Providentia

Childhood Trauma and Biochemical Markers in Adults with Personality Disorders

A study published in the January 2009 issue of Comprehensive Psychiatry examines the influence of various forms of childhood abuse on basal cortisol levels in a sample of adults with Axis II personality disorders. Participants included 63 adults (n = 19 women) who provided basal plasma cortisol samples and completed the Childhood Trauma Questionnaire. Statistical analysis that included all 5 subscales (ie, sexual abuse, physical abuse, emotional abuse, physical neglect and emotional neglect) demonstrated that physical abuse was related to lower cortisol levels which was consistent with prior literature. In contrast, physical neglect was associated with higher cortisol after controlling for other forms of abuse. Results are consistent with the view that childhood trauma has long-lasting neurobiological effects and suggest that different forms of trauma may have distinct biological effects.

Click here for the abstract.

January is National Stalking Awareness Month

This month marks the fifth annual National Stalking Awareness Month to raise awareness of stalking and its impact on victims. Data from a 2005 Center of Disease Control study has indicated that approximately seven million women and two million men in the U.S. alone have been stalked at some point in their lives. While the definition of stalking varies across different jurisdictions, victims have frequently had their lives disrupted by harassing or threatening behaviour, which is often a precursor to violence. An estimated 76% of cases of intimate partner homicide have involved victims being stalked before their deaths.

To learn more about stalking and what you can do about it, the National Centre for Victims of Crime maintains a Stalking Resources Center site at http://www.ncvc.org/src/main.aspx.  Information on the Department of Justice stalking study can be found here.

Click here for more information

Blind Tom (Part One)

Nobody thought he would be worth anything as a slave.

Born on May 25, 1849, it was apparent from the beginning that Thomas was blind. His parents, Domingo Wiggins and Charity Greene, and his two brothers were purchased by James Bethune, a Georgia landowner, when Tom was an infant. Since he would never be more than a burden, their blind son was added to his parents' bill of sale at no extra cost. Following the custom of the time, Tom and his parents took their master's surname and he would be known as Thomas Greene Bethune for much of his life. 

Since Tom was considered an idiot as well as blind (idiot being a legitimate medical term then) with nobody else to care for him, Charity had to bring him with her to the big house while she worked as a maid for the Bethune family. All the Bethune children were musically inclined and Tom spent his early childhood listening to them learning to sing and play piano. He quickly astonished them with his amazing talent at echolalia as well as imitating animal and bird calls.  By the time he was four years old, he was sitting at a keyboard and able to reproduce any complex piece of music after only hearing it briefly.

The Bethunes treated Tom like the family pet and allowed him to sit in on the music lessons. They also began teaching him language for the first time in his life (a blind slave hadn't been considered worth educating before then). By the age of six, he began creating his own musical compositions based on sounds that he heard around him. James Bethune began arranging music lessons for the young prodigy (even though he initially thought that Tom had no more intelligence than "the family dog"). These music teachers marveled at Tom's ability and commented that he picked up skills in hours that took most pianists years to learn.

Tom's master, realizing that the young slave could be a moneymaker, rented a concert hall in 1857 and "Blind Tom Bethune" made his first appearance on stage. He quickly became a popular draw for audiences who couldn't comprehend how a blind, mentally deficient slave could be an expert pianist. A concert promoter, Perry Oliver, persuaded Bethune to "hire out" Tom to him in 1858. Tom was separated from his family for the first time in his life and sent on the road. For the next few years, Tom had a gruelling schedule with four performances a day and little chance for rest.

Blind Tom was a sensation. Not only could he play complex pieces perfectly, he astonished his audience by sitting backwards at the piano and doing the same playing with his hands reversed. He traveled across the country and even gave a command performance for President James Buchanan.  Newspapers raved over "Blind Tom Bethune: The Eighth Wonder of the World" and the concert halls where he played were typically packed. By 1860, many of his compositions had been published to critical acclaim. Perry Oliver and James Bethune made a fortune from Tom's playing (very little of which went to Tom or his parents).

And then the Civil War broke out...

Tom and Perry Oliver were in New York City when Georgia seceded from the Union in 1861. After they returned to Georgia, Tom spent the rest of the war playing concerts to raise money for the Confederate cause. Many of these concerts included music that Tom had written himself and news about his playing still trickled back to Northern states. While the end of the war meant the end of Tom's slave status, James Bethune had foreseen the South's loss and made arrangements to retain control.  He had Tom's parents sign an indenturing agreement ensuring that he would act as Tom's manager until his twenty-first birthday. The money that the parents received represented only a fraction of Tom's true earnings.

The touring continued to rave reviews across the country. Mark Twain marveled over Tom's ability and wrote extensively about him in newspaper articles. In one article, Twain commented that "some archangel, cast out of upper Heaven like another Satan, inhabits this coarse casket; and he comforts himself and makes his prison beautiful with thoughts and dreams and memories of another time... It is not Blind Tom that does these wonderful things and plays this wonderful music--it is the other party." A lawsuit brought against James Bethune over Tom's services dragged on for years and provided even more publicity.

Audiences could never get enough of Tom's musical genius. On a European tour (in between command performances for various royal families), eminent musicians tested Tom's ability to reproduce even extremely discordant piano pieces and found that he could reproduce them all with virtually no error. His repertoire would eventually expand to more than seven thousand pieces. In addition to the piano, Tom became proficient with other instruments as well as singing.

Contemporary descriptions of Tom's performances tended to play up his idiotic nature including descriptions of his rocking behaviour, grimaces, and strange finger movements while on stage. How much of that was encouraged by his handlers to make his performances more theatrical is anybody's guess but it worked against Tom eventually.

Once Tom turned twenty-one and Bethune's agreement with the parents came to an end, there was another legal trick his manager was able to play.  James Bethune applied to the courts to have Tom declared legally insane and to have himself become his legal guardian. Despite contradictory evidence at the first custody hearing in 1870, the court ruled that Tom was incompetent and James Bethune continued to control Tom's career. After a few years on the road, John Bethune, James' son, eventually took over as Tom's manager.

Tom spent his summers living at the Bethune estate near Warrenton, Virginia in between concert seasons. He had his own room and piano where he could play and write music. Otherwise, he and John lived in New York City where Tom continued his music education when he wasn't on the road. He seemed happy enough despite his exhausting concert schedule but John often had to deal with Tom's frequent temper tantrums. John Bethune's accidental death in 1884 sparked a crisis when his ex-wife Eliza, aided by Tom's mother, went to court to take custody away from James Bethune.

And then...

Does Socioeconomic Status Affect the Developing Brain?

A review published in the January 2009 issue of Trends in Cognitive Sciences examines research into the link between childhood socioeconomic status (SES) and cognitive achievement throughout life. Previous research studies have used  behavioural, electrophysiological and neuroimaging methods to characterize SES disparities in neurocognitive function. These studies indicate that SES is an important predictor of neurocognitive performance, particularly with language and executive functioning, and that SES differences are found in neural processing even when performance levels are equal. The authors discuss the results in relation to mplications for basic cognitive neuroscience and for understanding and ameliorating the problems related to childhood poverty.

Click here for the abstract.

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Providentia-Year 2

January 17 marks the second anniversary of this crazy blog of mine.  I seem to be managing my current output so that's not likely to change in the near future.  At some point this year, I should hit the 500 post mark and I've try not to drift too far from my original mandate.  If I've shown a bias towards some topics, well, I never claimed differently.  I'll try not to check my stats so fervently in future but, over the past year, I've had over 19,000 visitors from 146 countries around the world so I assume I'm attracting a little attention with my scribblings.  Hopefully, you'll continue to tune in to see what I have to provide. 

Does Pain Increase Suicide Risk?

A study published in the December 2008 issue of the Journal of Pain examines the link between chronic pain and suicidal ideation and behaviour. Using the results from a nationwide US survey, self-report information from 5692 adult respondents was regarding pain conditions, nonpain medical conditions, and suicidal history. Additional information on DSM-IV mood, anxiety, and substance use disorders was obtained assessed using the World Health Organization's Composite International Diagnostic Interview. Antisocial and borderline personality traits were assessed with the International Personality Disorder Examination screening questionnaire. Statistical analysis of the results found the presence of any pain condition was associated with lifetime and suicidal ideation, plan, or attempt in the previous twelve months. After controlling for demographic, medical, and mental health covariates, the presence of any pain condition remained significantly associated with lifetime suicidal ideation and plan. Among pain subtypes, severe or frequent headaches and "other" chronic pain remained significantly associated with lifetime suicidal ideation and plan; "other" chronic pain was also associated with attempt. The researchers concluded that risk for suicidal thoughts and behaviors that may accompany back, neck, and joint pain can be accounted for by comorbid mental health disorders. There may be additional risk accompanying frequent headaches and "other" chronic pain that is secondary to psychosocial processes not captured by the mental disorders assessed.

Click here for the abstract.

Alzheimer Society Warns of Coming Dementia Epidemic

A new study released by the Alzheimer Society of Canada warns of an epidemic of dementia cases within a generation. While an estimated 500,000 Canadians now suffer from dementia, that number is expected to more than double over the next twenty-five years. The study, titled Rising Tide: The Impact of Dementia on Candian Society, presents the first new prevalence data since the 1991 Canadian Study on Health and Aging. While Alzheimer's Disease represents the most common form of dementia, there are a range of other medical conditions that can have the same devastating consequences.

Of the half million dementia patients in Canada at present, about 71,000 (15 percent) are under the age of 65 with 59,000 being under the age of 60. The Society predicts an additional 250,000 dementia diagnoses within the next five years with the number swelling to well over a million by 2040.

According to Society CEO, Scott Dudgeon ""I guess the thing that's most dramatic when you look at the numbers is this grey tsunami that people have been talking about ... seems to be arriving now.  And when you start looking at the number of people who are going to be developing dementia over the next few years, the impact is going to be tremendous."

The study predicts a far-reaching impact on health costs in caring for the extra dementia cases both in terms of foregone income for the patients themselves and job loss for family members who need to care for them. The full report is scheduled for release later this year.

While the figures apply to Canada alone, the dementia epidemic will be worldwide in scope. International studies estimate that one out of every twenty people over the age of 65 suffers from some sort of dementia. Current figures suggest 30 million dementia sufferers worldwide with the number swelling to 100 million by 2050. Sixty percent of dementia patients are in developing nations but that figure is expected to rise to over 70 percent by 2040. 4.6 million new cases are diagnosed each year.

Alzheimer's Disease International (ADI) has proposed a global charter that was launched on September 21, 2008 (World Alzheimer's Day). These principles include:

1. Promote awareness and understanding of the disease
2. Respect the human rights of people with the disease
3. Recognize the key role of families and carers
4. Provide access to health and social care
5. Stress the importance of optimal treatment after diagnosis
6. Take action to prevent the disease, through improvements in public health

ADI has issued an eleven point action plan stressing the need for more research into the prevention and treatment of dementia as well as providing compassionate care for patients and their caregivers.

Click here for more information.

What Is Salvia?

The Salvia Divinorum plant was originally native to parts of Oaxaca, Mexico. Easily identified by its large green leaves, square stems, and white flowers, it became known as Diviner's Sage due to its use by local shamans. By crushing  juice from Salvia leaves, shamans could brew a tea that they used in traditional "vision quests".

It wasn't until the 1990s when scientific analysis of Salvia plants determined that they were rich in a naturally occurring hallucinogenic known as Salvinorin A. Extremely potent even at low doses, salvia divinorum (more commonly known as Salvia) has gained popularity due to its intense "peak" lasting for a few minutes and quick return to normalcy after 20 minutes. The lack of aftereffects, versatility (it can be smoked, chewed, or used as a tincture), and low toxicity has ensured its widespread use

Salvia fans have praised its psychedelic properties and pushed for greater availability. Despite concerns about taking Salvia in concentrated form, Internet advocacy sites provide extensive advice on its use and even played up its therapeutic potential. Due to its recent introduction, Salvia remains legal in most parts of the world although this appears to be changing quickly. Increasing media attention (including YouTube videos of teenagers getting "high" on Salvia) has raised alarm over its widespread use and legal status.

A Delaware statute declaring Salvia a Schedule 1 prohibited substance was passed in 2006. Titled "Brett's Law", the statute was signed into law after the suicide of a Delaware teenager which was linked to Salvia use. Other states are pushing for similar legislation as well as regulation at the federal level. While Salvia remains legal in most jurisdictions, the backlash against its recreational use appears to be growing.

Are There Sex-Related Neural Differences In Risk Taking?

A study published in the October 2008 issue of Cerebral Cortex explores gender differences in the process of risk-taking. Using functional MRI (fMRI), the researchers observed that the female participants (n = 10) showed stronger activation in the right insula and bilateral orbitofrontal cortex (OFC) than did the male participants (n = 12) while they were performing in the Risky-Gains task. The female participants also showed stronger activations in the precentral, postcentral, and paracentral regions after receiving punishment feedback. In addition, the strength of neural activity in the insula correlated with the rate of risky behaviors for the female participants but not for the male participants. Similarly, the percent signal changes in the right OFC correlated negatively with the rate of selecting risky choices for the female group. These findings strongly suggest a sex-related influence modulating brain activity during risk-taking tasks. When taking the same level of risk, relative to men, women tend to engage in more neural processing involving the insula and the OFC to update and valuate possible uncertainty associated with risk-taking decision making. These results are consistent with the value-based decision-making model and offer insights into the possible neural mechanisms underlying the different risk-taking attitudes of men and women.

Click here for the abstract.