Providentia

Does Psychological Distress Increase Dementia Risk?

A study published in the February 2009 issue of Current Psychiatry Reports examines the role of neuropsychiatric symptoms in age-related cognitive decline.  Psychological distress, i.e., a reaction of an individual to external and internal stresses, is characterized by different psychological symptoms including depression, anxiety, and apathy. The authors examined recent evidence concerning the presence of psychological distress in healthy older adults and patients with mild cognitive impairments (MCI) in relation to risk for developing dementia. Results presented in this review show that psychological distress and depressive, anxious, and apathetic symptoms can be present in MCI and may predict progression to dementia. The implications of these results for future research and intervention strategies are discussed.

Click here for the abstract.

"Cancer Survivor" Charged After Five Years of Fraud

Five years after a "cancer scare" that proved to be groundless, 38-year old Keele Maynor has been arrested for fraud relating to the financial and social aid resulting from her pretending to be terminally ill with breast cancer. A Chattanooga grand jury has laid eight counts of theft and one count of forgery against the Tennessee woman and she may be facing a lengthy prison sentence.

In addition to receiving over $18,000 in paid leave and financial support from co-workers, Maynor also received extensive support from the cancer survivor community in Chattanooga before being exposed in December of last year. During the last five years, she walked with a cane, kept her hair closely cropped, and pleaded with friends and family members for financial support. As a single mother with three dependent children, she received considerable assistance and media attention.

Describing her "charade", Maynor reported that she had been diagnosed with breast cancer in 2000 although subsequent testing showed her to be cancer-free. Her elaborate deception only unraveled after a local hospital contacted other charities with which she had been involved warning them about inconsistencies in her story. She has yet to provide a reason for her actions although she is receiving counseling at present.

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Living With Patience

It's still not certain how "Patience Worth" came into Pearl Curran's life.

Born Pearl Lenore Pollard in 1883, her childhood seemed normal enough. By all accounts, she was extremely sensitive about her appearance and wished that she were more attractive. While not a good student (who eventually dropped out of high school), she had a passion for singing. Pearl's parents arranged for voice lessons and she eventually moved to Chicago to continue her voice training. To support herself, she worked in a music company and taught music herself.Whatever dreams Pearl had for a career as a singer or actress ended when she married John Howard Curran at the age of 24 and settled down to be a housewife in St. Louis, Missouri. While John wasn't wealthy, he made enough for Pearl to have a comfortable life, a maid to do the housework, and a fair sized home. The first seven years of marriage seemed happy enough.

Except...

Spiritualism was tremendously popular during the early years of the twentieth century with countless occult believers across most English speaking countries. Mediums like Eusapia Palladino and Helene Smith regularly conducted seances for the rich and not-so-rich alike and news of "spooky" happenings definitely sold newspapers. While Houdini's anti-spiritualism crusade helped deflate spiritualist claims, there was still enough interest for ouija boards to be a common item in many homes.

Which brings us to Pearl Curran having a quiet tea with her mother and a family friend at her home in 1913. Pearl was reluctant about using the ouija board that the friend had brought to her home but, after some initial success with messages from "Pat-C", the three of them decided to keep trying. On July 8 of that year, they received the following message: "Many moons ago I lived. Again I come. Patience Worth my name. Wait, I would speak with thee. If thou shalt live, then so shall I. I make my bread at thy hearth. Good friends, let us be merrie. The time for work is past. Let the tabby drowse and blink her wisdom to the firelog."

The "entity" in question identified herself as Patience Worth who had lived in one of the American colonies between 1649 and 1694. Pearl seemed to be the main target for the messagesand she stopped using the board when she realized that the sentences were "forming" in her mind at the same time that they were being spelled out. While she would hire a secretary to keep track of Patience's messages, Pearl later just wrote them out herself.

According to Patience, she was born "across the sea" (later identified as Dorsetshire in England) and made an Atlantic crossing in a three-masted schooner to live in one of the American colonies. The details of Patience's life (and her violent death by natives) tended to be sketchy with no real details that could be independently verified. Despite initial skepticism, Pearl (and Patience) were able to gain a considerable following. During the next 25 years, "Patience Worth" would dictate an estimated 400,000 words including 5,000 poems, a play, various short stories and four novels.

The controversy over Pearl Curran and her writing quickly polarized into two camps. On one side, the skeptics picked up on the various inconsistencies of her story. Not only was there no evidence that Patience Worth had ever existed but at least one of the novels was set in Victorian England,long after Patience "lived". On the other side, Pearl's supporters stressed her limited education making it unlikely that she could have written everything on her own.

One researcher in particular who took an interest in Pearl's case was Walter Franklin Prince (who had already made a name for himself through the Doris Fischer multiple personality case). He first began studying Pearl Curran in 1926 and, after a thorough investigation, published The Case of Patience Worth in 1927. Prince described the case as representing "an unexpected display of literary genius, ability to carry on complex mental operations, together with apparent divination of other minds". While he was ambivalent about whether Pearl Curran was actually "channeling" Patience, Prince wrote an article that was published in the 1926 issue of Scientific American titled The Riddle of Patience Worth.In the article, he specifically asked anyone with information that could related to the case to come forward. Nobody took him up on the offer.

Whatever reservations John Curran had about his wife's link to a long-dead women, he would keep careful records of the sessions until his death in 1922. Afterward, Pearl supported herself and her family through lecturing and financial help from friends but the sessions went on. She received her final communication from Patience in November, 1937, a little more than a month before Pearl's death from pneumonia (which Patience reportedly predicted). While later mediums would claim to receive messages from Patience over the years (Pearl didn't seem inclined to make contact herself), nobody would ever match the quality of the original writing.

Although Patience Worth is still considered to be a genuine example of spirit writing by true believers, skeptics tend to regard the case as being an example of dissociation (if not an outright hoax). Although automatic writing has long been recognized as a clinical tool by Freudian psychoanalysis, its value has been hotly disputed by other clinicians. Research into automatic writing tends to be limited although the phenomenon has been linked to hypnosis and suggestibility. There have been more recent examples of literary works being produced through automatic writing but the case of Pearl Lenore Curran is still the most well-known of its kind.

In the meantime, ouija boards continue to be sold (Parker Brothers still owns the trademark) but they're not as common as they used to be. Fledgling writers hoping to get published would probably be better off with a good writing class.

Does Bullying Lead To School Shootings?

A paper published in the December 2008 issue of the Journal of School Nursing provides an extensive review of the literature surrounding the impact of peer bullying on adolescent male victims in terms of somatic and emotional consequences of being victimized. Research into school shooters has been limited to date but available studies have found that a significant number of them were adolescents who were targets of bullies and claimed their shootings were in response to their victimization. While there is no consistent profile of the school shooter,  research has suggested various dynamics that contribute to an environment that can predispose a community to a school shooting. No published nursing research has examined the relationship between bullying and the school shooter or that of adolescents who experience peer bullying. Despite findings from other disciplines, such as law enforcement, education, sociology, and psychology, school nurses need to be part of the team to recognize the bullied teen and intervene before there are serious life-threatening consequences.

Click here for the abstract.

Can A Head Injury Trigger Musical Ability?

For Derek Amato, it all began in October, 2006.

Although he had dabbled in music when younger, he never took lessons and went on to have a business career. Although he had always dreamed of being on stage, his musical career only began at the age of 40 following an accident. After jumping into his mother's pool to catch a football, he sustained a concussion when he struck his head on the bottom of the pool.

The concussion affected his hearing but there appeared to be no other cognitive problems as a result. It was only while sitting at a friend's piano that he discovered that he had he could play music by ear. As he would report later, "I just sat down at the piano and, by chance, started playing," he remembered. "Obviously, I could never play piano so it was kind of surprise." Amato discovered that he could play kind of music. He has since left his business job and started a career as a recording artist.

While cases of savant syndrome involving unusual cognitive abilities have been recorded in the neurological literature, they are usually linked to autism spectrum disorders or other developmental disabilities. Examples of acquired savant syndrome developing later in life are considerably rarer.   Development of savant-like skills have even been observed in cases of frontotemporal dementia.  Derek Amato's case suggests a preexisting musical aptitude that was forcibly stimulated by the concussion, available neurological information remains limited. 

As for Derek Amato,his music career is definitely underway.  He views his music as "a reminder that gifts can come out of the most of the painful of circumstances".

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Happy Darwin's Day

To take part in the various festivities marking the 200th anniversary of Charles Darwin's birth, I thought I'd rerun this post that was first published on October 14, 2007. To check out what else is going on today, click here.

Dying of Evolution?

The publication of Charles Darwin's seminal masterwork On The Origin Of Species in 1859 marked a turning point in the understanding of how species form and change over time. It is doubtful that Darwin himself really anticipated the storm of protest that followed the book's publication. Scientists and theologians alike became locked in a battle that lasted for decades (and still continues today).

Of all the stout churchmen who were appalled at Darwin's theory, perhaps no one felt outrage more keenly than Robert Fitzroy, former captain of the HMS Beagle. Born in 1805, Fitzroy was part of one of the most illustrious families in England. After an idyllic childhood, he entered the Royal Naval College at the age of twelve and the Royal Navy a year later. His life was never the same following the suicide of his uncle, Viscount Castlereagh, in 1822. The stigma of having a suicide in the family left Fitzroy with a sense of dread over the possibility that the madness that had claimed his uncle was hereditary. This fear was made all the more real for him when he became Captain of the HMS Beagle in 1828 following the suicide of its previous captain, Pringle Stokes.

When the Beagle's second voyage was being planned in 1831, it seemed only natural that he arrange for a suitable traveling companion to help him stay sane on the proposed five-year voyage of exploration. After other candidates turned down his offer, Fitzroy settled on a 22-year old Cambridge naturalist and theologian named Charles Darwin (although Fitzroy was initially suspicious of Darwin due to the shape of his nose). Darwin's credentials as a naturalist appealed to Fitzroy who relished the opportunity to use the Beagle's voyage to gather evidence confirming the Biblical account of creation.

Over the course of the long voyage, Darwin and Fitzroy became fast friends despite Fitzroy's volatile temper leading to frequent clashes between them (often over matters of religion). The Beagle's voyage took them from South America to the Galapagos Islands and gave Darwin an unprecedented opportunity to learn about (and puzzle over) the diverse range of fauna and fossils to be found. On their return to England in 1836, both Darwin and Fitzroy published their research findings to critical and popular acclaim.

In the years that followed, the two men drifted apart as Darwin began formulating his famous theory while Fitzroy continued to champion the Biblical account of creation. Despite an illustrious naval and political career (including a disastrous five-year term as Governor of New Zealand), Fitzroy eventually retired from active service in 1851 and was then named to the Royal Society for his prominent work in meteorology (Darwin was one of his supporters).

Fitzroy's health had taken a turn for the worse by this time and the shock that he felt when Darwin finally published his treatise on evolution contributed to his decline. His sense of betrayal and guilt over the role that he had played in furthering Darwin's research led him to oppose evolution at every opportunity. When Bishop Samuel Wilberforce attacked Darwin's theory in 1860 at the famous British Association meeting with Darwin's supporters, Fitzroy was there imploring the audience to "believe in God rather than man". There was little sympathy when he spoke of the "acutest pain" that Darwin had caused him and he was shouted down.

Following Fitzroy's retirement in 1863, his depression worsened significantly. It didn't help matters that he was passed over for an important naval post. On the morning of April 30, 1865. Fitzroy got out of bed and went to the washroom. He then used a razor to cut his throat (much as his uncle had done years before). Only after his death was it discovered that his entire fortune had been spent during the course of his long public service. His wife and daughter would have been left destitute if friends had not launched a testimonial fund on their behalf (Charles Darwin contributed one hundred pounds). He is buried in Brompton Cemetery in London.

Robert Fitzroy left a substantial scientific and political legacy behind him with his numerous discoveries in meteorology and geography. Still, his life would be little more than a historical footnote except for the role that he unintentionally played in furthering Charles Darwin's revolutionary theory. Whether that contributed to the ardent churchman's death is anybody's guess.

Community Outreach Program Helps the Homeless

Despite the estimated 100 million homeless people worldwide and the prevalence of homelessness in virtually every region of the industrialized world, practical strategies to combat the problem remain elusive. In a review of the Victoria Integrated Community Outreach Team (VICOT) which was formed in Victoria, British Columbia last year, the impact of reduced homelessness on police and health-care costs has shown a clear benefit. After 44 out of 55 "hardest to house" individuals were successfully moved into housing, police calls regarding the formerly homeless has dropped from 1,181 calls in the 12 months before being housed to 381 since. Hospital use has also dropped from 465 bed days in local emergency wards prior to becoming housed to 330 days in the six months afterward. While not all "hard to house" clients were successfully placed, the program has had a remarkable impact on the lives of many of its clients.

The VICOT program was started as part of a joint initiative between ministries of the British Columbia government and the Victoria Police Department to address homelessness in an integrated manner. Based on a Assertive Community Treatment (ACT) framework, the program uses a Downtown Outreach Team consisting of community outreach workers, probation officers, police officers, and mental health professionals. Since street people often cycle through the medical and legal systems, the saved financial costs are considerable.

Click here for more information.

Cognitive abnormalities in PTSD

A review published in the January 2009 issue of Current Opinion in Psychiatry examines recent research on cognitive difficulties associated with posttraumatic stress disorder (PTSD) published between January 2007 and June 2008. The reviewed studies indicate that verbal and autobiographical memory problems are exhibited by individuals with PTSD relative to controls and may represent preexisting risk factors for PTSD rather than a consequence of PTSD symptoms. The reviewed findings also provide evidence for concentration and attention biases toward trauma-relevant information in PTSD. Although memories of traumatic events have been found to differ in PTSD patient relative to other types of memories and memories of depressed individuals, they are likely on the same continuum as nontraumatic memories rather than being qualitatively different. The author concluded that individuals with PTSD experience cognitive alterations ranging from impairments in overall memory functioning to difficulties specific to trauma-related cues. These cognitive difficulties appear to be importantly related to the development and/or maintenance of the disorder. At this point, it is unclear whether common mechanisms may account for these diverse cognitive difficulties and whether cognitive impairments are attributable to comorbid depression.

Click here for the abstract.

Nationwide Workshops Help Therapists Combat Self-Mutilation in Adolescents

Therapists across Canada have been reporting a rising trend of children and adolescents who injure themselves. Children as young as eleven have been engaging in self-mutilation including repeated cutting, scratching, branding (burning themselves with hot objects), excessive body piercings, and hair pulling. While an estimated one per cent of adults have reportedly engaged in self-harm at some point in their lives, the incidence among adolescents is as high as sixteen percent. This estimate probably doesn't reflect the true incidence of self-harm behaviour since many mutilation cases go unreported. Despite being linked to suicide attempts in adolescents, most self-mutilating adolescents do not try to kill themselves. Potential reasons for self-mutilation include psychological acting-out, depression, childhood trauma, a need for self-punishment, and even peer pressure. While therapists have reported a greater incidence of self-mutilation in girls over boys, there is still limited data available despite a growing awareness of the problem.

To assist therapists in recognizing and treating self-mutilation, the Winnipeg-based Crisis and Trauma Resource Institute offers a series of nationwide workshops on adolescent self-injury. The workshop focuses on teaching therapists to provide their adolescent patients with more constructive acting-out strategies to deal with the emotional issues that lead them to mutilate themselves. As front-line workers become better informed, adolescents seeking help are provided with the treatment that they need.

Click here for more information.

Blind Tom (Part Two)

Continued from Part One

Tom's second competency case dragged on for years until 1887 when Eliza Bethune and Charity Greene were confirmed as his guardians. Tom, who had been under James Bethune's custody almost his entire life, was bewildered by the change (which left him with a lifelong suspicion of lawyers). His mother was a virtual stranger to him and Eliza seemed determined to separate him from the family that he knew best. When he finally went to his new home in Hoboken, New Jersey, Tom had nothing more than his clothing and his silver flute. This was despite the fortune that Tom had earned for the Bethunes over the years.

His concert career continued as before (although his stage name was changed to Thomas Greene Wiggins) with Eliza in charge. She and her new husband oversaw Tom's career with an almost nonstop series of concerts across the entire United States and Canada. While Tom was able to adjust to his new home with Eliza, things were never the same for him. As for Charity Greene, she returned to Georgia after signing away all rights to her son. In a 1900 newspaper interview, Charity bitterly reported that she had not seen her son in years and had made almost no money from his career despite his success. She died in 1902.

The musical touring continued until 1904 when Tom's health problems made life on the road impossible. His last concert was in Boston in 1905. Even living in seclusion at Eliza's Hoboken home, Tom spent his days playing the piano and pretending that he was still giving concerts. He died from "cerebral apoplexy" (stroke) on June 13, 1908 at the age of 59. While news of his death received nationwide attention, most obituaries failed to mention that he had been exploited his entire life and that his actual family had been left in poverty. The most commonly run obituaries declared Tom to have been "a child all his life"and a "freak pianist" as well as stressing the loving care that he had received from Eliza. Strangely enough, there seems to be some dispute over his actual resting place. While the official record lists his burial place in Evergreen Cemetery in Brooklyn, New York, memorial ceremonies have been held in Brooklyn and Columbus, Georgia with gravestones in both cities.

It was John Langdon Down (of Down syndrome fame) who first coined the term idiot savant in 1887 based on his research into mentally defective individuals with amazing cognitive abilities. The term has since been replaced with the (slightly) less objectionable autistic savant. While autism was first independently identified by Leo Kanner and Hans Asperger in the mid-20th century, researchers have established that an estimated 10% of patients falling along the autistic spectrum (including Asperger's syndrome cases) have some form of savant syndrome.

Abilities that have been associated with savant syndrome include phenomenal memory, absolute pitch, mathematical ability, or other splinter skills.Musical and artistic talent tend to be the most commonly occurring savant skills with a special "triad" of blindness, musical talent, and mental disability being noted in the clinical literature over the last century. Savant syndrome occurs in males more frequently than females at a ratio of 6 to 1. Despite different theories relating to brain pathology and savant skills, no clear consensus concerning the role of specific areas of the brain in savant syndrome has emerged.

Other developmental disabilities that have been linked to savant syndrome include mental retardation, prenatal brain damage, or even brain damage occurring later in life in some rare cases. While cases of phenomenal memory have been observed without accompanying brain pathology, the link between savant syndrome and autism appears strong. The actual incidence of savant remains rare with no more than an estimated 100 cases of strong savant ability worldwide. Famous modern cases include Alonzo Clemens, Matt Savage, and Kim Peek (the real-life inspiration for Rain Man).

Despite being a true superstar of the nineteenth century and one of the most prolific African American composers of all time, Thomas Green Wiggins faded into obscurity for many years after his death. It was in 1999 when a commercial CD titled John Davis Plays Blind Tom released by pianist John Davis helped revive interest in Tom's work. A play by Robert Earl Price titled Hush: Composing Blind Tom Wiggins was first performed at Atlanta's 7 Stages Theater in 2002 to critical reviews.

The legend of Blind Tom lives on.