Serial Killers and Psychology

Researchers detected this effect by showing women a series of negative and neutral images and monitoring their encephalographic[EEG] responses. [Men were left out of the study to prevent sex difference in brain activity from clouding results] In some instances, participants were informed that a troubling image was coming up and that they should try to think about it in a positive way. If the image showed a man holding a knife to a woman's throat, for example, they might imagine that they woman escaped.

This reframing was tricky for worriers. Increases in two measure of electrical activity in their brains indicated both above-average anticipation of unpleasant images and heightened emotional arousal during the reappraisal task. For more positive thinkers, indicators of arousal decreased.

In a new study, researchers performed a detailed review of clinical trials that were conducted to examine the effect of vitamin D supplementation on depression.

Investigators found that few well-conducted trials of vitamin D supplementation for depression have been published and that the majority of these show little to no effect of vitamin D on depression.

The review, by Jonathan A. Shaffer, Ph.D., assistant professor of medical sciences at Columbia University Medical Center, was published recently in the online edition of Psychosomatic Medicine.

The review found that only seven trials with a total of approximately 3200 participants compared the effect of vitamin D supplementation on depression with no vitamin D supplementation.

Nearly all of these trials were characterized by methodological limitations, and all but two involved participants without clinically significant depression at the start of the study. The overall improvement in depression across all trials was small and not clinically meaningful.

However, additional analyses of the clinical data by Dr. Schaffer hinted that vitamin D supplements may help patients with clinically significant depression, particularly when combined with traditional antidepressant medication.

New well-designed trials that test the effect of vitamin D supplements in these patients are needed to determine if there is any clinical benefit.

The authors note that supplementation with vitamin D also may be effective only for those with vitamin D deficiency. They also recommend that future studies consider how vitamin D dosing and mode of delivery contribute to its effects on depression.

“Although tempting, adding vitamin D supplements to the armamentarium of remedies for depression appears premature based on the evidence available at this time,” said Shaffer.

Is uncomfortable in situations in which he or she is not the center of attention

Interaction with others is often characterized by inappropriate sexually seductive or provocative behavior

Displays rapidly shifting and shallow expression of emotions

Consistently uses physical appearance to draw attentionto themself

Has a style of speech that is excessively impressionistic and lacking in detail

Shows self-dramatization, theatricality, and exaggerated expression of emotion

Is highly suggestible, i.e., easily influenced by others or circumstances

Considers relationships to be more intimate than they actually are

Because personality disorders describe long-standing and enduring patterns of behavior, they are most often diagnosed in adulthood. It is uncommon for them to be diagnosed in childhood or adolescence, because a child or teen is under constant development, personality changes and maturation. However, if it is diagnosed in a child or teen, the features must have been present for at least 1 year.

Histrionic personality disorder is more prevalent in females than males. It occurs in about 1.8 percent in the general population.

Individuals with Histrionic Personality Disorder may have difficulty achieving emotional intimacy in romantic or sexual relationships. Without being aware of it, they often act out a role (e.g., “victim” or “princess”) in their relationships to others. They may seek to control their partner through emotional manipulation or seductiveness on one level, whereas displaying a marked dependency on them at another level.

Individuals with this disorder often have impaired relationships with same-sex friends because their sexually provocative interpersonal style may seem a threat to their friends’ relationships. These individuals may also alienate friends with demands for constant attention. They often become depressed and upset when they are not the center of attention.

People with histrionic personality disorder may crave novelty, stimulation, and excitement and have a tendency to become bored with their usual routine. These individuals are often intolerant of, or frustrated by, situations that involve delayed gratification, and their actions are often directed at obtaining immediate satisfaction. Although they often initiate a job or project with great enthusiasm, their interest may lag quickly.

Longer-term relationships may be neglected to make way for the excitement of new relationships.

The amygdala is a key emotional center in the brain that helps regulate anxiety and the flight-or-fight response, and this finding may help explain why many marijuana users say they take the drug to reduce anxiety.

The study also showed for the first time how nerve cells in this part of the brain make and release their own natural “endocannabinoids.”

The study “could be highly important for understanding how cannabis exerts its behavioral effects,” said Sachin Patel, M.D., Ph.D., the paper’s senior author and professor of Psychiatry and of Molecular Physiology and Biophysics.

As the legalization of marijuana spreads across the country, more people — and especially young people whose brains are still developing — are gaining access to and being exposed to the drug.

Previous studies at Vanderbilt and elsewhere, Patel said, have suggested the following:

The body’s natural endocannabinoid system regulates anxiety and our response to stress by cooling down excitatory signals that involve the neurotransmitter glutamate;

Chronic stress or severe emotional pain can trigger a reduction in both the production of endocannabinoids and the responsiveness of the receptors. Without this “buffering” effect, anxiety runs wild;

And finally, chronic use of the drug down-regulates the receptors, paradoxically increasing anxiety. This can trigger a cycle of increasing marijuana use that in some cases can lead to addiction.

In the current study, scientists used high-affinity antibodies to “label” the cannabinoid receptors so they could be seen using various microscopy techniques. This enabled researchers to see what was happening at individual synapses, or gaps between nerve cells.

“We know where the receptors are, we know their function, we know how these neurons make their own cannabinoids,” Patel said. “Now can we see how that system is affected by … stress and chronic (marijuana) use? It might fundamentally change our understanding of cellular communication in the amygdala.”

“We found that when people who are sad are exposed to pictures of indulgent food or indulgent words, their sadness highlights the negative consequences of indulging and encourages them to indulge less,” said researcher and graduate student Anthony Salerno and Juliano Laran, Ph.D., of the University of Miami, and Chris Janiszewski, Ph.D., of the University of Florida, in a study published in the Journal of Consumer Research.

The three conducted a series of five experiments to study the behavior of people who were exposed to either indulgent or neutral words or images and then made to feel sad.

In one study, participants were asked to look at a series of print ads that featured pleasurable foods like pizza and chocolate cake or to look at neutral ads featuring products like washing machines and electric cars.

Immediately after viewing the print ads, they were asked to complete a writing task that made them feel sad. At the end of the study, they were given the opportunity to eat indulgent foods like M&Ms or chocolate chip cookies.

The researchers found that when people were first exposed to pleasurable information and then made to feel sad, they decreased their consumption of indulgent foods. They also found that these participants were more likely to indicate how consuming indulgent foods could lead to health problems.

In contrast, when people were exposed to neutral information and made to feel sad, they increased their consumption of indulgent foods.

“Our research has important implications for consumers, particularly as obesity remains a major health concern in the United States,” the researchers noted.

Psychotherapy for PTSD

Most people who experience post-traumatic stress disorder undergo some type of psychotherapy (most commonly either cognitive-behavioral therapy or group psychotherapy, or combination of the two). You canlearn more about psychotherapy for PTSD now.

Psychotherapy techniques commonly prescribed include group psychotherapy, cognitive-behavioral therapy, EMDR and hypnotherapy.

Medications for PTSD

Medications are nearly always used in conjunction with psychotherapy for PTSD, because while medications may treat some of the symptoms commonly associated with the disorder, they will not relieve a person of the flashbacks or feelings associated with the original trauma. If one is receiving a medication from a general practitioner or their doctor, they should nearly always seek a psychotherapy referral in addition to the prescription.

Antidepressants

The most commonly prescribed class of medications for PTSD (and the one approved by the U.S. Food and Drug Administration) are the selective serotonin reuptake inhibitor (SSRI) antidepressants. These include drugs such as fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil). Research shows that this group of medicines tends to decreaseanxiety,depression, andpanicassociated with PTSD in many people. These types of antidepressants may also help reduce aggression, impulsivity, and suicidal thoughts that can occur in people with PTSD.

This class of antidepressants generally takes 6 to 8 weeks to work, so patience is needed when taking them. Many people don’t always respond to the first type ofantidepressanttried, so another antidepressant may need to be tried if the first one is ineffective. A relapse of posttraumatic stress disorder is less likely if antidepressants are prescribed for at least a year. Antidepressants are particularly useful in patients who also suffer from depression (although they can be useful even in the absence of depression). They are also useful when there is a history of abuse of alcohol or other substances,

Other Medications

There are a variety of other medications often prescribed to try and help reduce the symptoms associated with PTSD. The most common alternative to antidepressants are the atypical antipsychotics. Atypical antipsychotics include medications such as risperidone (Risperdal), olanzapine (Zyprexa), and quetiapine (Seroquel).Antipsychoticmedicines seem to be most useful in the treatment of PTSD in those who suffer from agitation, dissociation, hypervigilance, intense suspiciousness (paranoia), or brief breaks in being in touch with reality (brief psychotic reactions).

Other less directly effective but nevertheless potentially helpful medications for managing PTSD include mood stabilizers like lamotrigine (Lamictal), tiagabine (Gabitril), and divalproex sodium (Depakote). Medicines that help decrease the physical symptoms associated with PTSD include drugs such as clonidine (Catapres), guaneficine (Tenex), and propranolol.

Benzodiazepines (commonly referred to as minor tranquilizers, sleeping tablets, or anti-anxiety medications) are sometimes prescribed for certain symptoms of PTSD because they provide rapid relief of anxiety, but are also associated with dependence. In general, there is far more evidence for the use of antidepressants in PTSD than for the use of benzodiazepines. There is even a small amount of data indicating that although the benzodiazepines can provide immediate relief of symptoms, over the long haul they can exacerbate PTSD.

But using antidepressants in the treatment of depression of someone who has bipolar disorder can have unexpected — and unwanted — effects. Studies of antidepressant use in bipolar disorder have been decidedly mixed.

So it’s always welcome news when a new medication — or a new use for an existing medication — has been approved. Such is the case with Latuda (lurasidone).

Bipolar depression is a frustrating component of bipolar disorder to treat. The most recent meta-analytic study on the use of antidepressants to treat bipolar depression found little support for their use. Two previous meta-analyses came to contradictory conclusions.

The usefulness of antidepressants in bipolar depression therefore remains controversial. Current guidelines generally recommend the cautious antidepressant use in combination with mood stabilizers to reduce the risk of mood elevation or cycle acceleration.

With the arrival of atypical antipsychotic medications, people with bipolar disorder now have an additional treatment choice to help with the alleviation of depression symptoms.

Latuda (lurasidone) is one such atypical antipsychotic. It was first approved for the treatment of schizophrenia in late 2010; in the summer of 2013, its approved use was extended to help in the treatment of bipolar depression by the U.S. Food and Drug Administration. In schizophrenia, dosing usually starts at 40 mg/daily, but for bipolar depression treatment, 20 mg/daily is recommended. The dose can be increased if needed, but shouldn’t exceed 120 mg/day (160 mg/day in schizophrenia).

Like other atypical antipsychotics, it should be taken with food and it shouldn’t be used in people with liver disease, heart disease, heart problems or a history of heart attacks, or people with high cholesterol.

Latuda is well-tolerated by most people who take it. The most common side effects reported while taking Latuda are somnolence — a strong desire to sleep — (22%) and akathisia — a feeling of inner restlessness that makes it difficult for a person to be able to sit or stay still for long periods of time — (15%). Both of these are dose-related, and can often be controlled by changing the dosing.

Fasting glucose increased — higher blood sugar — (10-14%) and nausea (12%) have also been reported as common side effects. Some people complained of muscle stiffness, or muscle twitching, uncontrollable movements of your eyes, lips, tongue, face, arms, or legs, but these were less common.

Most people who take Latuda are going to start seeing improvement of their symptoms in 3 to 4 weeks. Like all psychiatric medications, Latuda may or may not work for your bipolar depression symptoms. A doctor can’t tell you if it’s going to work for you ahead of time; the only way to know is to try it.

While you are taking Latuda, you may be more sensitive to temperature extremes — so you should avoid getting too cold, or becoming overheated or dehydrated. Drink plenty of fluids, especially in hot weather and during exercise.

The biggest downside to Latuda? Well, because it’s new and still patented, it’s expensive. However, I noticed they do have a savings program that can significantly reduce your co-pay if you qualify.

Myth: All of us have been through frightening experiences and have at least one symptom of PTSD as a result of that experience.

Fact: Although memories of frightening experiences may be similar to symptoms of PTSD (e.g., vivid memories), most persons do not have the severity of symptoms or impairment associated with PTSD. The specific brain-based responses seen in PTSD differ from those seen in normalanxiety. Similarly, the experiences of normal anxiety and of PTSD are markedly different.

Myth: Stress reactions to trauma exist, but these should not be considered as a serious medical problem.

“Previous studies have shown the correlation between cardiovascular fitness and the risk of dementia in old age,” said Jenny Nyberg, Ph.D., a researcher at the Sahlgrenska Academy of Gothenburg University, who headed the study.

“Now, for the first time, we can show that the increased risk also applies to early-onset dementia and its precursors.”

The study shows that men who had poorer cardiovascular fitness when conscripted into the military were 2.5 times more likely to develop early-onset dementia later in life.

Those with a lower IQ had a four times greater risk, according to the researchers.

A combination of both poor cardiovascular fitness and low IQ correlated to a seven times greater risk of early-onset dementia, the researchers report.

The increased risk remained even when controlled for other risk factors, such as heredity, medical history, and socioeconomic circumstances, researchers added.

“We already knew that physical and cognitive exercise reduces the risk of neurological disease,” said Professor Georg Kuhn, Ph.D., senior author of the study.

“Physical exercise increases nerve cell complexity and function and even generation of new nerve cells in the adult brain, which strengthens our mental and physiological functions. In other words, good cardiovascular fitness makes the brain more resistant to damage and disease.”

“People who develop early-onset dementia are often of working age and can have children still living at home, which means the consequences for both the sufferers and their families are even more serious,” the researchers said. “Despite this, patients with early-onset dementia are a relatively overlooked group,” they added.

“This makes it important to initiate more research into how physical and mental exercise can affect the prevalence of different types of dementia,” Nyberg said. “Perhaps exercise can be used as both a prophylactic and a treatment for those in the risk zone for early-onset dementia.”