‘Cutting’ is one of the most common methods of self-injury. As the name implies, it involves cutting one’s body-usually in places that can’t readily be seen or are easily covered up- with sharp items such as razor blades, knives and scissors. Self-injury goes by many names including self-mutilation, self-harm, and parasuicide. It is notmeant as a suicide attempt although this does accidentally happen on occasion. Rather, self-injurious behavior is an unhealthy approach to dealing with the pain of strong emotions, intense pressure, or anger and frustration. The mental health profession has only recently discovered that cutting is not a ‘cry for help’ and is not a suicide attempt. In fact, most cutters are not suicidal and do not want to be found out. That is why they wear long sleeves (so no one will see their wrists) or cut on their upper inner thigh where nobody will look.

Cutting, and other self-injurious behavior like burning oneself with matches, can be dangerous but also can become addictive. It is a self-perpetuating cycle that is hard to break: a teenager feels emotional pain so cuts his or herself, feels release from the tension, followed by negative feelings of guilt or shame, which in turn causes emotional pain and the cycle continues. With each additional episode, the chances are greater of inflicting serious injury, infection, permanent disfigurement or even death (example: from blood loss if the cutter accidentally cuts a major vessel or artery).

Self-injury is frequently an impulsive act. The person becomes upset and has a sudden, strong urge to hurt herself. Some professionals prefer to view it as an impulse-control behavior problem and tackle treatment accordingly. Many of the individuals who self-injure do it only a few times and stop. For others, it can become a cycle that leads to compulsive, repetitive behavior as noted in the above paragraph.

Prevalence

Cutting appears to be more prevalent now than it was in the 1990’s. Research at that time suggested rates of 3% or lower. Recent studies, however, have current rates of 20% to 56% depending on the study. Researchers at Yale University indicated that 56% of girls they interviewed, 10 to 14 years of age, reported injuring themselves-with 36% reporting they had done so in the past year. Most studies put the figure at approximately 1 in 5 for females (no recent figures were available for males). This self-destructive behavior was previously thought to be more common in females than males, but recent studies refute that and report the behavior affecting both sexes equally.

Adolescents are more prone to cutting themselves although self-injury occurs at all ages. People with the following disorders have a higher risk factor for self-mutilation: depression, eating disorders, substance abuse, anxiety disorders, post-traumatic stress disorder and borderline personality disorder.

Symptoms

Cutting and other methods of self-injury are often kept secret, so it can be hard to spot these signs or symptoms:

• Scars from burns or cuts
• Fresh cuts, scratches, bruises or other wounds
• Broken bones
• Keeping sharp objects on hand
• Spending a great deal of time alone
• Relationship troubles
• Wearing long sleeves or pants, even in hot weather
• Claiming to have frequent accidents or mishaps

Other forms of self injury

Cutting is the most common form of self-injury, but people who self injure may use more than one method. Other common methods include:

• Severe scratching
• Burning
• Self-poisoning or overdosing
• Branding; carving words or symbols on the skin
• Breaking bones (using a hammer or similar object)
• Hitting or punching
• Piercing or stabbing the skin with sharp objects
• Head banging
• Self-biting
• Pulling out hair
• Interfering with wound healing (re-cutting or picking at scabs)

What causes them to do it?

Self-injury is an unhealthy coping mechanism in response to strong painful emotions, intense pressure or upsetting relationship problems. There are countless reasons behind this self-destructive behavior. They may not have developed healthier ways to cope or their coping skills are overpowered by emotions that are too intense. If emotions aren’t expressed in a healthy way, they tend to build up creating extreme tension. Cutting may relieve that tension, even if it is temporary. For others, cutting seems like a way of feeling in control in situations that are otherwise uncontrollable.

Cutting can be triggered by strong feelings that the person is unable to cope with like anger, hurt, shame, frustration or alienation. A cutter may engage in self-injury to find relief from the pain of a relationship break-up or to alleviate feelings of rejection.

Sometimes cutting is a symptom of other mental health disorders that contribute to their emotional tension. Cutting is sometimes (not always) associated with depression, bipolar disorder, eating disorders, obsessive thinking, compulsive behaviors or difficulty with impulse control. It is not uncommon to find cutters that have significant problems with drug or alcohol abuse.

Yet others use cutting to cope with the emotions that were caused by a traumatic experience such as abuse, violence, or disaster. For them, cutting feels like a way to wake-up from a sense of numbness after the experience. It can also be a means to express anger toward the experience or try to get control of it. The mix of emotions that trigger self-injury is complex and often multi-faceted. In general, cutting is the result of an inability to use healthy coping skills to deal with psychological pain.

Treatment

Intervention can be accomplished through therapy, medication, or a combination of the two. However, identifying and treating people who cut is difficult due to their tendency to hide the signs of self-mutilation. Self-injury also appears to be addictive, which further complicates treatment. The positive feeling that is generated by cutting may be due to the release of endorphins (‘endogenous opiates’) which mimic a “high” and are pain killers as well.

Psychotherapy can help recognize and manage underlying issues that may elicit self-injury. It can also teach the individual coping skills to better tolerate stress, regulate their emotions, increase self esteem and better handle relationship problems. Cognitive behavioral therapy, dialectical behavior therapy and psychodynamic psychotherapy have been particularly helpful in addressing the issues of self-injury.

A physician may recommend medication to help improve depression, decrease anxiety or help with other mental disorders commonly associated with self-injury. There are no medications for specifically treating cutting or self-injury.

Cutting is serious. The condition needs to be treated by medical or mental health professionals as its addictive and cyclical nature makes it almost impossible for a cutter to stop without help.

Resources

http://www.mayoclinic.com/health/self-injury/DS00775

http://www.psychologytoday.com/blog/sax-sex/201003/why-are-so-many-girls-cutting-themselves

http://suite101.com/article/why_do_people_cut_themselves-a151977

http://kidshealth.org/teen/your_mind/mental_health/cutting.html

A new study out by Israeli researchers indicates that at least some kinds of simple learning (via classical conditioning) can take place during non-REM sleep.

History

‘Sleep-learning’ allegedly conveys new information to an individual by playing a sound recording to them while they are asleep. This technique was supposed to be effective for teaching people to remember direct passages or facts, word for word.  Over 50 years ago, researchers (Simon, Emmons, 1956) concluded that sleep learning was “impractical and probably impossible”. They reported that material that had been presented during sleep was not recalled when the subject woke up unless alpha wave activity occurred at the same time as the material was presented. Alpha activity indicates that the subject is about to wake up, so the researchers suggested that any learning that took place occurred in a waking state.

Other research studies since then also consistently debunked the myth of learning while you sleep; sleeping is not a prime time to learn new material. However, it has been demonstrated that sleeping helps your brain consolidate and reorganize memories of what you learned that day while you were awake. Restful sleep has been shown to restore body and mind, clearly benefitting memory and creative problem solving with improved cognitive functioning upon waking- with the information that was learned while awake. The research showed that non-REM sleep could improve the memory of previously learned material and that REM sleep improved creative problem solving on mazes the subjects had been exposed to the day before.

On the other hand, a new study from the Weizmann Institute of Science has just been published that demonstrates that classical conditioning can occur during sleep. The study showed that people can learn during sleep, and that the learned information could unconsciously modify their behavior when they awoke.

The new study

Professor Noam Sobel, research student Anat Arzi, team members from the Weizmann Institute’s Neurobiology Department, along with experts from Loewenstein Hospital and the Academic College of Tel Aviv-Jaffa recently published a study in Nature Neuroscience that reported the results of an experiment they conducted. Their experiment investigated the effect of classical conditioning on a sleeping person; they chose classical conditioning as they could do it without waking the subjects. Classical conditioning is a form of simple learning which was made famous by Pavlov and his dog. They chose to utilize a tone followed by an odor, pairing them until the subjects responded similarly to just the tone without the odor. The researchers found that pairing tones and odors was advantageous as neither wakes the subject yet both are processed by the brain and even reacted to during sleep.

Sobel et al knew that the brain reacts the same to odors whether it is asleep or awake. That is, we inhale deeply when we smell something pleasant and shorten our inhalation when presented with an unpleasant smell. Furthermore, this ‘sniffing’ could be measured while asleep or awake. Although this type of conditioning appears uncomplicated, it is actually complex and associated with brain areas known for higher learning such as the hippocampus (involved in memory formation).

The researchers sprayed the participants with pleasant and unpleasant smells while they slept. As expected, the sleeping volunteers took longer breaths when there was a pleasant smell and shorter breaths when there was an unpleasant smell. Then they paired a tone with each smell (for example, a high pitched beep with the pleasant smell). Following this, they played the high pitched beep without the smell and found that the volunteers took long breaths, perhaps subconsciously expecting the pleasant smell. They did the same thing with the unpleasant smell (rotting fish) using a different tone. After repeated pairings, the tone alone caused the volunteers to take a shorter breath.

The lesson learned through conditioning while they were asleep stayed with the participants after they woke up. Upon waking, the participants had no conscious memory of having learned anything while asleep yet when the researchers played the different tones (with no accompanying odors) they responded the same way as they had while asleep- longer breaths or sniffs to the high pitched beep and shorter breaths to the other tone.

REM versus non-REM sleep

The research team conducted a second experiment to find out if this conditioning could happen only in a particular phase of sleep. They divided the sleep cycles into REM (rapid eye movement) and non-REM sleep and then initiated the pairings during just one phase or the other. They found that the learned sniffing response was considerably more pronounced during the REM phase but this did not carry over after waking. On the other hand, when the conditioning took place during non-REM, the volunteers did transfer the learned associations upon waking.  Sobel et al theorized that we may be more receptive to environmental stimuli during REM sleep but that “dream amnesia” (what makes us forget our dreams) exerts its influence on any learning or conditioning during that sleep phase. Non-REM sleep is known to be significant for memory consolidation and this may well be playing a part in this type of sleep-learning.

Anat Arzi reported that she intends to continue investigating how the brain processes information in altered states of consciousness such as sleep and coma. She stated, “Now that we know some kind of sleep learning is possible, we want to find where the limits lie- what information can be learned during sleep and what information cannot.”

Resources

http://www.healthharvard.edu/press_releases/can-you-learn-while-you-sleep

http://http://en.wikipedia.org/wiki/Sleep-learning

http://www.medicalnewstoday.com/article/2495050php

http://npr.org/blogs/health/2012/08/28160137395/can-you-learn-while-you-re-asleep

http://israel21c.org/social-action-2/scientists-find-you-can-learn-while-youre-asleep

Herpes virus

HSV-1 is a chronic infection that resides within the body for a lifetime, occasionally flaring up when the body is stressed, fatigued, exposed to certain foods or sunlight. After the original infection, the virus remains dormant in the peripheral nervous system. When the virus is activated, it damages cells and causes cold sores. Experts report up to 85% of the population has been infected (the older you are, the more likely you have been exposed to it) although only about 15% show symptoms.

The link

Research scientists have suggested for years that viruses could cause inflammation in the brain and inflammation in the brain has been associated with dementia. The researchers in the University of Rochester study found that the herpes virus remains dormant along with other versions of ApoE; but people who had the ApoE-4 gene variant were the ones that were most likely to suffer active infections along with the hallmark cold sores. As we age, the herpes virus (HSV-1) spreads to our brains where it can cause the buildup of protein deposits known as beta amyloid plaques and neurofibrillary tangles. These deposits damage the cells responsible for memory, language, and physical functions leading some people to develop Alzheimer’s disease. Another study investigated the presence of the herpes virus in people’s brains and found that it resided in 90% of the amyloid plaques. Furthermore, research has shown a significant correlation between the amount of beta amyloid in the brain and the degree of cognitive impairment in Alzheimer’s patients. Over the past several decades our understanding of beta amyloid’s role as a causative factor for dementia has become clearer.

Ruth Itzhaki of the University of Manchester conducted several studies demonstrating a correlation between herpes and Alzheimer’s. She found that people with Alzheimer’s who also had the ApoE-4 gene also had more herpes DNA in the brain regions that are affected by dementia. Moreover, people with the ApoE-4 gene who had herpes (HSV-1) were more likely to get Alzheimer’s disease than those who lacked both the gene variant and the virus. Other studies have demonstrated that people who frequently break out in cold sores are more likely to have the ApoE-4 gene variant that makes them more vulnerable to Alzheimer’s. According to Howard Federoff, M.D., Ph.D. at Georgetown University, “The link between herpes and Alzheimer’s has been there for a while, but more people are starting to pay attention, it’s no longer just a curiosity.”

Researchers and experts conclude that it is no longer a question of whether HSV-1 is involved in dementia, but rather how significant the involvement is. They suggested that the next step is to investigate whether anti-viral drugs used for treating acute herpes can be utilized for preventing or slowing down cognitive decline in patients with Alzheimer’s. Researchers also recommended that people treat a cold sore as quickly as possible in order to minimize the time the herpes virus is active in their nervous system. The quicker you treat a cold sore, the faster the herpes virus returns to its dormant stage.

Resources

http://www.medicalnewstoday.com/releases/221222.php

http://www.livescience.com/9494-herpes-alzheimer.html

http://www.huffingtonpost.com/dr-david-perlmutter-md/alzheimer-herpes-could-be-a-cause_b_814047.html

http://www.clinicaladvisor.com/herpes-simplex-virus-linked-to-dementia/article/117028

Previous studies

Prior to this study, there was a 2002 study published in the Canadian Medical Association Journal that concluded that occasional or light cannabis use did not have a long term negative effect on global intelligence. They also noted that current use had a negative impact on global intelligence only when the subject smoked 5 or more joints per week. They examined the subjects at ages 9 to 12 years (before they used marijuana) and again at ages 17 to 20. It found that subjects who had never used, current light users and former users showed modest IQ gains ranging from 2.6 to 5.8 points. In contrast, the only group to show an actual decrease in IQ points (4.1 points) was the group of subjects who were considered heavy users. In 2008, there was a small study (sample size of only 31 subjects) that indicated long-term, heavy marijuana use (over 5 joints daily for more than 10 years) was associated with structural abnormalities in the hippocampus and amygdala areas of the brain. Both of these areas tended to be smaller in the heavy, long term cannabis users. The hippocampus regulates emotions and memory while the amygdala is involved with fear and aggression, although both of these areas of the brain are closely related to learning and memory processes. The study concluded that “heavy daily cannabis use across protracted periods exerts harmful effects on brain tissue and mental health”.

What did the new study find?

In the new study, those who began smoking marijuana before the age of 18 and ‘habitually smoked’ (at least 4 days per week) as an adult showed an average drop of 8 points in IQ between when they were first tested at around 13 and when they were re-tested at age 38. Although 8 points may not seem like much, that means a person who was at the 50^th percentile would fall to the 29^th percentile which is a considerable decline. Furthermore, the heavier the use, the more cognitive decline was observed. People who started using cannabis as a teenager but used it less persistently also showed a decline in IQ points but it was less pronounced. Those subjects who never engaged in marijuana use, on average, gained a point. Madeleine Meier, the lead researcher, reported that persistent use of marijuana in adolescence appeared to blunt intelligence, attention and memory. She wrote, “Collectively, these findings are consistent with speculation that cannabis use in adolescence, when the brain is undergoing critical development, may have neurotoxic effects.”  The age of onset of smoking marijuana appears to be the significant variable. Users who began in adolescence and persisted into adulthood demonstrated IQ point declines, and quitting cannabis did not appear to reverse the loss. Interestingly, those who started after the age of 18 did not show declines in memory, attention or IQ.

The study found that habitual pot smokers showed deficits in memory, concentration and general cognitive functioning in relation to their peers. These problems were even more pronounced when the habit was initiated during the teen years. Individuals who smoked heavily in adolescence had consistently lower IQ’s at age 38, even if they had quit or cut back in the previous year. By contrast, the IQ of those who began cannabis use after age 18 was linked to how much pot they had smoked recently.

Why are adolescent brains more vulnerable?

There are different theories as to why the adolescent brain is more susceptible to the effects of marijuana. The brain is still developing in adolescence; neurons are growing and changing, and synapses are forming. Some theorize that the adolescent brain, because it is still growing and changing, is more vulnerable to environmental influences and that cannabis acts as a neurotoxic assault. As previously mentioned, some believe that structural abnormalities are more likely to develop since the adolescent brain is still in a state of change. Yet another theory involves cannabis and the formation of myelin; myelin acts as insulation for the brain’s nerve cells. It is not fully developed until around age 25. Therefore, since the myelination of the brain is not complete it leaves the brain more susceptible to damage from neurotoxins.

Of concern is the permanency of the cannabis effects among those in the study who began smoking marijuana as adolescents. Even after the research participants stopped using marijuana for a year, its adverse effects persisted and some neurological deficits remained. Teenagers who engage in frequent or heavy marijuana use may be setting themselves up for declines in cognitive function that persist into adulthood.

Resources

http://www.bbc.co.uk/news/health-19372456

http://cnn.com/2012/08/27/health/health-teen-pot/index.html

http://en.wikipedia.org/wiki/Long-term_effects_of_cannabis

http://abcnews.go/blogs/health/2012/08/27/teenage-marijuana-use-may-hurt-future-iq/

History

At the 1996 Paralympic Games in Atlanta, athletes with intellectual disabilities were allowed to compete for the first time after the International Paralympic Committee (IPC) added ‘intellectual impairment’ to its disability categories. However, an audacious cheating scandal at the 2000 Games in Sydney eliminated that category for 12 years. The Spanish basketball team had won gold in the intellectually disabled category until an undercover journalist revealed that 10 out of its 12 members were only pretending to have a mental disability. They went as far as growing beards and wearing bobble hats off court to conceal their identities and mask the deception. Since then, the IPC and the INAS (International Federation for Sport for Para-athletes with an Intellectual Disability) have worked on tightening up the eligibility process so that this could not happen again.

The assessments for inclusion in the 1996 and 2000 Games were simply a review of the medical information (which included a statement from a psychologist, special school and medical doctor all confirming the intellectual handicap). By 2009, a rigorous and reliable process was approved and the category was reinstated in time for the 2012 Paralympics in London. The category of ‘intellectual impairment’ was only granted for 3 sports:

• Athletics= long jump, shot put, 1500m (sport class T/F20)
• Swimming=200m freestyle, 100m breaststroke, 100mbackstroke (sport class 14)
• Table tennis (sport class 11)

It was made clear that all competitors in these sport classes would have to fulfill the WHO (World Health Organization) definition of intellectual disability in order to compete.

Definition

The WHO definition states that the individual must have an IQ below 75 and have an impairment in adaptive functioning (such as in social, domestic or communication skills). Most countries have a standardized test to measure adaptive functioning and it was found that people with an intellectual disability generally fall in the lowest 2% of the population.

The official definition as per the Paralympic Movement organization for the classification of ‘intellectual impairment’ is as follows:

“A disability characterized by significant limitation both in intellectual functioning and in adaptive behavior as expressed in conceptual, social and practical adaptive skills. This disability originates before the age of 18” (American Association on Intellectual and Developmental Disability, 2010). The diagnostics of intellectual functioning and adaptive behavior must be made using internationally recognized and professionally administered measures as recognized by INAS (International Federation for Sport for Para-athletes with an Intellectual Disability).

What is the new process?

The new process requires that a competitor submit “primary evidence” which includes a psychologist’s assessment with specific IQ tests, verification that their impairment affects their day to day performance (adaptive functioning) and that the impairment occurred prior to age 18. The primary evidence is then submitted to a committee of 2 to 3 independent psychology experts assembled by INAS. But that is just the beginning!

Once the individual has been approved as meeting those specific criteria, he or she must then undergo a sports-specific assessment. At that point they need to prove that the impairment has an impact on the performance of that particular sport. First, they are tested on overall “sports intelligence” which includes reaction time, memory, concentration and spatial perception. Potential competitors must score below the level of an able-bodied athlete to continue. Next they are tested on specific skills for their sport; for example, in table tennis they would need to return a serve from a ‘table tennis robot’ to a specific spot. They get several chances to hit the target with the ball. An able-bodied athlete will increase their accuracy on the 2^nd ball whereas an intellectually impaired athlete will not have learned from their first attempt.

When the tests are completed, the athletes who performed poorly in comparison to able-bodied athletes are allowed to participate in the Paralympics. Some might question as to why you would select someone who is not particularly good at a sport but that is the same standard that is used for people with physical impairments. If you perform as well as an able-bodied person in a sport, then your impairment is not limiting your ability to compete on an equal basis.

The new testing system is described as “extremely robust” and the athletes are tested repeatedly.  Sports researchers are now looking to future Paralympics and designing more tests that will allow the intellectually disabled to compete in a broader range of sports, including the now infamous game of basketball. Another cheating incident is unlikely with the new safety checks in place.

Resources

http://olympicstime.com/2012/08/29/how-the-paralympics-is-welcoming-back-intellectually-impaired-athletes-12-years-after-cheating-scandal/

http://www.bbc.co.uk/news/magazine-19371031

http://www.paralympic.org/Classification/Introduction

What is the MMSE?

The most commonly used brief measure of cognitive functioning is the Mini Mental State Exam or MMSE. It is a short questionnaire with 11 questions that is used to screen for cognitive impairment, especially in the elderly. It is most commonly used to screen for Alzheimer’s and dementia but has also been used for depression. It is a key component in a comprehensive evaluation for dementia. The MMSE takes only about 10 minutes to administer and 5 minutes to score, so it is a very quick yet reliable method to assess the status of an individual’s cognitive functioning. It tests five areas of cognitive function: orientation, attention, memory, language and visual-spatial skills. For example, to evaluate a person’s orientation to time they are asked to state the year, season, date, day and the month with each response earning one point each. This test is not a mental status examination. It is a screening test and is not meant to take the place of a comprehensive diagnostic workup. The MMSE has been used with adults from 18 to 100 years of age.

The MMSE has been validated and extensively used in both clinical practice and research since it was first introduced by Folstein et al in 1975. It provides a global score which correlates with daily function; the maximum score is 30 and generally a score of 24 or lower indicates cognitive impairment. The MMSE is used in medical practice to screen for dementia-to estimate the degree of impairment at a specific time, but it also is used as a means to follow and document a person’s response to treatment over time. Research has shown that the MMSE is an effective screening tool for cognitive impairment with older adults whether they are dwelling in the community, a hospital, or are institutionalized. Cognitive functioning in the elderly is best assessed when it is done routinely and systematically, thereby catching cognitive decline as it happens and changing treatment response as needed.

Scoring The MMSE

Scores on the MMSE range from 0 to 30 with any score 25 or higher considered to be intact (normal) cognitive functioning. Scores of 21 to 24 indicate mild cognitive impairment; 10 to 20 points are in the moderately impaired range and scores of 9 or lower indicate severe cognitive impairment. The raw score may also need to be adjusted for education and age; for example, a college educated person needs to score 26 points or lower for cognitive impairment but someone with a 7^th grade education would not be considered impaired unless they scored 22 or lower. Low to very low scores closely correlate with the presence of dementia. However, other mental or emotional disorders (such as depression) can also lead to low scores and need to be differentiated. Physical problems may interfere with the scoring unless these are accounted for (example: someone who is unable to hear or read the instructions correctly, or someone that has a motor deficit that affects their writing and drawing skills.).

Advantages and Disadvantages

As already mentioned, there are numerous advantages to utilizing the MMSE as a screening tool for dementia. It has proven reliability and validity, and it is quick to administer and score. It can be used repeatedly to monitor an individual’s cognitive decline. Furthermore, it has been translated into many foreign languages and has been adapted for the visually-impaired.

Although they are minor, there are some disadvantages to using the MMSE. One such disadvantage is the necessary score adjustments for age, education and ethnicity. Despite the many free versions on the internet, there could be copyright issues as this test has been copyrighted since 2000; prior to that time the test had been distributed for free. Lastly, the test is heavily reliant on verbal responses, reading and writing. This could give false low scores to individuals who have a hearing impairment, visual impairment (unless the adapted version is used), intubated patients, low English literacy or others with communication disorders.

Is there an updated version?

Yes, the 2^nd edition to the MMSE (MMSE-2) has been available since February 2010. The new edition includes the standard version plus it has both a brief form and an expanded form. The expanded form is more useful for populations with milder forms of cognitive impairment. The brief form takes only 5 minutes to administer. The MMSE-2 is currently available in 10 foreign language translations including German, Dutch, French, Spanish (3 versions), Chinese, Russian, Italian and Hindi.

Resources

http://www.getnhp.com/PDFs/ProviderPDF/Provider-Manual/Appendix/Tab13MiniMental State.pdf

http://alzheimers.about.com/od/testsandprocedures/a/The-Mini-mental-State-Exam-And-Its-Use-As-An-Alzheimers-Screening-Tool.htm?p=1

http://cfp.ca/content/47/10/2018.full.pdf

http://en.wikipedia.org/wiki/Mini-mental_state_examination

The term ‘pathological liar’ seems to be controversial in the literature, with some authors describing a pathological liar as a habitual or compulsive liar while others make a strong case for differentiating compulsive lying from pathological lying. The Merriam-Webster dictionary defines it as, “an individual who habitually tells lies so exaggerated or bizarre that they are suggestive of a mental disorder”. Indeed, some people do view it as a mental illness as it may take over rational judgment and sometimes advances into a fantasy world. However, DSM IV (The Diagnostic and Statistical Manual, 4^th edition), the mental health professionals’ “bible” does not have a specific definition for pathological lying nor considers it a mental disorder. They list it as a symptom, or criterion, for other psychiatric disorders. For example, pathological lying can be symptomatic of Antisocial Personality Disorder (APD, previously and more commonly known as ‘sociopath’) or of Narcissistic Personality Disorder (NPD).

Excessive lying is a common symptom of several mental illnesses. An individual with APD will use pathological lying in order to get his own way or benefit from others. There are people with Borderline Personality Disorder who lie in order to gain attention (such as claiming they have been treated poorly). Pathological lying may include these but can also be manifested more as an addiction to lying.

Pathological liars consistently lie about both big and small things, sometimes without any personal gain or reason. The lies are usually obvious and seem pointless to others. They may lie about the most mundane subjects (what they had for dinner, what they wore yesterday) or engage in a complex, detailed and long story. The stories they may tell are not entirely improbable and often have some grain of truth. The individual is not delusional and, if confronted, compulsive liars can admit them to be untrue, albeit somewhat unwillingly. Frequently the lies present the individual in a favorable light; the person comes off as incredibly brave, the best at whatever he or she is talking about or knowing (or being related to) many famous people. The stereotype is that pathological liars are men, but the reality is that they are equally distributed between males and females.

Compulsive lying vs. Antisocial Personality Disorder

A compulsive liar is a chronic or habitual liar. They lie out of habit and don’t seem to be able to control this behavior. It is their normal and reflexive way of reacting; it is an automatic way of responding and is hard to break.  For them, telling the truth is awkward and feels uncomfortable. They will lie about everything-large and small-to avoid feeling this discomfort. When they lie, there is often no personal gain and sometimes their lies will even present them in a negative rather than positive light. Their lies and stories tend to be more consistent when retold. Compulsive liars lie out of habit; they usually know they are lying but seem unable to do anything to stop it.

A ‘sociopath’ or person with APD (Antisocial Personality Disorder) engages in excessive lying in order to get their own way. They are manipulative and usually have a goal in mind when they tell lies. They have little or no concern for others and are not concerned with how their lies affect the other person(s). Individuals with APD can often believe their own lies to the point where they can become reality for them. Because they believe their own lies, they have no difficulty lying about their alleged experiences, incidents or illnesses. They have been known to pass lie detector tests. When confronted, they tend to become defensive and will not admit to telling falsehoods. They also engage in a great deal of exaggeration and continually change their stories. People with APD or NPD (Narcissistic Personality Disorder) are more likely to engage in this type of pathological lying, whereas individuals with ADHD (Attention deficit Hyperactivity Disorder), Bipolar Disorder or Borderline Personality Disorder tend to engage more in the compulsive, chronic lying as mentioned above where there is little personal gain.

Why do they lie?

A compulsive liar appears to develop their habit of lying in childhood. They typically have been exposed to an environment that made it necessary to lie; they lied out of fear- whether to avoid punishment, embarrassment or to prevent themselves from disappointing other significant people in their lives. Lying is like an addiction for them and it helps alleviate their feelings of discomfort. Most of the literature is in agreement that the compulsive liar suffers from insecurity and low self esteem. A compulsive liar does not necessarily suffer from another mental disorder.

APD individuals lie because they have a personality disorder which, debatably, they were born with or developed at a very young age. As expressed previously, they lie in order to gain something and to purposely manipulate others. They believe their lies and live in a false sense of reality.

What are the consequences?

As you can imagine, there are many negative consequences to being a pathological liar whether it stems from APD, other mental or personality disorders, or from being the habitual compulsive liar. Almost all pathological liars suffer failed relationships and friendships due to lack of trust. If the lying becomes more severe it can lead to legal problems such as fraud, impersonation or other serious offenses. The use of pharmaceutical medication has not shown any promise. At this point in time, psychotherapy has been the only method to treat pathological lying and it has had limited success.

Resources

http://en.wikipedia.org/wiki/Pseudologia_fantastica

http://livestrong.com/article/18324-pathological-liar/

http://suite101.com/article/what-are-pathological-liars-a132547/

http://buzzle.com/articles/pathological-liar-vs-compulsive-liar.html

http://wiki.answers.com?Q/How_can_you_tell_if_someone_is_a_pathological_liar_

Conflict and stress are components in most relationships. Understanding the reasons behind the conflict can help you mitigate current stress and prevent future altercations. Many people believe that marital and love relationships fall apart because of issues with money or sex. While it is true that many couples have the most arguments about money or sex, it is the factors behind those arguments that cause the relationship to fail. Let’s take money for example. You may think couples argue over money, or the lack of it, until it breaks up their relationship.

However, money is a concept; it is a person’s behavior that causes the conflict. It is a partner’s spending habits, failure to manage finances or excessive frugality that causes the antagonism within the relationship. Those behaviors are rooted in one of the common problems listed below (such as imbalance of power/control issues, selfishness, unrealistic expectations, or etc). The same is true regarding conflicts about sex. It is not sex itself but the reasons behind the actions that cause failed relationships. Most of the arguments come from issues outside of the bedroom that end up being played out in the bedroom. The conflicts that arise due to lack of sex, pornography or extramarital affairs are reflections of the problems listed below (such as resentment due to lack of trust, control issues, poor communication, or unrealistic expectations, etc).

Not all relationships should be considered failures just because they ended or they didn’t last long enough to hit certain yearly marks. Some endings or break ups may serve as a positive change for one of the partners, especially if there is abuse or other significant negative factors in the relationship. Knowing the risks and understanding the common problems that can destroy a relationship, puts you in the driver’s seat on the road toward a healthy, lasting relationship.

1.Trust
Some people would say that a lack of trust is the biggest issue a couple could face. John Gottman, prolific author and scientist, states that when trust dies, relationships fail. If we are unable to trust our partner, then at times when we are unsure of their motives or behaviors we assume the worst, further eroding that trust. Deliberate violations of trust such as lying, cheating or consistently failing to keep promises often result in failed relationships. If one of the partners repeatedly breaks the trust of the other, the problems accumulate and the relationship is doomed. A lack of trust may also be manifested as excessive jealousy. Jealousy is often cited as a frequent cause of failed romantic relationships.

2. Communication
All relationships need communication, whether they are romantic, platonic or work based. You need to be able to tell each other what you are thinking, how you are feeling or what you expect or the other person will inevitably disappoint you. Open communication, no matter how difficult it may be at times, assures that you are aware of each other’s wants and needs. Ineffective communication is a very common cause for break ups and for break downs in relationships. Both partners need to be able to share their thoughts, feelings, opinions, needs, frustrations and joys with each other. Relationship failures occur when the lines of communication break down and couples no longer verbally interact or misunderstand the interactions, leading to hurt feelings, anger and potentially divorce. Usually the failure to communicate effectively is due to both people in the relationship, it is not one sided. Both the listening and the speaking aspects are important.

3.Respect
Respect for your partner is the ‘minimum requirement’ when it comes to making a relationship work. A lack of respect for your partner can lead to a host of problems such as poor communication, infidelity, insecurity and constant negativity.

4.Imbalance of power/control issues
Another common reason for relationship failure is when one person dominates in the relationship, either having more decision-making power and/or if they try to control or manipulate the other. The relationship can become weak or unstable if one person habitually makes all the decisions about activities, money, household matters, holidays and even friends. A healthy relationship has a sense of equality where both people feel like equal partners and both value the freedom of others. Control issues can be seen in behaviors such as frequently checking up on their partner, threatening the partner, name-calling, requiring the partner to check in constantly, or not allowing any deviations from the partner’s schedule. Unwillingness to compromise might also be seen in this problem category. The dominating partner seems to need to be right all the time or is certain their opinion is always the correct one. They may need help in adapting to another point of view.

5. Negativity
Successful relationships require tolerance of each other’s faults or weaknesses. Everybody has faults; if we continually harp on the partner’s weaknesses we create permanent friction. Unfortunately, it seems to be human nature to be drawn to another’s faults, but it is detrimental to relationships to do this. Constant criticism will cause long term problems.

6.Unrealistic expectations
Relationships take time and effort to succeed. “And they lived happily ever after” is a myth; there is no perfect Prince Charming or perfect princess. Couples need to have realistic expectations of each other as well as toward their relationship. There will be unhappy times; there will be conflict and stress. Mistaken gender stereotypes create false expectations and are harmful to relationships.

7.Overdependence
Being “too needy” is a definite relationship killer; requiring attention or assistance 24-7 is a sign of insecurity not love. A healthy relationship gives both partners room to breathe or the relationship will feel claustrophobic. People who are introverted, in particular, need time to themselves. Strong relationships require a certain amount of detachment; they should be able to survive periods of separation.

8. Selfishness
When we are selfish, we ignore the needs of our partner, think of ourselves first and are egocentric. Egocentricity is a drain on any relationship. A relationship takes two and they both have to engage in the give and take process.

9. Not making time
Where and how you spend your time shows your priorities. If you are always at work or spend all your free time on a hobby, your partner will get the message that he or she is not important. Make time for your partner and for the relationship or you will lose both.

10. Low self esteem and insecurity
Low self esteem, insecurity or a lack of self confidence is commonly rooted in one partner’s feeling of being unworthy of love. Feelings of insecurity or low self esteem can lead to several of the problems noted above such as possessiveness, overdependence, jealousy, lack of trust or poor communication. It can also be seen in a partner who is extremely defensive, always making excuses and unable to handle constructive criticism.

Resources

http://www.life123.com/relationships/issues/resolving-relationship-issues/causes-of-marriage-failure-money-sex-and-communication.shtml
http://lifestyle.ca.msn.com/love-sex-relationships/10-reasons-your-relationships-never-last
http://suite101.com/article/why-relationships-end-a54774/print
http://pickthebrain.com/blog/7-common-reasons-relationships-fail

What is the Mozart Effect?

The Mozart Effect is the belief that listening to classical music while a woman is pregnant or during a child’s earliest years will make the baby smarter. The term ’Mozart Effect’ was first coined by Alfred A. Tomatisin in a 1991 book that explored 30 years of research on Mozart’s music and its effects on students with learning disabilities. The term was then popularized after a 1993 study by Rauscher, Shaw and Ky was published in Nature; the experiment examined the effect of listening to Mozart’s music on a person’s spatial reasoning ability. They compared the results of college students under three different listening conditions: listening to a Mozart sonata, listening to repetitive relaxation music and the third condition was silence. They found a temporary (about 15 minutes) improvement on three subtests of the Stanford-Binet IQ test that measured spatial-temporal reasoning. However, the media picked up on this study and reported that it made people smarter (perhaps because the subtests were from a standardized IQ test?) despite it being a temporary effect and in just one area. This effect was generalized to children and a popular trend was born among mothers who wanted to give their babies any advantage that they could.

Wikipedia now defines the Mozart Effect as,” A set of research results that indicate that listening to Mozart’s music may induce a short-term improvement on the performance of certain kinds of mental tasks known as spatial-temporal reasoning.” Spatial temporal reasoning is the ability to visualize spatial patterns and manipulate them mentally. This ability relates to multistep problem solving in the areas of math and science as well as in art and games.

Is the Mozart Effect Real?

Although Rauscher et al demonstrated only an increase in spatial-temporal reasoning, the results were misperceived as an increase in general IQ. Several studies in the past 5 years have debunked the myth of the Mozart Effect as it relates to increasing intelligence. The bottom line is that there is no causal link between listening to classical music and higher IQ. Some recent articles suggest that the short term improvement seen in spatial reasoning abilities right after listening to Mozart might be a good way to “prime” the brain before engaging in a problem solving task that requires those abilities (math, science, engineering, architecture, etc).

However, music has been shown to calm babies. Listening to classical music may soothe your baby and possibly turn him or her into a classical music aficionado later in life, but it won’t make your baby smarter.
Should babies be listening to classical music?

So why should your baby listen to classical music if the Mozart Effect is not real? The study demonstrated that spatial reasoning skills were increased in the short term but not in the long term. However there can be some long term benefits; if a child learns to love classical music he or she may be more apt to want to pick up a musical instrument to learn to play. Studies have shown that there are long term benefits to intelligence from actively learning to play an instrument due to the pattern recognition and the differentiation skills involved. Rhythm and beats, for example, are based in ratios and proportions as well as part-to-whole learning. These are essential skills necessary for other types of learning that are reflected in general intellectual ability.

Furthermore, children need to explore all their senses- auditory, visual, touch, smell and taste- at an early age in order to make strong connections for learning in those modes. If parents introduce their baby or young child to music, classical or otherwise, they help the child strengthen the auditory mode for future learning as well as current learning. Lastly, as any parent of a baby knows, anything that can calm a fussy baby is worth trying.

Resources

http://en.wikipedia.org/wiki/Mozart-effect
http://www.babycenter.com/0_the-mozart-effect-classical-music-and-your-baby’s-brain
http://newsvote.bbc.co.uk/mpapps/pagetools/print/news.bbc.co.uk
http://www.foxnews.com/story/0,2933,297994,00.html

Brain Structure

Size:
Almost all studies to date have shown that a boy’s brain, at birth, is approximately 12-20% larger than a girl’s brain. Their head circumference is 2% larger. However, if body weight is accounted for there seems to be little difference. In adults, the average male brain is 11-12% larger than the female brain and the head remains about 2% larger in circumference. Even when accounting for height and weight differences, men have slightly larger brains.

Harvard researchers in 2001 discovered that specific areas of the brain were different sizes in males and females. They found that parts of the frontal lobe (involved in problem solving and decision making) and the limbic system (regulating emotions) were larger in women. The study also found that the parietal cortex (space perception) and the amygdala (sexual and social behavior) were larger in men. These differences appear to balance out the overall size discrepancy.

Furthermore, men have about 6.5 times more gray matter but women have more than 9.5 times more white matter. Men seem to think with their gray matter which consists of active neurons, while women think with their white matter which is made up of the connections between the neurons. The neurons are more densely crowded in women’s brains; more connections and more tightly packed neurons might allow the female brain to think faster than a male brain.

In imaging studies, researchers have found not only denser female brains and larger male brains, but also that the sexes access different regions of the brain to do the same activity. For example, in a study that utilized sounding out different words as the task, men tended to use one small area of the left hemisphere to complete the task while women utilized both hemispheres. Interestingly, the sexes performed equally well suggesting that there are multiple ways for the brain to come up with the same result. Despite all the discrepancies, average IQ scores are the same for both males and females.

Corpus Callosum:
The bridge of nerve tissue that connects the right and left hemispheres is called the corpus callosum. Many studies have found the corpus callosum larger or more developed in women, but there are some studies that reported no significant discrepancies. Israeli researchers, using ultrasound, found that by 26 weeks into a pregnancy the female fetuses had thicker measurements in the corpus callosum than in male fetuses.

Hypothalamus:
The hypothalamus, on the other hand, has well-documented distinctions between men and women. There are two areas of the hypothalamus (the preoptic area and the suprachiasmatic nucleus) that have demonstrated clear differences.

Preoptic Area:
In males, the preoptic area (involved in mating behavior) is greater in volume, has twice as many cells and is 2.2 times larger than in females.

Suprachiasmatic Nucleus:
This area is involved in circadian rhythms and reproduction cycles. Here the difference is in shape: in males it is shaped like a sphere but in females it is more elongated.

Brain Function

Academic/language skills:
Male and female brains have their own areas of expertise. Males do better with spatial tasks (mentally rotating or manipulating an object), navigating routes and mathematical reasoning. Women shine on tests that measure word recall, verbal memory and remembering where objects are located.

The inferior-parietal lobule, which controls numerical brain function, is larger in males. In contrast, the parietal region is thicker in females which makes it harder to do spatial tasks such as mentally rotating objects. Women often report more difficulty with spatial tasks, both on tests as well as in real life.

Generally, boys outshine girls in brain processing of math and geometry; those areas of the male brain mature 4 years earlier than in the female brain. Researchers concluded that when it comes to math, the brain of a 12 year old girl resembles that of an 8 year old boy. But before the female readers take offence, the study also noted that areas of the brain responsible for processing language and fine motor skills mature 6 years earlier in girls compared to boys. Women often excel at language-based tasks for two reasons. As previously mentioned, they have two brain areas that are involved with language processing that are larger, and females use both hemispheres to process language while males rely on just the left.

Emotions:
Women are faster and more accurate at identifying emotions according to neurologist Ruben Gur (University of Pennsylvania). He and his colleagues discovered that the female brain is larger in areas that control aggression and anger, suggesting that women may be better than men at controlling their emotions. Perhaps due to their larger limbic system, women are more in touch with their feelings and better at expressing their emotions. Women are alleged to have better communication skills and emotional intelligence than men; they are more apt to talk out solutions to problems. Many men have difficulty picking up on emotional cues unless they are clearly verbalized. These basic differences in emotional responding can cause communication between the sexes to be difficult at times and lead to misunderstandings.

Brain function disorders:
Males tend to be more left brain dominant and, thus, more susceptible to dyslexia and other language based disabilities. They are also more disposed toward autism, ADHD and Tourette’s syndrome. Women are more prone to mood disorders like anxiety, depression or bipolar disorder.

The recent studies and facts mentioned above may lead us to believe that male and female brains have little in common. That’s not true; men and women have significantly more similarities than they do differences. Also note that there are many individual exceptions to any gender stereotype or generalizations, but exceptions don’t invalidate these generalizations. For example, there are plenty of women with excellent spatial skills and lots of men with superior writing skills. Not all men will have a strong male brain and not all women will have a strong female brain. But, in general, far more men are likely to have the male brain and far more women are likely to have the female brain. Although disparities in male and female brains can explain some behavior, many other differences in cognitive behavior (like memory) are related to individual differences between people, rather than due to whether or not they are a man or a woman.

Resources

http://brainfitnessforlife.com/brain-anatomy-and-imaging/9-differences-between-the-male-and-female-brain/
http://health.howstuffworks.com/human-body/systems/nervous-system/men-women-different-brains1.htm
http://www.webmd.com/balance/features/how-male-female-brains-differ
http://faculty.washington.edu/chudler/heshe.html