Psychiatry's "Bible" Gets an Overhaul: Meet DSM-5
jtotheizzoe:
The essential reference tome of the world’s psychiatrists is getting its first major update in 30 years. Due for publication in May 2013, Ferris Jabr has a great and detailed summary of the challenges, changes and history of the Diagnostic and Statistical Manual of Mental Disorders. Some highlights of the new edition:
- They’ve eliminated several diagnoses (including the controversial “childhood bipolar disorder”)
- They’ve combined several groups of related disorders (including officially grouping Asperger’s and CDD into “Autism Spectrum Disorders”) and increased the number of symptoms one must display to be diagnosed.
- They’ve added several new diagnoses, including binge eating disorder, gambling addiction, and both hypersexual and absexual disorder.
- They got rid of the Roman numerals.
Doctors and publishers have been more transparent in revising this version than in the past (posting drafts online for comment), but concerns remain. Although psychiatrists want to ensure that diagnoses are only given to those who meet certain criteria, will increased stringency prevent some high-functioning people from receiving needed treatment? How strong is the biology behind many of the criteria and distinct diagnoses? Will insurance companies and doctors continue to struggle with “gray-area” patients?
The debates surrounding the manual’s revisions are not merely back-office chatter. Although many psychiatrists do not sit down with the DSM and take its scripture literally—relying instead on personal expertise to make a diagnosis—the DSM largely determines the type of diagnoses clinicians make. Insurance companies often demand an official DSM diagnosis before they pay for medication and therapy. Many state educational and social services—such as after-school programs for kids with autism—also require a DSM diagnosis. Consequently, psychiatrists cannot dole out diagnoses of their own invention. They are bound to the disorders defined by the DSM.
SciAm will be publishing a week-long blog series about the new DSM-5. Highly recommended.
(via houseofmind)
The Dysfunctional Psychology of Winnie The Pooh Cartoons
In 1966 Disney had a featurette called “Winnie The Pooh and the Honey Tree” which in short told of Pooh’s quest to get some honey because he had no more. On this quest we meet all of the characters of the Hundred Acre Wood, Rabbit, Piglet, Tigger (Tee-eye-double-gerr-err) Kanga and Roo, Eeyore, Owl and Gopher (the only character added by Disney). So, in a bit of light humor, here’s the psychology of the characters of Winnie The Pooh.
Winnie The Pooh — He has an eating disorder, and Freud would automatically recognize it as an oral fixation. Pooh Bear’s constant quest for food and eating with his hands is unhealthy. Aside from the weight issues, which cause him to get stuck in Rabbit’s hole (wow! no pun intended) leading out of his warren, Pooh is trying to fulfill the loneliness as well. His food is acting as a comforter. Some people shop compulsively, some people drown their sorrows, Pooh eats compulsively. Just a cursory look at his house, you’d see nothing but discarded honey pots all around; they stand as a memorial to his disorder.
Rabbit — Obsessive Compulsive Disorder. Rabbit throughout the featurette and even when I was a kid in the late 80s and early 90s in the Saturday morning cartoon “The New Adventures of Winnie the Pooh” has always been a nag! Rabbit was always worried about how things looked and would go back and back and back again to make sure things were in order. From how the carrots were lined up and to how the house was ordered. And Rabbit would get totally bent out of shape if things weren’t in order.
Tigger — Attention Deficit Hyperactivity Disorder. Tigger couldn’t sit still. He was always bouncing from one thing to the other. He was always distracted, and above all didn’t care. Tigger would mess up Rabbit’s garden and bounce all the way down the road, and not care. Tigger needed to be on ritalin or some type of psychostimulant drug. His ADHD was destructive because he always found himself in trouble. This got more fleshed out in the subsequent cartoon series, but even still, he was a nuisance to the people around him and it resulted in a near alienation from the group.
Piglet — General Anxiety Disorder. In lamens terms, Piglet was a pussy. He was a wimp and was always scared. His fear result in him being anxious about everything. Piglet could barely function. This anxiety disorder almost manifests itself in paranoia having irrational and delusional fears about everything. Piglet has made up fantastic creatures such as “Jagulars” and “Hefflaumps” in his own mind (by the way, how is an imaginary creature going to have imaginary friends?). Piglet’s main statement is “Oh d-d-dear” and is especially scared of Tigger because he doesn’t know what Tigger is going to do next.
Owl — Narcissitic Personality Disorder. Owl was quite clear that he had all of the right answers. He was even given a British accent that seems to speak to his know-it-allness. Owl was so full of himself that he barely did any work. He was even a character, owls, associated with wisdom and knowledge and being a flying creature, he always hovered above everyone else.
Eeyore — Major Depressive Disorder. Frankly speaking, Eeyore was borderline suicidal. He didn’t much care about anything one way or the other. To say that he was gloomy was an understatement. He wasn’t bipolar or manic depressive because he never had any bouts of mirth mixed with fits of melancholy; he presented chronically as always being depressed.
Christopher Robin — Schizophrenia. This boy is talking to animals. Well, that’s one thing, but these animals are actually speaking back, therein lies the problem. Not just that, these animals have distinct personalities, and psychological disorders to boot.
And in the midst of all of this, these animals don’t wear any clothing. And the older you get, the fact that Winnie the Pooh wears a shirt with no pants makes it even the more weird and astonishing.
But the apparent benign messaging of cartoons of old may really be shaping the future consciousness of children. These cartoons are art not just in the sense of creating something for entertainment purposes, but art in the way that an artists pours their emotions into their creation for the public to give their own feedback. These cartoons don’t exist in a vacuum of vapid childhood entertainment; they are instrumental in creating and fashioning a set of ethics and morals that these children will inevitably carry with them into adolescence and possibly even adulthood.
(via thefreshxpress)
Locus of Control
Locus of Control refers to the extent to which individuals believe that they can control events that affect them. Individuals with a high internal locus of control believe that events result primarily from their own behaviour and actions. Those with a high external locus of control believe that powerful others, fate, or chance primarily determine events. Those with a high internal locus of control have better control of their behaviour and tend to exhibition more political behaviours than externals and are more likely to attempt to influence other people; they are more likely to assume that their efforts will be successful. They are more active in seeking information and knowledge concerning their situation than do externals. The propensity to engage in political behaviour is stronger for individuals who have a high internal locus of control than for those who have a high external locus of control.
Visual Cliff Experiment
In order to investigate depth perception, psychologist E. J. Gibson and R. D. Walk developed the visual cliff test in 1960 to use with human infants and animals. A visual cliff is created by connecting a transparent glass surface to an opaque patterned surface. The floor below has the same pattern as the opaque surface. This apparatus creates the visual illusion of a cliff, while protecting the subject from injury.
In the test, a child is placed on one end of the platform and the caregivers stands on the other side of the clear surface. The assumption was that if a child had developed depth perception, he or she would be able to perceive the visual cliff and would be reluctant or refuse to crawl to the caregiver.
Later research has demonstrated, however, that children as young as three-months are able to perceive the visual cliff. When placed over the apparent “edge,” their heart rate quickens, eyes widen and breathing rate increases. The issue is that children of this age do not yet fully realize that the consequence of going over this visual cliff is potentially falling. This realization only comes later when the child begins to crawl and gains real experience with taking tumbles.
A replication of Walter Mischel’s Standford marshmallow experiment
The Stanford marshmallow experiment was a study on deferred gratification conducted in 1972 by psychologist Walter Mischel of Stanford University. The original study at Stanford has been “regarded as one of the most successful behavioural experiments”.
In the study, a marshmallow was offered to each child. If the child could resist eating the marshmallow, he was promised two instead of one. The scientists analyzed how long each child resisted the temptation of eating the marshmallow, and whether or not doing so had an effect on their future success. He found that children who could delay gratification and wait for the second marshmallow were considered “more dependable” later as adolescents and generally scored higher on the SATs. Mischel and colleagues also found a relationship between seconds of delay of gratification and scores of ability to deal with stress and frustration
Learned helplessness, as a technical term in animal psychology and related human psychology, means a condition of a human person or an animal in which it has learned to behave helplessly, even when the opportunity is restored for it to help itself by avoiding an unpleasant or harmful circumstance to which it has been subjected.
The American psychologist Martin Seligman’s foundational experiments and theory of learned helplessness began at University of Pennsylvania in 1967, as an extension of his interest in depression. Quite by accident, Seligman and colleagues discovered that the conditioning of dogs led to outcomes that opposed the predictions of B.F. Skinner’s behaviorism, then a leading psychological theory.
In Part 1 of Seligman and Steve Maier’s experiment, three groups of dogs were placed in harnesses. Group 1 dogs were simply put in the harnesses for a period of time and later released. Groups 2 and 3 consisted of “yoked pairs.” A dog in Group 2 would be intentionally subjected to pain by being given electric shocks, which the dog could end by pressing a lever. A Group 3 dog was wired in parallel with a Group 2 dog, receiving shocks of identical intensity and duration, but his lever didn’t stop the electric shocks. To a dog in Group 3, it seemed that the shock ended at random, because it was his paired dog in Group 2 that was causing it to stop. For Group 3 dogs, the shock was apparently “inescapable.” Group 1 and Group 2 dogs quickly recovered from the experience, but Group 3 dogs learned to be helpless, and exhibited symptoms similar to chronic clinical depression.
In Part 2 of the Seligman and Maier experiment, these three groups of dogs were tested in a shuttle-box apparatus, in which the dogs could escape electric shocks by jumping over a low partition. For the most part, the Group 3 dogs, who had previously learned that nothing they did had any effect on the shocks, simply lay down passively and whined. Even though they could have easily escaped the shocks, the dogs didn’t try.
In a second experiment later that year, Overmier and Seligman ruled out the possibility that the Group 3 dogs learned some behavior in Part 1 of the experiment, while they were struggling in the harnesses against the “inescapable shocks,” that somehow interfered with what would have been their normal, successful behavior of escaping from the shocks in Part 2. The Group 3 dogs were immobilized with a paralyzing drug (Curare), and underwent a procedure similar to that in Part 1 of the Seligman and Maier experiment. A similar Part 2 in the shuttle-box was also undertaken in this experiment, and the Group 3 dogs exhibited the same “helpless” response.
However, not all of the dogs in Seligman’s experiments became helpless. Of the roughly 150 dogs in experiments in the latter half of the 1960s, about one-third did not become helpless, but instead managed to find a way out of the unpleasant situation despite their past experience with it. The corresponding characteristic in humans has been found to correlate highly with optimism: an explanatory style that views the situation as other than personal, pervasive, or permanent. This distinction between people who adapt and those who break down under long-term psychological pressure was also studied in the 1950s in the context of brainwashing.
neuropsy:
Your Brain on God
The article explores the possibility that the perceived presence and feeling of God is simply a product of temporal lobe stimulation. Persinger subjects the author of the article to his ‘God helmet,’ a contraption that stimulates the right temporal lobe with weak magnetic fields. And indeed, the author felt something when the helmet was placed on her head. While it might seem like an oversimplification to claim that spiritual feelings exist only because of neurons firing off, it’s a compelling idea that forces us to truly question what our brains are capable of.
AIDS Researcher Gail Ironson studied the effects of prayer on HIV patients and found that those who prayed regularly maintained a higher volume of immune cells than those who did not believe in God. These findings may not be conclusive but they are refreshing.
(via Your Brain on God « GLIMPSE journal blog)
(via poteau)
A group of researchers who fled Nazi persecution turned to psychodynamic theory to explain racism. They suggested that some people have the tendency to be attracted to racist ideology because of their personality traits. Theodore Adorno and his colleagues (1950) identified what they called the authoritarian personality, characterised by a tendency to hate people who are different or downtrodden. The individuals tended to have a dominant, stern and sometimes sadistic father and a submissive mother — interestingly, like the family of Adolf Hitler. According to this theory, children in such families fear and hate their father, but they would be brutally punished if they expose such feelings, so repression occurs. As adults, such individuals displace or project their rage onto group such as Jews, indigenous people, homosexuals or other people whom they perceive to be different.
For my social psychology class, we have to submit an essay explaining why prejudice continues to occur despite social sanctions against it. We have all seen various forms of racial, ethnic and religious prejudice throughout the human history. It can be traced back to the Holocaust, the Arab-Israeli conflict, the tribal warfare and genocide in Rwanda and other African countries, the civil war and atrocities in Bosnia and terrorist activities in the United States and throughout the world. The list goes on forever.
Do the roots of prejudice lie in individual psychology (such as personality dynamics or cognition) or in social dynamics (the oppression of one group by another)? And are the reasons for prejudice be found in cognition or motivation - in the way people think or in the way they want to think?
A penny for your thoughts?
“Abe Sada Incident”
Sada Abe (1905-1970) is best remembered in Japan for erotically asphyxiating her lover, Kichizo Ishida, on May 18, 1936, and then cutting off his penis and testicles and carrying them around in her handbag.
After strangling Ishida to death in his sleep, she next severed his genitalia with the kitchen knife, wrapped them in a magazine cover, and kept them until her arrest three days later. With the blood, she wrote Sada, Kichi Futari-kir (“Sada, Kichi together”) on Ishida’s left thigh, and on a bed sheet. She then carved the character for her name into his left arm. When asked why she had severed Ishida’s genitalia, Abe replied,
Because I couldn’t take his head or body with me. I wanted to take the part of him that brought back to me the most vivid memories.
On December 21, 1936, Abe was convicted of murder in the second degree and mutilation of a corpse. She was then sentenced to just six years in prison.
Tetraphobia
Tetraphobia is an irrational, persistent fear of the number 4. It is a superstition most commonly found in East Asia countries such as China, Taiwan, Japan and Korea. The Chinese word for four (四, pinyin: sì) is pronounced similarly to the word for death (死, pinyin: sǐ). Also, the Sino-Japanese and Sino-Korean words for four, shi (Japanese - other four is Yon) and sa (사, Korean) sounds identical to death in each language.
I was in Hong Kong last month for a short vacation and I noticed that some apartments skipped the 14th floor, while some skyscrapers skipped all the floors from 40 - 49 entirely.
Failure to carefully examine the literature for similar research
Failure to critically assess the prior literature
Failure to specify the inclusion and exclusion criteria for the subjects
Failure to determine and report the error of measurement methods
Failure to specify exact statistical assumptions made in the analysis
Failure to perform sample size analysis before the study begins
Failure to implement adequate bias control measures
Failure to write and stick to a detailed time line
Failure to vigorously recruit and retain subjects
Failure to have a detailed, written and vetted protocol
Failure to examine for normality of data
Failure to report missing data, dropped subjects and use of an intention to treat analysis
Failure to perform and report power calculations
Failure to point out the weaknesses of own study
Failure to understand and use correct scientific language.
