Projective Identification

Projective Identification is an important concept in psychodynamic psychotherapy.

There is an interesting discussion on the following site: https://www.linkedin.com/groups/94332

Pregnancy and Depression: What’s the Connection?

The following news item is from MNT(R) at http://www.medicalnewstoday.com. I do not check news items for accuracy,correctness or safety.

Pregnancy and Depression: What’s the Connection?

A pregnant woman hides her head with a pillow.

Everyone experiences feelings of sadness. They are a natural response to life’s difficult times and events, and they usually lessen with time.

Clinical depression goes beyond feelings of sadness and is a real illness with potentially serious consequences. It is a mood disorder and impacts people’s quality of life. People with depression struggle with daily life because it affects the way they function.

Relationships, self-esteem, work, motivation, sleep, appetite, and more are all affected by depression. It is not a weakness and is a condition that requires treatment from a healthcare professional. …

http://www.medicalnewstoday.com/articles/313398.php

What Effect Does Caffeine Have on Depression?

The following news item is from MNT(R). I do not check news items for accuracy, correctness or safety.

The medical world is divided, however, when it comes to the benefits and risks of caffeine. Its impact on mental health is hotly debated. Many believe that caffeine can relieve depression, while others warn it can make it worse. …

http://www.medicalnewstoday.com/articles/313988.php

What does it take to make a memory? Study says new proteins

The following news item is from Science Daily (R). I do not check new items for accuracy, correctness or safety.

What does it take to make a memory? Study says new proteins

Date:
November 10, 2016
Source:
Scripps Research Institute
Summary:
For the first time, scientists have identified a sub-region in the brain that works to form a particular kind of memory: fear-associated with a specific environmental cue or “contextual fear memory.”
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FULL STORY

A sub-region in the brain works to form a particular kind of memory: fear-associated with a specific environmental cue or “contextual fear memory.”
Credit: © Sergey Nivens / Fotolia

While the romantic poets’ idea of memories being akin to spirits may have poetic merit, the scientists’ perspective is that memories are concrete, physical entities that can be visualized within various regions of the brain.

Scientists from the Florida campus of The Scripps Research Institute (TSRI) have now for the first time identified a sub-region in the brain that works to form a particular kind of memory: fear-associated with a specific environmental cue or “contextual fear memory.”

The study, recently published in the journal Biological Psychiatry Cognitive Neuroscience and Neuroimaging, was led by TSRI Associate Professor Sathyanarayanan V. Puthanveettil.

“Much is still unknown about the identities of proteins synthesized to produce long-term memory,” Puthanveettil said. “The most striking observation from the new study is that the medial prefrontal cortex is the site of this early protein synthesis. We have also identified what proteins are newly synthesized in the medial prefrontal cortex.”

In particular, the study showed new protein synthesis in a specific sub-region of the prefrontal cortex known in rodents as the prelimbic. In humans, this area corresponds to the anterior cortex, which has been linked to processing emotional responses. Initially, Puthanveettil and his colleagues ignored the medial prefrontal cortex because no one believed that it had anything to do with early encoding of long term memories.

However, when they closely examined the effects on the brain of conditioning rodents with a mild foot shock, the scientists found several messenger RNAs recruited to polyribosomes in the medial prefrontal cortex — a clear indication of new protein synthesis there.

Puthanveettil and his colleagues also discovered that if they inhibited new protein synthesis in the prelimbic region right after fear conditioning took place, those memories did not form. But if the researchers waited just a few hours, inhibiting protein synthesis in prelimbic cortex had no impact and the memories took hold. There is temporal and spatial regulation of new protein synthesis in the medial prefrontal cortex.

“It may be that the first wave of protein synthesis is critical for encoding contextual fear memory, while second wave in other sub-regions is important for memory storage,” he said. It remains to be determined if other sub-regions of the cortex are also be involved in the synthesis of memory proteins.

“The medial prefrontal cortex has many sub-regions,” said TSRI Senior Research Associate Bindu L. Raveendra, co-first author of the study with Valerio Rizzo, Khalid Touzani and Supriya Swarnkar, all of TSRI at the time of the study. “But the specific roles of these sub-regions in encoding, expression and retrieval, as well as their underlying molecular mechanisms, remain to be unraveled.”


Journal Reference:

  1. Valerio Rizzo, Khalid Touzani, Bindu L. Raveendra, Supriya Swarnkar, Joan Lora, Beena M. Kadakkuzha, Xin-An Liu, Chao Zhang, Doron Betel, Robert W. Stackman, Sathyanarayanan V. Puthanveettil. Encoding of Contextual fear Memory Requires de novo Proteins in the Prelimbic Cortex. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, 2016; DOI: 10.1016/j.bpsc.2016.10.002

Autism gene slows down brain cell communication

This news story has been published on Science Daily(R). I do not check news items for accuracy, correctness or safety.

https://www.sciencedaily.com/releases/2016/11/161108124023.htm

Autism gene slows down brain cell communication

Date:
November 8, 2016
Source:
McMaster University
Summary:
The researchers discovered an important ‘on’ button in DIXDC1 protein that instructs brain cells to form mature connections called synapses with other brain cells during development.
FULL STORY

Brain cells form connections with their neighbours on hairlike growths that sprout from a cell’s branching arms (pictured here). These connections are important for learning. In individuals with Autism, the number of connections is not correct, which causes problems for individuals to form new memories and develop social skills.
Credit: Image courtesy of McMaster University

Scientists at McMaster University’s Stem Cell and Cancer Research Institute in collaboration with Sick Children’s Hospital have discovered genetic alterations in the gene DIXDC1 in individuals with autism spectrum disorders (ASD). This gene was found to change the way brain cells grow and communicate.

This finding, published in Cell Reports, provides new insights into ASD that will guide identification of new medications for people with ASD. This is critical because ASD affects one in 68 individuals, and there are no medications that target the core symptoms of this complex disorder.

The study was led by Karun Singh, a scientist with the Stem Cell and Cancer Research Institute (SCCRI) and an assistant professor of biochemistry and biomedical sciences at McMaster’s Michael G. DeGroote School of Medicine.

The researchers discovered an important ‘on’ button in DIXDC1 protein that instructs brain cells to form mature connections called synapses with other brain cells during development. Working with the leading geneticist Stephen Scherer from The Hospital for Sick Children and the University of Toronto, the team identified genetic changes that keep DIXDC1 turned “off” in a group individuals with autism, predicted to cause brain synapses to stay immature, and reduce brain activity.

“Because we pinpointed why DIXDC1 is turned off in some forms of autism, my lab at the SCCRI, which specializes in drug discovery, now has the opportunity to begin the searching for drugs that will turn DIXDC1 back on and correct synaptic connections,” said Singh. “This is exciting because such a drug would have the potential to be a new treatment for autism.”

While this discovery holds promise, mutations in DIXDC1 account for only a small number of individuals with autism and related psychiatric conditions, Singh said.

“However, there is strong evidence that many other autism genes disrupt the development of synapses similar to DIXDC1; therefore, the key to a new treatment for autism will be to find safe medications that restores brain cell synapse growth and activity.”

Mick Bhatia, director of the SCCRI, said the discovery signifies the institute’s strategic entry into the area of neural disease and genetic guided personalized drug development.

“This is the first step of many ahead as the SCCRI continues to strive for near term impact on human health through stem cell research,” he said, adding that the addition of Singh’s team was enabled by the support from the David Braley Chair in Neural Stem Cell Research.

Breathe. Exhale. Repeat: The Benefits of Controlled Breathing

This news item appeared on the website of the New York Times. I cannot check news items for correctness or safety.

For the article see

http://www.nytimes.com/2016/11/09/well/mind/breathe-exhale-repeat-the-benefits-of-controlled-breathing.html

Photo

CreditAndrew Rae

Take a deep breath, expanding your belly. Pause. Exhale slowly to the count of five. Repeat four times.

Congratulations. You’ve just calmed your nervous system.

Controlled breathing, like what you just practiced, has been shown to reduce stress, increase alertness and boost your immune system. For centuries yogis have used breath control, or pranayama, to promote concentration and improve vitality. Buddha advocated breath-meditation as a way to reach enlightenment.

Science is just beginning to provide evidence that the benefits of this ancient practice are real. Studies have found, for example, that breathing practices can help reduce symptoms associated with anxiety, insomnia, post-traumatic stress disorder, depression and attention deficit disorder.

“Breathing is massively practical,” says Belisa Vranich, a psychologist and author of the book “Breathe,” to be published in December. “It’s meditation for people who can’t meditate.”

How controlled breathing may promote healing remains a source of scientific study. One theory is that controlled breathing can change the response of the body’s autonomic nervous system, which controls unconscious processes such as heart rate and digestion as well as the body’s stress response, says Dr. Richard Brown, an associate clinical professor of psychiatry at Columbia University and co-author of “The Healing Power of the Breath.”

Consciously changing the way you breathe appears to send a signal to the brain to adjust the parasympathetic branch of the nervous system, which can slow heart rate and digestion and promote feelings of calm as well as the sympathetic system, which controls the release of stress hormones like cortisol.

Many maladies, such as anxiety and depression, are aggravated or triggered by stress. “I have seen patients transformed by adopting regular breathing practices,” says Dr. Brown, who has a private practice in Manhattan and teaches breathing workshops around the world.

When you take slow, steady breaths, your brain gets the message that all is well and activates the parasympathetic response, said Dr. Brown. When you take shallow rapid breaths or hold your breath, the sympathetic response is activated. “If you breathe correctly, your mind will calm down,” says Dr. Patricia Gerbarg, assistant clinical professor of psychiatry at New York Medical College and Dr. Brown’s co-author

Dr. Chris Streeter, an associate professor of psychiatry and neurology at Boston University, recently completed a small study in which she measured the effect of daily yoga and breathing on people with diagnoses of major depressive disorder.

After 12 weeks of daily yoga and coherent breathing, the subjects’ depressive symptoms significantly decreased and their levels of gamma-aminobutyric acid, a brain chemical that has calming and anti-anxiety effects, had increased. The research was presented in May at the International Congress on Integrative Medicine and Health in Las Vegas. While the study was small and lacked a control group, Dr. Streeter and her colleagues are planning a randomized controlled trial to further test the intervention.

“The findings were exciting,” she said. “They show that a behavioral intervention can have effects of similar magnitude as an antidepressant.”

Breathing may also affect the immune system. Researchers at the Medical University of South Carolina divided a group of 20 healthy adults into two groups. One group was instructed to do two sets of 10-minute breathing exercises, while the other group was told to read a text of their choice for 20 minutes. The subjects’ saliva was tested at various intervals during the exercise. The researchers found that the breathing group’s saliva had significantly lower levels of three cytokines that are associated with inflammation and stress. The findings were published in the journal BMC Complementary and Alternative Medicine in August.

Here are three basic breathing exercises to try on your own.

Coherent Breathing

If you have the time to learn only one technique, this is the one to try. In coherent breathing, the goal is to breathe at a rate of five breaths per minute, which generally translates into inhaling and exhaling to the count of six. If you have never practiced breathing before, you may have to work up to this practice slowly, starting with inhaling and exhaling to the count of three and working your way up to six.

Photo

CreditAndrew Rae

1. Sitting upright or lying down, place your hands on your belly.

2. Slowly breathe in, expanding your belly, to the count of five.

3. Pause.

4. Slowly breathe out to the count of six.

5. Work your way up to practicing this pattern for 10 to 20 minutes a day.

Stress Relief

When your mind is racing or you feel keyed up, try Rock and Roll breathing, which has the added benefit of strengthening your core.

Photo

CreditAndrew Rae

1. Sit up straight on the floor or the edge of a chair.

2. Place your hands on your belly.

3. As you inhale, lean forward and expand your belly.

4. As you exhale, squeeze the breath out and curl forward while leaning backward; exhale until you’re completely empty of breath.

5. Repeat 20 times.

Energizing HA Breath

When the midafternoon slump hits, stand up and do some quick breathwork to wake up your mind and body.

Photo

CreditAndrew Rae

1. Stand up tall, elbows bent, palms facing up.

2. As you inhale, draw your elbows back behind you, palms continuing to face up.

3. Then exhale quickly and thrust your palms forward and turning them downward, while saying “Ha” out loud.

4. Repeat quickly 10 to 15 times.

Better Communication

 

Better Communication

Dr Jonathan Haverkampf

 

Life is communication. Once cells in an organism stop communicating with other cells, the organism dies. Once partners stop communicating in a relationship, the relationship dies. Once countries stop communicating with each other, the world is economically a poorer place. Trade is communication, science is communication, art is communication. Life as a whole is the transfer of meaningful messages between cells, people and populations. Meaningfulness is the potential to bring about at least a tiny change in someone else. Emotions are as much a meaningful message as is a word in a personal email. (Spam messages are only meaningful if they make you angry.)

Communication enables us to better deal with whatever life throws at us, because it allows us to see more of the world around us. It provides us with more information to base our decisions on, but it also changes what we see of the world around us by changing the information we have about the world. Internal communication means observing and thinking about our own thoughts and emotions, and the more we do it, the more we see of the world inside us, ourselves.

Success in many endeavours depends on how we communicate what we need and what we want. Often, this is not easy because as children or adults we might have ‘learned’ not to say what we need and what we want. However, it is important that we need to verify for ourselves that this is true. If one feels that one does not deserve someone or something, it is important to ask where this voice comes from. Often we find the cause in past interactions with a parent, an ex-partner or other people in life who had issues with themselves, and projected these issues into us, not necessarily out of bad intentions but because they could not deal with their issues themselves. By this process, exploring our own inner world can lead to a sense of more self-confidence.

To improve self-confidence and self-esteem it is important to communicate one’s needs, desires and aspirations in a way that fit one’s personality. Communication at its core is a transparent process. Make belief communication cannot work in the long-run because you send billions of mostly unconscious messages in an instant, and it is impossible to control them all. A 200 millisecond twitch in the lateral edge of your left eye brow might give away information to an observer who, as unlikely as this may be, focuses on your left eyebrow. Even if you do not send any information at all, you still communicate something. Communication can be used strategically in love, business and politics, but people usually underestimate how much they are communicating and that the best strategy is not controlling one’s communication but finding out more about oneself, and become a far better communicator through this process.

If you watch a couple in a bar who just freshly met, you will notice how she might play with a strand of her hair, rock her foot or the short and stealthy glances he throws at her. They establish communication on so many more levels, and they do it automatically! So, what decides whether a kiss is in the cards for later in the evening? Primarily, it is that it has to feel right to each of them, and this is the result of what goes in on the inside, their respective values, preferences and aspirations. And the more they communicate with each other in meaningful ways, the easier it is for each of them to feel ‘right’ about the other.

Communicating better means not just being in touch with the world but also with oneself. The best preparation to go into a negotiation is to know what your values and preferences are, what is important to you and what your aspirations are for the future. Knowing these parameters makes it easier to communicate clearly, to be able to say ‘Yes’ and ‘No’ in just the right moments. You might not know consciously everything about your values and preferences, but your brain processes most of its information outside of your consciousness anyway. This is why we have a ‘gut feeling’ which often seems to be better informed than our consciously thinking parts. Better communication leads to higher quality information, which leads to a more informed gut instinct.

Selling someone on something you do not believe in does not work in the long-run. Communication is largely an automatic process, and to become better at communicating primarily means figuring out what you believe in, what your values are, and what you need and want. I have worked with many people with social anxieties and debilitating fears to give presentations, conduct meetings or speak to other parents at a local school meeting. The anxiety often resolves once people know what is important to them. This might not change one’s life from one day to the next but it gradually takes one to a place of less anxiety, a mutually more effective communication style and helps oneself and one’s environment in the process.

 

 

© 2012, 2016 Dr Christian Jonathan Haverkampf. All rights reserved.

jonathanhaverkampf@gmail.com

Psychotherapy & Counselling, Medicine (Psychiatry), Communication; Dublin, Ireland

For psychotherapy, counselling and communication visit www.jonathanhaverkampf.com, www.jonathan-haverkampf.com, www.wordnets.com and www.jonathanhaverkampf.ie.

This article is solely a basis for academic discussion and no medical advice can be given in this article, nor should anything herein be construed as advice. Always consult a professional if you believe you might suffer from a physical or mental health condition.

 

 

Infants Exposed to Antidepressants May Experience Effects for Up to a Month After Delivery

The following has been published in Psychiatric New Alerts on 2 November, 2015.

Infants Exposed to Antidepressants May Experience Effects for Up to a Month After Delivery

Pregnant women with major depressive disorder face a challenging decision when considering treatment over the course of their pregnancy. While there is evidence to suggest infants born to mothers whose depression goes untreated can experience behavioral problems, studies have also found that infants exposed to selective serotonin reuptake inhibitors (SSRIs) may experience adverse behavioral symptoms that typically resolve within the first two weeks following birth.

A study published in AJP in Advance now suggests some infants exposed to SSRIs and benzodiazepines may continue to experience the effects of the medications throughout their first month of life.

Researchers at Brown University assessed 184 pregnant women at two points during their pregnancy and classified them into four groups: no exposure, depression only (no medication taken), SSRI exposure, and SSRI plus benzodiazepine exposure. The infants born to these women were then examined with a structured neurobehavioral assessment (Neonatal Intensive Care Unit Network Neurobehavioral Scale) in the first week after delivery, with follow-up assessments on days 14 and 30.

Infants in the SSRI and SSRI plus benzodiazepine groups had lower movement quality and more CNS stress signs across the first postnatal month compared with infants in the no exposure or depression groups; there were no differences seen whether or not the mother discontinued SSRI use in the third trimester. In addition, infants in both SSRI groups showed lower self-regulation and higher arousal at day 14 compared with the other two groups. Infants in the SSRI plus benzodiazepine group had the least favorable scores on the Neonatal Intensive Care Unit Network Neurobehavioral Scale.

“In agreement with the current practice guidelines of the American Psychiatric Association and the American College of Obstetricians and Gynecologists, these findings do not support discontinuing SSRI medication in the third trimester of pregnancy for those women who have been successfully managing their depressive symptoms with SSRIs throughout pregnancy,” the study authors wrote. “Furthermore, our data suggest that concomitant use of benzodiazepines in conjunction with SSRIs is associated with more significant problems in infant neurological functioning than SSRI use alone. This may be a result of the underlying disorder and symptom severity or the neonate’s inefficiency in metabolizing multiple drugs.”

For related information, see the Psychiatric News article “Study Reports on Risks, Benefits of SSRIs Taken During Pregnancy.”

Neurocognitive Tests May Enhance Ability to Predict Those Most Likely to Convert to Psychosis

The following was published in Psychiatric News Alerts on Friday, November 4, 2016

Neurocognitive Tests May Enhance Ability to Predict Those Most Likely to Convert to Psychosis

Neurocognitive dysfunction is a well-known feature of schizophrenia, but questions remain as to the extent changes in cognitive function might predict transition to psychosis. A study published this week in JAMA Psychiatry found that people in the clinical high-risk (CHR) period of psychosis show significant impairments across neurocognitive dimensions compared with healthy controls. Those who converted to psychosis were significantly impaired in attention/working memory and declarative memory abilities compared with those who did not, Larry Seidman, Ph.D., of Harvard Medical School and colleagues reported.

“To our knowledge, this is the largest study of neuropsychological functioning in prodromal, clinical high-risk individuals to date,” Abraham Reichenberg, Ph.D., and Josephine Mollon, M.Sc., of Icahn School of Medicine at Mount Sinai wrote in a related editorial. “The results provide a new reference point for clinicians and researchers by elucidating the profile of neurocognitive deficits associated with the prodrome as well as their potential as risk markers for conversion to clinical psychosis.” 

Seidman and colleagues compared the baseline cognitive performance of 689 CHR individuals (including 89 who later converted to psychosis) with 264 healthy controls, collected as part of the second phase of the North American Prodrome Longitudinal Study (NAPLS 2). 

They found that the CHR group performed significantly worse than healthy controls on 19 psychological tests combined and on 14 of the 19 individual neuropsychological tests. Additional analysis revealed that people in the CHR group who transitioned to psychosis performed significantly worse on attention/working memory and declarative memory tests than those who did not transition to psychosis. Time to conversion in those who transitioned to psychosis was significantly predicted by high premorbid verbal abilities and impaired declarative memory abilities, the authors reported.

“This pattern of high verbal premorbid ability and impaired memory, coupled with the unusual thought content or delusional ideas and suspiciousness or persecutory ideas, appears to be a pernicious combination predicting conversion and needs replication,” they wrote. “Neurocognitive tests used in concert with other clinical and psychobiological measures may enhance prediction of psychosis or functional outcome.”

For related information, see the Psychiatric News article “CBT for Ultra-High-Risk Patients Lowers Incidence of Psychosis” and AJP articles “An Individualized Risk Calculator for Research in Prodromal Psychosis” and “Personalized Prediction of Psychosis: External Validation of the NAPLS-2 Psychosis Risk Calculator With the EDIPPP Project.”

Study Suggests Few Gamers Meet Proposed Criteria for Internet Gaming Disorder

The following is a news item from the American Psychiatric Association.

Study Suggests Few Gamers Meet Proposed Criteria for Internet Gaming Disorder

DSM-5 lists Internet gaming disorder as a potential psychiatric disorder, but notes the prevalence of the disorder is unclear and little is known of its impact on physical, social, and mental health.

A study published Friday in AJP in Advance suggests that while Internet-based games among adults are popular, only a small proportion of gamers appear to meet the proposed criteria for Internet gaming disorder listed in DSM-5. While those who met the proposed criteria for Internet gaming disorder played video games more regularly than those who did not meet the criteria for the disorder, there were no differences between the groups in physical, social, and mental health outcomes, Andrew K. Przybylski, Ph.D., of the University of Oxford and colleagues reported.These conclusions were drawn from an analysis of survey data responses from four cohorts totaling nearly 19,000 adults in the United States, United Kingdom, Canada, and Germany; two of the cohorts were exclusively young adults (aged 18 to 24) while the other two included adults of all ages. The surveys were designed to answer several questions, including what is the acute prevalence rate of the Internet gaming disorder and how does this prevalence compare with that for gambling disorder?

The researchers found that between 0.3% to 1.0% of the population might qualify for an acute diagnosis of Internet gaming disorder, though about two-thirds of active gamers do not report any diagnostic symptoms. The estimated prevalence of acute gambling disorder in the same cohort was between 1.0% to 2.6%. “This provides tentative evidence that despite being a new and popular activity, Internet-based games might be less dysregulating than gambling,” the authors wrote.The authors continued, “If one extrapolates from our data, upwards of 160 million American adults play Internet-based games, and as many as one million of these individuals might meet the proposed DSM-5 criteria for addiction to online games. This represents a large cohort of people struggling with what could be clinically dysregulated behavior. However, because we did not find evidence supporting a clear link to clinical outcomes, more evidence for clinical and behavioral effects is needed before concluding that this is a legitimate candidate for inclusion in future revisions of the DSM.”

For related information, see “Can Medications Help People With Gambling Disorder?” by Grace Hennessy, M.D., the director of the Substance Abuse Recovery Program at the Department of Veterans Affairs at New York Harbor Heath Care System.