The Basics of Addiction

Posted Posted in Brain Science, Continuing Education, Homestudy, Psychology

alcohol-428392_640By Barbara Sternberg, Ph.D.

Alcohol and drug use are as old as civilization. Equally ancient is the mystery of why one person can use a substance moderately while another becomes addicted. New research is now shedding light on this complex genetic, and biological, psychological, and sociological phenomenon. Many people and clinicians today have strong opinions on the best way to treat addiction. Indeed, the question of whether “harm-reduction” approaches can be successful is highly controversial.

One of the major risks of alcohol and drug use is the potential for overdose. Overdose happens when a toxic amount of a drug or combination of drugs overwhelms the body. Alcohol and drug overdoses have the potential to cause serious health consequences or death. Various factors influence the degree of risk experienced by any particular alcohol or drug user.

An over-the-counter medication called Naloxone (Narcan®) can be used to counter the effects of overdose from opioids such as morphine or heroin and can save lives. It is only effective for treatment of opioid overdose. However, it has no effect if a person does not have opioids in his or her system.

Addiction is defined as the compulsive need to use a habit-forming substance, or an “irresistible urge” to engage in a potentially harmful behavior. Two defining characteristics of addiction are tolerance and withdrawal. Tolerance is the ever increasing need for more of the substance to obtain the same effect. Withdrawal refers to the uncomfortable physical and psychological symptoms that occur when substance use is stopped suddenly or withheld.

The term addiction has come to refer to a wide range of behaviors. While most commonly used to refer to ingestion of alcohol, drugs, cigarettes, and food, it is sometimes used to mean excessive indulgence in activities including work, exercise, shopping, sex, and video-game playing although there is insufficient research evidence to warrant including these activities as diagnosable psychiatric disorders. In DSM-5, pathological gambling is classified as a behavioral addiction.

Addictive behaviors have been characterized as patterns, habits, compulsions, impulse control disorders, and physical addictions. Many psychologists believe that they can be best understood as learned habits or behavior patterns. According to this view, addictive behaviors are maladaptive habits and behavior patterns which are subject to the same principles of learning that govern all behaviors. Old or maladaptive habits can be broken and replaced with alternative and less harmful behaviors. In this way, addictive behaviors can be unlearned and new, healthier behaviors learned in their place.

Learn more about addiction in our homestudy course, Addictions: Alternatives to Abstinence.

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Statistics on Bullying

Posted Posted in Brain Science, Continuing Education, Homestudy, Psychology

cyber-bullying-122156_640Bullying is not only a serious problem, it is deceptively complex. As a result, it is not easy to understand bullying problems or to determine how to respond to them. It is important to address bullying because it is pervasive and accompanied by detrimental and often subtle effects that linger after the episodes end. The dynamics of bullying go beyond the children, youth, or adults who bully or are bullied. Individual features, family and peer interactions, and cultural considerations all contribute to bullying. Making the situation more complex are new forms of bullying such as cyberbullying, which has unique implications for prevention and intervention.

Common in the schoolyard and in the workplace for decades, bullying has been a predictable, “accepted,” usually undiscussed although painful, part of childhood, youth, and adulthood. It has been said that bullying is “the most prevalent form of low-level violence in schools today.” Until very recently, bullying has been tolerated in Western society, and school-based bullying was considered a “normal” part of childhood that had a possibly good outcome through “character-building.” Although some people still see it that way, possibly because of how pervasive bullying is in the school context, bullying has recently been recognized as a public health problem that needs to be addressed.

But it has taken acts of extreme violence in which bullying appeared to be a factor for this phenomenon really to become part of the public agenda. For example, after the April 1999 Columbine killings, it was learned that one of many factors that may have contributed to the killing spree by Eric Harris and Dylan Klebold was their chronic victimization by popular school athletes. Of course, this was a special case of extreme violence that doesn’t occur in the vast majority of schools. Still, Columbine was described by certain students, teachers, and parents as a place where bullying was tolerated.


Prevalence of Bullying

  •  In 2009, about 28 percent of 12- to 18-year-old students reported having been bullied at school during the school year and 6 percent reported having been cyberbullied.
  • High school students are more likely to be cyberbullied than middle school students
  •  Of all students who reported being cyberbullied in 2009, about 3 percent reported being subjected to harassing text messages (4 percent of girls and 2 percent of boys).
  •  20 percent of female and 13 percent of male students reported being the subject of adverse rumors in 2009
  • 10 percent of male and 8 percent of female students reported being pushed, shoved, tripped or spit upon
  • 6 percent of female and 4 percent of male students reported being deliberately excluded from activities

Other statistics:

  • 19 percent of students reported having been made fun of
  • 16 percent were the subject of negative rumors
  • 9 percent reported being pushed
  •  6 percent reported being threatened
  •  5 percent reported being excluded
  •  4 percent reported being forced to do things they didn’t want to do
  • 3 percent reported having their property destroyed
  •  Boys are 1.7 times as likely to bully as girls
  •  Boys are also 2.5 times as likely as girls to bully as well as be bullied
  •  Boys are typically bullied by boys, while girls are typically bullied by both boys and girls
  • 20 percent of girls and 25 percent of boys reported that they had either bullied, been bullied, or both two to three times a month or more

Learn all about bullying in our homestudy course, The Psychology of Bullying.   Check out all of our courses by clicking below.

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Focus on PTSD (Post Traumatic Stress Disorder)

Posted Posted in Brain Science, Continuing Education, Homestudy, Psychology

In the United States, lifetime prevalence of PTSD (Post Traumatic Stress Disorder) is estimated to be 6–9 percent. The highest occurrence of PTSD is associated with exposure to traumatic experiences such as terrorism (i.e., 9/11) or combat; yet rates of PTSD in impoverished, high-risk inner city populations in the U.S. may be at least as high as among veterans returning from combat or people exposed to terrorist attacks or other disasters.

PTSD_171315269PTSD is more common in women than in men. While it occurs in people of all ages, young and old persons are the most vulnerable. Other factors associated with increased risk for PTSD include low income, poor education, poor social supports, and prior psychotropic drug use.

The incidence and course of PTSD are variable and depend on various factors, including the source, type, proximity, intensity, and duration of the trauma, the patient’s subjective interpretation of the trauma, and the reaction of the patient’s relatives and associates. Factors that can contribute to a good prognosis include: prompt diagnosis and treatment, early and ongoing social support, avoidance of further trauma, absence of other psychiatric disorders or substance abuse, and positive premorbid function.

PTSD may be caused by exposure to a severe traumatic stress that threatens death or serious injury or threat to personal integrity; for example:

  • physical abuse
  • rape
  • sexual and physical abuse in childhood
  • car accidents
  • fires and industrial accidents
  • being in a war zone or terrorist activity zone
  • being in an earthquake or another natural disaster
  • receiving a serious medical diagnosis
  • being subjected to invasive, painful treatment of medical problems

A number of factors increase the likelihood that a patient will develop PTSD in response to a given stress, including the following:

  • lack of social support (in children, lack of parental support)
  • prior exposure to traumatic incidents
  • a pre-existing psychiatric disorder
  • repeated trauma
  • trauma caused by a trusted person rather than the result of an accident

PTSD is not a fatal disorder. Nevertheless, it frequently leads to conduct disorder, substance abuse, depression, anxiety disorders, and risk-taking that pose considerable danger. Approximately 80 percent of those with PTSD have at least one comorbid psychiatric disorder.
Younger patients, in particular, in addition to the symptoms of numbing, hyperarousal, and recurrent recollections of the event, often become unable to participate in the normal developmental experiences and fail at school and work. They often develop a host of emotional and behavioral problems, such as disruptive behavior disorders, eating disorders, sexual acting out, other risk-taking activities, depression, the full range of anxiety disorders, dissociation, mood lability, violence, and difficulty concentrating.

Learn more about PTSD in our homestudy course, Brain and Stress: PTSD & Adjustment Disorder.   Explore all of our homestudy courses by clicking the image below.

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The Mystery of Pain: Acute vs Chronic Pain

Posted Posted in Brain Science, Continuing Education, Pain, Psychology, Seminars, Webinars

By Michael Howard, Ph.D.

Early humans explained the mystery of pain by associating it with evil, magic, or demons. Relief was the responsibility of sorcerers, shamans, priests, and priestesses, who treated their clients with herbs and rituals.

Ancient civilizations recorded on stone tablets accounts of pain and the treatments used, including pressure, heat, water, and sun. The Greeks and Romans were the first to advance a theory of sensation, the idea that the brain and nervous system were involved in the perception of pain.pain

During the Middle Ages and into the Renaissance, evidence began to accumulate supporting these theories. Leonardo da Vinci and his contemporaries came to see the brain as the central organ responsible for sensation, with the spinal cord transmitting sensations to the brain.

In the 19th century, pain came to dwell under a new domain—science—which paved the way for advances in pain therapy. Physician-scientists discovered that opium, morphine, codeine, and cocaine could be used to treat pain. In the late 1800s, research led to the development of aspirin, to this day the most commonly-used pain reliever. Before long, anesthesia—both general and regional—was refined and applied during surgery.

Pain is defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage. There are two basic categories of pain, acute and chronic, and they differ greatly.

Acute pain usually results from disease, inflammation, or injury to tissues. This type of pain generally comes on suddenly—for example, after trauma or surgery—and may be accompanied by anxiety or emotional distress. The cause of acute pain can generally be diagnosed and treated, and the pain is self-limiting—confined to a given period of time and severity. In some instances, it can become chronic.

Chronic pain is widely believed to represent a disease in and of itself. It persists over a longer period of time than acute pain and is resistant to most medical treatments. Chronic pain often persists longer than three months, or longer than expected for normal healing. It can be made much worse by environmental and psychological factors. It can—and often does—cause severe problems for patients, as pain signals keep firing in the nervous system for weeks, months, or years. There may have been an initial mishap such as a sprained back or serious infection, or there may be an ongoing cause of pain such as arthritis, cancer, or infection. However, some people suffer chronic pain in the absence of any past injury or evidence of illness.

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Review of INR Seminar, “Understanding Depression and Bipolar Disorder”

Posted Posted in Brain Science, Continuing Education, Homestudy, Psychology, Seminars, Webinars

understanding-depressionRecently, I attended a continuing-education online seminar (Webinar) and was asked to write a blog post about my experience. The seminar’s title was “Understanding Depression and Bipolar Disorder.” The seminar’s sponsor was INR (Institute for Natural Resources). The presenter was Dr. David Longo (Ph.D.). The Webinar was six hours long. There were two breaks and time for lunch.

If you are a health-care professions (registered nurse, licensed practical nurse, pharmacist, registered dietitian, psychologist, social worker occupational therapist, physical therapist, case manager, nursing home administrator, counselor, or care-giver), this course is for you.

My first impression of the Webinar is that it was very well organized. My Webinar code worked correctly the first time. It appeared that no one else taking the Webinar had any technical issues. The Webinar platform was very simple and easy to understand. Dr. Longo, the presenter, had a pleasant voice and spoke at the right pace — not too fast and not too slowly. Dr. Longo kept my interest. He relied on case studies and his extensive knowledge.
The first hour examined the Three Brains of humans: The Brain Stem (Archaic Brain); Limbic System (Old Brain); and the Cerebral Cortex (New Brain). Dr. Longo discussed, in-depth, how changes in brain chemistry and structure occur in depression and bipolar disorder. Then, he covered how stress becomes a pathway for the development of major depressive disorders.

Dr. Longo discussed the new DSM-V (Diagnostic Statistics Manual, Version Five) criteria for the diagnosis of major depressive disorders and bipolar disorder.

I work in the marine industry, and I learned a fascinating fact: marine engineers have, by occupation, the highest suicide rates. Next in line are physicians and dentists.

Dr. Longo mentioned that there are many significant changes in the new Diagnostics and Statistical Manual of Mental Disorders. I was pleased to have an instructor who showed a working knowledge of such mental disorders.

The afternoon session focused on drugs used in the treatment of bipolar disorder, cyclothymia, and other disorders. Dr. Longo had experience with these medications and covered them thoroughly. He also focused on various forms of psychotherapy used to treat depression.

Overall, the Webinar provided superb information. Dr, Longo and INR did a superb job. I look forward to being part of future INR programs.

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Chronic Insomnia

Posted Posted in Brain Science, Continuing Education, Webinars

sleeping-child-812181_640By Nikita Katz, M.D., Ph.D.

Chronic insomnia is associated with an increased risk of depression, anxiety, excess disability, reduced quality of life, and increased use of health care resources.

Insufficient sleep can result in industrial and motor vehicle accidents, somatic complaints, cognitive dysfunction, depression, and decrements in daytime work performance owing to fatigue or sleepiness. It is also associated with hypertension, heart disease, and greater risk of mortality.

Statistical evidence highlights the scope and gravity of the problem of sleep loss among Americans.

  • More than one-third of all Americans suffer from sleep disorders at some point in their lives.
  • Up to two-thirds of adults report difficulty sleeping at some point each year. Approximately 20 percent of adults consider the problem to be serious.
  • Twenty percent of adults (approximately 40 million) report having a chronic sleep disorder.
  • The prevalence of insomnia is about 1.4 times higher among women than among men.
  • Mature age predisposes one to sleep disorders. The rate increases from 5 percent in persons aged 30 to 50 to approximately 30 percent in those more than 50 years old. In the National Institute on Aging’s Established Populations for Epidemiologic Studies of the Elderly, 42 percent of senior citizens who participated in the survey had difficulty falling and staying asleep.
  • Twenty-three percent of adults report having difficulties concentrating because they do not get enough sleep: For this reason, 18 percent say they have trouble remembering things; 38 percent report unintentionally falling asleep during the day at least once in the preceding month; and 5 percent, while driving, report nodding off or falling asleep at least once in the prior month.
  • Up to one in four adults reports using a “sleep aid” at least a few nights a week.
  • According to the 2011 Sleep In America Poll, conducted by the National Sleep Foundation, the growing use of cell phones and electronic devices (for phone calls, texting, or emailing) — shortly before going to bed and being awakened after going to sleep by one of these forms of communication — is causing individuals to get less sleep at night, negatively affecting millions of Americans’ functioning the next day.

Although insomnia is very common, evidence suggests that only a small proportion of people who suffer from sleep disturbance report it to their physicians. Moreover, physicians may not detect or adequately assess or treat insomnia. Factors that contribute to under-diagnosis and under-treatment of insomnia include reluctance on the part of patients to discuss it; physicians’ limited training in this condition; time constraints in medical practice; misperceptions about the impact poor sleep can have on patients’ daytime functioning, health, and safety (such as putting insomnia sufferers at risk for serious accidents); and misconceptions about the benefits and risks associated with the use of hypnotic medications.

Explore our bookstore for more continuing education and homestudy courses like this.
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The Importance of Sleep

Posted Posted in Brain Science, Continuing Education, Homestudy, Psychology

sleeping-child-812181_640When you’re scrambling to meet the countless demands in life, cutting back on sleep might seem like the only answer. Although you realize that getting a good night’s sleep is important, you might not realize the vital role sleep plays in our physical and emotional health. Not getting enough shuteye can have serious and even devastating consequences.

Unfortunately, sleep problems are quite common, and over 60% of Americans report having trouble getting to sleep or staying asleep at least a few nights a week. More troubling is the fact that over 40% of American adults report daytime sleepiness severe enough, at least a few days each month, to interfere with their daily activities.

During sleep, the brain is preparing itself for the next day—and even forming new neural pathways that help with learning, memory, and problem-solving. For teenagers and children, deep sleep actually stimulates the production of growth hormone which supports normal growth and development.

Sleep is also important in maintaining a healthy functioning heart, blood vessels, kidneys, and immune system. Emotional well-being—especially during times of stress—is also tied to getting enough sleep. The ability to react to stress without mood swings and undue anger, as well as the ability to get along with others, is affected by whether or not one gets enough sleep.

Lack of sleep causes not only fatigue, but also a wide range of health problems and disease. Chronic sleep deficiency can causes immune system dysfunction, making it difficult to fight infections. Insomnia can also lead to problematic changes in the endocrine system, which may exacerbate diseases such as diabetes. And sleep problems can lead to abnormalities in the central nervous system and cardiovascular system. Children and adults who don’t get enough sleep, for instance, are at increased risk for a host of emotional ailments, including depression, mood swings, impulsivity, and anxiety.

Below are just a few of the health problems that can result from lack of sleep:

  • Obesity
  • Kidney disease
  • Hypertension
  • Stroke
  • Depression
  • Chronic Pain

Many people think they can function well even with sleep deficits. But scientific research reveals that the opposite is true. After just several nights of not getting enough sleep—with a loss of 1 to 2 hours of sleep per night—your ability to function declines as much as if you hadn’t slept for a day or two.

Research has also shown that people who don’t get enough sleep take longer to finish tasks, have a slower reaction time, and are more likely to make mistakes. They also have difficulty making decisions, are less creative than those who get enough sleep, have a hard time controlling emotions and behavior, and suffer declines in their problem-solving abilities. So not only does lack of sleep compromise alertness and physical health, it can also reduce productivity at work and decrease one’s ability to weather life’s stresses.

When sleep is compromised, the body’s ability to heal, repair, and restore itself can be impaired. Blood pressure fluctuations, adrenaline production, and hormone synthesis are affected —and impede our ability to bounce back from the physical stresses of normal life. When sleep deficits persist for an extended length of time, these disruptions in normal bodily function can push a vulnerable organ system from health into disease.

The bottom line is that we live in a sleep deprived world. Sleep is good for your mind, body, and spirit. In the words of Homer — “There is a time for many words, and there is also a time for sleep.”

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Understanding Alzheimer’s Disease

Posted Posted in Brain Science, Continuing Education, Elder Care, Homestudy

alzheimersBy Dr. Mary O’Brien MD

Dr. Alois Alzheimer, a German neuropathologist, was the first identify and name Alzheimer’s Disease in 1906.  He had been treating a middle-aged woman who exhibited symptoms of memory loss and disorientation.  Five years later, the patient died after symptoms of dementia and suffering hallucinations.   The manifestations and course of the disease were so unusual that Dr. Alzheimer was unable to classify the disease into any existing category.  Postmortem examination of the brain revealed microscopic and macroscopic lesions and distortions, including neurofibrillary tangles and neuritic plaques.

Although it has been more than a century since the disease was identified, it has been only within the last four decades that it has received recognition.  In the past, symptoms were attributed to the “senility” of old age and victims were cared for at home.  The problems of dementia were gradually recognized as an issue associated with the older population, but the nature of the disease and how to treat it were still a mystery.  In the 1970s, researchers determined that people with Alzheimer’s disease had a neurochemical deficiency. This enabled them to study the disease in more detail and separate patients with Alzheimer’s disease from those with dementia of normal aging.

Researchers and scientist are conducting studies to learn more about plaques, tangles, and other biological features of Alzheimer’s disease. There have been great dvances in brain imaging techniques which allow researchers to see the development and spread of abnormal amyloid and tau proteins in the living brain, as well as changes in brain structure and function. Scientists are also exploring the very earliest steps in the disease process by studying changes in the brain and body fluids that can be detected years before Alzheimer’s symptoms appear. The findings from these studies will help in understanding the causes of Alzheimer’s and make diagnosis easier.

One of the great mysteries of Alzheimer’s disease is why it largely strikes older adults. Research on normal brain aging is shedding light on this question. For example, scientists are learning how age-related changes in the brain may harm neurons and contribute to Alzheimer’s damage. These age-related changes include atrophy (shrinking) of certain parts of the brain, inflammation, production of unstable molecules called free radicals, and mitochondrial dysfunction (a breakdown of energy production within a cell).

INR offers continuing educations courses that will present the elements of pathology, medical treatment, and care of victims of this progressive disease. It is hoped that the continued research into the causes of Alzheimer’s disease will provide some of the necessary information about the prevention and treatment of this relentless and socially damaging disease.

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Sources: www.nia.nih.gov/alzheimers