Providentia

Chronic Pain Affects Short-term Memory and Attention

In the May 2007 issue of Anesthesia and Analgesia, a study examining the relationship between chronic pain and performance on neuropsychological measures of short-term memory and attention is presented.  A team of researchers at the University of Alberta administered a series of computerized measures of working (short-term) memory and attention to a sample of chronic pain patients.  Their results indicated that two-thirds of the chronic pain patients tested were found to be impaired on tests of working memory and attention.  Additional factors such as age, education level, disturbed sleep, and pain relief were ruled out as possible confounding factors.  Performance on the cognitive tests was not improved by short-term pain relief using analgesics.   The researchers conclude that chronic pain can directly affect cognitive performance which can, in turn, affect quality of life and level of functioning.    

Click here for the study abstract.

Activists Seek to End Breast Ironing in Cameroon

A national network of mothers in Cameroon is forming a coalition with other agencies and journalists to call attention to the controversial cultural practice of breast ironing.  Designed to make pubescent girls less sexually attractive, breast ironing involves the pounding of a girl's breasts with a hot grinding stone for hours each day until they flatten out and stop growing.  Pestles, belts and other heated objects can also be used.  An estimated 50 per cent of women in the region of Douala, Cameroon have had it done and the practice remains shrouded in silence.  Typically viewed as a secret between mothers and daughters, many girls are believed to endure the pain in silence despite the trauma associated with the practice.    While traditionalists defend breast ironing as a way to prevent early pregnancy, the psychological effect can be devastating for young girls who can develop serious emotional and physical problems later in life (including breast cancer, abscesses, and inability to breastfeed). 

Click here for more information.

William James and the Bear

Picture yourself walking in the forest, ruminating on various philosophical matters.  As you go deeper into the bush, you realize that you have lost your way.  Stopping in a clearing to get your bearings, you hear a rustling off to the left and realize that a large black bear is ambling into the very same clearing.  The bear takes notice of you and starts moving in your direction.  As you pause, uncertain as to what to do next, you are reminded of a classic example posed by legendary philosopher and psychologist, William James. 
 

In 1884, James published a seminal paper titled  What is An Emotion in the philosophy journal Mind (there were no psychology journals around then).  In this paper, he reasoned that human emotion followed a sequence of events beginning with an arousing stimulus (i.e., physiological arousal linked to the sympathetic and parasympathetic nervous system) which then triggered the corresponding emotion.  In other words, do we run from a bear because we are afraid or are we afraid because we are running from the bear?  While the commonplace assumption is that the bear is the source of our fear, James argued that this commonsense interpretation is wrong.  It was James’ contention that bodily changes result from the perception of the “exciting fact” which in term leads to the psychological sensation called emotion.  Different situations trigger different physiological changes which in turn lead to different emotions.  It was this observation that formed the basis of what would be termed the James-Lange theory of emotion.

 

As might be expected, the James-Lange theory met with opposition, most notably by Walter Cannon and Philip Bard who, between them, proposed what is known as the Cannon-Bard theory in the 1920s.  This theory maintains that the psychological state we know as emotion is the direct consequence of the stimulus and that the physiological changes were the result, rather than the cause of emotion.  In other words, Seeing the bear makes us afraid and the physiological changes linked to fear occur as a result.   

Dissatisfaction with the two prevailing theories of emotion led to a third theory expounded in the 1960s by psychologists Stanley Schacter and Jerome Singer.  Titled the Two-Factor Theory of emotion, it states that emotion is mediated by two factors: physiological arousal and cognition.  We often can not tell what emotion we should be experiencing based on physical arousal alone.  Therefore, cognition of the situational context is needed to determine the appropriate emotion. Of course, when the bear is right in front of you, little interpretation is needed. To this day, each theory has its own proponents.

 

While you stand there rapt in speculation, the bear (who is no doubt puzzled by your odd behaviour in not running) continues to approach you.  You note this in passing and edge backwards slowly but surely.  You think, which is coming first?  The emotion or the physiological sensation associated with the emotion?  Your heart is certainly pounding and you are certainly afraid but the exact sequence is a mystery as you are too busy turning and running. 
                                                           

The bear, no doubt thinking that lunatics are not good to eat, does not pursue and you in turn stumble onto a familiar trail that leads you back to your campsite.  It occurs to you that for future philosophical ventures in the woods, it would be best to bring along a fellow enthusiast. 

   

Preferably someone you can outrun.

17th World Conference on Disaster Management, July 8-11, 2007

The 17th Annual World Conference on Disaster Management is being held in Toronto, Ontario from July 8 to the 11th at the Metro Toronto Convention Centre.  It is an international conference designed to bring together disaster management and business continuity professionals from around the world.  The conference will feature over 80 educational sessions, workshops and seminars, as well as a trade show featuring over 100 exhibitors of emergency management products and services.  Scheduled speakers include Minister for Public Safety Stockwell Day as well as representatives from the World Health Organization, World Resources Institute, and emergency preparation organizations from around the world. I served as a volunteer at last year's conference and found it to be a rewarding (and exhausting) experience. 

Click here for link.

UK Sex Change Doctor Under Fire

A prominent UK psychiatrist is facing legal action after the General Medical Council ruled that he inappropriately rushed six patients into hormonal and gender reassignment surgery.  Dr. Russell Reid (called "Uncle Russell" by his patients), widely considered to be the top British authority on transsexuals, faces disciplinary action over allegations that he failed to meet minimum guidelines of care set down by the Harry Benjamin International Gender Dysphoria Association with respect to the patients at the centre of the investigation.  In addition to receiving sexual hormone treatment, several of the patients were fast-tracked into gender reassignment surgery despite concerns that such surgery was unnecessary in their cases.  The Council is expected to meet later this week to determine whether Dr. Reid shoudl be removed from the professional register.

Legal representatives for the six  patients are seeking damages in a group claim that is likely to be considerable given the extent to which their lives have been affected.   Other former patients of Dr. Reid welcomed the ruling and indicated their willingness to seek damages.  Despite the Council's ruling, Dr. Reid continues to have widespread support from the UK transsexual community.

For more information, click here.

Mental Health Crisis in New Orleans Worsens

The mayor of New Orleans, Ray Nagin, has requested additional aid from the state of Louisiana to cope with the growing mental health crisis resulting from the devastation caused by Hurricane Katrina.  Due to a severe shortage in emergency room and hospital beds, some psychiatric patients in need of chronic mental health care are are being housed in jails.   Police officers and paramedics are also being forced to remain with psychiatric patients until beds become available. 

In a letter that Mayor Nagin has written to Louisiana governor Kathleen Blanco, he stated that ""the stress of survival and life in a damaged region has increased the rate of post-traumatic stress disorder and aggravated existing mental and physical health problems."   He is requesting state aid in setting up additional treatment beds and trained staff to deal with the current care shortage. 

The governor has not responded to date.

Click here for more information.

Comparing PTSD in Men and Women

The November 2006 issue of Psychological Bulletin presents a statistical overview of 25 years of research examining sex differences in PTSD symptoms and actual risk of encountering traumatic life events.  The researchers combined research data from 290 journal articles that met their criteria.  The results indicated that females were significantly more likely than males to meet DSM criteria for posttraumatic stress disorder.  In comparing males and females in terms of lifetime risk of encountering a traumatic life experience, it was found that females were far more likely than males to experience sexual assault or childhood sexual abuse.  Males, on the other hand, were far more likely than females to experience non-sexual violence, accidents, serious illness, or war-related traumatic events.   Direct comparison of males and females encountering the same type of traumatic events indicated greater severity of PTSD symptoms in females as opposed to males.  The researchers discuss the results in terms of limits in methodology and the potential influence of gender roles in dealing with traumatic stress.

Click here for the complete article.

Selling Cocaine

In 1855, the German chemist Friedrich Gaedcke achieved what many before him had tried and failed to accomplish, he successfully isolated the alkaloid found in the South American coca leaf.   While the stimulant properties in coca leaves had been recognized for centuries, gaining access to it was another matter for Europeans.  The coca plant could not be grown in Europe and its leaves tended not to travel well.  Naming the new alkaloid "erythroxyline", Gaedcke published his results but it would take another research chemist, Albert Niemann, to take the discovery further.  Basing his doctoral dissertation on the coca derivative, he developed a better purification process and he gave erythroxyline a new name based on the plant from which it was produced, cocaine. 

Once cocaine became widely available, the scientific world was quick to exploit this new discovery.  The value of cocaine as a local anesthetic, as a treatment for  fatigue and depression, and even as a treatment for morphine addiction added to it's allure.  Eminent medical researchers (including Sigmund Freud) advocated its use as a non-addictive stimulant and cocaine found it's way into a variety of products, from cigarettes to wine that could be purchased at any department store.  It was also used by athletes to enhance physical performance.  When Coca Cola was first introduced in 1886, the recipe included a "pinch of coca leaves" (hence the name).   

Then the backlash set in.  While the coca leaves that the original South American natives chewed rarely caused addiction problems, the refined cocaine was another story.  By the beginning of the twentieth century, it was well apparent that cocaine was just as addictive as the morphine and opium that it was originally used to combat.  Cocaine-laced products vanished quickly from store shelves (and Coca-Cola changed it's recipe in 1904).  Former advocates such as Freud publicly expressed their regret at the role that they played in popularizing what would become a major social problem.  By 1910, hospitals began reporting cases of nasal damage resulting from snorting cocaine.  By 1912, thousands of cases of cocaine-related fatalities were identified.  Fighting the spread of cocaine became a major preoccupation for politicians and the mass media and the anti-drug hysteria took some bizarre forms.  In the United States, newspapers would play on racist fears of the effects of cocaine on the "Negro brain" which would then make them more likely to prey on white women.  In 1914, the Harrison Narcotics Tax Act was passed to ban all narcotics including cocaine (despite the fact that it is a stimulant, not a narcotic).  The first wave of cocaine-related deaths subsided in the 1920s as a result of anti-drug policies (and the growing availabllity of amphetamines which were cheaper and safer). 

The popularity of cocaine (including freebased cocaine and it's offspring "crack") would grow and subside over the years.  Following a crackdown on amphetamine trafficking, a second cocaine epidemic struck the United States in the 1970s (the crack cocaine epidemic would begin in the 1980s). While heroin has since gained in popularity, cocaine is currently second only to cannabis in terms of popularity with millions of drug users around the world and crack houses being found in most major population centres. 

It seemed like such a good idea....

Is There a Link Between Domestic Violence And Asthma?

A new study from the Harvard School of Public Health which is to be published in the June 2007 issue of the International Journal of Epidemiology suggests a strong relationship between stress experienced by victims of domestic violence and asthma. The study involved a database of 92,000 households in India with face-to-face interviews of respondents.  Interview questions focused on incidence of experiencing or witnessing domestic violence, presence of at least one asthma sufferer in the household, and additional risk factors, i.e., environmental contributors to asthma. 

Results indicated that women who had been a victim of domestic violence in the previous year faced a 37 per cent increased risk of asthma.  Women, children, and adult males witnessing domestic abuse were also found to be at increased risk for asthma. 

Although the study results can not establish a causal link between asthma and domestic violence, the researchers discuss potential mechanisms to explain the relationship including the effects of stress on the immune system and use of coping behaviours that increase asthma risk (smoking).  The results represent an attempt to clarify the health effects of domestic violence and the role of stress in causing asthma. 

Click here for more information.

Why Aren't Suicidal Teens Getting Help?

The April 2007 issue of the Canadian Journal of Psychiatry presents the results of a research study examining mental health service use in adolescents and young adults with a history of depression.  Using data from the Canadian Community Health Survey: Mental Health and Well-Being,  619 subjects ranging in age from 15 to 24 who had diagnosed with depression and/or suicidality in the previous twelve months were identified.  The following disturbing results were reported by the researchers:

• Of adolescents aged 15 to 18 who had experienced depression, 40% had not used any mental health services
• Among adolescents with a history of suicidality, this rose to 50%
• In the 19 to 24 age group, 42% of those with depression had not used any mental health services
• Among adolescents or young adults who did seek help, 22% only sought help from a single provider.
• Female adolescents with depression or suicidality were more likely to seek help from family physicians than male adolescents
• No difference in overall use of mental health services were found between male and female adolescents

Based on these results, the researchers emphasize the need to determine why young people in need are not seeking help and to learn to overcome the barriers that they face. 

The complete study can be downloaded here.