />
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<span class="Z3988" title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.jtitle=Current+Opinion+in+Psychiatry&rft_id=info%3A%2F&rfr_id=info%3Asid%2Fresearchblogging.org&rft.atitle=Psychosis+Among+Substance+Users&rft.issn=&rft.date=2006&rft.volume=&rft.issue=&rft.spage=&rft.epage=&rft.artnum=http%3A%2F%2Fjournals.lww.com%2Fco-psychiatry%2FAbstract%2F2006%2F05000%2FPsychosis_among_substance_users.3.aspx&rft.au=Thirthalli%2C+J+%26+Benegal%2C+V.&rfe_dat=bpr3.included=1;bpr3.tags=Psychology%2CHealth%2CAbnormal+Psychology%2C+Clinical+Psychology%2C+Psychiatry">Thirthalli, J & Benegal, V. (2006). Psychosis Among Substance Users <span style="font-style: italic;">Current Opinion in Psychiatry</span></span>NeuroPsychhttp://www.blogger.com/profile/10654138293659468787noreply@blogger.com1tag:blogger.com,1999:blog-2301999496344158780.post-71874769805115067312010-05-03T14:09:00.000-07:002010-05-05T13:30:40.816-07:00"Anatomy of an Epidemic" or The Same Story Told Over and Over Again<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjAM7y6CImKwt-SHdBTN3WMGBRc_0QQQofEZKucCiBJG0NtS7EBCrdhp1Y7fhkfGhmq6cZs_AD_31DW4auQGVwCCpwvHTC8X1ip62iL0mK4KtgVL3fORfT8tMZgTTnMAYgeAQ7IukKR_9bG/s1600/anatomy.jpg" imageanchor="1" style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjAM7y6CImKwt-SHdBTN3WMGBRc_0QQQofEZKucCiBJG0NtS7EBCrdhp1Y7fhkfGhmq6cZs_AD_31DW4auQGVwCCpwvHTC8X1ip62iL0mK4KtgVL3fORfT8tMZgTTnMAYgeAQ7IukKR_9bG/s200/anatomy.jpg" tt="true" width="200" /></a></div>On <a href="http://www.salon.com/books/feature/2010/04/27/interview_whitaker_anatomy_of_an_epidemic/index.html">Salon.com</a>, there is an interview with <a href="http://en.wikipedia.org/wiki/Robert_Whitaker_(author)">Robert Whitaker</a>, the author of <a href="http://www.amazon.com/Mad-America-Medicine-Enduring-Mistreatment/dp/0465020143/ref=sr_1_1?ie=UTF8&s=books&qid=1272912629&sr=1-1#noop">Mad in America</a>, about his new book titled "<a href="http://www.amazon.com/Anatomy-Epidemic-Bullets-Psychiatric-Astonishing/dp/0307452417/ref=sr_1_1?ie=UTF8&s=books&qid=1272912945&sr=1-1">Anatomy of an Epidemic</a>: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America."<br />
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The article/interview at Salon is devoid of any context:<br />
<blockquote>"<span style="color: purple;">In the past few months, the perennial controversy over psychiatric drug use has been growing considerably more heated. A <a href="http://jama.ama-assn.org/cgi/content/full/303/1/47"><span style="color: blue;">January study</span></a> showed a negligible difference between antidepressants and placebos in treating all but the severest cases of depression. The study became the subject of a Newsweek cover story, and the value of psychiatric drugs has recently been debated in the pages of the New Yorker, the New York Times and Salon...The timing of Robert Whitaker’s "Anatomy of an Epidemic," a comprehensive and highly readable history of psychiatry in the United States, couldn’t be better.</span>" </blockquote>That study in JAMA is hardly a first (<a href="http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0050045">1</a>, <a href="http://psycnet.apa.org/journals/pre/5/1/23a/">2</a>, <a href="http://psycnet.apa.org/index.cfm?fa=buy.optionToBuy&id=1999-11094-001&CFID=8547600&CFTOKEN=46702049">3</a>), nor is Mr. Whitaker's book a first (<a href="http://www.amazon.com/America-Fooled-Antidepressants-Antipsychotics-Deceived/dp/0977307506/ref=sr_1_1?ie=UTF8&s=books&qid=1272913757&sr=1-1">4</a>, <a href="http://www.amazon.com/Emperors-New-Drugs-Exploding-Antidepressant/dp/046502016X/ref=sr_1_2?ie=UTF8&s=books&qid=1272913757&sr=1-2">5</a>, <a href="http://www.amazon.com/Unhinged-Trouble-Psychiatry-Revelations-Profession/dp/141659079X/ref=sr_1_1?ie=UTF8&s=books&qid=1272913829&sr=1-1">6</a>, and anything written by Peter Breggin). Timing couldn't be better? Sure, if by timing you mean, when can one cash in on anti-psychiatry sentiment.<br />
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I have not read this book. I did read his previous book, Mad in America, which surveyed the history of the treatment of mental illness in American and the rise of psychiatric drugs. Based on that book, which was sensationalistic and misrepresented research, I think I know what to expect in his new book. My focus, instead, will be on his interview. Comments in red.<br />
<blockquote>"<span style="color: purple;"><strong>Psychiatric drug use is a notoriously tough subject for writers, because of all the contradictory research. Why wade into it?</strong> </span><span style="color: purple;">In 1998, I was writing a series for the Boston Globe on abuse of psychiatric patients in research settings. I came across the World Health Organization’s outcomes study for schizophrenia patients, and found that outcomes were better for poor countries of the world -- like India, Colombia, Nigeria -- than for the rich countries. And I was startled to find that only a small percentage of patients in those countries were medicated. I also discovered that the number of people on disability for mental illness in this country has tripled over the last 20 years..."</span></blockquote><span style="color: purple;"></span> <span style="color: red;">He doesn't provide an actual number for "<span style="color: purple;">only a small percentage of patients</span>." However, according to the Worldwide-Schizophrenia Outpatient Health Outcomes (W-SOHO;</span><a href="http://www.medscape.com/viewarticle/711890_3"><span style="color: blue;">7</span></a><span style="color: red;">), which surveyed Europe, Asia, Africa, and Latin America, it revealed that a not so small 40% of patients where on antipsychotic medications. The real differences between rich and poor counties is that patients in developing countries were primarily on first generation antipsychotics (60%) and on monotherapy (75%). The reasons for outcome differences are many.</span><br />
<div><blockquote>"<span style="color: purple;">...If our psychiatric drugs are effective at preventing mental illness, I thought, why are we getting so many people unable to work?</span>"</blockquote></div><span style="color: red;">I don't think anyone of real importance claimed that psychiatric drugs were aimed at "<span style="color: purple;">preventing mental illness</span>." Again, there is no context. For example, one explanation for the increase of those on disability is that entitlement programs have increased their coverage over the years to include those with mental illnesses.</span><br />
<div><blockquote>"<strong><span style="color: purple;">What's so risky about Ritalin?</span></strong> <span style="color: purple;">For one, a significant percentage -- between 10 and 25 percent -- of kids prescribed medication for ADHD will have a manic episode or psychotic episode and deteriorate in such a way that they’re diagnosed with bipolar disorder...</span><span style="color: black;">"</span></blockquote></div><span style="color: red;">He is misrepresenting the data. That study</span> (<a href="http://www.ncbi.nlm.nih.gov/pubmed/8755796">8</a>)<span style="color: red;">, </span><span style="color: red;">examined the comorbidity of ADHD and mania, not the association of stimulant medication use and risk of mania. It's quite possible that those who eventually develop bipolar disorder have an ADHD appearance during childhood. </span><br />
<div><blockquote>"<span style="color: purple;"><strong>But if these studies are so groundbreaking, why have they gone unreported in the media?</strong></span> <span style="color: purple;">Because the NIMH didn’t announce it. Just as they didn’t announce the <a href="http://www.ncbi.nlm.nih.gov/pubmed/17502806">2007 outcome study</a> for schizophrenia patients. In that study, the recovery rate was 40 percent for those off meds, but only 5 percent for those on meds. I checked all the NIMH press releases for 2007, and found no release on this study. I found no announcement of it in any American Psychiatric Association publication or textbook. Not a single newspaper published an account of the study. And that’s because the psychiatric establishment -- the NIMH, the APA, even the National Alliance on Mental Illness, an advocacy organization -- did not put out any press release about it or try to alert the media in any way.</span><span style="color: black;">"</span></blockquote></div><span style="color: purple;"><span style="color: red;">Either he's lying or had a lobotomy. I have reviewed that study as well as it's follow-up (</span><a href="http://chekhovsgun.blogspot.com/2010/01/does-schizophrenia-need-to-be-treated.html">9</a><span style="color: red;">).</span> </span><span style="color: red;">Here is what the researchers actually discovered :</span><br />
<blockquote><span style="color: red;">"<span style="color: blue;">Looking at it from a different viewpoint, the data suggests that schizophrenia patients with good prognostic features, with better premorbid developmental achievements and with more favorable personality characteristics are the subgroup more likely to stay off antipsychotics for a prolonged period</span>"</span></blockquote><span style="color: red;">That's why the NIMH, APA, and NAMI didn't sound the alarm about that supposed discovery. Here's another way to highlight the absurdity of his conclusion: Two women have been diagnosed with breast cancer. One has a strong family history of breast cancer and tested positive for the BRCA gene (i.e., she has a poor prognosis). The other woman has no family history nor the BRCA gene. Both were treated with chemo. One recovered quickly stopped treatment. The other woman, while still being treated, died. The chemotherapy killed her, right? </span><br />
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<span style="color: red;"><span style="color: black;"> I could continue, but what's the point. His book has one intended audience: People who already hate psychiatry. If one cares to fully fact check the entire interview, you'll find one misleading statement after another. Whitaker is biased and has no scruples about misrepresenting facts and data to suit his narrative. </span></span><br />
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<span style="color: red;"><span style="color: black;">He is no different than the very industry that he is attacking. </span></span>NeuroPsychhttp://www.blogger.com/profile/10654138293659468787noreply@blogger.com19tag:blogger.com,1999:blog-2301999496344158780.post-55529290189583099352010-04-27T16:01:00.000-07:002010-05-04T23:18:48.495-07:00R-Rated Movies Aren't Bad for Your Kids...R They?<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEht455vWO6_hActukJV0gNMCC20OcNflNBPLyErklxVcZJBmDZJ_l3SMR1-bj9gRLN5W4x_-HLqU1THtG2Z8z6w-PjmQua4AZw7ttnPxSIpA_Gq2qZRKyH1iJk4CZA3qwJwCEmkPOn3oOfJ/s1600/rated_r.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="133" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEht455vWO6_hActukJV0gNMCC20OcNflNBPLyErklxVcZJBmDZJ_l3SMR1-bj9gRLN5W4x_-HLqU1THtG2Z8z6w-PjmQua4AZw7ttnPxSIpA_Gq2qZRKyH1iJk4CZA3qwJwCEmkPOn3oOfJ/s200/rated_r.jpg" tt="true" width="200" /></a></div>In the May issue of the <i>Journal of Studies on Alcohol and Drugs</i> is an article titled "Parental R-Rated Movie Restriction and Early-Onset Alcohol Use." (<a href="http://www.jsad.com/jsad/article/Parental_RRated_Movie_Restriction_and_EarlyOnset_Alcohol_Use/4460.html">1</a>) Without reading the study, one can guess the reported result : the more R-rated movies that youths watch, the higher the frequency of early-onset alcohol use. <br />
<br />
This study was funded by the National Cancer Institute and National Institute on Alcohol Abuse and Alcoholism. Remember what the Last Psychiatrist says: What do researchers want to be true?<br />
<br />
First comes the filter that will aid our interpretation of the results:<br />
<blockquote>"<span style="color: purple;">TODAY’S YOUTH HAVE UNPRECEDENTED ACCESS to entertainment media (Roberts et al., 2005), and longitudinal research has linked various forms of entertainment media with aggressive behavior (Bushman and Anderson, 2001), sexual behavior (Collins et al., 2004), and tobacco use (Sargent, 2005). Indeed, the available research evidence has led the National Cancer Institute (2008) to declare a causal relation between exposure to movie smoking and youth smoking initiation.</span>"</blockquote>In the words of Mr. Mackey, "Mm..R-rated movies are bad...mmkay." <br />
<br />
The study was done by survey. 3,577 youths where chosen out of 4,655 (grades 5-8) because they reported to never have drunken alcohol without the knowledge of their parents. Also at baseline assessment the youths rated how restrictive their parents were in allowing them to view R-rate movies. <br />
<br />
<b>Statistics 101:</b> Very boring, but very important to interpret these results.<br />
<br />
This study is correlational. This results are known as the standardized coefficient. This can vary from +1 (indicating a perfect positive relationship), to zero (indicating no relationship), all the way down to -1 (indicating a perfect negative relationship, that is, when the frequency of a factor goes up, the other factor goes down). As a rule of thumb, standardized coefficients between .00 and .30 are considered weak, between .30 and .70 are moderate, and between .70 and 1.00 are considered strong.<br />
<br />
The primary meaning of standardized coefficients lies in the amount of variation in one variable that is accounted for by the variable with which it is correlated. To obtain this information, you square the standardized coefficient (e.g., .30 x.30). This number is called the coefficient of determination. Then you multiply the coefficient by determination 100. This proportion of variance indicates the percentage of variance. The coefficient of determination is the primary information measure. Correlation coefficients of .30 account for about 10 percent of the variance (.30x.30 =.90x100= 9%). <br />
<br />
Here are the results as reported in the abstract, that is, the information they want you to know:<br />
<blockquote>"<span style="color: purple;">The sample included 2,406 baseline never-drinkers who were surveyed at follow-up, of whom 14.8% had initiated alcohol use. At baseline, 20% reported never being allowed to watch R movies, and 21% reported being allowed all the time. Adolescents allowed to watch R-rated movies had higher rates of alcohol initiation (2.9% initiation among never allowed, 12.5% once in a while, 18.8% sometimes, and 24.4% all the time). Controlling for sociodemographics, personality characteristics, and authoritative parenting style, the adjusted odds ratios for initiating alcohol use were 3.0 (95% CI [1.7-5.1]) for those once in a while allowed, 3.3 [1.9, 5.6] for those sometimes allowed, and 3.5 [2.0, 6.0] for those always allowed to watch R-rated movies. Alcohol initiation was more likely if R-rated movie restriction relaxed over time; tightening of restriction had a protective effect (p < .001).</span>"</blockquote>With odds-ratios, 1.0 represent the prevalence of something (e.g., drinking behavior) that already exists in the population. Anything above that represents an increase in prevalence. For example, in the study, it's reported that youths who have peers who drink have an OR of 5.7, meaning that there is over a 400% increase in the incidence of early on-set drinking when one's peers start drinking early (peer pressure). Kids allowed to view R-rated content once in a while showed a 200% increase, those allowed sometimes saw a 230% increase, and those allowed all the time saw a 250% increase.<br />
<br />
While these numbers are quite high, this tells us nothing about the relationship strength. Remember multiple variables can lead to this result. Here is a graph of the correlation coefficients:<br />
<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiQ7CpSlmj8HTyds_b_UrCcwMrX4-x5QmFsz5v-ndUfHA3fjRW6SWxD15QqwluwpKZ7EIjAuLMSrX61QzCkQnIFFna7daEyv3Br5qg6IgomBjsqbGNi6QkjOr728pNkCnzRCuZ3qTy9fanz/s1600/correlation.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="252" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiQ7CpSlmj8HTyds_b_UrCcwMrX4-x5QmFsz5v-ndUfHA3fjRW6SWxD15QqwluwpKZ7EIjAuLMSrX61QzCkQnIFFna7daEyv3Br5qg6IgomBjsqbGNi6QkjOr728pNkCnzRCuZ3qTy9fanz/s400/correlation.JPG" tt="true" width="400" /></a></div>Exposure to R-rate movies has a standardized coefficient of 0.10. This relationship is weak. Using the formula above, the amount of variance in behavior attributed to viewing R-rated content is only 1%. <br />
<br />
So why are youths, who are exposed to R-rated content, 2 times more likely to try alcohol at an earlier age?<br />
<br />
Here is how the authors explain it: <br />
<blockquote>"<span style="color: purple;">Youth who say that their parents allow them to watch R movies see more R movies and, therefore, more depictions of alcohol use...thus, the mechanism could be social influence via modeling of positive depictions of alcohol use.</span>"</blockquote>Wrong!<br />
<br />
Exposure to R-rated movies various with onset of early alcohol use by 1%. That means 99% of the variance is explained by other reasons (e.g., peer pressure!) While it is true that this tiny relationship is statistically significant, it has no practical significance what so ever. <br />
<br />
But who cares about the actual science, politicians and other nanny state advocates have their sound bite, <br />
<blockquote>"<span style="color: purple;">The research to date suggests that keeping kids from R-rated movies can help keep them from drinking, smoking and doing a lot of other things that parents don't want them to do, Sargent said.</span>" (<a href="http://www.businessweek.com/lifestyle/content/healthday/638467.html">2</a>)</blockquote>If only it were that simple.<br />
<br />
<span style="float: left; padding: 5px;"><a href="http://researchblogging.org/news/?p=1343"><img alt="This post was chosen as an Editor's Selection for ResearchBlogging.org" src="http://www.researchblogging.org/public/citation_icons/rb_editors-selection.png" style="border:0;"/></a></span><br />
<br />
<span class="Z3988" title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.jtitle=Journal+of+studies+on+alcohol+and+drugs&rft_id=info%3Apmid%2F20409440&rfr_id=info%3Asid%2Fresearchblogging.org&rft.atitle=Parental+R-rated+movie+restriction+and+early-onset+alcohol+use.&rft.issn=1937-1888&rft.date=2010&rft.volume=71&rft.issue=3&rft.spage=452&rft.epage=9&rft.artnum=&rft.au=Tanski+SE&rft.au=Cin+SD&rft.au=Stoolmiller+M&rft.au=Sargent+JD&rfe_dat=bpr3.included=1;bpr3.tags=Psychology%2CSocial+Science%2CResearch+%2F+Scholarship">Tanski SE, Cin SD, Stoolmiller M, & Sargent JD (2010). Parental R-rated movie restriction and early-onset alcohol use. <span style="font-style: italic;">Journal of studies on alcohol and drugs, 71</span> (3), 452-9 PMID: <a href="http://www.ncbi.nlm.nih.gov/pubmed/20409440" rev="review">20409440</a></span>NeuroPsychhttp://www.blogger.com/profile/10654138293659468787noreply@blogger.com3tag:blogger.com,1999:blog-2301999496344158780.post-29089795820114675732010-04-22T16:40:00.000-07:002010-04-22T16:40:47.924-07:00Do Antidepressants Enhance Stroke Recovery?<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhTuu5A0xI-590z7tfG59dhqSzzmo1eAhfr320ZBJXY-_RfpN2phG45vAH-_Uwkt13f-3BckYWikBHqkA1Qz0rIXiFm3yZDn5i2pb2QuuvFKP04OldcVK0ZzwZ-WtNwFmeDi2omgyZfYHS3/s1600/stroke_9704140_std.jpg" imageanchor="1" style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhTuu5A0xI-590z7tfG59dhqSzzmo1eAhfr320ZBJXY-_RfpN2phG45vAH-_Uwkt13f-3BckYWikBHqkA1Qz0rIXiFm3yZDn5i2pb2QuuvFKP04OldcVK0ZzwZ-WtNwFmeDi2omgyZfYHS3/s200/stroke_9704140_std.jpg" width="200" wt="true" /></a></div>A few months ago, in the February issue of <em>Archives of General Psychiatry</em> appeared this study (<a href="http://archpsyc.ama-assn.org/cgi/content/abstract/67/2/187?maxtoshow=&hits=10&RESULTFORMAT=&fulltext=RBANS&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT">1</a>) title, "<span style="color: purple;">Escitalopram and Enhancement of Cognitive Recovery Following Stroke.</span>"<br />
<br />
The design was simple: a placebo group, an escitalopram group, and a problem solving therapy group (a manual based therapy to treat depression in the medically ill). No patients in this group met diagnostic criteria for Major Depression (so why the PST group?) according to the Hamilton Scale for Depression (HAM-D). Patients were administered the following neuropsychological tests at baseline and post-treatment:<br />
<br />
"<span style="color: purple;">-The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). This 25- to 30-minute battery assesses functioning in 5 domains (immediate memory, visuospatial/constructional, language, attention, and delayed memory). These domains are evaluated by 12 individual subtests, including List Learning, List Recall, List Recognition, Story Memory, Story Recall, Figure Copy, Figure Recall, Line Orientation, Picture Naming, Semantic Fluency, Digit Span, and Coding. This battery provides age-corrected norms for overall performance (total scale score) and scores in each domain."</span><br />
<br />
<div align="center">(Number of Subjects in Each Treatment Group)</div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiu3Zs27hQMANXBgoZTkwuPcIw3Wx_l8xRZ2NIGQlaHcgzVfXUAmDHH37R8FZ9IBTebagG8DB22Kv_ub-SW43MOMXBJfuAIq3A5rJl4ucQJ_BJur6tH3AFj3heT5ZevHTb4rum5aN6TFLnB/s1600/n.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiu3Zs27hQMANXBgoZTkwuPcIw3Wx_l8xRZ2NIGQlaHcgzVfXUAmDHH37R8FZ9IBTebagG8DB22Kv_ub-SW43MOMXBJfuAIq3A5rJl4ucQJ_BJur6tH3AFj3heT5ZevHTb4rum5aN6TFLnB/s1600/n.JPG" wt="true" /></a></div><div class="separator" style="clear: both; text-align: center;"><br />
</div><div class="separator" style="clear: both; text-align: left;">Here is what the researchers discovered: "<span style="color: purple;">We found a difference among the 3 treatment groups in change in RBANS total score (P<.01) and RBANS delayed memory score (P<.01).</span>" They also found a significant result for immediate memory too, but for reasons beyond my knowledge (crack-cocaine?) they neglected to report this result. Test scores are below.</div><div class="separator" style="clear: both; text-align: left;"><br />
</div><div align="center">(Click to Enlarge)</div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjXHF18fMGelI04RupqqyeqVG0C3HM3y2o5Nq7ZywkzLZq5TDJkNex8VOCJo41P5kYS1WBfyS-iHxoS6tMlS_7hbk5NnQUmD4cUdt6APTUEeEtxPItuMDzCSbTJ86x-1_Y0amoC2juPqTW9/s1600/results.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="110" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjXHF18fMGelI04RupqqyeqVG0C3HM3y2o5Nq7ZywkzLZq5TDJkNex8VOCJo41P5kYS1WBfyS-iHxoS6tMlS_7hbk5NnQUmD4cUdt6APTUEeEtxPItuMDzCSbTJ86x-1_Y0amoC2juPqTW9/s400/results.JPG" width="400" wt="true" /></a></div><br />
The authors then engaged in a trite discussion about how escitalopram led to an improvement in memory and how serotonin theoretically affects memory, and blah, blah, blah.<br />
<br />
On the surface, it does appear that escitalopram led to better outcomes: For the Total Score (a global measure of cognition) the escitalopram improved by 9.1 points compared to 5.7 for placebo; for delayed memory the escitalopram group improved by 12.4 points versus 5.9 for placebo, and for immediate memory (i.e., learning) the escitalopram group improved by 11.7 points versus 7.4 versus placebo.<br />
<br />
However, look at the post-treatment final scores for both groups: total score: 89.8 (escitalopram) versus 91 (placebo); delayed memory 96.6 (escitalopram) versus 94.2 (placebo); and immediate memory 95.1 (escitalopram) versus 98.5 (placebo). Essentially, both groups post-treatment performance was nearly identical. The reason why the escitalopram group showed a larger magnitude in change was because that group had lower baseline scores.<br />
<br />
The authors did point out that there was not statistical different between any of the baseline scores; however, that's irrelevant. Neuropsychological test performance scores are classified as either average, low average, mild deficit, moderate deficit, or severe deficit. Many of the escitalopram group baseline scores where in the mild-deficit range while the placebo group scores were in the low-average range. Functionally, that kind of difference is significant*.<br />
<br />
Another factor not discussed is the rate of recovery in stroke patients. There is a pretty well delineated recovery curve for patients with mild-to-moderate strokes. Most recovery occurs in the first 6 months, followed by a slower recovery over the next 1-2 years. Those with more severe deficits will show greater initial recovery and then plateau at a level similar to the less sever group. This is why the groups matched on post-treatment assessment scores. <br />
<br />
*It's actually more complicated than that. Scores actually fall within a certain range. So a person could perform in the mild-deficit range at point then in the low-average range at another point. So it's quite possible that these results reflect the error in the psychological instrument rather than a benefit from escitalopram.<br />
<br />
Either way, I'm skeptical that escitalopram actually helped these people.<br />
<br />
<span style="float: left; padding: 5px;"><a href="http://www.researchblogging.org"><img alt="ResearchBlogging.org" src="http://www.researchblogging.org/public/citation_icons/rb2_large_gray.png" style="border:0;"/></a></span><br />
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<span class="Z3988" title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.jtitle=Archives+of+general+psychiatry&rft_id=info%3Apmid%2F20124118&rfr_id=info%3Asid%2Fresearchblogging.org&rft.atitle=Escitalopram+and+enhancement+of+cognitive+recovery+following+stroke.&rft.issn=0003-990X&rft.date=2010&rft.volume=67&rft.issue=2&rft.spage=187&rft.epage=96&rft.artnum=&rft.au=Jorge+RE&rft.au=Acion+L&rft.au=Moser+D&rft.au=Adams+HP+Jr&rft.au=Robinson+RG&rfe_dat=bpr3.included=1;bpr3.tags=Clinical+Research%2CPsychology%2CHealth%2CNeuroscience">Jorge RE, Acion L, Moser D, Adams HP Jr, & Robinson RG (2010). Escitalopram and enhancement of cognitive recovery following stroke. <span style="font-style: italic;">Archives of general psychiatry, 67</span> (2), 187-96 PMID: <a rev="review" href="http://www.ncbi.nlm.nih.gov/pubmed/20124118">20124118</a></span>NeuroPsychhttp://www.blogger.com/profile/10654138293659468787noreply@blogger.com8tag:blogger.com,1999:blog-2301999496344158780.post-59853425876318679442010-04-21T17:11:00.000-07:002010-05-12T09:50:25.113-07:00Health Care the Squeakquel: A Requiem in Two Parts<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg6ULy2ZnyU4VNe_M7gLZ0H6-76MNW4yIs9CVlYcpds9g_bo3z5-02mJBx8HP3vCRn8ythtTlLobiIjJNUGX9gs7OmDOv7SDg_nsvWEdb9ubpHPdhmJuDffxLnaRVc0120-ejsWSaGC07CD/s1600/nancy_pelosi.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg6ULy2ZnyU4VNe_M7gLZ0H6-76MNW4yIs9CVlYcpds9g_bo3z5-02mJBx8HP3vCRn8ythtTlLobiIjJNUGX9gs7OmDOv7SDg_nsvWEdb9ubpHPdhmJuDffxLnaRVc0120-ejsWSaGC07CD/s200/nancy_pelosi.jpg" width="142" wt="true" /></a></div>An interesting read over at the New York Times <br />
<blockquote>"<span style="color: purple;">In a new report, the Congressional Research Service says the law may have significant unintended consequences for the 'personal health insurance coverage' of senators, representatives and their staff members. For example, it says, the law may 'remove members of Congress and Congressional staff' from their current coverage, in the Federal Employees Health Benefits Program, before any alternatives are available.</span>" (<a href="http://www.nytimes.com/2010/04/13/us/politics/13health.html?partner=rss&emc=rss">1</a>)</blockquote><br />
I guess that's the problem when you "<span style="color: purple;">pass the bill so that you can find out what is in it</span>" (<a href="http://www.speaker.gov/newsroom/pressreleases?id=1576">2</a>). <br />
<blockquote>"<span style="color: purple;">The confusion raises the inevitable question: If they did not know exactly what they were doing to themselves, did lawmakers who wrote and passed the bill fully grasp the details of how it would influence the lives of other Americans?</span>"</blockquote>As Ted Stevens likes to yell "NO!" (<a href="http://www.youtube.com/watch?v=NxGKUujCBJs">3</a>)<br />
<br />
One major selling point of the new health care bill was that it will reduce the deficit by $138 billion over the 2010–2019 period (<a href="http://en.wikipedia.org/wiki/Health_Care_and_Education_Reconciliation_Act_of_2010">4</a>). That estimate was made by the nonpartisan Congressional Budget Office (CBO). The problem, however, is in how the CBO makes their estimates: they assume every provision in the bill will be carried out (e.g., cuts to medicare). In reality, congress never follows through with anything. For example, cuts to medicare have been delayed 5 times over the last 10 years (3 times by Republicans and 2 times by Democrats). A former CBO director wrote an article that details some of ways that this bill could contribute to the deficit rather than reduce it (<a href="http://www.nytimes.com/2010/03/21/opinion/21holtz-eakin.html">5</a>).<br />
<br />
Last point about the deficit: if the debt is currently $12, 875, 520, 291, 623, 42 (<a href="http://www.brillig.com/debt_clock/">6</a>), what percentage is $138 billion? I tried to put that into my calculator, and all I got was this "60 2 4377".<br />
<br />
Remember when Obama said this during the campaign: "<span style="color: purple;">One thing we have not done is raise income taxes on families making less than $250,000. That's another promise we've kept.</span>" (<a href="http://www.whitehouse.gov/the-press-office/weekly-address-recovery-act-benefiting-american-families-during-tax-season">7</a>).<br />
<br />
Actually, that is what he said during his most recent radio address. Here is what he said during the campaign "<span style="color: purple;">I can make a firm pledge: Under my plan, no family making less than $250,000 will see their taxes increase—not your income taxes, not your payroll taxes, not your capital gains taxes, <i>not any of your taxes</i>.</span>" (<a href="http://www.presidency.ucsb.edu/ws/index.php?pid=78612">8</a>) <br />
<br />
Needless to say, he's broken that promise more times than Tiger Woods cheated on his wife. According to Americans for Tax Reform (ATR), you can add 7 more tax hikes for that below $250,000 tax group (<a href="http://www.atr.org/obama-sign-massive-tax-hike-working-a4681#">9</a>), four of which affect income, thus also nullifying his revised statement about income tax increases. Here is a list of more taxes being implemented as well (<a href="http://www.washingtonexaminer.com/opinion/columns/OpEd-Contributor/Grace-Marie-Turner-Obamacare-will-make-every-day-feel-like-April-15th-90773369.html">10</a>). The upshot of this is that congress will be taxed too, though, through their own stupidity (<a href="http://dailycaller.com/2010/04/19/congress-may-get-fined-by-its-own-health-care-law/?utm_source=MadMimi&utm_medium=email&utm_content=The+DC+Links&utm_campaign=The+DC+Links&utm_term=2_%2529%2BCongress%2Bmay%2Bget%2Bfined%2Bby%2Bits%2Bown%2Bhealth-care%2Blaw">11</a>).<br />
<br />
In an earlier post (<a href="http://chekhovsgun.blogspot.com/2010/03/54-of-voters-oppose-health-care-plan.html">12</a>), I lamented that this was a health insurance bill, not a health care bill. I might have been wrong with that assertion, since it is quite possible that actual health care will be affected. You see, we have a microcosm that can act as a crystal ball to see our future. It's the state of Massachusetts. When that<strike> Moron</strike> Mormon Mitt Romney was governor of Massachusetts, he passed a health care reform bill for the state. It was the model after which the Democrats constructed their health care bill. <br />
<br />
Here is the current state of things is Massachusetts: <br />
<blockquote>"<span style="color: purple;">People seeking to buy health insurance for the first time, or customers looking to change policies, found they could not do so.</span>" (<a href="http://www.boston.com/business/healthcare/articles/2010/04/07/mass_health_insurers_halt_new_coverage_offers/">13</a>) </blockquote>The state rejected of 235 of 274 proposed health insurance rate increases. That decision will cost insurance companies a lot of money (rendering them profitless). A judge ruled that the companies must comply with those rate rejections (<a href="http://www.boston.com/business/healthcare/articles/2010/04/14/list_rates_or_pay_state_tells_insurers/">14</a>). That decision lead some insurers to do this:<br />
<div><blockquote>"<span style="color: purple;">Health insurers are starting to sell policies that largely bar consumers from receiving medical care at popular but expensive hospitals such as Massachusetts General and Brigham and Women’s — a once radical idea that is gaining traction as a way to control soaring health care costs.</span>" (<a href="http://www.boston.com/news/health/articles/2010/04/17/some_health_networks_drop_elite_hospitals/">15</a>) </blockquote></div>Even the Massachusetts Treasurer (a recently former Democrat) has warned us of the things to come <br />
<blockquote>"<span style="color: purple;">The Massachusetts treasurer said Tuesday that Congress will 'threaten to wipe out the American economy within four years' if it adopts a health-care overhaul modeled after the Bay State’s.</span> " (<a href="http://www.masslive.com/news/index.ssf/2010/03/mass-type_health_care_could_wi.html">16</a>)</blockquote>I think history is about to repeat itself. In the Senate: <br />
<blockquote>"<span style="color: purple;">Fearing that health insurance premiums may shoot up in the next few years...Mr. Harkin praised a bill introduced by Senator Dianne Feinstein, Democrat of California, that would give the secretary of health and human services the power to <i>review premiums and block 'any rate increase found to be unreasonable.'</i> Under the bill, the federal government could regulate rates in states where state officials did not have 'sufficient authority and capability' to do so.</span>" (<a href="http://www.nytimes.com/2010/04/21/health/policy/21health.html">17</a>) </blockquote>We're fucked.<br />
<br />
UPDATE: Oops! Heath Care bill costs $251 billion more than originally thought (that's larger than $138 billion right?). From the Obama Administration's Health and Human Services Administration Department (pdf; <a href="http://www.politico.com/static/PPM130_oact_memorandum_on_financial_impact_of_ppaca_as_enacted.html">18</a>).<br />
<blockquote>"<span style="background-color: white; color: purple;">Medicare cuts could drive about 15 percent of hospitals and other institutional providers into the red, 'possibly jeopardizing access' to care for seniors</span>."(<a href="http://reason.com/blog/2010/04/23/obamacare-to-cost-more-than-ex">19</a>).</blockquote>UPDATE: Double oops! "<span style="color: purple;">CBO: Medicare Payment 'Doc Fix' Is More Expensive Than Expected</span>." (<a href="http://www.kaiserhealthnews.org/Daily-Reports/2010/May/04/Doc-Pay-Fix.aspx">20</a>)<br />
<br />
UPDATE: The Health Insurance Trade-Off Game (<a href="http://reason.com/blog/2010/05/11/the-health-insurance-trade-off">22</a>)<br />
<br />
UPDATE: It just keeps going up, up, up. New CBO report say that an additional $115 billion in discretionary spending will be needed (<a href="http://cboblog.cbo.gov/?p=835">23</a>)<br />
<br />
FYI: To all you conservatives out there, don't think the Republicans are going to "repeal the bill" either. (<a href="http://news.yahoo.com/s/ap/20100331/ap_on_bi_ge/us_health_overhaul_republicans_3">21</a>)<br />
<br />
And please, do not nominate this guy...<br />
<br />
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(part 1 <a href="http://chekhovsgun.blogspot.com/2010/03/health-care-requiem-in-two-parts.html">here</a>)NeuroPsychhttp://www.blogger.com/profile/10654138293659468787noreply@blogger.com2tag:blogger.com,1999:blog-2301999496344158780.post-79088330634269500412010-04-01T17:31:00.000-07:002010-04-01T18:22:16.464-07:00Sexual Addiction or It's Not My Fault That My Penis Fell Into Her Vagina<div class="separator" style="clear: both; text-align: left;"><a href="http://cinephiliac.com/img/2006/I-Am-a-Sex-Addict.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" nt="true" src="http://cinephiliac.com/img/2006/I-Am-a-Sex-Addict.jpg" width="134" /></a>David Duchovny, Tiger Woods, Steve Phillips, and now Jesse James. All men, all self-diagnosed <a href="http://en.wikipedia.org/wiki/Sex_addiction">sex addicts</a>, and all <i>victims</i> of their disorder. Well, that's how they want to be betrayed in the media. To most people, sexual addiction appears to be a "get out of jail free" card for sleazy douche bags. So this begs the question, is it a real disorder?</div><br />
Like any other complex human behavior, it all depends on who you ask.<br />
<br />
There appear to be four main camps: those who liken the condition to a <a href="http://en.wikipedia.org/wiki/Chemical_dependence">chemical dependency disorder</a>, those who view it as a disorder similar to <a href="http://en.wikipedia.org/wiki/OCD">obsessive-compulsive disorder</a>, and those who believe it to be an <a href="http://en.wikipedia.org/wiki/Impulse_control_disorder">impulse control disorder</a>. The fourth group believes that the other three groups are full of shit. <br />
<br />
Even though many people are diagnosed with, and treated for sexual addiction every year (estimated 3-6% of US population), there is no actual disorder in any of the previous versions of the DSM. A new disorder is being considered for the DSM-V, which is termed "<a href="http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=415">Hypersexual Disorder</a>."<br />
<br />
Here of some examples of proposed diagnostic criteria:<br />
<span style="color: purple;">1) A maladaptive pattern of behavior, leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occurring at any time in the same 12-month period:</span><br />
<br />
<span style="color: purple;">A) tolerance, as defined by either of the following: </span><br />
<span style="color: purple;">-a need for markedly increased amount or intensity of the behavior to achieve the desired effect </span><br />
<span style="color: purple;">-markedly diminished effect with continued involvement in the behavior at the same level or intensity </span><br />
<br />
<span style="color: purple;">B) withdrawal, as manifested by either of the following: </span><br />
<span style="color: purple;">-characteristic psychophysiological withdrawal syndrome of physiologically described changes and/or psychologically described changes upon discontinuation of the behavior </span><br />
<span style="color: purple;">-the same (or a closely related) behavior is engaged in to relieve or avoid withdrawal symptoms </span><br />
<span style="color: purple;">-the behavior is often engaged in over a longer period, in greater quantity, or at a higher intensity than was intended </span><br />
<br />
<span style="color: purple;">C) there is a persistent desire or unsuccessful efforts to cut down or control the behavior </span><br />
<span style="color: purple;">D) a great deal of time spent in activities necessary to prepare for the behavior, to engage in the behavior, or to recover from its effects </span><br />
<span style="color: purple;">E) important social, occupational, or recreational activities are given up or reduced because of the behavior </span><br />
<span style="color: purple;">F) the behavior continues despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the behavior</span> <br />
<br />
I'd argue that these criteria adhere too closely to the substance dependence model and fail the capture the essence of human sexual behavior. Moreover, I don't know think "<a href="http://en.wikipedia.org/wiki/Blue_balls">blue balls</a>" would technically count as a withdrawal symptom.<br />
<br />
From the DSM-V<br />
<span style="color: purple;">A. Over a period of at least six months, recurrent and intense sexual fantasies, sexual urges, and sexual behavior in association with four or more of the following five criteria:</span><span style="color: purple;">(1) A great deal of time is consumed by sexual fantasies and urges, and by planning for and engaging in sexual behavior. </span><br />
<span style="color: purple;">(2) Repetitively engaging in these sexual fantasies, urges, and behavior in response to dysphoric mood states (e.g., anxiety, depression, boredom, irritability). </span><br />
<span style="color: purple;">(3) Repetitively engaging in sexual fantasies, urges, and behavior in response to stressful life events. </span><br />
<span style="color: purple;">(4) Repetitive but unsuccessful efforts to control or significantly reduce these sexual fantasies, urges, and behavior. </span><br />
<span style="color: purple;">(5) Repetitively engaging in sexual behavior while disregarding the risk for physical or emotional harm to self or others. </span><span style="color: purple;">B. There is clinically significant personal distress or impairment in social, occupational or other important areas of functioning associated with the frequency and intensity of these sexual fantasies, urges, and behavior. </span><br />
<span style="color: purple;">C. These sexual fantasies, urges, and behavior are not due to the direct physiological effect of an exogenous substance (e.g., a drug of abuse or a medication).</span> <br />
<br />
There are some similarities between substance dependence, OCD, and impulse control disorders: impulsivity, obsessions, and compulsions.<br />
<br />
<a href="http://en.wikipedia.org/wiki/Impulsivity">Impulsive</a> behaviors are by done without any forethought, spur of the moment. <br />
<a href="http://en.wikipedia.org/wiki/Obsessive%E2%80%93compulsive_disorder#Obsessions">Obsessions</a> are intrusive thoughts that an individual does not want to have, but has them anyway.<br />
<a href="http://en.wikipedia.org/wiki/Compulsive_behavior">Compulsive</a> behaviors are behaviors that people do, but they do not want to do them. <br />
<br />
There is another feature that ties all these disorders together: the addiction, obsession, or compulsion is the central organizing principle of that individual's life. The crack addict lives his life around obtaining and using crack, the patient with OCD is so fearful of contamination that she washes her hands so many times that she has blisters, someone with trichotillomania is completely bald because they cannot stop pulling their hair out. These people do not live happy lives. Their disorder rules their life; they are disabled. These people are doing something that they most certainly do not want to do.<br />
<br />
Jesse James had an 11 month affair and Tiger Woods had a 2 year affair (plus other alleged affairs). David Duckovny banged his tennis partner. Steven Phillips is a misogynist. Sounds more like these were guys who got caught cheating and are now doing major damage control. <br />
<br />
One more thought. If true addicts cannot use the substance to which they were addicted, are sex addicts not allowed to have sex anymore? If Jesse James porks Sandra again, did he relapse?<br />
<br />
Discuss amongst yourselves.NeuroPsychhttp://www.blogger.com/profile/10654138293659468787noreply@blogger.com5tag:blogger.com,1999:blog-2301999496344158780.post-12523139661258776982010-03-30T16:16:00.000-07:002010-03-30T16:20:31.178-07:00Health Care: A Requiem In Two Parts<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgcVKqTDsU8HL5X8826US9kQrkdNftePn3xp3_rndsuqW0ZfBawH9XGLQc-4Wj00JEsj_b55ZTw5ASvtm_LrN0-CwZpofbwdI2vhMX_wCvMt5oPdXQDlcPA0TH6vGhS4kEPbR-pTL7cNxa6/s1600-h/hi.jpg" imageanchor="1" style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="150" nt="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgcVKqTDsU8HL5X8826US9kQrkdNftePn3xp3_rndsuqW0ZfBawH9XGLQc-4Wj00JEsj_b55ZTw5ASvtm_LrN0-CwZpofbwdI2vhMX_wCvMt5oPdXQDlcPA0TH6vGhS4kEPbR-pTL7cNxa6/s200/hi.jpg" width="200" /></a></div>I need to take a drug holiday from my usual concoction of Valium, Restoril, Ambien CR, and Benadryl to sleep at night. Apparently, I slept through an important change in human ethical thought. No longer does society have a moral obligation to provide health care, but rather, it's health insurance which we have the "moral imperative" to provide (<a href="http://www.politico.com/news/stories/0609/23635.html">1</a>).<br />
<br />
I find that really odd, since insurance, as I've come to know it, is defined as the "<span style="color: purple;">equitable transfer of the risk of a loss, from one entity to another, in exchange for a premium, and can be thought of as a guaranteed and known small loss to prevent a large, possibly devastating loss</span>" (<a href="http://en.wikipedia.org/wiki/Insurance">2</a>). Perhaps all that moral imperative stuff is found in the new revelation of Jesus Christ found in the Book of <strike>Moron </strike>Mormon. I'll have to look into that...<br />
<br />
With health insurance, the "risk" that is being transferred is that of incurring <em>medical expenses</em>. As it turns out, there are a lot people in this country who do not have health insurance and therefore, are at risk for incurring medical expenses. The oft quoted (and inflated) statistic of people who do not have health insurance is 47 million (<a href="http://reason.com/archives/2009/10/09/the-madness-of-the-mandate">3</a>). Even after the bill's passage, some 23 million still will not be covered.<br />
<br />
But, who is to blame to for this high number? <br />
<br />
"It's the insurance companies dummy!" was the implied message I got from one reader, who opined:<br />
<blockquote>"<span style="color: purple;">I have no idea why everyone is defending the insurance companies who have been raping consumers' wallets for years and padding the pockets of politicians to keep antitrust laws from applying to them (thankfully, no more).</span>"</blockquote>Wow. Those companies sound really awful. I love my wallet. I would never let any harm come to it, sexual or otherwise. I guess a big "Thank You Mr. President Obama" is in order (and if you come into the oval office, a nice sloppy blow job too).<br />
<br />
Obama sure screwed those wallet raping insurance companies (<a href="http://www.politico.com/livepulse/0310/Obama_closes_.html">4</a>): no more excluding people with pre-existing conditions, and no more setting rates based on a person's health status.<br />
<blockquote>“<span style="color: purple;">In addition, a weak economy is causing younger, healthier individuals to drop their insurance. As healthy people forego health insurance, the rates for those Americans who need coverage increases. That is why going into 2009 we advocated for robust insurance market reforms, including</span> <span style="color: red;">guaranteed coverage with no pre-existing condition exclusions or health status rating paired with an effective personal coverage requirement to get everyone covered</span>." (<a href="http://www.americanhealthsolution.org/blog/search?keywords=pre-existing">5</a>)</blockquote>The above quote is not from an Obama speech. It's from America’s Health Insurance Plans (<a href="http://en.wikipedia.org/wiki/America%E2%80%99s_Health_Insurance_Plans">AHIP</a>) President and CEO Karen Ignagni (i.e., the evil insurance lobby, dun, dun, dun...). <br />
<br />
If the insurance industry actually <em>supports</em> those provisions in the bill, how exactly did Obama screw them?<br />
<br />
The real question to ask is why the insurance industry supports those provisions. The answer: national health insurance mandate (i.e., "personal coverage requirement"). The health insurance industry is happy to drop those practices as long as they have a nice pool of "<span style="color: purple;">younger</span><span style="color: purple;">, healthier individuals</span>" to be conscripted. Since unhealthy individuals can no longer be charged higher premiums, it's healthier individuals who will see their premiums go up by as little as 10-13% or as high as 27-30%, depending on varying sets of circumstances (<a href="http://draft.blogger.com/post-edit.g?blogID=2301999496344158780&postID=1252313966125877698">6</a>).<br />
<br />
We never learn from our mistakes. Many states have experimented with banning certain insurance practices such as the exclusion practice. This essentially kills any incentive to obtain insurance until you're actually sick. This ends up costing insurance providers a lot of money. The federal government's solution? Coerce their citizens to buy insurance. That's it, problem solved right?<br />
<br />
Not exactly. Even with the mandate, there is still no incentive for healthy people to buy insurance. The average cost for an individual policy is $5,500 (<a href="http://draft.blogger.com/post-edit.g?blogID=2301999496344158780&postID=1252313966125877698">7</a>). The fine for not purchasing insurance ranges from $95 (1% of income) the first year to $695 (or 2% of income) after that. Would you rather pay $700 or $5000? Even if you're eligible for federal subsidies, $2,300 is still more expensive than $700. It's for this reason, the health insurance industry does not support this bill. The fines are too small (and currently, not enforceable). <br />
<br />
We can predict what will happen next. It's known as a "death spiral." When premiums rise for those healthy people who already have policies (since unhealthy people can no longer be charged higher rates), more and more healthy people will drop their insurance. This will create an insurance pool of primarily of high cost, sick people (<a href="http://www.ahip.org/content/fileviewer.aspx?docid=20794&linkid=179392">8</a>). Many insurance companies will not be able to stay in business under these sets of circumstances. More and more health care dollars will become the responsibility of the government, which of course, is funded by taxing it citizens.<br />
<br />
So in this sense, Obama has screwed the insurance companies. And us along with them.<br />
<br />
(FYI: Those pesky anti-trust laws <em>still</em> don't apply to the health insurance companies).<br />
<br />
(Coming soon: Will the health care bill reduce the deficit?)NeuroPsychhttp://www.blogger.com/profile/10654138293659468787noreply@blogger.com5tag:blogger.com,1999:blog-2301999496344158780.post-15181169016508757642010-03-23T19:57:00.000-07:002010-03-25T00:11:31.767-07:00The Dumbest Study I've Ever Read<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhcvDh1j8okPPWzVt4Ud43yZ3jJ5voxZZZH10wMhJ0YvDBG3n7WOXKGRlIQbcaDH7x02bSHk1ZKGeHHDdW9bRTH9P38CRFKjQ4XabU2hOijpUOeKzFF0WBFr9pgLCemXu6TarSFGPXbZKV1/s1600-h/last_supper5.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="174" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhcvDh1j8okPPWzVt4Ud43yZ3jJ5voxZZZH10wMhJ0YvDBG3n7WOXKGRlIQbcaDH7x02bSHk1ZKGeHHDdW9bRTH9P38CRFKjQ4XabU2hOijpUOeKzFF0WBFr9pgLCemXu6TarSFGPXbZKV1/s320/last_supper5.jpg" width="320" /></a></div>This <a href="http://www.nature.com/ijo/journal/vaop/ncurrent/abs/ijo201037a.html">study</a> has nothing to do with drugs, psychotherapy, or even neuroscience. It's about Jesus' head; more specifically, it's about Jesus' head in relation to the size of the main course in 52 different depictions of the Last Supper.<br />
<br />
I know what you're all thinking, it's barely past noon, and I've hit the scotch too hard this time. From the International Journal of Obesity:<br />
<blockquote>"<span style="color: purple;">Portion sizes of foods have been noticably increasing in recent years, but when did this trend begin? If art imitates life and if food portions have been generally increasing with time, we might expect this trend to be reflected in paintings that depict food. Perhaps the most commonly painted meal has been that of Jesus Christ's Last Supper, chronicled in the New Testament of the Bible. A CAD–CAM analysis of the relative food-to-head ratio in 52 representative paintings of the Last Supper showed that the relative sizes of the main dish</span><span class="mb" style="color: purple;"></span><span style="color: purple;"></span><span class="mb" style="color: purple;"></span><span style="color: purple;">, bread</span><span class="mb" style="color: purple;"></span><span style="color: purple;"></span><span class="mb" style="color: purple;"></span><span style="color: purple;">, and plates</span><span class="mb" style="color: purple;"></span><span style="color: purple;"></span><span class="mb" style="color: purple;"></span><span style="color: purple;"> have linearly increased over the past millennium.</span>"</blockquote>First, it's spelled <b>noticeably</b>, not <b>noticably</b>. No need to thank me, I'm just here to help.<br />
<br />
Lead author, Brian Wansink, proudly displayed his virginity by saying, "<span style="color: purple;">I think people assume that increased serving sizes, or ‘portion distortion,’ is a recent phenomenon, but this research indicates that it’s a general trend for at least the last millennium.</span>"<br />
<br />
His brother Craig Wansink, proving that mental illness does run in their family added, "<span style="color: purple;">As the most famously depicted dinner of all time, the Last Supper is ideally suited for review.</span>"<br />
<br />
<div style="text-align: center;">Here is a graph showing some of the data that will one day lead to a vaccination for jock itch. <a href="http://www.mindlesseating.org/lastsupper/images/fig02.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="220" src="http://www.mindlesseating.org/lastsupper/images/fig02.jpg" width="320" /></a> </div><div style="text-align: center;">I am posting another graph below because I hate all of you.</div><br />
<div class="separator" style="clear: both; text-align: center;"><a href="http://www.mindlesseating.org/lastsupper/images/fig01.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="220" src="http://www.mindlesseating.org/lastsupper/images/fig01.jpg" width="320" /></a></div> What they found was that "<span style="color: purple;">the main courses depicted in the paintings grew by 69%, plate size by 66%, and bread size by 23%</span>" over the course of 1000 years.<br />
<br />
<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhjSb2m_CrzZRL1w86yG6Uxq-5f-bbac7UM3vSAF_jMwplPpeqMyeBa0IgQkFsHVhlFDKee9ihm6a1yTEahNZO44Yz4dPXjwFyX8Q3UmZ4OPl5XSGqNXY04WcWltG3Ybcng8beBLph8beH4/s1600-h/retard.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="158" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhjSb2m_CrzZRL1w86yG6Uxq-5f-bbac7UM3vSAF_jMwplPpeqMyeBa0IgQkFsHVhlFDKee9ihm6a1yTEahNZO44Yz4dPXjwFyX8Q3UmZ4OPl5XSGqNXY04WcWltG3Ybcng8beBLph8beH4/s200/retard.jpg" width="200" /></a></div> I've lost precious minutes from my life. I've created this post to waste your time as well. <br />
<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhTdg07-1wThO6Rql1zOob-dOe7cEiIUKogzdNRnRcOUX07TLpyS78B7AhJcFcBZeC5_rYN7C5sf-ApJb0fDrn-SEgZqlaaF-O2RYfpSCvjmJ69S33NrxS8W8csrVD-0JAG31Ltf1PYovlo/s1600-h/idiot.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhTdg07-1wThO6Rql1zOob-dOe7cEiIUKogzdNRnRcOUX07TLpyS78B7AhJcFcBZeC5_rYN7C5sf-ApJb0fDrn-SEgZqlaaF-O2RYfpSCvjmJ69S33NrxS8W8csrVD-0JAG31Ltf1PYovlo/s320/idiot.png" width="320" /></a></div>Be careful everyone. Stupid can kill...<br />
<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEigO4Z_LpJhzhW-FPo3yJ5vz1DR2J51E_hz6uj6zRLRfTLS-1I45F3YlsLeWZArjpLwNX5V6uqKRiHEPrXxWZYrRCKFPSA7V2YgC-5DtLHXIkOmdOUJ67exnwRw36O4keRRVY8Hoq4a9XOM/s1600-h/stupid.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEigO4Z_LpJhzhW-FPo3yJ5vz1DR2J51E_hz6uj6zRLRfTLS-1I45F3YlsLeWZArjpLwNX5V6uqKRiHEPrXxWZYrRCKFPSA7V2YgC-5DtLHXIkOmdOUJ67exnwRw36O4keRRVY8Hoq4a9XOM/s320/stupid.jpg" width="281" /></a></div><br />
<span style="float: left; padding: 5px;"><a href="http://www.researchblogging.org/"><img alt="ResearchBlogging.org" src="http://www.researchblogging.org/public/citation_icons/rb2_large_gray.png" style="border: 0pt none;" /></a></span><br />
<br />
<span class="Z3988" title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.jtitle=International+Journal+of+Obesity&rft_id=info%3A%2F&rfr_id=info%3Asid%2Fresearchblogging.org&rft.atitle=The+largest+Last+Supper%3A+depictions+of+food+portions+and+plate+size+increased+over+the+millennium&rft.issn=&rft.date=2010&rft.volume=37&rft.issue=&rft.spage=&rft.epage=&rft.artnum=http%3A%2F%2Fwww.nature.com%2Fijo%2Fjournal%2Fvaop%2Fncurrent%2Fabs%2Fijo201037a.html&rft.au=B+Wansink++and+C+S+Wansink&rfe_dat=bpr3.included=1;bpr3.tags=Computer+Science%2CResearch+%2F+Scholarship">B Wansink and C S Wansink (2010). The largest Last Supper: depictions of food portions and plate size increased over the millennium <span style="font-style: italic;">International Journal of Obesity, 37</span></span><br />
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<br />
<b>UPDATE:</b> It just got worse...<br />
<object height="344" width="425"><param name="movie" value="http://www.youtube.com/v/RZ9PZjVQTkM&hl=en_US&fs=1&rel=0&color1=0x3a3a3a&color2=0x999999"></param><param name="allowFullScreen" value="true"></param><param name="allowscriptaccess" value="always"></param><embed src="http://www.youtube.com/v/RZ9PZjVQTkM&hl=en_US&fs=1&rel=0&color1=0x3a3a3a&color2=0x999999" type="application/x-shockwave-flash" allowscriptaccess="always" allowfullscreen="true" width="425" height="344"></embed></object>NeuroPsychhttp://www.blogger.com/profile/10654138293659468787noreply@blogger.com4tag:blogger.com,1999:blog-2301999496344158780.post-19217168821111139002010-03-23T10:03:00.000-07:002010-03-23T21:34:44.456-07:00"54% of Voters Oppose the Health Care Plan"<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhbs5qRJp7YmCvp4tFN8lmpF0seqsAr3uJmzBmUcNY4PUg__IH9ev5egw_aEaz8MHN4_RcEQtGwAj36VKYtkKNuWPhV8HFCyZY_eEcno4JLypQAVYWThme_fo8_S1FqR4AhmD8-N0s03C8O/s1600-h/idiots.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="287" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhbs5qRJp7YmCvp4tFN8lmpF0seqsAr3uJmzBmUcNY4PUg__IH9ev5egw_aEaz8MHN4_RcEQtGwAj36VKYtkKNuWPhV8HFCyZY_eEcno4JLypQAVYWThme_fo8_S1FqR4AhmD8-N0s03C8O/s400/idiots.jpg" vt="true" width="400" /></a></div>So why are these people so fucking proud of themselves? <br />
I don't care what people or other media say (<a href="http://www.politicsdaily.com/2010/03/23/in-historic-first-step-obama-to-sign-health-care-bill-this-morn/?icid=main%7Cmain%7Cdl1%7Clink3%7Chttp%3A%2F%2Fwww.politicsdaily.com%2F2010%2F03%2F23%2Fin-historic-first-step-obama-to-sign-health-care-bill-this-morn%2F">1</a>), this is not a "health care reform bill," it's a (really expensive) health <i>insurance bill</i>. It doesn't matter whether you have medicare or private coverage. Insurance does not equal actual health care (Nor quality of care either).<br />
<br />
Update: Reader comment:<br />
<blockquote><div style="color: purple;">"Anonymous said... </div></blockquote><div style="color: purple;">You claim to have some background in psychology and science, yet your title is a rather emphatic and dubious conclusion based on a source that provides absolutely no information regarding the methodology employed. There is nothing easier in the world than to obtain a skewed polling result based simply upon the wording of a question. Yet, we do not know what questions were asked, the order in which they were asked, etc. From what I can see from their site Rasmussen is about as objective as Fox News and leans in the same direction."</div><div style="text-align: center;"><b>(Click to Enlarge)</b></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgML6DgzP-3Ift9Jxm-E6sIwCeasnpZNxeRGXjg1Sos8X0g_vaL8n7NAuKHVTdcHBTcuTXXPFnLo3xNfJ2WRPbAgh7qBGHAfSFr29aUniVIWcq-F2TQYOuDHDJzbFfpv5QJWvGUd8g1BO-G/s1600-h/polls.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="232" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgML6DgzP-3Ift9Jxm-E6sIwCeasnpZNxeRGXjg1Sos8X0g_vaL8n7NAuKHVTdcHBTcuTXXPFnLo3xNfJ2WRPbAgh7qBGHAfSFr29aUniVIWcq-F2TQYOuDHDJzbFfpv5QJWvGUd8g1BO-G/s400/polls.png" vt="true" width="400" /></a></div>From realclearpolitics (<a href="http://www.realclearpolitics.com/epolls/other/obama_and_democrats_health_care_plan-1130.html">1</a>). You'll notice ALL of the polls show lack of support. Douche.<br />
<br />
Update Too:<br />
<blockquote>"<span style="color: purple;">a source that <i>provides absolutely no information regarding the methodology</i> employed. There is nothing easier in the world than to obtain a skewed polling result based simply upon the wording of a question. Yet, <i>we do not know what questions were asked, the order in which they were asked, etc.</i> From what I can see from their site Rasmussen is about as objective as Fox News and leans in the same direction.</span>"</blockquote> Methodology located at the bottom of the article page (<a href="http://www.rasmussenreports.com/public_content/politics/current_events/healthcare/september_2009/health_care_reform">2</a>) "This national telephone survey of 1,000 Likely Voters was conducted by Rasmussen Reports March 19-20, 2010. The margin of sampling error for the survey is +/- 3 percentage points with a 95% level of confidence (<a href="http://www.rasmussenreports.com/public_content/about_us/methodology" target="_self">see methodology</a>)."<br />
<br />
Amazingly, this right-wing whack job website also lists the questions and the order in which they were asked too (<a href="http://www.rasmussenreports.com/public_content/politics/toplines/pt_survey_toplines/march_2010/toplines_health_care_reform_march_19_20_2010">3</a>).NeuroPsychhttp://www.blogger.com/profile/10654138293659468787noreply@blogger.com7tag:blogger.com,1999:blog-2301999496344158780.post-1727711768829966272010-03-15T16:30:00.000-07:002010-03-15T16:38:14.592-07:00WARNING: Chantix Causes Suicide, Herpes, and Nocturnal Vaginal Itch Syndrome<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgTZ2nJtt86etwi0CrJ2JtOvlk75SJbAHszWHFLaVM4W0_r0etBymc_1awEs2JcfSXMEtvsMR54Y2B-Wzb4pCxmEO_Y_YUYA7wdBsIIHRFYsMrobFt7IKWJH1Qdpun5WXQm3JMMYChLhG4u/s1600-h/champix.jpg" imageanchor="1" style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="142" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgTZ2nJtt86etwi0CrJ2JtOvlk75SJbAHszWHFLaVM4W0_r0etBymc_1awEs2JcfSXMEtvsMR54Y2B-Wzb4pCxmEO_Y_YUYA7wdBsIIHRFYsMrobFt7IKWJH1Qdpun5WXQm3JMMYChLhG4u/s200/champix.jpg" vt="true" width="200" /></a></div>Here is a brief tale of an American dream deferred...<br />
<blockquote>"<span style="color: purple;">Tina Hurst is a suburban mother and a manager at a Fortune 500 company. Her life was great, but she had one dark secret...'I was a closet smoker,' Hurst said.</span>" </blockquote>Here is where the plot thickens...<br />
<blockquote>"<span style="color: purple;">Her doctor prescribed a drug called Chantix to help her quit. Seven million Americans have taken it. Hurst says she took Chantix for two months and it worked great.</span>"</blockquote>Then, tragedy struck...<br />
<blockquote>"<span style="color: purple;">But when she stopped, 'I totally went off the deep end,' she said. Hurst says she started walking around the house in circles, crying and hallucinating. 'I thought somebody died. And I was freaked out,' Hurst said." </span> </blockquote><div>But, it wasn't over just yet...</div><blockquote>"<span style="color: purple;">An ambulance rushed Hurst to a hospital where records indicate she was very agitated and had to be restrained. She spent four days in a psych unit. Prior to this, Hurst said she never had a history of anxiety, depression or any mental problems. She thinks it was caused by Chantix. Her doctor's diagnosis? "Substance-induced psychotic disorder.</span>" (<a href="http://cbs4.com/health/chantix.smoking.anti.2.1550733.html">1</a>) </blockquote>No, this isn't the plot of Gothika (<a href="http://en.wikipedia.org/wiki/Gothika">2</a>), this is an account of a woman who claims that she was adversely affected by Pfizer's anti-smoking drug Chantix (<a href="http://en.wikipedia.org/wiki/Chantix">varenicline</a>). Stories like this are common place now. Since the drug has come to market, it has racked up some 10,102 reports in the FDA's adverse events database (<a href="http://www.fdable.com/aers/advanced_query?encoded_value=a54ab42b6bee">3</a>).<br />
<br />
Normally, I'm all for psychoactive drugs causing harm to people. However, I think a skeptical approach should be taken when it comes to this drug. <br />
<br />
The most widely heard side-effect of Chantix is that it causes suicidality. For the sake of argument, let's forget that suicidality is a very complex and multifaceted human condition; we're going to pretend that this little pill can lead an otherwise normal and healthy person to want to kill himself (<a href="http://www.lawyersandsettlements.com/articles/13718/interview-chantix-suicide-side-effects.html">4</a>).<br />
<br />
First, let's examine the neurobiological reasons why this might happen...oh, wait a minute, there are no widely accepted (or proposed?) mechanisms of how this happens, just like there is no proposed mechanism for the supposed anti-depressant induced mania phenomenon (<a href="http://chekhovsgun.blogspot.com/2009/02/lets-say-that-youre-at-your-buddys.html">5</a>) or the anti-depressant induced suicidality phenomenon.<br />
<br />
What we do have is a <em>temporal association </em>(<a href="http://geoparent.com/dictionary/Detailed/318.htm">6</a>). That is, event B happens around, near by, within some sort of proximity of event A. Once that happens, our minds automatically link events A and B together, and we have <a href="http://en.wikipedia.org/wiki/Causation">causation</a>! No need for scientific investigation. Just turn on your computer, sign onto word press and start blogging about how "<a href="http://www.furiousseasons.com/archives/2008/05/chantix_causes_traffic_accident_passengers_almost_die.html">Chantix Causes Traffic Accident, Passengers Almost Die</a>."<br />
<br />
Here's why I am skeptical of the Chantix-suicidality link: smoking is associated with psychiatric illness (<a href="http://www.ncbi.nlm.nih.gov/pubmed/15520358?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum">8</a>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/18366824?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum">9</a>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/18324562?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum">10</a>). Specifically, individuals who smoke and have a comorbid psychiatric (i.e., Axis I or II) disorder make up 7% of the population, yet they consume 34% of all cigarettes smoked in the United States. Moreover, cigarette use is associated with most major psychiatric disorders. This means that 7% of 45 million smokers are mentally ill. That's a lot of people who are already at risk for suicide, regardless of whether they use Chantix or not.<br />
<br />
Here is another interesting piece of research: <br />
<blockquote>"<span style="color: purple;">This study examined the relation between smoking and suicide, controlling for various confounders...We found a positive, dose-related association between smoking and suicide among White men. Although inference about causality is not justified, our findings indicate that the smoking-suicide connection is not entirely due to the greater tendency among smokers to be unmarried, to be sedentary, to drink heavily, or to develop cancers.</span>" (<a href="http://www.ncbi.nlm.nih.gov/pubmed/10800427?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum">11</a>) </blockquote>I almost forgot about this study:<br />
<blockquote><span style="color: purple;">RESULTS: Current daily smoking, but not past smoking, predicted the subsequent occurrence of suicidal thoughts or attempt, independent of prior depression and substance use disorders (adjusted odds ratio, 1.82; 95% confidence interval, 1.22-2.69). Additionally, current daily smoking, but not past smoking, predicted the subsequent occurrence of suicidal thoughts or attempt, adjusting for suicidal predisposition, indicated by prior suicidality, and controlling for prior psychiatric disorders (adjusted odds ratio, 1.74; 95% confidence interval, 1.17-2.54). </span>(<a href="http://www.ncbi.nlm.nih.gov/pubmed/15753246?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum">12</a>)</blockquote>Anybody ever abruptly stop their anti-depressant medication? Bad stuff happens, right? Here is a pretty picture from a study in the September 2003 issues of <strike>PENIS</strike> er, PNAS (<a href="http://www.pnas.org/content/100/20/11600.abstract">13</a>).<br />
<br />
<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiKJcvtC5nCcTIdLwWaZXsH7TOaU1RcCSYxrfDpd14CVsc08sm2ZMwJjGq1whtRwhr-gOiCXcCJf144MMptd5u5Jw936cSGzbdSZRP9kFlwVAghgE5IfjN2zMlDHmghSMgu_pE2UsGed0LL/s1600-h/maoi.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="239" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiKJcvtC5nCcTIdLwWaZXsH7TOaU1RcCSYxrfDpd14CVsc08sm2ZMwJjGq1whtRwhr-gOiCXcCJf144MMptd5u5Jw936cSGzbdSZRP9kFlwVAghgE5IfjN2zMlDHmghSMgu_pE2UsGed0LL/s320/maoi.JPG" vt="true" width="320" /></a></div><br />
Here is a comparison of a smoker and nonsmoker and the amount of <a href="http://en.wikipedia.org/wiki/MAO">monoamine oxidase</a> throughout their bodies. Smoking lowers the amount of this enzyme, which breaks down the catecholamines (5HT, DA, NE). Without this enzyme, the levels of these neurotransmitters rises. This is how the class of anti-depressants known as <a href="http://en.wikipedia.org/wiki/Monoamine_oxidase_inhibitor">monoamine oxidase inhibitors</a> are supposed to work. <br />
<br />
Here are the instructions for how a patient is supposed to use Chantix:<br />
<br />
<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjdH3XkA6zxsMS-b6YiB2UfmxrAR96ug6FUf0EbGDUzeXvAnQyM5AwnebRnCFNwfdbvijv8lieLZCuACpcd-5rWx7osonbzlPeEev6_9CEvRz5H0yWTD4GfD6ttU12ubyjTd-zSkslRx0uc/s1600-h/chantix.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="40" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjdH3XkA6zxsMS-b6YiB2UfmxrAR96ug6FUf0EbGDUzeXvAnQyM5AwnebRnCFNwfdbvijv8lieLZCuACpcd-5rWx7osonbzlPeEev6_9CEvRz5H0yWTD4GfD6ttU12ubyjTd-zSkslRx0uc/s400/chantix.JPG" vt="true" width="400" /></a></div> That is, they quit smoking one week after starting Chantix. Since Chantix is a partial-nicotinic agonist and not an MAOI, this could have the same effect as abruptly stopping your anti-depressant medication. <br />
<br />
What if the instructions read like this instead. "<span style="color: purple;">Patients should be instructed to set a date to quit smoking and <em>to stop their antidepressant</em> medication and to initiate CHANTIX treatment one week before the quit date.</span>" Would you still take it? <br />
<br />
Earlier, I mentioned the FDA's adverse events database. This is a system, where if an adverse reaction to a drug is <em>suspected, </em>it can be reported. <br />
<br />
Here is a <a href="http:///">link</a> (14) to the FDA's adverse events database on those who quit smoking cold turkey.<br />
<br />
You'll notice that there is no real link because there is no actual database for this. The data that is collected by the FDA's actual database is <em>biased, there are too many confounds that are not accounted for.</em> <br />
<br />
What about actual research? If you search PubMed for the terms "varenicline" and "suicide" you get 19 hits. Only three are actual prospective studies that looked at the matter (<a href="http://www.bmj.com/cgi/content/full/339/dec31_1/b5654?view=long&pmid=20044403">15</a>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/19797344">16</a>). The first study only had 1 suicide, but the patent's psychiatric background is unknown since the study is not complete. In the second study,<br />
<blockquote>"<span style="color: purple;">There was no evidence that varenicline was associated with an increased risk of depression or suicidal thoughts.</span>"</blockquote>The third study uses an adverse events reporting paradigm (<a href="http://www.ncbi.nlm.nih.gov/pubmed/19459717">17</a>):<br />
<blockquote>"<span style="color: purple;">All patients with suicidal events either had a past medical history of psychiatric illness prior to starting varenicline and/or a precipitating factor for the event. Clinicians should closely monitor patients with pre-existing psychiatric illness who are taking varenicline.</span>"</blockquote>I'm not defending Chantix or Pfizer; over 10,000 reported adverse events for a drug that has been on the market for less that 4 years is a lot. Also, I have no explanation for how seemingly normal people such as Ms. Hurst have such horrible reactions. But, let's not always play the "drug companies are evil" card either. Chantix is the most effective smoking cessation drug on the market. It actually has helped 2 or 3 people. <br />
<br />
Just remember, things are not always as they seem; do your own research; and don't trust the shit you read on blogs!NeuroPsychhttp://www.blogger.com/profile/10654138293659468787noreply@blogger.com6tag:blogger.com,1999:blog-2301999496344158780.post-84537421118501275772010-02-25T16:41:00.000-08:002010-02-25T16:41:27.179-08:00Is the Clinical Significance Criterion Significant?<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg5wPXH4L2l_Pxg46G4qgIFL4C9Zf9OYsE_atjq45qnnpGQWZoMtZUhrEl9dmbvOrIOquip-Dp-vINEew-0UvbFp2OkDpuvuu800zRBvjG0YgOUJoPeaJbwY-nuxqu8coABAsm-6iVBqmho/s1600-h/3749171668_bbc1711625_m.jpg" imageanchor="1" style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" kt="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg5wPXH4L2l_Pxg46G4qgIFL4C9Zf9OYsE_atjq45qnnpGQWZoMtZUhrEl9dmbvOrIOquip-Dp-vINEew-0UvbFp2OkDpuvuu800zRBvjG0YgOUJoPeaJbwY-nuxqu8coABAsm-6iVBqmho/s1600/3749171668_bbc1711625_m.jpg" /></a></div>The draft version of <em>DSM-V: Revenge of the Fallen</em> has been online for a few weeks (<a href="http://www.dsm5.org/Pages/Default.aspx">1</a>) and much has already been written about it (<a href="http://neuroskeptic.blogspot.com/2010/02/dsm-v-change-we-can-believe-in.html">1</a>, <a href="http://www.mindhacks.com/blog/2010/02/the_draft_of_the_new.html">2</a>, <a href="http://clinpsyc.blogspot.com/2010/02/say-hello-to-temper-dysregulation.html">3</a>, <a href="http://www.furiousseasons.com/archives/2010/02/some_initial_thoughts_on_the_draft_dsm5.html">4</a>). Much focus has been on what is "new" and what is "gone." One feature that is shared by the majority of DSM diagnoses, the "clinical significance" criterion, might be on its way out. Typically this criterion reads "<span style="color: purple;">The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.</span>" The general rule being, if the person does not satisfy this criterion, a diagnosis probably should not be made.<br />
<br />
This criterion is unique to the DSM-IV and is not found in the earlier versions of the text. The stated reason for adding it to the DSM was to<br />
<blockquote>"<span style="color: purple;">establish the threshold for the diagnosis of a disorder in those situations in which the symptomatic presentation by itself (particularly in its milder forms) is not inherently pathological and may be encountered in individuals for whom a diagnosis of mental disorder would be inappropriate</span>." </blockquote>Since mental health disorders are made by subjective analysis (often referred to as <em>clinical judgment</em>), does the addition of this criterion aid in the diagnostic process?<br />
<br />
Not according to Wakefield et. al who published an article in the January 2010 issue of the <em>American Journal of Psychiatry</em> (<a href="http://ajp.psychiatryonline.org/cgi/content/abstract/appi.ajp.2009.09040553v1?maxtoshow=&hits=10&RESULTFORMAT=&fulltext=does+the+dsm&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT">5</a>). In the article, titled, "<span style="color: purple;">Does the DSM-IV Clinical Significance Criterion for Major Depression Reduce False Positives? Evidence From the National Comorbidity Survey Replication</span>," the authors' reason why the criterion is ineffective, is because it is redundant.<br />
<br />
Wakefield argues that "<span style="color: purple;">distress is common to both normal reactions (e.g., acute grief) and disordered conditions, 'since most of these symptoms are either intrinsically distressing or are almost invariably accompanied by distress about having the symptom</span>."<br />
<br />
In other words, it's highly unlikely that an individual will satisfy full diagnostic criteria for a disorder and not be distressed or impaired.<br />
<br />
<div style="text-align: center;"><strong>(Click to Enlarge)</strong></div><br />
<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiz_wP-gV3CJ2e6ch2lTNGyXNXpuFYiJs5wJHHmwJ_AbRVoq4KlmHnpx1CTpH8JsRtnelY97jVhIMrhmyxUHu2gx8NxLLuRaPbs0GIXHssEYdGtOk2j7sqNjKoY22dO4RIhtcrfL8t4vS-s/s1600-h/results.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="165" kt="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiz_wP-gV3CJ2e6ch2lTNGyXNXpuFYiJs5wJHHmwJ_AbRVoq4KlmHnpx1CTpH8JsRtnelY97jVhIMrhmyxUHu2gx8NxLLuRaPbs0GIXHssEYdGtOk2j7sqNjKoY22dO4RIhtcrfL8t4vS-s/s400/results.JPG" width="400" /></a></div>In the results reproduced above, out 2,071 respondents who reported episodes of sadness, 1,254 (60.5%) met diagnostic criteria for major depressive disorder (MDD). Of those who did not meet full criteria for MDD (n=817 or 39.5%), 93.5% <em>did satisfy</em> the "clinically significant distress or impairment" criterion. This suggests that the criterion is a poor indicator of diagnostic status. This result agrees with other research (<a href="http://ajp.psychiatryonline.org/cgi/content/abstract/156/12/1856?maxtoshow=&hits=10&RESULTFORMAT=1&title=dsm-iv+diagnostic+criterion&andorexacttitle=and&andorexacttitleabs=and&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT">6</a>). <br />
<br />
It's unlikely that any modification of this criterion, other than its deletion, will resolve this issue of redundancy. If the definition is narrowed, there will be more false negatives; if the definition is broadened, there will be more false positives. Actually, the whole idea of false negatives/positives for already highly arbitrary (i.e. not valid) diagnoses is quite humorous, but I digress...<br />
<br />
<span style="float: left; padding: 5px;"><a href="http://www.researchblogging.org"><img alt="ResearchBlogging.org" src="http://www.researchblogging.org/public/citation_icons/rb2_large_gray.png" style="border:0;"/></a></span><br />
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<span class="Z3988" title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.jtitle=American+Journal+of+Psychiatry&rft_id=info%3Adoi%2F10.1176%2Fappi.ajp.2009.09040553&rfr_id=info%3Asid%2Fresearchblogging.org&rft.atitle=Does+the+DSM-IV+Clinical+Significance+Criterion+for+Major+Depression+Reduce+False+Positives%3F+Evidence+From+the+National+Comorbidity+Survey+Replication&rft.issn=0002-953X&rft.date=2010&rft.volume=&rft.issue=&rft.spage=&rft.epage=&rft.artnum=http%3A%2F%2Fajp.psychiatryonline.org%2Fcgi%2Fdoi%2F10.1176%2Fappi.ajp.2009.09040553&rft.au=Wakefield%2C+J.&rft.au=Schmitz%2C+M.&rft.au=Baer%2C+J.&rfe_dat=bpr3.included=1;bpr3.tags=Psychology">Wakefield, J., Schmitz, M., & Baer, J. (2010). Does the DSM-IV Clinical Significance Criterion for Major Depression Reduce False Positives? Evidence From the National Comorbidity Survey Replication <span style="font-style: italic;">American Journal of Psychiatry</span> DOI: <a rev="review" href="http://dx.doi.org/10.1176/appi.ajp.2009.09040553">10.1176/appi.ajp.2009.09040553</a></span>NeuroPsychhttp://www.blogger.com/profile/10654138293659468787noreply@blogger.com1tag:blogger.com,1999:blog-2301999496344158780.post-19655203968901191572010-02-25T00:01:00.000-08:002010-02-25T00:01:53.644-08:00Women: Know Your Limits!<div style="text-align: center;"><b>A Public Service Announcement</b>.</div><br />
<div style="text-align: center;"><object height="344" width="425"><param name="movie" value="http://www.youtube.com/v/LS37SNYjg8w&hl=en_US&fs=1&rel=0&color1=0x3a3a3a&color2=0x999999"></param><param name="allowFullScreen" value="true"></param><param name="allowscriptaccess" value="always"></param><embed src="http://www.youtube.com/v/LS37SNYjg8w&hl=en_US&fs=1&rel=0&color1=0x3a3a3a&color2=0x999999" type="application/x-shockwave-flash" allowscriptaccess="always" allowfullscreen="true" width="425" height="344"></embed></object></div>NeuroPsychhttp://www.blogger.com/profile/10654138293659468787noreply@blogger.com1tag:blogger.com,1999:blog-2301999496344158780.post-80306577099712028792010-02-24T16:54:00.000-08:002010-02-24T23:25:27.845-08:00A Tale of Two Studies: Voxel-Based Lesion-Symptom MappingBrain imaging has contributed greatly to our understanding of the functional neuroataomy of the human brain. A lot these contributions have been blogged about by my bestest buddy <a href="http://neuroskeptic.blogspot.com/search?q=MRI">Neuroskeptic</a> (why don't you return my phone calls anymore!?). One of the more popular methods used to capture brain function is the functional magnetic resonance (<a href="http://en.wikipedia.org/wiki/FMRI">fMRI</a>). However, the results of fMRI studies are correlational and do not represent causation. There is another method, however, that "<span style="color: purple;">can identify regions, including white matter tracts, playing a <i>causal role</i> in a particular cognitive domain.</span>" This method is known as voxel-based lesion-symptom mapping (VLSM). A <i>voxel</i> is the three-dimensional analog of a pixel, and represents a volume of about 1 cubic millimeter. This method produces pretty images such as this one below.<br />
<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg7HGhPUT_I6I09RElyTpd7MHm4zKVeuEGiVJdvsE1nTQGI5h4Evk2gNN72kWdwwk1Q9KDZ5GAt1JVLJyf68l1Mb5J-MZgGyK_KfxCzP6m4qj9Jk80xartNTyL-y7eU58MDaKcu-ui7PSOz/s1600-h/voxel.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="256" kt="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg7HGhPUT_I6I09RElyTpd7MHm4zKVeuEGiVJdvsE1nTQGI5h4Evk2gNN72kWdwwk1Q9KDZ5GAt1JVLJyf68l1Mb5J-MZgGyK_KfxCzP6m4qj9Jk80xartNTyL-y7eU58MDaKcu-ui7PSOz/s320/voxel.jpg" width="320" /></a></div>A team of researchers from various important sounding universities published a study in this month's Proceedings of the National Academy of Sciences (PNAS; <a href="http://www.pnas.org/content/early/2010/02/05/0910397107.abstract">1</a>). In this issue of PNAS (pronounced <i>penis)</i>, is an article titled "<span style="color: purple;">Distributed Neural System for General Intelligence Revealed by Lesion Mapping.</span>" The researchers created 3-D representations of the lesions of 241 subjects who had "<span style="color: purple;">single, focal, stable, chronic lesions of the brain.</span>" The subjects also had undergone neuropsychological testing, which included either the <a href="http://en.wikipedia.org/wiki/Wechsler_Adult_Intelligence_Scale#WAIS-R">WAIS-R</a>/<a href="http://en.wikipedia.org/wiki/Wechsler_Adult_Intelligence_Scale#WAIS-III">WAIS-III</a>.<br />
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The researchers were trying to discover where in the brain is <a href="http://en.wikipedia.org/wiki/General_intelligence_factor">general intelligence</a> (often designated as "g"). Specifically,<br />
<blockquote>"<span style="color: purple;">we address the question of whether g draws upon specific brain regions, as opposed to being correlated with global brain properties (such as total brain volume). Identifying such brain regions would help shed light on how g contributes to information processing and open the door to further exploration of its biological underpinnings, such as its emergence through evolution and development, and its alteration through psychiatric or neurological disease.</span>"</blockquote>If "g" sounds like a highly abstract to concept to you, that's because it is. It's actually a really controversial concept within the field (<a href="http://en.wikipedia.org/wiki/General_intelligence_factor#Challenges_to_g">2</a>, <a href="http://en.wikipedia.org/wiki/Intelligence_quotient#Criticism_and_views">3</a>). Below are the "g" loadings from this study.<br />
<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgisDPptGJyQtdFAKhCiEbQCw38vxDxqeQRhuGT1Vd5YIIsFJXAyhiCBF4YTgLENMwYheJTgJ06jddWWTQIv7YUyKzRE1u6DhRAnuMWN2HgQLt5BqeD-gydtVIrEUZHdp2uG3_5I0QtFSzh/s1600-h/gloadings.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="200" kt="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgisDPptGJyQtdFAKhCiEbQCw38vxDxqeQRhuGT1Vd5YIIsFJXAyhiCBF4YTgLENMwYheJTgJ06jddWWTQIv7YUyKzRE1u6DhRAnuMWN2HgQLt5BqeD-gydtVIrEUZHdp2uG3_5I0QtFSzh/s200/gloadings.JPG" width="190" /></a></div><div class="separator" style="clear: both; text-align: left;">The closer the color is to red, the closer that particular subtest loaded onto one of three g-related functions (i.e., verbal, spatial, working memory). The statistics of this study are admittedly over my head, since calculating g loadings require factor analysis. Since "g" is an abstraction, no actual number is presented for "g." Only how well a specific test loads onto "g" is provided.</div><div class="separator" style="clear: both; text-align: left;"><br />
</div><div class="separator" style="clear: both; text-align: left;">What the researchers discovered should not be surprising to any biped mammal with working frontal lobes,</div><br />
<blockquote>"<span style="color: purple;">One of the main findings that really struck us was that there was a distributed system here. Several brain regions, and the connections between them, were what was most important to general intelligence.</span>" (<a href="http://www.sciencedaily.com/releases/2010/02/100222161843.htm">4</a>)</blockquote>More specifically,<br />
<blockquote>"<span style="color: purple;">Statistically significant associations were found between g and damage to a remarkably circumscribed albeit distributed network in frontal and parietal cortex, critically including white matter association tracts and frontopolar cortex. We suggest that general intelligence draws on connections between regions that integrate verbal, visuospatial, working memory, and executive processes</span>." (<a href="http://www.pnas.org/content/early/2010/02/05/0910397107.abstract">1</a>)</blockquote>"Statistically significant associations" is not same as "causal role." It's correlational. Still, nice sleight of hand.<br />
<br />
What this group of geniuses is saying is that different brain functions are located in different parts of the brain, and when everything works in harmony, you have general intelligence.<br />
<blockquote>"<span style="color: purple;">The researchers say the findings will open the door to further investigations about how the brain, intelligence, and environment all interact.</span>"</blockquote>Open doors? That would mean that this research is original and ground breaking. It's not. In fact, in the March 2009 issue of Neuron (<a href="http://www.cell.com/neuron/abstract/S0896-6273%2809%2900093-2">5</a>) appeared this study, "<span style="color: purple;">Lesion Mapping of Cognitive Abilities Linked to Intelligence</span>." Here is the press release (<a href="http://www.sciencedaily.com/releases/2009/03/090311124020.htm">6</a>). In this study, there were 241 patients with "<span style="color: purple;">single, focal, stable, chronic lesions of the brain,</span>" who had their lesions mapped and were also administered either the WAIS-R/WAIS-III. Also, the researchers are the same in both studies.<br />
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This study also found that performance on these (same) tests mapped primarily onto the frontal and parietal lobes.<br />
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<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhddjNoXIJSiaD0vSUDcBDF8PGYnyHvjNTzVQJX9vq6quMnepqMC_1RcuspglzkxvCkbCxw-tLkjKNbBd_k8LJ_rlRkhjSqKd1P7CzcJyhXMFNxE4oC5oictRgt4DNWNSDdJtRQ3zNx600L/s1600-h/iqs.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="130" kt="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhddjNoXIJSiaD0vSUDcBDF8PGYnyHvjNTzVQJX9vq6quMnepqMC_1RcuspglzkxvCkbCxw-tLkjKNbBd_k8LJ_rlRkhjSqKd1P7CzcJyhXMFNxE4oC5oictRgt4DNWNSDdJtRQ3zNx600L/s320/iqs.JPG" width="320" /></a></div>The main difference is that the former study examined the anatomical location of <i>intelligence in general</i>, while the latter examine the anatomical location <i>of general intelligence</i>.<br />
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"So, what's the difference smart ass!?"<br />
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It depends on who you ask. Some say there is no difference, while others say there is a difference. At this point in the debate, however, we're engaging in mental masturbation (which is equally satisfying, plus people don't stare when you do it on the bus).<br />
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What I've been trying to figure out is if this counts as a duplicate publication? Sure, this doesn't have the far reaching consequences of these douche baggers (<a href="http://clinpsyc.blogspot.com/2008/09/cymbalta-schatz-storm-duplicate.html">7</a>, <a href="http://chekhovsgun.blogspot.com/2008/09/update-and-now-drug-recommendation-from.html">8</a>). There is a slight <i>theoretical</i> difference, the results are essentially identical. <strike>Curiously, in the most recent study, there is no citation to the other study. You'd think that the researchers want other people to read both of their studies</strike>.<br />
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Perhaps I'm looking too much into this. Or, perhaps I just enjoy mental masturbation...<br />
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<span class="Z3988" title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.jtitle=Proceedings+of+the+National+Academy+of+Sciences+of+the+United+States+of+America&rft_id=info%3Apmid%2F20176936&rfr_id=info%3Asid%2Fresearchblogging.org&rft.atitle=Distributed+neural+system+for+general+intelligence+revealed+by+lesion+mapping.&rft.issn=0027-8424&rft.date=2010&rft.volume=&rft.issue=&rft.spage=&rft.epage=&rft.artnum=&rft.au=Gl%C3%A4scher+J&rft.au=Rudrauf+D&rft.au=Colom+R&rft.au=Paul+LK&rft.au=Tranel+D&rft.au=Damasio+H&rft.au=Adolphs+R&rfe_dat=bpr3.included=1;bpr3.tags=Psychology%2CResearch+%2F+Scholarship%2CNeuroscience%2CCognitive+Neuroscience%2C+Computational+Neuroscience%2C+Cognitive+Psychology">Gläscher J, Rudrauf D, Colom R, Paul LK, Tranel D, Damasio H, & Adolphs R (2010). Distributed neural system for general intelligence revealed by lesion mapping. <span style="font-style: italic;">Proceedings of the National Academy of Sciences of the United States of America</span> PMID: <a href="http://www.ncbi.nlm.nih.gov/pubmed/20176936" rev="review">20176936</a></span><br />
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<span class="Z3988" title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.jtitle=Neuron&rft_id=info%3Apmid%2F19285465&rfr_id=info%3Asid%2Fresearchblogging.org&rft.atitle=Lesion+mapping+of+cognitive+abilities+linked+to+intelligence.&rft.issn=0896-6273&rft.date=2009&rft.volume=61&rft.issue=5&rft.spage=681&rft.epage=91&rft.artnum=&rft.au=Gl%C3%A4scher+J&rft.au=Tranel+D&rft.au=Paul+LK&rft.au=Rudrauf+D&rft.au=Rorden+C&rft.au=Hornaday+A&rft.au=Grabowski+T&rft.au=Damasio+H&rft.au=Adolphs+R&rfe_dat=bpr3.included=1;bpr3.tags=Psychology%2CResearch+%2F+Scholarship%2CNeuroscience%2CCognitive+Neuroscience%2C+Cognitive+Psychology">Gläscher J, Tranel D, Paul LK, Rudrauf D, Rorden C, Hornaday A, Grabowski T, Damasio H, & Adolphs R (2009). Lesion mapping of cognitive abilities linked to intelligence. <span style="font-style: italic;">Neuron, 61</span> (5), 681-91 PMID: <a href="http://www.ncbi.nlm.nih.gov/pubmed/19285465" rev="review">19285465</a></span>NeuroPsychhttp://www.blogger.com/profile/10654138293659468787noreply@blogger.com3