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Sociology of health and illness

The sociology of health and illness, sociology of health and wellness, or health sociology examines the interaction between society and health. As a field of study it is interested in all aspects of life, including contemporary as well as historical influences, that impact and alter our health and wellbeing. It establishes that, from our births to our deaths, social processes interweave and influence our health and wellbeing. These influences could be where we were brought up, how illness is understood and framed by immediate community members, or the impact that technology has with our health. As such, it outlines that both our health and the medical science that engages it are social constructs; that our way of knowing illness, wellbeing, and our interactions with them are socially interpreted. Health sociology uses this insight to critique long established ideas around the human body as a mechanical entity alongside disrupting the idea that the mind and body can be treated as distinct spaces. This biomedical model is viewed as not holistically placing humans within the wider social, cultural, economic, political, and environmental contexts that play a large part in how health and wellbeing are deprived, maintained, or improved. Alternative models include the biopsychosocial model that aims to incorporate these elements alongside the psychological aspect of the mind. This field of research acts as a broad school overlapping with areas like the sociology of medicine, sociology of the body, sociology of disease to wider sociologies like that of the family or education as they contribute insights from their distinct focuses on the life-course of our health and wellness. Theoretical perspectives The field of sociology of health and illness has been shaped by the perspectives and contributing works of various authors that have enabled its development. Many research studies touch on the relationship between the patient and doctor aswell as their environment within the healthcare system. One of the founders of the sociology of health and illness is Talcott Parsons, an American sociologist, who analyzed the relationship between patients and their doctors in his book The Social System written in 1951. In his sick role theory, he argued that people who were sick adopted a social role, not just a biological condition. Those who were sick deviated from social roles were unable to fulfill their respective functions, thus if too many people claimed to be ill, this would create a dysfunctional society that needed regulating. Creating this mechanism would prevent people who were pretending to be sick to form a subculture of being sick. By developing the “sick role mechanism” patients and doctors had to abide by a set of “rights” and “obligations” that would monitor entry into the sick role. The “rights” of a patient constituted an exemption from performing their respective social roles, such as going to work or housekeeping with the further exemption being given to those severely ill. These rights were given if they maintained two obligations, the first being that they had to view being sick as undesirable and thus must find a way to get better. Second, after a while of being sick, the person must seek the help of a doctor and follow their advice in other to alleviate their illness. The “obligations” of the doctors were to be trained in their field, be motivated to help the patient, have objective and emotional detachment from the patient, and be bound by the rules of professional conduct. Their “rights” consisted of being able to examine the patient physically and ask about their personal life, and have a position of authority and autonomy in their professional practice. Lastly, receive status and reward from their important role in society. Parson’s perspective. In addition, Michel Foucault published The Birth of the Clinic in 1963, in which he developed his theory of the “medical gaze” referring to how doctors filter patient information into a biomedical paradigm, which focuses solely on biological factors excluding how social, environmental and psychological factors can influence a patient’s condition. According to Foucault doctors are trained to be doctor-oriented rather than patient-oriented, which creates a form of abusive power structure. Among these authors have contributed to the development of the field of health and illness by bringing in their perspectives at the time. Historical background Humans have long sought advice from those with knowledge or skill in healing. Paleopathology and other historical records, allow an examination of how ancient societies dealt with illness and outbreak. Rulers in Ancient Egypt sponsored physicians that were specialists in specific diseases. Imhotep was the first medical doctor known by name. An Egyptian who lived around 2650 B.C., he was an adviser to King Zoser at a time when Egyptians were making progress in medicine. Among his contributions to medicine was a textbook on the treatment of wounds, broken bones, and even tumors. Stopping the spread of infectious disease was of utmost importance for maintaining a healthy society. The outbreak of disease during the Peloponnesian War was recorded by Thucydides who survived the epidemic. From his account it is shown how factors outside the disease itself can affect society. The Athenians were under siege and concentrated within the city. Major city centers were the hardest hit. This made the outbreak even more deadly and with probable food shortages the fate of Athens was inevitable. Approximately 25% of the population died of the disease. Thucydides stated that the epidemic "carried away all alike". The disease attacked people of different ages, sexes and nationalities. Ancient medical systems stressed the importance of reducing illness through divination and ritual. Other codes of behavior and dietary protocols were widespread in the ancient world. During the Zhou dynasty in China, doctors suggested exercise, meditation and temperance to preserve one's health. The Chinese closely link health with spiritual well-being. Health regimes in ancient India focused on oral health as the best method for a healthy life. The Talmudic code created rules for health which stressed ritual cleanliness, connected disease with certain animals and created diets. Other examples include the Mosaic Code and Roman baths and aqueducts. Those that were most concerned with health, sanitation and illness in the ancient world were those in the elite class. Good health was thought to reduce the risk of spiritual defilement and therefore enhanced the social status of the ruling class who saw themselves as the beacon of civilization. During the late Roman Period, sanitation for the lower classes was a concern for the leisured class. Those that had the means would donate to charities that focused on the health of non-elites. After the decline of the Roman Empire, physicians and concern with public health disappeared except in the largest cities. Health and public doctors remained in the Byzantine Empire. Focusing on preventing the spread of diseases such as small pox lead to a smaller mortality rate in much of the western world. Other factors that allowed the modern rise in population include: better nutrition and environmental reforms (such as getting clean water supplies). The present day sense of health being a public concern for the state began in the Middle Ages. A few state interventions include maintaining clean towns, enforcing quarantines during epidemics and supervising sewer systems. Private corporations also played a role in public health. The funding for research and the institutions for them to work were funded by governments and private firms. Epidemics were the cause of most government interventions. The early goal of public health was reactionary whereas the modern goal is to prevent disease before it becomes a problem. Despite the overall improvement of world health, there still has not been any decrease in the health gap between the affluent and the impoverished. Today, society is more likely to blame health issues on the individual rather than society as a whole. This was the prevailing view in the late 20th century. In the 1980s the Black Report, published in the United Kingdom, went against this view and argued that the true root of the problem was material deprivation. This report proposed a comprehensive anti-poverty strategy to address these issues. Since this did not parallel the views of the Conservative government, it did not go into action immediately. The Conservative government was criticized by the Labour Party for not implementing the suggestions that the Black Report listed. This criticism gave the Black Report the exposure it needed and its arguments were considered a valid explanation for health inequality. There is also a debate over whether poverty causes ill-health or if ill-health causes poverty. Arguments by the National Health Service gave considerable emphasis to poverty and lack of access to health care. It has also been found that heredity has more of a bearing on health than social environment, but research has also proved that there is indeed a positive correlation between socioeconomic inequalities and illness. Methodology The Sociology of Health and Illness focuses on three areas: the conceptualization, the study of measurement and social distribution, and the justification of patterns in health and illness. By looking at these things researchers can look at different diseases through a sociological lens. The prevalence and response to different diseases varies by culture. By looking at bad health, researchers can see if health affects different social regulations or controls. When measuring the distribution of health and illness, it is useful to look at official statistics and community surveys. Official statistics make it possible to look at people who have been treated. It shows that they are both willing and able to use health services. It also sheds light on the infected person's view of their illness. On the other hand, community surveys look at people's rating of their health. Then looking at the relation of clinically defined illness and self reports and find that there is often a discrepancy. A great deal of the time, mortality statistics take the place of the morbidity statistics because in many developed societies where people typically die from degenerative conditions, the age in which they die sheds more light on their life-time health. This produces many limitations when looking at the pattern of sickness, but sociologists try to look at various data to analyze the distribution better. Normally, developing societies have lower life expectancies in comparison to developed countries. They have also found correlations between mortality and sex and age. Very young and old people are more susceptible to sickness and death. On average women typically live longer than men, although women are more likely to have bad health. Disparities in health were also found between people in different social classes and ethnicities within the same society, even though in the medical profession they put more importance in "health related behaviors" such as alcohol consumption, smoking, diet, and exercise. There is a great deal of data supporting the conclusion that these behaviors affect health more significantly than other factors. Sociologists think that it is more helpful to look at health and illness through a broad lens. Sociologists agree that alcohol consumption, smoking, diet, and exercise are important issues, but they also see the importance of analyzing the cultural factors that affect these patterns. Sociologists also look at the effects that the productive process has on health and illness. While also looking at things such as industrial pollution, environmental pollution, accidents at work, and stress-related diseases. Social factors play a significant role in developing health and illness. Studies of epidemiology show that autonomy and control in the workplace are vital factors in the etiology of heart disease. One cause is an effort-reward imbalance. Decreasing career advancement opportunities and major imbalances in control over work have been coupled with various negative health costs. Various studies have shown that pension rights may shed light on mortality differences between retired men and women of different socioeconomic statuses. These studies show that there are outside factors that influence health and illness. International perspective Africa HIV/AIDS is the leading epidemic that affects the social welfare of Africa. Human Immunodeficiency virus (HIV) can cause AIDS which is an acronym for Acquired Immunodeficiency Syndrome (AIDS), a condition in humans in which the immune system begins to fail, leading to life-threatening infections. Two-thirds of the world's HIV population is located in Sub-Saharan Africa. Since the epidemic started more than 15 million Africans have died by complications with HIV/AIDS. People who are a part of religious sub-groups of Sub-Saharan Africa, and those who actively and frequently participate in religious activities, are more likely to be at a lower risk of contracting HIV/AIDS. On the opposite end, there are many beliefs that an infected male can be cured of the infection by having sex with a virgin. These beliefs increase the number of people with the virus and also increase the number of rapes against women. Herbal treatment is one of the primary medicines used to treat HIV in Africa. It is used more than standard treatment because it is more affordable. Herbal treatment is more affordable but is not researched and is poorly regulated . This lack of research on whether the herbal medicines work and what the medicines consist of is a major flaw in the healing cycle of HIV in Africa. Economically, HIV has a significant negative effect. The labor force in Africa is slowly diminishing, due to HIV-related deaths and illness. In response, government income declines and so does tax revenue. The government has to spend more money than it is making, in order to care for those affected with HIV/AIDS. A major social problem in Africa in regards to HIV is the orphan epidemic. The orphan epidemic in Africa is a regional problem. In most cases, both of the parents are affected with HIV. Due to this, the children are usually raised by their grandmothers and in extreme cases they are raised by themselves. In order to care for the sick parents, the children have to take on more responsibility by working to produce an income. Not only do the children lose their parents but they also lose their childhood as well. Having to provide care for their parents, the children also miss out on an education which increases the risk of teen pregnancy and people affected with HIV. The most efficient way to diminish the orphan epidemic is prevention: preventing children from acquiring HIV from their mothers at birth, as well as educating them on the disease as they grow older. Also, educating adults about HIV and caring for the infected people adequately will lower the orphan population. The HIV/AIDS epidemic is reducing the average life expectancy of people in Africa by twenty years. The age range with the highest death rates, due to HIV, are those between the ages of 20 and 49 years. The fact that this age range is when adults acquire most of their income means they often cannot afford to send their children to school due to the high medication costs. It also removes the people who could help aid in responding to the epidemic. Asia Asian countries have wide variations of population, wealth, technology and health care, causing attitudes towards health and illness to differ. Japan, for example, has the third highest life expectancy (82 years old), while Afghanistan has the 11th worst (44 years old). Key issues in Asian health include childbirth and maternal health, HIV and AIDS, mental health, and aging and the elderly. These problems are influenced by the sociological factors of religion or belief systems, attempts to reconcile traditional medicinal practices with modern professionalism, and the economic status of the inhabitants of Asia. Like the rest of the world, Asia is threatened by a possible pandemic of HIV and AIDS. Vietnam is a good example of how society is shaping Asian HIV/AIDS awareness and attitudes towards this disease. Vietnam is a country with feudal, traditional roots, which, due to invasion, wars, technology and travel is becoming increasingly globalized. Globalization has altered traditional viewpoints and values. It is also responsible for the spread of HIV and AIDS in Vietnam. Even early globalization has added to this problem – Chinese influence made Vietnam a Confucian society, in which women are of less importance than men. Men in their superiority have no need to be sexually responsible, and women, generally not well educated, are often unaware of the risk, perpetuating the spread of HIV and AIDS as well as other STIs. Confucianism has had a strong influence on the belief system in Asia for centuries, particularly in China, Japan, and Korea, and its influence can be seen in the way people chose to seek, or not seek, medical care. An important issue in Asia is societal effect on the ability of disabled individuals to adjust to a disability. Cultural beliefs shape attitudes towards physical and mental disabilities. China exemplifies this problem. According to Chinese Confucian tradition (which is also applicable in other countries where Confucianism has been spread), people should always pursue good health in their lives, with an emphasis on health promotion and disease prevention. To the Chinese, having a disability signifies that one has not led a proper lifestyle and therefore there is a lack of opportunities for disabled individuals to explore better ways to accept or adapt to their disability. Indigenous healing practices are extremely diverse throughout Asia but often follow certain patterns and are still prevalent today. Many traditional healing practices include shamanism and herbal medicines, and may have been passed down orally in small groups or even institutionalized and professionalized. In many developing countries the only health care available until a few decades ago were those based on traditional medicine and spiritual healing. Now governments must be careful to create health policies that strike a balance between modernity and tradition. Organizations, like the World Health Organization, try to create policies that respect tradition without trying to replace it with modern science, instead regulating it to ensure safety but keeping it accessible. India in particular tries to make traditional medicines safe but still available to as many people as possible, adapting tradition to match modernization while still considering the economic positions and culture of its citizens. Mental health issues are gaining an increasing amount of attention in the Asian countries. Many of these countries have a preoccupation with modernizing and developing their economies, resulting in cultural changes. In order to reconcile modern techniques with traditional practices, social psychologists in India are in the process of "indigenizing psychology". Indigenous psychology is that which is derived from the laws, theories, principals, and ideas of a culture and unique to each society. In many Asian countries, childbirth is still treated by traditional means and is thought of with regional attitudes. For example, in Pakistan, decisions concerning pregnancy and antenatal care (ANC) are usually made by older women, often the pregnant woman's mother-in-law, while the mother and father to be are distanced from the process. They may or may not receive professional ANC depending on their education, class, and financial situation. Generally in Asia, childbirth is still a woman's area and male obstetricians are rare. Female midwives and healers are still the norm in most places. Western methods are overtaking the traditional in an attempt to improve maternal health and increase the number of live births. Asian countries, which are mostly developing nations, are aging rapidly even as they are attempting to build their economies. Even wealthy Asian nations, such as Japan, Singapore, and Taiwan, also have very elderly populations and thus have to try to sustain their economies and society with small younger generations while caring for their elderly citizens. The elderly have been traditionally well respected and well cared for in most Asian cultures; experts predict that younger generations in the future are less likely to be concerned and involved in the health care of their older relatives due to various factors such as women joining the workforce more, the separation of families because of urbanization or migration, and the proliferation of Western ideals such as individualism. Australia The health patterns found on the continent of Australia which includes the Pacific Islands, have been very much influenced by European colonization. While indigenous medicinal beliefs are not significantly prevalent in Australia, traditional ideas are still influential in the health care problems in many of the islands of the Pacific. The rapid urbanization of Australia led to epidemics of typhoid fever and the Bubonic plague. Because of this, public health was professionalized beginning in the late 1870s in an effort to control these and other diseases. Since then Australia's health system has evolved similarly to Western countries and the main cultural influence affecting health care are the political ideologies of the parties in control of the government. Australia has had treatment facilities for 'problem drinkers' since the 1870s. In the 1960s and 1970s it was recognized that Australia had several hundred thousand alcoholics and prevention became a priority over cures, as there was a societal consensus that treatments are generally ineffective. The government began passing laws attempting to curb alcohol consumption but consistently met opposition from the wine-making regions of southern Australia. The government has also waged a war on illegal drugs, particularly heroin, which in the 1950s became widely used as a pain reliever. Experts believe that many of the health problems in the Pacific Islands can be traced back to European colonization and the subsequent globalization and modernization of island communities. (See History of the Pacific Islands.) European colonization and late independence meant modernization but also slow economic growth, which had an enormous effect on health care, particularly on nutrition in the Pacific Islands. The end of colonization meant a loss of medical resources, and the fledgling independent governments could not afford to continue the health policies put in place by the colonial governments. Nutrition was changed radically, contributing to various other health problems. While more prosperous, urban areas could afford food, they chose poor diets, causing 'overnourishment', and leading to extremely high levels of obesity, type 2 diabetes, and cardiovascular diseases. Poorer rural communities, on the other hand, continue to suffer from malnutrition and malaria. Traditional diets in the Pacific are very low in fat, but since World War II there has been a significant increase in fat and protein in Pacific diets. Native attitudes towards weight contribute to the obesity problem. Tongan natives see obesity as a positive thing, especially in men. They also believe that women should do as little physical work as possible while the men provide for them, meaning they get very little exercise. Europe The largest endeavors to improve health across Europe is the World Health Organization European Region. The goal is to improve the health of poor and disadvantaged populations by promoting healthy lifestyles including environmental, economic, social and providing health care. Overall health in Europe is very high compared to the rest of the world. The average life expectancy is around 78 in EU countries but there is a wide gap between Western and Eastern Europe. It is as low as 67 in Russia and 73 in the Balkan states. Europe is seeing an increase in the spread of HIV/AIDS in Eastern Europe because of a worsening socioeconomic situation. Cardiovascular disease, cancer and diabetes mellitus are more prevalent is Eastern Europe. The WHO claims that poverty is the most important factor bringing on ill health across Europe. Those at low socioeconomic status levels and many young people are also at risk because of their increased tobacco, alcohol, and non-medical substance use. Health and illness prevention in Europe is largely funded by the governmental services including: regulating health care, insurance and social programs. The role of religion and traditional medicine, however, is often left unexamined in such reports. The study of hypertension within the United Kingdom has turned to examining the role that beliefs play in its diagnosis and treatment. Hypertension is an essential topic for study since it is linked to increased risk of stroke and coronary heart disease. The most common treatment for hypertension is medication but compliance for this treatment plan is low. A study conducted in the UK examined the differences between 'white' patients and first generation immigrants from the West Indies. There were differing reasons for non-compliance that involve the patients' perception and beliefs about the diagnosis. Patients commonly believe that high levels of anxiety when first diagnosed are the major cause and think that when stress levels decline so too will their hypertension. Other respondents in this UK based study had varying beliefs concerning the necessity of medication while others still argued that it was the side effects of medication that made them end their prescribed regimen. West Indian respondents whose lay culture teaches them to reject long-term drug therapy opted instead for folk remedies in higher numbers than the 'white' respondents. What can be seen here is that some people will choose to ignore a doctor's expert advice and will employ 'lay consultation' instead. Before people seek medical help they try to interpret the symptoms themselves and often consult people in their lives or use 'self-help' measures. A study of 'everyday illness' in Finland including: influenza, infections and musculo-skeletal problems focused on reasons for consulting medical experts and explanations of illness. These common illness were examined not because of their seriousness but because of their frequency. The researchers explain five possible triggers that people seek medical aid: 1- the occurrence of an interpersonal crisis 2- perceived interference with social and personal relations 3- perceived interference with vocational & physical activity 4- sanctioning by other people 5- patients' ideas about how long certain complaints should last. These kind of explanatory models are part of the process that people use to construct medical culture. They give meaning to illness and health, answer questions about personal responsibility about health and most importantly are part of the dialogue between patients' and professionals' illness explanations. It can help explore why some patients will follow a doctors instructions to the letter and others ignore them completely. A patient's explanation or understanding of their illness can be much broader than a physician's and this dynamic has become a major criticism of modern medical practice since it normally excludes the "social, psychological and experiential dimensions of illness." The Finnish study examined 127 patients and the results have been different from findings in other countries where there is more 'lay consultation'. Half of the respondents did not have any lay consultation before coming to the doctors office. One-third did not try any self-treatment and three-quarters of the sample consulted the doctor within three days of symptoms developing. Possible explanations are that in Finland there is an aspect "over-protectiveness" within their health care system. Many might conclude that the Finnish people are dependent and helpless but the researchers of this study found that people chose to consult professionals because they trusted them over some lay explanation. These results echo similar studies in Ireland that explain this phenomenon as being based in a strong work ethic. Illness in these countries will affect their work and Finnish people will quickly get treatment so they can return to work. This research out of Finland also describes that this relationship between patient and doctor is based on: national and municipal administrative bureaucracies that demand more output and more satisfied patients the public demanding better care nurses criticizing physicians for not taking a holistic view of patients hospital specialists wanting better/earlier screening for serious illnesses (e.g. cancer). The conflict between medical and lay worlds is prominent. On one hand many patients believe they are the expert of their own body and view the Doctor-patient relationship as authoritarian. These people will often use knowledge outside the medical field to deal with health and illness. Others see the doctor as the expert and are shy about describing their symptoms and therefore rely on the doctor for diagnosis and treatment. In Europe, sociology of health and illness is represented by the European Society for Health and Medical Sociology (ESHMS). North America North America is a fairly recent settled continent, made up of the United States, Canada, Mexico, Central America, and the Caribbean. It was built by an amalgamation of wealth, ideas, culture, and practices. North America is highly advanced intellectually, technologically, and traditionally. This advantageous character of North American nations has caused a high average life expectancy of 75 years for males and 80 years for females. This leads to the conclusion that North America has cultivated a comparatively healthy society. As North America contains several core nations, the growing economies in those nations are able to maintain and develop medical institutions. This subsequently provides more access to health care for American citizens but health care is not universal. North America is known for being a leading nation in regards to industrialization and modernization, but the United States lacks federal laws regarding health care as a basic human right. This lag of health care security causes subsequent issues with pharmaceutical competition, lack of care for the elderly, and little attention to alternative medicine. Health care and education are plentiful at a price and illness still persists for many reasons. A main reason is that a lower- and middle-class population still exists in plentiful numbers, maintaining a group that is highly vulnerable to physical ailment. North America's primary risk factors for illness are currently excessive alcohol use, malnutrition, obesity, tobacco use, and water sanitation. Obesity is a recent epidemic in North America. The 1990s brought a rise in the average Body Mass Index, or BMI. From the beginning and to the end of the decade, the median percent of adults who were obese rose from 12% to 20%. Alcoholism is the addiction of over-consumption of alcohol and is highly prevalent in the US. There are high incidence rates in many other world regions. Roughly 61% of American adults drank in 2007, and 21% of current drinkers consumed five or more drinks at one point in the last year. There have also been 22,073 alcohol induced deaths in the United States in the past year, about 13,000 of which were related to liver disease. Alcoholism has many risk factors ingrained in North American culture, such as heredity, stress from competition or availability. The Swine Flu (also known as H1N1) epidemic is a recent disease emerging in the early 21st century. In April 2009, during the early days of the outbreak, a molecular biologist named Dr. Henry Miller wrote in the Wall Street Journal about New York City high-school students. These students apparently brought the virus back from Mexico and infected their classmates. All six cases so far reported in Canada were connected directly or indirectly with travel to Mexico as well. Flu viruses can be directly transmitted (via droplets from sneezing or coughing) from pigs to people, and vice versa. These cross-species infections occur most commonly when people are close to large numbers of pigs, such as in barns, livestock exhibits at fairs, and slaughterhouses. The flu is transmissible from human to human, either directly or via contaminated surfaces." South America There are many diseases that affect South America, but two major conditions are malaria and Hepatitis D. Malaria affects every country in South America except Uruguay, Chile, and The Falkland Islands. Elevation is a major factor in the areas where malaria is found. The disease is spread from person to person via mosquito bites. People are typically bitten by mosquitoes at dusk and dawn. Symptoms of this disorder are: high fever, chills, sweating, headaches, body aches, weakness, vomiting and diarrhea. If left untreated, new symptoms can occur; people that are infected may experience seizures, delirium and coma. Severe cases may end in death. Malaria can be cured, but the symptoms may not become noticeable until months later. There are three forms of medication that can cure Malaria. An infected person's accessibility to these drugs is dependent upon their access to medical care and their financial situation. Literature about Malaria treatment typically is focused toward people who are tourists. Most sources are not written with the native in mind. The first sign of Hepatitis D was detected in 1978 when a strange and unrecognizable internuclear antigen was discovered during a liver biopsy of several Italians who developed HBV infections. Scientists initially thought that it was an antigenic specificity of HBV, but they soon found that it was a protein from another disease altogether. They called it "Hepatitis Delta Virus" (HDV). This new virus was found to be defective. HDV needed HBV to act as a helper function in order for it to be detected. Normally Hepatitis B is transmitted through blood or any type of blood product. In South America Hepatitis D was found to be fatal. Scientists are still unsure in what way this disease was being transmitted throughout certain South American countries. Sexual contact and drug use are the most common means of transmission. HDV is still considered an unusual form of hepatitis. Agents of this virus resemble that of plant viroids. It is still hard to tell how many stereotypes exist because HDV is under the umbrella of HBV. HDV causes very high titers in the blood of people who are infected. Incubation of Hepatitis D typically lasts for thirty five days. Most often Hepatitis D is a co-infection with Hepatitis B or a super-infection with chronic hepatitis. In terms of super infections there are high mortality rates, ranging seventy to eighty percent; in contrast with co-infections which have a one to three percent mortality rate. There is little information with the ecology of Hepatitis D. Epidemics have been found in Venezuela, Peru, Columbia, and Brazil. People who are treated for Hepatitis B have been able to control Hepatitis D. People who have chronic HDB will continue to get HDV. Another disease that affects South America is HIV and AIDS. In 2008 roughly two million people had HIV and AIDS. By the end of 2008 one hundred and seventy thousand people were infected with AIDS and HIV. Seventy seven thousand people died from this disease by the end of that year. Brazil has the most people that are affected with AIDS and HIV in South America. In Brazil sixty percent of the inhabitants are HIV positive because of drug use. Usually this disease is transmitted by either drug use involving needles or unprotected sex. Sharing needles and being infected with HIV and AIDS is most common in Paraguay and Uruguay. South America is trying to get treatment to the thousands of people infected by this disease. Brazil is offering generic AIDS prescriptions that are much less expensive than the name brand drugs. One hundred and eighty-one thousand inhabitants in Brazil who were infected are being treated. That accounts for eighty percent of those who needed immediate help. This aid from the government has had positive results. Statistics show that there was a fifty percent decrease in mortality rates, approximately sixty to eighty percent decrease in morbidity rates and a seventy percent decrease in hospitalization of infected people. In very remote areas of South America, traditional healers are the only forms of health care people have. In north Aymara and south Mapuche, where the indigenous groups have the strongest voices, they still heavily use traditional medicine. The government in Chile has implemented an Indigenous Health System to help strengthen the health care system. Even with Chile's indigenous groups, Chile still has the best public health services in South America. They also have the lowest mortality rates in the area. Their health care policies are centered around family and community wellbeing by focusing on the strategies for prevention health strategies. Reports have shown an increase in mental health issues, diabetes, and cardiovascular diseases. South America's economy is developing rapidly and has a great deal of industries. The major industry in South America are agriculture. Other industries are fishing, handicrafts, and natural resources. Its trade and import-export market is continually thriving. In the past South American countries moved slowly in regards to economic development. South America began to build its economy ever since World War II. South America's largest economies are Brazil, Chile, Argentina, and Columbia. Venezuela, Peru, and Argentina's economy are growing very rapidly. Journals See also References Further reading Seale, Gabe, Wainwright, Williams. Sociology of Health & Illness, Vol. 33 2011 Alternative medical systems Medical sociology

Reciprocal determinism

Reciprocal determinism is the theory set forth by psychologist Albert Bandura which states that a person's behavior both influences and is influenced by personal factors and the social environment. Bandura accepts the possibility that an individual's behavior may be conditioned through the use of consequences. At the same time he asserts that a person's behavior (and personal factors, such as cognitive skills or attitudes) can impact the environment. Bandura was able to show this when he created the Bandura's Box experiment. As an example, Bandura's reciprocal determinism could occur when a child is acting out in school. The child doesn't like going to school; therefore, they act out in class. This results in teachers and administrators of the school disliking having the child around. When confronted by the situation, the child admits they hate school and other peers don't like them. This results in the child acting inappropriately, forcing the administrators who dislike having them around to create a more restrictive environment for children of this stature. Each behavioral and environmental factor coincides with the child and so forth resulting in a continuous battle on all three levels. Reciprocal determinism is the idea that behavior is controlled or determined by the individual, through cognitive processes, and by the environment, through external social stimulus events. The basis of reciprocal determinism should transform individual behavior by allowing subjective thought processes transparency when contrasted with cognitive, environmental, and external social stimulus events. Actions do not go one way or the other, as it is affected by repercussions, meaning one's behavior is complicated and can't be thought of as individual and environmental means. Behavior consist of environmental and individual parts that interlink together to function. Many studies showed reciprocal associations between people and their environments over time. Research Research conducted in this field include the study of doctor-patient relationships where one group of patients are termed 'physician-reliant' and the other group 'self-reliant'. The physician-reliant patients tend to be more passive in their decision making and rely on their physicians to make their choices for them. Self-reliant patients take a more active role in deciding which health options would better suit them. Mathematics Another relevant research is regarding the reciprocal determinism of self-efficacy and mathematical performance. It shows that reciprocal determinism may not be the appropriate model in all cultures but does take place in most. Self-efficacy is a conceptualized assessment of the person's competence to perform a specific task. Self-efficacy results from success or failures that arise in attempts to learn a task. Self-efficacy, measure by a personal confidence level before each question, and the mathematical scores were obtained in 41 countries for the study by Kitty and Trevor Williams. The reciprocal determinism of mathematics self-efficacy and achievement was found in 26 of the 30 nations. They suggest that this might be a fundamental psychological process that takes place across national boundaries. According to Albert Bandura, self-efficacy is defined as a person's belief in their capability to accomplish a certain task. Another study looked at the relationship of self-efficacy and job culture with job satisfaction among athletic trainers. The study used Bandura's triadic reciprocal causation model as a template to label job satisfaction as the behavioural factor, self-efficacy as the personal factor, and job culture as the environmental factor. Triadic reciprocal causation Triadic reciprocal causation is a term introduced by Albert Bandura to refer to the mutual influence between three sets of factors: personal factors (e.g., cognitive, affective and biological events), the environment, behavior Interaction of genes and environment Behavioral genetics is a relatively new field of study attempting to make sense of both genetic and environmental contributions to individual variations in human behavior. Genes can be turned on and off. Multiple genes are factors in forming behavior traits. Aggression in abused boys Researchers believe there is a genetic link to impulsive aggression through the impact of a gene on the production of an enzyme called Monoamine oxidase A (MAOA). The MAOA gene reduces the production of MAOA, leading to increased incidents of impulsive aggression. A 26-year study in New Zealand found strong correlation between experience of childhood abuse and criminal or violent behavior in males with the MAOA gene. In that study, impulsive aggression was found to be nine times more likely to manifest in males with the gene who were abused than in abused males without the gene or males with the gene who had not been abused. See also Individual differences psychology Field theory (psychology) References Further reading Behaviorism Determinism Psychological theories

Archetypal psychology

Archetypal psychology was initiated as a distinct movement in the early 1970s by James Hillman, a psychologist who trained in analytical psychology and became the first Director of the Jung Institute in Zürich. Hillman reports that archetypal psychology emerged partly from the Jungian tradition whilst drawing also from other traditions and authorities such as Henry Corbin, Giambattista Vico, and Plotinus. Archetypal psychology relativizes and deliteralizes the notion of ego and focuses on what it calls the psyche, or soul, and the deepest patterns of psychic functioning, "the fundamental fantasies that animate all life" (Moore, in Hillman, 1991). Archetypal psychology likens itself to a polytheistic mythology in that it attempts to recognize the myriad fantasies and myths – gods, goddesses, demigods, mortals and animals – that shape and are shaped by our psychological lives. In this framework the ego is but one psychological fantasy within an assemblage of fantasies. Archetypal psychology is, along with the classical and developmental schools, one of the three schools of post-Jungian psychology outlined by Andrew Samuels (see Samuels, 1995). Influences The main influence on the development of archetypal psychology is Carl Jung's analytical psychology. It is strongly influenced by Classical Greek, Renaissance, and Romantic ideas and thought. Influential artists, poets, philosophers and psychologists include Nietzsche, Henry Corbin, Keats, Shelley, Petrarch, and Paracelsus. Though all different in their theories and psychologies, they appear to be unified by their common concern for the psyche – the soul. C. G. Jung Carl Gustav Jung was a Swiss psychologist who was the first father of archetypal psychology. Jungian archetypes are thought patterns that find worldwide parallels in individuals or entire cultures. Archai appear in dreams, religions, the arts, and social customs in all people and they manifest impulsively in mental disorders. According to Jung archetypal ideas and patterns reside within the collective unconscious, which is a blueprint inherent in every individual, as opposed to the personal unconscious, which contains a single individual's repressed ideas, desires and memories as described by Freud. What differentiates Jungian psychology from archetypal psychology is that Jung believed archetypes are cultural, anthropological, and transcend the empirical world of time and place, and are not observable through experience (e.g., phenomenal). On the contrary, Archetypal psychology views archetypes to always be phenomenal. Henry Corbin Henry Corbin, a French scholar and philosopher, is the second father of archetypal psychology. Corbin created the idea of the existence of the mundus imaginalis which is a distinct field of imaginable realities and offers an ontological mode of location of archetypes of the psyche. The mundus imaginalis provided an evaluative and cosmic grounding for archetypes. The second contribution Corbin made to the field was the idea that archetypes are accessible to imagination and first present themselves as images, so the procedure of archetypal psychology must be rhetorical and poetic, without logical reasoning, and the goal in therapy should be to restore the patient's imaginable realities. Therefore, the goal of therapy is the middle ground of psychic realities, a development of a sense of soul. Also, according to Corbin, the method of therapy is the cultivation of imagination. Edward Casey Edward S. Casey is attributed with distinguishing archetypal psychology from other theories by explaining an image as a way of seeing rather than something seen. According to Casey, an image is only perceived by imagining because an image is not what one sees but the way one sees. He also states that imagination is an activity of soul and not just a human faculty. An image appears to be more profound, more powerful, and more beautiful than the comprehension of it. This explains the drive behind the arts which provide disciplines that can actualize the complexity of the image. James Hillman Hillman (1975) sketches a brief lineage of archetypal psychology. By calling upon Jung to begin with, I am partly acknowledging the fundamental debt that archetypal psychology owes him. He is the immediate ancestor in a long line that stretches back through Freud, Dilthey, Coleridge, Schelling, Vico, Ficino, Plotinus, and Plato to Heraclitus – and with even more branches yet to be traced (p. xvii). Polytheistic psychology Thomas Moore says of James Hillman's teaching that he "portrays the psyche as inherently multiple". In Hillman's archetypal/polytheistic view, the psyche or soul has many directions and sources of meaning – and this can feel like an ongoing state of conflict – a struggle with one's daimones. According to Hillman, "polytheistic psychology can give sacred differentiation to our psychic turmoil...." Hillman states that The power of myth, its reality, resides precisely in its power to seize and influence psychic life. The Greeks knew this so well, and so they had no depth psychology and psychopathology such as we have. They had myths. And we have no myths – instead, depth psychology and psychopathology. Therefore... psychology shows myths in modern dress and myths show our depth psychology in ancient dress." Hillman qualifies his many references to gods as differing from a literalistic approach saying that for him they are aides memoires, i.e. sounding boards employed "for echoing life today or as bass chords giving resonance to the little melodies of life." Hillman further insists that he does not view the pantheon of gods as a 'master matrix' against which we should measure today and thereby decry modern loss of richness. Psyche or soul Hillman says he has been critical of the 20th century's psychologies (e.g., biological psychology, behaviorism, cognitive psychology) that have adopted a natural scientific philosophy and praxis. His main criticisms include that they are reductive, materialistic, and literal; they are psychologies without psyche, without soul. Accordingly, Hillman's oeuvre has been an attempt to restore psyche to its proper place in psychology. Hillman sees the soul at work in imagination, fantasy, myth and metaphor. He also sees soul revealed in psychopathology, in the symptoms of psychological disorders. Psyche-pathos-logos is the "speech of the suffering soul" or the soul's suffering of meaning. A great portion of Hillman's thought attempts to attend to the speech of the soul as it is revealed via images and fantasies. Hillman has his own definition of soul. Primarily, he notes that soul is not a "thing", not an entity. Nor is it something that is located "inside" a person. Rather, soul is "a perspective rather than a substance, a viewpoint towards things... (it is) reflective; it mediates events and makes differences..."(1975). Soul is not to be located in the brain or in the head, for example (where most modern psychologies place it), but human beings are in psyche. The world, in turn, is the anima mundi, or the world ensouled. Hillman often quotes a phrase coined by the Romantic poet John Keats: "call the world the vale of soul-making." Additionally, Hillman (1975) says he observes that soul: refers to the deepening of events into experiences; second the significance of soul makes possible, whether in love or religious concern, derives from its special relationship with death. And third, by 'soul' I mean the imaginative possibility in our natures, the experiencing through reflective speculation, dream, image, fantasy—that mode which recognizes all realities as primarily symbolic or metaphorical. The notion of soul as imaginative possibility, in relation to the archai or root metaphors, is what Hillman has termed the "poetic basis of mind". Dream analysis Because Hillman's archetypal psychology is concerned with fantasy, myth, and image, dreams are considered to be significant in relation to the soul. Hillman does not believe that dreams are simply random residue or flotsam from waking life (as advanced by physiologists), but neither does he believe that dreams are compensatory for the struggles of waking life, or are invested with "secret" meanings of how one should live (à la Jung). Rather, "dreams tell us where we are, not what to do" (1979). Therefore, Hillman is against the 20th century traditional interpretive methods of dream analysis. Hillman's approach is phenomenological rather than analytic (which breaks the dream down into its constituent parts) and interpretive/hermeneutic (which may make a dream image "something other" than what it appears to be in the dream). His dictum with regard to dream content and process is "Stick with the image." Hillman (1983) describes his position succinctly: For instance, a black snake comes in a dream, a great big black snake, and you can spend a whole hour with this black snake talking about the devouring mother, talking about anxiety, talking about the repressed sexuality, talking about the natural mind, all those interpretive moves that people make, and what is left, what is vitally important, is what this snake is doing, this crawling huge black snake that's walking into your life... and the moment you've defined the snake, you've interpreted it, you've lost the snake, you've stopped it.... The task of analysis is to keep the snake there.... The snake in the dream does not become something else: it is none of the things Hillman mentioned, and neither is it a penis, as Hillman says Freud might have maintained, nor the serpent from the Garden of Eden, as Hillman thinks Jung might have mentioned. It is not something someone can look up in a dream dictionary; its meaning has not been given in advance. Rather, the black snake is the black snake. Approaching the dream snake phenomenologically simply means describing the snake and attending to how the snake appears as a snake in the dream. It is a huge black snake, that is given. But are there other snakes in the dream? If so, is it bigger than the other snakes? Smaller? Is it a black snake among green snakes? Or is it alone? What is the setting, a desert or a rain forest? Is the snake getting ready to feed? Shedding its skin? Sunning itself on a rock? All of these questions are elicited from the primary image of the snake in the dream, and as such can be rich material revealing the psychological life of the dreamer and the life of the psyche spoken through the dream. The Soul's Code Hillman's 1996 book, The Soul's Code: In Search of Character and Calling, outlines an "acorn theory of the soul". His theory states that each individual holds the potential for their unique possibilities inside themselves already, much as an acorn holds the pattern for an oak, invisible within itself. It argues against the parental fallacy whereby our parents are seen as crucial in determining who we are by supplying us with genetic material and behavioral patterns. Instead the book suggests for a reconnection with what is invisible within us, our daimon or soul or acorn and the acorn's calling to the wider world of nature. It argues against theories which attempt to map life into phases, suggesting that this is counter-productive and makes people feel like they are failing to live up to what is normal. This in turn produces a truncated, normalized society of soulless mediocrity where evil is not allowed but injustice is everywhere – a society that cannot tolerate eccentricity or the further reaches of life experiences but sees them as illnesses to be medicated out of existence. Hillman diverges from Jung and his idea of the Self. Hillman sees Jung as too prescriptive and argues against the idea of life-maps by which to try to grow properly. Instead, Hillman suggests a reappraisal of each individual's childhood and present life to try to find the individual's particular calling, the acorn of the soul. He has written that he is the one to help precipitate a re-souling of the world in the space between rationality and psychology. He replaces the notion of growing up, with the myth of growing down from the womb into a messy, confusing earthy world. Hillman rejects formal logic in favour of reference to case histories of well known people and considers his arguments to be in line with the puer aeternus or eternal youth whose brief burning existence could be seen in the work of romantic poets like Keats and Byron and in recently deceased young rock stars like Jeff Buckley or Kurt Cobain. Hillman also rejects causality as a defining framework and suggests in its place a shifting form of fate whereby events are not inevitable but bound to be expressed in some way dependent on the character of the soul or acorn in question. Psychopathology and therapy Psychopathology is viewed as the psyche's independent ability to create morbidity, disorder, illness, abnormality and suffering in any part of its behavior and to imagine and experience life through a deformed perspective. Archetypal psychology follows the following procedures for therapy: Regular meetings Face-to-face The therapist chooses the location A fee is charged These procedures may be modified depending on the therapist and the client. In therapy both the therapist and client explore the client's habitual behavior, feelings, fantasies, dreams, memories, and ideas. The goal of therapy is the improvement of the client and termination of treatment. Goals are not stated for therapy. Influence Hillman's archetypal or imaginal psychology influenced a number of younger analysts and colleagues, among the most well known being Thomas Moore and Jungian analyst Stanton Marlan. A brief history of the early influence of Hillman and of archetypal/imaginal psychology can be found in Marlan's Archetypal Psychologies. Criticism See James Hillman: Criticism See also Archetypal pedagogy Analytical psychology Polytheistic myth as psychology Psychological astrology References Select bibliography Inter Views (with Laura Pozzo), 1983 Other writers The Power of Soul, Robert Sardello Hells and Holy Ghosts, David L. Miller Echo's Subtle Body, Patricia Berry 1982 The Soul in Grief, Robert Romanyshyn Technology as Symptom and Dream, Robert Romanyshyn, 1989 Mirror and Metaphor: Images and Stories of Psychological Life, Robert Romanyshyn, 2001 Waking Dreams, Mary Watkins The Alchemy of Discourse, Paul Kugler Words As Eggs: Psyche in Language and Clinic, by Russell Arthur Lockhart The Moon and The Virgin, Nor Hall The Academy of the Dead, Stephen Simmer Svet Zhizni (Light of Life) (in Russian), Alexander Zelitchenko, 2006 Samuels, A. (1995). Jung and the Post-Jungians. London: Routledge. External links The Archetypal Mind Spring Publications website Brent Dean Robbins' James Hillman webpage International Association for Jungian Studies Jungian Archetypes Pacifica Graduate Institute – Graduate school offering programs in Jungian and post-Jungian studies – A journal for Archetypal studies and the arts 1970s introductions Analytical psychology Psychoanalytic schools

Tend and befriend

Tend-and-befriend is a purported behavior exhibited by some animals, including humans, in response to threat. It refers to protection of offspring (tending) and seeking out their social group for mutual defense (befriending). In evolutionary psychology, tend-and-befriend is theorized as having evolved as the typical female response to stress. The tend-and-befriend theoretical model was originally developed by Shelley E. Taylor and her research team at the University of California, Los Angeles and first described in a Psychological Review article published in the year 2000. Biological bases According to the Polyvagal theory developed by Dr. Stephen Porges, the "Social Nervous System" is an affiliative neurocircuitry that prompts affiliation, particularly in response to stress. This system is described as regulating social approach behavior. A biological basis for this regulation appears to be oxytocin. Oxytocin has been tied to a broad array of social relationships and activities, including peer bonding, sexual activity, and affiliative preferences. Oxytocin is released in humans in response to a broad array of stressors, especially those that may trigger affiliative needs. Oxytocin promotes affiliative behavior, including maternal tending and social contact with peers. Thus, affiliation under stress serves tending needs, including protective responses towards offspring. Affiliation may also take the form of befriending, namely seeking social contact for one's own protection, the protection of offspring, and the protection of the social group. These social responses to threat reduce biological stress responses, including lowering heart rate, blood pressure, and hypothalamic pituitary adrenal axis (HPA) stress activity, such as cortisol responses. According to some research, women are more likely to respond to stress through tending and befriending than men. Paralleling this behavioral sex difference, estrogen enhances the effects of oxytocin, whereas androgens inhibit oxytocin release. Tending under stress Female stress responses that increased offspring survival would have led to higher fitness and thus were more likely to be passed on through natural selection. In the presence of threats, protecting and calming offspring while blending into the environment may have increased chances of survival for mother and child. When faced with stress, females often respond by tending to offspring, which in turn reduces stress levels. Studies conducted by Repetti (1989) show that mothers respond to highly stressful workdays by providing more nurturing behaviors towards their children. In contrast, fathers who experienced stressful workdays were more likely to withdraw from their families or were more interpersonally conflictual that evening at home. Furthermore, physical contact between mothers and their offspring following a threatening event decreased HPA activity and sympathetic nervous system arousal. Oxytocin, released in response to stressors, may be the mechanism underlying the female caregiving response. Studies of ewes show that administration of oxytocin promoted maternal behavior. Breastfeeding in humans, which is associated with maternal oxytocin release, is physiologically calming to both mothers and infants. Cooperative breeding Tend-and-befriend is a critical, adaptive strategy that is hypothesized to have enhanced reproductive success among female cooperative breeders. Cooperative breeders are group-living animals where infant and juvenile care from non-mother helpers are essential to offspring survival. Cooperative breeders include wolves, elephants, many nonhuman primates, and humans. Among all primates and most mammals, endocrinological and neural processes lead females to nurture infants, including unrelated infants, after being exposed long enough to infant signals. Non-mother female wolves and wild dogs sometimes begin lactating to nurse the alpha female's pups. Humans are born helpless and altricial, mature slowly, and depend on parental investment well into their young adult lives, and often even later. Humans have spent most of human evolution as hunter-gatherer foragers. Among foraging societies without modern birth control methods, women tend to give birth about every four years during their reproductive lifespan. When mothers give birth, they often have multiple dependent children in their care, who rely on adults for food and shelter for years. Such a reproductive strategy would not have been able to evolve if women did not have help from others. Allomothers (helpers who are not a child's mother) often protect, provision, carry, and care for children. Allomothers are usually a child's aunts, uncles, fathers, grandmothers, siblings, and other persons in the community. Even in modern Western societies, parents often rely on family members, friends, and babysitters to help care for children. Burkart, Hrdy, and Van Schaik (2009) argue that cooperative breeding in humans may have led to the evolution of psychological adaptations for greater prosociality, enhanced social cognition, and cognitive abilities for cooperative purposes, including willingness to share mental states and shared intentionality. These cognitive, prosocial processes brought on by cooperative breeding may have led to the emergence of culture and language. Befriending under stress Group living provides numerous benefits, including protection from predators and cooperation to achieve shared goals and access to resources. In modernized societies at least, it is found that women create, maintain, and use social networks—especially friendships with other women—to manage stressful conditions. During threatening situations, group members can be a source of support and protection for women and their children. Research shows that women operating in a modern and westernized paradigm are more likely to seek the company of others in times of stress, compared to men. In some cultures, women and adolescent girls report more sources of social support and are more likely to turn to same-sex peers for support than men or boys are. One study of six cultures (five of whom were non-western) found that women and girls tend to provide more frequent and effective support than men do, and they are more likely to seek help and support from other female friends and family members, although there was a degree of cultural variation based on the metric used. Women tend to affiliate with other women under stressful situations. However, when women were given a choice to either wait alone or to affiliate with an unfamiliar man before a stressful laboratory challenge, they chose to wait alone. Female-female social networks can provide assistance for childcare, exchange of resources, and protection from predators, other threats, and other group members. Smuts (1992) and Taylor et al. (2000) argue that female social groups also provide protection from male aggression. In spite of the large cultural diversity within this six-culture sample, none of the societies included demonstrated matrilineal tendencies, which have been found to negate and cancel out many supposedly "universal" sex differences (see "criticism" section below). Additionally, the metrics used by the Whitings for evaluating sex differences in social support are somewhat questionable in their ability to predict friendship and relational quality and solidarity. Many other surveys and tests, for instance, find that males actually demonstrate a greater degree of social support than women do in many non-western cultures, particularly from same-gender friendship networks. Neuroendocrine underpinnings Human and animal studies (reviewed in Taylor et al., 2000) suggest that oxytocin is the neuroendocrine mechanism underlying the female "befriend" stress response. Oxytocin administration to rats and prairie voles increased social contact and social grooming behaviors, reduced stress, and lowered aggression. In humans, oxytocin promotes mother-infant attachments, romantic pair bonds, and friendships. Social contact or support during stressful times leads to lowered sympathetic and neuroendocrine stress responses. Although social support downregulates these physiological stress responses in both men and women, women are more likely to seek some forms of social contact during stress. Furthermore, support from another female provides enhanced stress-reducing benefits to women. However, a review of female aggression noted that "The fact that OT [oxytocin] enhances, rather than diminishes, attention to potential threat in the environment casts doubt on the popular ‘tend-and-befriend’ hypothesis which is based on the presumed anxiolytic effect of OT". Benefits of affiliation under stress According to Taylor (2000), affiliative behaviors and tending activities reduce biological stress responses in both parents and offspring, thereby reducing stress-related health threats. "Befriending" may lead to substantial mental and physical health benefits in times of stress. Social isolation is associated with significantly enhanced risk of mortality, whereas social support is tied to positive health outcomes, including reduced risk of illness and death. Women have higher life expectancies from birth in modernized countries where there is equal access to medical care. In the United States, for example, this difference is almost 6 years. One hypothesis is that men's responses to stress (which include aggression, social withdrawal, and substance abuse) place them at risk for adverse health-related consequences. In contrast, women's responses to stress, which include turning to social sources for support, may be protective to health. There are a number of problems and controversies inherent in this reading, however. One major issue is that the female advantage in life expectancy is relatively recent and seems to be related to major societal changes accompanying industrialization, only some of which relate to modern medical advancements. Prior to the Industrial Revolution, men outlived women in many of the societies for which we have demographic data, and in many non-western societies the gap only begun to close and then reverse in the mid-to-late 20th century. The supposed "universality" of women's more adaptive coping mechanisms in response to stress is further challenged by pre-modern data indicating that female rates of suicide were much higher than male rates in many traditional societies. Competition for resources Group living and affiliation with multiple unrelated others of the same sex (who do not share genetic interests) also presents the problem of competing for access to limited resources, such as social status, food, and mates. Interpersonal stress is the most common and distressing type of stress for women. Although the befriending stress response may be especially activated for women under conditions of resource scarcity, resource scarcity also entails more intense competition for these resources. In environments with a female-biased sex ratio, where males are a more limited resource, female-to-female competition for mates is intensified, sometimes even resorting to violence. Although male crime rates far exceed those of females, arrests for assault among females follow a similar age distribution as in males, peaking for females in the late teens to mid-twenties. Those are ages in which females are at peak reproductive potential and experience the most mating competition. However, the benefits of affiliation would have outweighed the costs in order for tend-and-befriend to have evolved. Competition and aggression Rates of aggression between human males and females may not differ, but the patterns of aggression between the sexes do differ in many societies and by many different metrics. Although females in general are less physically aggressive, they tend to engage in as much or even more indirect aggression (e.g. social exclusion, gossip, rumors, denigration). When experimentally primed with a mating motive or status competition motive, men were more willing to become directly aggressive towards another man, whereas women were more likely to indirectly aggress against another woman in an aggression-provoking situation. However, experimentally priming people with a resource competition motive increased direct aggression in both men and women. Consistent with this result, rates of violence and crime are higher among males and females under conditions of resource scarcity. In contrast, resource competition did not increase direct aggression in either men or women when they were asked to imagine themselves married and with a young child. The costs of physical injury to a parent would also entail costs to his or her family. Lower variance in reproductive success and higher costs of physical aggression may explain the lower rates of physical aggression among human females compared to males. Females are in general more likely to produce offspring in their lifetimes than males, although this difference lessens or disappears in societies where monogamy or polyandry have become standardized. Therefore, they typically have less to gain from fighting and the risk of injury or death would produce greater fitness cost for females. The survival of young children might depend more on maternal than paternal care (although a number of studies of traditional societies have found that parental care in general is less essential than sometimes believed, and can be compensated for via alloparenting by both sexes), which underscores the importance of maternal safety, survival, and risk aversion. In this hypothetical model, infants' primary attachment is to their mother; notably, one study found that maternal death increased the chances of childhood mortality in foraging societies by fivefold, compared to threefold in the cases of paternal death. Therefore, women are believed by certain researchers to respond to threats by tending and befriending, and female aggression is often indirect and covert in nature to avoid retaliation and physical injury. Informational warfare Women befriend others not only for protection, but also to form alliances to compete with outgroup members for resources, such as food, mates, and social and cultural resources (e.g. status, social positions, rights and responsibilities). Informational warfare is the strategic, competitive tactics taking the form of indirect, verbal aggression directed towards rivals. Gossip is one such tactic, functioning to spread information that would damage the reputation of a competitor. There are several theories regarding gossip, including social bonding and group cohesion. However, consistent with informational warfare theory, the content of gossip is relevant to the context in which competition is occurring. For example, when competing for a work promotion, people were more likely to spread negative work-related information about a competitor to coworkers. Negative gossip also increases with resource scarcity and higher resource value. In addition, people are more likely to spread negative information about potential rivals but more likely to pass on positive information about family members and friends. As mentioned above, befriending can serve to protect women from threats, including harm from other people. Such threats are not limited to physical harm but also include reputational damage. Women form friendships and alliances in part to compete for limited resources, and also in part to protect themselves from relational and reputational harm. The presence of friends and allies can help deter malicious gossip, due to an alliance's greater ability to retaliate, compared to a single individual's ability. Studies by Hess and Hagen (2009) show that the presence of a competitor's friend reduced people's tendencies to gossip about the competitor. This effect was stronger when the friend was from the same competitive social environment (e.g. same workplace) than when the friend was from a nonrelevant social environment. Friends increase women's perceived capabilities for inflicting reputational harm on a rival as well as perceptions of defensive capabilities against indirect aggression. Criticism and controversy Like most evolutionary psychological theories related to sex differences in behavior, the "tend and befriend" model relies on a great deal of speculation, projection of present-day data into the distant past, untestable and unfalsifiable hypotheses, and reliance on a model of gender essentialism which has come under increasing critique from various social scientists in recent years. One major issue from an anthropological standpoint is the considerable diversity of gendered norms and behaviors in traditional societies, and the difficulty for western researchers to interpret these adequately using quantitative and etic means. Social and behavioral scientists often struggle to keep their personal biases and paradigms from affecting their interpretation of the data, with mixed results. For instance, anthropologists working within a psychoanalytic framework often set out on their project expecting to find cross-cultural confirmation of western gendered ideas such as castration anxiety or the Oedipus complex, only to run into considerable difficulty when non-western societies frequently deviate from these perceived "universal" norms. Sociobiologists and evolutionary psychologists in general have come under fire for cherry-picking and misinterpreting cross-cultural data in order to align with preconceptions about the universality of "human nature", and then accusing cultural anthropologists of various cognitive biases and over-reliance on the alleged "standard social science model". The perceived cross-cultural validation of gender norms such as higher female nurturance or male aggression and assertiveness would therefore have to be evaluated, as much as possible, using emic or culturally-specific means, or through researchers trained in culturally sensitive methodologies (such as Franz Boas' cultural relativism) with the hopes of minimizing western cultural biases. In spite of the perceived universal and biological basis for the tend and befriend response in human women, there is actually a great deal of controversy as to how consistently replicable western gender norms are across the broad range of human societies. Some researchers have found apparently consistent differences across countries favoring women's greater sociability and agreeableness (the dimensions most likely to map onto the tend and befriend theory). However, there are considerable variations between countries, particularly on extraversion, which would seem to frustrate any attempt to find universal bidirectional patterns favoring women's greater tendencies towards cooperative or gregarious behaviors. Many cross-cultural quantitative samples utilized by evolutionary psychologists are also plagued by a patrilineal or patriarchal bias. There is a rich body of data illustrating greater tendencies among women in various cultures toward cooperation, less overt competitiveness, more pro-social and nurturant responses, and preference for indirect and non-confrontational speech styles. For instance, Whiting and Whiting's influential "six culture study" found apparently consistent confirmation of western-stereotyped gender behaviors in six different communities spread across the world: New Englanders in the United States, Mixtec in Mexico, Ilocanos in the Philippines, Rajputs in India, Okinawans in Japan, and Gusii in Kenya. All of these communities are traditional patriarchal, and four of the six are also patrilineal. Even in the two non-patrilineal societies (New Englanders and Ilocanos), there was considerable inculcation towards conformity with patriarchal gender norms, from the capitalistic wage economy in New England and the influence of Spanish Roman Catholicism in the Philippines. This is important since matrilineal and bilateral descent is consistently associated with elimination or even reversal of purported gender differences in competitiveness versus co-operation. Folklore illustrates another piece of evidence for the diversity of gendered behavioral norms; while the familiar construction of dominant and assertive males vs submissive and nurturing females is replicated frequently in cross-cultural folklore motifs, there are notable exceptions and instances of reversed motifs (dominant and assertive females, submissive and nurturing males) in monogamous or matrilineal cultures like the Kadiweu and the Palikur. Heide Gottner-Abendroth's analysis of matriarchal societies (which she defines as all non-patriarchal societies) further challenges the notion that men are inherently less nurturant and therefore less prone to tending and befriending. In non-patriarchal societies, men are often expected to internalize virtues that western society codes as stereotypically "feminine", and the culturally constructed machismo which prevents men in many parts of the world from participating in child care or nurturing warm and pro-social coalitional relationships does not seem to exist. The tend and befriend model also assumes a lower emotional and psychological quality to male same-sex friendships as compared to those between women, interpreting the former as largely "instrumental" and focused on giving and returning favors, building coalitions or acquiring resources while the latter function as superior means of social support. This claim runs squarely counter to data finding that male friendships are equally if not more valuable to men's psychological well-being and societal adjustment than women's. This tendency to read men's homosocial relationships as somehow inherently "defective" in terms of psychoemotional support compared to women's does not fit with historical or cross-cultural accounts of deep romantic friendships between males and considerable emotional intimacy that male friends exchange in a number of non-western societies. Even in modern times, some quantitative research suggest that in some societies which are not affected by Northern European male anxieties about homosocial intimacy (such as Turkey or Portugal), men are equally or even more likely than women to share emotional hardships with same-sexed friends and to offer and receive emotional support from them. In the past, before globalization and industrialization standardized the modern cultural traits of males disproportionately "projecting inward" by killing themselves or using maladaptive coping mechanisms (such as substance abuse), such homosocial intimacy may have been higher across much of the world. it's worth noting that in eastern societies where heterosexual cross-sex contact is often limited men display as much intimacy in their same sex friendships and self disclose to their same sex friends just as much if not slightly more such as in India and Jordan See also Coping (psychology) Need for affiliation Peer support Positive psychology References Further reading Aronson, E., Wilson, T.D., & Akert, R.M. (2005). Social Psychology. (5th ed.) Upper Saddle River, NJ: Pearson Education, Inc. Friedman, H.S., & Silver, R.C. (Eds.) (2007). Foundations of Health Psychology. New York: Oxford University Press. Gurung, R.A.R. (2006). Health Psychology: A Cultural Approach. Belmont, CA: Thomson Wadsworth. External links "Tend and Befriend", Nancy K. Dess, Psychology Today Human behavior Psychological stress

Adaptation model of nursing

In 1976, Sister Callista Roy developed the Adaptation Model of Nursing, a prominent nursing theory. Nursing theories frame, explain or define the practice of nursing. Roy's model sees the individual as a set of interrelated systems (biological, psychological and social). The individual strives to maintain a balance between these systems and the outside world, but there is no absolute level of balance. Individuals strive to live within a unique band in which he or she can cope adequately. Overview of the theory This model comprises the four domain concepts of person, health, environment, and nursing; it also involves a six-step nursing process. Andrews & Roy (1991) state that the person can be a representation of an individual or a group of individuals. Roy's model sees the person as "a biopsychosocial being in constant interaction with a changing environment". The person is an open, adaptive system who uses coping skills to deal with stressors. Roy sees the environment as "all conditions, circumstances and influences that surround and affect the development and behaviour of the person". Roy describes stressors as stimuli and uses the term residual stimuli to describe those stressors whose influence on the person is not clear. Originally, Roy wrote that health and illness are on a continuum with many different states or degrees possible. More recently, she states that health is the process of being and becoming an integrated and whole person. Roy's goal for nursing is "the promotion of adaptation in each of the four modes, thereby contributing to the person's health, quality of life and dying with dignity". These four modes are physiological, self-concept, role function and interdependence. Roy employs a six-step nursing process: assessment of behaviour; assessment of stimuli; nursing diagnosis; goal setting; intervention and evaluation. In the first step, the person's behaviour in each of the four modes is observed. This behaviour is compared with norms and is deemed either adaptive or ineffective. The second step is concerned with factors that influence behaviour. Stimuli are classified as focal, contextual or residual. The nursing diagnosis is the statement of the ineffective behaviours along with the identification of the probable cause. This is typically stated as the nursing problem related to the focal stimuli, forming a direct relationship. In the fourth step, goal setting is the focus. Goals need to be realistic and attainable and are set in collaboration with the person. There are usually both short term and long-term goals that the nurse sets for the patient. Intervention occurs as the fifth step, and this is when the stimuli are manipulated. It is also called the 'doing phase' . In the final stage, evaluation takes place. The degree of change as evidenced by change in behaviour, is determined. Ineffective behaviours would be reassessed, and the interventions would be revised. The model had its inception in 1964 when Roy was a graduate student. She was challenged by nursing faculty member Dorothy E. Johnson to develop a conceptual model for nursing practice. Roy's model drew heavily on the work of Harry Helson, a physiologic psychologist. The Roy adaptation model is generally considered a "systems" model; however, it also includes elements of an "interactional" model. The model was developed specifically for the individual client, but it can be adapted to families and to communities (Roy, 1983). Roy states (Clements and Roberts, 1983) that "just as the person as an adaptive system has input, output. and internal processes so too the family can be described from this perspective." Basic to Roy's model are three concepts: the human being, adaptation, and nursing. The human being is viewed as a biopsychosocial being who is continually interacting with the environment. The human being's goal through this interaction is adaptation. According to Roy and Roberts (1981, p. 43), ‘The person has two major internal processing subsystems, the regulator and the cognator." These subsystems are the mechanisms used by human beings to cope with stimuli from the internal and external environment. The regulator mechanism works primarily through the autonomic nervous system and includes endocrine, neural, and perception pathways. This mechanism prepares the individual for coping with environmental stimuli. The cognator mechanism includes emotions, perceptual/information processing, learning, and judgment. The process of perception bridges the two mechanisms (Roy and Roberts, 1981). Types of Stimuli Three types of stimuli influence an individual's ability to cope with the environment. These include focal stimuli, contextual stimuli, and residual stimuli. Focal stimuli are those that immediately confront the individual in a particular situation. Focal stimuli for a family include individual needs; the level of family adaptation; and changes within the family members, among the members and in the family environment (Roy, 1983). Contextual stimuli are those other stimuli that influence the situation. Residual stimuli include the individual's beliefs or attitudes that may influence the situation. Many times this is the nurse's "hunch" about other factors that can affect the problem. Contextual and residual stimuli for a family system include nurturance, socialization, and support (Roy, 1983). Adaptation occurs when the total stimuli fall within the individual's/family's adaptive capacity, or zone of adaptation. The inputs for a family include all of the stimuli that affect the family as a group. The outputs of the family system are three basic goals: survival, continuity, and growth (Roy, 1983). Roy states (Clements and Roberts, 1983): Since adaptation level results from the pooled effect of all other relevant stimuli, the nurse examines the contextual and residual stimuli associated with the focal stimulus to ascertain the zone within which positive family coping can take place and to predict when the given stimulus is outside that zone and will require nursing intervention. Four Modes of Adaptation Levine believes that an individual's adaptation occurs in four different modes. This also holds true for families (Hanson, 1984). These include the physiologic mode, the self-concept mode, the role function mode, and the interdependence mode. The individual's regulator mechanism is involved primarily with the physiologic mode, whereas the cognator mechanism is involved in all four modes (Roy and Roberts, 1981). The family goals correspond to the model's modes of adaptation: survival = physiologic mode; growth = self-concept mode; continuity = role function mode. Transactional patterns fall into the interdependence mode (Clements and Roberts, 1983). In the physiologic mode, adaptation involves the maintenance of physical integrity. Basic human needs such as nutrition, oxygen, fluids, and temperature regulation are identified with this mode (Fawcett, 1984). In assessing a family, the nurse would ask how the family provides for the physical and survival needs of the family members. A function of the self-concept mode is the need for maintenance of psychic integrity. Perceptions of one's physical and personal self are included in this mode. Families also have concepts of themselves as a family unit. Assessment of the family in this mode would include the amount of understanding provided to the family members, the solidarity of the family, the values of the family, the amount of companionship provided to the members, and the orientation (present or future) of the family (Hanson, 1984). The need for social integrity is emphasized in the role function mode. When human beings adapt to various role changes that occur throughout a lifetime, they are adapting in this mode. According to Hanson (1984), the family's role can be assessed by observing the communication patterns in the family. Assessment should include how decisions are reached, the roles and communication patterns of the members, how role changes are tolerated, and the effectiveness of communication (Hanson, 1984). For example, when a couple adjusts their lifestyle appropriately following retirement from full-time employment, they are adapting in this mode. The need for social integrity is also emphasized in the interdependence mode. Interdependence involves maintaining a balance between independence and dependence in one's relationships with others. Dependent behaviors include affection seeking, help seeking, and attention seeking. Independent behaviors include mastery of obstacles and initiative taking. According to Hanson (1984), when assessing this mode in families, the nurse tries to determine how successfully the family lives within a given community. The nurse would assess the interactions of the family with the neighbors and other community groups, the support systems of the family, and the significant others (Hanson, 1984). The goal of nursing is to promote adaptation of the client during both health and illness in all four of the modes. Actions of the nurse begin with the assessment process, The family is assessed on two levels. First, the nurse makes a judgment with regard to the presence or absence of maladaptation. Then, the nurse focuses the assessment on the stimuli influencing the family's maladaptive behaviors. The nurse may need to manipulate the environment, an element or elements of the client system, or both in order to promote adaptation. Many nurses, as well as schools of nursing, have adopted the Roy adaptation model as a framework for nursing practice. The model views the client in a holistic manner and contributes significantly to nursing knowledge. The model continues to undergo clarification and development by the author. Applying Roy’s Model to Family Assessment When using Roy's model as a theoretical framework, the following can serve as a guide for the assessment of families. I. Adaptation Modes A. Physiologic Mode 1. To what extent is the family able to meet the basic survival needs of its members? 2. Are any family members having difficulty meeting basic survival needs? B. Self-Concept Mode 1. How does the family view itself in terms of its ability to meet its goals and to assist its members to achieve their goals? To what extent do they see themselves as self-directed? Other directed? 2. What are the values of the family? 3. Describe the degree of companionship and understanding given to the family members C. Role Function Mode 1. Describe the roles assumed by the family members. 2. To what extent are the family roles supportive, in conflict, reflective of role overload? 3. How are family decisions reached? D. Interdependence Mode 1. To what extent are family members and subsystems within the family allowed to be independent in goal identification and achievement (e.g., adolescents)? 2. To what extent are the members supportive of one another? 3. What are the family's support systems? Significant others? 4. To what extent is the family open to information and assistance from outside the family unit? Willing to assist other families outside the family unit? 5. Describe the interaction patterns of the family In the community. II. Adaptive Mechanisms A. Regulator: Physical status of the family in terms of health? i.e., nutritional state, physical strength, availability of physical resources B. Cognator: Educational level, knowledge base of family, source of decision making, power base, degree of openness in the system to input, ability to process III. Stimuli A. Focal 1. What are the major concerns of the family at this time? 2. What are the major concerns of the individual members? 3. This is usually related to the nursing diagnoses or the main stimuli causing the problem behaviors. It is important for the nurse to try to fix this before they can fix the problem behaviors as they are related to each other. B. Contextual 1. What elements in the family structure, dynamic, and environment are impinging on the manner and degree to which the family can cope with and adapt to their major concerns (i.e., financial and physical resources, presence or absence of support systems, clinical setting and so on)? These can be either negative or positive as it relates to the main nursing problem. C. Residual 1. What knowledge, skills, beliefs, and values of this family must be considered as the family attempts to adapt (i.e., stage of development, cultural background, spiritual/religious beliefs, goals, expectations)? This is normally an assumption that the nurse has that could impact care. One could describe it as one's educational guess about something going on in the patient's life that could be further contributing to the problem. The nurse assesses the degree to which the family's actions in each mode are leading to positive coping and adaptation to the focal stimuli. If coping and adaptation are not health promoting, assessment of the types of stimuli and the effectiveness of the regulators provides the basis for the design of nursing interventions to promote adaptation. By answering each of these questions in each assessment, a nurse can have a full understanding of the problem's a patient may be having. It is important to recognize each stimuli because without it, not every aspect of the person's problem can be confronted and fixed. As a nurse, it is their job to recognize all of these modes, mechanisms, and stimuli while taking care of a patient. They do so through the use of their advanced knowledge of the nursing process as well as with interviews with the individuals and the family members. Callista Roy maintains there are four main adaptation systems, which she calls modes of adaptation. She calls these the 1. the physiological - physical system 2. the self-concept group identity system 3. the role mastery/function system 4. the interdependency system. See also Nursing theory References Bibliography External links Roy's faculty profile, Boston College Nursing theory

Personal and social education

Personal and social education (PSE) is a component of the state school curriculum in Scotland and Wales. PSE became a statutory requirement in schools in September 2003, and is compulsory for all students at key stages 1, 2, 3 and 4 (5 to 16 years old), and shares some similar elements with Personal, social, health and economic education and citizenship education in England. These include: local and global communities sex education spirituality morals environmental issues PSE framework For each key stage, learning outcomes for knowledge and understanding are set in each of the Aspects (listed below); additionally, learning outcomes for the development of attitudes and values and skills are prescribed across all aspects. ACCAC, the curriculum authority for Wales (part of the Welsh Assembly Government from 1 April 2006), published these in the PSE framework (2000). While it is not compulsory for schools to use the framework, they are expected to use schemes of work in order to standardize practice across teachers and classes. Aspects: Community Emotional Environmental Learning Moral Physical Sexual Social Spiritual Vocational See also Education in Wales Personal, Social, Health and Economic (PSHE) education (the equivalent in England and Scotland) References External links HEALTH EDCO PSE and PSHE Resources BBC PSHE & Citizenship Education by subject Education in Scotland Education in Wales

Student development theories

Student development theory refers to a body of scholarship that seeks to understand and explain the developmental processes of how students learn, grow, and develop in post-secondary education. Student development theory has been defined as a “collection of theories related to college students that explain how they grow and develop holistically, with increased complexity, while enrolled in a postsecondary educational environment”. Early ideas about student development were informed by the larger disciplines of psychology and sociology. Some student development theories are informed by educational psychology that theorizes how students gain knowledge in post-secondary educational environments. There are many theorists that make up early student development theories, such as Arthur Chickering's 7 vectors of identity development, William Perry's theory of intellectual development, Lawrence Kohlberg's theory of moral development, David A. Kolb's theory of experiential learning, and Nevitt Sanford's theory of challenge and support. Student developmental theories are typically understood within theoretical categories of psychosocial, cognitive-structural, person-environment, typology, maturity, social identity, integrative theories, and critical theory frameworks. Student development theories can be understood as evolving across 3 generational waves. First wave developmental theories, often cited as foundational, tended to view student development as universal for all students. First wave theories primarily focus on students’ psychosocial and cognitive-structural development, as well as examining the impact of the campus environment. Second wave theories advanced the developmental focus of the first wave to examine more closely the diversity of student populations and students experiences of social identities across gender, sexuality, race, and ethnicity. Second wave theories brought attention to the socially constructed nature of social identities as well as to the historical exclusion of diverse groups of students from student development theories. Second wave theories may include, Marcia Baxter Magolda's theory of self-authorship, Carol Gilligan's theory of women's moral development, in addition to other social identity and multidimensional identity theories. Third wave theories re-examine student development theory through critical theory and post-structural perspectives. Critical frameworks are used to analyze structures of power, privilege, and oppression in order to call attention to systemic inequality, transformative practices, and social justice. Critical theoretical perspectives that have been used to re-examine student development theory have included, intersectionality, critical race theory, black feminist thought, feminist theory, queer theory, postcolonialism, and poststructuralism. Critical perspectives in the third wave also contribute to the ongoing growth and expansion of the body of student development theories themselves. Student development theories may be used by post-secondary educators and student affairs professionals to better understand and address student needs as well as to guide student affairs practices and policies that impact student development. History The earliest manifestation of student development theory—or tradition—in Europe was in loco parentis. Loosely translated, this concept refers to the manner in which children's schools acted on behalf of and in partnership with parents for the moral and ethical development and improvement of students' character development. Ostensibly this instruction emphasized traditional Christian values through strict rules, enforced by rigid discipline. As such, the primary objective of in loco parentis was on the conditioning of social and individual behavior, rather than intellectual cultivation. The second distinct shift toward a unified student development theory emerged in the late nineteenth century, through the first quarter of the twentieth century, marked by the growth of colleges and universities throughout Europe and the United States, simultaneous with the development of social science disciplines like psychology. By mid-twentieth century, behavioral psychologists such as B.F. Skinner and Carl Rogers influenced educational theory and policy, and a new paradigm emerged known as the Student Services paradigm. As the name indicates, the "student services" perspective said that students ought to be provided with the services that benefit knowledge acquisition. By the mid-twentieth century, the service paradigm started to be replaced with the student development paradigm. This paradigm was influenced by the growing body of psychological and sociological theories, reflecting the idea that students learn both in-class and out-of-class, and are influenced both by their genetics and social environment (see nature and nurture). Basic assumptions guiding the student development movement: Each student is a different individual with unique needs. The entire environment of the student should be taken into account and used for education. Student has a personal responsibility for getting educated. Student Development Theories Categories Student development theories generally can be divided into five categories: Psychosocial. Psychosocial theories focus on long-term issues that tend to occur in sequence and are correlated with chronological age, concentrating on individuals progress through various 'life stages' by accomplishing certain deeds. Cognitive-structural. Cognitive-structural theories address how students perceive and rationalize their experiences. Person–environment. Person–environment theories address interaction between conceptualizations of the college student and the college environment, looking at behavior as a social function of the person and the environment. Those theories are particularly common in career planning. Humanistic existential. Humanistic existential theories concentrate on certain philosophical concepts about human nature: freedom, responsibility, self-actualization and that education and personal growth are encouraged by self-disclosure, self-acceptance and self-awareness. These theories are used extensively in counseling. Student development process models. Student development process models can be divided into abstract and practical. There are dozens of theories falling into these five families. Among the most known are: Arthur W. Chickering's theory of identity development William G. Perry's cognitive theory of student development Schlossberg's transition theory Schlossberg's transition theory has been worked on over time and has changed some of it original context. This theory is mostly based on the individual and what they consider to be a transition in their life. This theory is used as a guideline from what steps should be taken during the transition to help the young adult to continue to work on and transition into what they need. We use different questionnaires to determine and assess the ability of a certain person to cope with the transition. Here is a quick review of the steps and ideas behind Schlossberg's theory: Transitions Events or nonevents resulting in changed relationships, routines, assumptions, or even roles Meaning for the individual based on Type: anticipated, unanticipated, nonevent Context: relationship to transition and the setting Impact: alterations in daily life The transition process Reactions over time Moving in, moving through, and moving out Coping with transitions Influenced by ration or assets and liabilities in regard to four sets of factors: Situation: trigger, timing, control, role change, duration, previous experience, concurrent stress, assessment Self: personal and demographic characteristics, psychological resources Support: types, functions, measurement Strategies: categories, coping modes Kohlberg's theory of moral development Using ideas of Piaget and cognitive development Kohlberg looks into the judgments of people and what they consider justifiable to determine about their ideas of Morality come into play. Using only these ideas, not culture, we see how people develop their own moral code and how it changes or stays the same over time. Stages of Kohlberg's moral development theory Level I: Preconventional Stage One: Heteronomous morality: Obeying rules so not to be punished (focus more on self than the other) Stage Two: Individualistic, instrumental morality: Focusing on only following the rules that benefit themselves. Level II: Conventional Stage Three: Interpersonally normative morality: The person begins to start living up to the expectations of the important people around them. (i.e.: friends, parents, teachers) Stage Four: Social system morality: We begin to realize that everyone has morals and we live in the society's morals established by the people in it. Level III: Postconventional or Principled Stage Five: Human rights and social welfare morality: Being able to depend on everyone around to carry out the social justices and entering groups to maintain these ideas that the individual holds as well. Stage Six: Morality of universalizable, reversible, and prescriptive general ethical principles: Coming up with generalized morals that can apply to everyone and everything that the individual does. Kolb's theory of experiential learning Looking at how individuals learn is a huge part in the development of self according to Kolb and his model. By knowing what the individual needs to do to learn makes it easier for the individual to grow as a person. Using the different personality types and ways to learn, we become more self-aware and willing to learn from new ways. Kolb's cycle of learning Concrete Experience (CE): Full and unbiased involvement in learning experience Reflective Observation (RO): Contemplation of one's experiences from various perspectives Abstract Conceptualization (AC): Idea formulation and integration Active Experiment (AE): Incorporation of new ideas into action Kolb's learning style model Accommodator (CE + RO): Is action oriented and at ease with people, prefers trial-and-error problem solving Is good at carrying out plans, is open to new experiences, adapts easily to change Diverger (RO + AC): Is people- and feeling-oriented Has imagination and is aware of meaning and values, is good at generating and analyzing alternatives Converger (AC + AE): Prefers technical tasks over social or interpersonal settings Excels at problem solving, decision making, and practical applications Assimilator (AC + RO): Emphasizes ideas rather than people Is good at inductive reasoning, creating theoretical models, and integrating observations Sanford's theory of challenge and support Sanford's theory of challenge and support states that for optimal student developmental growth in a college environment, challenges they experience must be met with supports that can sufficiently tolerate the stress of the challenge itself. Nevitt Sanford, a psychologist, was a scholar who theorized about the process college students would encounter throughout their college development. He addressed the relationship between the student and their college environment. Sanford proposed three developmental conditions: readiness, challenge, and support. Readiness refers to internal processes associated with maturation or beneficial environmental factors. This condition of readiness can aid a student's developmental growth if he or she is physically or psychologically ready. If not, it could limit their developmental growth. Challenge refers to situations in which an individual does not have the skills, knowledge, or attitude to cope. Support refers to buffers in the environment that help the individual to successfully meet challenges. Sanford speculated that if students are met with too much challenge, they could regress in their developmental growth and give up on the challenge at hand. For example, in a review by the University of California, Los Angeles, Chaves discussed the juggling of multiple challenges that adult student learners encounter such as integration into an institution, commuting to campus, social integration, and absence from school for a number of years that cause adult student learners to regress in their time to graduation or not graduate at all. If students are met with excessive support, they may not understand what they need and their development would be limited. For example, in a qualitative study grounded in constructivist theory methodology, Marx concluded that college campuses provided too much support, limiting students' forward movement in their ability to internally define their own beliefs, identity, and relationships during college. In both studies, the research indicated that students were unable to reach optimal developmental growth without the appropriate amount of challenge or support. It is likely that most students will face an academic, social, or personal challenge during their postsecondary college or university journey. Research shows that challenges are different for traditional age students and adult student learners, various marginalized and majority identity groups, international students, students in specific learning communities, and numerous other characteristics. Research indicates that support for students can be in the form of mentoring and involvement from faculty, staff, family, and peers, ability to be involved in meaningful college activity, believing they matter, and designing their own curriculum or programs, among other support options. When challenges are met with appropriate support, students' developmental growth in a college environment is optimal. For example, a longitudinal study conducted by Ong, Phinney, and Dennis examined 123 Latino college students attending an ethnically diverse urban university in southern California. These Latino students faced challenges of being low socioeconomic status (SES), psychological stress, feelings of alienation, and low rates of college retention. However, these students were met with consistent parental support, family interdependence, and an affirmation of their membership in their ethnic group. The support correlated positively to an increased grade point average and greater academic achievement, resilience, and positive adaptation. Disability Identity Development In College Students The importance of accommodation for students with disabilities as grown substantially since the turn of the millennium. Disability was once viewed as resulting from a moral lapse, such as poor actions of parents, resulting in having a child with disabilities. Post Secondary institutions historically viewed disability from the lens of the medical model, whether it is curable or incurable by medicine. More recently institutions are beginning to view disability as a limitation of the social and physical environments and not a limitation of the individual. For example, stairs are a limitation for individuals who have mobility issues, but ramps are accessible to individuals with and without a mobility limitation. Refitting institutional design to this view is a result of a change in adopted model of disability. Stage Models of Disability Identity Gibson (2006) identified a three staged model to describe the trajectories of disabled students and how they come to understand themselves inclusive of their disability. Stage 1: Passive Awareness (childhood) ·        Individual's medical needs are met however they avoid attention and avoids associating with other disabled individuals. Stage 2: Realization (Adolescence/ Early Adulthood) ·        Begins to view themselves as having a disability and may experience self-hate, and become more socially aware of how their disability impacts the perceptions that others have of them. Stage 3: Acceptance (Adulthood) ·        Begins to understand their differences in a positive way and integrate themselves into the able-bodied world. Will also incorporate other individuals with disabilities into their lives. These stages can be fluid, meaning movement from one stage to another does not mean it is a permanent move. For students in stage three an event such as moving to on campus residence and have to share a bedroom or bathroom may move them back to stage 2. Building off of this model proposed by Gibson (2006), Forber-Pratt and Aragon (2013) proposed a four staged model: Stage 1: Acceptance ·        Student undergoes a process of accepting their disability which includes denial, anger, bargaining, depression and eventually acceptance. This includes acceptance of the disability from friends, family, and educators. Stage 2: Relationship Phase ·        Begins to interact with students with disabilities and learn the norms and activities of the group. Creating connection to others with disabilities is the key component of this stage. Stage 3: Adoption ·        Begins to internalize the core values of the disability culture. Being independent by navigating the world and managing personal hygiene and participating in social justice whether this be self advocacy or collective activism. Stage 4: Giving Back to Community Phase ·        Become leaders in disability culture and demonstrate role modelling behaviour for other students with disabilities. Combining theories Student development theories, such as Sanford's theory of challenge and support, are not meant to be used alone in practice. It is important to acknowledge that multiple theories, such as Astin's involvement theory, Chickering's theory of identity development, Kohlberg's theory of moral development, Rendon's theory of validation, Schlossberg's theory of mattering and marginality, Schlossberg's transition theory, among others, can be cross pollinated in an individual student's situation. Often the intersection of many student development theories is what is most effective in working with postsecondary college or university student environments. References Further reading Astin, A. Student involvement: a developmental theory for higher education. Journal of College Student Personnel, 25(4), 297–308, 1984. Creamer, Don G. (Ed.). Student Development in Higher Education: Theories, Practices and Future Directions. Cincinnati: ACPA, 1980. Knefelkamp, Lee, Widick, Carole and Parker, Clyde (eds.). Applying New Developmental Findings. New Directions for Student Services No. 4. San Francisco: Jossey-Bass, 1978. Miller, T.K. and Winston, Jr., R.B. "Human Development and Higher Education." In T.K. Miller, R.B. Winston, Jr. and Associates. Administration and Leadership in Student Affairs: Actualizing Student Development in Higher Education. Muncie, Indiana: Accelerated Development, Inc., 1991 Rodgers, R. F. "Student Development." In U. Delworth, G. R. Hanson, and Associates, Student Services: A Handbook for the Profession. San Francisco: Jossey-Bass, 1989. Sanford, N. Self & society: social change and individual development. New York, NY: Atherton Press, 1967. Strange, C. "Managing College Environments: Theory and Practice." In T.K. Miller, R. B. Winston, Jr. and Associates, Administration and Leadership in Student Affairs: Actualizing Student Development in Higher Education. Muncie, Indiana: Accelerated Development, Inc., 1991. Strange, C. C., & Banning, J. H. (2001). Educating by design: Creating campus learning environments that work. San Francisco: Jossey-Bass. Upcraft, M. Lee and Gardner, John L. (Eds.). The Freshman Year Experience. San Francisco: Jossey-Bass, 1989. p. 41–46. Upcraft, M. Lee and Moore, Leila V. "Evolving Theoretical Perspectives of Student Development." In Margaret J. Barr, M. Lee Upcraft and Associates. New Futures for Student Affairs. San Francisco: Jossey-Bass, 1990. Educational psychology Education theory

Hypostasis (linguistics)

In linguistics, a hypostasis (from the Greek word ὑπόστασις meaning foundation, base or that which stands behind) is a relationship between a name and a known quantity, as a cultural personification (i.e. objectification with personality) of an entity or quality. It often connotes the personification of typically elemental powers, such as wind and fire, or human life, fertility, and death. In descriptive linguistics, the term was first introduced by Leonard Bloomfield to account for uses of synsemantic words as autosemantic in sentences such as I'm tired of your ifs and buts. In this sense, the usage meaning of the word is referred to as a whole. The term hypostasis is considered to be scientifically and culturally neutral, for the purpose of describing name-to-term relationships that, within religion and theology, might be termed a "deification", or otherwise by the more pejorative "idolatry". The concept of "hypostasis" functions as a kind of conceptual inverse for terms which may have originated as personal names, and have linguistically evolved to become common terms for general concepts and qualities. See also Hypostasis (literature) Notes Onomastics

Ethnozoology

Ethnozoology is a field of study that explores the complex relationships between humans and animals in their environment. This discipline encompasses the classification and naming of various animal species, as well as the cultural knowledge and use of both wild and domesticated animals. Ethnozoology is a subdiscipline of ethnobiology, which also includes ethnobotany, the study of human-plant relationships. However, unlike ethnobotany, ethnozoology focuses specifically on human-animal relationships and the knowledge that humans have acquired about the animals in their surroundings. The study of ethnozoology sheds light on the roles that animals have played in human societies throughout history, from their utilitarian functions to their cultural, religious, artistic, and philosophical significance. Ethnozoology can be approached from various perspectives, such as ecological, cognitive, and symbolic, and it connects scientific methods to traditional systems of knowledge and cultural beliefs. Conservation In a broader context, ethnozoology and its companion discipline, ethnobotany, contribute to the larger science of ethnobiology. The history of ethnobiology is divided into three periods. The pre-classical period, which began around 1860, focused on collecting information about humans' use of resources, while the classical period, which began in 1954, produced anthropological studies on linguistics and biological classifications. The current period, or post-classical period, has been described as a meeting of social science and the study of natural resources. Given the profound human influence on faunal biodiversity, wildlife conservation planning is becoming increasingly urgent. It is widely acknowledged that environmental health is important to human health, and biodiversity loss can have both indirect and direct negative effects on human wellbeing. The close link between human health and ecological/faunal health is substantiated with five important concepts: animals cause and disseminate disease for humans and vice versa, animals can be guards of human health, animals are used in traditional medicine practices throughout the world, animals are a source of drugs and treatments in human diseases, and animals are used in medical research. The social sciences Sociology Sociology has been slow to explore ethnozoology and grant it credibility. The study of ethnozoology is important because policy makers and concerned citizens are too often left to be informed only by animal advocates or biomedical researchers, both of which are inherently biased. Animals provide humans with a better understanding of ourselves, and how we think and act toward animals has the potential to reveal our attitudes toward other people and social order. Evidence of this can be seen in the ways that animal images may at times be expressing underlying racism: "the most damning testimony given by accused police at the Rodney King trial involved characterization of King as a 'gorilla'; during the Persian Gulf War Saddam Hussein was described in the American press as a 'rat'; and the actions of people in the Los Angeles riots were likened by the media commentators to 'packs of vicious animals'". Sociology is a science concerned with groups and group formation, including those facing structural and interpersonal oppression, suffering, and vulnerability. Sub-fields in this area include African Americans studies, women's studies, and gay/lesbian studies. However, not much attention or legitimacy is awarded animal studies as a sub-field. Modern use of animals in the developed world, especially in the United States, can be characterized by exploitation, domination, and oppression. Animal cruelty and abuse is not only present in the industrial farming of livestock, but also in such circumstances as dog fighting, cow tipping, horse racing, circus acts, and other entertainment industries and practices. Furthermore, animals are often victims and pawns used in domestic violence. The widespread abuse of animals in modern society is important for sociology because it involves an entrenched assumption about the connection between cruelty toward animals and violence directed and human beings. Some research has even suggested ways in which the human-animal interaction can challenge dominant sociological theories about the self. Anthropology Anthropology has done more to study ethnozoology in terms of the history of the function of animals in non-industrialized societies and the role that animals play symbolically and religiously in different cultures around the world. The domestication process has been a chief concern for anthropologists, whose interests are in the history of human desire to understand animals, enslave them, and harness their power. Animal-derived products have been used especially for food, but also for clothing, tools, toys, and for medicinal and magic-religious purposes. Many cultures associate strong supernatural powers between the animal and human worlds, including mythologies and connections with totemic, ancestral, or magical animals and animal-gods. Animals are given symbolic meaning, as in the western association of black cats with poor luck. Biological knowledge varies according to cultural and traditional knowledge and experiences. People share a basic way of comprehending the natural world based on common evolutionary history, and this foundation connects scientific biology with its historical roots in different cultures. The evolutionary perspective on human cognition and affect indicates some degree of universality in perception and decision-making with regard to the natural world and its fauna. The interaction between these aspects of psychology, biodiversity of the Earth's wildlife, and the unique social, cultural, and economic contexts within which humans interact and develop produces cultural diversity. Paleoanthropological studies suggest that linguistic approaches to ethnobiology have only recently evolved in the context of human history, which suggests that these linguistic approaches only provide a partial understanding to how humans perceive and engage with the natural world around them. See also Anthrozoology References External links Notes on Bukusu ethnozoology from western Kenya Ethnobiology Traditional knowledge Zoology

Connectivism

Connectivism is a theoretical framework for understanding learning in a digital age. It emphasizes how internet technologies such as web browsers, search engines, wikis, online discussion forums, and social networks contributed to new avenues of learning. Technologies have enabled people to learn and share information across the World Wide Web and among themselves in ways that were not possible before the digital age. Learning does not simply happen within an individual, but within and across the networks. What sets connectivism apart from theories such as constructivism is the view that "learning (defined as actionable knowledge) can reside outside of ourselves (within an organization or a database), is focused on connecting specialized information sets, and the connections that enable us to learn more are more important than our current state of knowing". Connectivism sees knowledge as a network and learning as a process of pattern recognition. Connectivism has similarities with Vygotsky's zone of proximal development (ZPD) and Engeström's activity theory. The phrase "a learning theory for the digital age" indicates the emphasis that connectivism gives to technology's effect on how people live, communicate, and learn. Connectivism is an integration of principles related to chaos, network, complexity, and self-organization theories. History Connectivism was first introduced in 2004 on a blog post which was later published as an article in 2005 by George Siemens. It was later expanded in 2005 by two publications, Siemens' Connectivism: Learning as Network Creation and Stephen Downes' An Introduction to Connective Knowledge. Both works received significant attention in the blogosphere and an extended discourse has followed on the appropriateness of connectivism as a learning theory for the digital age. In 2007, Bill Kerr entered into the debate with a series of lectures and talks on the matter, as did Forster, both at the Online Connectivism Conference at the University of Manitoba. In 2008, in the context of digital and e-learning, connectivism was reconsidered and its technological implications were discussed by Siemens' and Ally. Nodes and links The central aspect of connectivism is the metaphor of a network with nodes and connections. In this metaphor, a node is anything that can be connected to another node such as an organization, information, data, feelings, and images. Connectivism recognizes three node types: neural, conceptual (internal) and external. Connectivism sees learning as the process of creating connections and expanding or increasing network complexity. Connections may have different directions and strength. In this sense, a connection joining nodes A and B which goes from A to B is not the same as one that goes from B to A. There are some special kinds of connections such as "self-join" and pattern. A self-join connection joins a node to itself and a pattern can be defined as "a set of connections appearing together as a single whole". The idea of organisation as cognitive systems where knowledge is distributed across nodes originated from the Perceptron (Artificial neuron) in an Artificial Neural Network, and is directly borrowed from Connectionism, "a software structure developed based on concepts inspired by biological functions of brain; it aims at creating machines able to learn like human". The network metaphor allows a notion of "know-where" (the understanding of where to find the knowledge when it is needed) to supplement to the ones of "know-how" and "know-what" that make the cornerstones of many theories of learning. As Downes states: "at its heart, connectivism is the thesis that knowledge is distributed across a network of connections, and therefore that learning consists of the ability to construct and traverse those networks". Principles Principles of connectivism include: Learning and knowledge rests in diversity of opinions. Learning is a process of connecting specialized nodes or information sources. Learning may reside in non-human appliances. Learning is more critical than knowing. Maintaining and nurturing connections is needed to facilitate continuous learning. When the interaction time between the actors of a learning environment is not enough, the learning networks cannot be consolidated. Perceiving connections between fields, ideas and concepts is a core skill. Currency (accurate, up-to-date knowledge) is the intent of learning activities. Decision-making is itself a learning process. Choosing what to learn and the meaning of incoming information is seen through the lens of a shifting reality. While there is a right answer now, it may be wrong tomorrow due to alterations in the information climate affecting the decision. Teaching methods Summarizing connectivist teaching and learning, Downes states: "to teach is to model and demonstrate, to learn is to practice and reflect." In 2008, Siemens and Downes delivered an online course called "Connectivism and Connective Knowledge". It covered connectivism as content while attempting to implement some of their ideas. The course was free to anyone who wished to participate, and over 2000 people worldwide enrolled. The phrase "Massive Open Online Course" (MOOC) describes this model. All course content was available through RSS feeds, and learners could participate with their choice of tools: threaded discussions in Moodle, blog posts, Second Life and synchronous online meetings. The course was repeated in 2009 and in 2011. At its core, connectivism is a form of experiential learning which prioritizes the set of formed by actions and experience over the idea that knowledge is propositional. Criticisms The idea that connectivism is a new theory of learning is not widely accepted. Verhagen argued that connectivism is rather a "pedagogical view." The lack of comparative literature reviews in Connectivism papers complicate evaluating how Connectivism relates to prior theories, such as socially distributed cognition (Hutchins, 1995), which explored how connectionist ideas could be applied to social systems. Classical theories of cognition such as activity theory (Vygotsky, Leont'ev, Luria, and others starting in the 1920s) proposed that people are embedded actors, with learning considered via three features – a subject (the learner), an object (the task or activity) and tool or mediating artifacts. Social cognitive theory (Bandura, 1962) claimed that people learn by watching others. Social learning theory (Miller and Dollard) elaborated this notion. Situated cognition (Brown, Collins, & Duguid, 1989; Greeno & Moore, 1993) alleged that knowledge is situated in activity bound to social, cultural and physical contexts; knowledge and learning that requires thinking on the fly rather than the storage and retrieval of conceptual knowledge. Community of practice (Lave & Wenger 1991) asserted that the process of sharing information and experiences with the group enables members to learn from each other. Collective intelligence (Lévy, 1994) described a shared or group intelligence that emerges from collaboration and competition. Kerr claims that although technology affects learning environments, existing learning theories are sufficient. Kop and Hill conclude that while it does not seem that connectivism is a separate learning theory, it "continues to play an important role in the development and emergence of new pedagogies, where control is shifting from the tutor to an increasingly more autonomous learner." AlDahdouh examined the relation between connectivism and Artificial Neural Network (ANN) and the results, unexpectedly, revealed that ANN researchers use constructivism principles to teach ANN with labeled training data. However, he argued that connectivism principles are used to teach ANN only when the knowledge is unknown. Ally recognizes that the world has changed and become more networked, so learning theories developed prior to these global changes are less relevant. However, he argues that, "What is needed is not a new stand-alone theory for the digital age, but a model that integrates the different theories to guide the design of online learning materials.". Chatti notes that Connectivism misses some concepts, which are crucial for learning, such as reflection, learning from failures, error detection and correction, and inquiry. He introduces the Learning as a Network (LaaN) theory which builds upon connectivism, complexity theory, and double-loop learning. LaaN starts from the learner and views learning as the continuous creation of a personal knowledge network (PKN). Schwebel of Torrens University notes that Connectivism provides limited account for how learning occurs online. Conceding that learning occurs across networks, he introduces a paradox of change. If Connectivism accounts for this changing in networks, and these networks change so drastically, as technology has in the past, then theses like this must account for that change too, making it no longer the same theory. Furthermore, citing Understanding Media: The Extensions of Man, Schwebel notes that the nodes can impede on the types of learning that can occur, leading to issues with democratised education, as content presented within the network will both be limited to how the network can handle information, and what content is likely to be presented within the network through behaviourist style principles of reinforcement, as providers are likely to recirculate, reproduce and reiterate information that is rewarded through things such as likes. See also References External links Web Presentation (Oral/Slide show) on Connectivism Connectivism: Learning Theory or Pastime for the Self-Amused? Learning theory (education) Philosophy of education Technology integration models

Robopsychology

Robopsychology is the study of the personalities and behavior of intelligent machines. The term was coined by Isaac Asimov in the short stories collected in I, Robot, which featured robopsychologist Dr. Susan Calvin, and whose plots largely revolved around the protagonist solving problems connected with intelligent robot behaviour. The term has been also used in some academic studies from the field of psychology and human–computer interactions, and it refers to the study of the psychological consequences of living in societies where the application of robotics is becoming increasingly common. In real life Andrea Kuszewski, a self-described robopsychologist gives the following examples of potential responsibilities for a robopsychologist in Discover. "Assisting in the design of cognitive architectures Developing appropriate lesson plans for teaching AI targeted skills Create guides to help the AI through the learning process Address any maladaptive machine behaviors Research the nature of ethics and how it can be taught and/or reinforced Create new and innovative therapy approaches for the domain of computer-based intelligences" There is a robopsychology research division at Ars Electronica Futurelab. The term "robopsychology" has been proposed to indicate a "sub-discipline in psychology to systematically study the psychological corollaries of living in societies where the application of robotic and artificial intelligence (AI) technologies is becoming increasingly common." According to proponents of robopsychology, such a discipline does not currently exist: a systematic review of scientific literature shows that in 2022 there was no psychological sub-discipline dedicated to the study of the effects robots have on people's lives. A.V. Libin and E.V. Libin define the term as follows: "[it is] a systematic study of compatibility between people and artificial creatures on many different levels [...]. Robotic psychology studies individual differences in people’s interactions with various robots, as well as the diversity of the robots themselves, applying principles of differential psychology to the traditional fields of human factors and human–computer interactions. Moreover, robopsychologists study psychological mechanisms of the animation of the technological entity which result in a unique phenomenon defined as a robot’s “personality.”" In fiction As described by Asimov, robopsychology appears to be a mixture of detailed mathematical analysis and traditional psychology, applied to robots. Human psychology is also a part, covering human interaction with robots. This includes the "Frankenstein complex" – the irrational fear that robots (or other creations) will turn on their creator. See also Cybernetics Human-robot interaction Psychohistory Three Laws of Robotics References Foundation universe Fictional science Cybernetics Robotics Human–computer interaction

Writing therapy

Writing therapy is a form of expressive therapy that uses the act of writing and processing the written word in clinical interventions for healing and personal growth. Writing therapy posits that writing one's feelings gradually eases feelings of emotional trauma; studies have found this therapy primarily beneficial for alleviating stress caused by previously undisclosed adverse events and for those suffering from medical conditions associated with the immune system. Writing therapeutically can take place individually or in a group and can be administered in person with a therapist or remotely through mailing or the Internet. The field of writing therapy includes many practitioners in a variety of settings, usually administered by a therapist or counselor. Writing group leaders also work in hospitals with patients dealing with mental and physical illnesses. In university departments, they aid student self-awareness and self-development. Online and distance interventions are useful for those who prefer to remain anonymous and/or are not ready to disclose their most private thoughts and anxieties in a face-to-face situation. As with most forms of therapy, writing therapy is adapted and used to work with a wide range of psychoneurotic issues, including bereavement, desertion and abuse. Many interventions take the form of classes where clients write on specific themes chosen by the therapist or counselor. Assignments may include writing unsent letters to selected individuals, alive or dead, followed by imagined replies from the recipient, or a dialogue with the recovering alcoholic's bottle of alcohol. Research Expressive writing paradigm Expressive writing is a form of writing therapy developed primarily by James W. Pennebaker in the late 1980s. The seminal expressive writing study instructed participants in the experimental group to write about a 'past trauma', expressing their very deepest thoughts and feelings surrounding it. In contrast, control participants were asked to write as objectively and factually as possible about neutral topics (e.g., a particular room or their plans for the day) without revealing their emotions or opinions. Both groups wrote continuously for 15 minutes per day for 4 consecutive days. If participants felt they could not write any more details, they were instructed to return to the beginning, potentially repeating what they wrote or writing it in a different manner. The following text provides an example of writing instructions for expressive writing: For the next 4 days, I would like you to write your very deepest thoughts and feelings about the most traumatic experience of your entire life or an extremely important emotional issue that has affected you and your life. In your writing, I'd like you to really let go and explore your deepest emotions and thoughts. You might tie your topic to your relationships with others, including parents, lovers, friends, or relatives; to your past, your present or your future; or to who you have been, who you would like to be or who you are now. You may write about the same general issues or experiences on all days of writing or about different topics each day. All of your writing will be completely confidential. Don't worry about spelling, grammar or sentence structure. The only rule is that once you begin writing, you continue until the time is up. Pennebaker and his team took several measurements before and after, but the most striking finding was that relative to the control group, the experimental group made significantly fewer visits to a physician in the following months. Although many reported being upset by the writing experience, they also found it valuable and meaningful. Pennebaker has either written or co-written over 130 articles on expressive writing. One publication suggested expressive writing may boost the immune system, perhaps explaining the reduction in physician visits. This was shown by measuring lymphocyte response to the foreign mitogens phytohaemagglutinin (PHA) and concanavalin A (ConA) just prior to and six weeks after writing. The significantly increased lymphocyte response led to speculation that expressive writing enhances immunocompetence. The results of a preliminary study of 40 people diagnosed with Major Depressive Disorder suggests that routinely engaging in expressive writing may be effective in reducing symptoms of depression. Reception and criticism of Pennebaker's expressive writing theories Pennebaker's experiments have been widely replicated and validated. Following on from Pennebaker's original work, there has been a renewed interest in the therapeutic value of abreaction. This was first discussed by Josef Breuer and Freud in Studies on Hysteria but not much explored since. At the heart of Pennebaker's theory is the idea that actively inhibiting thoughts and feelings about traumatic events requires effort, serves as a cumulative stressor on the body, and is associated with increased physiological activity, obsessive thinking or ruminating about the event, and longer-term disease. However, as Baikie and Wilhelm note, the theory has intuitive appeal but mixed empirical support.Studies have shown that expressive writing results in significant improvements in various biochemical markers of physical and immune functioning (Pennebaker et al, 1988; Esterling et al, 1994; Petrie et al, 1995; Booth et al, 1997). This suggests that written disclosure may reduce the physiological stress on the body caused by inhibition, although it does not necessarily mean that disinhibition is the causal mechanism underlying these biological effects. On the other hand, participants writing about previously undisclosed traumas showed no differences in health outcomes from those writing about previously disclosed traumas (Greenberg & Stone, 1992) and participants writing about imaginary traumas that they had not actually experienced, and therefore could not have inhibited, also demonstrated significant improvements in physical health (Greenberg et al, 1996). Therefore, although inhibition may play a part, the observed benefits of writing are not entirely due to reductions in inhibition.In a 2013 article by Nazarian and Smyth, writing instructions for the expressive writing task was manipulated in that 6 conditions were created (i.e., cognitive processing, exposure, self-regulation, and benefit-finding, standard expressive writing and a control group). While salivary cortisol was measured for each condition, none of the conditions significantly influenced cortisol, but instructions did impact mood differentially depending on the condition. For example, the cognitive processing as measured post-intervention was influenced not only by the cognitive processing instructions but also, by exposure and benefit-finding. These results demonstrate a spillover effect from instructions to outcomes. In related research, Travagin, Margola, Dennis, and Revenson compared cognitive-processing instructions to standard expressive writing for adolescents with peer problems. This research demonstrated better long-term social adjustment compared to standard expressive writing and greater increased positive affect for those adolescents who reported more peer problems than most. Other theories related to writing therapy An additional line of inquiry, which has particular bearing on the difference between talking and writing, derives from Robert Ornstein's studies into the bicameral structure of the brain. While noting that what follows should be considered "wildly hypothetical", L'Abate, quoting Ornstein, postulates that: Julie Gray, founder of Stories Without Borders notes that "People who have experienced trauma in their lives, whether or not they consider themselves writers, can benefit from creating narratives out of their stories. It is helpful to write it down, in other words, in safety and in non-judgment. Trauma can be quite isolating. Those who have suffered need to understand how they feel and also to try to communicate that to others." Clinical implications Additional research since the 1980s has demonstrated that expressive writing may act as an agent to increase long-term health. Expressive writing can result in physiological, psychological, and biological outcomes, and is part of the emerging medical humanities field. Experiments demonstrate quantitative physiological readouts such as changes in immune counts, and blood pressure, in addition to qualitative readouts relating to psychiatric symptoms. Past attempts at implementing expressive writing interventions in clinical settings indicate that there are potential benefits for treatment plans. However, the specifics of such expressive writing procedures or protocols, and the populations most likely to benefit are not entirely clear. Potential benefits of expressive writing One of the most important aspects of expressive writing used in therapy is the short-term, and long-term effects on the individuals participating. Karen Baikie and Kay Wilhelm go into a brief description of the effects people will have after completing a therapeutic expressive writing session. The short-term effects after utilizing this form of therapy are usually a quick span of feeling distressed or being in a negative mood. However, following up with clients after a longer amount of time to measure those effects finds evidence of many mental and physical health benefits. These benefits include but are not limited to "reduced blood pressure, improved mood, reduced depressive symptoms, and fewer post-traumatic intrusion/avoidance symptoms." This study also showed that these positive long-term emotional outcomes correlated to positive physical outcomes such as improved memory, improved performance at work, quicker re-employment, and many more. While the short-term effects of this therapeutic practice may seem daunting, they are just the stepping stones for individuals to begin a cycle of growth. Potential benefits for cancer patients Illness and disease are experienced on multiple different fronts: biological, psychological, and social. Recent research has explored how narrative medicine and expressive writing, independently, may play a therapeutic role in chronic diseases such as cancer. Comparisons in practice have been made between expressive writing and psychotherapy. Similarly, practices such as integrative, holistic, humanistic, or complementary medicine have already been incorporated into the field. Expressive writing is self-administered with minimal prompting. With further research and refinement, it may be used as a more cost-effective alternative to psychotherapy. Recent experiments, systematic reviews, and meta-analyses examining the effects of expressive writing on ameliorating negative cancer symptoms yielded primarily non-significant initial results. However, analysis of sub-groups and moderating variables suggest that particular symptoms, or situations, may benefit some more than others with the implementation of an expressive writing intervention. For example, a review by Antoni and Dhabhar (2019) examined how psychosocial stress negatively impacts the immune response of patients with cancer. Even if an expressive writing intervention cannot directly impact cancer prognosis, it may play an important role in mediating factors such as chronic stress, trauma, depression, and anxiety. Potential benefits for war trauma victims It is widely acknowledged that trauma is prevalent among veterans, and research indicates that writing therapy can play a significant role in their self-healing journey. A primary contributor to trauma is the sense of powerlessness. Writing facilitates self-healing against this sense of helplessness through the strategy of mythologization. Neil P Baird defines mythologization as the process of establishing standardized narratives that transform uncontrollable events into ones that are contained and predictable. Janis Haswell expands on this concept by highlighting how individuals can utilize writing to manipulate and reshape the traumatic events they have experienced. This allows them to convey the emotional truths of their pasts to not only themselves but to others through the words on a page. Mark Bracher emphasizes the benefits of literacy in general for self-healing. His research indicates that literacy acknowledges the challenges veterans face during their deployment. This acknowledgement can in turn boost their morale and contribute to them feeling valued. Additionally, it aids in diminishing the recollection of distressing memories and reinforces one's sense of self-identity. Nancy Miller explores further the reinforcement of self-identity by examining Kim Phuc, a victim of napalm burns during the Vietnam War. In Kim's biographical memoir, she sought to transform her portrayal from that of a helpless child frightened by war into a tale of forgiveness. Her objective with her writing was to illustrate how she overcame her trauma from war through her deliberate effort to reshape her past with a more optimistic perspective. Potential benefits for individuals recovering from addiction Writing therapy may play a significant role in recovery for individuals with a substance use disorder. Writing exercises have been found to have the potential to improve those in addiction recovery the ability to cope with their conditions, and overall health. Role of distance therapies With the accessibility provided by the Internet, the reach of writing therapies has increased considerably, as clients and therapists can work together from anywhere in the world, provided they can write the same language. They simply "enter" into a private "chat room" and engage in an ongoing text dialogue in "real-time". Participants can also receive therapy sessions via e-text and/or voice with video, and complete online questionnaires, handouts, workout sheets, and similar exercises. This requires the services of a counselor or therapist, albeit sitting at a computer. Given the huge disjunction between the amount of mental illness compared with the paucity of skilled resources, new ways have been sought to provide therapy other than drugs. In the more advanced societies pressure for cost-effective treatments, supported by evidence-based results, has come from both insurance companies and government agencies. Hence the decline in long-term intensive psychoanalysis and the rise of much briefer forms, such as cognitive therapy. Via the Internet Currently, the most widely used mode of Internet writing therapy is via e-mail (see analytic psychotherapist Nathan Field's paper "The Therapeutic Action of Writing in Self-Disclosure and Self-Expression"). It is asynchronous; i.e. messages are passed between therapist and client within an agreed time frame (for instance, one week), but at any time within that week. Where both parties remain anonymous the client benefits from the online disinhibition effect; that is to say, feels freer to disclose memories, thoughts, and feelings that they might withhold in a face-to-face situation. Both client and therapist have time for reflecting on the past and recapturing forgotten memories, time for privately processing their reactions and giving thought to their own responses. With e-therapy, space is eliminated, and time is expanded. Overall, it considerably reduces the amount of therapeutic input, as well as the speed and pressure that therapists habitually have to work under. The anonymity and invisibility provides a therapeutic environment that comes much closer than classical analysis to Freud's ideal of the "analytic blank screen". Sitting behind the patient on the couch still leaves room for a multitude of clues to the analyst's individuality; e-therapy provides almost none. Whether distance and reciprocal anonymity reduces or increases the level of transference has yet to be investigated. In a 2016 randomized controlled trial, expressive writing was tested against direction to an online support group for individuals with anxiety and depression. No difference between the groups was found. Both groups showed a moderate improvement over time but of a magnitude comparable to what one would expect to see over the time period concerned without intervention. Journaling The oldest and most widely practiced form of self-help through writing is that of keeping a personal journal or diary—as distinct from a diary or calendar of daily appointments—in which the writer records their most meaningful thoughts and feelings. One individual benefit is that the act of writing puts a powerful brake on the torment of endlessly repeating troubled thoughts to which everyone is prone. Kathleen Adams states that through the act of journal writing, the writer is also able to "literally [read] his or her own mind" and thus "to perceive experiences more clearly and thus feels a relief of tension". Self-concealment Self-disclosure Reflective writing Poetry Poetry has been a very powerful form of writing for many and there are beneficial factors that correspond with writing and reading poetry. Alicia Ostriker explains how personal experience and memories, whether traumatic or repressed, can be tackled by the person through the artistic ability of writing and facing these emotions that have been neglected in order to release and ease a writer's pain. Robert Baden elaborates how poetry allows a wide range of emotions to be portrayed to describe the feeling or what the writer had felt within their experience to later allow others to engage and relate to their work. Baden expands this concept with the idea that no emotion is too grand or too small for poetry, which allows others to engage with the healing experience. Baden also points out that for there to be an act of healing and release between the emotions that have been held within the conscience, the writer must recognize that there must be a strong enough need to be vulnerable and willing to be able to confront these emotions and trust that the audience will then be able to relate and potentially make others want to use this written release within their own lives. Vasiliki Antzoulis believes that writers should be vulnerable because ignorance should never be the course of action when experiencing all kinds of emotions. Without the ability to talk about what the writer is experiencing, it becomes more difficult to understand what each of these emotions represents and how they affect the writer's current views of life. Dale M. Bauer provides insight that poetry has the power to allow people to be able to talk about inner suffering without judgment and rather gain the ability to have others be able to compare and connect with the writer's experience. Bauer goes on to say that these experiences, no matter if they are good or bad, correspond with the human experience. Being able to have others relate to them allows the writer to feel supported and reflect on what has been shared and what they have obtained with this release and be able to begin healing. Veteran Writer, Liam Corley, healed significantly from his trauma through the means of poetry. By sharing this method with fellow veterans and examining its positive impacts, Corley’s research indicates the concise nature and inherent significance of poetry works greatly for self-healing. This is because poetry fulfills the crucial need for self-expression and assists in providing a voice to those who have felt silenced. James W. Pennebaker has discovered that "writing about trauma allows writers to externalize an event, thereby detaching themselves from the experience" (Writing to Heal 98). Pennebaker argues that once the writer can free themselves from what has been weighing them down, they are then able to begin healing and decide whether they are going to learn from the experience, or if it is something that has been long overdue for a release. Benjamin Batzer recognized that only the writer knows what they have gone through, so the first steps into healing and coping with what life has given, we must first be able to talk about these experiences to take back the power and decide the next point of action. See also Medical humanities Graphic medicine Narrative criticism Storytelling Narration Slow medicine Health humanities Reflective writing References Further reading Psychotherapy by type therapy

Novelty seeking

In psychology, novelty seeking (NS) is a personality trait associated with exploratory activity in response to novel stimulation, impulsive decision making, extravagance in approach to reward cues, quick loss of temper, and avoidance of frustration. That is, novelty seeking (or sensation seeking) refers to the tendency to pursue new experiences with intense emotional sensations. It is a multifaceted behavioral construct that includes thrill seeking, novelty preference, risk taking, harm avoidance, and reward dependence. The novelty-seeking trait is considered a heritable tendency of individuals to take risks for the purpose of achieving stimulation and seeking new environments and situations that make their experiences more intense. The trait has been associated with the level of motive and excitement in response to novelty. Persons with high levels of novelty seeking have been described as more impulsive and disorderly than low novelty seekers and have a higher propensity to get involved in risky activities, such as starting to misuse drugs, engaging in risky sexual activities, and suffering accidental injuries. It is measured in the Tridimensional Personality Questionnaire and the Temperament and Character Inventory, a later version, and is considered one of the temperament dimensions of personality. Like the other temperament dimensions, it has been found to be highly heritable. The related variety seeking, or variety-seeking buying behavior, describes consumers' desire to search for alternative products even they are satisfied with a current product. For example, someone may drink tea with lunch one day but choose orange juice the next day specifically to get something different. High NS has been suggested to be related to low dopaminergic activity. In the revised version of the Temperament and Character Inventory (TCI-R) novelty seeking consists of the following four subscales: Exploratory excitability (NS1) Impulsiveness (NS2) Extravagance (NS3) Disorderliness (NS4) Relationship to other personality traits A research study found that novelty seeking had inverse relationships with other dimensions of the Temperament and Character Inventory, particularly harm avoidance and to a more moderate extent self-directedness and self-transcendence. Novelty seeking is positively associated with the five factor model trait of extraversion and to a lesser extent openness to experience and is inversely associated with conscientiousness. Novelty seeking is positively related to impulsive sensation seeking from Marvin Zuckerman's alternative five model of personality and with psychoticism in Hans J. Eysenck's model. When novelty seeking is defined as a decision process (i.e. in terms of the tradeoff between foregoing a familiar choice option in favor of deciding to explore a novel choice option), dopamine is directly shown to increase novelty-seeking behavior. Specifically, blockade of the dopamine transporter, causing a rise in extracellular dopamine levels, increases the propensity of monkeys to select novel over familiar choice options. Causes Genetics Although the exact causes for novelty-seeking behaviors is unknown, there may be a link to genetics. Studies have found an area on the Dopamine receptor D4 gene on chromosome 11 that is characterized by several repeats in a particular base sequence. Multiple studies have identified a link to genetics, particulalyr that was one conducted by Dr. Benjamin and colleagues in which individuals who had longer alleles of this gene had higher novelty-seeking scores than individuals with the shorter allele. In another study relating to the gene and financial risk, Dr. Dreber and colleagues found a correlation between increased risk-taking and the DRD4 gene in young males. Although studies support the link between novelty seeking and dopaminergic activity via DRD4, other studies do not exhibit a strong correlation. The importance of DRD4 in novelty seeking has yet to be confirmed conclusively. Dopamine In addition to potential heredity, novelty-seeking behaviors are seen with the modulation of dopamine. The overall effect of dopamine when exposed to a novel stimulus is a mass release of the neurotransmitter in reward systems of the brain including the mesolimbic pathway. The mesolimbic pathway is active in every type of addiction and is involved with reinforcement. Because of the activation in the brain, novelty seeking has been linked to personality disorders as well as substance abuse and other addictive behaviors. DRD4 receptors are highly expressed in areas of the limbic system, which is associated with emotion and cognition. Single-nucleotide polymorphisms such as rs4680 have also been examined within this realm of study. Age It is important to note the individual's age with novelty seeking. The behavior will decrease with time, especially as the brains of adolescents and young adults finalize their development. Possible factors of variation include gender, ethnicity, temperament, and environment. See also Adrenaline junkie Attention-deficit hyperactivity disorder Low arousal theory Neophilia Openness to experience Sensation Seeking Scale References Personality traits

Ethnic identity development

Ethnic identity development includes the identity formation in an individual's self-categorization in, and psychological attachment to, (an) ethnic group(s). Ethnic identity is characterized as part of one's overarching self-concept and identification. It is distinct from the development of ethnic group identities. With some few exceptions, ethnic and racial identity development is associated positively with good psychological outcomes, psychosocial outcomes (e.g., better self-beliefs, less depressive symptoms), academic outcomes (e.g., better engagement in school), and health outcomes (e.g., less risk of risky sexual behavior or drug use). Development of ethnic identity begins during adolescence but is described as a process of the construction of identity over time due to a combination of experience and actions of the individual and includes gaining knowledge and understanding of in-group(s), as well as a sense of belonging to (an) ethnic group(s). It is important to note that given the vastly different histories of various racial groups, particularly in the United States, that ethnic and racial identity development looks very different between different groups, especially when looking at minority (e.g., Black American) compared to majority (e.g., White American) group comparisons. Ethnic identity is sometimes interchanged with, held distinct from, or considered as overlapping with racial, cultural and even national identities. This disagreement in the distinction (or lack thereof) between these concepts may originate from the incongruity of definitions of race and ethnicity, as well as the historic conceptualization of models and research surrounding ethnic and racial identity. Research on racial identity development emerged from the experiences of African Americans during the civil rights movement, however expanded over time to include the experiences of other racial groups. The concept of racial identity is often misunderstood and can have several meanings which are derived from biological dimensions and social dimensions. Race is socially understood to be derived from an individual's physical features, such as white or black skin tone. The social construction of racial identity can be referred as a sense of group or collective identity based on one's perception that they share a common heritage with a particular racial group. Racial identity is a surface-level manifestation based on what people look like yet has deep implications in how people are treated. History Generally, group level processes of ethnic identity have been explored by social science disciplines, including sociology and anthropology. In contrast, ethnic identity research within psychology usually focuses on the individual and interpersonal processes. Within psychology, ethnic identity is typically studied by social, developmental and cross-cultural psychologists. Models of ethnic development emerged both social and developmental psychology, with different theoretical roots. Roots in social psychology Ethnic identity emerged in social psychology out of social identity theory. Social identity theory posits that belonging to social groups (e.g. religious groups or occupational groups) serves an important basis for one's identity. Membership in a group(s), as well as one's value and emotional significance attached to this membership, is an important part of one's self-concept. One of the earliest statements of social identity was made by Kurt Lewin, who emphasized that individuals need a firm sense of group identification in order to maintain a sense of well-being. Social identity theory emphasizes a need to maintain a positive sense of self. Therefore, in respect to ethnic identity, this underscores affirmation to and salience of ethnic group membership(s). In light of this, affirmation of ethnicity has been proposed to be more salient among groups who have faced greater discrimination, in order to maintain self-esteem. There has also been research on family influences, such as cultural values of the family. Also, specific aspects of parenting, such as their racial socialization of youth, can contribute to the socialization of adolescents. Relatedly, collective identity is an overarching framework for different types of identity development, emphasizing the multidimensionality of group membership. Part of collective identity includes positioning oneself psychologically in a group to which one shares some characteristic(s). This positioning does not require individuals to have direct contact with all members of the group. The collective identity framework has been related to ethnic identity development, particularly in recognizing the importance of personal identification of ethnicity through categorical membership. Collective identity also includes evaluation of one's category. This affective dimension is related to the importance of commitment and attachment toward one's ethnic group(s). A behavioral component of collective identity recognizes that individuals reflect group membership through individual actions, such as language usage, in respect to ethnic identity. Roots in developmental psychology Identity becomes especially salient during adolescence as recognized by Erik Erikson's stage theory of psychosocial development. An individual faces a specific developmental crisis at each stage of development. In adolescence, identity search and development are critical tasks during what is termed the ‘Identity versus Role-confusion’ stage. Achievement of this stage ultimately leads to a stable sense of self. The idea of an achieved identity includes reconciling identities imposed on oneself with one's need to assert control and seek out an identity that brings satisfaction, feelings of industry and competence. In contrast, identity confusion occurs when individuals fail to achieve a secure identity, and lack clarity about their role in life. James Marcia elaborated on Erik Erikson's model to include identity formation in a variety of life domains. Marcia's focus of identity formation includes two processes which can be applied to ethnic identity development: an exploration of identity and a commitment. Marcia defines four identity statuses which combines the presence or absence of the processes of exploration and commitment: Identity diffusion (not engaged in exploration or commitment), identity foreclosure (a lack of exploration, yet committed), moratorium (process of exploration without having made a commitment), and identity achievement (exploration and commitment of identity). Researchers believe and have frequently reported that older individuals are more likely to be in an achieved identity status than younger people. Evidence shows that increasing age and a wide range of life experiences helps individuals develop cognitive skills. This combination of age, life experiences, and improved cognitive skills helps adolescents and young adults find their authentic selves. Adolescents with strong commitments to their ethnic identities also tend to explore these identities more than their peers. Factors Adolescence While children in early to middle childhood develop the ability to categorize themselves and others using racial and ethnic labels, it is largely during adolescence that ethnic and racial identity develops. Adriana J. Umaña-Taylor and colleagues write about the following concepts as playing key roles during this stage: Cognitive milestones include: abstract thinking, introspection, metacognition, and further development of social-cognitive abilities. Physiological changes include puberty and development of body image Social and environmental context includes: family, peers, social demands and transitions, navigating an expanding world, and media Ethnic and Racial Identity (ERI) components about process: Contestation Elaboration Negotiation Internalization of cultural values Collective self-verification Ethnic and Racial Identity (ERI) components about content: Public regard Ideology Affect (affirmation, private regard) Salience Centrality Importance Understanding of common fate or destiny Identity self-denial Certainty Suburbanization Critical race theory has explored the development of suburban "whiteness" in the United States as representing the racialized and classless fantasy of a heterogeneous white population. This work stands in contrast with earlier studies of white flight that assume a broad or homogeneous concept of "white people" who suburbanize in the post World War II era. The culture of suburbanization in Los Angeles through the 40s, 50's and 60's was represented by the icons of popular culture that were often exclusionary and became hallmarks of a "culture of suburban whiteness". There were some improvements for African-Americans during the era of New Deal reforms, but the housing policies of the Federal Housing Administration (FHA) and the Home Owners' Loan Corporation (HOLC) made it a practical certainty that nonwhites would not be able to own suburban homes. The HOLC tied its calculus of property values to racial demographics with the most racially homogeneous neighborhoods being given the highest ratings. Based on this, FHA loans were directed to the suburbs, making home ownership in the city out of reach for most residents. The FHA said that loans to support urban homeowners would not be sound investments because of the "presence of inharmonious racial or nationality groups". In a 1933 report the agency acknowledged some fluidity to the concept of "white identity": If the entrance of a colored family into a white neighborhood causes a general exodus of white people it is reflected in property values. Except in the case of Negroes and Mexicans, however, these racial and national barriers disappear when the individuals of foreign nationality groups rise in the economic scale to conform to American standards of living... Models for ethnic identity formation Jean Phinney Jean Phinney's model of ethnic identity development is a multidimensional model, with theoretical underpinnings of both Erikson and Marcia. In line with Erikson's identity formation, Phinney focuses on the adolescent, acknowledging significant changes during this time period, including greater abilities in cognition to contemplate ethnic identity, as well as a broader exposure outside of their own community, a greater focus on one's social life, and an increased concern for physical appearance. Phinney's three-stage progression: Unexamined ethnic identity – Prior to adolescence, children either give ethnicity little thought (related to Marcia's diffuse status) or are assumed to have derived their ethnic identity from others, rather than engaging in personal examination. This is related to Marcia's foreclosed identity status. Knowledge of one's ethnicity is "absorbed", which reflects the process of socialization. Broadly, socialization in the context of ethnic identity development refers to the acquisition of behaviors, perceptions, values, and attitudes of an ethnic group(s). This process recognizes that feelings about one's ethnic group(s) can be influenced by family, peers, community, and larger society. These contextual systems or networks of influence delineate from ecological systems theory. These systems influence children's feelings of belonging and overall affect toward ethnic group(s). Children may internalize both positive and negative messages and therefore hold conflicting feelings about ethnicity. Socialization highlights how early experiences for children are considered crucial in regards to their ethnic identity development. Ethnic identity search – During the onset of adolescence, there is a questioning of accepted views of ethnicity and a greater understanding of ethnicity in a more abstract sense. Typically this stage has been characterized as being initiated by a significant experience that creates heightened awareness of ethnicity, such as discrimination. Engagement in some form of exploration includes an interest in learning more about one's culture and actively involving oneself in activities such as talking with others about ethnicity, reading books on the subject, and thinking about both the current and future effects of one's ethnicity. This stage is related to Erikson's ‘Identity versus Role-confusion’, and Marcia's moratorium. Ethnic identity achievement – This stage is characterized by clarity about one's ethnic identity. The achievement phase includes a secure, confident, and stable sense of self. Achievement also is characterized as a realistic assessment of one's in-group(s) in a larger social context. In essence, the individual has internalized their ethnicity. This stage is related to Erikson's achieved identity, and identity achievement of Marcia. Identity achievement is also related to social identity theory in that this acceptance replaces one's negative ethnic self-image. Although achievement represents the highest level of ethnic identity development, Phinney believes reexamination can occur depending on experiences over time. More recently, Phinney has focused on the continuous dimensions of one's exploration and commitment to one's ethnic group(s), rather than on distinct identity statuses. Cultural Identity Development Model On top of Phinney's model, Atkinson, Morton & Sue present a racial and cultural identity development model. The model is split into five different stages that are experienced when individuals attempt to understand themselves within their culture, the dominant culture, and the relationship between the two. The stages include: conformity, dissonance, resistance and immersion, introspection, and integrative awareness. Stage 1 Conformity: the phase in which a person believes that the dominant culture is superior to all others and that their own cultural group is inferior. Stage 2 Dissonance: a person's conviction that the dominant group is superior and that minority groups, including his or her own, are inferior by an event that occurs suddenly or gradually. Stage 3 Resistance and Immersion: the period during which a person immerses themselves more deeply inside their own cultural group, rejecting the mainstream culture while experiencing intense feelings of rage, guilt, and humiliation for having initially chosen to identify with the dominant culture and rejected their own. Stage 4 Introspection: the period of time during which a person experiences some internal conflict but also becomes less hostile toward and distrustful of the dominant group, less enmeshed in their own culture, more appreciative of other cultures, and more likely to learn about their own identity. Stage 5 Integrative awareness: The phase in which a human being achieves better equilibrium, values both his or her own as well as other cultural groups, and develops self-awareness as both a cultural and an individual, recognizing both good and negative contrasts among cultural groups. Social/personality models Social/personality models for ethnic identity, unlike the more known Phinney's model for ethnic identity development derived from Erickson's model of personality development, focus less so on the development stages of ERI and more so on their content -what it means to the person and its impact on said person (concepts typically more explored in personality psychology). Though, like Phinney's model, ethnic identity is still viewed as being multidimensional. In the meta-analysis done by Tiffany Yip, Yijie Wang, Candace Mootoo, and Sheena Mirpuri, the prominent Multidimensional Model of Racial Identity (MMRI) is detailed along with possible, though conflicting dimensions: the Social Identity Theory (SIT) vs. the Self-Categorization Theory (SCT). These theories differ in their suggestion of the impact high ethnic/racial identity centrality on a person's personality. Social Identity Theory (SIT) suggests that the effects of ethnic/racial discrimination (ERD) will be mediated in a person with high ERI centrality whereas Self-Categorization Theory (SCT) suggests that high ethnic/racial identity centrality may result in more negative outcomes when faced with ethnic/racial discrimination. Effects Psychological Research has linked ethnic identity development with positive self-evaluation and self-esteem. Ethnic identity development has also been shown to serve as a buffer between perceived discrimination and depression. Specifically, commitment of an ethnic identity may help to abate depressive symptoms experienced soon after experiencing discrimination, which in turn alleviates overall stress. Researchers posit commitment to an ethnic identity group(s) is related to additional resources accumulated through the exploration process, including social support. Ethnic identity development has been linked to happiness and decreased anxiety. Specifically, regard for one's ethnic group may buffer normative stress. Numerous studies show many positive outcomes associated with strong and stable ethnic identities, including increased self-esteem, improved mental health, decreased self-destructive behaviors, and greater academic achievement. In contrast, empirical evidence suggests that ethnic identity exploration may be related to vulnerability to negative outcomes, such as depression. Findings suggest this is due to an individual's sensitivity to awareness of discrimination and conflicts of positive and negative images of ethnicity during exploration. Also, while commitment to an ethnic group(s) is related to additional resources, exploration is related to a lack of ready-access resources. Family Studies have found that in terms of family cohesion, the closer adolescents felt to their parents, the more they reported feeling connected to their ethnic group. Given the family is a key source of ethnic socialization, closeness with the family may highly overlap with closeness with one's ethnic group. Resources like family cohesion, proportion of same-ethnic peers, and ethnic centrality act as correlates of within-person change in ethnic identity, but it is only on the individual level and not as adolescents as a group. Limitations of research Ethnic identity development has been conceptualized and researched primarily within the United States. Due to the fact the individuals studied are typically from the United States, it may not be appropriate to extend findings or models to individuals in other countries. Some research has been conducted outside of the United States, however a majority of these studies were in Europe or countries settled by Europeans. Further, researchers also suggest that racial and ethnic identity development must be viewed, studied, and considered alongside the other normative developmental processes (e.g., gender identity development) and cannot be considered in a vacuum - racial and ethnic identity exist in particular contexts. Research considers some studies of ethnic developments cross-sectional in design. This type of design pales in comparison to longitudinal design whose topic of investigation is developmental in nature. This is because cross-sectional studies collect data at or around the same time from multiple individuals of different ages of interest, instead of collecting data over multiple time points for each individual in the study, which would allow the researcher to compare change for individuals over time, as well as differences between individuals. Another research consideration in the field is why certain ethnic and racial groups are looking towards their own expanding community for mates instead of continuing interracial marriages. An article in The New York Times explained that Asian-American couples have been kicking the trend and finding Asian mates because it gives them resurgence of interest in language and ancestral traditions. Further research can be found and explored throughout the many different racial and ethnic groups. Some researchers question the number of dimensions of ethnic identity development. For example, some measures of ethnic identity development include measures of behaviors, such as eating ethnic food or participating in customs specific to an ethnic group. One argument is that while behaviors oftentimes express identity, and are typically correlated with identity, ethnic identity is an internal structure that can exist without behavior. It has been suggested one can be clear and confident about one's ethnicity, without wanting to maintain customs. Others have found evidence of a behavioral component of ethnic identity development, separate from cognition and affect, and pertaining to one's ethnic identity. Ethnic identity development points toward the importance of allowing an individual to self-identify ethnicity during data collection. This method helps us collect the most accurate and relevant information about the subjective identification of the participant, and can be useful in particular with respect to research with multiethnic individuals. See also Group identity Ethnogenesis Identity formation Identity (social science) Cultural identity National identity Passing (racial identity) Racial-ethnic socialization White Racial Identity Development References Further reading Ethnicity Identity (social science) Social constructionism Collective identity

Enabling

In psychotherapy and mental health, enabling is the encouragement of some behaviour, especially if said behaviour is either particularly positive or dysfunctional. Positive As a positive term, "enabling" describes patterns of interaction which allow individuals to develop and grow in a healthy direction. These patterns may be on any scale, for example within the family. Negative In a negative sense, "enabling" can describe dysfunctional behavior approaches that are intended to help resolve a specific problem but, in fact, may perpetuate or exacerbate the problem. A common theme of enabling in this latter sense is that third parties take responsibility or blame, or make accommodations for a person's ineffective or harmful conduct (often with the best of intentions, or from fear or insecurity which inhibits action). The practical effect is that the person themselves does not have to do so, and is shielded from awareness of the harm it may do, and the need or pressure to change. Codependency Codependency is a theory that attempts to explain imbalanced relationships in which one person enables another person's self-destructive behavior such as addiction, poor mental health, immaturity, irresponsibility, or under-achievement. Enabling may be observed in the relationship between a person with a substance use disorder and their partner, spouse or a parent. Enabling behaviors may include making excuses that prevent others from holding the person accountable, or cleaning up messes that occur in the wake of their impaired judgment. Enabling may prevent psychological growth in the person being enabled, and may contribute to negative symptoms in the enabler. Enabling may be driven by concern for retaliation, or fear of consequence to the person with the substance use disorder, such as job loss, injury or suicide. A parent may allow an addicted adult child to live at home without contributing to the household such as by helping with chores, and be manipulated by the child's excuses, emotional attacks, and threats of self-harm. Abuse In the context of abuse, enablers are distinct from flying monkeys (proxy abusers). Enablers allow or cover for the abuser's own bad behavior while flying monkeys actually perpetrate bad behavior to a third party on their behalf. Padilla et al. (2007), in analyzing destructive leadership, distinguished between conformers and colluders, in which the latter are those who actively participate in the destructive behavior. Emotional abuse is a brainwashing method that over time can turn someone into an enabler. While the abuser often plays the victim, it is quite common for the true victim to believe that he or she is responsible for the abuse and thus must adapt and adjust to it. Examples of enabling in an abusive context are as follows: Making excuses for another's violent rages. Cleaning up someone else's mess. Hiding an abuser's dysfunctional actions from public view. Absorbing the negative consequences of someone else's bad choices. Paying off another person's debts. Refusing to confront or protect oneself when exposed to physical, emotional or verbal assault. Regurgitating the abuser's 'facts' / version of reality to a third party without seeking evidence. Revictimising the abuser's other victims with behaviour such as gaslighting, denial, or scapegoating. Triangulation (playing the part in an abuse triangle as either victim or protector, but never seeing themselves as perpetrator). Keeping secrets for the abuser such as affairs, extramarital children, alcoholism, gambling, incest. Projecting / passing on their own shame (the shame projected on to them by the abuser) to third parties. Giving up/over knowledge of their finances to be taken care of by the abuser (oftentimes resulting in considerable debt). See also Personal boundaries Sycophancy References Motivation Counseling Behavior modification Behavioural syndromes associated with physiological disturbances and physical factors Interpersonal relationships Narcissism Abuse Anti-social behaviour

History of psychopathy

Psychopathy, from psych (soul or mind) and pathy (suffering or disease), was coined by German psychiatrists in the 19th century and originally just meant what would today be called mental disorder, the study of which is still known as psychopathology. By the turn of the century 'psychopathic inferiority' referred to the type of mental disorder that might now be termed personality disorder, along with a wide variety of other conditions now otherwise classified. Through the early 20th century this and other terms such as 'constitutional (inborn) psychopaths' or 'psychopathic personalities', were used very broadly to cover anyone who violated legal or moral expectations or was considered inherently socially undesirable in some way. The term sociopathy was popularized from 1929/30 by the American psychologist George E. Partridge and was originally intended as an alternative term to indicate that the defining feature was a pervasive failure to adhere to societal norms in a way that could harm others. The term psychopathy also gradually narrowed to the latter sense, based on interpretations of the work of a Scottish psychiatrist and especially checklists popularized by an American psychiatrist and later a Canadian psychologist. Psychopathy became defined in these quarters as a constellation of personality traits allegedly associated with immorality, criminality, or in some cases socioeconomic success. Official psychiatric diagnostic manuals adopted a mixture of approaches, eventually going by the term antisocial or dissocial personality disorder. In the meantime concepts of psychopaths/sociopaths had become notorious among the general public and as characters in fiction. Early literature Labels for personality and behavior patterns consistent with psychopathy exist in most cultures. In rural Nigeria, the term Aranakan, was used by the Yoruba people to describe an individual who "always goes his own way regardless of others, who is uncooperative, full of malice, and bullheaded." Similarly, the word Kunlangeta was used by the Inuit to describe "mind knows what to do but does not do it." The psychiatric anthropologist Jane M. Murphy writes that, in northwest Alaska, the term Kunlangeta might be applied to "a man who… repeatedly lies and cheats and steals things and does not go hunting and, when the other men are out of the village, raping many women—someone who does not pay attention to reprimands and who is always brought to the elders for punishment." Historical descriptions of people or characters are sometimes noted in discussions of psychopathy, with claims of superficial resemblance or retrospective diagnosisfor example, a vignette by Theophrastus in Ancient Greece concerning The Unscrupulous Man. On the other hand, the ancient Greek military statesman Alcibiades has been described as the best example of a probable psychopath – due to inconsistent failures despite his potential and confident speaking. Figures of insanity (e.g. vagabonds, libertines, the "mad") have, at least since the 18th century, often represented an image of darkness and threat to society, as later would "the psychopath" – a mixture of concepts of dangerousness, evil and illness. Early clinical concepts Psychiatric concepts began to develop in the early 19th century which to some extent fed into the use of the term psychopathy from the late 19th century, when that term still had a different and far broader meaning than today. In 1801, French psychiatrist Philippe Pinel described without moral judgment patients who appeared mentally unimpaired but who nonetheless engaged in impulsive and self-defeating acts. He described this as insanity without confusion/delusion (manie sans délire), or rational insanity (la folie raisonnante), and his anecdotes generally described people carried away by instinctive fury (instincte fureur). American Benjamin Rush wrote in 1812 about individuals with an apparent "perversion of the moral faculties", which he saw as a sign of innate defective organization. He also saw such people as objects of compassion whose mental alienation could be helped, even if that was in prison or what he referred to as the "Christian system of criminal jurisprudence". In 1835 English psychiatrist James Cowles Prichard, based partly on Pinel's publications, developed a broad category of mental disorder he called moral insanity - a "madness" of emotional or social dispositions without significant delusions or hallucinations. Generally Prichard referred more to eccentric behaviour than, as had Pinel, out of control passions. Prichard's diagnosis came into widespread use in Europe for several decades. None of these concepts are comparable to current specific constructs of psychopathy, or even to the broader category of personality disorders. Moreover, "moral" did not necessarily refer at that time to morality but to the psychological or emotional faculties. In the latter half of the 19th century the (pseudo) scientific study of individuals thought to lack a conscience flourished. Notably the Italian physician Cesare Lombroso rejected the view that criminality could occur in anyone and sought to identify particular "born criminals" who he thought showed certain physical signs, such as proportionately long arms or a low and narrow forehead. By the beginning of the 20th century the English psychiatrist Henry Maudsley was writing about not just "moral insanity" but the "moral imbecile" and "criminal psychosis", conditions he believed were genetic in origin and impervious to punishment or correction, and which he applied to the lower class of chronic offenders by comparison to "the higher industrial classes". First uses of term Initially physicians who specialised in mental disorders might be referred to as psychopaths (e.g. the American Journal of the Medical Sciences in 1864) and their hospitals as psychopathic institutions (compare to the etymologically similar use of the term homeopathic). Treatments of physical conditions by psychological or spiritualist methods might be referred to as psychopathic. Up until the 1840s, the term psychopathy was also used in a way consistent with its etymology to refer to any illness of the mind. German psychiatrist von Feuchtersleben's (1845) The Principles of Medical Psychology, which was translated into English, used it in this sense, as well as the roughly equivalent new term psychosis, now traced back to Karl Friedrich Canstatt's Handbuch der Medicinischen Klinik (1841). William Griesinger (1868) and Krafft-Ebing (1886) also notably employed the term in distinct ways. The use of the term in a criminological context was popularised by a high-profile legal case in Russia between 1883 and 1885, concerning the murder of a girl who had previously lived in Britain for some time, Sarah Becker (Sarra Bekker). The owner of the pawnbroker shop in which she worked and where her body was found, a retired military man Mr Mironovich, was eventually convicted on circumstantial evidence and imprisoned. In the meantime, however, a Ms Semenova had handed herself in saying she had killed Becker while trying to steal jewellery with her lover Bezak, a married policeman, though she soon recanted and changed her confession. Semenova was found not guilty following testimony from eminent Russian psychiatrist Prof Ivan M. Balinsky, who described her as a psychopath, still then a very general term. Dictionaries to this day note this as the first use of the noun, via British or American articles which had suggested a known murderer had been released and in some cases that psychopaths should be immediately hanged. In 1888 Julius Ludwig August Koch first published on his concept of "psychopathic inferiority" (psychopathische Minderwertigkeiten), which would become influential domestically and internationally. He used it to refer to various kinds of dysfunction or strange conduct noted in patients in the absence of obvious mental illness or retardation. Koch was a Christian and also influenced by the degeneration theory popular in Europe at the time, though he referred to both congenital and acquired types. Habitual criminality was only a small part of his concept but the German public soon used the shortened version "inferiors" to refer to anyone supposedly suffering from an inherent ('constitutional') disposition toward crime. Early 20th century Some writers would still use psychopathy in the general sense of mental illness, such as Austrian psychiatrist Sigmund Freud in Psychopathic Characters on Stage. By contrast influential German psychiatrist Emil Kraepelin, who had previously included a section on moral insanity in his psychiatric classification scheme, was by 1904 referring to specific psychopathic subtypes all involving antisocial, criminal or dissocial behaviour, including: born criminals (inborn delinquents), liars and swindlers, querulous persons, and driven persons (including vagabonds, spendthrifts, and dipsomaniacs). The influential Adolf Meyer (psychiatrist) spread the concept of constitutional psychopathy when he emigrated to the US, though unlike Koch he separated out cases of what was termed psychoneurosis. After World War I German psychiatrists dropped the term inferiors/defectives (Minderwertigkeiten) and used psychopathic (psychopathisch) and its derivatives instead, at that time a more neutral term covering a wide range of conditions. Emil Kraepelin, Kurt Schneider and Karl Birnbaum developed categorisation schemes under the heading 'psychopathic personality', only some subtypes of which were thought to have particular links to antisocial behaviour. Schneider in particular advanced the term and tried to formulate it in less judgemental terms than Kraepelin, though infamously defining it as ‘those abnormal personalities who suffer from their abnormality or from whose abnormality society suffers.’ In a similar vein, Birnbaum, a biological psychiatrist, suggested from 1909 a concept similar to sociopathy, implying the social environment could determine whether dispositions became criminal or not. From 1917 a forerunner to later diagnostic manuals, called the Statistical Manual for the Use of Institutions for the Insane, included a category of 'psychoses with constitutional psychopathic inferiority'. This covered abnormalities in the emotional and volitional spheres associated with episodic disturbances which did not fit into the established categories of psychosis: "The type of behavior disorder, the social reactions, the trends of interests, etc., which the psychopathic inferior may show give special features to many cases, e. g., criminal traits, moral deficiency, tramp life, sexual perversions and various temperamental peculiarities." Constitutional psychopathic inferiority without psychosis was listed separately as one term to apply to patients considered 'Not insane'. Meanwhile, the American Prison Association had its own definition, in which psychopathic personalities were considered non-psychotic and characterized by failure to adjust to environment, lacking purpose, ambition and proper feelings, while often showing tendencies towards delinquency, lying and various eccentricities, perversions or manias (including dromomania (compulsion to travel or experience new lifestyles), kleptomania (stealing), pyromania (fire-setting) etc.). In the UK the Mental Deficiency Act 1913 included the category of moral imbeciles, who were not intellectually idiots but displayed from an early age an alleged mental defect coupled with alleged vicious or criminal propensities, and on whom punishment has little or no deterrent effect. Cyril Burt and others pointed out that 'psychopathic personality' was used in a broader and somewhat different way in America than in the UK. In the first decades of the 20th century, "constitutional psychopathic inferiority" had become a commonly used term in the US, implying the issue was inherent to the genetics or makeup of the person, an organic disease. As a category it was used to target any and all dysfunctional or antisocial behavior, and in psychiatric categorization it labeled a broad range of alleged mental deviances, including homosexuality. Some courts began to develop "psychopathic laboratories" for the classification and treatment of offenders; the term psychopathic was chosen to avoid the social stigma of "lunacy" or "insanity", while emphasizing variance from normality rather than simply a mental hygiene issue. Nevertheless, at least one such laboratory issued a report on eugenic sterilization initiatives. From the 1930s, "sexual psychopath" laws (a term going back to Krafft-Ebing) started to be implemented in many US states, allowing for the indeterminate psychiatric commitment of sex offenders. From the late 1920s American psychologist George E. Partridge influentially narrowed the definition of psychopathy to antisocial personality, and from 1930 suggested that a more apt name for it would be sociopathy. He suggested that anyone, and indeed groups of people acting together, could be considered sociopathic at times, but that sociopaths – or technically 'essential sociopaths' - were chronically and pervasively so in their motivation and behavior. In 1933, American Psychiatrist Harry Stack Sullivan first coined the term "Psychopathic child," which is now thought to be the first formulation of autism spectrum disorder, to describe interpersonal deficiency which starts from childhood. Scottish psychiatrist David Henderson published in 1939 a theory of "psychopathic states" which, although he described different types and unusually suggested that psychopaths might not all be criminals, included a violently antisocial type which ended up contributing to that being the popular meaning of the term. In the 1940s a diagnosis of autistic psychopathy was introduced, later coming to wider notice and renamed Asperger syndrome to avoid the stigma of the term psychopathy. Mid-20th century The Mask of Sanity by American psychiatrist Hervey M. Cleckley, first published in 1941 and with revised editions for several decades, is considered a seminal work which provided a vivid series of case studies of individuals described as psychopaths. Cleckley proposed 16 characteristics of psychopathy, derived mainly from his work with male psychiatric patients in a locked institution. The title refers to the "mask" of normal functioning that Cleckley thought concealed the disorganization, amorality and disorder of the psychopathic personality. This marked the start in America of the current clinical and popularist conception of psychopathy as a particular type of antisocial, emotionless and criminal character. Cleckley would produce five editions of the book over subsequent decades, including a substantial revision in 1950, expanding his case studies and theories to more non-prisoners and non-criminals. In Nazi Germany, especially during World War II, psychiatrists and others in programmes such as Action T4 and Action 14f13 systematically deported, sterilised, interned and euthanised patients and prisoners who could be classed as mentally ill, feebleminded, psychopathic, criminally insane or just asocial. In the aftermath of the war, therefore, concepts of antisocial psychopathic personalities fell out of favour in Europe to some extent. At the same time, however, in America and other countries the concept became increasingly prominent, used to categorise allied soldiers as fit or unfit for duty or on return to society, or, conversely, in the more specific sinister sense of the term, as a way to explain the actions of Nazis. The first version of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1952 did not use the term psychopathy as a diagnosis, but "sociopathic personality disturbance". Individuals to be placed in this category were said to be "...ill primarily in terms of society and of conformity with the prevailing milieu, and not only in terms of personal discomfort and relations with other individuals". There were four subtypes (called 'reactions' after Adolf Meyer): antisocial, dyssocial, sexual and addiction. The antisocial reaction was said to include "individuals who are chronically in trouble and do not seem to change as a result of experience or punishment, with no loyalties to anyone", as well as being frequently callous and lacking responsibility, with an ability to 'rationalize' their behaviour. The dyssocial reaction was for "individuals who disregard societal rules, although they are capable of strong loyalties to others or groups." Although the sociopathy category was very broad by today's definitions, the DSM-I itself pointed out that it was more specific and limited than the then current notions of 'constitutional psychopathic state' or 'psychopathic personality'. Meanwhile, other subtypes of psychopathy were sometimes proposed, notably by psychoanalyst Benjamin Karpman from the 1940s. He described psychopathy due to psychological problems (e.g. psychotic, hysterical or neurotic conditions) and idiopathic psychopathy where there was no obvious psychological cause, concluding that the former could not be attributed to a psychopathic personality and that the latter appeared so absent of any redeeming features that it couldn't be seen as a personality issue either but must be a constitutional "anethopathy" (amorality or antipathy). Various theories of distinctions between primary and secondary psychopathy remain to this day. Cleckley's concept of psychopathy as expanded on in new editions of his book, particularly the sense of a conscience-less man beneath a mask of normality, caught the public imagination around this time. It also became increasingly influential in psychiatric circles. It later fell out of favor for some time, however, such that when he died in 1984 he was better remembered for a vivid case study of a female patient published in 1956, turned into a movie The Three Faces of Eve in 1957, which had (re)popularized in America another controversial diagnosis, multiple personality disorder. A sociologist reviewing the field in 1958 wrote that "Without exception, on every point regarding psychopathic personality, psychiatrists present varying or contradictory views." Nevertheless, criminologist sociologists William and Joan McCord were influential in narrowing the definition of psychopathy in some quarters to mean an antisocial lack of guilt accompanied by reactive aggression. From another direction, sociologist Lee Robins was also an influential figure in sociopathy research, stemming largely from her research-based 1966 book 'Deviant Children Grown Up: a sociological and psychiatric study of sociopathic personality', based on operational criteria provided by Eli Robins, which would shape the later diagnosis of Antisocial Personality Disorder. In the Mental Health Act in England, a new category of 'Psychopathic Personality' was added in 1959, renamed Psychopathic Disorder in 1983 (then in 2007 removed entirely). This was a legal subcategory in addition to 'mental illness' which did not equate to any one psychiatric diagnosis but covered anyone with "a persistent disorder or disability of mind which results in abnormally aggressive or seriously irresponsible conduct." On the other hand, various analysts began to identify "successful" psychopaths in society, some even suggesting it was but an adaption to the social or economic mores of the age, others noting they could be hard to spot either because they were so good at hiding their lack of conscience, or because many people showed the traits to some degree. Late 20th century In 1968 the second edition of the DSM, in place of the antisocial subtype of sociopathic personality disturbance, listed "antisocial personality" as one of ten personality disorders. This was still described in similar terms as the DSM-I's category, for individuals who are "basically unsocialized", in repeated conflicts with society, incapable of significant loyalty, selfish, irresponsible, unable to feel guilt or learn from prior experiences, and tend to blame others and rationalise. It warned that a history of legal or social offenses was not by itself enough to justify the diagnosis and that a 'group delinquent reaction' of childhood or adolescence or 'social maladjustment without manifest psychiatric disorder' should be ruled out first. The dyssocial type from the DSM-I was relegated, though would resurface as the main diagnosis in the ICD manual of the World Health Organization. In 1974 (and republished in 1984) clinical psychologist Bobby E. Wright wrote about 'The Psychopathic Racial Personality', in which he suggested that negative aspects of the overall behavior of white peoples towards non-white peoples could be understood by seeing the former as displaying psychopathic traits – involving predatory behavior and senseless destruction combined with ability to persuade. There remained no international clinical agreement on the diagnosis of psychopathy. A 1977 study found little relationship with the characteristics commonly attributed to psychopaths and concluded that the concept was being used too widely and loosely. Robert D. Hare had published a book in 1970 summarizing research on psychopathy, and was subsequently at the forefront of psychopathy research. Frustrated by a lack of agreed definitions or rating systems for psychopathy, including at a ten-day international North Atlantic Treaty Organization (NATO) conference in 1975, Hare began developing a Psychopathy Checklist. Produced for initial circulation in 1980, it was based largely on the list of traits advanced by Cleckley and partly on the theories of other authors and on his own experiences with clients in prisons. Meanwhile, a DSM-III task force instead developed the diagnosis of antisocial personality disorder, based on 1972 Feighner Criteria for research and published in the DSM in 1980. This was based on some of the criteria put forward by Cleckley but operationalized in behavioral rather than personality terms, more specifically related to conduct. APA was most concerned to demonstrate inter-rater reliability rather than necessarily validity. Nevertheless, one author referred to the concept of psychopathy in 1987 as an "infinitely elastic, catch-all category". In 1988, psychologist Blackburn wrote in the British Journal of Psychiatry that as commonly used in psychiatry it is little more than a moral judgment masquerading as a clinical diagnosis, and should be scrapped. Ellard argued similarly in the same year in the Australian and New Zealand Journal of Psychiatry, describing the concept as 'a reflection of the customs and prejudices of a particular social group. Most psychiatrists are from that group and therefore fail to see the incongruity.' By the 1970s and 80s the sexual psychopath laws were falling out of favor in many states; the Group for the Advancement of Psychiatry called them a failure based on a confusing label mixing law and psychiatry. Hare redrafted his checklist in 1985 (Cleckley had died in 1984), renaming it the Hare Psychopathy Checklist Revised and finalising it as a first edition in 1991, updated with extra data in a 2nd edition in 2003. Hare's list differed from Cleckley's not just in rewordings and introducing quantitative scores for each point. Cleckley had required an absence of delusions and an absence of nervousness, which was central to how he defined psychopathy, whereas neither were mentioned in Hare's list. Hare also left out mention of suicidality being rarely completed and behavior with alcohol. Moreover, while Cleckley only listed "inadequately motivated antisocial behavior", Hare turned this into an array of specific antisocial behaviors covering a person's whole life, including juvenile delinquency, parasitic lifestyle, poor behavioural controls, and criminal versatility. Blackburn has noted that overall Hare's checklist is closer to the criminological concept of the McCords than that of Cleckley. Hare himself, while noting his promotion of Cleckley's work for four decades, would subsequently distance himself from it to some extent. Meanwhile, following some criticism over the lack of psychological criteria in the DSM, further studies were conducted leading up the DSM-IV in 1994 and some personality criteria were included as "associated features" which were outlined in the text. The World Health Organization's ICD incorporated a similar diagnosis of Dissocial Personality Disorder. Both state that psychopathy (or sociopathy) may be considered synonyms of their diagnosis. Hare wrote two bestsellers on psychopathy, "Without Conscience" in 1993 and "Snakes in Suits: When Psychopaths Go to Work" in 2006. Cleckley had described psychopathic patients as "carr[ying] disaster lightly in each hand" and "not deeply vicious", but Hare presented a more malevolent picture; the "mask of sanity" had acquired a more sinister meaning. 21st century In 2002 an academic dispute arose around claims and counterclaims of racism in the use of the concept of psychopathy. British psychologist Richard Lynn claimed that some races were inherently more psychopathic than others, while other psychologists criticized his data and interpretations. The Federal Bureau of Investigation's monthly outreach and communication bulletin focused on psychopathy in June 2012, featuring articles introduced and co-authored by the main contemporary proponent of the construct, Robert D. Hare. The DSM-5 published in 2013 had criteria for an overall diagnosis of Antisocial (Dissocial) Personality Disorder similar to DSM-IV, still noting that it has also been known as psychopathy or sociopathy. In an 'alternative model' suggested at the end of the manual, there is an optional specifier for "psychopathic features" - where there is a lack of anxiety/fear accompanied by a bold and efficacious interpersonal style. Overall trends One exhaustive analysis by a Canadian psychologist describes the various lines of work as 'a psychopathy project' attempting to establish psychopathy as an object of science. Overall this was found to have suffered from 'a number of serious logical confusions and deliberate mischaracterizations of its scientific merits' - including its early basis in degeneration theory, tautological definitions and associated neuroscience findings, routinely unclarified assumptions and shifting levels of explanation about the core concept, and exaggerated statistical claims such as based on Hare's use of factor analysis. It was noted, however, that some of the limited research findings may prove useful in a better explanatory framework (i.e. not necessarily under the umbrella of 'psychopathy'). Swedish sociologist Roland Paulsen has further placed the more recent resurgence in popular coverage of psychopathy in the context of "the Enlightenment project" to use rationality and technology to deal with problems in human life and society. A Scottish sociologist of biomedical ethics has suggested that the DSM's attempt to develop different standards for Antisocial Personality Disorder have been limited and modified by path dependence on the concept of psychopathy/sociopathy, due to the latter being embedded in diverse sociotechnological networks and thereby demanded by various users. See also History of mental disorders References Psychopathy Psychopathy

Personality hire

In recruitment, a personality hire refers to the practice of hiring candidates for their personality and vibes, rather than their tangible skill set. Personality hires typically have stronger soft skills than hard skills, may serve as a morale booster within the workplace, and help build corporate culture. Some candidates may label themselves as personality hires due to imposter syndrome. The term came into mainstream use in 2023 and is similar to that of a diversity hire. A personality hire may be reflective of an implicit cognitive affinity bias. Personality hires have been criticized for their lack of skills and competency. Due to their sociable personalities, personality hires may have to set personal boundaries. See also Cult of personality References Personality Recruitment Employment services Human resource management

Euthenics

Euthenics is the study of improvement of human functioning and well-being by improvement of living conditions. "Improvement" is conducted by altering external factors such as education and the controllable environments, including environmentalism, education regarding employment, home economics, sanitation, and housing, as well as the prevention and removal of contagious disease and parasites. In a New York Times article of May 23, 1926, Rose Field notes of the description, "the simplest [is] efficient living". It is also described as "a right to environment", commonly as dual to a "right of birth" that correspondingly falls under the purview of eugenics. Euthenics is not normally interpreted to have anything to do with changing the composition of the human gene pool by definition, although everything that affects society has some effect on who reproduces and who does not. Etymology The term was derived in the late 19th century from the Greek verb eutheneo, εὐθηνέω (eu, well; the, root of τίθημι tithemi, to cause). (To be in a flourishing state, to abound in, to prosper.—Demosthenes. To be strong or vigorous.—Herodotus. To be vigorous in body.—Aristotle.) Also from the Greek Euthenia, Εὐθηνία. Good state of the body: prosperity, good fortune, abundance.—Herodotus. The opposite of Euthenia is Penia, Πενία ("deficiency" or "poverty") the personification of poverty and need. History Ellen Swallow Richards (Born in 1842–died in 1911; Vassar Class of '70) was one of the first writers to use the term, in The Cost of Shelter (1905), with the meaning "the science of better living". It is unclear if (and probably unlikely that) any of the study programs of euthenics ever completely embraced Richards' multidisciplinary concept, though several nuances remain today, especially that of interdisciplinarity. Vassar College Institute of Euthenics After Richards' death in 1911, Julia Lathrop (1858–1932; VC '80) continued to promote the development of an interdisciplinary program in euthenics at the college. Lathrop soon teamed with alumna Minnie Cumnock Blodgett (1862–1931; VC '84), who with her husband, John Wood Blodgett, offered financial support to create a program of euthenics at Vassar College. Curriculum planning, suggested by Vassar president Henry Noble MacCracken in 1922, began in earnest by 1923, under the direction of Professor Annie Louise Macleod (Chemistry; First woman PhD, McGill University, 1910). According to Vassar's chronology entry for March 17, 1924, "the faculty recognized euthenics as a satisfactory field for sequential study (major). A Division of Euthenics was authorized to offer a multidisciplinary program [radical at the time] focusing the techniques and disciplines of the arts, sciences and social sciences on the life experiences and relationships of women. Students in euthenics could take courses in horticulture, food chemistry, sociology and statistics, education, child study, economics, economic geography, physiology, hygiene, public health, psychology and domestic architecture and furniture. With the new division came the first major in child study at an American liberal arts college." For example, a typical major in child study in euthenics includes introductory psychology, laboratory psychology, applied psychology, child study and social psychology in the Department of Psychology; the three courses offered in the Department of Child Study; beginning economics, programs of social reorganization and the family in Economics; and in the Department of Physiology, human physiology, child hygiene, principles of public health. The Vassar Summer Institute of Euthenics accepted its first students in June 1926. Created to supplement the controversial euthenics major which began February 21, 1925, it was also located in the new Minnie Cumnock Blodgett Hall of Euthenics (York & Sawyer, architects; ground broke October 25, 1925). Some Vassar faculty members (perhaps emotionally upset with being displaced on campus to make way, or otherwise politically motivated) contentiously "believed the entire concept of euthenics was vague and counter-productive to women's progress." Having overcome a lukewarm reception, Vassar College officially opened its Minnie Cumnock Blodgett Hall of Euthenics in 1929. Dr. Ruth Wheeler (Physiology and Nutrition – VC '99) took over as director of euthenics studies in 1924. Wheeler remained director until Mary Shattuck Fisher Langmuir (VC '20) succeeded her in 1944, until 1951. The college continued for the 1934–35 academic year its successful cooperative housing experiment in three residence halls. Intended to help students meet their college costs by working in their residences. For example, in Main, students earned $40 a year by doing relatively light work such as cleaning their rooms. In 1951, Katharine Blodgett Hadley (VC '20) donated $400,000, through the Rubicon Foundation, to Vassar to help fund operating deficits in the current and succeeding years and to improve faculty salaries. "Discontinued for financial reasons, the Vassar Summer Institute for Family and Community Living, founded in 1926 as the Vassar Summer Institute of Euthenics, held its last session, July 2, 1958. This was the first and last session for the institute's new director, Dr. Mervin Freedman." Elmira College Elmira College is noted as the oldest college still in existence which (as a college for women) granted degrees to women which were the equivalent of those given to men (the first to do so was the now-defunct Mary Sharp College). Elmira College became coeducational in all of its programs in 1969. A special article was written in the December 12, 1937 The New York Times, quoting recent graduates of Elmira College, urging for courses in colleges for men on the care of children. Reporting that "preparation for the greatest of all professions, that of motherhood and child-training, is being given the students at Elmira College in the Nursery School which is Conducted as part of the Department of Euthenics." Elmira College was one of the first of the liberal arts colleges to recognize the fact that women should have some special training, integrated with the so-called liberal studies, which would prepare them to carry on, with less effort and fewer mistakes, a successful family life. Courses in nutrition, household economics, clothing selection, principles of foods and meal planning, child psychology, and education in family relations are a part of the curriculum. The Elmira College nursery school for fifteen children between the ages of two and five years was opened primarily as a laboratory for college students, but it had become so popular with parents in the community that there was always a long waiting list. The New York Times article notes how the nursery had become one of the essential laboratories of the college, where recent mothers testified to the value of the training they received while in college. "Today," one graduate said, "when it is often necessary for young women to continue professional work outside the home after marriage, it is important that young fathers, who must share in the actual care and training of the children, should have some knowledge of correct methods." Today Many factors led to the movement never getting the funding it needed to remain relevant, including: vigorous debate about the exact meaning of euthenics, a strong antifeminism movement paralleling even stronger women's rights movements, confusion with the term eugenics, the economic impact of the Great Depression and two world wars. These factors also prevented the discipline from gaining the attention it needed to put together a lasting, vastly multidisciplinary curriculum. Therefore, it split off into separate disciplines. Child Study is one such curriculum. Martin Heggestad of the Mann Library notes that "Starting around 1920, however, home economists tended to move into other fields, such as nutrition and textiles, that offered more career opportunities, while health issues were dealt with more in the hard sciences and in the professions of nursing and public health. Also, improvements in public sanitation (for example, the wider availability of sewage systems and of food inspection) led to a decline in infectious diseases and thus a decreasing need for the largely household-based measures taught by home economists." Thus, the end of euthenics as originally defined by Ellen Swallow Richards ensued. Debate, misconceptions and opposition The influential historian of education Abraham Flexner questions its scientific value in stating: Eugenicist Charles Benedict Davenport noted in his article "Euthenics and Eugenics," reprinted in Popular Science Monthly: Along similar lines argued psychologist and early intelligence researcher Edward L. Thorndike some two years later for an understanding that better integrates eugenic study:The more rational the race becomes, the better roads, ships, tools, machines, foods, medicines and the like it will produce to aid itself, though it will need them less. The more sagacious and just and humane the original nature that is bred into man, the better schools, laws, churches, traditions and customs it will fortify itself by. There is no so certain and economical a way to improve man's environment as to improve his nature. See also References Further reading Adapted from External links "Euthenics" search query, OCLC - WorldCat Hygiene Public health Standard of living Quality of life Sanitation Well-being Academic disciplines

Psychodermatology

Psychodermatology is the treatment of skin disorders using psychological and psychiatric techniques by addressing the interaction between mind and skin. Though historically there has not been strong scientific support for its practice, there is increasing evidence that behavioral treatments may be effective in the management of chronic skin disorders. The practice of psychodermatology is based on the complex interplay between neurological, immunological, cutaneous and endocrine systems, known alternatively as the NICE network, NICS, and by other similar acronyms. The interaction between nervous system, skin, and immunity has been explained by release of mediators from network. In the course of several inflammatory skin diseases and psychiatric conditions, the neuroendocrine-immune-cutaneous network is destabilized. Concept The disorders that proponents classify as psychodermatologic fall into three general categories: psychophysiologic disorders, primary psychiatric disorders and secondary psychiatric disorders. Proponents frequently claim treatment for psoriasis, eczema, hives, genital and oral herpes, acne, warts, skin allergies, pain, burning sensations, and hair loss. Psychodermatological treatment techniques include psychotherapy, meditation, relaxation, hypnosis, acupuncture, yoga, tai chi, and anti-anxiety drugs. Additionally, cosmetics companies may offer products utilizing terms such as "psychodermatology" or "neurocosmetics" in their marketing, though these terms are not regulated. Psychophysiologic disorders are conditions that are precipitated by or worsened by experiencing stressful emotions. These conditions are not always related to stress and in many cases respond to medication but stress can be a contributing factor in some cases. Controversy In a 2013 paper published in the Clinics in Dermatology, the official journal of the International Academy of Cosmetic Dermatology, the facts and controversies of this topic were examined with the conclusion: Although clinical experience is often in concordance with this notion, apparently scientific proof can sometimes be challenging rather than straight forward. Although many data have been published, it appears that not enough good statistical evidence exists to support them. The difficulty in validating beyond a doubt the stress-skin interactions has rendered some skepticism among physicians. Harriet Hall notes that the specialty may not be needed at all because medicine already takes a holistic approach to treating a patient. A 2007 review of the literature generated from 1951 to 2004 finds that most dermatologists and psychologists recommend a synthesis of treatment rather than seeing another specialist. See also British Association of Dermatologists Hypnodermatology List of cutaneous conditions Pseudoscience External links Association for Psychoneurocutaneous Medicine of North America (APMNA) References Dermatology

Holistic nursing

Holistic nursing is a way of treating and taking care of the patient as a whole body, which involves physical, social, environmental, psychological, cultural and religious factors. There are many theories that support the importance of nurses approaching the patient holistically and education on this is there to support the goal of holistic nursing. The important skill to be used in holistic nursing would be communicating skills with patients and other practitioners. This emphasizes that patients being treated would be treated not only in their body but also their mind and spirit.. Holistic nursing is a nursing speciality concerning the integration of one's mind, body, and spirit with his or her environment. This speciality has a theoretical basis in a few grand nursing theories, most notably the science of unitary human beings, as published by Martha E. Rogers in An Introduction to the Theoretical Basis of Nursing, and the mid-range theory Empowered Holistic Nursing Education, as published by Dr. Katie Love. Holistic nursing has gained recognition by the American Nurses Association (ANA) as a nursing specialty with a defined scope of practice and standards. Holistic nursing focuses on the mind, body, and spirit working together as a whole and how spiritual awareness in nursing can help heal illness. Holistic medicine focuses on maintaining optimum well-being and preventing rather than just treating disease. Core values The holistic philosophy: theory and ethics Holistic nursing is based on the fundamental theories of nursing, such as the works of Florence Nightingale and Jean Watson as well as alternative theories of world connectedness, wholeness, and healing. Hohistic nurses respect the patient as the decision-maker throughout the continuum of care. The holistic nurse and patient relationship is based on a partnership in which the holistic nurse engages the patient in treatment options and healthcare choices. The holistic nurse seeks to establish a professional and ethical relationship with the patient in order to preserve the patient's sense of dignity, wholesomeness, and inner worth. Theories of holistic nursing The goal for holistic nursing is in the definition of holistic where it is to treat the patient in whole not just physically. Various nursing theories have helped on viewing the importance holistic nursing. These theories may differ on the views of holistic nursing care but have common goal which is to treat the patient in whole body and mind. One of the theories is The Intersystem Model, explaining that individuals are holistic being therefore their illness are interacted and adapted them as a whole not just physically. Also as health can be a different value to individuals which ranges constantly from well-being to disease. For example, despite their chronic condition the patient is satisfied with the changed healthy life for their living. In holistic nursing knowing the theory does not mean that this will be implanted in doing in real life practice many nurses are not able to apply the theory in real life. Holistic caring process Holistic nursing combines standard nursing interventions with various modalities that are focused on treating the patient in totality. Alternative therapies can include stress management, aroma therapy, and therapeutic touch. The combination of interventions allows the patient to heal in mind, body, and spirit by focusing on the patient's emotions, spirituality, and cultural identity as much as the illness. The six steps of the holistic caring process occur simultaneously, including assessment, diagnosis, outcomes, therapeutic plan of care, implementation, and evaluation. The holistic assessment of the patient can include spiritual, transpersonal, and energy-field assessments in combination with the standard physical and emotional assessments. The therapeutic plan of care in holistic nursing includes a highly individualized and unique plan for each patient. Holistic nurses recognize that the plan of care will change based on the individual patient, and therefore embrace healing as a process that is always changing and adapting to the individual's personal healing journey. Therapies utilized by holistic nurses include stress management techniques and alternative or complementary practices such as reiki and guided imagery. These therapy modalities are focused on empowering individuals to reduce stress levels and elicit a relaxation response in order to promote healing and well-being. The caring for patients in holistic nursing may differ from other nursing care as some may lack in caring for the patient as a whole, which includes spiritually. In holistic nursing, taking care of the patient does not differ from other nursing, but is focused on mental and spiritual needs as well as physical health. In holistic nursing there should be a therapeutic trust between the patient and nurse, as caring holistically involves knowing the patient's illness as whole. This can be only done by the patient who is the one to tell the nurse about the social, spiritual and internal illness that they are experiencing. Also as caring could be involved as assertive action, quiet support or even both which assist in understanding a person's cultural differences, physical and social needs. Through this the nurse is able to give more holistic care to meet the social and spiritual needs of the patient. The attitude of nurse includes helping, sharing and nurturing. In holistic caring there is spiritual care where it needs an understanding of patient's beliefs and religious views. This is the reason why there should be therapeutic trust between nurse and patient, as in order to understand and respect the patient's religious beliefs the nurse has to get information from the patient directly which is hard to get when there is not therapeutic trust. There is no specific order or template for how to care holistically, but the principle of holistic caring is to include patient's social and internal needs and not just focus on treating the physical illness. Holistic communication Holistic nurses use intentional listening techniques ("Focus completely on the speaker") and unconditional positive regard to communicate with patients. The goal of using these communication techniques is to create authentic, compassionate, and therapeutic relationships with each patient. In holistic nursing having therapeutic trust with patient and nurse gives great advantage of achieving the goal of treating patients as a whole. Therapeutic trust can be developed by having conversation with the patient. In communication the sender can also become a receiver or vice versa which in holistic nursing the nurses are the receiver of patients concern and the pass the information on to the doctor and do the vice versa. As communication is vital element in nursing it is strongly recommended to nurses to understand what is needed and how to communicate with patients. Communicating with patients can help in the performances of nurses in holistic nursing as by communicating the nurses are able to understand the cultural, social values and psychological conditions. Through this the nurses are able to satisfy the needs of a patient and as well as protecting the nurse for doing their roles as a nurse. In holistic nursing non-verbal communication is also another skill that is taught to nurses which are expressed by gestures, facial expression, posture and creating physical barriers. In holistic nursing as all individuals are not all the same but their social and psychological illness should be treated it is up to the nurse on how they communicate in order to build a therapeutic trust. To achieve the goal of holistic nursing it is important to communicate with the patient properly and to this successfully between the nurse and patient is freakiness and honesty. Without these communicating skills the nurse would not be able to build therapeutic trust and is likely to fail the goal of holistic nursing. Building a therapeutic environment Holistic nursing focuses on creating not only a therapeutic relationship with patients but also on creating a therapeutic environment for patients. Several of the therapies included in holistic nursing rely on therapeutic environments to be successful and effective. A therapeutic environment empowers patients to connect with the holistic nurse and with themselves introspectively. Depending on the environment of where the patient is holistic approach may be different and knowing this will help nurses to achieve better in holistic nursing. For patients with illness, trauma and surgery increasing sleep will benefit in recovery, blood pressure, pain relief and emotional wellbeing. As in hospital there are many disturbances which can effect patients’ quality of sleep and due to this the patients are lacking in aid for healing, recovery and emotional wellbeing. Nurse being able note or take care of patient's sleep will determine how closely they are approaching to holistic nursing. Depending on disease some of the treatment may differ and may need further check-ups or programs for patients. For example, there are higher chances for women to experience cardiovascular disease but there are fewer enrollments for cardiac rehabilitation programs compared to men. This was due to the environment of hospital not being able to support females in completing the CR programs. Some examples are physicians are less likely to refer CR programs to women and patient's thought against safety of the program. In situation like this from the knowledge and education that comes from holistic nursing the nurses will be able to approach the patient as they can relate to what the patient is going through which gives more comfort and safety to patients in doing the programs. Cultural diversity Part of any type of nursing includes understanding the patient's comprehension level, ability to cope, social supports, and background or base knowledge. The nurse must use this information to effectively communicate with the patient and the patient's family, to build a trusting relationship, and to comprehensively educate the patient. The ability of a holistic nurse to build a therapeutic relationship with a patient is especially important. Holistic nurses ask themselves how they can culturally care for patients through holistic assessment because holistic nurses engage in ethical practices and the treatment of all aspects of the individual. Australia has many different cultures as they are many people who were born overseas and migrated to Australia, which we can experience many cultural diversities. Culture can be defined as how people create collective beliefs and shared practices in order to make sense of their lived experiences which how concepts of language, religion and ethnicity are built in the culture. As the meaning of holistic nursing to heal the person as a whole knowing their cultural identities or backgrounds will help to reach the goal (Mariano, 2007). Understanding peoples culture may help to approach treatment correctly to the patient as it provides knowledge to nurses how patient's view of the concept of illness and disease are to their values and identity. As in holistic approach culture, beliefs and values are essential components to achieve the goal. People's actions to promote, maintain and restore health and healing are mainly influenced by their culture which is why knowing other cultures will assist in holistic nursing. By developing knowledge, communication, assessment skills and practices for nurses it guides to provide better experiences to patients who have diverse beliefs, values, and behaviors that respects their social, cultural and linguistic needs. As for most patients and families their decision on having treatment against illness or disease are done from cultural beliefs. This means if the nurses are unable to understand and give information relating to what they believe in the patients will most likely reject the treatment and give hardship on holistic nursing. Holistic education and research Holistic registered nurses are responsible for learning the scope of practice established in Holistic Nursing: Scope and Standards of Practice(2007) and for incorporating every core value into daily practice. It is the holistic nurse's responsibility to become familiar with both conventional practices as well as alternative therapies and modalities. Through continuing education and research, the holistic nurse will remain updated on all treatment options for patients. Areas of research completed by holistic nurses includes: measurements of outcomes of holistic therapies, measurements of caring behaviors and spirituality, patient responsiveness to holistic care, and theory development in areas such as intentionality, empowerment, and several other topics. The goal of holistic nursing is treat the patient's individual's social, cognitive, emotional and physical problems as well as understanding their spiritual and cultural beliefs. Involving holistic nursing in the education will help future nurses to be more familiar in the terms holistic and how to approach the concept. In the education of holistic nursing all other nursing knowledge is included which once again developed through reflective practice. In holistic nursing the nurses are taught on the five core values in caring, critical thinking, holism, nursing role development and accountability. These values help the nurse to be able to focus on the health care on the clients, their families and the allied health practitioners who is also involved in patient care. Education in holistic nursing is continuous education program which will be ongoing even after graduation to improve in reaching the goal. Education on holistic nursing would be beneficial to nurses if this concept is introduced earlier as repetition of educating holistic nursing could also be the revision of it. There is different education on commutating skills and an example would be the non-verbal and verbal communication with patients. This is done to improve when would the right or wrong to use the communication skill and how powerful skills this could be. Holistic nurse self-care Through the holistic nurse's integration of self-care, self-awareness, and self-healing practices, the holistic nurse is living the values that are taught to patients in practice. Holistic "nurses cannot facilitate healing unless they are in the process of healing themselves." In order to provide holistic nursing to patient it is also important for nurses to take care of themselves. There are various ways which the nurses can heal, assess and care for themselves such as self-assessment, meditation, yoga, good nutrition, energy therapies, support and lifelong learning. By nurses being able achieve balance and harmony in their lives it can assist to understand how to take care of patient holistically. In Florida Atlantic University there is a program that focus on all caring aspects and recognize how to take care of others as well as on how to start evaluation on their own mind, body and spirit. Also there is Travis’ Wellness Model which explores the idea of “self-care, wellness results from an ongoing process of self-awareness, exploring options, looking within, receiving from others (education), trying out new options (growth), and constantly re-evaluating the entire process. Self-awareness and education precede personal growth and wellness”. This model of concepts shows being able to understand own status of health can benefit to patients and reach the goal of holistic nursing. Certification National certification for holistic nursing is regulated by the American Holistic Nurses Certification Corporation (AHNCC). There are two levels of certification: one for nurses holding a bachelor's degree and one for nurses holding a master's degree. Accreditation through the AHNCC is approved by the American Nurses Credentialing Center (ANCC). Global initiatives United States American Holistic Nurses Association (AHNA): Mission Statement "The Mission of the American Holistic Nurses Association is to illuminate holism in nursing practice, community, advocacy, research and education." Canada Canadian Holistic Nurses Association (CHNA): Mission Statement "To support the practice of holistic nursing across Canada by: acting as a body of knowledge for its practitioners, by advocating with policy makers and provincial regulatory bodies and by educating Canadians on the benefits of complementary and integrative health care." Australia Australian Holistic Nurses Association (AHNA) "The Mission of the Australian Holistic Nurses Association (AHNA) is to illuminate holism in nursing practice, research, and education; act as a body of knowledge for its practitioners; advocate with policymakers and regulatory bodies; and educate Australians on the benefits of Complementary and Alternative Medicine (CAM) and integrative health care." See also Alternative medicine Alternative Therapies in Health and Medicine Journal of Holistic Nursing Nursing References Nursing specialties Alternative medicine

Pluriculturalism

Pluriculturalism is an approach to the self and others as complex rich beings which act and react from the perspective of multiple identifications and experiences which combine to make up their pluricultural repertoire. Identity or identities are the by-products of experiences in different cultures and with people with different cultural repertoires. As an effect, multiple identifications create a unique personality instead of or more than a static identity. An individual's pluriculturalism includes their own cultural diversity and their awareness and experience with the cultural diversity of others. It can be influenced by their job or occupational trajectory, geographic location, family history and mobility, leisure or occupational travel, personal interests or experience with media. The term pluricultural competence is a consequence of the idea of plurilingualism. There is a distinction between pluriculturalism and multiculturalism. Spain has been referred to as a pluricultural country, due to its nationalisms and regionalisms. See also Multiculturalism Cultural diversity Interculturalism Intercultural communication Polyethnicity References Identity politics Multiculturalism Social theories Sociology of culture

False statement

A false statement, also known as a falsehood, falsity, misstatement or untruth, is a statement that is false or does not align with reality. This concept spans various fields, including communication, law, linguistics, and philosophy. It is considered a fundamental issue in human discourse. The intentional dissemination of misstatements (disinformation) is commonly termed as deception or lying, while unintentional inaccuracies may arise from misconceptions, misinformation, or mistakes. Although the word fallacy is sometimes used as a synonym for false statement, that is not how the word is used in most formal contexts. Overview Characteristics Intention: Misstatements can be made deliberately with the intent to deceive or unintentionally due to misconception. Consequences: Impact of misstatements can vary, ranging from minor misconceptions to significant societal repercussions. In legal contexts, making false statements can have serious repercussions such as defamation, fraud, or perjury. The accuracy of statements is pivotal in maintaining trust within interpersonal relationships, professional settings, and broader societal structures. Types Lie: Deliberate misstatement intended to deceive. Misinformation: Inaccurate information spread without the intent to deceive. Disinformation: Misinformation spread with the intent to deceive and manipulate opinions. Causes and Motivations Understanding the motivations behind misstatements is complex. Individuals may lie to protect themselves, gain an advantage, manipulate perceptions, or evade accountability. Psychological factors, societal pressures, and cognitive biases can contribute to the inclination to make misstatements. Cognitive dissonance may also play a role when individuals resist acknowledging the falsity of their statements. The ethics surrounding misstatements are multifaceted. Honest communication is often considered a fundamental value, but ethical dilemmas may arise in situations where the truth conflicts with other moral principles or when individuals face personal or professional consequences for honesty. Detection and Correction Fact checking: Verification of statements through fact-checking organizations helps identify and correct misinformation. Technology plays a role in both the spread and prevention of misinformation, with algorithms and artificial intelligence being employed to identify and combat false narratives. Media literacy: Promoting media literacy can empower individuals to critically evaluate information and discern between true and false statements. Historical Examples Propaganda: Throughout history, misstatements have been used in propaganda to manipulate public opinion during times of war or political unrest. Political campaign: Throughout history, misstatements have played significant roles in shaping narratives, influencing public opinion, discrediting dissidents and affecting political landscapes. In law In some jurisdictions, false statement is a crime similar to perjury. United States In U.S. law, a "false statement" generally refers to United States federal false statements statute, contained in . Most commonly, prosecutors use this statute to reach cover-up crimes such as perjury, false declarations, and obstruction of justice and government fraud cases. Its earliest progenitor was the False Claims Act of 1863, and in 1934 the requirement of an intent to defraud was eliminated to enforce the National Industrial Recovery Act of 1933 (NIRA) against producers of "hot oil", oil produced in violation of production restrictions established pursuant to the NIRA. The statute criminalizes a government official who "knowingly and willfully": (1) falsifies, conceals, or covers up by any trick, scheme, or device a material fact;(2) makes any materially false, fictitious, or fraudulent statement or representation; or(3) makes or uses any false writing or document knowing the same to contain any materially false, fictitious, or fraudulent statement or entry. See also Misinformation Fake news False accusation False statements of fact Jumping to conclusions Making false statements References Statements

Narrative inquiry

Narrative inquiry or narrative analysis emerged as a discipline from within the broader field of qualitative research in the early 20th century, as evidence exists that this method was used in psychology and sociology. Narrative inquiry uses field texts, such as stories, autobiography, journals, field notes, letters, conversations, interviews, family stories, photos (and other artifacts), and life experience, as the units of analysis to research and understand the way people create meaning in their lives as narratives. Narrative inquiry has been employed as a tool for analysis in the fields of cognitive science, organizational studies, knowledge theory, applied linguistics, sociology, occupational science and education studies, among others. Other approaches include the development of quantitative methods and tools based on the large volume captured by fragmented anecdotal material, and that which is self signified or indexed at the point of capture. Narrative inquiry challenges the philosophy behind quantitative/grounded data-gathering and questions the idea of "objective" data; however, it has been criticized for not being "theoretical enough." In disciplines like applied linguistics, scholarly work has pointed out that enough critical mass of studies exists in the discipline that uses this theory, and that a framework can be developed to guide its application. Background Narrative inquiry is a form of qualitative research, that emerged in the field of management science and later also developed in the field of knowledge management, which shares the sphere of information management. Narrative case studies were used by Sigmund Freud in the field of psychology, and biographies were used in sociology in the early twentieth century. Thus narrative inquiry focuses on the organization of human knowledge more than merely the collection and processing of data. It also implies that knowledge itself is considered valuable and noteworthy even when known by only one person. Knowledge management was coined as a discipline in the early 1980s as a method of identifying, representing, sharing, and communicating knowledge. Knowledge management and narrative inquiry share the idea of knowledge transfer, a theory which seeks to transfer unquantifiable elements of knowledge, including experience. Knowledge, if not communicated, becomes arguably useless, literally unused. Philosopher Andy Clark speculates that the ways in which minds deal with narrative (second-hand information) and memory (first-hand perception) are cognitively indistinguishable. Narrative, then, becomes an effective and powerful method of transferring knowledge. More recently, there has been a "narrative turn" in social science in response to the criticism against the paradigmatic methods of research. It has also been forecasted that soon narrative inquiry will emerge as an independent research method as opposed to being an extension of the qualitative method. Narrative ways of knowing Narrative is a powerful tool in the transfer, or sharing, of knowledge, one that is bound to cognitive issues of memory, constructed memory, and perceived memory. Jerome Bruner discusses this issue in his 1990 book, Acts of Meaning, where he considers the narrative form as a non-neutral rhetorical account that aims at "illocutionary intentions", or the desire to communicate meaning. This technique might be called "narrative" or defined as a particular branch of storytelling within the narrative method. Bruner's approach places the narrative in time, to "assume an experience of time" rather than just making reference to historical time. This narrative approach captures the emotion of the moment described, rendering the event active rather than passive, infused with the latent meaning being communicated by the teller. Two concepts are thus tied to narrative storytelling: memory and notions of time; both as time as found in the past and time as re-lived in the present. A narrative method accepts the idea that knowledge can be held in stories that can be relayed, stored, and retrieved. There is also a view that a critical event can play an important role as creating the context of a narrative to be captured. Method 1. Develop a research question A qualitative study seeks to learn why or how, so the writer's research must be directed at determining the why and how of the research topic. Therefore, when crafting a research question for a qualitative study, the writer will need to ask a why or how question about the topic. 2. Select or produce raw data The raw data tend to be interview transcriptions, but can also be the result of field notes compiled during participant observation or from other forms of data collection that can be used to produce a narrative. 3. Organize data According to psychology professor Donald Polkinghorne, the goal of organizing data is to refine the research question and separate irrelevant or redundant information from that which will be eventually analyzed, sometimes referred to as "narrative smoothing." Some approaches to organizing data are as follows: (When choosing a method of organization, one should choose the approach best suited to the research question and the goal of the project. For instance, Gee's method of organization would be best if studying the role language plays in narrative construction whereas Labov's method would more ideal for examining a certain event and its effect on an individual's experiences.) Labov's: Thematic organization or Synchronic Organization. This method is considered useful for understanding major events in the narrative and the effect those events have on the individual constructing the narrative. The approach utilizes an "evaluation model" that organizes the data into an abstract (What was this about?), an orientation (Who? What? When? Where?), a complication (Then what happened?), an evaluation (So what?), a result (What finally happened?), and a coda (the finished narrative). Said narrative elements may not occur in a constant order; multiple or reoccurring elements may exist within a single narrative. Polkinghorne's: Chronological Organization or Diachronic Organization also related to the sociology of stories approach that focuses on the contexts in which narratives are constructed. This approach attends to the "embodied nature" of the person telling the narrative, the context from which the narrative is created, the relationships between the narrative teller and others within the narrative, historical continuity, and the chronological organization of events. A story with a clear beginning, middle, and end is constructed from the narrative data. Polkinghorne makes the distinction between narrative analysis and analysis of narratives. Narrative analysis utilizes "narrative reasoning" by shaping data in a narrative form and doing an in-depth analysis of each narrative on its own, whereas analysis of narratives utilizes paradigmatic reasoning and analyzes themes across data that take the form of narratives. Bruner's functional approach focuses on what roles narratives serve for different individuals. In this approach, narratives are viewed as the way in which individuals construct and make sense of reality as well as the ways in which meanings are created and shared. This is considered a functional approach to narrative analysis because the emphasis of the analysis is focused on the work that the narrative serves in helping individuals make sense of their lives, particularly through shaping random and chaotic events into a coherent narrative that makes the events easier to handle by giving them meaning. The focus of this form of analysis is on the interpretations of events related in the narratives by the individual telling the story. Gee's approach of structural analysis focuses on the ways in which the narrative is conveyed by the speaker with particular emphasis given to the interaction between the speaker and the listener. In this form of analysis, the language that the speaker uses is the focus. This includes the language, the pauses in speech, discourse markers, and other similar structural aspects. In this approach, the narrative is divided into stanzas and each stanza is analyzed by itself and also in the way in which it connects to the other pieces of the narrative. Jaber F. Gubrium's form of narrative ethnography features the storytelling process as much as the story in analyzing narrativity. Moving from text to field, he and his associate James A. Holstein present an analytic vocabulary and procedural strategies for collecting and analyzing narrative material in everyday contexts, such as families and care settings. In their view, the structure and meaning of texts cannot be understood separate from the everyday contexts of their production. Their two books--"Analyzing Narrative Reality" and "Varieties of Narrative Analysis" provide dimensions of an institutionally-sensitive, constructionist approach to narrative production. There are a multitude of ways of organizing narrative data that fall under narrative analysis; different types of research questions lend themselves to different approaches. Regardless of the approach, qualitative researchers organize their data into groups based on various common traits. 4. Interpret data Some paradigms/theories that can be used to interpret data: {| class="wikitable" |- ! Paradigm or theory !! Criteria !! Form of theory !! Type of narration |- | Positivist/postpositivist || Universalist, evidence-based, internal, external validity || Logical-deductive grounded || Scientific report |- | Constructivist || Trustworthiness, credibility, transferability, confirmability || Substantive || Interpretive case studies, ethnographic fiction |- | Feminist || Afrocentric, lived experience, dialogue, caring, accountability, race, class, gender, reflexivity, praxis, emotion, concrete grounding || Critical, standpoint || Essays, stories, experimental writing |- | Ethnic || Afrocentric, lived experience, dialogue, caring, accountability, race, class, gender || Standpoint, critical, historical || Essays, fables, dramas |- | Marxism || Emancipatory theory, falsifiability dialogical, race, class, gender || Critical, historical, economic || Historical, economic, sociocultural analyses |- | Cultural studies || Cultural practices, praxis, social texts, subjectivities || Social criticism || Cultural theory as criticism |- | Queer theory || Reflexivity, deconstruction || Social criticism, historical analysis || Theory as criticism, autobiography |} While interpreting qualitative data, researchers suggest looking for patterns, themes, and regularities as well as contrasts, paradoxes, and irregularities. (The research question may have to change at this stage if the data does not offer insight to the inquiry.) The interpretation is seen in some approaches as co-created by not only the interviewer but also with help from the interviewee, as the researcher uses the interpretation given by the interviewee while also constructing their own meaning from the narrative. With these approaches, the researcher should draw upon their own knowledge and the research to label the narrative. According to some qualitative researchers, the goal of data interpretation is to facilitate the interviewee's experience of the story through a narrative form. Narrative forms are produced by constructing a coherent story from the data and looking at the data from the perspective of one's research question. Interpretive research The idea of imagination is where narrative inquiry and storytelling converge within narrative methodologies. Within narrative inquiry, storytelling seeks to better understand the "why" behind human action. Story collecting as a form of narrative inquiry allows the research participants to put the data into their own words and reveal the latent "why" behind their assertions. "Interpretive research" is a form of field research methodology that also searches for the subjective "why". Interpretive research, using methods such as those termed ""storytelling" or "narrative inquiry", does not attempt to predefine independent variables and dependent variables, but acknowledges context and seeks to "understand phenomena through the meanings that people assign to them." Two influential proponents of a narrative research model are Mark Johnson and Alasdair MacIntyre. In his work on experiential, embodied metaphors, Johnson encourages the researcher to challenge "how you see knowledge as embodied, embedded in a culture based on narrative unity," the "construct of continuity in individual lives." The seven "functions of narrative work" as outlined by Catherine Kohler Riessman: Narrative constitutes past experiences as it provides ways for individuals to make sense of the past. Narrators argue with stories. Persuading. Using rhetorical skill to position a statement to make it persuasive/to tell it how it "really" happened. To give it authenticity or 'truth'. Engagement, keeping the audience in the dynamic relationship with the narrator. Entertainment. Stories can function to mislead an audience. Stories can mobilize others into action for progressive change. Practices Narrative analysis therefore can be used to acquire a deeper understanding of the ways in which a few individuals organize and derive meaning from events. It can be particularly useful for studying the impact of social structures on an individual and how that relates to identity, intimate relationships, and family. For example: Feminist scholars have found narrative analysis useful for data collection of perspectives that have been traditionally marginalized. The method is also appropriate to cross-cultural research. As Michael Brecher and Frank P. Harvey advocate, when asking unusual questions it is logical to ask them in an unusual manner. Developmental psychology utilizes narrative inquiry to depict a child's experiences in areas such as self-regulation, problem-solving and development of self. Personality uses the narrative approach in order to illustrate an individual's identity over a lifespan. Social movements have used narrative analysis in their persuasive techniques. Political practices. Stories are connected to the flow of power in the wider world. Some narratives serve different purposes for individuals and others, for groups. Some narratives overlap both individual experiences and social. Promulgation of a culture: Narratives and storytelling are used to remember past events, reveal morals, entertain, relate to one another, and engage a community. Narrative inquiry helps to create an identity and demonstrate/carry on cultural values/traditions. Stories connect humans to each other and to their culture. These cultural definitions aid to make social knowledge accessible to people who are unfamiliar with the culture/situation. An example of this is how children in a given society learn from their parents and the culture around them. Notable people Jerome Bruner D. Jean Clandinin F. Michael Connelly James Paul Gee Jaber F. Gubrium Mark Johnson William Labov Carl Leggo Alasdair MacIntyre Elliott Mishler Catherine Kohler Riessman Donald Polkinghorne See also Content analysis Frame analysis Hermeneutics Narrative psychology Narratology Organizational storytelling Praxis intervention Thematic analysis Reflective practice References Bibliography David M. Boje, Narrative Methods for Organizational and Communication Research (Thousand Oaks, CA: Sage, 2001). Barbara Czarniawska-Joerges, Narratives in Social Science Research (Thousand Oaks, CA: Sage, 2004). D. Jean Clandinin and F. Michael Connelly, Narrative Inquiry: Experience and Story in Qualitative Research (San Francisco: Jossey-Bass Publishers, 2000). F. Michael Connelly and D. Jean Clandinin, "Stories of Experience and Narrative Inquiry." Educational Researcher 19, no. 5 (June–July 1990): 2–14. C. Conle, "Narrative Inquiry: Research Tool and Medium for Professional Development," European Journal of Teacher Education 23, no.1 (March 2000): 49–63. Jaber F. Gubrium & James A. Holstein. 2009. "Analyzing Narrative Reality." Thousand Oaks, CA: Sage. James A. Holstein & Jaber F. Gubrium (eds.). 2012. "Varieties of Narrative Analysis." Thousand Oaks, CA: Sage. Nona Lyons and Vicki Kubler LaBoskey, Narrative Inquiry in Practice: Advancing the Knowledge of Teaching (New York: Teachers College Press, 2002). Lene Nielsen and Sabine Madsen, "Storytelling as Method for Sharing Knowledge across IT Projects," Proceedings of the 39th Hawaii International Conference on System Sciences, 2006 Gary Oliver and Dave Snowden, "Patterns of Narrative in Organizational Knowledge Sharing," in Knowledge Management and Narratives: Organizational Effectiveness Through Storytelling, Georg Schreyögg and Joch Koch, eds. (Berlin: Erich Schmidt Verlag, 2005). Gian Pagnucci, Living the Narrative Life: Stories as a Tool for Meaning Making (Portsmouth, NH: Boynton/Cook, 2004). Donald Polkinghorne, Narrative Knowing and the Human Sciences (Albany: SUNY Press, 1988). Dave Snowden, "Complex Acts of Knowing: Paradox and Descriptive Self-Awareness," Journal of Knowledge Management 6, no. 2 (Spring 2002): 100–111. Dave Snowden, "Narrative Patterns: the perils and possibilities of using story in organisations," in Creating Value With Knowledge, Eric Lesser and Laurence Prusak, eds. (Oxford: Oxford University Press, 2004). Organizational studies Cognitive science Qualitative research Inquiry Intellectual capital

Social Foundations of Thought and Action

Social Foundations of Thought and Action: A Social Cognitive Theory is a landmark work in psychology published in 1986 by Albert Bandura. The book expands Bandura's initial social learning theory into a comprehensive theory of human motivation and action, analyzing the role of cognitive, vicarious, self-regulatory, and self-reflective processes in psychosocial functioning. Bandura first advanced his thesis of reciprocal determinism in Social Foundations of Thought and Action. The book was originally published in the United States in 1986. Translations have been published in Chinese, Russian, and Spanish.<ref name=banduracv>CV of Albert Bandura, accessed 30 May 2010.</ref> The book has been reviewed and discussed in several professional social science journals,<ref name=baron87/><ref name=locke87/><ref name=cahill87/><ref name=kihlstrom90/><ref name=lerner90/><ref name=meichenbaum90/> and widely cited in the professional literatures of psychology, sociology, and other fields. Topics covered Social Foundations of Thought and Action: A Social Cognitive Theory contains 10 chapters: 1. Models of Human Nature and Causality. 2. Observational Learning. 3. Enactive Learning. 4. Social Diffusion and Innovation. 5. Predictive Knowledge and Forethought. 6. Incentive Motivators. 7. Vicarious Motivators. 8. Self-Regulatory Mechanisms. 9. Self-Efficacy. 10. Cognitive Regulators. It also contains a preface, author and subject indices, and a 60-page reference section. The preface explained that: For convenience... theories need to be given summary labels [and] the theoretical approach presented in this volume is usually designated as social learning theory [although] the scope of this approach has always been much broader than its descriptive label, which is becoming increasing ill-fitting.... [and] is further compounded because several theories with dissimilar postulates—Dollard and Miller's drive theory, Rotter's expectancy theory, and Patterson's conditioning theory—all bear the social learning label. In the interest of more fitting and separable labeling, the theoretical approach of this book is designated as social cognitive theory. The social portion of the terminology acknowledges the social origins of much human thought and action; the cognitive portion recognizes the influential causal contribution of thought processes to human motivation, affect, and action. (p. xii) Reviews and influence Reviews have appeared in Contemporary Psychology, the Academy of Management Review, and Contemporary Sociology. It was also the focus of a special section in the inaugural issue of Psychological Inquiry.<ref name=kihlstrom90></ref><ref name=lerner90></ref><ref name=meichenbaum90></ref><ref name=bandura90></ref> In Contemporary Psychology, Robert A. Baron wrote that in his view, the book "is a work of great significance to the field" and has a "high (sometimes dazzling) level of sophistication [that] is apparent not only in the theoretical perspective but also in the extremely broad scope of the volume." The book is so filled with intriguing findings and challenging hypotheses that several generations of researchers will undoubtedly be needed to assess its full potential.... For more than a century, psychologists have searched for a "grand theory" of human behavior—one that will provide a comprehensive, accurate, and usable account of this complex and fascinating topic.... social cognitive theory does not yet provide such an account, [but I] discern in its great breadth and sophistication outlines of the grand theory we seek. In the Academy of Management Review, Edwin A. Locke wrote that this is a brilliant and important book that should be required reading for all doctoral students in organizational behavior, human resource management and industrial-organizational psychology... I also recommend it to organizational researchers and consultants. It is a classic that will be cited for decades to come. In a special section in the 1990 inaugural issue of Psychological Inquiry, John F. Kihlstrom and Judith M. Harackiewicz wrote that Publication of Albert Bandura's Social Foundations of Thought and Action... was a significant event in the history of the scientific study of personality. It provides a detailed account of the acquisition of knowledge and skills relevant to personality and social interaction, provides a new perspective on motivational issues of longstanding interest, and offers an overarching framework for integrating personality and social psychology.... Bandura is a central figure in the movement away from static conceptualizations of personality in terms of types and traits, toward a more dynamic view that emphasizes the interaction between the person and his or her social environment.... his book marks the furthest departure yet made by social learning theory from its sources in behaviorism... Also in that special section, Richard M. Lerner, a developmental psychologist, began by quoting several key ideas from Bandura's book, and wrote that "the set of ideas quoted at the outset of this article would not be seen as especially new to contemporary developmental psychologists." However, he went on to state that what makes the quoted ideas quite significant and in fact provocative... is that they are not written by a developmental psychologist [but by] Albert Bandura, one of this country's most deservedly acclaimed personality and social psychologists. Bandura's (1986) book... is a major statement.... Given Bandura's scientific stature... of scholarly contributions so seminal that its substance is obligatory knowledge for all people seeking training in psychology... his book is, then, an event of major historical importance in the study of personality and social psychology, and indeed for the discipline as a whole. By so insistently weaving development into the very fabric of the phenomena studied by personality and social psychologists, Bandura's book signals the end of one era, of one way of "doing business," in these areas of psychology, and sets the stage for the beginning of quite a different one. In a third commentary in that special section, Donald H. Meichenbaum wrote that he "concur[red] totally" with Baron's assessment of Bandura's book as "a sophisticated, eloquent, ambitious attempt to provide a 'grand theory' of human behavior." He further suggested that "there is little that is not offered to illustrate the potential of social cognitive theory.... If the American Psychological Association is ever asked to contribute to a time capsule to illustrate what has preoccupied psychologists in the 1970s and early 1980s, I heartily recommend Bandura's book." However, Meichenbaum also wrote that "the conceptual framework and language of social cognitive theory can be seductive. Caution is required! Perhaps, the best place to highlight the need for such caution is in the context of a homage." He expressed cautions with regard to three issues: Nature of self-efficacy theory. "Is the 'grand theory' merely an expression of common sense?" "The concept of perceived self-efficacy carries a heavy burden in explaining so many diverse behaviors. When does explaining too much mean that one is not really explaining any one thing well?" (Meichenbaum extensively quoted Smedslund.) Broader implications. Meichenbaum found Bandura's "discussion of the nature of the social foundations of thought and action to be somewhat narrow [so he] challenge[s] Bandura and other social cognitive theorists to consider the implications of the works of Baldwin (1894), Mead (1934), Bakhtin (Morson, 1986), Vygotsky (1978), Wertsch (1985), and Rogoff (1982), each of whom has written thoughtfully about the social formulation of the mind." Role of cognitive structures. "It is with regard to cognitive structures... that social cognitive theory is weakest.... Bandura [refers] to 'knowledge structures, beliefs, scripts, stereotypes, and prototypes' (p. 218). Are these equivalent concepts?... [I predict] that as social cognitive theorists embrace the challenging task of understanding the nature of cognitive structures and affective themes, the supposed barriers between social learning theorists and psychodynamically oriented theorists will break down." In a reply that was published with these three commentaries in Psychological Inquiry, Bandura responded to what he called "several puzzling misconstruals of social cognitive theory" in Meichenbaum's commentary. Bandura stated that "two chapters examine how... knowledge structures are acquired through observational learning, inferences from exploratory experiences, information conveyed by tuition, and innovative cognitive syntheses of preexisting knowledge," and that "ecumenical appeals for unification of social cognitive and psychodynamic theories go unsupported by any empirical evidence for the superiority of the theoretical hybridization." Bandura responded to the other two reviews, which he called "thoughtful," by expanding on the nature of triadic reciprocal causation, on the "interdependence of [psychological] process and structure," and on how self-efficacy is defined and measured with respect to particular domains of functioning and skill. He noted that "a major current movement in psychology is away from vague, omnibus cognitive structures to more domain-linked competencies." Outside of the psychology literature, in Contemporary Sociology, Spencer E. Cahill wrote that Bandura may not deliver the comprehensive and interdisciplinary theory of the Social Foundations of Thought and Action that he promises in the preface, but he does advance the cause. His conception of the person, his analysis of the cognitive processes implicated in the acquisition and performance of behavior, and his devastating criticisms of a number of theoretical perspectives are all important contributions. However, Cahill also criticized the book on several grounds. He expressed concern that Bandura's excursions across disciplinary boundaries are far too circumscribed. For example, while the person of Bandura's social cognitive theory closely resembles the... person of the Meadian sociological psychology, Bandura ignores this entire tradition.... His list of the various ways in which the person "disengages" internal control bears a striking resemblance to Sykes and Matza's "Techniques of Neutralization" (1957), yet there is no reference to this.... [and] Although Bandura's model of triadic reciprocality suggests that the environment and behavior recursively determine one another, he is apparently unaware of... the numerous analyses by symbolic interactionists, ethnomethodologists, and other sociologists. Cahill also expressed concern that Bandura "closely scrutinizes empirical studies for technical flaws if their results are inconsistent with his theoretical analysis, but he does not apply the same exacting standards to studies that do support his arguments. While this is to be expected, the reader must be familiar with the research under review in order to adequately evaluate the empirical evidence that Bandura marshals." Editions The original and only English-language edition was published in the US in 1986 by Prentice Hall. Several foreign (non-English) editions have also been published. The English, Chinese and Spanish editions are: , (2 volume set, 34 & 964 pages) , (651 pages) Бандура А. Теория социального научения. — СПб.: Евразия, 2000. — 320 с. Bandura has stated that a Russian translation has also been published. See also Timeline of psychology References Books about social psychology 1986 non-fiction books Prentice Hall books

Purple hat therapy

Purple hat therapy refers to any medical practice in which an established form of therapy is mixed with an unlikely new addition (such as wearing a purple hat) and then is claimed to be effective because of the new addition, when in fact the effectiveness is due to the established component. Origin and description The term "purple hat therapy" was coined by Gerald Rosen and Gerald Davison in their 2003 paper, Psychology should list empirically supported principles of change (ESPs) and not credential trademarked therapies or other treatment packages. The therapy is accepted as effective because it is assessed overall; the additional element of the "purple hat" is not tested as distinct and does not need to prove its extra worth. Its invention is followed by the publication of papers discussing it and special training courses. In addition to introducing unnecessary elements into the treatment, purple hat therapies can hinder the scientific understanding of effective treatments for the condition in question. Application Purple hat therapy has been used as an analogue for eye movement desensitization and reprocessing since it takes established exposure therapy and adds non-science based activities such as eye movement as a "purple hat". See also Fallacy of composition Stone soup References Sources Further reading Metaphors referring to objects 2003 neologisms Hats Psychotherapy by type Pseudoscience

Human potential

Human potential is the capacity for humans to improve themselves through studying, training, and practice, to reach the limit of their ability to develop aptitudes and skills. "Inherent within the notion of human potential is the belief that in reaching their full potential an individual will be able to lead a happy and more fulfilled life". Meaning and scope The term potential generally refers to a currently unrealized ability. The term is used in a wide variety of fields, from physics to the social sciences to indicate things that are in a state where they are able to change in ways ranging from the simple release of energy by objects to the realization of abilities in people. The philosopher Aristotle incorporated this concept into his theory of potentiality and actuality, a pair of closely connected principles which he used to analyze motion, causality, ethics, and physiology in his Physics, Metaphysics, Nicomachean Ethics and De Anima, which is about the human psyche. That which is potential can theoretically be made actual by taking the right action; for example, a boulder on the edge of a cliff has potential to fall that could be actualized by pushing it over the edge, and a person whose natural aptitudes give them the potential to be a great pianist can actualize that potential by diligently practicing playing the piano. The concept of developing potential is sometimes described in terms of becoming the best version of oneself. Persons who are believed to have a degree of potential that they do not pursue are often described as having failed to "live up to their potential". Early conceptions of human potential suggested that the full potential of any person was innate in that person from before their birth, possibly from the moment of their conception. More recent definitions have encompassed both internal and societal influences. Human-potential model According to the American Psychological Association, the human-potential model is an approach in the field of Education that "emphasizes the importance of helping learners to achieve the maximum development of their potential in all aspects of their functioning". It is related to and draws from the associated field of humanistic psychology. Human Potential Movement The Human Potential Movement was a particular counterculture movement started in the 1960s with a focus of maximizing human potential. It was influenced by the work of those such as Abraham Maslow, and took the form of a type of psychological philosophy. See also Maslow's hierarchy of needs, psychological theory regarding behavioral motivation and self-actualization Personal development, activities over the course of a person's life that contribute to things such as the improvement of awareness and identity Social development theory, which attempts to explain qualitative changes in the structure and framework of society, that help the society to better realize aims and objectives References Human development

Cognitive emotional behavioral therapy

Cognitive emotional behavioral therapy (CEBT) is an extended version of cognitive behavioral therapy (CBT) aimed at helping individuals to evaluate the basis of their emotional distress and thus reduce the need for associated dysfunctional coping behaviors (e.g., eating behaviors including binging, purging, restriction of food intake, and substance misuse). This psychotherapeutic intervention draws on a range of models and techniques including dialectical behavior therapy (DBT), mindfulness meditation, acceptance and commitment therapy (ACT), and experiential exercises. CEBT has been used primarily for individuals with eating disorders, as it offers an alternative when standard CBT is unsuccessful in relieving symptoms. Research indicates that CEBT may help reduce emotional eating, depression, and anxiety and also improve self-esteem. CEBT was developed in 2006 by British psychologist Emma Gray (née Corstorphine). Its key components include psychological education; techniques to enhance awareness of emotions and motivation to change; and strategies to restructure beliefs about the experience and expression of emotions. Although (CEBT) was initially developed to help individuals with eating disorders, its effectiveness in helping people to better understand and manage their emotions has meant that it is increasingly being used by psychologists as a 'pretreatment' to prepare patients for the process of therapy for a range of problems including anxiety, depression, obsessive compulsive disorder (OCD), and post traumatic stress disorder (PTSD), which can often be emotionally challenging. Techniques Dialectical behavior therapy (DBT) - DBT is a type of psychotherapy used to treat various disorders. The purpose of this therapy is to help create positive changes in a person's behavior. DBT focuses mainly on treating individuals who have bulimia, drug-dependence, borderline personality disorder, depression, or other psychological disorders. Mindfulness meditation - Mindfulness meditation is a technique that increases and improves awareness. This technique aims to lower stress and improve our attention. It is a form of focusing on what is presently happening. Mindfulness meditation aims at improving mental health through helping those with disorders be able to manage their emotions. Acceptance and commitment therapy (ACT) - Acceptance and commitment therapy is a treatment aimed at helping people to accept the feelings and experiences they go through. Oftentimes people must deal with unpleasant feelings, thoughts or experiences and in response they avoid those emotions as a way of coping. In regards to the way we react, ACT helps with acceptance, making a decision to make changes, and going through with that commitment. Experiential exercises - Experiential exercises play an important part in CEBT because it allows individuals to become actively involved in the learning process. Experiencing what is being taught can have a positive impact on those individuals who experience emotional and behavioral difficulties. These exercises are often used in different types of therapy in order to help individuals learn about diversity, acceptance, injustice, and so forth. Experiential exercises can be incorporated in the treatment of individuals dealing with disorders. These exercises help people to know how to react or cope in certain situations. Background In 2006, Dr. Emma Gray (née Corstorphine) started the idea of Cognitive emotional behavioral therapy (CEBT). CEBT uses techniques from other types of treatment such as Cognitive behavior therapy and Dialectical behavioral therapy. The main goal of CEBT is to help individuals learn to cope with their emotions, reduce stress and anxiety, and make changes to their behavior. Gray noted that emotion plays a crucial part in disorders, therefore it needs to be further addressed in terms of treatment. Cognitive behavioral therapy aims to treat where a patient needs the most help, whether that is emotional, behavioral, cognitive, etc. CBT has been practiced since the 1960s. There is a greater focus on cognitive psychology and its impact on behavior. In 2003 there began to be suggestions that CBT needed to be expanded to meet the needs of even more specific vulnerabilities such as emotion, social environments, relationships, etc. Gray saw the need for an approach that has a greater focus on the emotional components. Gray's research specifically analyzes cognitive emotional behavioral therapy (CBT) for eating disorders. She found that CBT and related techniques for bulimia were not effective. CBT mainly uses treatments aimed at discovering cognitive or behavioral issues to be the source. Gray's findings show that therapy focused on emotion helped individuals manage their emotions and difficulties. Research has shown that emotional distress is a major cause of bulimia. Additional studies show that what triggers bulimia is oftentimes one's emotional state and their relationships. CEBT helps these individuals with disorders to cope with their emotions and develop the skills necessary to positively handle their situation. Case Gray (née Corstorphine) analyzes a case to determine whether cognitive emotional behavior therapy for eating disorders (CEBT-ED) is effective. In this case, a 22-year-old woman named Anna, who has bulimia and anorexia, goes through CBT and is able to regulate some of her eating patterns and lower the number of times she purges. It was acknowledged that Anna had emotional trauma due to the environment she grew up in. Her self esteem and expression of emotion were repressed because of her family. CEBT-ED allowed her to feel encouraged to show her emotions and discover the source of her difficulties. CEBT is an effective way of easing the symptoms of cognitive and emotional disorders when the typical CBT does not provide sufficient exercises and training. Emotion is the primary issue of eating disorders. In Anna's case CBT would have been helpful but would have focused mainly on changing negative or unreasonable thoughts. At the center of Anna's problem was her emotional trauma as a child and her difficulty in expressing how she felt. To address Anna's specific needs, CBT was not enough, but CEBT allowed room for self-reflection to find the root of her issues. CEBT helped her to identify and understand her emotions, allowing her to learn skills that would help her cope with these emotions and relieve the symptoms of her issues. References Further reading Corstorphine, E. (2006) Cognitive-emotional-behavioural therapy for the eating disorders: Working with beliefs about emotions. European Eating Disorders Research, 14, 448–461. Corstorphine (2008). Modifying cognitive behavioural therapy for the treatment of eating disorders – using schema modes to work with emotions. In J. Buckroyd (Ed.) Psychological responses to treatment in eating disorders and obesity. Wiley Cognitive behavioral therapy Mindfulness (psychology)

Ingratiation

Ingratiating is a psychological technique in which an individual attempts to influence another person by becoming more likeable to their target. This term was coined by social psychologist Edward E. Jones, who further defined ingratiating as "a class of strategic behaviors illicitly designed to influence a particular other person concerning the attractiveness of one's personal qualities." Ingratiation research has identified some specific tactics of employing ingratiation: Complimentary Other-Enhancement: the act of using compliments or flattery to improve the esteem of another individual. Conformity in Opinion, Judgment, and Behavior: altering the expression of one's personal opinions to match the opinion(s) of another individual. Self-Presentation or Self-Promotion: explicit presentation of an individual's own characteristics, typically done in a favorable manner. Rendering Favors: Performing helpful requests for another individual. Modesty: Moderating the estimation of one's own abilities, sometimes seen as self-deprecation. Expression of Humour: any event shared by an individual with the target individual that is intended to be amusing. Instrumental Dependency: the act of convincing the target individual that the ingratiator is completely dependent upon them. Name-dropping: the act of referencing one or more other individuals in a conversation with the intent of using the reference(s) to increase perceived attractiveness or credibility. Research has also identified three distinct types of ingratiation, each defined by their ultimate goal. Regardless of the goal of ingratiation, the tactics of employment remain the same: Acquisitive ingratiation: ingratiation with the goal of obtaining some form of resource or reward from a target individual. Protective Ingratiation: ingratiation used to prevent possible sanctions or other negative consequences elicited from a target individual. Significance ingratiation: ingratiation designed to cultivate respect and/or approval from a target individual, rather than an explicit reward. Ingratiation has been confused with another social psychological term, Impression management. Impression management is defined as "the process by which people control the impressions others form of them." While these terms may seem similar, it is important to note that impression management represents a larger construct of which ingratiation is a component. In other words, ingratiation is a method of impression management. Edward E. Jones: the Father of Ingratiation Ingratiation, as a topic in social psychology, was first defined and analyzed by social psychologist Edward E. Jones. In addition to his pioneering studies on ingratiation, Jones also helped develop some of the fundamental theories of social psychology such as the fundamental attribution error and the actor-observer bias. Jones' first extensive studies of ingratiation were published in his 1964 book Ingratiation: A Social Psychological Analysis. In citing his reasons for studying ingratiation, Jones reasoned that ingratiation was an important phenomenon to study because it elucidated some of the central mysteries of social interaction and was also the stepping stone towards understanding other common social phenomena such as group cohesiveness. Tactics of ingratiation Complimentary Other enhancement is said to "involve communication of directly enhancing, evaluative statements" and is most correlated to the practice of flattery. Most often, other enhancement is achieved when the ingratiator exaggerates the positive qualities of the target while leaving out the negative qualities. According to Jones, this form of ingratiation is effective based on the Gestaltian axiom that it is hard for a person to dislike someone that thinks highly of them. In addition to this, other enhancement seems to be most effective when compliments are directed at the target's sources of self-doubt. To shield the obviousness of the flattery, the ingratiator may first talk negatively about qualities the target knows are weaknesses and then compliment him/her on a weak quality the target is unsure of. Conformity in Opinion, Judgment, and Behavior is based on the tenet that people like those whose values and beliefs are similar to their own. According to Jones, ingratiation in the form of conformity can "range from simple agreement with expressed opinions to the most complex forms of behavior imitation and identification." Similar to other enhancement, conformity is thought to be most effective when there is a change of opinion. When the ingratiator switches from a divergent opinion to an agreeing one, the target assumes the ingratiator values his/her opinion enough to change, in turn strengthening the positive feelings the target has for the ingratiator. With this, the target person is likely to be most appreciative of agreement when he wants to believe that something is true but is not sure that it is. Jones argues, therefore, that it is best to start by disagreeing in trivial issue and agreeing on issues that the target person needs affirmation. Self-Presentation or Self-Promotion is the "explicit presentation or description of one's own attributes to increase the likelihood of being judged attractively". The ingratiator is one who models himself along the lines of the target person's suggested ideals. Self-presentation is said to be most effective by exaggerating strengths and minimizing weaknesses. This tactic, however, seems to be dependent of the normal self-image of the ingratiator. For example, those who are of high esteem are considered with more favor if they are modest and those who are not are seen as more favorable when they exaggerate their strengths. One can also present weakness in order to impress the target. By revealing weaknesses, one implies a sense of respect and trust of the target. Interview responses such as "I am the kind of person who...", "You can count on me to..." are examples of self-presentation techniques. Rendering Favors is the act of performing helpful requests for another individual. This is a positive ingratiation tactic, as "persons are likely to be attracted to those who do nice things for them." By providing favors or gifts, the ingratiator promotes attraction in the target by making him/herself appear more favorable. In some instances, people may use favors or gifts with the goal of "...influencing others to give us the things we want more than they do, but giving them the things they want more than we do." Modesty is the act of moderating the estimation of one's own abilities. Modesty is seen as an effective ingratiation strategy because it provides a relatively less transparent format for the ingratiator to promote likeability. Modesty can sometimes take the form of self-deprecation, or Deprecation directed toward one's self, which is the opposite of self-promotion. Instead of the ingratiator making him/herself seem more attractive in the eyes of the target individual, the goal of self-deprecation is to decrease the perceived attractiveness of the ingratiator. In doing so, the ingratiator hopes to receive pity from the target individual, and is thus able to enact persuasion via such pity. Expression of humor is the intentional use of humor to create a positive affect with the target individual. The expression of humor is best implicated when the ingratiator is of higher status than the target individual, such as from supervisor to employee. "As long as the target perceives the individual's joke as appropriate, funny, and has no alternative implications, than the joke will be taken in a positive as opposed to a negative manner." When humor is used by an individual of lower status within the setting, it may prove to be risky, inappropriate, and distracting, and may damage likeability as opposed to promoting likeability. Instrumental Dependency is the act of instilling the impression upon the target individual that the ingratiator is completely dependent upon that individual. Similar to modesty, instrumental dependency works by creating a sense of pity for the ingratiator. While instrumental dependency as a process is similar to modesty or self-deprecation, it is defined separately due to the notion that instrumental dependency is typically task-dependent, meaning the ingratiator would insinuate that he/she is dependent upon the target individual for the completion of a specific task or goal. Name-dropping is the act of using the name of an influential person(s) as reference(s) while communicating with the target individual. Typically, name-dropping is done strategically in a manner that the reference(s) in question will be known and respected by the target individual. As a result, the target individual is likely to see the ingratiator as more attractive. Major empirical findings In business Seiter conducted a study that looked into the effect of ingratiation tactics on tipping behavior in the restaurant business. The study was done at two restaurants in Northern Utah, and the participant pool was 94 dining parties of 2 people each, equaling 188 participants in total. In order to ensure that the person paying the bill was complimented, the experimenters were told to genuinely compliment both members of the party. The data was collected by two female communication students, both the age of 22, who worked part-time as waitresses. The results of the experiment supported the initial hypothesis that customers receiving compliments on their choice of dish would tip larger amounts than customers who received no compliment after ordering. A one-way ANOVA test was performed, and this test found significant differences in tipping behavior between the two conditions. Customers who received compliments left larger tips (M = 18.94) than those who were not the recipients of ingratiation tactics (M = 16.41). Treadway, Ferris, Duke, Adams, and Thatcher wanted to explore how the role of subordinate ingratiation and political skill on supervisors’ impressions and ratings of interpersonal facilitation. Specifically, the researchers wanted to see if political skill and ingratiation interact in the business setting. "Political skill refer to the ability to exercise influence through the use of persuasion, manipulation, and negotiation" They hypothesized that employees who used high rates of ingratiation, and had low levels of political skill would have motivations more easily detectable by their supervisors. Treadway et al. found that ingratiation was only effective if the motivation was not discovered by the supervisor. In addition, the researchers found that when supervisors rating of an employee's use of ingratiation increased, their rating of an employee's use of interpersonal facilitation decreased. In conversation and interviews Godfrey conducted a study that looked into the difference between self-promoters and ingratiators. The study subjects consisted of 50 pairs of unacquainted, same sex students from Princeton University (25 male pairs, 25 female pairs). The pairs of students participated in two sessions of videotaped, 20-minute conversations, spaced one week apart. The first session was an unstructured conversation where the two subjects just talked about arbitrary topics. After the first conversation, one subject was randomly assigned to be the presenter. The presenter was asked to fill out a two-question survey that rated the likability and the competency of the other subject on a scale from 1 to 10. The second subject was assigned the role of the target, and was instructed to fill out a much longer survey about the other subject, which included the likability and competency scale, 41 trait attributes, and 7 emotions. In the second session, the presenters were asked to participate as an ingratiator or a self-promoter. They were both given specific directions: ingratiators were told to try to make the target like them, while the self-promoters were instructed to make the targets view them as extremely competent. The results show that the presenters only partly achieved their goal. Partners of ingratiators rated them as somewhat more likable after the second conversation than after the first conversation (Ms = 7.35 vs. 6.55) but no more competent (Ms = 5.80 vs. 5.85), whereas partners of self-promoters rated them as no more competent after the second conversation than after the first conversation (Ms = 5.25 vs. 5.05) but somewhat less likable (Ms = 5.15 vs. 5.85). Ingratiators gained in likability without sacrificing perceived competence, whereas self-promoters sacrificed likability with no gain in competency. Applications When ingratiation works Ingratiation can be a hard tactic to implicate, without having the target individual realize what you are trying to do. The tactics of ingratiation works well in different situations and settings. For example, “Tactics that match role expectations of low-status subordinates, such as opinion conformity, would appear to be better suited to exchanges between low-status ingratiators and high-status targets." Or, “The tactic of other enhancement would appear to be more appropriate for exchanges between high-status ingratiators and low-status targets because judgment and evaluation are congruent with a high-status supervisory role." Within a work setting, it is best to evaluate the situation to figure out which method of ingratiation is best to use. The ingratiator should also have some transparency to their method, so that the target individual is not suspicious of their motives. For example, ingratiating a target individual when it is uncharacteristic of your behavior or making it obvious that you are trying to ingratiate. “Given the strength of reciprocity as a social norm, it is possible that in situations in which the ingratiation attempt is interpreted by the target as 'ingratiation,' the most appropriate response might be to reciprocate the 'feigned' liking while forming more negative judgments and evaluations of the ingratiator.". Self-esteem and stress Ingratiation is a method that can be used to cope with job-related stress. Decreased self-esteem coupled with stress may cause an individual to use coping mechanisms, such as ingratiation. Self-affirmation and image maintenance are likely reactions when there is a threat to self-image. "Since self-esteem is a resource for coping with stress, it becomes depleted in this coping process and the individual becomes more likely to use ingratiation to protect, repair, or even boost self-image." There are two models that are presented to describe self-esteem in relation to ingratiatory behaviors. The self-esteem moderator model is when stress leads to ingratiatory behavior and self-esteem impacts this relationship. Then there is the mediation model that suggests that stress leads to decreased self-esteem, which increases ingratiatory behaviors to uplift one's self-image (a linear model). Research supports the mediation model, while literature supports the moderator model. Self-monitoring Within Turnely and Boino's study, "They had students complete a self-monitoring scale at the beginning of the project. At the conclusion of the project, participants indicated the extent to which they had engaged in each of the five impression-management tactics. Four days (two class periods) later, participants provided their perceptions of each of the other three members of their group. Each member of the four-person team, then, was evaluated by three teammates. Thus, given that there were 171 participants in the study, there were a total of 513 (171 X 3) student-student dyads. All of this information was collected before students received their grade on the project." Results revealed that high self-monitors were better able to use ingratiation, self-promotion, and exemplification to achieve favorable images among their colleagues successfully than their low self-monitor peers. “Specifically, when high self-monitors used these tactics, they were more likely to be seen as likeable, competent, and dedicated by the other members of their work groups. In contrast, low self-monitors appear to be less effective at using these tactics to obtain favorable images. In fact, the more low self-monitors used such tactics, the more likely they were to be seen as a sycophant, to be perceived as conceited, or to be perceived as egotistical by their work group colleagues.” High self-monitors are better able to use impression management tactics, such as ingratiation, than low self-monitors. Social rejection Ingratiation can be applied to many real world situations. As mentioned previously, research has delved into the areas of tipping in the restaurant business and conversations. More research shows how ingratiation is applicable in the online dating community and job interviews. In a study of social rejection in the online dating community, researchers tested whether ingratiation or hostility would be the first reaction of the rejected individual and whether men or women would be most likely to ingratiate in different situations. The study showed that cases in which the woman had felt “close” to a potential dating partner from the mutual sharing of information and was rejected, she was more likely than men to engage in ingratiation. Furthermore, men were shown to be more likely to be willing to pay for a date (as prompted by the researchers, not for the date itself) with a woman who had previously harshly rejected him over a woman who had mildly rejected him. Both cases show that while men and women have different social and emotional investments, they are equally likely to ingratiate in a situation which is self-defining to them. In the workplace In another study in the context of an interview, research showed that a combination of ingratiation and self-promotion tactics was more effective than using either one by itself or neither when trying to get hired by a potential employer. The most positive reviews and recommendations came from interviewers whose interviewees had used such a combination, and they were also most likely to be given a job offer. However, when compared by themselves, self-promotion was more effective in producing such an outcome than ingratiation; this may be due to how the nature of an interview requires the individual being considered for the job to talk about their positive qualities and what they would add to the company. See also Impression management Reinforcement Superficial charm References Persuasion techniques Conformity

Age appropriateness

Age appropriateness refers to people behaving as predicted by their perspective timetable of development. The perspective timetable is embedded throughout people's social life, primarily based on socially-agreed age expectations and age norms. For a given behavior, such as crawling, learning to walk, learning to talk, etc., there are years within which the behavior is regarded appropriate. By contrast, if the behavior falls out of the age range, it will be considered age-inappropriate. Most people are adhered to these age norms and are aware of whether their timing is "early," "delayed," or "on time." Age appropriateness is considered essential for children's skills development. Children's motor, cognitive and social skills are formed through several development stages. Looking at a child's functional development involves observing whether or not the child has mastered certain developmental milestones and expectations for their age. Lack of exposure to age-appropriate activities and experiences in a specific stage is thought to prevent a child from gaining the skills necessary for their current and thus their next stage of development. There are various sanctions associated with age inappropriateness, ranging from social isolation, damage to physical health and cognitive development, and forming of improper behaviour. Social participation Application Age-appropriate social skills and communication with peers can be interpreted in terms of cause and effect. Insufficient sets of age-appropriate social skills result in difficulty establishing social relations, and lack of social ties can worsen the underdeveloped set of social skills. Students prefer to associate with those similar to them in various dimensions, such as age, gender, race, educational attainment, values, interests and/or beliefs, etc. This phenomenon is termed homophily. Therefore, normal students with age-appropriate social skills are more likely to gather together, building up friendships and cohesive groups within peers. Sanctions of age-inappropriateness Students with special needs, especially those with autism spectrum disorders and serious behavioural disorders, experience severe obstacles in social participation, which involves building up friendships or relationships, contacts or interactions, social self-perception, and being accepted by classmates. These experiences of segregation in the early school years may threaten children's social development directly. Their lack of contact with peers, underdevelopment of age-appropriate social skills, and negative self-concepts result in externalizing, such as aggression, and internalizing problems, such as anxiety. School entry Applications School is an institute designed to provide students with learning spaces and environments under the guidance of teachers, where students lay the foundation and get prepared for future skill development. Therefore, it is vital that children enter school at an appropriate age. Some students are older-within-cohort, which means they fall outside their cohort's standard 12-month age range, either because they are forced to hold back or voluntarily postpone the entry. Forced grade retention occurs because students fail to catch up with peers or their families fail to support their studies. Voluntary late access to school is termed "academic redshirting." Redshirting happens among students who have a relatively late birthday just before the cutoff date or those considered relatively immature for school. Both forced and voluntary retention aims to spare time for the students to catch up or get prepared. There are four views comparing the strengths and weaknesses of delayed and on-time entry. The nativist view states that children should be adequately mature when entering school. The environmental view holds that children's readiness for school is evaluated by the amount of common knowledge they have. The social constructivist view states that school readiness depends on individual, social, and cultural backgrounds. The interactionist view considers readiness as bi-directional, regarding both students' readiness and the capacity of the school to meet the child's needs. The nativist and social constructivist stand for retention since they believe it prepares children for school, predicting better academic performance. On the other hand, the environmental and interactionist views are often the basis for on-time schooling because it is age-appropriate for children to do so, and school will accommodate variations in students. Sanctions of age-inappropriateness Research has shown that retention or "redshirting" generates few academic advantages. Though delayed entry could generate statistically significant improvements in academic performance in the short run (usually in the first three years), the progress loses its significance in the long run. Long-term speaking, markedly older-for-cohort students were higher in school disengagement, lower in positive intentions, lower in homework completion, and lower in performance scores. These findings stand for environmental and interactionist views, enhancing the importance of age appropriateness in children's development. Playing Application It is crucial that parents select appropriate toys for children to aid their development and ensure their safety. Various guidelines have been published to ensure toy safety, such as U.S. Consumer Product Safety Commission (CPSC) in the US, Guidance on Toy Safety by EU Commission, etc. Importance of age-appropriateness Research has shown that appropriate playing enhances children's development in 4 dimensions: physical development cognitive development (creativity, discovery, language skills, verbal judgment and reasoning, symbolic thought, problem-solving skills, and the ability to focus and control behaviour), emotional development (awareness, sensitivity to others, emotional strength and stability, spontaneity, humour, and feelings about self) social development (social learning) These toys match with children's current developmental skills and abilities, further encouraging the development of new skills. In determining toy safety, the toy's characteristics, how the toy might be used or abused, and the amount of supervision needed for playing safely should be considered. Typical risky toys may include high-powered magnetic objects, toys with small parts that could cause a potentially fatal choking hazard, etc. Exposure to media Application Various content rating systems have been developed to prevent the harm that age-inappropriate media presentations bring to children. The two main categories of rating are the evaluating rating system based on age appropriateness and the descriptive rating system based on the content description. Examples of evaluating rating systems include the Canadian Home Video Rating System, Korea Media Rating Board, the Movie and Television Review and Classification Board of the Philippines, the Office of Film and Literature Classification (New Zealand), the British Board of Film Classification, the Australian Classification Board, and the Film Classification and Rating Organization (Eirin) of Japan. Impact of age-inappropriateness See Effects of violence in mass media. See also Adultism Ageism Elsagate Family-friendly Lie-to-children Status offense Children's Online Privacy Protection Act References External links Toys safety guidance by U.S. Consumer Product Safety Commission(CPSC) Guidance on Toy Safety by EU Commission Canadian Home Video Rating System Office of Film and Literature Classification (New Zealand) British Board of Film Classification Australian Classification Board Film Classification and Rating Organization Child development Educational stages Educational psychology Ageism Child safety

Animalism (philosophy)

In the philosophical subdiscipline of ontology, animalism is a theory of personal identity that asserts that humans are animals. The concept of animalism is advocated by philosophers Eric T. Olson, Peter van Inwagen, Paul Snowdon, Stephan Blatti, David Hershenov and David Wiggins. The view stands in contrast to positions such as John Locke's psychological criterion for personal identity or various forms of mind–body dualism, such as Richard Swinburne's account. Thinking-animal argument A common argument for animalism is known as the thinking-animal argument. It asserts the following: A person that occupies a given space also has a Homo sapiens animal occupying the same space. The Homo sapiens animal is thinking. The person occupying the space is thinking. Therefore, a human person is also a human animal. Use of term in ethics A less common, but perhaps increasing, use of the term animalism is to refer to the ethical view that all or most animals are worthy of moral consideration. It may be similar, though not necessarily, to sentientism. See also Human evolution References Footnotes Bibliography Further reading Conceptions of self Metaphysical theories

Neuroinformatics

Neuroinformatics is the emergent field that combines informatics and neuroscience. Neuroinformatics is related with neuroscience data and information processing by artificial neural networks. There are three main directions where neuroinformatics has to be applied: the development of computational models of the nervous system and neural processes; the development of tools for analyzing and modeling neuroscience data; and the development of tools and databases for management and sharing of neuroscience data at all levels of analysis. Neuroinformatics encompasses philosophy (computational theory of mind), psychology (information processing theory), computer science (natural computing, bio-inspired computing), among others disciplines. Neuroinformatics doesn't deal with matter or energy, so it can be seen as a branch of neurobiology that studies various aspects of nervous systems. The term neuroinformatics seems to be used synonymously with cognitive informatics, described by Journal of Biomedical Informatics as interdisciplinary domain that focuses on human information processing, mechanisms and processes within the context of computing and computing applications. According to German National Library, neuroinformatics is synonymous with neurocomputing. At Proceedings of the 10th IEEE International Conference on Cognitive Informatics and Cognitive Computing was introduced the following description: Cognitive Informatics (CI) as a transdisciplinary enquiry of computer science, information sciences, cognitive science, and intelligence science. CI investigates into the internal information processing mechanisms and processes of the brain and natural intelligence, as well as their engineering applications in cognitive computing. According to INCF, neuroinformatics is a research field devoted to the development of neuroscience data and knowledge bases together with computational models. Neuroinformatics in neuropsychology and neurobiology Models of neural computation Models of neural computation are attempts to elucidate, in an abstract and mathematical fashion, the core principles that underlie information processing in biological nervous systems, or functional components thereof. Due to the complexity of nervous system behavior, the associated experimental error bounds are ill-defined, but the relative merit of the different models of a particular subsystem can be compared according to how closely they reproduce real-world behaviors or respond to specific input signals. In the closely related field of computational neuroethology, the practice is to include the environment in the model in such a way that the loop is closed. In the cases where competing models are unavailable, or where only gross responses have been measured or quantified, a clearly formulated model can guide the scientist in designing experiments to probe biochemical mechanisms or network connectivity. Neurocomputing technologies Artificial neural networks Artificial neural networks (ANNs), usually simply called neural networks (NNs), are computing systems vaguely inspired by the biological neural networks that constitute animal brains. An ANN is based on a collection of connected units or nodes called artificial neurons, which loosely model the neurons in a biological brain. Each connection, like the synapses in a biological brain, can transmit a signal to other neurons. An artificial neuron that receives a signal then processes it and can signal neurons connected to it. The "signal" at a connection is a real number, and the output of each neuron is computed by some non-linear function of the sum of its inputs. The connections are called edges. Neurons and edges typically have a weight that adjusts as learning proceeds. The weight increases or decreases the strength of the signal at a connection. Neurons may have a threshold such that a signal is sent only if the aggregate signal crosses that threshold. Typically, neurons are aggregated into layers. Different layers may perform different transformations on their inputs. Signals travel from the first layer (the input layer), to the last layer (the output layer), possibly after traversing the layers multiple times. Brain emulation and mind uploading Brain emulation is the concept of creating a functioning computational model and emulation of a brain or part of a brain. In December 2006, the Blue Brain project completed a simulation of a rat's neocortical column. The neocortical column is considered the smallest functional unit of the neocortex. The neocortex is the part of the brain thought to be responsible for higher-order functions like conscious thought, and contains 10,000 neurons in the rat brain (and 108 synapses). In November 2007, the project reported the end of its first phase, delivering a data-driven process for creating, validating, and researching the neocortical column. An artificial neural network described as being "as big and as complex as half of a mouse brain" was run on an IBM Blue Gene supercomputer by the University of Nevada's research team in 2007. Each second of simulated time took ten seconds of computer time. The researchers claimed to observe "biologically consistent" nerve impulses that flowed through the virtual cortex. However, the simulation lacked the structures seen in real mice brains, and they intend to improve the accuracy of the neuron and synapse models. Mind uploading is the process of scanning a physical structure of the brain accurately enough to create an emulation of the mental state (including long-term memory and "self") and copying it to a computer in a digital form. The computer would then run a simulation of the brain's information processing, such that it would respond in essentially the same way as the original brain and experience having a sentient conscious mind. Substantial mainstream research in related areas is being conducted in animal brain mapping and simulation, development of faster supercomputers, virtual reality, brain–computer interfaces, connectomics, and information extraction from dynamically functioning brains. According to supporters, many of the tools and ideas needed to achieve mind uploading already exist or are currently under active development; however, they will admit that others are, as yet, very speculative, but say they are still in the realm of engineering possibility. Brain–computer interface Research on brain–computer interface began in the 1970s at the University of California, Los Angeles under a grant from the National Science Foundation, followed by a contract from DARPA. The papers published after this research also mark the first appearance of the expression brain–computer interface in scientific literature. Recently, studies in Human-computer interaction through the application of machine learning with statistical temporal features extracted from the frontal lobe, EEG brainwave data has shown high levels of success in classifying mental states (Relaxed, Neutral, Concentrating) mental emotional states (Negative, Neutral, Positive) and thalamocortical dysrhythmia. Neuroengineering & Neuroinformatics Neuroinformatics is the scientific study of information flow and processing in the nervous system. Institute scientists utilize brain imaging techniques, such as magnetic resonance imaging, to reveal the organization of brain networks involved in human thought. Brain simulation is the concept of creating a functioning computer model of a brain or part of a brain. There are three main directions where neuroinformatics has to be applied: the development of computational models of the nervous system and neural processes, the development of tools for analyzing data from devices for neurological diagnostic devices, the development of tools and databases for management and sharing of patients brain data in healthcare institutions. Brain mapping and simulation Brain simulation is the concept of creating a functioning computational model of a brain or part of a brain. In December 2006, the Blue Brain project completed a simulation of a rat's neocortical column. The neocortical column is considered the smallest functional unit of the neocortex. The neocortex is the part of the brain thought to be responsible for higher-order functions like conscious thought, and contains 10,000 neurons in the rat brain (and 108 synapses). In November 2007, the project reported the end of its first phase, delivering a data-driven process for creating, validating, and researching the neocortical column. An artificial neural network described as being "as big and as complex as half of a mouse brain" was run on an IBM Blue Gene supercomputer by the University of Nevada's research team in 2007. Each second of simulated time took ten seconds of computer time. The researchers claimed to observe "biologically consistent" nerve impulses that flowed through the virtual cortex. However, the simulation lacked the structures seen in real mice brains, and they intend to improve the accuracy of the neuron and synapse models. Mind uploading Mind uploading is the process of scanning a physical structure of the brain accurately enough to create an emulation of the mental state (including long-term memory and "self") and copying it to a computer in a digital form. The computer would then run a simulation of the brain's information processing, such that it would respond in essentially the same way as the original brain and experience having a sentient conscious mind. Substantial mainstream research in related areas is being conducted in animal brain mapping and simulation, development of faster supercomputers, virtual reality, brain–computer interfaces, connectomics, and information extraction from dynamically functioning brains. According to supporters, many of the tools and ideas needed to achieve mind uploading already exist or are currently under active development; however, they will admit that others are, as yet, very speculative, but say they are still in the realm of engineering possibility. Auxiliary sciences of neuroinformatics Data analysis and knowledge organisation Neuroinformatics (in context of library science) is also devoted to the development of neurobiology knowledge with computational models and analytical tools for sharing, integration, and analysis of experimental data and advancement of theories about the nervous system function. In the INCF context, this field refers to scientific information about primary experimental data, ontology, metadata, analytical tools, and computational models of the nervous system. The primary data includes experiments and experimental conditions concerning the genomic, molecular, structural, cellular, networks, systems and behavioural level, in all species and preparations in both the normal and disordered states. In the recent decade, as vast amounts of diverse data about the brain were gathered by many research groups, the problem was raised of how to integrate the data from thousands of publications in order to enable efficient tools for further research. The biological and neuroscience data are highly interconnected and complex, and by itself, integration represents a great challenge for scientists. History The United States National Institute of Mental Health (NIMH), the National Institute of Drug Abuse (NIDA) and the National Science Foundation (NSF) provided the National Academy of Sciences Institute of Medicine with funds to undertake a careful analysis and study of the need to introduce computational techniques to brain research. The positive recommendations were reported in 1991. This positive report enabled NIMH, now directed by Allan Leshner, to create the "Human Brain Project" (HBP), with the first grants awarded in 1993. Next, Koslow pursued the globalization of the HPG and neuroinformatics through the European Union and the Office for Economic Co-operation and Development (OECD), Paris, France. Two particular opportunities occurred in 1996. The first was the existence of the US/European Commission Biotechnology Task force co-chaired by Mary Clutter from NSF. Within the mandate of this committee, of which Koslow was a member the United States European Commission Committee on Neuroinformatics was established and co-chaired by Koslow from the United States. This committee resulted in the European Commission initiating support for neuroinformatics in Framework 5 and it has continued to support activities in neuroinformatics research and training. A second opportunity for globalization of neuroinformatics occurred when the participating governments of the Mega Science Forum (MSF) of the OECD were asked if they had any new scientific initiatives to bring forward for scientific cooperation around the globe. The White House Office of Science and Technology Policy requested that agencies in the federal government meet at NIH to decide if cooperation were needed that would be of global benefit. The NIH held a series of meetings in which proposals from different agencies were discussed. The proposal recommendation from the U.S. for the MSF was a combination of the NSF and NIH proposals. Jim Edwards of NSF supported databases and data-sharing in the area of biodiversity. The two related initiatives were combined to form the United States proposal on "Biological Informatics". This initiative was supported by the White House Office of Science and Technology Policy and presented at the OECD MSF by Edwards and Koslow. An MSF committee was established on Biological Informatics with two subcommittees: 1. Biodiversity (Chair, James Edwards, NSF), and 2. Neuroinformatics (Chair, Stephen Koslow, NIH). At the end of two years the Neuroinformatics subcommittee of the Biological Working Group issued a report supporting a global neuroinformatics effort. Koslow, working with the NIH and the White House Office of Science and Technology Policy to establishing a new Neuroinformatics working group to develop specific recommendation to support the more general recommendations of the first report. The Global Science Forum (GSF; renamed from MSF) of the OECD supported this recommendation. Community Institute of Neuroinformatics, University of Zurich The Institute of Neuroinformatics was established at the University of Zurich and ETH Zurich at the end of 1995. The mission of the Institute is to discover the key principles by which brains work and to implement these in artificial systems that interact intelligently with the real world. Institute for Adaptive and Neural Computation, School of Informatics, University of Edinburgh Computational Neuroscience and Neuroinformatics Group in Institute for Adaptive and Neural Computation of University of Edinburgh's School of Informatics study how the brain processes information. The International Neuroinformatics Coordinating Facility An international organization with the mission to develop, evaluate, and endorse standards and best practices that embrace the principles of open, fair, and citable neuroscience. As of October 2019, the INCF has active nodes in 18 countries. This committee presented 3 recommendations to the member governments of GSF. These recommendations were: National neuroinformatics programs should be continued or initiated in each country should have a national node to both provide research resources nationally and to serve as the contact for national and international coordination. An International Neuroinformatics Coordinating Facility should be established. The INCF will coordinate the implementation of a global neuroinformatics network through integration of national neuroinformatics nodes. A new international funding scheme should be established. This scheme should eliminate national and disciplinary barriers and provide a most efficient approach to global collaborative research and data sharing. In this new scheme, each country will be expected to fund the participating researchers from their country. The GSF neuroinformatics committee then developed a business plan for the operation, support and establishment of the INCF which was supported and approved by the GSF Science Ministers at its 2004 meeting. In 2006 the INCF was created and its central office established and set into operation at the Karolinska Institute, Stockholm, Sweden under the leadership of Sten Grillner. Sixteen countries (Australia, Canada, China, the Czech Republic, Denmark, Finland, France, Germany, India, Italy, Japan, the Netherlands, Norway, Sweden, Switzerland, the United Kingdom and the United States), and the EU Commission established the legal basis for the INCF and Programme in International Neuroinformatics (PIN). To date, eighteen countries (Australia, Belgium, Czech Republic, Finland, France, Germany, India, Italy, Japan, Malaysia, Netherlands, Norway, Poland, Republic of Korea, Sweden, Switzerland, the United Kingdom and the United States) are members of the INCF. Membership is pending for several other countries. The goal of the INCF is to coordinate and promote international activities in neuroinformatics. The INCF contributes to the development and maintenance of database and computational infrastructure and support mechanisms for neuroscience applications. The system is expected to provide access to all freely accessible human brain data and resources to the international research community. The more general task of INCF is to provide conditions for developing convenient and flexible applications for neuroscience laboratories in order to improve our knowledge about the human brain and its disorders. Laboratory of Neuroinformatics, Nencki Institute of Experimental Biology The main activity of the group is development of computational tools and models, and using them to understand brain structure and function. Neuroimaging & Neuroinformatics, Howard Florey Institute, University of Melbourne Institute scientists utilize brain imaging techniques, such as magnetic resonance imaging, to reveal the organization of brain networks involved in human thought. Led by Gary Egan. Montreal Neurological Institute, McGill University Led by Alan Evans, MCIN conducts computationally-intensive brain research using innovative mathematical and statistical approaches to integrate clinical, psychological and brain imaging data with genetics. MCIN researchers and staff also develop infrastructure and software tools in the areas of image processing, databasing, and high performance computing. The MCIN community, together with the Ludmer Centre for Neuroinformatics and Mental Health, collaborates with a broad range of researchers and increasingly focuses on open data sharing and open science, including for the Montreal Neurological Institute. The THOR Center for Neuroinformatics Established April 1998 at the Department of Mathematical Modelling, Technical University of Denmark. Besides pursuing independent research goals, the THOR Center hosts a number of related projects concerning neural networks, functional neuroimaging, multimedia signal processing, and biomedical signal processing. The Neuroinformatics Portal Pilot The project is part of a larger effort to enhance the exchange of neuroscience data, data-analysis tools, and modeling software. The portal is supported from many members of the OECD Working Group on Neuroinformatics. The Portal Pilot is promoted by the German Ministry for Science and Education. Computational Neuroscience, ITB, Humboldt-University Berlin This group focuses on computational neurobiology, in particular on the dynamics and signal processing capabilities of systems with spiking neurons. Led by Andreas VM Herz. The Neuroinformatics Group in Bielefeld Active in the field of Artificial Neural Networks since 1989. Current research programmes within the group are focused on the improvement of man-machine-interfaces, robot-force-control, eye-tracking experiments, machine vision, virtual reality and distributed systems. Laboratory of Computational Embodied Neuroscience (LOCEN) This group, part of the Institute of Cognitive Sciences and Technologies, Italian National Research Council (ISTC-CNR) in Rome and founded in 2006 is currently led by Gianluca Baldassarre. It has two objectives: (a) understanding the brain mechanisms underlying learning and expression of sensorimotor behaviour, and related motivations and higher-level cognition grounded on it, on the basis of embodied computational models; (b) transferring the acquired knowledge to building innovative controllers for autonomous humanoid robots capable of learning in an open-ended fashion on the basis of intrinsic and extrinsic motivations. Japan national neuroinformatics resource The Visiome Platform is the Neuroinformatics Search Service that provides access to mathematical models, experimental data, analysis libraries and related resources. An online portal for neurophysiological data sharing is also available at BrainLiner.jp as part of the MEXT Strategic Research Program for Brain Sciences (SRPBS). Laboratory for Mathematical Neuroscience, RIKEN Brain Science Institute (Wako, Saitama) The target of Laboratory for Mathematical Neuroscience is to establish mathematical foundations of brain-style computations toward construction of a new type of information science. Led by Shun-ichi Amari. Netherlands state program in neuroinformatics Started in the light of the international OECD Global Science Forum which aim is to create a worldwide program in Neuroinformatics. NUST-SEECS Neuroinformatics Research Lab Establishment of the Neuro-Informatics Lab at SEECS-NUST has enabled Pakistani researchers and members of the faculty to actively participate in such efforts, thereby becoming an active part of the above-mentioned experimentation, simulation, and visualization processes. The lab collaborates with the leading international institutions to develop highly skilled human resource in the related field. This lab facilitates neuroscientists and computer scientists in Pakistan to conduct their experiments and analysis on the data collected using state of the art research methodologies without investing in establishing the experimental neuroscience facilities. The key goal of this lab is to provide state of the art experimental and simulation facilities, to all beneficiaries including higher education institutes, medical researchers/practitioners, and technology industry. The Blue Brain Project The Blue Brain Project was founded in May 2005, and uses an 8000 processor Blue Gene/L supercomputer developed by IBM. At the time, this was one of the fastest supercomputers in the world. The project involves: Databases: 3D reconstructed model neurons, synapses, synaptic pathways, microcircuit statistics, computer model neurons, virtual neurons. Visualization: microcircuit builder and simulation results visualizator, 2D, 3D and immersive visualization systems are being developed. Simulation: a simulation environment for large-scale simulations of morphologically complex neurons on 8000 processors of IBM's Blue Gene supercomputer. Simulations and experiments: iterations between large-scale simulations of neocortical microcircuits and experiments in order to verify the computational model and explore predictions. The mission of the Blue Brain Project is to understand mammalian brain function and dysfunction through detailed simulations. The Blue Brain Project will invite researchers to build their own models of different brain regions in different species and at different levels of detail using Blue Brain Software for simulation on Blue Gene. These models will be deposited in an internet database from which Blue Brain software can extract and connect models together to build brain regions and begin the first whole brain simulations. Genes to Cognition Project Genes to Cognition Project, a neuroscience research programme that studies genes, the brain and behaviour in an integrated manner. It is engaged in a large-scale investigation of the function of molecules found at the synapse. This is mainly focused on proteins that interact with the NMDA receptor, a receptor for the neurotransmitter, glutamate, which is required for processes of synaptic plasticity such as long-term potentiation (LTP). Many of the techniques used are high-throughout in nature, and integrating the various data sources, along with guiding the experiments has raised numerous informatics questions. The program is primarily run by Professor Seth Grant at the Wellcome Trust Sanger Institute, but there are many other teams of collaborators across the world. The CARMEN project The CARMEN project is a multi-site (11 universities in the United Kingdom) research project aimed at using GRID computing to enable experimental neuroscientists to archive their datasets in a structured database, making them widely accessible for further research, and for modellers and algorithm developers to exploit. EBI Computational Neurobiology, EMBL-EBI (Hinxton) The main goal of the group is to build realistic models of neuronal function at various levels, from the synapse to the micro-circuit, based on the precise knowledge of molecule functions and interactions (Systems Biology). Led by Nicolas Le Novère. Neurogenetics GeneNetwork Genenetwork started as component of the NIH Human Brain Project in 1999 with a focus on the genetic analysis of brain structure and function. This international program consists of tightly integrated genome and phenome data sets for human, mouse, and rat that are designed specifically for large-scale systems and network studies relating gene variants to differences in mRNA and protein expression and to differences in CNS structure and behavior. The great majority of data are open access. GeneNetwork has a companion neuroimaging web site—the Mouse Brain Library—that contains high resolution images for thousands of genetically defined strains of mice. The Neuronal Time Series Analysis (NTSA) NTSA Workbench is a set of tools, techniques and standards designed to meet the needs of neuroscientists who work with neuronal time series data. The goal of this project is to develop information system that will make the storage, organization, retrieval, analysis and sharing of experimental and simulated neuronal data easier. The ultimate aim is to develop a set of tools, techniques and standards in order to satisfy the needs of neuroscientists who work with neuronal data. The Cognitive Atlas The Cognitive Atlas is a project developing a shared knowledge base in cognitive science and neuroscience. This comprises two basic kinds of knowledge: tasks and concepts, providing definitions and properties thereof, and also relationships between them. An important feature of the site is ability to cite literature for assertions (e.g. "The Stroop task measures executive control") and to discuss their validity. It contributes to NeuroLex and the Neuroscience Information Framework, allows programmatic access to the database, and is built around semantic web technologies. Brain Big Data research group at the Allen Institute for Brain Science (Seattle, WA) Led by Hanchuan Peng, this group has focused on using large-scale imaging computing and data analysis techniques to reconstruct single neuron models and mapping them in brains of different animals. See also References Citations Sources Further reading Books Journals and conferences Computational neuroscience Bioinformatics Computational fields of study

Medical sociology

Medical sociology is the sociological analysis of health, Illness, differential access to medical resources, the social organization of medicine, Health Care Delivery, the production of medical knowledge, selection of methods, the study of actions and interactions of healthcare professionals, and the social or cultural (rather than clinical or bodily) effects of medical practice. The field commonly interacts with the sociology of knowledge, science and technology studies, and social epistemology. Medical sociologists are also interested in the qualitative experiences of patients, doctors, and medical education; often working at the boundaries of public health, social work, demography and gerontology to explore phenomena at the intersection of the social and clinical sciences. Health disparities commonly relate to typical categories such as class, race, ethnicity, immigration, gender, sexuality, and age. Objective sociological research findings quickly become a normative and political issue. Early work in medical sociology was conducted by Lawrence J Henderson whose theoretical interests in the work of Vilfredo Pareto inspired Talcott Parsons interests in sociological systems theory. Parsons is one of the founding fathers of medical sociology, and applied social role theory to interactional relations between sick people and others. Later other sociologists such as Eliot Freidson have taken a conflict theory perspective, looking at how the medical profession secures its own interests. Key contributors to medical sociology since the 1950s include Howard S. Becker, Mike Bury, Peter Conrad, Jack Douglas, Eliot Freidson, David Silverman, Phil Strong, Bernice Pescosolido, Carl May, Anne Rogers, Anselm Strauss, Renee Fox, and Joseph W. Schneider. The field of medical sociology is usually taught as part of a wider sociology, clinical psychology or health studies degree course, or on dedicated master's degree courses where it is sometimes combined with the study of medical ethics and bioethics. In Britain, sociology was introduced into the medical curriculum following the Goodenough report in 1944: "In medicine, 'social explanations' of the etiology of disease meant for some doctors a redirection of medical thought from the purely clinical and psychological criteria of illness. The introduction of 'social' factors into medical explanation was most strongly evidenced in branches of medicine closely related to the community — Social Medicine and, later, General Practice" . History Samuel W. Bloom argues that the study of medical sociology has a long history but tended to be done as one of advocacy in response to social events rather than a field of study. He cites the 1842 publication of the sanitary conditions of the labouring population of Great Britain as a good example of such research. This medical sociology included an element of social science, studying social structures as a cause or mediating factor in disease, such as for public health or social medicine. Bloom argues the development of medical sociology is linked to the development of sociology within American universities. He argues that the 1865 creation of the American Social Science Association (ASSA) was a key event in this development. ASSA's initial aim was policy reform on the basis of science. Bloom argues that over the next few decades the role of ASSA moved from advocacy to academic discipline, noting that a number of academic professional bodies broke away from the ASSA during this period, starting with the American Historical Association in 1884. The American Sociological Society formed in 1905. The Russell Sage Foundation, formed in 1907, was a large philanthropic organization which worked closely with the American Sociological Society, which had medical sociology as a primary focus of its suggested policy reform. Bloom argues that the presidency of Donald R Young, a professor of sociology, that started in 1947 was significant in the development of medical sociology. Young motivated by a desire to legitimize sociology, encouraged Esther Lucile Brown, an anthropologist who studied the professions, to focus her work on the medical professions due to medicine's societal status. Harry Stock Sullivan Harry Stack Sullivan was a psychiatrist who investigated the treatment of schizophrenia using approaches of interpersonal psychotherapy working with sociologists and social scientists including Lawrence K. Frank, W. I. Thomas, Ruth Benedict, Harold Lasswell and Edward Sapir. Bloom argues that Sullivans work, and its focus on putative interpersonal causes and treatment of schizophrenia influenced ethnographic study of the hospital setting. The Medical Profession The profession of medicine has been studied by sociologists. Talcott Parsons looked at the profession from a functionalist perspective, focusing on medics roles as experts, their altruism, and how they support communities. Other sociologists have taken a conflict theory perspective, looking at how the medical profession secures its own interests. Of these, Marxist conflict theory perspective considers how the ruling classes can enact power through medicine, while other theories propose a more structural pluralist approach, exemplified by Eliot Freidson, looking at how the professions themselves secure influence. Medical Education The study of medical education was a central part of the medical sociology since its emergence in the 1950s. The first publication onn the topic was Robert Merton's, The Student Physician. Other scholars who studied the field include Howard S. Becker, with his publication, Boys in white. The hidden curriculum is a concept in medical education that refers to a distinction between what is officially taught and what is learned by a medical student. The concept was introduced by Philip W. Jackson in his book, Life in the classroom, but developed further by Benson Snyder. The concept have been criticised by Lakomski and there was considerable debate on the concepts within the educational community. Medical Dominance Writing the 1970s Eliot Freidson argued that medicine had reached a point of "Professional Dominance" over the content of their work, other health professions and their clients by convincing the public of medicine's effectiveness, gaining a legal monopoly over their work, and appropriating other "medical" knowledge through control of training. This concept of dominance was extended to professions as a whole in closure theory, where professions were seen as competing for scope of practice, for example in the work of Andrew Abbott. Coburn argued that the academic interest in medical dominance decreased over time due to the increased role of capitalism in healthcare in the US, challenges to the control of health policy by politicians, economists and planners, and increased agency of patients through their access to the internet. Kath M. Melia, sociologist nursing professor, argued that, so far as nurses were concerned the medical 'paternalistic' attitudes remained. Medicalization Medicalization describe the process whereby an ever wider range of human experiences are understood is defined, experienced and treated as a medical condition. Examples of medicalization can be seen in deviance such as defining addiction or antisocial personality disorder as a medical condition. Feminist scholars have shown that the female body is prone to medicalization, arguing that the tendency of viewing the female body as the other has been a factor in this. Medicalization can obscure social factors by defining a condition as existing entirely within an individual and can be depoliticizing, suggesting than an intervention should be medical when the best intervention is political. Medicalization can give the profession of medicine undue influence. Social construction of illness Social constructionists study the relationships between ideas about illness and expression, perception and understanding of illness by individuals, institutions and society. Social constructionists study why diseases exist in one place and not another, or disappear from a particular area. For example, premenstrual syndrome, anorexia nervosa and susto appear to exist in some cultures but not others. There are a broad range of social constructionist frameworks used in medical sociology that make different assumptions about the relationships between ideas, social processes and the material world. Illnesses vary in the degree to which their definition is socially constructed and some illnesses are straightforwardly biologically. For these straightforwardly biologically diseases it would not be meaningful to describe them a social construction, though it might be meaningful to study the social processes that resulted in the discovery of the disease. Some illnesses are contested when someone complains about a disease despite the medical community being unable to find a biological mechanism for disease. Examples of contested diseases include myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), fibromyalgia and Gulf War syndrome. For contested diseases can be studied as social constructs but there is no biomedical understanding. Some contested diseases, such as ME/CFS, are accepted by the institutions of biomedicine while others, such as environmental diseases, are not. Sick role The study of the social construction of illness within medical sociology can be traced to Talcott Parsons notion of the sick role. Talcott Parsons introduced the notion of the sick role in his book The Social System. Parsons argued that the sick role is a social role approved and enforced by social norms and institutional behaviours where an individual is viewed as showing certain behaviour because they are in need of support. Parsons argues that defining properties are that the sick person is exempt from normal social roles, that they are not "responsible" for their condition, that they should try to get well, and that they should seek technically competent people to help them. The concept of the sick role was critiqued by sociologists from a neo-marxist, phenomonological and social interactionist perspective, as well as by those with an anti-establishment viewpoint. Burnham argues that part of this criticism was a rejection of functionalism due to its associations with conservatism. The sick role fell out of favour in the 1990s. Labelling theory Labelling theory derived from work by Howard S. Becker who studied the sociology of marijuana use. He argued that norms and deviant behaviour are partly the result of the definitions applied by others. Eliot Freidson applied these concepts to illness. Labelling theory separates the aspects of an individual's behaviour that is caused by an illness, and that which is caused by the application of a label. Freidson distinguished labels based on legitimacy and the degree to which to this legitimacy affected an individual's responsibilities. Labelling theory has been criticized on the ground that it does not explain which behaviours are labelled as deviant and why people engage in behaviours which are labelled as deviant: labelling theory is not a complete theory of deviant behaviour. Mental health An illness framework is the dominant framework for disease in psychiatry and diagnosis is considered worthwhile. Psychiatry has emphasizes the biological when considering mental illness. Some psychiatrists have criticized this model: some prefer biopsychosocial definitions, some prefer social constructionist models, others have argued that madness is an intelligent response if all circumstances are understood (Laing and Esterson). Thomas Szasz, who trained as psychiatrist, argued that mental health was a bad concept in his 1961 book, The Myth of Mental Illness, arguing that minds can only be ill metaphorically. The Doctor-Patient relationship The doctor–patient relationship, the social interactions between healthcare providers and those who interact with them, is studied by medical sociology. There are different models for the interaction between a patient and doctor, which may have been more or less prevalent at different times. One such model is medical consumerism that has partly given way to patient consumerism. Medical Paternalism Medical paternalism is the perspective that doctors want what is best for the patient and must take decisions on behalf of the patient because the patient is not competent to make their own decisions. Parsons argued that though there was an asymmetry of knowledge and power in the doctor patient relationship the medical system provided sufficient safeguards to protect the patient justifying a paternalistic role by the doctor and medical system. A system of medical paternalism was prominent following the second world war through to the mid-1960s. Writing in the 1970s, Eliot Freidson referred to medicine as having "professional dominance", determining its work and defining a conceptualization of the problems that are brought to it and the best solutions to them. Professional dominance is defined by three characteristics: practitioners having power over clients, for example through dependency, knowledge, or location asymmetry; control over juniors in the field, requiring juniors deference and submission; and control over other professions either by excluding them from practice, or placing them under control of the medical profession. Yeyoung Oh Nelson argues that this system of paternalism was in part undermined by organizational change in the following decades in the US whereby insurance companies, managers and the pharmaceutical industry started competing for role of conceptualizing and delivering medical services, part of the motive being cost saving. Bioethics Bioethics studies ethical concern in medical treatment and research. Many scholars believe that bioethics arose due to a perceived lack of accountability of the medical profession, the field has been broadly adopted with most US hospitals offering some form of ethical consultation. The social effects of the field of bioethics have been studied by medical sociologists. Informed consent, having its roots in biothetics, is the process by which a doctor and a patient agree to a particular intervention and has. Medical sociology study the social processes that influences and at times limit consent. Related fields Social medicine Social medicine is a similar field to medical sociology in that it tries to conceptualize social interactions in investigating how the study of social interactions can be used in medicine. However, the two fields have different training, career paths, titles, funding and publication.In the 2010s, Rose and Callard argued that this distinction may be arbitrary. In the 1950s, Strauss argued that it was important to maintain the independence of medical sociology from medicine so that there was a different perspective on sociology separate from the aims of medicine. Strauss feared that if medical sociology started to adopt the goals expected by medicine it risked losing its focus on analysing society. These fears that have been echoed since by Reid, Gold and Timmermans. Rosenfeld argues that the study of sociology focused solely on making recommendations for medicine has limited use for theory building and its findings cease to apply in different social situations. Richard Boulton argues that medical sociology and social medicine are "co-produced" in the sense that social medicine responds to the conceptualization of medical practices created by medical sociology and alters medical practice and medical understanding in response, and that the effects of these changes are then analyzed by medical sociology once again. He argues that the tendency to view certain theories such as the scientific method (positivism) as the basis for all knowledge, and conversely the tendency to view all knowledge as associated with some activity both risk undermining the field of medical sociology. Medical anthropology Peter Conrad notes that medical anthropology studies some of the same phenomena as medical sociology but argues that medical anthropology has different origins, originally studying medicine within non-western cultures and using different methodologies. He argues that there was some convergence between the disciplines, as medical sociology started to adopt some of the methodologies of anthropology such as qualitative research and began to focus more on the patient, and medical anthropology started to focus on western medicine. He argues that more interdisciplinary communication could improve both disciplines. See also Epidemiological transition Gothenburg Study of Children with DAMP Health disparities Medicalization Sociology of health and illness Stroke Belt References Further reading Medicine in society

Child psychopathology

Child psychopathology refers to the scientific study of mental disorders in children and adolescents. Oppositional defiant disorder, attention-deficit hyperactivity disorder, and autism spectrum disorder are examples of psychopathology that are typically first diagnosed during childhood. Mental health providers who work with children and adolescents are informed by research in developmental psychology, clinical child psychology, and family systems. Lists of child and adult mental disorders can be found in the International Statistical Classification of Diseases and Related Health Problems, 10th Edition (ICD-10), published by the World Health Organization (WHO) and in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), published by the American Psychiatric Association (APA). In addition, the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC: 0-3R) is used in assessing mental health and developmental disorders in children up to age five. Causes The etiology of child psychopathology has many explanations which differ from case to case. Many psychopathological disorders in children involve genetic and physiological mechanisms, though there are still many without any physical grounds. It is absolutely imperative that multiple sources of data be gathered. Diagnosing the psychopathology of children is daunting. It is influenced by development and contest, in addition to the traditional sources. Interviews with parents about school, etc., are inadequate. Either reports from teachers or direct observation by the professional are critical. (author, Robert B. Bloom, Ph.D.) The disorders with physical or biological mechanisms are easier to diagnose in children and are often diagnosed earlier in childhood. As psychopathy exists on a spectrum, the initial indications of the disorder can differ greatly. Certain children may exhibit subtle indications as early as two or three years old, while in other children, symptoms may not come apparent unit later in life. It's also possible for signs to manifest before the age of two in some cases. However, there are some disorders, no matter the mechanisms, that are not identified until adulthood. There is also reason to believe that there is co-morbidity of disorders, in that if one disorder is present, there is often another. Stress Emotional stress or trauma in the parent-child relationship tends to be a cause of child psychopathology. First seen in infants, separation anxiety in root of parental-child stress may lay the foundations for future disorders in children. There is a direct correlation between maternal stress and child stress that is factored in both throughout adolescent development. In a situation where the mother is absent, any primary caregiver to the child could be seen as the "maternal" relationship. Essentially, the child would bond with the primary caregiver, and may exude some personality traits of the caregiver. In studies of child in two age groups of pregnancy to five years, and fifteen years and twenty years, Raposa and colleagues (2011) studied the impact of psychopathology in the child-maternal relationship and how not only the mothers stress affected the child, but the child's stress affected the mother. Historically, it was believed that mothers who had post partum depression might be the reason their child has mental disorders both earlier and later in development. However this correlation was found to not only reflect maternal depression on child psychopathology, but also child psychopathology could reflect on maternal depression. Children with a predisposition to psychopathology may cause higher stress in the relationship with their mother, and mothers who have psychopathology may also cause higher stress in the relationship with their child. Child psychopathology creates stress in parenting which may increase the severity of the psychopathology within the child. Together, these factors push and pull the relationship thus causing higher levels of depression, ADHD, defiant disorder, learning disabilities, and pervasive developmental disorder in both the mother and the child. The outline and summary of this study is found below: ""In looking at child-related stress, the number of past child mental health diagnoses significantly predicted a higher number of acute stressors for mothers as well as more chronic stress in the mother-child relationship at age 15. These increased levels of maternal stress and mother-child relationship stress at age 15 then predicted higher levels of maternal depression when the youth were 20 years old. Looking more closely at the data, the authors found that it was the chronic stress in the mother-child relationship and the child-related acute stressors that were the linchpins between child psychopathology and maternal depression. The stress is what fueled the fires between mother and child mental health. Going one step further, the researchers found that youth with a history of more than one diagnosis as well as youth that had externalizing disorders (e.g., conduct disorder) had the highest number of child-related stressors and the highest levels of mother-child stress. Again, all of the findings held up when other potentially stressful variables, such as economic worries and past maternal depression, were controlled for. Additionally, siblings- both older and younger and of both genders, can be factored into the etiology and development of child psychopathology. In a longitudinal study of maternal depression and older male child depression and antisocial behaviors on younger siblings adolescent mental health outcome. The study factored in ineffective parenting and sibling conflicts such as sibling rivalry. Younger female siblings were more directly affected by maternal depression and older brother depression and anti social behaviors when the indirect effects were not place, in comparison to younger male siblings who showed no such comparison. However, if an older brother were anti-social, the younger child- female or male would exude higher anti-social behaviors. In the presence of a sibling conflict, anti social behavior was more influential on younger male children than younger female children. Female children were more sensitive to pathological familial environments, thus showing that in a high- stress environment with both maternal depression and older- male sibling depression and anti social behavior, there is a higher risk of female children developing psychopathological disorders. This was a small study, and more research needs to be done especially with older female children, paternal relationships, maternal-paternal-child stress relationships, and/or caregiver-child stress relationships if the child is orphaned or not being raised by the biological parent to reach a conclusive child-parent stress model on the effects of familial and environmental pathology on the child's development. Temperament The child-parent stress and development is only one hypothesis for the etiology of child psychopathology. Other experts believe that child temperament is a large factor in the development of child psychopathology. High susceptibility to child psychopathology is marked by low levels of effortful control and high levels of emotionality and neuroticism. Parental divorce is often a large factor in childhood depression and other psychopathological disorders. This is more so when the divorce involves a long-drawn separation and one parent bad-mouthing the other. That is not to say that divorce will lead to psychopathological disorders, there are also other factors such as temperament, trauma, and other negative life events (e.g. death, sudden moving of home, physical or sexual abuse), genetics, environment, and nurture that correlate to the onset of a disorder. Research has also shown that child maltreatment may increase risk for various forms of psychopathology as it increases threat sensitivity, decreases responsivity to reward, and causes deficits in emotion recognition and understanding. Psychopaths states that up to 30% of the population exhibits varying levels of diminished empathy, a tendency towards taking risks, and an excessive sense of self importance. Found in "The Role of Temperament in the Etiology of Child Psychopathology", a model for the etiology of child psychopathology by Vasey and Dadds (2001) proposed that the four things that are important to the development of psychopathological disorders is: 1) biological factors: hormones, genetics, neurotransmitters 2) psychological: self-esteem, coping skills, cognitive issues 3) social factors: family rearing, negative learning experiences, and stress 4) child's temperament. Using an array of neurological scans and exams, psychological evaluations, family medical history, and observing the child in daily factors can help the physician find the etiology of the psychopathological disorder to help release the child of the symptoms through therapy, medication use, social skills training, and life style changes. Child psychopathology can cause separation anxiety from parents, attention deficit disorders in children, sleep disorders in children, aggression with both peers and adults, night terrors, extreme anxiety, anti social behavior, depression symptoms, aloof attitude, sensitive emotions, and rebellious behavior that are not in line of typical childhood development. Aggression is found to manifest in children before five years of age, and early stress and aggression in the parental-child relationship correlates with the manifestation of aggression. Aggression in children causes problematic peer relationships, difficulty adjusting, and coping problems. Children who fail to overcome acceptable ways of coping and emotion expression are put on tract for psychopathological disorders and violent and anti social behaviors into adolescence and adulthood. There is a higher rate of substance abuse in these children with coping and aggression issues, and causes a cycle of emotional instability and manifestation psychopathological disorders. Neurology and etiology Borderline personality disorder (BPD) is one of many psychopathology disorders a child can develop. In the neurobiological scheme, borderline personality disorder may have effects on the left amygdala. In a 2003 study of BPD patients versus control patients, when faced with expressions that were happy, sad, or fearful BPD patients showed significantly more activation versus control patients. In neutral faces, BPD patients attributed negative qualities to these faces. As stated by Gabbard, an experimenter in this study: "A hyperactive amygdala may be involved in the predisposition to be hyper vigilant and over reactive to relatively benign emotional expressions. Misreading neutral faces is clearly related to transference misreadings that occur in psychotherapy and the creation of bad object experiences linked with projective identification." Also linked to BPD, is the presence of serotonin transporter (5-HTT) in a short allele demonstrated larger amygdala neuronal activity when presented with fearful stimuli as in comparison to individuals with a long allele of 5-HTT. As found in the Dunedin Longitudinal Study a short allele of 5-HTT predisposes the person to have hyperactivity in the amygdala in response to trauma, and thus moderated the impact of stressful life events leading to a higher risk of depression and suicidal idealities. These same qualities were not observed in individuals with long alleles of 5-HTT. However, the environment the child is in can change in impact of this gene, proving that correct treatment, intensive social support, and a healthy and nurturing environment can modify genetic vulnerability. Possibly the most studied or documented of the child psychopathologies is attention deficit hyperactivity disorder (ADHD) which is marked with learning disabilities, mood disorders, or aggression. Though believed to be over diagnosed, ADHD is highly comorbid for other disorders such as depression and obsessive compulsive disorder. In studies of the prefrontal cortex in ADHD children, which is responsible for the regulation of behavior, cognition, and attention; and in the dopamine system there has been identified a hidden genetic polymorphisms. More specifically, the 7-repeat allele of the dopamine D4 receptor gene, responsible for inhibited prefrontal cortex cognition and less efficient receptors, causes more externalized behaviors such as aggression since the child has trouble "thinking through" seemingly ordinary and at level childhood tasks. Agenesis of the corpus callosum and etiology Agenesis of the corpus callosum (ACC) is used to determine the frequency of social and behavioral problems in children with a prevalence rate of about 2-3%. ACC is described as a defect in the brain where the 200 million axons that make the corpus callosum are either completely absent, or partially gone. In many cases, the anterior commissure is still present to allow for the passing of information from one cerebral hemisphere to the other. The children are of normal intelligence level. For younger children, ages two to five, Agenesis of the corpus callosum causes problems in sleep. Sleep is critical for development in children, and lack of sleep can set the grounds for a manifestation of psychopathological disorders. In children ages six to eleven, ACC showed manifestation in problems with social function, thought, attention, and somatic grievances. In comparison, of children with autism, children with ACC showed less impairment on almost all scales such as anxiety and depression, attention, abnormal thoughts, and social function versus autistic children. However, a small percentage of children with ACC showed traits that may lead to the diagnosis of autism in the areas of social communications and social interactions but do not show the same symptoms of autism in the repetitive and restricted behaviors category. The difficulties from ACC may lead to the etiology of child psychopathological disorders, such as depression or ADHD and manifest many autistic-like disorders that can cause future psychological disorders in later adolescence. The etiology of child psychopathology is a multi-factor path. A slew of factors must be taken into account before diagnosis of a disorder. The child's genetics, environment, temperament, past medical history, family medical history, prevalence of symptoms and neuro-anatomical structures are all factors that should be considered when diagnosing a child with a psychopathological disorder. Thousands of children each year are misdiagnosed and put on the wrong treatment, which may result in the manifestation of other disorders the child would have not have gotten else wise. There are hundreds of causes of psychopathological disorders, and each one manifests at different ages and stages in child development and can come out due to trauma and stress. Some disorders may "disappear" and reappear in the presence of a trauma, depression, or stress similar to the one that brought the disorder out in the child in the beginning. Treatment In the United States, It is estimated that 1 in 6 children from ages two to eight have a psychopathology disorder. Boys of this age are more likely to be diagnosed with a disorder than girls. From age 9-17, at least 1 in 5 children have a diagnosed disorder, but only about a third of these children receive treatment for their disorder. Anxiety and depression disorders in children- whether noted or unnoted, are found to be a precursor for similar episodes in adulthood. Usually a large stressor similar to the one the person experienced in childhood brings out the anxiety or depression in adulthood. Multifinality refers to the idea that two children can react to same stressful event quite differently, and may display divergent types of problem behavior. Psychopathological disorders are extremely situational- having to take into account the child, the genetics, the environment, the stressor, and many other factors to tailor the best type of treatment to relieve the child of the psychopathology symptoms. Many child psychopathology disorders are treated with control medications prescribed by a pediatrician or psychiatrist. After extensive evaluation of the child through school visits, by psychologists and physicians, a medication can be prescribed. A patient may need to go through several trials of medicines to find the best fit, as many cause uncomfortable and undesired side effects- such as dry mouth or suicidal thoughts can occur. There are many classes of drugs a physician can choose from and they are: psychostimulants, beta blockers, atypical antipsychotics, lithium, alpha-2 agonists, traditional antipsychotics, SSRIs, and anticonvulsant mood- stabilizers. Given the multifinality of psychopathological disorders, two children may be on the same medication for two completely different disorders, or have the same disorder and be taking two completely different medications. ADHD is the most commonly diagnosed disorder of child psychopathology; however, the medications used to treat it have a high abuse rate, especially among college-aged student. Psycho stimulants such as Ritalin, amphetamine- related stimulant drugs: e.g., Adderall, and antidepressants such as Wellbutrin have been successfully used to treat ADHD. Many of these drug treatment options are paired with behavioral treatment such as therapy or social skills lessons. Counter-intuitively, patients whose ADHD is given therapeutic treatment with psychostimulants actually have significantly lower rates of drug abuse and addiction than their untreated peers; psychostimulants are widely abused drugs, but in those treated for ADHD, psychostimulant treatment actually reduces the patient's risk of acquiring an addiction. Lithium has shown to be extremely effective in treating bipolar disorder, as it is affective for both mania and depression, and with chronic treatment it helps to prevent relapse. Additionally, lithium treatment produces notable reductions in suicide in all exposed populations, including general populations whose drinking water has naturally high levels of lithium salts. Lithium is the only known intervention that is generically effective in reducing suicidal ideation and behavior, and is additionally the only agent known to affect suicide directly and specifically; this treatment effect is independent from the resolution of any other possible underlying cause, and so it is still observed even in, e.g., patients who continue to experience severe depression that is resistant to treatment. This effect on suicide is especially remarkable in BPD patients, who are especially high risk; in BPD patients that successfully comply with lithium treatment, suicide rates begin to more closely resemble the non-BPD population, and do so for as long as these BPD patients continue to take use lithium as directed. Additionally, lithium is effective in reducing aggressive and/or antisocial behavior; as in suicide, this effect is generic and occurs in all exposed populations, but the effect is larger in patients with predisposing illness, such as ADHD. Consequently, lithium appears to be highly effective in treating antisocial behaviors in BPD patients that also have ADHD (which is highly co-morbid with BPD, and thus frequently co-occurs in BPD patients). However, there is some uncertainty as to whether this observed treatment effect may be an indirect result of inadequate initial treatment of ADHD in those with BPD. Psychostimulant medications, such as methylphenidate and mixed amphetamine salts, are the only known gold standard treatment for ADHD, being both safe and highly effective for most patients with ADHD; however, unfortunately, psychostimulant use (or abuse) is a known risk factor for the occurrence of (hypo)manic episodes in BPD patients. (Indeed, even in those without BPD, these medications can produce states resembling mania, even in those who do not experience them otherwise, though such occurrences are extremely rare at the therapeutic dosages used to treat ADHD.) As a result, clinicians are reluctant to prescribe these medications for patients with BPD, and where do choose to prescribe them, they may be reluctant to titrate the patient's dosage upward as they normally would, as a precaution against any possible risk of inducing (hypo)mania. Thus, ADHD-associated antisocial behaviors that persist despite the patient receiving ADHD treatment, which are resolved by subsequent treatment with lithium, may simply indicate inadequate control of ADHD symptoms, and not that lithium is a uniquely effective frontline treatment for "treatment-resistant" antisocial behavior in BPD patients with co-morbid ADHD. In any case, there is no evidence that lithium is effective as a primary treatment for ADHD; its only observed utility is a reduction in aggressive/antisocial behavior, which is observed generically in anyone taking lithium, and is not specific to ADHD, and those symptoms may be better controlled by simply ensuring that gold standard treatments for ADHD are being titrated adequately. The mechanism of lithium include the inhibition of GSK-3, it is a glutamate antagonism at NMDA receptors that together make lithium a neuroprotective medicine. The drug relieves bipolar symptoms, aggressiveness and irritability. Lithium has many, many side effects and requires weekly blood tests to tests for toxicity of the drug. Medications that act on cell membrane ion channels, are GABA inhibitory neurotransmission, and also inhibit excitatory glutamate transmission have shown to be extremely effective in treating an array of child psychopathological disorders. Pharmaceutical companies are in the process of creating new drugs and improving those on the market to help avoid negative and possibly life altering short term and long term side effects, making drugs more safe to use in younger children and over long periods of time during adolescent development. Psychotherapy Treatments for Common Psychological Disorders in Children Some psychological disorders commonly found in children include depression, anxiety, and conduct disorder. For adolescents with depression, a combination of antidepressants and cognitive-behavioral or interpersonal psychotherapy is recommended, in contrast there is not much evidence for the efficacy of antidepressants in children under 12 years of age, therefore a combination of parent training and cognitive-behavioral psychotherapy is recommended. For children and adolescents with anxiety disorders, cognitive-behavioral therapy in combination with exposure-based techniques is a highly recommended and evidence-based treatment. Research suggests that children and adolescents with conduct disorder or disruptive behavior may benefit from psychotherapy that includes both a behavioral component and parental involvement. Future of Child Psychopathology The future of child psychopathology- etiology and treatment has a two-way path. While many professionals agree that many children who have a disorder do not receive proper treatment, at the rate of 5-15% that receive treatment leaving many children in the dark. In the same boat are the physicians who also say that not only do more of these disorders need to be recognized in children and treated properly, but also even those children who show some qualifying symptoms of a disorder but not to the degree of diagnosis should also receive treatment and therapy to avoid the manifestation of the disorder. By treating children even with slight degrees of a psychopathological disorder, children can show improvements in their relationships with peers, family, and teachers and also improvements in school, mental health, and personal development. Many physicians believe the best prevention and help starts in the home and the school of the child, before physicians and psychologists are contacted. Theory and Research The current trend in the U.S. is to understand child psychopathology from a systems based perspective called developmental psychopathology. Recent emphasis has also been on understanding psychological disorders from a relational perspective with attention also given to neurobiology. Practitioners who follow attachment theory believe that early attachment experiences of children can promote adaptive strategies or lay the groundwork for maladaptive ways of coping which can later lead to mental health disorders. Research and clinical work on child psychopathology tends to fall under several main areas: etiology, epidemiology, diagnosis, assessment, and treatment. Parents are considered a reliable source of information because they spend more time with children than any other adult. A child's psychopathology can be connected to parental behaviors. Clinicians and researchers have experienced problems with children's self-reports and rely on adults to provide the information. Early Detection and Prevention of Child Psychopathology Detecting signs of psychopathology in children during their formative years is crucial for timely intervention. Early intervention programs focus on mitigating risk factors and strengthening protective factors to prevent the onset or progression of mental health disorders. These preventative measures can range from cognitive-behavioral therapy to social skills training for the children. Recognizing and addressing symptoms early can significantly improve long-term outcomes, potentially reducing the severity or even preventing certain disorders from developing fully. The first sign of pyschopathy in children is if their ears are joined to their heads at the base. See also :Category:Mental disorders diagnosed in childhood References External links Cause (medicine) Child and adolescent psychiatry Psychopathology

Biological psychopathology

Biological psychopathology is the study of the biological etiology of mental illnesses with a particular emphasis on the genetic and neurophysiological basis of clinical psychology. Biological psychopathology attempts to explain psychiatric disorders using multiple levels of analysis from the genome to brain functioning to behavior. Although closely related to clinical psychology, it is fundamentally an interdisciplinary approach that attempts to synthesize methods across fields such as neuroscience, psychopharmacology, biochemistry, genetics, and physiology. It is known by several alternative names, including "clinical neuroscience" and "experimental psychopathology." Due to the focus on biological processes of the central and peripheral nervous systems, biological psychopathology has been important in developing new biologically-based treatments for mental disorders. Scope Biological psychopathology is a field that focuses mostly on the research and understanding the biological basis of major mental disorders such as bipolar and unipolar affective disorder, schizophrenia and Alzheimer's disease. Much of the understanding thus far has come from neuroimaging techniques such as radiotracer positron emission tomography(PET), and functional magnetic resonance imaging (fMRI) scans, as well as genetic studies. Together, neuroimaging with multimodal PET/fMRI, and pharmacological investigations are revealing how the differences in behaviorally relevant brain activations can arise from underlying variations in certain brain signaling pathways. Understanding the detailed interplay between neurotransmitters and the psychiatric drugs that affect them is key to the research within this field. Significant research includes investigations relevant to biological bases such as biochemical, genetic, physiological, neurological, and anatomical fields. In a clinical viewpoint, the etiology of these diseases takes into account various therapies, diet, drugs, potential environmental contaminants, exercise, and adverse effects of life stressors, all of which can cause noticeable biochemical changes. Origins and basis Sigmund Freud initially concentrated on the biological causes of mental illness and its relationship to evident behavioral factors. His belief in biological factors lead to the concept that certain drugs, such as cocaine, had an antidepressant functionality. In the 1950s the first modern antipsychotic and antidepressant drugs were developed: chlorpromazine (Thorazine), which was one of the first widely used antipsychotic medications to be developed, and iproniazid, which was one of the first antidepressants developed. The research on some of these drugs helped to formulate the monoamine and catecholamine theories, which alluded to the fact that chemical imbalances provide the basis for mental health disorders. New research points to the concept of neuronal plasticity, specifically mentioning that mental health disorders may involve a neurophysiological problem that inhibits neuronal plasticity. Diagnostics This field expresses the importance of accurately identifying and diagnosing mental health disorders. If not accurately diagnosed, certain treatments could only worsen the previous condition. This can be difficult since there are numerous etiologies that could reveal symptoms of mental health disorders. Some important disorders to focus on are: seasonal affective disorder, clinical depression, bipolar disorder, schizophrenia, generalized anxiety disorder, and obsessive compulsive disorder. References Gleitman, H., Fridlund, A. J., & Reisberg, D. (2004).Psychology. (6 ed., pp. 642–715). New York, NY: W W Norton & Co Inc. Hariri, A. R. (2009, November). Biological pathways to psychopathology. Retrieved from http://www.apa.org/science/about/psa/2009/11/sci-brief.aspx Kalat, J. W. (2010). Biological psychology. (10 ed.). Belmont, CA: Wadsworth Pub Co. Pennington, B. F., & Ozonoff, S. (2006). Executive functions and developmental psychopathology. Journal of Child Psychology and Psychiatry,37(1), 51-87. Cicchetti, D., & Posner, M. I. (2005). Cognitive and affective neuroscience and developmental psychopathology. Development and Psychopathology, 17, 569-575. Behavioral neuroscience Psychopathology

Controversies about psychiatry

Psychiatry is, and has historically been, viewed as controversial by those under its care, as well as sociologists and psychiatrists themselves. There are a variety of reasons cited for this controversy, including the subjectivity of diagnosis, the use of diagnosis and treatment for social and political control including detaining citizens and treating them without consent, the side effects of treatments such as electroconvulsive therapy, antipsychotics and historical procedures like the lobotomy and other forms of psychosurgery or insulin shock therapy, and the history of racism within the profession in the United States. In addition, there are a number of groups who are either critical towards psychiatry or entirely hostile to the field. The Critical Psychiatry Network is a group of psychiatrists who are critical of psychiatry. Additionally, there are self-described psychiatric survivor groups such as MindFreedom International and religious groups such as Scientologists that are critical towards psychiatry. Challenges to conceptions of mental illness Since the 1960s there have been challenges to the concept of mental illness. Sociologists Erving Goffman and Thomas Scheff argued that mental illness was merely another example of how society labels and controls non-conformists, behavioral psychologists challenged psychiatry's fundamental reliance on unchallengable or unfalsifiable concepts, and gay rights activists criticized the APA's inclusion of homosexuality as a mental disorder in the DSM. As societal views on homosexuality have changed in recent decades, it is no longer considered a mental illness and is more widely accepted by society. As another example that challenged conceptions of mental illness, a widely publicized study by Professor David Rosenhan, known as the Rosenhan experiment, was viewed as an attack on the efficacy of psychiatric diagnosis. Medicalization Medicalization, a concept in medical sociology, is the process by which human conditions and problems come to be defined and treated as medical conditions, and thus become the subject of medical study, diagnosis, prevention, or treatment. Medicalization can be driven by new evidence or hypotheses about conditions, by changing social attitudes or economic considerations, or by the development of new medications or treatments. For many years, several psychiatrists, such as David Rosenhan, Peter Breggin, Paula Caplan, Thomas Szasz, and critics outside the field of psychiatry, such as Stuart A. Kirk, have "been accusing psychiatry of engaging in the systematic medicalization of normality". More recently these concerns have come from insiders who have worked for the APA themselves (e.g., Robert Spitzer, Allen Frances). For example, in 2013, Allen Frances said that "psychiatric diagnosis still relies exclusively on fallible subjective judgments rather than objective biological tests". The concept of medicalization was devised by sociologists to explain how medical knowledge is applied to behaviors which are not self-evidently medical or biological. The term medicalization entered the sociology literature in the 1970s in the works of Irving Zola, Peter Conrad, and Thomas Szasz, among others. These sociologists viewed medicalization as a form of social control in which medical authority expanded into domains of everyday existence, and they rejected medicalization in the name of liberation. This critique was embodied in works such as Conrad's "The discovery of hyperkinesis: notes on medicalization of deviance", published in 1973 (hyperkinesis was the term then used to describe what we might now call ADHD), and Szasz's "The Myth of Mental Illness." These sociologists did not believe medicalization to be a new phenomenon, arguing that medical authorities had always been concerned with social behavior and traditionally functioned as agents of social control (Foucault, 1965; Szasz, 1970; Rosen). However, these authors took the view that increasingly sophisticated technology had extended the potential reach of medicalization as a form of social control, especially in terms of "psychotechnology" (Chorover, 1973). In the 1975 book Limits to medicine: Medical nemesis (1975), Ivan Illich put forth one of the earliest uses of the term "medicalization". Illich, a philosopher, argued that the medical profession harms people through iatrogenesis, a process in which illness and social problems increase due to medical intervention. Illich saw iatrogenesis occurring on three levels: the clinical, involving serious side effects worse than the original condition; the social, whereby the general public is made docile and reliant on the medical profession to cope with life in their society; and the structural, whereby the idea of aging and dying as medical illnesses effectively "medicalized" human life and left individuals and societies less able to deal with these natural processes. Marxists such as Vicente Navarro (1980) linked medicalization to an oppressive capitalist society. They argued that medicine disguised the underlying causes of disease, such as social inequality and poverty, and instead presented health as an individual issue. Others examined the power and prestige of the medical profession, including use of terminology to mystify and of professional rules to exclude or subordinate others. Some argue that in practice the process of medicalization tends to strip subjects of their social context, so they come to be understood in terms of the prevailing biomedical ideology, resulting in a disregard for overarching social causes such as unequal distribution of power and resources. A series of publications by Mens Sana Monographs have focused on medicine as a corporate capitalist enterprise. Political abuse In unstable countries, political prisoners are sometimes confined and abused in mental institutions. The diagnosis of mental illness allows the state to hold persons against their will and insist upon therapy in their interest and in the broader interests of society. In addition, receiving a psychiatric diagnosis can in and of itself be regarded as oppressive. In a monolithic state, psychiatry can be used to bypass standard legal procedures for establishing guilt or innocence and allow political incarceration without the ordinary odium attaching to such political trials. The use of hospitals instead of jails prevents the victims from receiving legal aid before the courts, makes indefinite incarceration possible, and discredits the individuals and their ideas. In that manner, whenever open trials are undesirable, they are avoided. Examples of political abuse of the power, entrusted in physicians and particularly psychiatrists, are abundant in history and seen during the Nazi era and the Soviet rule when political dissenters were labeled as "mentally ill" and subjected to inhumane "treatments." In the period from the 1960s up to 1986, abuse of psychiatry for political purposes was reported to be systematic in the Soviet Union, and occasional in other Eastern European countries such as Romania, Hungary, Czechoslovakia, and Yugoslavia. The practice of incarceration of political dissidents in mental hospitals in Eastern Europe and the former USSR damaged the credibility of psychiatric practice in these states and entailed strong condemnation from the international community. Political abuse of psychiatry also takes place in the People's Republic of China and in Russia. Psychiatric diagnoses such as the diagnosis of 'sluggish schizophrenia' in political dissidents in the USSR were used for political purposes. History of racism in psychiatry in the United States The history of racism in psychiatry dates back to the days of slavery and segregation in the United States. Such racism in psychiatry exemplifies the concept of scientific racism, which falsely alleges that science and other empirical evidence supports racism and proves certain racial inferiorities. Diagnosis Psychiatric diagnoses were influenced by Black people's status as free or enslaved. Enslaved people were not considered civilized enough to be diagnosed with insanity, while free Black people were over-diagnosed with insanity, having much higher diagnosis rates than white people. Specific diagnoses in the 19th century were crafted specifically to fit Black people – drapetomania and dysesthesia aethiopica, disorders meant to explain why slaves ran away and why they were lazy or lacked a strong work ethic, respectively, and justify the institution of slavery. Prominent political figures such as John C. Calhoun used this supposed evidence to argue for slavery, arguing that free Black people could not be entrusted with their lives and would ultimately develop lunacy. All in all, throughout the 19th century, psychiatric diagnoses and scientifically racist theories were used to medicalize Blackness and uphold systems of slavery and racism, further constraining the rights, freedom, and humanity of Black people. Scientific racism Proponents of scientific racism have historically attempted to "prove" that Black people are physiologically and cognitively inferior to white people based on faulty assumptions and prejudices. Perpetuated by the inaccurate application of biodeterminism, specialists in neuroanatomy and psychiatry compared disproportionate numbers of brains from Black and white individuals to support their racial agendas based on "science." Compulsory sterilization The proportion of Black individuals confined in establishments for "flawed and imbecile" patients increased throughout the late 19th and early 20th century. Psychiatry contributed towards the inaccurate and racist belief that if they were left to their respective means, they would not be able to remain in decent condition. At the beginning of the 20th century, Black people were disproportionally sterilized in eugenics programs that compulsorarily sterilized those classed as feebleminded or who received welfare payments. The premise that the genes of those deemed mentally ill were undesirable was used to justify sterilization which was frequently supervised by physicians, including psychiatrists. Hospitals Segregation within mental institutions and hospitals is another example of the history of racism within psychiatry. Many psychiatric hospitals in the 19th century either excluded or segregated Black patients or admitted Black slaves to work at the hospital in exchange for care. The founding fathers of psychiatry themselves supported the notion that Black people were inferior, lower class citizens that must be treated separately and differently from white patients. With time, racial segregation within hospitals became interspersed with entirely separate hospitals for white and Black patients, each with differential treatment and quality of care. Political figures in the post-Civil War era argued that emancipation had led to a significant increase in insanity cases amongst Black individuals, and they cited the need to accommodate this increase via segregated and Black-only insane asylums. Many hospitals, especially in the southern United States, did not admit Black patients until they were eventually mandated to do so. The last segregated hospital opened in 1933. Popular arguments also circulated that Black patients were more difficult to take care of in mental institutions, making psychiatric care for them more difficult and justifying the need for segregated facilities. Until the late 1960s, many hospitals remained segregated. This affected the experiences of racial minorities accessing psychiatric care in mental institutions and hospitals in the United States. When Lyndon B. Johnson's administration stated that no segregated hospital would receive federal Medicare funds, hospitals began to integrate quickly in order to be able to continue to access such funding. In January 1966, around two-thirds of Southern hospitals were segregated facilities and many Northern facilities remain segregated in-effect. One year later, by January 1967, there were very few hospitals in the United States that remained segregated. Segregation within mental institutions and hospitals is one example of the history of racism within psychiatry. In the profession Black psychiatrists often experienced racism as practitioners within the field. Some of this history is detailed in Jeanne Spurlock's book titled Black Psychiatrists and American Psychiatry, published in 1999, in which she profiles Black psychiatrists who were influential in American psychiatry and their experiences in the profession. During the Civil Rights Movement, Black psychiatrists expressed concerns to the APA that the needs of Black communities and Black psychiatrists were being ignored by the professional organization. In 1969, a contingent of Black psychiatrists presented a list of 9 concerns to the APA Board of Trustees regarding experiences of structural racism in the field. Their '9 points' represented a wide array of experiences of discrimination, both from the experiences of practitioners and patients, and on the institutional and individual level and the group demanded change from within the APA. For example, they called for more Black leaders on APA committees as well as the desegregation of all mental health facilities, both public and private, in the United States. As of 2020, within psychiatry, historically underrepresented groups continue to be less represented as residents, faculty, and practicing physicians in comparison to their proportion in the U.S. population. Nature of diagnosis Arbitrariness Psychiatry has been criticized for its broad range of mental diseases and disorders. Which diagnoses exist and are considered valid have changed over time depending on society's norms. Homosexuality was considered a mental illness but due to changing attitudes, it is no longer recognised as an illness. Historic disorders that are no longer recognised include orthorexia nervosa, sexual addiction, parental alienation syndrome, pathological demand avoidance, and Internet addiction disorder. New disorders include compulsive hoarding and binge eating disorder. The act of diagnosis itself has been criticized for being arbitrary with some conditions being overdiagnosed. Individuals may be diagnosed with a mental disorder despite having been perceived as having no issues with their behavior. In Virginia, U.S., it was found up to 33% of white boys are diagnosed with ADHD leading to alarm in the medical community. Thomas Szasz argued that mental health diagnoses were used as a form of labelling violations of societies norms. Bill Fullford, introduced the idea of "value-laden" mental health diagnosis with mental health lying between physical health and a moral judgment. Under this system personality disorders are seen as not very factual and very value-laden while delirium is quite factual and not very value-laden. Biological basis In 2013, psychiatrist Allen Frances said that he believes that "psychiatric diagnosis still relies exclusively on fallible subjective judgments rather than objective biological tests". Mary Boyle argues that psychiatry is actually the study of behavior, but acts as if it is the study of the brain based on a presumed connection between patterns of behavior and the biological function of the brain. She argues that in the case of schizophrenia it is the bizarre behavior of individuals that justifies the presumption of a biological cause for this behavior rather than the existence of any evidence. She argues that the concept of schizophrenia and its biological basis serves a social function for psychiatrists. She views the concept of schizophrenia as necessary for psychiatry to be considered as a medical field, that the claimed biological link gives psychiatrists protection from accusations of social control, and that the belief in the biological basis for schizophrenia is maintained through secondary source's misrepresentation of underlying data. She argues that schizophrenia and its biological basis also gives families, psychiatrists and society as a whole the ability to avoid blame for the damage they cause individuals and the ineffectiveness of treatment. Schizophrenia diagnosis Underlying issues associated with schizophrenia would be better addressed as a spectrum of conditions or as individual dimensions along which everyone varies rather than by a diagnostic category based on an arbitrary cut-off between normal and ill. This approach appears consistent with research on schizotypy, and with a relatively high prevalence of psychotic experiences, mostly non-distressing delusional beliefs, among the general public. In concordance with this observation, psychologist Edgar Jones, and psychiatrists Tony David and Nassir Ghaemi, surveying the existing literature on delusions, pointed out that the consistency and completeness of the definition of delusion have been found wanting by many; delusions are neither necessarily fixed nor false, and need not involve the presence of incontrovertible evidence. Nancy Andreasen has criticized the current DSM-IV and ICD-10 criteria for sacrificing diagnostic validity for the sake of artificially improving reliability. She argues that overemphasis on psychosis in the diagnostic criteria, while improving diagnostic reliability, ignores more fundamental cognitive impairments that are harder to assess due to large variations in presentation. This view is supported by other psychiatrists. In the same vein, Ming Tsuang and colleagues argue that psychotic symptoms may be a common end-state in a variety of disorders, including schizophrenia, rather than a reflection of the specific etiology of schizophrenia, and warn that there is little basis for regarding DSM's operational definition as the "true" construct of schizophrenia. Neuropsychologist Michael Foster Green went further in suggesting the presence of specific neurocognitive deficits may be used to construct phenotypes that are alternatives to those that are purely symptom-based. These deficits take the form of a reduction or impairment in basic psychological functions such as memory, attention, executive function and problem solving. The exclusion of affective components from the criteria for schizophrenia, despite their ubiquity in clinical settings, has also caused contention. This exclusion in the DSM has resulted in a "rather convoluted" separate disorder—schizoaffective disorder. Citing poor interrater reliability, some psychiatrists have totally contested the concept of schizoaffective disorder as a separate entity. The categorical distinction between mood disorders and schizophrenia, known as the Kraepelinian dichotomy, has also been challenged by data from genetic epidemiology. Jonathan Metzl, in his book The Protest Psychosis, argues that the Ionia State Hospital in Ionia, Michigan disproportionately diagnosed African Americans with schizophrenia because of their civil rights activism. ADHD ADHD, its diagnosis, and its treatment have been controversial since the 1970s. The controversies involve clinicians, teachers, policymakers, parents, and the media. Positions range from the view that ADHD is within the normal range of behavior to the hypothesis that ADHD is a genetic condition. Other areas of controversy include the use of stimulant medications in children, the method of diagnosis, and the possibility of overdiagnosis. In 2012, the National Institute for Health and Care Excellence, while acknowledging the controversy, states that the current treatments and methods of diagnosis are based on the dominant view of the academic literature. In 2014, Keith Conners, one of the early advocates for recognition of the disorder, spoke out against overdiagnosis in an article in The New York Times. In contrast, a 2014 peer-reviewed medical literature review indicated that ADHD is underdiagnosed in adults. With widely differing rates of diagnosis across countries, states within countries, races, and ethnicities, some suspect factors other than the presence of the symptoms of ADHD are playing a role in diagnosis. Some sociologists consider ADHD to be an example of the medicalization of deviant behavior, that is, the turning of the previously issue of school performance into a medical one. Most healthcare providers accept ADHD as a genuine disorder, at least in the small number of people with severe symptoms. Among healthcare providers the debate mainly centers on diagnosis and treatment in the much larger number of people with less severe symptoms. , 8% of all United States Major League Baseball players had been diagnosed with ADHD, making the disorder common among this population. The increase coincided with the League's 2006 ban on stimulants, which has raised concern that some players are mimicking or falsifying the symptoms or history of ADHD to get around the ban on the use of stimulants in sport. Treatment Psychosurgery Psychosurgery is brain surgery with the aim of changing an individual's behavior or psychological function. Historically, this was achieved through ablative psychosurgery that removed or deliberately damaged (lesioning) a section of the brain, but more recently deep brain stimulation is used to remotely stimulate sections of the brain. One such practice was the lobotomy, that was used between the 1930s and 1950s, for which one its creators, António Egas Moniz, received a Nobel Prize in 1949. The lobotomy fell out of favor in by 1960s and 1970s. Other forms of ablative psychosurgery were in use in the UK in the late 1970s to treat psychotic and mood disorders. Bilateral cingulotomy was used to treat substance abuse disorder in Russia until 2002. Deep brain stimulation is used in China to treat substance abuse disorders. In the US, the lobotomy, while initially received with positivity in the late 1930s, came to be seen more negative in the late 1940s and early 1950s. The New York Times discussed the personality changes of lobotomy in 1947, and in the same year the Science Digest reported on papers questioning the effects of lobotomy on personality and intelligence. The lobotomy was prominently depicted a means to control nonconformity in the 1962 book One Flew Over the Cuckoo's Nest. Psychosurgery was criticized in the US in the late 1960s and 1970s by psychiatrist Peter Breggin. He identified all psychosurgery with the lobotomy as a rhetorical device to criticize the practice of psychosurgery more broadly. He stated that "psychosurgery is a crime against humanity, a crime that cannot be condoned on medical, ethical, or legal grounds". Psycho-surgeons William Beecher Scoville and Petter Lindström said that Breggin's critique was emotional and not based on facts. Psychosurgery was investigated by the US Senate in the 1973 by the Health Subcommittee of the Senate's Committee on Labor and Public Welfare chaired by Senator Edward Kennedy due to growing concern about the ethical boundaries of science and medicine. At this committee Breggin argued that newer forms of psychosurgery were the same as the lobotomy since it had the same effects "emotional blunting, passivity, reduced capacity to learn" and said that psycho-surgeons "represent the greatest future threat that we are going to face for our traditional American values", arguing that if the US became a totalitarian regime lobotomy and psychosurgery would be the equivalent of the secret police. The subcommittee published a report in 1977 suggesting that data should be carefully collected about psychosurgery and that it should not be performed upon children or prisoners. Electroconvulsive therapy Electroconvulsive therapy is a therapy method which was used widely between the 1930s and 1960s and is, in a modified form, still used today. Electroconvulsive therapy was one treatment that the anti-psychiatry movement wanted to be eliminated from psychiatric practice. Their arguments were that ECT damages the brain, and was used as punishment or as a threat to keep the patients "in line". Since then, ECT has improved considerably, and is now performed under general anesthesia in a medically supervised environment. The National Institute for Health and Care Excellence recommends ECT for the short-term treatment of severe, treatment-resistant depression, and advises against its use in schizophrenia. According to the Canadian Network for Mood and Anxiety Treatments, ECT is more efficacious for the treatment of depression than antidepressants, with a response rate of 90% in first line treatment and 50-60% in treatment-resistant patients. The most common side effects of ECT include headache, muscle soreness, confusion, and temporary loss of recent memory. Patients may also experience permanent amnesia. Marketing of antipsychotic drugs Psychiatry has greatly benefitted by advances in pharmacotherapy. However, the close relationship between those prescribing psychiatric medication and pharmaceutical companies, and the risk of a conflict of interest, is also a source of concern. This relationship is often described as being part of the medical-industrial complex. This marketing by the pharmaceutical industry has an influence on practicing psychiatrists, which affects prescription. Child psychiatry is one of the areas in which prescription of psychotropic medication has grown massively. In the past, prescription of these medications for children was rare, but nowadays child psychiatrists prescribe psychotropic substances, such as Ritalin, on a regular basis to children. Joanna Moncrieff has argued that antipsychotic drug treatment is often undertaken as a means of control rather than to treat specific symptoms experienced by the patient. Moncreiff has further argued, in the controversial and non-peer reviewed journal Medical Hypotheses, that the evidence for antipsychotics from discontinuation-relapse studies may be flawed, because they do not take into account that antipsychotics may sensitize the brain and provoke psychosis if discontinued, which may then be wrongly interpreted as a relapse of the original condition. Use of this class of drugs has a history of criticism in residential care. As the drugs used can make patients calmer and more compliant, critics claim that the drugs can be overused. Outside doctors can feel pressure from care home staff. In an official review commissioned by UK government ministers it was reported that the needless use of antipsychotic medication in dementia care was widespread and was linked to 1800 deaths per year. In the US, the government has initiated legal action against the pharmaceutical company Johnson & Johnson for allegedly paying kickbacks to Omnicare to promote its antipsychotic risperidone (Risperdal) in nursing homes. There has also been controversy about the role of pharmaceutical companies in marketing and promoting antipsychotics, including allegations of downplaying or covering up adverse effects, expanding the number of conditions or illegally promoting off-label usage; influencing drug trials (or their publication) to try to show that the expensive and profitable newer atypicals were superior to the older cheaper typicals that were out of patent. Following charges of illegal marketing, settlements by two large pharmaceutical companies in the US set records for the largest criminal fines ever imposed on corporations. One case involved Eli Lilly and Company's antipsychotic Zyprexa, and the other involved Bextra. In the Bextra case, the government also charged Pfizer with illegally marketing another antipsychotic, Geodon. In addition, Astrazeneca faces numerous personal-injury lawsuits from former users of Seroquel (quetiapine), amidst federal investigations of its marketing practices. By expanding the conditions for which they were indicated, Astrazeneca's Seroquel and Eli Lilly's Zyprexa had become the biggest selling antipsychotics in 2008 with global sales of $5.5 billion and $5.4 billion respectively. Harvard medical professor Joseph Biederman conducted research on bipolar disorder in children that led to an increase in such diagnoses. A 2008 Senate investigation found that Biederman also received $1.6 million in speaking and consulting fees between 2000 and 2007— some of them undisclosed to Harvard— from companies including the makers of antipsychotic drugs prescribed for children with bipolar disorder. Johnson & Johnson gave more than $700,000 to a research center that was headed by Biederman from 2002 to 2005, where research was conducted, in part, on Risperdal, the company's antipsychotic drug. Biederman has responded saying that the money did not influence him and that he did not promote a specific diagnosis or treatment. In 2004, University of Minnesota research participant Dan Markingson committed suicide while enrolled in an industry-sponsored pharmaceutical trial comparing three FDA-approved atypical antipsychotics: Seroquel (quetiapine), Zyprexa (olanzapine), and Risperdal (risperidone). Writing on the circumstances surrounding Markingson's death in the study, which was designed and funded by Seroquel manufacturer AstraZeneca, University of Minnesota Professor of Bioethics Carl Elliott noted that Markingson was enrolled in the study against the wishes of his mother, Mary Weiss, and that he was forced to choose between enrolling in the study or being involuntarily committed to a state mental institution. Further investigation revealed financial ties to AstraZeneca by Markingson's psychiatrist, Dr. Stephen C. Olson, oversights and biases in AstraZeneca's trial design, and the inadequacy of university Institutional Review Board (IRB) protections for research subjects. A 2005 FDA investigation cleared the university. Nonetheless, controversy around the case has continued. Mother Jones resulted in a group of university faculty members sending a public letter to the university Board of Regents urging an external investigation into Markingson's death. Pharmaceutical companies have also been accused of attempting to set the mental health agenda through activities such as funding consumer advocacy groups. In an effort to reduce the potential for hidden conflicts of interest between researchers and pharmaceutical companies, the US Government issued a mandate in 2012 requiring that drug manufacturers receiving funds under the Medicare and Medicaid programs collect data, and make public, all gifts to doctors and hospitals. Anti-psychiatry The term anti-psychiatry was coined by psychiatrist David Cooper in 1967 and is understood in current psychiatry to mean opposition to psychiatry's perceived role aspects of treatment. The anti-psychiatry message is that psychiatric treatments are "ultimately more damaging than helpful to patients". Psychiatry is seen to involve an "unequal power relationship between doctor and patient", and advocates of anti-psychiatry claim a subjective diagnostic process, leaving much room for opinions and interpretations. Every society, including liberal Western society, permits compulsory treatment of mental patients. The World Health Organization (WHO) recognizes that "poor quality services and human rights violations in mental health and social care facilities are still an everyday occurrence in many places", but has recently taken steps to improve the situation globally. Electroconvulsive therapy is a therapy method, which was used widely between the 1930s and 1960s and is, in a modified form, still in use today. Valium and other sedatives have arguably been over-prescribed, leading to a claimed epidemic of dependence. These are a few of the arguments that the anti-psychiatry movement use to highlight the harms of psychiatric practice. Multiple authors are well known for the movement against psychiatry, including those who have been practicing psychiatrists. The most influential was R.D. Laing, who wrote a series of books, including; The Divided Self. Thomas Szasz rose to fame with the book The Myth of Mental Illness. Michael Foucault challenged the very basis of psychiatric practice and cast it as repressive and controlling. The term "anti-psychiatry" itself was coined by David Cooper in 1967. The founder of the non-psychiatric approach to psychological suffering is Giorgio Antonucci. Divergence within psychiatry generated the anti-psychiatry movement in the 1960s and 1970s, and is still present. Issues remaining relevant in contemporary psychiatry are questions of; freedom versus coercion, mind versus brain, nature versus nurture, and the right to be different. Psychiatric survivors movement The psychiatric survivors movement arose out of the civil rights ferment of the late 1960s and early 1970s and the personal histories of psychiatric abuse experienced by some ex-patients rather than the intradisciplinary discourse of antipsychiatry. The key text in the intellectual development of the survivor movement, at least in the US, was Judi Chamberlin's 1978 text, On Our Own: Patient Controlled Alternatives to the Mental Health System. Chamberlin was an ex-patient and co-founder of the Mental Patients' Liberation Front. Coalescing around the ex-patient newsletter Dendron, in late 1988 leaders from several of the main national and grassroots psychiatric survivor groups felt that an independent, human rights coalition focused on problems in the mental health system was needed. That year the Support Coalition International (SCI) was formed. SCI's first public action was to stage a counter-conference and protest in New York City, in May, 1990, at the same time as (and directly outside of) the American Psychiatric Association's annual meeting. In 2005 the SCI changed its name to Mind Freedom International with David W. Oaks as its director. References Cited texts

Peer support

Peer support occurs when people provide knowledge, experience, emotional, social or practical help to each other. It commonly refers to an initiative consisting of trained supporters (although it can be provided by peers without training), and can take a number of forms such as peer mentoring, reflective listening (reflecting content and/or feelings), or counseling. Peer support is also used to refer to initiatives where colleagues, members of self-help organizations and others meet, in person or online, as equals to give each other connection and support on a reciprocal basis. Peer support is distinct from other forms of social support in that the source of support is a peer, a person who is similar in fundamental ways to the recipient of the support; their relationship is one of equality. A peer is in a position to offer support by virtue of relevant experience: he or she has "been there, done that" and can relate to others who are now in a similar situation. Trained peer support workers such as peer support specialists and peer counselors receive special training and are required to obtain Continuing Education Units, like clinical staff. Some other trained peer support workers may also be law-enforcement personnel and firefighters as well as emergency medical responders The social peer support also offers an online system of distributed expertise, interactivity, social distance and control, which may promote disclosure of personal problems (Paterson, Brewer, & Leeseberg, 2013). Underlying theory Peer support has been shown to be effective in substance use and related behaviour, treatment engagement, and ameliorating risk behaviours associated with HIV and hepatitis C, and empowering people with mental illness and improving their quality of life. Its effectiveness is believed to derive from a variety of psychosocial processes first described by Mark Salzer and colleagues in 2002: social support, experiential knowledge, social learning theory, social comparison theory, the helper-therapy principle, and self-determination theory. Social support is the existence of positive psychosocial interactions with others with whom there is mutual trust and concern. Positive relationships contribute to positive adjustment and buffer against stressors and adversities by offering (a) emotional support (esteem, attachment, and reassurance), (b) instrumental support (material goods and services), (c) companionship and (d) information support (advice, guidance, and feedback). Experiential knowledge is specialized information and perspectives that people obtain from living through a particular experience such as substance abuse, a physical disability, chronic physical or mental illness, or a traumatic event such as combat, a natural disaster, domestic violence or a violent crime, sexual abuse, or imprisonment. Experiential knowledge tends to be unique and pragmatic and when shared contributes to solving problems and improving quality of life. Social learning theory postulates that peers, because they have undergone and survived relevant experiences, are more credible role models for others. Interactions with peers who are successfully coping with their experiences or illness are more likely to result in positive behavior change. Social comparison means that individuals are more comfortable interacting with others who share common characteristics with themselves, such as a psychiatric illness, in order to establish a sense of normalcy. By interacting with others who are perceived to be better than them, peers are given a sense of optimism and something to strive toward. The helper-therapy principle proposes that there are four significant benefits to those who provide peer support: (a) increased sense of interpersonal competence as a result of making an impact on another person's life; (b) development of a sense of equality in giving and taking between himself or herself and others; (c) helper gains new personally-relevant knowledge while helping; and (d) the helper receives social approval from the person they help, and others. Self-determination means that individuals have the right to determine their own future—people are more likely to act on their own decisions rather than decisions made by others for them. In schools and education Peer mentoring Peer mentoring takes place in learning environments such as schools, usually between an older more experienced student and a new student. Peer mentors appear mainly in secondary schools where students moving up from primary schools may need assistance in settling into the whole new schedule and lifestyle of secondary school life. Peer mentoring is also used in the workplace as a means of orienting new employees. New employees who are paired with a peer mentor are twice as likely to remain in their job than those who do not receive mentorship. Peer listening This form of peer support is widely used within schools. Peer supporters are trained, normally from within schools or universities, or sometimes by outside organizations, such as Childline's CHIPS (Childline In Partnership With Schools) program, to be "active listeners". Within schools, peer supporters are normally available at break or lunch times. Peer mediation Peer mediation is a means of handling incidents of bullying by bringing the victim and the bully together under mediation by one of their peers. Peer helper in sports A peer helper in sports works with young adults in sports such as football, soccer, track, volleyball, baseball, cheerleading, swimming, and basketball. They may provide help with game tactics (e.g. keeping your eye on the ball), emotional support, training support, and social support. In health In mental health Peer support can occur within, outside or around traditional mental health services and programs, between two people or in groups. Peer support is increasingly being offered through digital health like text messaging and smartphone apps. Peer support is a key concept in the recovery approach and in consumer-operated services programs. Consumers/clients of mental health programs have also formed non-profit self-help organizations, and serve to support each other and to challenge associated stigma and discrimination. The role of peer workers in mental health services was the subject of a conference in London in April 2012, jointly organized by the Centre for Mental Health and the NHS Confederation. Research has shown that peer-run self-help groups yield improvement in psychiatric symptoms resulting in decreased hospitalization, larger social support networks and enhanced self-esteem and social functioning. There is considerable variety in the ways that peer support is defined and conceptualized as it relates to mental health services. In some cases, clinicians, psychiatrists, and other staff who do not necessarily have their own experiences of receiving psychiatric treatment are being trained, often by psychiatric survivors, in peer support as an approach to building relationships that are genuine, mutual, and non-coercive. For anxiety and depression In Canada, the LEAF (Living Effectively with Anxiety and Fear) Program is a peer-led support group for cognitive-behavioral therapy of persons with mild to moderate panic disorders. In a 2011 meta-analysis of seven randomized trials that compared a peer support intervention to group cognitive-behavioral therapy in patients with depression, peer support interventions were found to improve depression symptoms more than usual care alone and results may be comparable to those of group cognitive behavioral therapy. These findings suggest that peer support interventions have the potential to be effective components of depression care, and they support the inclusion of peer support in recovery-oriented mental health treatment. Several studies have shown that peer support reduces fear during stressful situations such as combat and domestic violence and may mitigate post-traumatic stress disorder. The 1982 Vietnam-Era Veterans Adjustment Survey showed that PTSD was highest in those men and women who lacked positive social support from family, friends, and society in general. For first responders Peer support programs have also been implemented to address stress and psychological trauma among law-enforcement personnel and firefighters as well as emergency medical responders. Peer support is an important component of the critical incident stress management program used to alleviate stress and trauma among disaster first responders. For survivors of trauma Peer support has been used to help survivors of trauma, such as refugees, cope with stress and deal with difficult living conditions. Peer support is integral to the services provided by the National Center for Trauma-Informed Care. Other programs have been designed for female survivors of domestic violence and for women in prison. Survivor Corps defines peer support for trauma survivors as "Encouragement and assistance provided by a colleague who has overcome similar difficulties to engender self-confidence and autonomy and to enable the survivor to make his or her own decisions and implement them." Peer support is a fundamental strategy in the rehabilitation of landmine survivors in Afghanistan, Bosnia, El Salvador and Vietnam. A study of 470 amputee survivors of war-related violence in six countries showed that nearly one hundred percent said they had benefited from peer support. A peer support program operated by the Centre d’Encadrement et de Développement des Anciens Combattants in Burundi with support from the Center for International Stabilization and Recovery and Action on Armed Violence has assisted survivors of war-related violence, including women with disabilities, and female ex-combatants since 2010. A similar program in Rwanda works with survivors of the Rwandan genocide. Peer support has been recommended as a fundamental part of victim assistance programs for survivors of war-related violence. A 1984 study on the impact of peer support and support groups for victims of domestic violence showed that 146 battered women found women's peer support groups the most helpful source of a range of available treatments. The women in these groups appeared to give direct advice and to act as role models. A 1986 study on 70 adolescent mothers considered to be at risk for domestic violence showed that peer support improved cognitive problem-solving skills, self-reinforcement, and parenting competence. Pandora's Aquarium, an online support group operating as part of Pandora's Project, offers peer support to survivors of rape and sexual abuse and their friends and family. In addiction Twelve-step programs for overcoming substance misuse and other addiction recovery groups are often based on peer support. Since the 1930s Alcoholics Anonymous has promoted peer support between new members and their sponsors: "The process of sponsorship is this: an alcoholic who has made some progress in the recovery program shares that experience on a continuous, individual basis with another alcoholic who is attempting to attain or maintain sobriety through AA." Other addiction recovery programs rely on peer support without following the twelve-step model. In chronic illness Peer support has been beneficial for many people living with diabetes. Diabetes encompasses all aspects of people's lives, often for decades. Support from peers can offer emotional, social, and practical assistance that helps people do the things they need to do to stay healthy. Peer support groups for diabetics complement and enhance other health care services. J.F. Caro is the co-founder and Chief Scientific Officer of one of such groups named Peer for Progress. Peer support has also been provided for people with cancer and HIV. The Breast Cancer Network of Strength trains peer counselors to work with breast cancer survivors. For people with disabilities Peer support is considered to be a key component of the independent living movement and has been widely used by organizations that work with people with disabilities, including the Amputee Coalition of America (ACA) and Survivor Corps. Since 1998 the ACA has operated a National Peer Network for survivors of limb loss. The Blinded Veterans Association has recently launched Operation Peer Support (OPS), a program designed to support men and women returning to the US blinded or experiencing significant visual impairment in connection with their military service. Peer support has also benefited survivors of traumatic brain injury and their families. There is also FacingDisability for Families Facing Spinal Cord Injuries , which has a peer counseling program in addition to 1,000 videos drawn from interviews of people with spinal cord injuries, their families, caregivers and experts. For veterans and their families Several programs exist that provide peer support for military veterans in the US and Canada. In 2010 the Military Women to Women Peer Support Group was established in Helena, Montana. The Tragedy Assistance Program for Survivors (TAPS) provides peer support, crisis care, casualty casework assistance, and grief and trauma resources for families of members of the US military. Operation Peer Support (OPS) is a program for US military veterans who were blinded or have significant visual impairment. In January 2013 Senator Patty Murray, Chairman of the United States Senate Committee on Veterans' Affairs, sponsored an amendment of the National Defense Authorization Act (S.3254) that would require peer counseling as part of a comprehensive suicide prevention program for US veterans. For veterans with PTSD Peer support outreach for those exposed to traumatic events refers to programs that seek to identify and reach out to those with or at risk for mental health problems following a traumatic event as a means of connecting those people to mental health services. Paraprofessional peers are defined as having a shared background as the target population and work closely with and supplement the services of the mental healthcare team. These peers are trained in certain interventions (such as Psychological First Aid) and are closely supervised by professional mental healthcare personnel. Peer support for recovery from PTSD refers to programs in which someone with lived experience of PTSD, who experienced a significant reduction in symptoms, provides formal services to those who have not yet made significant steps in recovery from his or her condition. The peer support for recovery model focuses on improvement in overall health and wellness, and has long been successful in the treatment of SMI (serious mental illness) but is relatively new for PTSD. A further review of existing literature found that carefully recruited, trained, supervised, and supported paraprofessionals can deliver mental health interventions effectively, and may be valuable in communities with fewer resources for mental healthcare. Researchers at the Palo Alto VA National Center for PTSD also conducted focus groups at the VA Palo Alto Health Care System Trauma Recovery Programs, a PTSD Residential Rehabilitation Program, and a Women's Trauma Recovery Program to determine veteran and staff perceptions of informal peer support interventions already in place. Four themes were identified, including "peer support contributing to a feeling of social connectedness", "positive role modeling by the peer support provider", "peer support augmenting care offered by professional providers", and "peer supporter acting as a 'culture broker' and orienting recipients to mental health treatment." These findings have been put into practice through a peer support program for veterans in the Sonora, Stockton, and Modesto VA outpatient clinics. The clinics are part of the Palo Alto Veterans Affairs Healthcare System that extend to more rural parts of northern California. The program is funded through grants in support of new treatment approaches to serve veterans in rural, traditionally underserved areas. Leadership for the program comes from the Menlo Park division of the Palo Alto VA system. The peer support program has been operational since 2012 with over 268 unique veterans seen between 2012 and 2015. The two peer support providers involved in the program are veterans of the Vietnam and Iraq wars, respectively, and after having recovered from their own mental health disorders utilize their experiences to help their fellow veterans. The two providers have been responsible for leading between 5 and 7 groups each week as well as conducting telephone outreach and one-on-one engagement visits. These services have successfully helped to augment the often overburdened mental health treatment teams at the central valley outpatient VA clinics. The peer support program has been described in several publications. A personal story of success was featured in Stanford Medicine magazine and the collaborative nature of the program was described in the book, Partnerships for Mental Health. For people at work Trauma risk management (TRiM) is a work-place based peer support for use in helping to protect the mental health of employees who have been exposed to traumatic stress. The TRiM process enables non-healthcare staff to monitor and manage colleagues. TRiM peer support training provides TRiM Practitioners with a background understanding of psychological trauma and its effects. TRiM was developed in the UK by military mental health professionals including Professor Neil Greenberg. There have been numerous scientific publications on the use of TRiM which have demonstrated it to be an acceptable and effective method of peer support. Similar to TRiM, the sustaining resilience at work (StRaW) peer support could increase recognition among coworkers and managers about the significance of supporting fellow workers in applying their recently acquired knowledge and abilities on the job.. StRaW was developed by March on Stress Ltd and early research again shows it to be a credible and effective way of supporting staff at work. Sex workers Several peer-based organizations exist for sex workers. The aim of these organizations is to support the health, rights, and well-being of sex workers and advocate on their behalf for law reform in order to make work safer. Sex work is work and there are many people who willingly choose it as a job/career. While sex trafficking does exist, not everyone who does sex work is doing so under duress. Social stigma is a major hurdle sex workers encounter, with many people trying to 'save' them. Peer support workers and peer educators are seen as best practices by the Sex Industry Network (SIN) when engaging with community members because peers can understand that someone could willingly choose to do sex work. References External links International Federation of the Red Cross/Red Crescent Reference Centre for Psychosocial Support American Self-Help Group Clearinghouse LEAF (Living Effectively with Anxiety and Fear) Program Counseling Mental health support groups Drug rehabilitation Educational psychology Anxiety Personal development Support groups Peer learning Peer-to-peer

Treatments for PTSD

PTSD or post-traumatic stress disorder, is a psychiatric disorder characterised by intrusive thoughts and memories, dreams or flashbacks of the event; avoidance of people, places and activities that remind the individual of the event; ongoing negative beliefs about oneself or the world, mood changes and persistent feelings of anger, guilt or fear; alterations in arousal such as increased irritability, angry outbursts, being hypervigilant, or having difficulty with concentration and sleep. Many people who have PTSD also experience feeling detached or distanced from their friends and family. It is not uncommon for people with PTSD to experience the disorder simultaneously with other psychiatric illnesses like anxiety disorder, depression and substance use disorder. Uncovering any comorbidities is an important part in moving forward with treatment and finding one that works best for each unique individual. Exposure to trauma induces stress as a result of an individual directly or indirectly experiencing some type of threat to life, also referred to as a Potentially Traumatic Experience (PTE). PTEs can include—but are not limited to—sexual violence, physical abuse, death of a loved one, witnessing another person injured, exposure to natural disaster, being a victim of a serious crime, car accident, combat and interpersonal violence. PTEs can also include learning that a traumatic event occurred to another person or witnessing the traumatic event; an individual does not have to experience the event themselves to develop post-traumatic stress disorder (PTSD). PTEs are labeled as such because not everyone who experiences one or more of the events listed will develop PTSD. However, PTSD is estimated to develop in about 4% of individuals who experience some type of traumatic experience. The prevalence of PTSD will vary due to individual differences such as population characteristics, previous trauma exposure, trauma type, military service history and other personal differences. Approximately 8% of adults in the United States will experience PTSD at some point in their lives. Stress responses can be adaptive at the time of the traumatic event, but biological stress responses over time can lead to symptoms that impede daily functioning and general quality of life. This is when trauma exposure becomes PTSD. PTSD is commonly treated with various types of psychotherapy and antidepressants. Everyone is very different in terms of how they respond to different treatments and medications. Because people experience different symptoms of PTSD, they will need the therapy they choose to target different things, and therefore act in different ways. People may need to try different combinations of treatments to find the one that works best for them. Regardless of what type of treatment someone chooses, it is important to go to a trained professional first who has experience with treating PTSD, and can help the patient through their recovery journey. The Anxiety and Depression Association of America recommends anyone experiencing symptoms longer than a few weeks that interfere with daily functioning to seek professional help. Psychotherapy Evidence-based, trauma-focused psychotherapy is the first-line treatment for PTSD. Psychotherapy is defined as a treatment where a therapist and patient build a therapeutic relationship and focus on the patient's thoughts, attitudes, affect, behavior, and social development to lessen the patient's psychopathologies and functional impairment. Cognitive behavioral therapy Cognitive behavioral therapy (CBT) focuses on the relationship between someone's thoughts, feelings, and behaviors. It helps people understand the discrete nature of their thoughts and feelings, and to be better able to control and relate to them. It began with the work of American psychologist Albert Ellis in the late 1950s, and was notably expanded on by American psychiatrist Aaron Beck. CBT involves exposure to the trauma narrative in a controlled way to reduce avoidance behaviors related to the trauma. Education about the effects of trauma and stress management techniques are common aspects of CBT. There is evidence that CBT combined with exposure therapy can reduce PTSD symptoms, lead to a loss of PTSD diagnosis, and reduce depression symptoms. Some common CBT techniques are: Cognitive restructuring: exchanging negative thoughts for positive ones. Exposure therapy Cognitive processing therapy: patients are encouraged to consider the factual basis of their thoughts. Stress inoculation training: patients are taught relaxation techniques such as breathing, progressive muscle relaxation skills, and communication coping skills. Eye movement desensitization and reprocessing: a back and forth eye movement that helps patients process traumatic events. Acceptance and commitment therapy: focuses on accepting the traumatic event rather than challenging it. CBT is strongly recommended for treatment of PTSD by the American Psychological Association. The most applicable techniques vary from person to person, with no current front-runner showing any particular advantage over the other. Trauma-focused cognitive behavioral therapy Trauma-focused cognitive-behavioral therapy (TF-CBT) was developed by Anthony Mannarino, Judith Cohen, and Esther Deblinger in the mid-1990s to help children and adolescents with PTSD. Individuals work through the memories of the trauma in a safe and structured environment, trying to correct negative cognitions and thoughts while also performing gradual exposure to triggers. This therapy is held over 8 to 25 sessions with the child/adolescent and their caregiver. The treatment helps correct distorted beliefs in the children while also helping parents and caregivers process their own distress and support the children. Researchers are working to develop culturally-adapted versions of TF-CBT. Cultural adaptations may rely on targeting the unique experience of a group, such as chronic exposure to racial trauma, or culture-specific coping strategies, such as including racial socialization and community support. In recent years, psychologists have tested the effectiveness of culturally modified TF-CBT approaches with different communities, such as unaccompanied child migrants and women in war-torn countries. Research suggests that cultural adaptations to TF-CBT can improve intervention effectiveness. TF-CBT has repeatedly demonstrated effectiveness and is currently recommended as a first-line treatment for PTSD by the American Psychological Association, Australian Centre for Posttraumatic Mental Health, and the National Institute of Clinical Excellence (NICE). The Australian Psychological Society considers it a Level I (strongest evidence) treatment method. Cognitive therapy for PTSD (Ehlers and Clark) In 2000, husband-and-wife Anke Ehlers and David M Clark developed a cognitive model that explains what prevents people from recovering from traumatic experiences and thus why people develop PTSD. The model suggests that PTSD develops when individuals process the traumatic event in a way that makes them feel that there is serious current threat. This perception of a threat is followed by reexperiencing arousal symptoms and persistent negative emotions like anger and sadness. Differences in how the individual appraises the event ("I cannot trust anyone anymore" or "I should have prevented what happened") and the poor integration of the most intense moments of the trauma into memory contribute to the distorted way people with PTSD make sense of what happened to them. Ehlers, Clark and others developed a cognitive therapy based on this model, the details of which were first published in 2005. It is a form of cognitive behavioural therapy that involves developing and believing a new, less threatening understanding of the trauma experiences. Patients gain an increased understanding of how they perceive themselves and the world around them, and how these beliefs motivate their behavior, before beginning the process of changing these thought patterns. Thus, three goals drive cognitive therapy for PTSD: Modify negative appraisals of the trauma Reduce reexperiencing symptoms by discussing trauma memories and learning how to differentiate between types of trauma triggers Reduce behaviors and thoughts that contribute to the maintenance of the "sense of current threat" One specific practice is imagery rescripting where the therapist guides the patient to reimagine their traumatic memory in a way that gives them control so that they can create new outcomes. For example, adult patients with childhood trauma are encouraged to imagine their trauma from the point-of-view of an adult rescuing and protecting the vulnerable child. Imagery rehearsal therapy helps people with nightmares by documenting their dreams and creating new endings to them. They then write down their dreams, monitor them, and regularly act out the improved dream scenarios. "Cognitive therapy" of this kind should not be confused with the earlier established cognitive therapy of Aaron Beck. Ehlers and Clark inspired cognitive therapy is strongly recommended for treatment of PTSD by the American Psychological Association. Prolonged exposure therapy Prolonged exposure therapy (PE) was developed by Edna Foa and Micheal J Kozak from 1986. It has been extensively tested in clinical trials. While, as the name suggests, it includes exposure therapy, it also includes other psychotherapy elements. Foa was chair of the PTSD work group of the DSM-IV. Prolonged exposure therapy typically consists of 8 to 15 weekly, 90 minute sessions. Patients will first be exposed to a past traumatic memory (imaginal exposure), after which they immediately discuss the traumatic memory and then are exposed to, "safe, but trauma-related, situations that the client fears and avoids". Slowed breathing techniques and psychoeducation are also touched on in these sessions. PE is theoretically grounded in emotional processing theory, which proposes "a hypothetical sequence of fear-reducing changes evoked by emotional engagement with the memory of a significant event, particularly a trauma." While PE has received substantial empirical support for its efficacy (albeit with high dropout rates), emotional processing theory has received mixed support. PE is strongly recommended as a first-line treatment for PTSD by the American Psychological Association. Cognitive processing therapy Cognitive processing therapy (CPT) was developed by Patricia Resick from 1988. Is an evidence-based treatment aimed at individuals diagnosed with PTSD. This therapy focuses on processing and working through the trauma, designed using techniques from Cognitive Behavioral Therapy discussed previously. CPT is founded on the principle that generally, individuals can gradually recover from traumatic events over time, but in those diagnosed with PTSD, this recovery pathway is impaired. During therapy sessions, clients write and recite written passages either related to why the individual thinks they were exposed to the traumatic event, or narratives outlining the event in explicit detail. CPT is typically completed over 12 one-hour weekly sessions with a practitioner. The first phase of treatment is psychoeducation. During this part of therapy, individuals learn about the relationship between thoughts and emotions, and importantly, they look for "automatic thoughts" that are detrimental to their recovery. This initial phase ends as patients write their understanding of the causes of the traumatic event and its impacts. The second phase is concerned with processing the trauma: outlining the traumatic experience and continuing to discuss the experience and feelings over the following sessions. During this stage, the therapist tries to identify and correct negative cognitions that may lead to continued PTSD symptoms. The final phase assists the individual in strengthening beliefs, skills, and strategies to combat the symptoms of the trauma when they arise. CPT is a strongly recommended treatment for PTSD by the American Psychological Association. Eye movement desensitization and reprocessing Eye movement desensitization and reprocessing (EMDR) was developed by Francine Shapiro in 1988 as a method to diminish the impacts of traumatic memories. During treatment, patients are asked to focus on specific distressing memories while at the same time undergoing bilateral stimulation. This is usually performed through eye movements or other forms of stimulation to both sides of the body such as tones and tapping. The patient discusses their distressing thoughts as the therapist reinforces positive cognitions and utilizes strategies such as a body scan. These sessions are usually once or twice a week for about 6 to 12 weeks. By the end of these sessions, individuals usually demonstrate reduced emotional distress related to the traumatic event. The methodology behind EMDR focuses on the Adaptive Information Processing model of PTSD in which the PTSD symptoms are caused by the impaired processing of the traumatic memory. The symptoms arise when the memories are triggered, bringing back the emotions and sensations of the trauma. Therapy with the incorporation of EMDR has been shown to aid patients in processing distressing memories and reducing their harmful effects. A proposed neurophysiological basis behind EMDR is that it mimics REM sleep, which plays a vital role in memory consolidation. Imaging studies suggest that "eye movements in both REM sleep and wakefulness activate similar cortical areas". The bilateral stimulation facilitated by EMDR "shifts the brain into a memory processing mode", reintegrating the traumatic events with more positively reinforced cognitions. The information can then be integrated completely to lessen the symptoms of triggers. The restoration of the pathway can help with recovery from traumatic events. A 2018 review reported EMDR for PTSD was supported by moderate quality evidence as of 2018. It is a conditionally recommended treatment for PTSD by the American Psychological Association. The Australian Psychological Society considers it a Level I (strongest evidence) treatment method. However, it has separately been classified as a purple hat therapy, and the US National Institute of Medicine found insufficient evidence to recommend it as of 2008. Narrative exposure therapy Narrative exposure therapy creates a written account of the traumatic experiences of a patient or group of patients, in a way that serves to recapture their self-respect and acknowledges their value. Under this name it is used mainly with refugees, in groups. It also forms an important part of cognitive processing therapy. Patients are asked to narrate their life-story while staying in the present moment. They receive an autobiography at the end from their therapist and this often serves as motivation to complete their narration. It is conditionally recommended for treatment of PTSD by the American Psychological Association. Brief eclectic psychotherapy Brief eclectic psychotherapy (BEP) for PTSD was developed by Berthold Gersons and Ingrid Carlier in 1994. It emphasizes the psychodynamic perspective of shame and guilt in addition to the principles of cognitive-behavioral therapy. In 16 sessions, patients create a detailed account of the primary trauma experience, explore the connected emotional reactions, and how to move forward. The first few sessions deal with the traumatic experience as well as reliving the event in the present using objects or core memories. Through this process, the client discusses upsetting feelings and emotions as the therapist helps them to process the event. The individual also writes a letter to the person or group they feel holds responsibility for the trauma although it is not sent. The therapists then assist the individual in assessing the impacts of the trauma from beliefs to physical changes to help them learn and grow from the event instead of avoiding and fearing the impacts. Finally, the therapist helps to develop relapse prevention methods and looks forward to a better future. It is a conditionally recommended treatment for PTSD by the American Psychological Association. Dialectical behavioral therapy Dialectical behavioral therapy is a branch of cognitive behavioral therapy aimed at helping individuals to "accept the reality of their lives". Therapists use strategies such as behavioral therapy techniques and mindfulness to address thoughts and behaviors, and help individuals to regulate and change these. It is usually recommended and used in patients with borderline personality disorder and other personality disorders which are difficult to treat. The specific skills focused on are mindfulness, distress tolerance, interpersonal effectiveness, and emotional regulation. The main goal of DBT is to help clients manage their treatment and better understand their symptoms. The focus of DBT for PTSD is the future and adapting to the symptoms of the trauma. The Australian Psychological Society considers dialectical behavioral therapy (DBT) to be a Level II treatment method. Emotion focused therapy Emotion focused therapy (EFT) was developed by Leslie S. Greenberg in the 1980s. It advocates that emotional change is necessary for permanent or enduring change in clients' growth and well-being. EFT draws on knowledge about the effect of emotional expression and identifies the adaptive potential of emotions as critical in creating meaningful psychological change. A major premise of EFT is that emotion is fundamental to the construction of the self and is a key determinant of self-organization. At the most basic level of functioning, emotions are an adaptive form of information-processing and action readiness that orient people to their environment and promote their well-being. EFT suggests that the developing cortex added the ability for complex learning to the emotional brain in-wired emotional responses. EFT has also been found to be effective in treating abuse, resolving interpersonal problems, and promoting forgiveness. EFT has a high effective rate in people who suffer from childhood abuse and trauma. There are studies of EFT being used for couple interventions for people who have a partner in the military with PTSD, which is EFT's unique approach to helping combat PTSD within service members. Studies have shown that PTSD can lead to decreased marital satisfaction, increased verbal and physical aggression, and heightened sexual dissatisfaction. It was also shown that negative social support intensifies PTSD. Couple interventions for PTSD have strong promise to not only treat PTSD in service members, but also to treat many of the other relational and family issues related to coping with deployment and deployment-related PTSD. The Australian Psychological Society considers emotion focused therapy (EFT) to be a Level II treatment method. Metacognitive therapy Metacognition is a branch of cognition that is responsible for thinking and other mental processes. Most people have some conscious awareness of their metacognition such as when they know of something but cannot recall it right now. This is also called the 'tip-of-the-tongue' effect. Metacognitions control the negative thoughts and ruminations prevalent in many psychiatric diseases such as PTSD. Metacognitive therapy (MCT) was developed by Adrian Wells and is based on an information processing model by Wells and Gerald Matthews. This psychotherapy aims at changing metacognitive beliefs that focus on states of worry, rumination, and attention fixation. As per the metacognitive model, the symptoms are caused by worry, threat monitoring, and coping behaviors that are thought to be helpful but actually backfire. These three processes are called the cognitive attentional syndrome (CAS). Through MCT, patients first discover their own metacognitive beliefs, then are shown how these beliefs lead to unhelpful responses, and finally are taught how to respond to these beliefs in a productive way. MCT typically lasts for around 8-12 sessions and therapy includes experiments, attentional training technique, and detached mindfulness. MCT has been used successfully to treat social anxiety disorder, generalized anxiety disorder (GAD), health anxiety, obsessive compulsive disorder (OCD), and post-traumatic stress disorder (PTSD). MCT has been shown to treat PTSD better than Prolonged Exposure (PE). It has also shown clinically significant results for different causes of PTSD such as accident survivors, and assault and rape victims. The Australian Psychological Society considers metacognitive therapy (MCT) to be a Level II treatment method. Mindfulness-based stress reduction Mindfulness-based stress reduction is an eight-week program that helps train people to help with their stress, anxiety, depression, and pain. It was developed by Jon Kabat-Zinn in the 1970s. The program uses a combination of mindfulness meditation, body awareness, yoga, and exploration of patterns of behavior, thinking, feeling, and action. One of the main concepts in mindfulness is accepting and not judging oneself or others while developing increased emotional regulation. People can participate in this type of therapy while in a structured program, or practice mindfulness meditation on their own. The Australian Psychological Society considers mindfulness-based stress reduction to be a Level II treatment method. Exposure therapy Exposure therapy involves exposing the patient to PTSD-anxiety-triggering stimuli, with the aim of weakening the neural connections between triggers and trauma memories (aka desensitization). Forms include: Flooding – exposing the patient directly to a triggering stimulus, while simultaneously making them not feel afraid. Systematic desensitization (aka "graduated exposure") – gradually exposing the patient to increasingly vivid experiences that are related to the trauma, but do not trigger post-traumatic stress. Exposure may involve a real life trigger ("in vivo"), an imagined trigger ("imaginal"), or a triggered feeling generated in a physical but harmless way ("interoceptive"). Researchers began experimenting with virtual reality therapy in PTSD exposure therapy in 1997 with the advent of the "Virtual Vietnam" scenario. Virtual Vietnam was used as a graduated exposure therapy treatment for Vietnam veterans meeting the qualification criteria for PTSD. A 50-year-old Caucasian male was the first veteran studied. The preliminary results concluded improvement post-treatment across all measures of PTSD and maintenance of the gains at the six-month follow up. Subsequent open clinical trial of Virtual Vietnam using 16 veterans, showed a reduction in PTSD symptoms. Exposure therapy remains a controversial form of therapy to treat PTSD. Those suffering with extreme re-experiencing and arousal symptoms may find exposure to be triggering. Confronting trauma too early after a traumatic event may be upsetting and only worsen symptoms for patients; severe negative reactions include self harm, panic disorder, dissociative disorder, and even suicidal thoughts. It is suggested exposure therapy, if used, should be resorted to only as second line of treatment—therapy ought to first focus on stabilizing and solving present symptoms before incorporating exposure. Occupational therapy Occupational therapy (OT) assists individuals in meaningful daily activities. OT helps individuals in response to an impairment such as an illness, disability, or in the case of PTSD, a traumatic event. Sleep disturbances such as insomnia, night terrors, and inconsistent REM sleep impact the lives of many with PTSD. Occupational therapists are equipped to address this meaningful area through sleep hygiene. Some examples of this technique are reducing screen time, developing nighttime routines, and creating a safe and quiet environment within the bedroom. Another meaningful area of occupational therapy is self-care. Occupational therapists provide education and adaptation/modification in self-care to maintain independence and prevent triggers that may cause flashbacks. Occupational therapists help clients with PTSD engage in meaningful life roles in daily lives, leisure, and work activities through healthy habit formation and stable daily routines while managing PTSD triggers. Social engagement can be challenging for those with PTSD, and as such, occupational therapists work with their clients to help build a supportive social network of family and friends who can assist in reducing this stress. Occupational therapy interventions also include stress management and relaxation techniques such as deep breathing, mindfulness, meditation, progressive muscle relaxation, and biofeedback. The goal is to help clients adjust to the demands of daily life. Occupational Therapy interventions are wide ranging, from group therapy to therapy tailored to the specific cause of PTSD. Other more unique OT interventions include, high intensity sports, role playing scenarios, and sensory modulation therapy. One specific study with promising results, analyzed a sports-oriented OT intervention using surfing to help veterans with PTSD return to civilian life. Positive psychology Positive psychology coaching has been used as PTSD treatment, described as a strengths-focused method centered around reducing arousal states, meeting goals, and cultivating self-control. Past successful case studies of positive psychology interventions begin with journaling on strengths, completing a craft with fellow veterans, and group reflections answering positive psychology prompts. Stress inoculation training Stress inoculation training was developed to reduce anxiety in doctors during times of intense stress by Donald Meichenbaum in 1985. It is a combination of techniques including relaxation, negative thought suppression, and real-life exposure to feared situations used in PTSD treatment. The therapy is divided into four phases and is based on the principles of cognitive behavioral therapy. The first phase identifies the individual's specific reaction to stressors and how they manifest into symptoms. The second phase helps teach techniques to regulate these symptoms using relaxation methods. The third phase deals with specific coping strategies and positive cognitions to work through the stressors. Finally, the fourth phase exposes the client to imagined and real-life situations related to the traumatic event. This training helps to shape the response to future triggers to diminish impairment in daily life. Biological interventions Biological therapy, which can also be referred to as biomedical therapy or biological interventions are any form of treatment for mental disorders that attempts to alter physiological functioning, including drug therapies, electroconvulsive therapy, and psychosurgery. Medication Psychoactive drug therapy, also known as pharmacotherapy, is used to treat psychiatric disorders and is a second-line treatment for PTSD. A second-line treatment refers to a treatment that is used after the initial treatment has been shown to be unsuccessful or has stopped working when treating a specific condition. Antidepressants are the only form of medication recommended by major bodies. Antidepressants Antidepressants are widely used in the treatment of PTSD. The most popular types are SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin-norepinephrine reuptake inhibitors). SSRIs and SNRIs are recommended as the first-choice medication for people with PTSD by both the VA (US Department of Veteran Affairs) and APA (American Psychological Association). According to the APA Practice Guidelines, "SSRIs have proven efficacy for PTSD symptoms and related functional problems". Despite this, it has been estimated that around 40-60% of patients with PTSD do not respond to SSRIs. The only two medications for PTSD that are approved by the FDA are sertraline (Zoloft) and paroxetine (Paxil), both antidepressants of the SSRI class. The APA clinical practice guideline also recommends the SSRI fluoxetine and the SNRI venlafaxine. Many people who have PTSD take antidepressants and inhibitors to help cope with sleeping disorders, panic attacks, depression, and anxiety attacks. There is evidence that antidepressants and inhibitors, such as tricyclics, SSRI, and MAOI antidepressants have demonstrated efficacy in larger, longer-term controlled trials. The efficacy of SSRIs in mild or moderate cases of depression have been disputed and may or may not be outweighed by side effects, especially in adolescent populations. There are only two FDA approved SSRI drugs for PTSD, paroxetine and sertraline. Neither are fully effective but paroxetine has a higher efficacy rate than sertraline. MAOI antidepressants block the actions of monoamine oxidase enzymes. Monoamine oxidase enzymes are responsible for breaking down neurotransmitters such as dopamine, norepinephrine, and serotonin in the brain. Low levels of these three neurotransmitters have been linked with depression and anxiety. By blocking these enzymes, scientists believe that it helps relieve symptoms of depression. MAOI antidepressants are often used as a last resort because they have a higher risk of drug interactions than standard antidepressants and can also interact with certain types of food such as aged cheeses and cured meats. Alternative and complementary therapies Alternative medicine is any product or practice that is not considered part of standard medical care. Standard medical care, also known as standard of care, best practice, or standard therapy, is any treatment that is widely accepted as proper and correct by medical professionals. Complementary medicine is a treatment that is used alongside standard medical care, but is not part of that category itself. One example of this is acupuncture, hypnosis, or meditation. Alternative medicine, on the other hand, is used instead of standard medical care. These treatments may include specialised diets or the use of vitamins or herbs. In the recent decade, alternative and complementary treatments have shown increasing promise in treating people with post traumatic stress disorder and have gained general popularity. In the United States, approximately 38% of adults and 12% of children use complementary or alternative medicines. Relaxation techniques may be the earliest behavioral treatment for PTSD, and are often included as part of PTSD treatment. They can use relaxing movements such as successively tensing and relaxing muscles and works by reducing the fear associated with traumatic responses. Other relaxation techniques include meditation, deep breathing, massages, and yoga. Yoga therapy treatment Yoga has shown promise of reducing symptoms of PTSD when is it used alongside other treatments. Yoga promotes a mind and body connection that can help empower people to embrace their own general wellness. Yoga also increases affect awareness and can help people learn to regulate their emotions, which can be instrumental in helping people overcome symptoms of PTSD. A randomised controlled trial including 209 participants, mainly veterans, showed a decrease in the severity of PTSD symptoms among the group that participated in a yoga program, as opposed to another group that participated in a wellness lifestyle program. After 16 weeks, the yoga group displayed a statistically significant decrease in PTSD symptoms compared to the other group. Some of these symptoms that were improved included sleep quality, emotional awareness, depression, anxiety, and others. The Clinician Administered PTSD Scale and the PTSD checklist were used to assess PTSD symptoms. A statistically significant difference between the two groups was not found again at a 7-month follow up, suggesting that this sort of therapy may be best used in addition to other types of treatments. Other studies have shown similar, promising effects on symptoms of PTSD. Among these, there was a randomised controlled trial using 64 women with chronic, treatment resistant PTSD. A control was compared to a group that participated in yoga and another group that attended supportive women's health education classes. Statistically significant differences were found between all three of these groups, the yoga group seeing the most drastic reduction in symptoms of PTSD. This option is usually very accessible and easy for people to do in conjunction with other treatments. Acupuncture Acupuncture is a practice using small needles to penetrate the skin in specific areas of the body to stimulate the nervous system. This technique has evolved from traditional Chinese medicine that utilizes over 2000 acupuncture points to change energy flow in the body. Individuals with PTSD often have several comorbidities and acupuncture has been shown to assist in diminishing these symptoms. The evidence for this practice are based in the stimulation of the "autonomic nervous system, and the prefrontal as well as limbic brain structures, making it able to relieve the symptoms of PTSD". This stimulation leads to the production and regulation of hormones and neurotransmitters especially those related to pain management like endogenous opioids. Acupuncture is a safe practice that shows promise in the field of many health conditions and research supports the practice in reducing PTSD symptoms. Group therapy Group therapy can take on many forms. Group cognitive behavioral therapy and group exposure therapy are the most common types. The format of group cognitive behavioral therapy is based on participants connecting and sharing past experiences while developing trust. Since World War II, the method of having soldiers come together and converse amongst each other has been in practice. This type of therapy can be a good option for people because it is often more accessible and cheaper. Studies have also shown various therapeutic benefits for group therapy. For example, group therapy allows people to work together and form meaningful relationships. It also helps people develop their communication skills. Another very important aspect is showing people who have PTSD that they are not alone. Oftentimes, group therapy can give people a community to support them when they feel detached from other people in their lives. As with any form of treatment, there are concerns for group therapy and it will not be the best option for every individual. One concern is that people will compare their trauma and experiences to others in a group setting, instead of learning and helping each other. Animal-assisted intervention Animal-assisted intervention, previously referred to as animal-assisted therapy, is any therapy that includes animals in the treatment. This sort of treatment can be classified by the type of animal, the targeted population, and how the animal is incorporated into the therapeutic plan. The goal of animal-assisted intervention is to improve a patient's social, emotional, or cognitive functioning and literature reviews state that animals can be useful for educational and motivational effectiveness for participants. The most commonly used types of animal-assisted intervention are canine-assisted therapy and equine-assisted therapy. Canine therapy, because it is much more easily accessible, is the most commonly used form of animal assisted therapy. Service dogs have shown a lot of promise in mitigating PTSD symptoms, specifically among the veteran population. The mechanism for this may be that dogs help instil a sense of confidence and safety in their owner. They can also act as a companion for individuals who may otherwise experience detachment or feeling isolated and alone. Various studies, as well as lots of anecdotal evidence, have shown reduction in PTSD symptomatology with the use of service dogs and canine therapy. Physiologically, the presence of animals has been linked to the release of oxytocin and the reduction in anxious arousal symptoms, which is one of the most intrusive symptoms in many people with PTSD. The most promising findings indicate the efficacy of animal assisted therapy used with other types of therapy. Equine therapy has also proved to be helpful for many populations with PTSD. There are both physical and psychological benefits to equine therapy and therapeutic horseback riding. The physical benefits may include improved posture and balance, decreased muscle tension, and reduction of pain. Psychological benefits include increased self efficacy, motivation, and courage, reduction in psychological stress, and enhanced psychological well-being. Equine therapy has been shown to be most effective when done over long periods of time. While equine and canine therapies are the most common, other animals, like pigs, have also been used to help treat people with PTSD. There are many different ways to participate in this type of therapy. People should pick whatever works best for them and is accessible, if this options speaks to them. Present centered therapy Present centered therapy (PCT) was initially developed as a nonspecific comparison condition to test the effectiveness of trauma focused cognitive behavioral therapy in two large studies conducted by the US Department of Veterans Affairs. PCT focuses on adapting to life stressors and developing responses to those stressors, and can be done in a group format or with an individual. Sessions will range from 60 to 90 minutes. Session numbers range from 12 to 32 for group sessions and 10-12 for individuals. The first two sessions in group or individual format include an overview of PCT and education about PTSD symptoms and responses to trauma. After these two preliminary sessions, the rest of the sessions are more free form, usually focusing on topics chosen by the patient/patients. Patients are also encouraged in this type of therapy to keep a journal and note issues/concerns that come up throughout their week. Meditation Many studies suggest that meditation can reduce the symptoms of PTSD, particularly in war veterans. These studies show that meditation reduces stress hormones by calming the sympathetic nervous system, which is responsible for the 'fight-or-flight' response to danger. Researchers found that practicing transcendental meditation can help reduce or even reverse symptoms of PTSD and associated depression. Specifically for this study, after 3 months of meditation, the group, on average, recovered from PTSD. Somatic therapy During somatic therapy, a person works with a therapist to modify the trauma-related stress response produced by their body. In addition to helping with emotional regulation, somatic therapy can also reduce trauma-related pain, disability, insomnia, and other manifestations of stress. Some common somatic therapy techniques are: Body awareness: Learning to notice and identify feelings of tension and calmness in the body. Grounding and centering: Using inherent self-awareness to connect with, manage, and mitigate feelings of distress as they arise. Titration: The therapist guides the patient through recounting a traumatic memory while describing any tension or physical sensations that occur in the process. Sequencing: The patient is asked to closely monitor the order in which sensations and tension leave the body, such as a tightening in the chest and a trembling as the tension dissipates. Pendulation: The therapist guides the patient from a relaxed state to one that feels similar to their traumatic experience, allowing the patient to release pent-up pain and emotion. With these techniques, a person learns how to safely release built-up energy, pain, and emotions stemming from trauma. This allows a person to heal and move on from their PTSD triggers gradually. More research is needed before the American Psychological Association can list somatic therapy as a recommended treatment, but initial evidence has found it to be effective. Multicultural perspectives Trauma is ingrained in culture, and different cultures receive and treat trauma in different ways. Some cultures treat trauma with ancient practices such as praying or ritual. The term "historical trauma" (HT) gained currency in the clinical and health science literature in the first two decades of the 21st century. It is defined as ongoing trauma experienced across generations by a group that shares an identity, affiliation, or circumstance. Native Americans, African Americans, Holocaust survivors, and Irish people are communities who may experience historical trauma. In the case of Native Americans, many therapists use "a return to indigenous traditional practices" as a form of treatment for HT. This is very different from Cognitive Behavioral Therapy or SSRIs that may be prescribed for someone with PTSD. The goal of this kind of treatment is not "adaptation" or cognitive restructuring of the individual to the prevailing cultural norm, "but rather spiritual transformations and accompanying shifts in collective identity, purpose, and meaning making." HT is often overlooked because of a misconstrued view held by some mental health professionals that it is equivalent to PTSD. This can lead to a misunderstanding of HT, due to an exclusive focus on the individual, rather than historical causes and events. Researchers at the Stress-response Syndromes Lab at the University of Zurich, Switzerland, use the historical contributions of the Swiss psychologist Carl Gustav Jung to develop culturally sensitive treatments like symbolism and different myth stories to treat PTSD. Jung's psychology asserts that "the fundamental 'language' of the psyche is not words, but images...studying the trinity of myths, metaphors, and archetypes enhances clinical interventions and psychotherapy." A combination of Western psychotherapy and Japanese culture is helpful when using psychotherapy as an effective treatment in Japan. "After the Kobe-Awaji earthquake in 1995...Japanese psychologists became acutely aware of the need to receive specialized training in the treatment of post-traumatic stress disorder (PTSD) as well as crisis intervention." Psychotherapy is a recent practice used in Japan in which some practices of western psychotherapy are "modified to suit the Japanese client population" and forms to create a sense of cultural integration. The  two main methods of treatment practices Japanese psychotherapists work with are nonverbal tasks and parallel therapy. Art therapy Art therapy may alleviate trauma-induced emotions, such as shame and anger. It is also likely to increase trauma survivors' sense of empowerment and has an established history of being used to treat veterans, with the American Art Therapy Association documenting its use as early as 1945. Art therapy in addition to psychotherapy offered more reduction in trauma symptoms than just psychotherapy alone. Children's Accelerated Trauma Treatment Children's Accelerated Trauma Treatment (CATT) is a holistic trauma-focused therapy that fuses cognitive behavioural theory with creative arts methods, whilst taking a human rights and child-centred approach to treatment. CATT was initially created for children and adolescents at least 4 years old. However, CATT has since been used with individuals of all ages, including adults. Developed by Carlotta Raby in 1997 in London, CATT is based on empirical research and is UK NICE guidance and World Health Organisation (WHO) guidance compliant for PTSD and complex trauma treatments. A 2021 Gaza study found CATT to be an effective treatment for symptoms of trauma in children and young people, including PTSD. Digital interventions Digital delivery is an expansion of telemedicine that focuses on symptom monitoring and clinical services. Modern technologies allow the usage of multiple engagements of interactions, such as smartphone usage for messaging, video calls, and completing self-report measures. There are two characteristics for providers in the digital delivery format: synchronous for real-time interaction (e.g., live video and telephone call) and asynchronous for interactions that involve a delay (e.g., messages and video recordings). Mobile technologies have improved access to self-help applications; some are assisted through artificial intelligence, such as chatbots or social robots. The integration of digital delivery has various forms to provide multiple modalities, such as platforms with both synchronous and asynchronous interactions (e.g., instant messaging with a provider). Digital Interventions are found to improve the accessibility and clinical effectiveness of mental health interventions. The utilization of digital interventions is important because of barriers to seeking treatment, such as stigma, difficulties in scheduling, waitlist, and limited mental health resources. Digital interventions address these barriers by tailoring the intervention to the individuals' needs and the cost-efficiency of implementing the treatment. Engagement with digital interventions has shown promise in randomized controlled trials. There is some concern about how these digital intervention will translate from research settings to real world settings. Some recommendations for real-world data implementation include the amount of times a digital intervention has been accessed or opened, the total number of downloads in a specific period of time, the demographics of the users, and the number of modules completed by users. Data suggest that it may be inefficient to use evidence-based practices for all users without understanding their symptom presentation.  For PTSD, some considerations for digital intervention include which individual characteristics to use to guide treatment, how to use that data to inform the progress of treatment, and how to tailor evidence-based practices to each specific users' needs. One review examined the usage of digital interventions for PTSD symptoms in the general population and found emerging evidence supporting the effectiveness of digitally delivered Cognitive Behavioral Therapy (iCBT) compared to other interventions (e.g., mindfulness, expressive writing, and cognitive tasks). The review also highlighted that it is important to explore the risks and potential adverse effects of completing a digital intervention. Another review examined different randomized controlled trials (RCTs) exploring telehealth, Internet-based interventions, virtual reality exposure therapy, and mobile apps for PTSD. Internet-based interventions (IBIs) involve course-based computer programs that provide cognitive training, psychoeducation, and interactive exercises. The modules are designed to be completely weekly. In terms of IBIs, there were moderate effects when compared to passive control conditions and not for active controls; therefore, the benefits of using IBIs are unclear. Virtual Reality (VR) is computer generated, three-dimensional simulated environment. The common use for VR therapy is exposure therapy (VRET), allowing the therapist to control the pace of the exposure before having the individual confront real-world situations. VRET is different from standard VR experience because VRE is multisensory and increases the user's experiential engagement during treatment sessions. Virtual reality can help users feel more comfortable facing stressful situations in a virtual setting to learn new behaviors for real-life situations. A meta-analysis suggested that VRET is an effective treatment for PTSD and depression symptoms, with treatment benefits maintained for up to 6 months. However, these results were limited to male service members, which reduced the generalizability to women and other trauma populations. Mobile apps are software programs accessible on mobile devices and tablets. Mobile apps formats such as stand-alone or guided self-help had promising results for reducing PTSD symptoms; whereas depression symptoms were limited to small samples with no studies compared to evidence-based treatments for PTSD. PTSD Coach PTSD Coach is an application developed by the US Department of Veteran Affairs (VA) National Center for PTSD (NCPTSD) and the US Department of Defense Center for Telehealth Technology. PTSD Coach was designed for service members and veterans and as a public health resource for any individuals impacted by trauma. Many studies support the feasibility and effectiveness of PTSD Coach as a mobile health intervention for self-management care of PTSD symptoms. One study found that most users accessed the app to manage symptoms through the use of a coping tool (e.g., cognitive restructuring). It was found that PTSD Coach has been positively received by the general public, who found the app helpful in reducing momentary distress. The broad dissemination to the general public for PTSD Coach has continued to be supported with an average usage of three times across three separate days with a duration of 18 minutes of use. One study compared the mobile app version of PTSD Coach to the web-based version, PTSD Coach Online, and found lower attrition rates on the mobile app compared to the web-based version. The use of human support yielded better outcomes than self-management alone, as participants were guided through structured weekly sessions. Another study also highlighted that clinician support increases the effectiveness of PTSD Coach for mobile app engagement. Because of the increased access to smartphones, one study examined the global use of PTSD Coach in Australia, Canada, The Netherlands, Germany, Sweden, and Denmark. There is potential for PTSD Coach to address a global unmet need for care; however, there is still much work for disseminating PTSD Coach for areas where resources are nonexistent. For community trauma survivors, PTSD Coach was found to be a feasible intervention for learning about PTSD, self-management symptoms, and symptom monitoring. The examination of PTSD Coach for efficacy was not clear compared to the waitlist condition; however, the study condition using PTSD Coach had a significant reduction in symptoms, and the waitlist did not. Therefore, it is encouraged to continue to explore the efficacy of PTSD Coach for community trauma survivors. Digital Attrition Because digital interventions require active user engagement, it is important to understand what facilitates digital engagement versus digital intervention attrition. Many studies highlighted the impact of digital engagement on users in PTSD Coach. Some theories to highlight digital engagements are the Technology Acceptance Model (TAM) and the Unified Theory of Acceptance and Use of Technology (UTAUT). TAM is technology acceptance through an individual's perspective of ease of use, usefulness, and subjective norms. UTAUT highlighted the behavioral intention of using digital interventions through a user's effort expectancy, performance expectancy, social influence, facilitating conditions, and habit. The importance of an effective digital intervention is to examine the user's experience and flow of engaging with technology to create a balance of challenges and content. There are other factors, such as Internet anxiety, that moderated the relationship between digital intervention usage with recommendations of providing information about data security to help users feel supported. Cannabinoids Recent research has shown that cannabis is beneficial for PTSD Treatment according to the VFW (Veterans of Foreign Wars) in those who receive doses with higher levels in THC. According to Mallory Lofl, a volunteer assistant professor of psychiatry at the UC San Diego School of Medicine, one of the biggest takeaways from this study is that veterans with PTSD can use cannabis at self-managed doses, at least in the short term, and not experience a plethora of side effects or a worsening of symptoms. Currently, 37 states, four territories, and the District of Columbia allow the use of cannabis for medical purposes. Two studies that have been published recently showed two different mechanisms that allow cannabinoids to help with PTSD. One showcased cannabis's effect in the amygdala — a part of the brain associated with fear responses to threats — by reducing activity in that region. The second study suggests that cannabinoids could aid in blocking traumatic memories. Psychedelic assisted psychotherapy Psychedelic therapy is the use of psychedelic substances such as MDMA, psilocybin, LSD, and ayahuasca to treat mental illnesses. Most of these substances are controlled substances in most countries and are not legally prescribed. They are mostly used in clinical trials. The way of administering psychedelic drugs is different from most other medical drugs. Psychedelic drugs are usually given in a single sessions or a few sessions after which the patient wears eyeshades and listens to music so that they can focus on the psychedelic experience. The therapeutic team is available in case of any distress or anxiety. Psychotherapy itself often does not cause complete recovery in PTSD patients. The investigation of psychedelic drugs as an alternative to antidepressants and psychotherapy is becoming popular and there are many clinical trials being run on this. The advantage of using psychedelic drugs is that many of these drugs are not physically addictive, unlike drugs like nicotine. The disadvantages of using psychedelics include the risk of a "bad trip" causing the patient to feel unsafe and causing long-term negative impact on their mental state. Some patients have also reported flashbacks upon taking psychedelics thus decreasing their overall well-being by bringing back the memories causing PTSD. MDMA In 2018, the US Food and Drug and Drug Administration granted "Breakthrough Therapy" designation for MDMA-assisted psychotherapy trials. There is weak evidence MDMA might improve PTSD symptoms, with possible adverse effects including nausea and jaw clenching. The use of MDMA for treating PTSD is currently undergoing clinical trials and not yet approved by the FDA. However, MDMA has potential to be a promising treatment for PTSD because it decreases fear, increases wellbeing, increases sociability, increases trust, and creates and alert state of consciousness. This helps patients them more easily process their memories and changes their views on life and purpose. Only 2-3 sessions of MDMA-assisted psychotherapy have shown positive results for reducing symptoms of PTSD. There is also evidence that treatments using classical psychedelics like psilocybin and LSD must only be considered after the patient has tried MDMA-assisted therapy. This is because MDMA only mildly alters the patient's emotional state and self-perception while classical psychedelics may alter them much more. Psilocybin Some studies have shown that mice overcome fear after being given psilocybin. This is because psilocybin stimulates the growth of neurons in the hippocampus which is the area of the brain responsible for memory and emotion. There has also been success in using psilocybin on human patients with PTSD. Ketamine Ketamine has been shown to rapidly decrease PTSD symptoms by altering memory processes such as increases in fear extinction. Ketamine therapy in combination with exposure therapy has promising effects for the treatment of PTSD. A systematic review of the literature found that ketamine therapy significantly reduced PTSD scores at the time of last follow-up while also significantly increasing the time to relapse versus control therapy. Benzodiazepines Benzodiazepines are not recommended for the treatment of PTSD due to a lack of evidence of benefit and risk of worsening PTSD symptoms. Benzodiazepines are a group of anti-anxiety medications that make people feel calm, relaxed, or sleepy. They are recommended for short-term treatment of severe anxiety, panic, or insomnia. Some authors believe that the use of benzodiazepines is contraindicated for acute stress, as this group of drugs can cause dissociation. Nevertheless, some people use benzodiazepines for short-term anxiety and insomnia. For those who already have PTSD, benzodiazepines may worsen and prolong the course of illness, by worsening psychotherapy outcomes, and causing or exacerbating aggression, depression (including suicidality), and substance use. The National Center for PTSD has claimed that if benzodiazepines are used by PTSD patients, patients may be unable to learn how to manage stress which makes it harder to recover. Effective treatments for PTSD, like talk therapy, help stop avoiding distressing situations and memories. Drawbacks include the risk of developing a benzodiazepine dependence, tolerance (i.e., short-term benefits wearing off with time), and withdrawal syndrome; additionally, individuals with PTSD (even those without a history of alcohol or drug misuse) are at an increased risk of abusing benzodiazepines. Topiramate Topiramate is an anti-epileptic section of medications used to modulate glutamate transmission and could result in PTSD symptom reduction. However, the side effects of topiramate are greater than SSRI antidepressants so it is generally not recommended since it is not uncommon for patients to experience side effects such as cognitive dulling. Cognitive dulling refers to a form of mental fatigue that leads to difficulty concentrating, decreased productivity, and a decline in emotional and mental health, according to Jennifer Bahrman, assistant professor in the Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences. Prazosin Prazosin, an alpha-adrenoceptor antagonist, is often prescribed, particularly for sleep-related symptoms. Early studies have shown evidence of efficacy, though a recent large trial did not show a statistically significant difference between prazosin and placebo. Antipsychotic medications Antipsychotic medications have also been prescribed to treat PTSD, though clinical trials have not yielded consistent evidence for their efficacy. Stellate ganglion block A promising invasive treatment for PTSD was proposed in 2008. The treatment is known as SGB (stellate ganglion block), which can also be referred to as CSB (cervical sympathetic blockade). The stellate ganglion is treated with an injection of local anesthetic (numbing medicine) to block the sympathetic nerves located on either side of the voice box in the neck. The block targets these sympathetic nerves because they control a person's fight or flight response. The subjects of SGB have mixed reviews as patients saw improvements in depression and anxiety but not in pain. There is no relevant literature or evidence-based guidelines regarding the clinical effectiveness of SGB for the treatment of depression or anxiety. Overall, considering the limitations mentioned, the findings and recommendations summarized in this report need to be interpreted with caution. While SGB has helped certain symptoms of PTSD, it is a new treatment that should be looked at with caution and skepticism. It is not a cure for PTSD. Nepicastat Moreira-Rodrigues et al. demonstrated that mice lacking epinephrine exhibit reduced contextual memory after fear conditioning. In addition, in PTSD epinephrine enhances traumatic-contextual memory. Nepicastat is a drug that inhibits dopamine-β-hydroxylase (DBH), which is the enzyme that is responsible for the conversion of dopamine to norepinephrine. Studies have shown that nepicastat effectively reduces norepinephrine in both peripheral and central tissues in rats and dogs. Nepicastat also unregulated the transcription Npas4 and Bdnf genes in the hippocampus, potentially contributing to neuronal regulation and the attenuation of traumatic contextual memories. Although no DBH inhibitor has received marketing approval due to poor DBH selectivity, low potency and side effects, DBH gene silencing may be an alternative for patients with heightened sympathetic activity. Some studies, however have shown that nepicastat is well-tolerated in healthy adults and significant no differences in adverse events were observed. Given that nepicastat  treatment has been proven to be effective in reducing signs in PTSD mice model with elevated catecholamine levels, it could be a promising treatment option for humans with PTSD characterized by increased catecholamine plasma levels. Sotalol It has been shown that reduction of sympathetic autonomic overshooting in PTSD patients may be achieved through inhibition of β-Adrenergic receptor activity. Propranolol, a peripheral and central β-Adrenergic antagonist is effective on preventing the onset and progression of PTSD symptoms in humans however its beneficial effects are undermined by unwanted side effects like gastrointestinal disturbances, bradycardia, fatigue, sleep disorders and memory deficits. Sotalol is a peripherally acting β-Adrenergic receptor antagonist which has been proven to decrease traumatic contextual memories, anxiety-like behaviours and plasma catecholamines in animals and it is thought to have less side effects than centrally acting propranolol. It has also been shown that Sotalol decreases Nr4a1 mRNA transcripts in the hippocampus which is important for contextual fear memory formation and consolidation. Sotalol is currently used in patients with ventricular and supraventricular arrhythmias, despite unwanted pro-arrhythmic effects. Treatment of PTSD with sotalol may be a possibility if effective when using smaller doses. Recommendations A number of major health bodies have developed lists of treatment recommendations. These include: American Psychological Association United States Department of Veterans Affairs The UK's National Institute for Health and Care Excellence Australian Psychological Society Australia's National Health and Medical Research Council See also PTSD treatment in South Africa References Post-traumatic stress disorder Treatment by mental disorder Sensory accommodations

Positive affectivity

Positive affectivity (PA) is a human characteristic that describes how much people experience positive affects (sensations, emotions, sentiments); and as a consequence how they interact with others and with their surroundings. People with high positive affectivity are typically enthusiastic, energetic, confident, active, and alert. Research has linked positive affectivity with an increase in longevity, better sleep, and a decrease in stress hormones. People with a high positive affectivity have healthier coping styles, more positive self-qualities, and are more goal oriented. Positive affectivity also promotes an open-minded attitude, sociability, and helpfulness. Those having low levels of positive affectivity (and high levels of negative affectivity) are characterized by sadness, lethargy, distress, and un-pleasurable engagement (see negative affectivity). Low levels of positive affect are correlated with social anxiety and depression, due to decreased levels of dopamine. Psychology Happiness, a feeling of well-being, and high levels of self-esteem are often associated with high levels of positive affectivity, but they are each influenced by negative affectivity as well. Trait PA roughly corresponds to the dominant personality factors of extraversion; however, this construct is also influenced by interpersonal components. Effects Overall, positive affect results in a more positive outlook, increases problem solving skills, increases social skills, increases activity and projects, and can play a role in motor function. Positive affectivity is an integral part of everyday life. PA helps individuals to process emotional information accurately and efficiently, to solve problems, to make plans, and to earn achievements. The broaden-and-build theory of PA suggests that PA broadens people's momentary thought-action repertoires and builds their enduring personal resources. Research shows that PA relates to different classes of variables, such as social activity and the frequency of pleasant events. PA also strongly relates to life satisfaction. The high energy and engagement, optimism, and social interest characteristic of high-PA individuals suggest that they are more likely to be satisfied with their lives. In fact, the content similarities between these affective traits and life satisfaction have led some researchers to view both PA, NA, and life satisfaction as specific indicators of the broader construct of subjective well-being. PA may influence the relationships between variables in organizational research. PA increases attentional focus and behavioral repertoire, and these enhanced personal resources can help to overcome or deal with distressing situations. These resources are physical (e.g., better health), social (e.g., social support networks), and intellectual and psychological (e.g., resilience, optimism, and creativity). PA provides a psychological break or respite from stress, supporting continued efforts to replenish resources depleted by stress. Its buffering functions provide a useful antidote to the problems associated with negative emotions and ill health due to stress, as PA reduces allostatic load. Likewise, happy people are better at coping. McCrae and Costa concluded that PA was associated with more mature coping efforts. Negative affectivity Positive affectivity (PA) and negative affectivity (NA) are nearly independent of each other; it is possible for a person to be high in both PA and NA, high in one and low in the other, or low in both. Affectivity has been found to be moderately stable over time and across situations (such as working versus relaxing). Positive affectivity may influence an individual's choices in general, particularly their responses to questionnaires. Neuropsychology Studies are finding there is a relationship between dopamine release and positive affect in cognitive abilities. For instance, when dopamine levels are low, positive affect can stimulate the release of more dopamine, temporarily increasing cognitive, motor, and emotional processing. Stimulating dopamine release influences several cognitive functions. First, an increase in dopamine in the nigrostriatal system can temporarily relieve motor or cognitive dysfunction, due to Parkinson's. An increase in dopamine release also influences the mesocorticolimbic system through the VTA cells, increasing mood and open mindedness in older adults. Positive affect also stimulates dopamine production in the prefrontal cortex and the anterior cingulate facilities, which help with processing working memory and executive attention. Lastly, PA indirectly improves memory consolidation in the hippocampus, by increasing acetylcholine release from an increase in dopamine. Business management Positive affectivity is a managerial and organizational behavior tool used to create positive environments in the workplace. Through the use of PA, the manager can induce a positive employee experience and culture. "Since affectivity is related to the employee experiences, we expect the employees with high PA to feel considerable organizational support. Their optimism and confidence also helps them discuss their views in a manner characterized by constructive controversy with their supervisor, so that problems are solved and their positive feelings confirmed". Positive Affectivity allows creative problem solving to flourish in an environment where employees are not intimidated to approach managers, therefore employees believe they are playing a key role in the organization in coming forward with solutions. The goal is to maximize PA and minimize any negative affectivity circulating in the business. Negative emotions, such as fear, anger, stress, hostility, sadness, and guilt, increase the predictability of workplace deviance, and therefore reduce the productivity of the business. Testing Because there is not a hard-and-fast rule for defining certain levels of positive affectivity, different self-reported assessments use different scales of measure. Several prominent tests are listed below; in each of these, the respondent determines the degree to which a given adjective or phrase accurately characterizes him or her. Differential Emotions Scale (DES): A PA scale that assesses enjoyment (happy or joyful feelings) and interest (excitement, alertness, curiosity). Multiple Affect Adjective Checklist – Revised (MAACL-R): Measures PA according to the DES scale and to an additional scale assessing thrill-seeking behavior (i.e., how daring or adventurous the person is). Profile of Mood States (POMS): Uses vigor scale to assess the domain of PA. Expanded Form of the Positive and Negative Affect Schedule (PANAS-X): This test uses three main scales: joviality (how cheerful, happy, or lively), self-assurance (how confident and strong), and attentiveness (alertness and concentration). International Positive and Negative Affect Schedule Short-Form (I-PANAS-SF): This is a brief, 10-item version of the PANAS that has been developed and extensively validated for use in English with both native and non-native English speakers. Internal consistency reliability for the 5-item PA scale is reported to range between .72 and .78. See also Affection Anhedonia Gratitude Happiness Joy Satisfaction Surgency References Further reading Lopez, S. J. (2008). Positive psychology: Exploring the best in people. (Vol. 2). Westport, CT: Praeger Publications. Lopez, S., & Snyder, C. R. (2009). Oxford handbook of positive psychology. (2nd ed.). Oxford, New York: Oxford University Press. Tomkins, S. S. (1962). Affect, imagery, consciousness. (Vol. I). New York, NY: Springer Publishing Company, Inc. Personality Positive psychology Emotional issues Affection

International Encyclopedia of the Social & Behavioral Sciences

The International Encyclopedia of the Social & Behavioral Sciences, originally edited by Neil J. Smelser and Paul B. Baltes, is a 26-volume work published by Elsevier. It has some 4,000 signed articles (commissioned by around 50 subject editors), and includes 150 biographical entries, 122,400 entries, and an extensive hierarchical subject index. It is also available in online editions. Contemporary Psychology described the work as "the largest corpus of knowledge about the social and behavioral sciences in existence." It was first published in 2001, with a 2nd edition published in 2015. The second edition is edited by James D. Wright. Subject Classification Contents include the following broad Subject Classification. Overarching Topics: Institutions and infrastructure, History of the social sciences and the behavioral sciences, Ethics of research and applications, Biographies, Integrative concepts and issues Methodology: Statistics, Mathematics and computer sciences, Logic of inquiry and research design. Disciplines: Anthropology, Demography, Economics, Education, History, Linguistics. Philosophy, Political science, Clinical psychology and applied psychology, Cognitive psychology and cognitive science, Developmental psychology, social psychology, personality psychology and motivational psychology, Sociology Intersecting Fields: Evolutionary sciences, Genetics, behavior and society, Behavioral neuroscience and cognitive neuroscience, Psychiatry, Health, Gender studies, Religious studies, Expressive forms, Environmental sciences/ecological sciences, Science and technology studies, Area studies and international studies Applications: Organizational studies and management studies, Media studies and commercial applications, Urban studies and Urban planning, Public policy, Modern cultural concerns Subclassification of articles with an example The above Subject Classification is alphabetized with a link for each such general subject at ScienceDirect.Com. Each such link leads to subclassification links for that subject. The hierarchical classification of articles for a subject can be used to locate an article. For example, the Economics link above brings up these subclassification links: Agricultural and Natural Resource Economics Financial Economics General Methods and Schools Industrial Organization and Law and Economics International Economics, Growth, and Development Labor Economics Public and Welfare Economics Each such subclassification link goes to corresponding Encyclopedia article titles with the author, page numbers, and links to the article Abstract and a View of Related Articles. (The latter is an extensive list of references separate from the Bibliography in the article.) For example, under the Economics link above, the link for "General Methods and Schools" brings up: Auctions, Pages 917-923, S. Müller | Abstract | View Related Articles Behavioral Economics, Pages 1094-1100, S. Mullainathan and R. H. Thaler ... Consumer Economics, Pages 2669-2674, A. P. Barten Econometric Software, Pages 4058-4065, W. H. Greene Econometrics, History of, Pages 4065-4069, M. S. Morgan and D. Qin Economic Education, Pages 4078-4084, W. E. Becker Economics and Ethics, Pages 4146-4152, J. Broome Economics, History of, Pages 4152-4158, M. Schabas Economics, Philosophy of, Pages 4159-4165, D. M. Hausman Economics: Overview, Pages 4158-4159, O. Ashenfelter Expectations, Economics of, Pages 5060-5067, G. W. Evans and S. Honkapohja Experimental Economics, Pages 5100-5108, V. L. Smith Feminist Economics, Pages 5451-5457, D. Meulders Firm Behavior, Pages 5676-5681, F. M. Scherer Game Theory: Noncooperative Games, Pages 5873-5880, E. van Damme Information, Economics of, Pages 7480-7486, S. S. Lippman and J. J. McCall Institutional Economic Thought, Pages 7543-7550, G. M. Hodgson Macroeconomic Data, Pages 9111-9117, T. P. Hill Market Areas, Pages 9203-9207, J.-C. Thill Marxian Economic Thought, Pages 9286-9292, R. Bellofiore Monetary Policy, Pages 9976-9984, B. M. Friedman Political Economy, History of, Pages 11649-11653, K. Tribe Post-Keynesian Thought, Pages 11849-11856, G. C. Harcourt Psychiatric Care, Economics of, Pages 12267-12272, S. Tyutyulkova and S. S. Sharfstein Psychology and Economics, Pages 12390-12396, K. Fiedler and M. Wänke Science, Economics of, Pages 13664-13668, W. E. Steinmueller Search, Economics of, Pages 13760-13768, C. A. Pissarides Transaction Costs and Property Rights, Pages 15840-15845, O. E. Williamson The abstract for each article can be linked from the article link. An example of an Abstract link is that for the article "Economics: Overview" above. See also Economics handbooks List of encyclopedias by branch of knowledge International Encyclopedia of the Social Sciences (1968) The New Palgrave: A Dictionary of Economics (1987) The New Palgrave Dictionary of Economics, 2nd Edition (2008) References Further reading External links Official website: 2nd ed., 1st ed. American encyclopedias Social sciences literature 21st-century encyclopedias Encyclopedias of science 2001 non-fiction books

Psychodynamic Diagnostic Manual

The Psychodynamic Diagnostic Manual (PDM) is a diagnostic handbook similar to the International Statistical Classification of Diseases and Related Health Problems (ICD) or the Diagnostic and Statistical Manual of Mental Disorders (DSM). The PDM was published on May 28, 2006. The information contained in the PDM was collected by a collaborative task force which includes members of the American Psychoanalytic Association, the International Psychoanalytical Association, the Division of Psychoanalysis (Division 39) of the American Psychological Association, the American Academy of Psychoanalysis and Dynamic Psychiatry, and the National Membership Committee on Psychoanalysis in Clinical Social Work. Although it is based on current neuroscience and treatment outcome studies, Benedict Carey pointed out in a 2006 New York Times article that many of the concepts in the PDM are adapted from the classical psychoanalytic tradition of psychotherapy. For example, the PDM indicates that the anxiety disorders may be traced to the "four basic danger situations" described by Sigmund Freud (1926) as the loss of a significant other; the loss of love; the loss of body integrity; and the loss of affirmation by one's own conscience. It uses a new perspective on the existing diagnostic system as it enables clinicians to describe and categorize personality patterns, related social and emotional capacities, unique mental profiles, and personal experiences of the patient. The PDM is not intended to compete with the DSM or ICD. The authors report the work emphasizes "individual variations as well as commonalities" by "focusing on the full range of mental functioning" and serves as a "[complement to] the DSM and ICD efforts in cataloguing symptoms. The task force intends for the PDM to augment the existing diagnostic taxonomies by providing "a multi dimensional approach to describe the intricacies of the patient's overall functioning and ways of engaging in the therapeutic process." With the publication of the DSM-3 in 1980, the manual switched from a psychoanalytically influenced dimensional model to a "neo-Kraepelinian" descriptive symptom-focused model based on present versus absent symptoms. The PDM provided a return to a psychodynamic model for the nosological evaluation of symptom clusters, personality dimensions, and dimensions of mental functioning. Taxonomy Dimension I: Personality Patterns and Disorders This first dimension classifies personality patterns in two domains. First, it looks at the spectrum of personality types and places the person's personality on a continuum from unhealthy and maladaptive to healthy and adaptive. Second, it classifies how the person "organizes mental functioning and engages the world". The task force adds, "This dimension has been placed first in the PDM system because of the accumulating evidence that symptoms or problems cannot be understood, assessed, or treated in the absence of an understanding of the mental life of the person who has the symptoms". In other words, a list of symptoms characteristic of a diagnosis does not adequately inform a clinician how to understand and treat the symptoms without proper context. By analogy, if a patient went to her physician complaining of watering eyes and a runny nose, the symptoms alone do not indicate the appropriate treatment. Her symptoms could be a function of seasonal allergies, a bacterial sinus infection, the common cold, or she may have just come from her grandmother's funeral. The doctor might treat allergies with an antihistamine, the sinus infection with antibiotics, the cold with zinc, and give her patient a Kleenex tissue after the funeral. All four conditions may have very similar symptoms; all four condition are treated very differently. Dimension II: Mental Functioning Next, the PDM provides a "detailed description of emotional functioning" which are understood to be "the capacities that contribute to an individual's personality and overall level of psychological health or pathology". This dimension provides a "microscopic" examination of the patient's mental life by systematically accounting for their functional capacity to Process information Self-regulate Establish and maintain relationships Experience, organize, and express feelings and emotions at different levels Represent, differentiate, and integrate experience Utilize appropriate coping strategies and defense mechanisms Accurately observe oneself and others Form internal values and standards Dimension III: Manifest Symptoms and Concerns The third dimension starts with the DSM-IV-TR diagnostic categories; moreover, beyond simply listing symptoms, the PDM "goes on to describe the affective states, cognitive processes, somatic experiences, and relational patterns most often associated clinically" with each diagnosis. In this dimension, "symptom clusters" are "useful descriptors" which presents the patient's "symptom patterns in terms of the patient's personal experience of his or her prevailing difficulties". The task force concludes, "The patient may evidence a few or many patterns, which may or may not be related, and which should be seen in the context of the person's personality and mental functioning. The multi dimensional approach... provides a systematic way to describe patients that is faithful to their complexity and helpful in planning appropriate treatments". The new edition (PDM-2) Guilford Press published a new edition of the Psychodynamic Diagnostic Manual (PDM-2), developed by a steering committee composed by Vittorio Lingiardi (Editor), Nancy McWilliams (Editor), and Robert S. Wallerstein (Honorary Chair). Guilford Press received a manuscript for PDM-2 in September 2016, and the release date was June 20, 2017. Like the PDM-1, the PDM-2 classifies patients on three axes: 'P-Axis - Personality Syndromes', 'M-Axis - Profiles of Mental Functioning', and 'S-Axis - Symptom Patterns: The Subjective Experience'. The P-Axis is intended to be viewed as a "map" of personality instead of a listing of personality disorders as in the DSM-5 and ICD-10. The PDM-2 defines different terms as part of the P-Axis including "personality", "character", "temperament", "traits", "type", "style", and "defense". The S-Axis bears a lot of similarity to the DSM and ICD due to the inclusion of predominantly psychotic disorders, mood disorders, disorders related primarily to anxiety, event- and stressor-related disorders, somatic symptom disorders and addiction disorders. See also Diagnostic and Statistical Manual of Mental Disorders DSM-IV Codes International Statistical Classification of Diseases and Related Health Problems ICD-10 Research Domain Criteria (RDoC), a framework being developed by the National Institute of Mental Health References External links Website of the Psychodynamic Diagnostic Manual APA News monitor: Five psychoanalytic associations collaborate to publish a new diagnostic manual. 2006 non-fiction books Medical manuals Classification of mental disorders Books about psychoanalysis

Evolutionary medicine

Evolutionary medicine or Darwinian medicine is the application of modern evolutionary theory to understanding health and disease. Modern biomedical research and practice have focused on the molecular and physiological mechanisms underlying health and disease, while evolutionary medicine focuses on the question of why evolution has shaped these mechanisms in ways that may leave us susceptible to disease. The evolutionary approach has driven important advances in the understanding of cancer, autoimmune disease, and anatomy. Medical schools have been slower to integrate evolutionary approaches because of limitations on what can be added to existing medical curricula. The International Society for Evolution, Medicine and Public Health coordinates efforts to develop the field. It owns the Oxford University Press journal Evolution, Medicine and Public Health and The Evolution and Medicine Review. Core principles Utilizing the Delphi method, 56 experts from a variety of disciplines, including anthropology, medicine, nursing, and biology agreed upon 14 core principles intrinsic to the education and practice of evolutionary medicine. These 14 principles can be further grouped into five general categories: question framing, evolution I and II (with II involving a higher level of complexity), evolutionary trade-offs, reasons for vulnerability, and culture. Additional information regarding these principles may be found in the table below. Human adaptations Adaptation works within constraints, makes compromises and trade-offs, and occurs in the context of different forms of competition. Constraints Adaptations can only occur if they are evolvable. Some adaptations which would prevent ill health are therefore not possible. DNA cannot be totally prevented from undergoing somatic replication corruption; this has meant that cancer, which is caused by somatic mutations, has not (so far) been eliminated by natural selection. Humans cannot biosynthesize vitamin C, and so risk scurvy, vitamin C deficiency disease, if dietary intake of the vitamin is insufficient. Retinal neurons and their axon output have evolved to be inside the layer of retinal pigment cells. This creates a constraint on the evolution of the visual system such that the optic nerve is forced to exit the retina through a point called the optic disc. This, in turn, creates a blind spot. More importantly, it makes vision vulnerable to increased pressure within the eye (glaucoma) since this cups and damages the optic nerve at this point, resulting in impaired vision. Other constraints occur as the byproduct of adaptive innovations. Trade-offs and conflicts One constraint upon selection is that different adaptations can conflict, which requires a compromise between them to ensure an optimal cost-benefit tradeoff. Running efficiency in women, and birth canal size Encephalization, and gut size Skin pigmentation protection from UV, and the skin synthesis of vitamin D Speech and its use of a descended larynx, and increased risk of choking Competition effects Different forms of competition exist and these can shape the processes of genetic change. mate choice and disease susceptibility genomic conflict between mother and fetus that results in pre-eclampsia Lifestyle Humans evolved to live as simple hunter-gatherers in small tribal bands, while contemporary humans have a more complex life. This change may make present-day humans susceptible to lifestyle diseases. Diet In contrast to the diet of early hunter-gatherers, the modern Western diet often contains high quantities of fat, salt, and simple carbohydrates, such as refined sugars and flours. Trans fat health risks Dental caries High GI foods Modern diet based on "common wisdom" regarding diets in the paleolithic era Among different countries, the incidence of colon cancer varies widely, and the extent of exposure to a Western pattern diet may be a factor in cancer incidence. Life expectancy Examples of aging-associated diseases are atherosclerosis and cardiovascular disease, cancer, arthritis, cataracts, osteoporosis, type 2 diabetes, hypertension and Alzheimer's disease. The incidence of all of these diseases increases rapidly with aging (increases exponentially with age, in the case of cancer). Of the roughly 150,000 people who die each day across the globe, about two thirds—100,000 per day—die of age-related causes. In industrialized nations, the proportion is much higher, reaching 90%. Exercise Many contemporary humans engage in little physical exercise compared to the physically active lifestyles of ancestral hunter-gatherers. Prolonged periods of inactivity may have only occurred in early humans following illness or injury, so a modern sedentary lifestyle may continuously cue the body to trigger life preserving metabolic and stress-related responses such as inflammation, and some theorize that this causes chronic diseases. Cleanliness Contemporary humans in developed countries are mostly free of parasites, particularly intestinal ones. This is largely due to frequent washing of clothing and the body, and improved sanitation. Although such hygiene can be very important when it comes to maintaining good health, it can be problematic for the proper development of the immune system. The hygiene hypothesis is that humans evolved to be dependent on certain microorganisms that help establish the immune system, and modern hygiene practices can prevent necessary exposure to these microorganisms. "Microorganisms and macroorganisms such as helminths from mud, animals, and feces play a critical role in driving immunoregulation" (Rook, 2012). Essential microorganisms play a crucial role in building and training immune functions that fight off and repel some diseases, and protect against excessive inflammation, which has been implicated in several diseases. For instance, recent studies have found evidence supporting inflammation as a contributing factor in Alzheimer's Disease. Specific explanations This is a partial list: all links here go to a section describing or debating its evolutionary origin. Life stage related Adipose tissue in human infants Arthritis and other chronic inflammatory diseases Ageing Alzheimer disease Childhood Menarche Menopause Menstruation Morning sickness Other Atherosclerosis Arthritis and other chronic inflammatory diseases Cough] Cystic fibrosis Dental occlusion Diabetes Type II Diarrhea Essential hypertension Fever Gestational hypertension Gout Iron deficiency (paradoxical benefits) Obesity Phenylketonuria Placebos Osteoporosis Red blood cell polymorphism disorders Sickle cell anemia Sickness behavior Women's reproductive cancers Evolutionary psychology As noted in the table below, adaptationist hypotheses regarding the etiology of psychological disorders are often based on analogies with evolutionary perspectives on medicine and physiological dysfunctions (see in particular, Randy Nesse and George C. Williams' book Why We Get Sick). Evolutionary psychiatrists and psychologists suggest that some mental disorders likely have multiple causes. See several topic areas, and the associated references, below. Agoraphobia Anxiety Depression Drug abuse Schizophrenia Unhappiness History Charles Darwin did not discuss the implications of his work for medicine, though biologists quickly appreciated the germ theory of disease and its implications for understanding the evolution of pathogens, as well as an organism's need to defend against them. Medicine, in turn, ignored evolution, and instead focused (as done in the hard sciences) upon proximate mechanical causes. George C. Williams was the first to apply evolutionary theory to health in the context of senescence. Also in the 1950s, John Bowlby approached the problem of disturbed child development from an evolutionary perspective upon attachment. An important theoretical development was Nikolaas Tinbergen's distinction made originally in ethology between evolutionary and proximate mechanisms. Randolph M. Nesse summarizes its relevance to medicine: The paper of Paul Ewald in 1980, "Evolutionary Biology and the Treatment of Signs and Symptoms of Infectious Disease", and that of Williams and Nesse in 1991, "The Dawn of Darwinian Medicine" were key developments. The latter paper "draw a favorable reception",page x and led to a book, Why We Get Sick (published as Evolution and healing in the UK). In 2008, an online journal started: Evolution and Medicine Review. In 2000, Paul Sherman hypothesised that morning sickness could be an adaptation that protects the developing fetus from foodborne illnesses, some of which can cause miscarriage or birth defects, such as listeriosis and toxoplasmosis. See also Evolutionary therapy Evolutionary psychiatry Evolutionary physiology Evolutionary psychology Evolutionary developmental psychopathology Evolutionary approaches to depression Illness Paleolithic lifestyle Universal Darwinism References Further reading Books Online articles External links Evolution and Medicine Network Special Issue of Evolutionary Applications on Evolutionary Medicine Evolutionary biology Clinical medicine

Clinical neuroscience

Clinical neuroscience is a branch of neuroscience that focuses on the scientific study of fundamental mechanisms that underlie diseases and disorders of the brain and central nervous system. It seeks to develop new ways of conceptualizing and diagnosing such disorders and ultimately of developing novel treatments. A clinical neuroscientist is a scientist who has specialized knowledge in the field. Not all clinicians are clinical neuroscientists. Clinicians and scientists -including psychiatrists, neurologists, clinical psychologists, neuroscientists, and other specialists—use basic research findings from neuroscience in general and clinical neuroscience in particular to develop diagnostic methods and ways to prevent and treat neurobiological disorders. Such disorders include addiction, Alzheimer's disease, amyotrophic lateral sclerosis, anxiety disorders, attention deficit hyperactivity disorder, autism, bipolar disorder, brain tumors, depression, Down syndrome, dyslexia, epilepsy, Huntington's disease, multiple sclerosis, neurological AIDS, neurological trauma, pain, obsessive-compulsive disorder, Parkinson's disease, schizophrenia, sleep disorders, stroke and Tourette syndrome. While neurology, neurosurgery and psychiatry are the main medical specialties that use neuroscientific information, other specialties such as cognitive neuroscience, neuroradiology, neuropathology, ophthalmology, otorhinolaryngology, anesthesiology and rehabilitation medicine can contribute to the discipline. Integration of the neuroscience perspective alongside other traditions like psychotherapy, social psychiatry or social psychology will become increasingly important. One Mind for Research The "One Mind for Research" forum was a convention held in Boston, Massachusetts on May 23–25, 2011 that produced the blueprint document A Ten-Year Plan for Neuroscience: From Molecules to Brain Health. Leading neuroscience researchers and practitioners in the United States contributed to the creation of this document, in which 17 key areas of opportunities are listed under the Clinical Neuroscience section. These include the following: Rethinking curricula to break down intellectual silos Training translational neuroscientists and clinical investigators Investigating biomarkers Improving psychiatric diagnosis Developing a “Framingham Study of Brain Disorders” (i.e. longitudinal cohort for central nervous system disease) Identifying developmental risk factors and producing effective interventions Discovering new treatments for pain, including neuropathic pain Treating disorders of neural signaling and pathological synchrony Treating disorders of immunity or inflammation Treating metabolic and mitochondrial disorders Developing new treatments for depression Treating addictive disorders Improving treatment of schizophrenia Preventing and treating cerebrovascular disease Achieving personalized medicine Understanding shared mechanisms of neurodegeneration Advancing anesthesia In particular, it advocates for better integrated and scientifically driven curricula for practitioners, and it recommends that such curricula be shared among neurologists, psychiatrists, psychologists, neurosurgeons and neuroradiologists. Given the various ethical, legal and societal implications for healthcare practitioners arising from advances in neuroscience, the University of Pennsylvania inaugurated the Penn Conference on Clinical Neuroscience and Society in July 2011. See also Behavioral neurology Neuropsychiatry Neuropsychology Society for Neuroscience Cognitive neuroscience References Clinical neuroscience

Domain knowledge

Domain knowledge is knowledge of a specific discipline or field in contrast to general (or domain-independent) knowledge. The term is often used in reference to a more general discipline—for example, in describing a software engineer who has general knowledge of computer programming as well as domain knowledge about developing programs for a particular industry. People with domain knowledge are often regarded as specialists or experts in their field. Knowledge capture In software engineering, domain knowledge is knowledge about the environment in which the target system operates, for example, software agents. Domain knowledge usually must be learned from software users in the domain (as domain specialists/experts), rather than from software developers. It may include user workflows, data pipelines, business policies, configurations and constraints and is crucial in the development of a software application. Expert domain knowledge (frequently informal and ill-structured) is transformed in computer programs and active data, for example in a set of rules in knowledge bases, by knowledge engineers. Communicating between end-users and software developers is often difficult. They must find a common language to communicate in. Developing enough shared vocabulary to communicate can often take a while. The same knowledge can be included in different domain knowledge. Knowledge which may be applicable across a number of domains is called domain-independent knowledge, for example logic and mathematics. Operations on domain knowledge are performed by metaknowledge. See also Artificial intelligence Domain (software engineering) Domain engineering Domain of discourse Knowledge engineering Subject-matter expert Literature Hjørland, B. & Albrechtsen, H. (1995). Toward A New Horizon in Information Science: Domain Analysis. Journal of the American Society for Information Science, 1995, 46(6), p. 400–425. Knowledge engineering

Synectics

Synectics is a problem solving methodology that stimulates thought processes of which the subject may be unaware. This method was developed by George M. Prince (1918–2009) and William J.J. Gordon, originating in the Arthur D. Little Invention Design Unit in the 1950s. According to Gordon, Synectics research has three main assumptions: the creative process can be described and taught invention processes in arts and sciences are analogous and are driven by the same "psychic" processes individual and group creativity are analogous History The process was derived from tape-recording (initially audio, later video) meetings, analysis of the results, and experiments with alternative ways of dealing with the obstacles to success in the meeting. "Success" was defined as getting a creative solution that the group was committed to implement. The name Synectics comes from Greek and means "the joining together of different and apparently irrelevant elements." Gordon and Prince named both their practice and their new company Synectics, which can cause confusion, as people not part of the company are trained and use the practice. While the name was trademarked, it has become a standard word for describing creative problem solving in groups. Theory Synectics is a way to approach creativity and problem-solving in a rational way. "Traditionally, the creative process has been considered after the fact... The Synectics study has attempted to research creative process in vivo, while it is going on." According to Gordon, Synectics research has three main assumptions: The creative process can be described and taught; Invention processes in arts and sciences are analogous and are driven by the same "psychic" processes; Individual and group creativity are analogous. With these assumptions in mind, Synectics believes that people can be better at being creative if they understand how creativity works. One important element in creativity is embracing the seemingly irrelevant. Emotion is emphasized over intellect and the irrational over the rational. Through understanding the emotional and irrational elements of a problem or idea, a group can be more successful at solving a problem. Prince emphasized the importance of creative behaviour in reducing inhibitions and releasing the inherent creativity of everyone. He and his colleagues developed specific practices and meeting structures which help people to ensure that their constructive intentions are experienced positively by one another. The use of the creative behaviour tools extends the application of Synectics to many situations beyond invention sessions (particularly constructive resolution of conflict). Gordon emphasized the importance of metaphorical process' to make the familiar strange and the strange familiar". He expressed his central principle as: "Trust things that are alien, and alienate things that are trusted." This encourages, on the one hand, fundamental problem-analysis and, on the other hand, the alienation of the original problem through the creation of analogies. It is thus possible for new and surprising solutions to emerge. As an invention tool, Synectics invented a technique called "springboarding" for getting creative beginning ideas. For the development of beginning ideas, the method incorporates brainstorming and deepens and widens it with metaphor; it also adds an important evaluation process for Idea Development, which takes embryonic new ideas that are attractive but not yet feasible and builds them into new courses of action which have the commitment of the people who will implement them. Synectics is more demanding of the subject than brainstorming, as the steps involved imply that the process is more complicated and requires more time and effort. The success of the Synectics methodology depends highly on the skill of a trained facilitator. Books The Practice of Creativity: A Manual for Dynamic Group Problem-Solving. George M. Prince, 2012, Vermont: Echo Point Books & Media, LLC, 0-9638-7848-4 The Practice of Creativity by George Prince 1970 Synectics: The Development of Creative Capacity by W. J. J. Gordon, London, Collier-MacMillan, 1961 Design Synectics: Stimulating Creativity in Design by Nicholas Roukes, Published by Davis Publications, 1988 The Innovators Handbook by Vincent Nolan 1989 Creativity Inc.: Building an Inventive Organization by Jeff Mauzy and Richard Harriman 2003 Imagine That! by Vincent Nolan and Connie Williams, Publishers Graphics, LLC, 2010 See also List of thought processes References External links George Prince website "Thoughts on Creativity" Synecticsworld's Founders page on George M. Prince and Bill Gordon Creativity Problem solving

Denial (Freud)

Denial or abnegation is a psychological defense mechanism postulated by psychoanalyst Sigmund Freud, in which a person is faced with a fact that is too uncomfortable to accept and rejects it instead, insisting that it is not true despite what may be overwhelming evidence. The subject may use: simple denial: deny the reality of the unpleasant fact altogether minimisation: admit the fact but deny its seriousness (a combination of denial and rationalization) projection: admit both the fact and seriousness but deny responsibility by blaming somebody or something else Description The theory of denial was first researched seriously by Anna Freud. She classified denial as a mechanism of the immature mind because it conflicts with the ability to learn from and cope with reality. Where denial occurs in mature minds, it is most often associated with death, dying and rape. More recent research has significantly expanded the scope and utility of the concept. Elisabeth Kübler-Ross used denial as the first of five stages in the psychology of a dying patient, and the idea has been extended to include the reactions of survivors to news of a death. Many contemporary psychoanalysts treat denial as the first stage of a coping cycle. When an unwelcome change occurs, a trauma of some sort, the first impulse to disbelieve begins the process of coping. That denial, in a healthy mind, slowly rises to greater consciousness. Gradually becoming a subconscious pressure, just beneath the surface of overt awareness, the mechanism of coping then involves repression, while the person accumulates the emotional resources to fully face the trauma. Once faced, the person deals with the trauma in a stage alternately called acceptance or enlightenment, depending on the scope of the issue and the therapist's school of thought. After this stage, once sufficiently dealt with, or dealt with for the time being, the trauma must sink away from total conscious awareness again. Left out of the conscious mind, the process of sublimation involves a balance of neither quite forgetting nor quite remembering. This allows the trauma to re-emerge in consciousness if it involves an ongoing process such as a protracted illness. Alternately, sublimation may begin the full resolution process, where the trauma finally sinks away into eventual forgetfulness. Occasionally this entire cycle has been referred to in modern parlance as denial, confusing the full cycle with only one stage of it. To further muddy discourse, the terms denial and cycle of denial sometimes get used to refer to an unhealthy, dysfunctional cycle of unresolved coping, particularly with regard to addiction and compulsion. Unlike some other defense mechanisms postulated by psychoanalytic theory (for instance, repression), the general existence of denial is fairly easy to verify, even for non-specialists. However, denial is one of the most controversial defense mechanisms, since it can be easily used to create unfalsifiable theories: anything the subject says or does that appears to disprove the interpreter's theory is explained, not as evidence that the interpreter's theory is wrong, but as the subject's being "in denial". However, researchers note that in some cases of corroborated child sexual abuse, the victims sometimes make a series of partial confessions and recantations as they struggle with their own denial and the denial of abusers or family members. Use of denial theory in a legal setting, therefore, is carefully regulated and experts' credentials verified. "Formulaic guilt" simply by "being a denier" has been castigated by English judges and academics. The main objection is that denial theory is founded on the premise that which the supposed denier is denying the truth. This usurps the judge (and jury) as triers of fact. Denial is especially characteristic of mania, hypomania, and generally of people with bipolar affective disorder in the manic stage – in this state, one can deny, remarkably a long period of time, the fact that one has fatigue, hunger, negative emotions and problems in general, until one is physically exhausted. Denial and disavowal Freud employs the term (usually translated either as "disavowal" or as "denial") as distinct from (usually translated as "denial" or as "abnegation"). In Verleugnung, the defense consists of denying something that affects the individual and is a way of affirming what he or she is apparently denying. For Freud, Verleugnung is related to psychoses, whereas Verdrängung is a neurotic defense mechanism. Freud broadened his clinical work on disavowal beyond the realm of psychosis. In "Fetishism" (1927), he reported a case of two young men each of whom denied the death of his father. Freud notes that neither of them developed a psychosis, even though "a piece of reality which was undoubtedly important has been disavowed [verleugnet], just as the unwelcome fact of women's castration is disavowed in fetishists." Types Denial of fact In this form of denial, someone avoids a fact by utilizing deception. This lying can take the form of an outright falsehood (commission), leaving out certain details to tailor a story (omission), or by falsely agreeing to something (assent). Someone who is in denial of fact is typically using lies to avoid facts they think may be painful to themselves or others. Denial of responsibility This form of denial involves avoiding personal responsibility by: blaming: a direct statement shifting culpability and may overlap with denial of fact minimizing: an attempt to make the effects or results of an action appear to be less harmful than they may actually be justifying: when someone takes a choice and attempts to make that choice appear acceptable due to their perception of what is right in a situation regression: when someone acts in a way unbecoming of their age Someone using denial of responsibility is usually attempting to avoid potential harm or pain by shifting attention away from themselves. Denial of impact Denial of impact involves a person's avoiding thinking about or understanding the harms of his or her behavior has caused to self or others, i.e. denial of consequences. Doing this enables that person to avoid feeling a sense of guilt and it can prevent him or her from developing remorse or empathy for others. Denial of impact reduces or eliminates a sense of pain or harm from poor decisions. Denial of awareness This form of denial attempts to divert pain by claiming that the level of awareness was inhibited by some mitigating variable. This is most typically seen in addiction situations where drug or alcohol abuse is a factor, though it also occasionally manifests itself in relation to mental health issues or the pharmaceutical substances used to treat mental health issues. This form of denial may also overlap with denial of responsibility. See also Screen memory References Further reading Defence mechanisms

Recovery model

The recovery model, recovery approach or psychological recovery is an approach to mental disorder or substance dependence that emphasizes and supports a person's potential for recovery. Recovery is generally seen in this model as a personal journey rather than a set outcome, and one that may involve developing hope, a secure base and sense of self, supportive relationships, empowerment, social inclusion, coping skills, and meaning. Recovery sees symptoms as a continuum of the norm rather than an aberration and rejects sane-insane dichotomy. William Anthony, Director of the Boston Centre for Psychiatric Rehabilitation developed a cornerstone definition of mental health recovery in 1993. "Recovery is a deeply personal, unique process of changing one's attitudes, values, feelings, goals, skills and/or roles. It is a way of living a satisfying, hopeful, and contributing life even with limitations caused by the illness. Recovery involves the development of new meaning and purpose in one's life as one grows beyond the catastrophic effects of mental illness." The concept of recovery in mental health emerged as deinstitutionalization led to more individuals living in the community. It gained momentum as a social movement in response to a perceived failure by services or wider society to adequately support social inclusion, coupled with studies demonstrating that many people do recover. A recovery-oriented approach has since been explicitly embraced as the guiding principle of mental health and substance dependency policies in numerous countries and states. Practical measures are being implemented in many cases to align services with a recovery model, although various obstacles, concerns, and criticisms have been raised by both service providers and recipients of services. Several standardized measures have been developed to assess different aspects of recovery, although there is some divergence between professionalized models and those originating in the psychiatric survivors movement. According to a study, a combined social and physical environment intervention has the potential to enhance the need for recovery. However, the study's focus on a general healthy and well-functioning population posed challenges in achieving significant impact. The researchers suggested implementing the intervention among a population with higher baseline values on the need for recovery and providing opportunities for physical activity, such as organizing lunchtime walking or yoga classes at work. Additionally, they recommended strategically integrating a social media platform with incentives for regular use, linking it to other platforms like Facebook, and considering more drastic physical interventions, such as restructuring an entire department floor, to enhance the intervention's effectiveness. The study concluded that relatively simple environment modifications, such as placing signs to promote stair use, did not lead to changes in the need for recovery. History In general medicine and psychiatry, recovery has long been used to refer to the end of a particular experience or episode of illness. The broader concept of "recovery" as a general philosophy and model was first popularized in regard to recovery from substance abuse/drug addiction, for example within twelve-step programs or the California Sober method. Mental health recovery emerged in Geel, Belgium in the 13th century. Saint Dymphna—the patron saint of mental illness—was martyred there by her father in the 7th century. The Church of Saint Dymphna (built in 1349) became a pilgrimage destination for those seeking help with their psychiatric conditions. By the late 1400s, so many pilgrims were coming to Geel that the townspeople began hosting them as guests in their homes. This tradition of community recovery continues to this day. More widespread application of recovery models to psychiatric disorders is comparatively recent. The concept of recovery can be traced back as far as 1840, when John Thomas Perceval, son of Prime Minister Spencer Perceval, wrote of his personal recovery from the psychosis that he experienced from 1830 until 1832, a recovery that he obtained despite the "treatment" he received from the "lunatic" doctors who attended him. But by consensus the main impetus for the development came from within the consumer/survivor/ex-patient movement, a grassroots self-help and advocacy initiative, particularly within the United States during the late 1980s and early 1990s. The professional literature, starting with the psychiatric rehabilitation movement in particular, began to incorporate the concept from the early 1990s in the United States, followed by New Zealand and more recently across nearly all countries within the "First World". Similar approaches developed around the same time, without necessarily using the term recovery, in Italy, the Netherlands and the UK. Developments were fueled by a number of long-term outcome studies of people with "major mental illnesses" in populations from virtually every continent, including landmark cross-national studies by the World Health Organization from the 1970s and 1990s, showing unexpectedly high rates of complete or partial recovery, with exact statistics varying by region and the criteria used. The cumulative impact of personal stories or testimony of recovery has also been a powerful force behind the development of recovery approaches and policies. A key issue became how service consumers could maintain the ownership and authenticity of recovery concepts while also supporting them in professional policy and practice. Increasingly, recovery became both a subject of mental health services research and a term emblematic of many of the goals of the Consumer/Survivor/Ex-Patient Movement. The concept of recovery was often defined and applied differently by consumers/survivors and professionals. Specific policy and clinical strategies were developed to implement recovery principles although key questions remained. Elements of recovery It has been emphasized that each individual's journey to recovery is a deeply personal process, as well as being related to an individual's community and society. A number of features or signs of recovery have been proposed as often core elements and comprehensively they have been categorized under the concept of CHIME. CHIME is a mnemonic of connectedness, hope & optimism, identity, meaning & purpose and empowerment. Connectedness and supportive relationships A common aspect of recovery is said to be the presence of others who believe in the person's potential to recover and who stand by them. According to Relational Cultural Theory as developed by Jean Baker Miller, recovery requires mutuality and empathy in relationships. The theory states this requires relationships that embody respect, authenticity, and emotional availability. Supportive relationships can also be made safer through predictability and avoiding shaming and violence. While mental health professionals can offer a particular limited kind of relationship and help foster hope, relationships with friends, family and the community are said to often be of wider and longer-term importance. Case managers can play the role of connecting recovering persons to services that the recovering person may have limited access to, such as food stamps and medical care. Others who have experienced similar difficulties and are on a journey of recovery can also play a role in establishing community and combating a recovering person's feelings of isolation. An example of a recovery approach that fosters a sense of community to combat feelings of isolation is the safe house or transitional housing model of rehabilitation. This approach supports victims of trauma through a community-centered, transitional housing method that provides social services, healthcare, and psychological support to navigate through and past experiences. Safe houses aim to support survivors on account of their individual needs and can effectively rehabilitate those recovering from issues such as sexual violence and drug addiction without criminalization. Additionally, safe houses provide a comfortable space where survivors can be listened to and uplifted through compassion. In practice, this can be accomplished through one on one interviews with other recovering persons, engaging in communal story circles, or peer-led support groups. Those who share the same values and outlooks more generally (not just in the area of mental health) may also be particularly important. It is said that one-way relationships based on being helped can actually be devaluing and potentially re-traumatizing, and that reciprocal relationships and mutual support networks can be of more value to self-esteem and recovery. Hope Finding and nurturing hope has been described as a key to recovery. It is said to include not just optimism but a sustainable belief in oneself and a willingness to persevere through uncertainty and setbacks. Hope may start at a certain turning point, or emerge gradually as a small and fragile feeling, and may fluctuate with despair. It is said to involve trusting, and risking disappointment, failure and further hurt. Identity Recovery of a durable sense of self (if it had been lost or taken away) has been proposed as an important element. A research review suggested that people sometimes achieve this by "positive withdrawal"—regulating social involvement and negotiating public space in order to only move towards others in a way that feels safe yet meaningful; and nurturing personal psychological space that allows room for developing understanding and a broad sense of self, interests, spirituality, etc. It was suggested that the process is usually greatly facilitated by experiences of interpersonal acceptance, mutuality, and a sense of social belonging; and is often challenging in the face of the typical barrage of overt and covert negative messages that come from the broader social context. Being able to move on can mean having to cope with feelings of loss, which may include despair and anger. When an individual is ready for change, a process of grieving is initiated. It may require accepting past suffering and lost opportunities or lost time. Formation of healthy coping strategies and meaningful internal schema The development of personal coping strategies (including self-management or self-help) is said to be an important element. This can involve making use of medication or psychotherapy if the patient is fully informed and listened to, including about adverse effects and about which methods fit with the consumer's life and their journey of recovery. Developing coping and problem solving skills to manage individual traits and problem issues (which may or may not be seen as symptoms of mental disorder) may require a person becoming their own expert, in order to identify key stress points and possible crisis points, and to understand and develop personal ways of responding and coping. Developing a sense of meaning and overall purpose is said to be important for sustaining the recovery process. This may involve recovering or developing a social or work role. It may also involve renewing, finding or developing a guiding philosophy, religion, politics or culture. From a postmodern perspective, this can be seen as developing a narrative. Empowerment and building a secure base Building a positive culture of healing is essential in the recovery approach. Since recovering is a long process, a strong supportive network can be helpful. Appropriate housing, a sufficient income, freedom from violence, and adequate access to health care have also been proposed as important tools to empowering someone and increasing her/his self-sufficiency. Empowerment and self-determination are said to be important to recovery for reducing the social and psychological effects of stress and trauma. Women's Empowerment Theory suggests that recovery from mental illness, substance abuse, and trauma requires helping survivors understand their rights so they can increase their capacity to make autonomous choices. This can mean develop the confidence for independent assertive decision making and help-seeking which translates into proper medication and active self care practices. Achieving social inclusion and overcoming challenging social stigma and prejudice about mental distress/disorder/difference is also an important part of empowerment. Advocates of Women's Empowerment Theory argue it is important to recognize that a recovering person's view of self is perpetuated by stereotypes and combating those narratives. Empowerment according to this logic requires reframing a survivor's view of self and the world. In practice, empowerment and building a secure base require mutually supportive relationships between survivors and service providers, identifying a survivor's existing strengths, and an awareness of the survivor's trauma and cultural context. Concepts of recovery Varied definitions What constitutes 'recovery', or a recovery model, is a matter of ongoing debate both in theory and in practice. In general, professionalized clinical models tend to focus on improvement in particular symptoms and functions, and on the role of treatments, while consumer/survivor models tend to put more emphasis on peer support, empowerment and real-world personal experience. "Recovery from", the medical approach, is defined by a dwindling of symptoms, whereas "recovery in", the peer approach, may still involve symptoms, but the person feels they are gaining more control over their life. Similarly, recovery may be viewed in terms of a social model of disability rather than a medical model of disability, and there may be differences in the acceptance of diagnostic "labels" and treatments. A review of research suggested that writers on recovery are rarely explicit about which of the various concepts they are employing. The reviewers classified the approaches they found in to broadly "rehabilitation" perspectives, which they defined as being focused on life and meaning within the context of enduring disability, and "clinical" perspectives which focused on observable remission of symptoms and restoration of functioning. From a psychiatric rehabilitation perspective, a number of additional qualities of the recovery process have been suggested, including that it: can occur without professional intervention, but requires people who believe in and stand by the person in recovery; does not depend on believing certain theories about the cause of conditions; can be said to occur even if symptoms later re-occur, but does change the frequency and duration of symptoms; requires recovery from the consequences of a psychiatric condition as well as the condition itself; is not linear but does tend to take place as a series of small steps; does not mean the person was never really psychiatrically disabled; focuses on wellness not illness, and on consumer choice. A consensus statement on mental health recovery from US agencies, that involved some consumer input, defined recovery as a journey of healing and transformation enabling a person with a mental health problem to live a meaningful life in a community of his or her choice while striving to achieve his or her full potential. Ten fundamental components were elucidated, all assuming that the person continues to be a "consumer" or to have a "mental disability". Conferences have been held on the importance of the "elusive" concept from the perspectives of consumers and psychiatrists. One approach to recovery known as the Tidal Model focuses on the continuous process of change inherent in all people, conveying the meaning of experiences through water metaphors. Crisis is seen as involving opportunity; creativity is valued; and different domains are explored such as sense of security, personal narrative and relationships. Initially developed by mental health nurses along with service users, Tidal is a particular model that has been specifically researched. Based on a discrete set of values (the Ten Commitments), it emphasizes the importance of each person's own voice, resourcefulness and wisdom. Since 1999, projects based on the Tidal Model have been established in several countries. For many, recovery has a political as well as personal implication—where to recover is to: find meaning; challenge prejudice (including diagnostic "labels" in some cases); perhaps to be a "bad" non-compliant patient and refuse to accept the indoctrination of the system; to reclaim a chosen life and place within society; and to validate the self. Recovery can thus be viewed as one manifestation of empowerment. Such an empowerment model may emphasize that conditions are not necessarily permanent; that other people have recovered who can be role models and share experiences; and that "symptoms" can be understood as expressions of distress related to emotions and other people. One such model from the US National Empowerment Center proposes a number of principles of how people recover and seeks to identify the characteristics of people in recovery. In general, recovery may be seen as more of a philosophy or attitude than a specific model, requiring fundamentally that "we regain personal power and a valued place in our communities. Sometimes we need services to support us to get there". Recovery from substance dependence Particular kinds of recovery models have been adopted in drug rehabilitation services. While interventions in this area have tended to focus on harm reduction, particularly through substitute prescribing (or alternatively requiring total abstinence) recovery approaches have emphasized the need to simultaneously address the whole of people's lives, and to encourage aspirations while promoting equal access and opportunities within society. Some examples of harm reduction services include overdose reversal medications (such as Narcan), substance testing kits, supplies for sterile injections, HIV, HBV, and HCV at-home testing equipment– and trauma-informed care in the form of group therapy, community building/events, case management, and rental assistance services. The purpose of this model is to rehabilitate those experiencing addiction in a holistic way rather than through law enforcement and criminal justice-based intervention which can fail to address victims’ circumstances on a need-by-need basis. From the perspective of services the work may include helping people with "developing the skills to prevent relapse into further illegal drug taking, rebuilding broken relationships or forging new ones, actively engaging in meaningful activities and taking steps to build a home and provide for themselves and their families. Milestones could be as simple as gaining weight, re-establishing relationships with friends, or building self-esteem. What is key is that recovery is sustained.". Key to the philosophy of the recovery movement is the aim for an equal relationship between "Experts by Profession" and "Experts by Experience". Trauma-Informed Recovery Trauma-Informed care is a philosophy for recovery that combines the conditions and needs of people recovering from mental illness and/or substance abuse into one framework. This framework combines all of the elements of the Recovery Approach and adds an awareness of trauma. Advocates of trauma-informed care argue the principles and strategies should be applied to individuals experiencing mental illness, substance dependence, and trauma as these three often occur simultaneously or as result of each other. The paradigms surrounding trauma-informed care began to shift in 1998 and 1999. In 1998, the Center for Mental Health Services, the Center for Substance Abuse Treatment, and the Center for Substance Abuse Prevention collaborated to fund 14 sites to develop integrated services in order to address the interrelated effects of violence, mental health, and substance abuse. In 1999, the National Association of State Mental Health Program Directors passed a resolution recognizing the impact of violence and trauma and developed a toolkit of resources for the implementation of trauma services in state mental health agencies. Trauma-informed care has been supported in academia as well. Scholars claim that neglecting the role of trauma in a person's story can interfere with recovery in the form of misdiagnosis, inaccurate treatment, or retraumatization. Some principles of trauma-informed care include validating survivor experiences and resiliency, aiming to increase a survivor's control over her/his/their recovery, creating atmospheres for recovery that embody consistency and confidentiality, minimizing the possibilities of triggering past trauma, and integrating survivors/recovering persons in service evaluation. In practice, trauma-informed care has shown to be most effective when every participant in a service providing context to be committed to following these principles. In addition, these principles can apply to all steps of the recovery process within a service providing context, including outreach and engagement, screening, advocacy, crisis intervention, and resource coordination. The overall goal in trauma-informed care is facilitating healing and empowerment using strengths-based empowerment practices and a comprehensive array of services that integrate co-occurring disorders and the multitude of needs a recovering person might have, such as drug treatment, housing, relationship building, and parenting support. These approaches are in contrast to traditional care systems. Advocates of trauma-informed care critique traditional service delivery systems, such as standard hospitals, for failing to understand the role of trauma in a patient's life. Traditional service delivery systems are also critiqued for isolating the conditions of a recovering person and not addressing conditions such as substance abuse and mental illness simultaneously as part of one source. Specific practices in traditional service delivery systems, such as unnecessary procedures, undressing for examinations, involuntary hospitalizations, crowded emergency rooms, and limited time for providers to meet with patients, have all been critiqued as insensitive to persons recovering from trauma and consequential mental illness or substance abuse. Limited resources and time in the United States healthcare system can make the implementation of trauma-informed care difficult. There are other challenges to trauma-informed care besides limits in the United States healthcare system that can make trauma-informed care ineffective for treating persons recovering from mental illness or substance dependence. Advocates of trauma-informed care argue implementation requires a strong commitment from leadership in an agency to train staff members to be trauma-aware, but this training can be costly and time-consuming. "Trauma-informed care" and "trauma" also have contested definitions and can be hard to measure in a real world service setting. Another barrier to trauma-informed care is the necessity of screening for histories of trauma. While agencies need to screen for histories of trauma in order to give the best care, there can be feelings of shame and fear of being invalidated that can prevent a recovering person from disclosing their personal experiences. Concerns Some concerns have been raised about a recovery approach in theory and in practice. These include suggestions that it: is an old concept; only happens to very few people; represents an irresponsible fad; happens only as a result of active treatment; implies a cure; can only be implemented with new resources; adds to the burden of already stretched providers; is neither reimbursable nor evidence based; devalues the role of professional intervention; and increases providers' exposure to risk and liability. Other criticisms focused on practical implementation by service providers include that: the recovery model can be manipulated by officials to serve various political and financial interests including withdrawing services and pushing people out before they're ready; that it is becoming a new orthodoxy or bandwagon that neglects the empowerment aspects and structural problems of societies and primarily represents a middle class experience; that it hides the continued dominance of a medical model; and that it potentially increases social exclusion and marginalizes those who don't fit into a recovery narrative. There have been specific tensions between recovery models and "evidence-based practice" models in the transformation of US mental health services based on the recommendations of the New Freedom Commission on Mental Health. The commission's emphasis on recovery has been interpreted by some critics as saying that everyone can fully recover through sheer will power and therefore as giving false hope and implicitly blaming those who may be unable to recover. However, the critics have themselves been charged with undermining consumer rights and failing to recognize that the model is intended to support a person in their personal journey rather than expecting a given outcome, and that it relates to social and political support and empowerment as well as the individual. Various stages of resistance to recovery approaches have been identified amongst staff in traditional services, starting with "Our people are much sicker than yours. They won't be able to recover" and ending in "Our doctors will never agree to this". However, ways to harness the energy of this perceived resistance and use it to move forward have been proposed. In addition, staff training materials have been developed by various organisations, for example by the National Empowerment Center. Some positives and negatives of recovery models were highlighted in a study of a community mental health service for people diagnosed with schizophrenia. It was concluded that while the approach may be a useful corrective to the usual style of case management - at least when genuinely chosen and shaped by each unique individual on the ground - serious social, institutional and personal difficulties made it essential that there be sufficient ongoing effective support with stress management and coping in daily life. Cultural biases and uncertainties were also noted in the 'North American' model of recovery in practice, reflecting views about the sorts of contributions and lifestyles that should be considered valuable or acceptable. Assessment A number of standardized questionnaires and assessments have been developed to try to assess aspects of an individual's recovery journey. These include the Milestones of Recovery (MOR) Scale, Recovery Enhancing Environment (REE) measure, Recovery Measurement Tool (RMT), Recovery Oriented System Indicators (ROSI) Measure, Stages of Recovery Instrument (STORI), and numerous related instruments. The data-collection systems and terminology used by services and funders are said to be typically incompatible with recovery frameworks, so methods of adapting them have been developed. It has also been argued that the Diagnostic and Statistical Manual of Mental Disorders (and to some extent any system of categorical classification of mental disorders) uses definitions and terminology that are inconsistent with a recovery model, leading to suggestions that the next version, the DSM-V, requires: greater sensitivity to cultural issues and gender; to recognize the need for others to change as well as just those singled out for a diagnosis of disorder; and to adopt a dimensional approach to assessment that better captures individuality and does not erroneously imply excess psychopathology or chronicity. National policies and implementation United States and Canada The New Freedom Commission on Mental Health has proposed to transform the mental health system in the US by shifting the paradigm of care from traditional medical psychiatric treatment toward the concept of recovery, and the American Psychiatric Association has endorsed a recovery model from a psychiatric services perspective. The US Department of Health and Human Services reports developing national and state initiatives to empower consumers and support recovery, with specific committees planning to launch nationwide pro-recovery, anti-stigma education campaigns; develop and synthesize recovery policies; train consumers in carrying out evaluations of mental health systems; and help further the development of peer-run services. Mental Health service directors and planners are providing guidance to help state services implement recovery approaches. Some US states, such as California (see the California Mental Health Services Act), Wisconsin and Ohio, already report redesigning their mental health systems to stress recovery model values like hope, healing, empowerment, social connectedness, human rights, and recovery-oriented services. At least some parts of the Canadian Mental Health Association, such as the Ontario region, have adopted recovery as a guiding principle for reforming and developing the mental health system. New Zealand and Australia Since 1998, all mental health services in New Zealand have been required by government policy to use a recovery approach and mental health professionals are expected to demonstrate competence in the recovery model. Australia's National Mental Health Plan 2003-2008 states that services should adopt a recovery orientation although there is variation between Australian states and territories in the level of knowledge, commitment and implementation. UK and Ireland In 2005, the National Institute for Mental Health in England (NIMHE) endorsed a recovery model as a possible guiding principle of mental health service provision and public education. The National Health Service is implementing a recovery approach in at least some regions, and has developed a new professional role of Support Time and Recovery Worker. Centre for Mental Health issued a 2008 policy paper proposing that the recovery approach is an idea "whose time has come" and, in partnership with the NHS Confederation Mental Health Network, and support and funding from the Department of Health, manages the Implementing Recovery through Organisational Change (ImROC) nationwide project that aims to put recovery at the heart of mental health services in the UK. The Scottish Executive has included the promotion and support of recovery as one of its four key mental health aims and funded a Scottish Recovery Network to facilitate this. A 2006 review of nursing in Scotland recommended a recovery approach as the model for mental health nursing care and intervention. The Mental Health Commission of Ireland reports that its guiding documents place the service user at the core and emphasize an individual's personal journey towards recovery. See also Addiction recovery groups Anti-psychiatry Clinical psychology Capability approach Celebrate Recovery Critical Psychiatry Critical Psychiatry Network Emotions Anonymous Hearing Voices Movement Hearing Voices Network GROW Mark Ragins Mentalism (discrimination) Physical medicine and rehabilitation Recovery coaching Recovery International Rethinking Madness Self-help groups for mental health Shared decision making Social firm Social psychiatry Social work Soteria (psychiatric treatment) Therapeutic community United States Psychiatric Rehabilitation Association Wellness Recovery Action Plan References Further reading Karasaki et al.,(2013). The Place of Volition in Addiction: Differing Approaches and their Implications for Policy and Service Provision. External links The Strengths Model: A Recovery-Oriented Approach to Mental Health Services, St Vincent's Hospital, Melbourne, 2014. NASW Practice Snapshot: The Mental Health Recovery Model Recovery as a Journey of the Heart (PDF) A Critical Exploration of Social Inequities in the Mental Health Recovery Literature National Resource Center on Psychiatric Advance Directives Treatment of mental disorders Psychiatric rehabilitation Drug rehabilitation Twelve-step programs

Psychagogy

Psychagogy is a psycho-therapeutic method of influencing behavior by suggesting desirable life goals. In a more spiritual context, it can mean guidance of the soul. It is considered to be one of many antecedents and components of modern psychology. European psychagogy's beginnings can be dated back to the time of Socrates and Plato. Psychagogic methods were implemented by such groups as the Stoics, Epicureans, and Cynics. The method was also eventually adopted by Paul the Apostle, James, as well as other early Christian thinkers. Enduring well into the 20th century, psychagogy began to influence and be influenced by other psychological disciplines. Eventually the term psychagogy itself largely died out during the 1970s and 1980s, however the concept continues to be practiced through modalities like cognitive behavioral therapy, life coaching and pastoral counseling. Etymology The word comes from the Greek ψυχαγωγία from ψυχή "soul" and ἄγω "lead"; so it literally means "soul guidance". History Ancient Greek psychagogy The psychagogy of Ancient Greece, also known as maieutic psychagogy, involved Socrates (or another advanced teacher) helping a participant to “give birth” to new ideas, goals, plans, etc. Because these were claimed to have been latent within the participant, the teacher was described as a figurative midwife. Maieutic: from midwife, one who helps in the delivery of new life Psychagogy: from Greek, psûchê (soul) and agogê (transport) Within the ancient Greek tradition, psychagogy was viewed as the art of influencing the soul by the means of rhetoric. Plato believed that the human soul possesses latent knowledge, which could be brought out and elucidated by a specific type of discourse which he called dialectic: a bringing to birth from the depths of a person's higher being. He believed that a higher consciousness was needed in order to do this, and the result would bring forth a literal enlightenment and a furthered understanding of human nature. Plato also believed that only a prepared student can be involved in this process, and that the only way to prepare a student was to have them learn by doing. The process of maieutic psychagogy cannot be transmitted through writing, since it requires that a person actually experience the dynamically unfolding procedure. Dialectic took place in public areas as well as private ones, as can be seen in many of Plato's works (such as Phaedo, Meno, Phaedrus and Theaetetus). Socrates is often recorded in these works as using the process of dialectic to bring the ideas of others into being, acting as a sort of soul guide (also known as a psychagogue). In Plato's Theaetetus Socrates equates himself to a midwife, helping to bring the thoughts of others to light through his words. The term was used was used Plato's Phaedrus (261a and 271c). Additionally, key to ancient Greek philosophy was the idea of living life well and becoming the best that a person can be. This idea can be summed up by the term eudaimonia (human flourishing). Psychagogy was one practice philosophers would use to encourage people to strive toward such a goal. Although this end goal may have differed slightly between the Stoics, Epicureans, and Cynics, each group included the use of psychagogic methods in their guiding of others. Greco-Roman philosophers often practiced psychogogy by asking people to drop their thoughts of traditional wisdom, and to ignore reputation, wealth and luxury. The term was also used by the ancient Greeks to describe plays intended to teach civilians higher concepts. If the play had no higher teachings but still captivating it was considered "entertainment". (Entertainment is about someone coming into and controlling your mind Εnter] - from Latin intrō, from intrā (“inside”) [-tain] - from Latin sub- + teneo ("hold, grasp, possess, occupy, control") e.g. sustain, obtain. [-ment] - from Latin mēns (“the mind”).) Early Christian psychagogy It is thought that the idea of psychagogy was taken up by the Apostle Paul of Tarsus and early Christian thinkers, who relied on psychagogic techniques in writing the New Testament. However, psychagogy in Early Christianity took on a flavor of its own, differing slightly from the form of psychagogy that was familiar to the ancient Greeks. Psychagogy in the Early Christian sense, while retaining its use of rhetoric, placed a special emphasis on the emotions. Paul especially used this tactic while writing his epistles. He wrote these letters to new members of the Christian faith, often encouraging them toward virtue and to become mature and complete. Paul used psychagogy in order to do so effectively, fashioning his words to fit the needs of the community. Paul presented his words gently, unlike most Cynics who were known to speak critically and aggressively. Psychagogy around this time was widespread and was recognized by most all religious and philosophical groups. Considering this, it makes sense that psychagogy would have been taught in many philosophical schools, which was perhaps how Paul learned to use such language to influence the mindset and behaviors of his audience. One such group that recognized and applied psychagogic methods were those who led monastic lifestyles. Paul Dilley, an assistant professor of religious studies at the University of Iowa, has extensively studied this topic. Much of his research is summarized in his book Care of the Other in Ancient Monasticism: A Cultural History of Ascetic Guidance. In it, he argues that monastic psychagogy is based on the fundamental concept of a struggle for identity, a battle against hostile forces which challenge disciples' progress in virtue and salvation. He describes the two fundamental ascetic exercises, which recent converts began to practice immediately: the recitation of scripture and the fear of God, a complex sense of shame, guilt, and aversion to pain which could be mobilized to combat temptation. These exercises were learned both through individual effort, and the often harsh chastisement, both physical and verbal, of one's teacher. This style of psychagogy is similar to Plato's in that it involves a teacher in order to properly convey the techniques. Dilley states that the war with thoughts and emotions is definitely one of the most distinctive aspects of Christian psychagogy, and is connected to the importance of teachers and their emotional support, for the progress of disciples, until they are qualified to instruct others. 20th century psychagogy Psychagogy maintained its association with ethical and moral self-improvement, and during the 1920s psychagogic methods were assimilated into the work of hypnosis, psychoanalysis, and psychotherapy. The International Institute for Psychagogy and Psychotherapy was founded in 1924 by Charles Baudouin, a Swiss psychoanalyst. In turn, psychagogy was influenced by other psychological fields such as social psychology, developmental psychology, and depth psychology. Due to the additional effect of special education and social work on the field during the 1950s and 1960s, psychagogy and its practitioners found their way to the specialized role of working with emotionally disturbed adolescents. In 1955, Rational Emotive Behavior Therapy (REBT) was developed by Albert Ellis, an American psychologist. Heavily influenced by psychagogic methods, REBT is an evidence-based psychotherapy that promotes goal achievement and well-being by first resolving negative emotions and behaviors. Ellis' work was extended by American psychiatrist Aaron Beck through his development of cognitive therapy. The work of Ellis, Beck and their students became known as cognitive behavioral therapy (CBT), which became a very common form of psychotherapy. As CBT became more known and practiced, the term psychagogy fell out of use during the 1970s and 1980s. Psychagogy today Although the term itself is no longer common, psychagogy's influence on modern day psychology can be seen mostly within the context of pastoral counseling and cognitive behavioral therapy. Like those previously labeled "psychagogues", pastoral counselors and practitioners of CBT exhibit the same kind of care, gentleness, and encouragement in the interest of helping their patients to alter maladaptive thoughts and behaviors (or in other words, changing negative patterns of thinking and behaving to more positive ways of thinking and behaving in response to a given stimulus). These are the people "guiding souls" today. See also Cognitive behavioral therapy Life coaching Pastoral counseling References Psychotherapy History of mental disorders

Climate psychology

Climate psychology is a field that aims to further our understanding of the psychological processes that occur in response to climate change and its resultant effects. It also seeks to promote creative ways to engage with the public about climate change; contribute to change at the personal, community, cultural, and political levels; support activists, scientists and policy makers to bring about effective change; to nurture psychological resilience to the destructive impacts of climate change happening now and in the future. Definition Climate psychology can refer to: Effects of climate change on mental health Psychological impact of climate change Psychological aspects surrounding climate inaction Psychological aspects surrounding climate communication (see Climate communication#Applying findings from psychology) Psychology of climate change denial Academic discipline Climate psychology is a trans-disciplinary approach to research and practice. It focuses on the society-wide reluctance to take appropriate action in relation to the escalating threat of climate change. It seems the problem as requiring a deeper approach, that examines our resistance to knowing and acting, rather than seeing it as an “information deficit” to be treated by cognitive or behavioral approaches. It stresses the significance of human emotions, identities and cultural assumptions. Furthermore, it acknowledges the human subject as nested within their social and ecological context. In order to meet its aims and develop its approach, climate psychology draws on a broad range of perspectives, including: literature, philosophy, world religions, the arts, humanities and systems thinking. The core of the approach is based on various psychotherapeutic traditions and psycho-social studies, allowing climate psychologists to understand the unconscious or unacknowledged emotions and processes influencing people’s thoughts, motivations and behaviors. This applies especially to these processes that manifest in the broader context of the wider society and culture. As of 2020, the discipline of climate psychology had grown to include many subfields. This is in response to the spread of, what has recently been called, climate anxiety, which is a manifestation of the decades-old understanding of eco-anxiety. Climate psychologists are working with the United Nations, national and local governments, with corporations, NGOs, and individuals. Climate psychology in practice In recent years, climate psychologists are facilitating support groups for activists, particularly those active in the support of pro-environmental behaviors across society. They are also developing initiatives such as cooperative inquiry, a method of doing research into psychological phenomena where the participants are fully involved and act as co-researchers, allowing for a broader range of richer, qualitative data. In August 2022, scientists and their colleagues came together to protest rebellion outside of the Department of Business, Energy, and Industrial Strategy in London. During this time, as shown on the news, many climate scientists were having mental breakdowns and showing extreme signs of emotional turmoil and anguish. Climate psychologists over the years have watched not only scientists go through this environmental change, seeing how it has negatively impacted millions. They support groups through behavioral practices and studies to help obtain precise data and comprehension from person to person within these activist groups. The United States Agency for International Development (USAID) reports that roughly 971 million individuals are residing in regions with moderate to high exposure to climate hazards due to industrial development, environmental exploitation, and excessive consumerism, particularly in the Asia-Pacific and South Asia regions. In response to the issues and difficulties resulting from climate change, the Psychological Association of the Philippines (PAP) is actively providing psychological aid during natural disasters and catastrophic events. In addition, psychologists around the globe encourage networking and connections to maintain knowledge exchange and create a community of climate action proponents to assure that all individuals have access to the aid and amenities needed in areas currently under pressure from the ongoing climate crisis. A study in 2021 found that mental health issues related to climate change are recognized by Polish psychologists and psychotherapists. Climate and Mental Health The climate can have various impacts on mental health. For example, increased temperature can be linked to a worsening of a variety of mental health issues such as aggression, anxiety, dementia, mood, and suicide. The worsening of these symptoms can lead to increases in crime rates and hospital admissions rates during heat waves. The increased prevalence of natural disasters can also cause mental distress which can cause PTSD in many patients, which is a pressing concern for some climate psychologists. Natural disasters have also been linked to acute stress disorder, drug abuse disorder, and depression in some people. Climate change may also result in socioeconomic impacts; the associated economic hardship can negatively impact mental health, leading to stress and depression. Workers often face worse conditions due to climate change leading to increased risk of injury. The negative impacts on physical health can then lead to decreases in mental health as well. Workers may then become demoralized and lose interest in their work as a result of worsened mental health. These socioeconomic impacts can also lead to disproportionate impacts on minorities and repressed groups within a society. For example women are often disproportionately impacted compared to men in the aftermath of a natural disaster. Due to the impacts of climate change on mental health, psychologists and social workers have begun to take climate into account when assessing patients. This includes reaching out to the community and applying psychological principals to decrease climate change and to address climate anxiety in clinical sessions.Psychologists may council patients with climate related anxiety and attempt to shift those anxieties into positive changes. Climate change and psychological defenses Non-avoidant coping has three predominant forms: active coping, which is direct action taken to deal with a stressful situation; acceptance, which is a cognitive and emotional acknowledgment of stressful realities; and cognitive reinterpretation, which involves learning or positive reframing. A distinction can also be made between proactive and reactive coping. Proactive coping, also known as anticipatory adaptation or psychological preparedness, is made in anticipation of an event. On the other hand, reactive coping is made during or after the event. Climate psychologists consider how coping responses can be adaptive or maladaptive, not just personally but also for the wider environment and ecology. More precisely, do the responses promote positive psychological adjustment and stimulate appropriate and proportional pro-environmental action, or do they serve to justify the individual in their inaction and allow them to refrain from the necessary, radical changes? Psycho-social approaches A psycho-social approach to Climate psychology examines the interplay between internal, psychological factors and external, sociocultural factors- such as values, beliefs, and norms- in people’s responses to climate change. Furthermore, it offers a distinctive qualitative methodology for understanding the lived experience of research subjects, which has been adopted by researchers seeking to investigate how climate change and environmental destruction are experienced by different groups across society. In this case, ‘lived experience’ refers to the feelings, thoughts and imaginations and the meaning frames which both affect and are effected by those experiences.   Coping responses to impending climate destabilization are psycho-social phenomena, culturally sanctioned and maintained by social normss and structures, not simply isolated psychological processes. For example, modern mass consumerism is dictated by the needs of a globalized, deregulated economy, yet it is one of the driving forces of climate change. It has been suggested that this “culture of un-care” performs an ideological function, insulating consumers from experiencing too much anxiety and moral disquiet. Cultural mechanisms also support ways of down-regulating the powerful feelings that would otherwise be elicited by the awareness of potential threats. These include strong, embedded cultural assumptions such as entitlement, exceptionalism, and faith in progress. Entitlement is the belief that certain groups or species deserve more than others and is embedded in the unequal relations governing developed and developing human societies. Exceptionalism is the idea that one’s species, nation, ethnic group or individual self is special and therefore absolved from the rules that apply to others, giving license to breach natural limits of resource consumption. Faith in progress, a key element of post-industrial ideology, results in a conviction that science and technology can solve every problem, therefore encouraging wishful thinking and false optimism. History The origins of climate psychology can be traced back to the work of psychoanalyst Harold Searles and his work on the unconscious factors that influence the estrangement of people from the rest of nature. It has also been strongly influenced by the field of Ecopsychology and its emphasis on the relationships of people with the natural world. Due to the increase in society-wide acceptance of the dangers of climate change, there has been greater interest in understanding the psychological processes underlying the resistance to taking appropriate action, and in particular, the phenomenon of climate change denial. More recently, a literature base by climate psychologists has started to focus on the powerful emotions associated with climate change and planetary-wide biodiversity loss. See also Ecopsychology Effects of climate change on mental health Environmental Psychology Ecological Grief Psychology of climate change denial References External links Climate Psychology Alliance Psychologists for a Safe Climate Climate & Mind Environmental psychology Climate change and society Climate Climate change

Self-as-context

Self-as-context, one of the core principles in acceptance and commitment therapy (ACT), is the concept that people are not the content of their thoughts or feelings, but rather are the consciousness experiencing or observing the thoughts and feelings. Self-as-context is distinguished from self-as-content, defined in ACT as the social scripts people maintain about who they are and how they operate in the world. A related concept, decentering which is a central change strategy of mindfulness-based cognitive therapy, is defined as a process of stepping outside of one’s own mental events leading to an objective and non-judging stance towards the self. Buddhist influence Buddhist mindfulness practices in conjunction with functional contextualism deeply influenced the formation of ACT and its concept of self-as-context. The approach was originally called comprehensive distancing and was developed in the late 1980s by Steven C. Hayes, Kelly G. Wilson, and Kirk D. Strosahl. Self-as-context vs. self-as-content To differentiate self-as-context from self-as-content, ACT presents the conceptual self (participant), the thinking self (participant observer), and the observational self (observer). Conceptual self The conceptual self is a person's self-as-content. A personal narrative, the conceptual self includes objective facts (name, age, sex, cultural background, marital status, occupation, etc.), subjective details (likes, dislikes, hopes, fears, and perceived strengths and weaknesses), social roles (friend, spouse, parent, child), and gender roles (mother, father, daughter, son). When a person "holds" their conceptual self lightly then their identity construct is adaptable, however, should a person become unable to differentiate themselves from the rules and restrictions comprising their conceptual self then, according to ACT, they may struggle in different areas of their life. Examples include saying things like "I wish I could, but I'm not the sort of person to _" or "I'm a strong person, I don't need any help." Thinking self The thinking self is the inner monologue actively assessing, questioning, judging, reasoning, and rationalizing any given moment, situation, or behavior. The relationship between the participant and participant-observer is described in Russ Harris' The Happiness Trap (2007) as being like that of an actor and director: Observational self The observational self is defined in ACT as a transcendent state of self-awareness accessible through mindful expansion of awareness. In ACT cognitive defusion exercises are utilized to demonstrate how thoughts have no literal power over action, thereby increasing mental flexibility. If someone thinks "I am the worst," for example, a cognitive defusion exercise would observe "I am having the thought that I am the worst." Other exercises demonstrating how thoughts have no actual power include saying "I can't walk and talk" while proceeding to walk and talk, or saying "I have to stand up" while remaining seated. Experientially, the observational self is the part of consciousness that hears one's inner voice, and sees images in the mind's eye. ACT presents the idea that the more practiced a person is at accessing their observational self, the easier it is to perceive emotions within their situational context, remain mentally flexible, and commit to value congruent action. Additions to self-as-content Somatic self Self-as-content also includes the nonverbal sense of self experienced through physiological responses, including instinct, attraction, repulsion, and emotional affect. In ACT for Gender Identity: The Comprehensive Guide, Alex Stitt differentiates the somatic self from the thinking self and says that a person's relationship with their body begins to develop before their inner monologue. Since gender is more than just a thought, and identity is often described in "felt" terms, the somatic self accounts for the sense of "resonance" and "dissonance" either attracting or repelling people to certain aspects of gender and gender expression. Unlike the observational self, which is able to step back and see self-as-context, the somatic self can be as unreliable as the thinking self. Examples of this include when a person's physiological fear response is triggered in moments of safety, when a person is in a dissociative state, or when a person's affect is incongruent with their content of speech. See also Metacognitive therapy Metacognition Relational frame theory References Further reading Cognitive behavioral therapy Mindfulness (psychology)

T-groups

A T-group or training group (sometimes also referred to as sensitivity-training group, human relations training group or encounter group) is a form of group training where participants (typically between eight and fifteen people) learn about themselves (and about small group processes in general) through their interaction with each other. They use feedback, problem solving, and role play to gain insights into themselves, others, and groups. Experimental studies have been undertaken with the aim of determining what effects, if any, participating in a T-group has on the participants. For example, a 1975 article by Nancy E. Adler and Daniel Goleman concluded that "Students who had participated in a T-group showed significantly more change toward their selected goal than those who had not." Carl Rogers described sensitivity training groups as "...the most significant social invention of the century". Concept The concept of encounter as "a meeting of two, eye to eye, face to face," was articulated by J.L. Moreno in Vienna in 1914–15, in his "" ("Invitation to an Encounter"), maturing into his psychodrama therapy. It was pioneered in the mid-1940s by Moreno's protege Kurt Lewin and his colleagues as a method of learning about human behavior in what became the National Training Laboratories (also known as the NTL Institute) that was created by the Office of Naval Research and the National Education Association in Bethel, Maine, in 1947. First conceived as a research technique with a goal to change the standards, attitudes and behavior of individuals, the T-group evolved into educational and treatment schemes for non-psychiatric patient people. A T-group meeting does not have an explicit agenda, structure, or expressed goal. Under the guidance of a facilitator, the participants are encouraged to share emotional reactions (for example, anger, fear, warmth, or envy) that arise in response to their fellow participants' actions and statements. The emphasis is on sharing emotions, as opposed to judgments or conclusions. In this way, T-group participants can learn how their words and actions trigger emotional responses in the people they communicate with. Group types There are a number of group types. Task groups focus on the here and now, involving learning through doing, activity and processing; and involves daily living skills and work skills. Evaluative groups focus on evaluating the skills, behaviors, needs, and functions of a group and is the first step in a group process. Topical discussion groups focus on a common topic that can be shared by all the members to encourage involvement. Developmental groups encourage the members to develop sequentially organized social interaction skills with the other members. Parallel groups are made up of clients doing individual tasks side by side. Project groups emphasize task accomplishment. Some interaction may be built in, such as shared materials and tools and sharing the work. Egocentric cooperative groups require the members to select and implement the task. Tasks are longer term and socialization is required. Cooperative groups require the therapist only as an advisor. Members are encouraged to identify and gratify each other's social and emotional needs in conjunction with task accomplishment. The task in a cooperative group may be secondary to social aspects. Mature groups involve the therapist as a co-equal member. The group members take on all leadership roles in order to balance task accomplishment with need satisfaction of the members. Self-help groups are supportive and educational, and focus on personal growth around a single major life disrupting problem (for example, Alcoholics Anonymous). Support groups focus on helping others in a crisis and continue to do so until the crisis is gone and is usually before the self-help group. Advocacy groups focus on changing others or changing the system, rather than changing one's self: "getting one from point A to point B". Psychotherapy groups focus on helping individuals in the present that have past conflicts which affect their behavior. Variations Many varieties of T-groups have existed, from the initial T-groups that focused on small group dynamics, to those that aim more explicitly to develop self-understanding and interpersonal communication. Industry also widely used T-groups, particularly in the 1960s and 1970s, and in many ways these were predecessors of current team building and corporate culture initiatives. A current T-group version that addresses the issue of openness is the "Tough Stuff™" workshop of Robert P. Crosby and his associates. Crosby trainers carefully focus the group on their experience of their immediate interactions and group dynamics, and away from openness in the form of personal stories. Applying the behavioral communication model of John L. Wallen, The Interpersonal Gap, the participants are given a structure for talking about and learning from their interactions. The Crosby T-group also puts much of the feedback task in the hands of the participants. Using Wallen's model and behavioral skills, the participants are encouraged to give and receive feedback throughout the process, both while they are in the T-group, and in other reflective and skill building activities. Crosby was first a T-group participant in 1953, and was mentored by Lewin associates Ken Benne, Leland Bradford and Ronald Lippitt. Crosby, worked closely with Mr. Wallen from 1968 to 1975, co-leading several National Training Laboratories T-groups during that time. When Crosby founded the Leadership Institute of Seattle (LIOS) Applied Behavioral Science Graduate Program he made T-groups a core requirement of the curriculum, and he did the same when founding and leading the ALCOA Corporate leadership program from 1990 to 2005. Throughout Crosby's Organization Development career he has used T-groups in numerous business culture change and performance improvement initiatives, most famously during the PECO Nuclear turnaround following the shutdown of Peach Bottom Atomic Power Station for human performance issues by the Nuclear Regulatory Commission in 1987. Crosby and his associates still lead T-groups in public workshops and in businesses. Another recent version of the T-groups is the Appreciative Inquiry Human Interaction Laboratory, which focuses on strengths-based learning processes. It is a variation of the NTL T-groups, since it shares the values and experiential learning model with the classic T-groups. A commercialized strand of the encounter group movement developed into large-group awareness training. Other variations popular in the late 1960s and early 1970s included the nude encounter group, where participants are naked, and the marathon encounter group, where participants carry on for 24 hours or longer without sleep. "Encounter groups, in contrast to T-groups, are far less concerned with group dynamics. Instead, they focus on the individual, on getting each group participant to talk about and express his feelings as deeply and spontaneously as possible." Controversial aspects This type of training is controversial as the behaviors it encourages are often self-disclosure and openness, which many people believe some organizations ultimately punish. The feedback used in this type of training can be highly personal, hence it must be given by highly trained observers (trainers).. In the NTL-tradition, the T-group is always embedded in a Human Interaction Laboratory, with reflection time and theory sessions. In these sessions, the participants have the opportunity to make sense of what's happening in the T-group. Encounter groups are also controversial because of scientific claims that they can cause serious and lasting psychological damage. One 1971 study found that 9% of normal college students participating in an encounter group developed psychological problems lasting at least six months after their experience. The most dangerous groups had authoritarian and charismatic leaders who used vicious emotional attacks and public humiliation to try to break participants. However, a peer-reviewed review of studies published in 1975 concluded that "No study yet published provides a basis for concluding that adverse effects arising from sensitivity training are any more frequent than adverse effects arising in equivalent populations not in groups". See also Appreciative inquiry Focusing (psychotherapy) Four-sides model Improvisation Learning circle Nonviolent communication Notes References Aronson, Elliot, 1984. The Social Animal, Fourth Edition. New York: W.H.Freeman and Company. Further reading Carl Rogers, Encounter Groups, 1970 Crosby, G. "Planned Change: Why Kurt Lewin's Social Science is Still Best Practice for Business Results, Change Management, and Human Progress." (2021) (Routledge) Chapter 10 is "The Birth of the T-group." William Schutz, Elements of Encounter, 1973 Gerald Corey, Theory and Practice of Group Counseling, second edition, 1985 Group psychotherapy United States Navy

Content theory

Content theory is a subset of motivational theories that try to define what motivates people. Content theories of motivation often describe a system of needs that motivate peoples' actions. While process theories of motivation attempt to explain how and why our motivations affect our behaviors, content theories of motivation attempt to define what those motives or needs are. Content theory includes the work of David McClelland, Abraham Maslow and other psychologists. McGregor's Theory X and Theory Y Douglas McGregor proposed two different motivational theories. Managers tend to believe one or the other and treat their employees accordingly. Theory X states that employees dislike and try to avoid work, so they must be coerced into doing it. Most workers do not want responsibilities, lack ambition, and value job security more than anything else. McGregor personally held that the more optimistic theory, Y, was more valid. This theory holds that employees can view work as natural, are creative, can be self-motivated, and appreciate responsibility. This type of thinking is popular now, with people becoming more aware of the productivity of self-empowered work teams. ERG theory ERG Theory was introduced by Clayton Alderfer as an extension to the famous Maslow's Hierarchy of Needs. In this theory, the existence or physiological needs are at the base. These include the needs for things such as food, drink, shelter, and safety. Next come the Relatedness Needs, the need to feel connected to other individuals or a group. These needs are fulfilled by establishing and maintaining relationships. At the top of the hierarchy are Growth Needs, the needs for personal achievement and self-actualization. If a person is continuously frustrated in trying to satisfy growth needs, relatedness needs will re-emerge. This phenomenon is known as the frustration-regression process. Herzberg's Motivation-Hygiene theory (Two-factor theory) Frederick Herzberg felt that job satisfaction and dissatisfaction do not exist on the same continuum, but on dual scales. In other words, certain things, which Herzberg called hygiene factors, could cause a person to become unhappy with their job. These things, including pay, job security, and physical work environment, could never bring about job satisfaction. Motivating factors, on the other hand, can increase job satisfaction. Giving employees things such as a sense of recognition, responsibility, or achievement can bring satisfaction about. Need theory David McClelland proposed a context for understanding the needs in people, which holds significance in understanding their motivations and behaviors. It is subdivided into three categories: the Need for Achievement, the Need for Affiliation, and the Need for Power. The Need for Achievement refers to the notion of getting ahead and succeeding. The Need for Affiliation is the desire to be around people and be well received socially. It also includes the desire for being a member in a group and conformity. The Need for Power is the desire for control over others and over yourself. It confers the need to be able to exercise direction in the world surrounding you, and cause things to happen. Individuals who have high needs for achievement will tend to engage in competitive activities in order to fulfill this desire. Individuals who need to feel affiliated will tend to join clubs, groups and teams to satiate that want. Individuals who have the need for power will seek activities which likewise satisfy this need, such as, running for high positions in organizations and seeking opportunities to exercise that dominance. This is not to say that one person cannot have needs spanning all three categories. A person may have the need for affiliation at the same time they have the need for power. While this may initially seem contradictory, there are instances where both needs can be fulfilled. Also, timing may connote different strengths of needs at different moments. So, while a person may strongly feel the need to affiliate during times of loneliness, they may at another time feel the strong need for power when instructed to organize an event. Needs may arise and change along with a change of context. Maslow's hierarchy of needs Content theory of human motivation includes both Abraham Maslow's hierarchy of needs and Herzberg's two-factor theory. Maslow's theory is one of the most widely discussed theories of motivation. Abraham Maslow believed that man is inherently good and argued that individuals possess a constantly growing inner drive that has great potential. The needs hierarchy system is a commonly used scheme for classifying human motives. The American motivation psychologist Abraham H. Maslow (1954) developed the hierarchy of needs consisting of five hierarchic classes. According to Maslow, people are motivated by unsatisfied needs. The needs, listed from basic (lowest-earliest) to most complex (highest-latest) are as follows: Physiology (hunger, thirst, sleep, etc.) Safety/Security/Shelter/Health Social/Love/Friendship Self-esteem/Recognition/Achievement Self actualization/achievement of full potential The basic requirements build upon the first step in the pyramid: physiology. If there are deficits on this level, all behavior will be oriented to satisfy this deficit. Essentially, if you have not slept or eaten adequately, you won't be interested in your self-esteem desires. Subsequently, we have the second level, which awakens a need for security. After securing those two levels, the motives shift to the social sphere, the third level. Psychological requirements comprise the fourth level, while the top of the hierarchy consists of self-realization and self-actualization. Maslow's hierarchy of needs theory can be summarized as follows: Human beings have wants and desires which, when unsatisfied, may influence behavior. Differing levels of importance to human life are reflected in a hierarchical structure of needs. Needs at higher levels in the hierarchy are held in abeyance until lower-level needs are at least minimally satisfied. Needs at higher levels of the hierarchy are associated with individuality , humanness, and psychological health. Sex, Hedonism, and Evolution One of the first influential figures to discuss the topic of hedonism was Socrates, and he did so around 470–399 BCE in ancient Greece. Hedonism, as Socrates described it, is the motivation wherein a person will behave in a manner that will maximize pleasure and minimize pain. The only instance in which a person will behave in a manner that results in more pain than pleasure is when the knowledge of the effects of the behavior is lacking. Sex is one of the pleasures people pursue. Sex is on the first level of Maslow's hierarchy of needs. It is a necessary physiological need like air, warmth, or sleep, and if the body lacks it will not function optimally. Without the orgasm that comes with sex, a person will experience "pain," and as hedonism would predict, a person will minimize this pain by pursuing sex. That being said, sex as a basic need is different from the need for sexual intimacy, which is located on the third level in Maslow's hierarchy. There are multiple theories for why sex is a strong motivation, and many fall under the theory of evolution. On an evolutionary level, the motivation for sex likely has to do with a species' ability to reproduce. Species that reproduce more, survive and pass on their genes. Therefore, species have a sexual desire that leads to sexual intercourse as a means to create more offspring. Without this innate motivation, a species may determine that attaining intercourse is too costly in terms of effort, energy, and danger. In addition to sexual desire, the motivation for romantic love runs parallel in having an evolutionary function for the survival of a species. On an emotional level, romantic love satiates a psychological need for belonging. Therefore, this is another hedonistic pursuit of pleasure. From the evolutionary perspective, romantic love creates bonds with the parents of offspring. This bond will make it so that the parents will stay together and take care of and protect the offspring until it is independent. By rearing the child together, it increases the chances that the offspring will survive and pass on its genes themselves, therefore continuing the survival of the species. Without the romantic love bond, the male will pursue satiation of his sexual desire with as many mates as possible, leaving behind the female to rear the offspring by herself. Child-rearing with one parent is more difficult and provides less assurance of the offspring's survival than with two parents. Romantic love therefore solves the commitment problem of parents needing to be together; individuals that are loyal and faithful to one another will have mutual survival benefits. Additionally, under the umbrella of evolution, is Darwin's term sexual selection. This refers to how the female selects the male for reproduction. The male is motivated to attain sex because of all the aforementioned reasons, but how he attains it can vary based on his qualities. For some females, they are motivated by the will to survive mostly, and will prefer a mate that can physically defend her, or financially provide for her (among humans). Some females are more attracted to charm, as it is an indicator of being a good loyal lover that will in turn make for a dependable child-rearing partner. Altogether, sex is a hedonistic pleasure-seeking behavior that satiates physical and psychological needs and is instinctively guided by principles of evolution. Self-determination theory Since the early 1970s Deci and Ryan have developed and tested their self-determination theory (SDT). SDT identifies three innate needs that, if satisfied, allow optimal function and growth: competence, relatedness, and autonomy. These three psychological needs are suggested to be essential for psychological health & well-being along with behavioral motivation. There are three essential elements to the theory: Humans are inherently proactive with their potential and at mastering their inner forces (such as drive and emotions). Humans have an inherent tendency towards growth, development, and integrated functioning. Optimal development and actions are inherent in humans but they do not happen automatically. Within Self-Determination Theory, Deci & Ryan distinguish between four different types of extrinsic motivation, differing in their levels of perceived autonomy: External regulation: This is the least autonomous of the four and is determined by external punishment or reward. Introjected regulation: This form of external motivation arises when the individuals have somewhat internalized regulations but do not fully accept them as their own. They may comply for self-esteem reasons or social acceptability - essentially internal reasons but externally driven. Identified regulation: This is more autonomously driven - when the individuals consciously perceive the actions as valuable. Integrated regulation: This is the most autonomous form of motivation and the action has been internalized and is aligned with the individual's values, beliefs and is perceived as necessary for their wellbeing. However, this is still classified as extrinsic motivation as it is still driven by external processes and not by inherent enjoyment for the task itself. "16 basic desires" theory Starting from studies involving more than 6,000 people, Reiss proposed that 16 basic desires guide nearly all human behavior. In this model the basic desires that motivate our actions and define our personalities are: Natural theories The natural system assumes that people have higher-order needs, which contrasts with the rational theory that suggests that people dislike work and only respond to rewards and punishment. According to McGregor's Theory Y, human behavior is based on satisfying a hierarchy of needs: physiological, safety, social, ego, and self-fulfillment. Physiological needs are the lowest and the most important level. These fundamental requirements include food, rest, shelter, and exercise. After the physiological needs are satisfied, employees can focus on safety needs, which include "protection against danger, threat and deprivation." However, if management makes arbitrary or biased employment decisions, then an employee's safety needs are unfulfilled. The next set of needs is social, which refers to the desire for acceptance, affiliation, reciprocal friendships, and love. As such, the natural system of management assumes that close-knit work teams are productive. Accordingly, if an employee's social needs are unmet, then he will act disobediently. There are two types of egoistic needs, the second-highest order of needs. The first type refers to one's self-esteem, which encompasses self-confidence, independence, achievement, competence, and knowledge. The second type of needs deals with reputation, status, recognition, and respect from colleagues. Egoistic needs are much more difficult to satisfy. The highest order of needs is for self-fulfillment, including recognition of one's full potential, areas for self-improvement, and the opportunity for creativity. This differs from the rational system, which assumes that people prefer routine and security to creativity. Unlike the rational management system, which assumes that humans don't care about these higher-order needs, the natural system is based on these needs as a means for motivation. The author of the reductionist motivation model is Sigmund Freud. According to the model, physiological needs raise tension, thereby forcing an individual to seek an outlet by satisfying those needs Self-management through teamwork To successfully manage and motivate employees, the natural system posits that being a part of a group is necessary. Because of structural changes in the social order, the workplace is more fluid and adaptive according to Mayo. As a result, individual employees have lost their sense of stability and security, which can be provided by being a member of a group. However, if teams continuously change within jobs, then employees feel anxious, empty, and irrational and become harder to work with. The innate desire for lasting human association and management "is not related to single workers, but always to working groups." In groups, employees will self-manage and form relevant customs, duties, and traditions. Wage incentives Humans are motivated by additional factors besides wage incentives. Unlike the rational theory of motivation, people are not driven toward economic interests per the natural system. For instance, the straight piecework system pays employees based on each unit of their output. Based on studies such as the Bank Wiring Observation Room, using a piece rate incentive system does not lead to higher production. Employees actually set upper limits on each person's daily output. These actions stand "in direct opposition to the ideas underlying their system of financial incentive, which countenanced no upper limit to performance other than the physical capacity of the individual." Therefore, as opposed to the rational system that depends on economic rewards and punishments, the natural system of management assumes that humans are also motivated by non-economic factors. Autonomy: increased motivation for autonomous tasks Employees seek autonomy and responsibility in their work, contrary to assumptions of the rational theory of management. Because supervisors have direct authority over employees, they must ensure that the employee's actions are in line with the standards of efficient conduct. This creates a sense of restriction on the employee and these constraints are viewed as "annoying and seemingly functioned only as subordinating or differentiating mechanisms." Accordingly, the natural management system assumes that employees prefer autonomy and responsibility on the job and dislike arbitrary rules and overwhelming supervision. An individual's motivation to complete a task is increased when the task is autonomous. When the motivation to complete a task comes from an "external pressure" that pressure then "undermines" the person's motivation, and as a result decreases the person's desire to complete the task. Rational motivations The idea that human beings are rational and that the human behavior is guided by reason is an old one. However, recent research (on satisfying for example) has significantly undermined the idea of homo economicus or of perfect rationality in favor of a more bounded rationality. The field of behavioral economics is particularly concerned with the limits of rationality in economic agents. Incentive theories: intrinsic and extrinsic motivation Motivation can be divided into two different theories known as intrinsic (internal or inherent in the activity itself) motivation and extrinsic (contingent on external rewards or punishment) motivation. Intrinsic motivation Intrinsic motivation has been studied since the early 1970s. Intrinsic motivation is a behavior that is driven by satisfying internal rewards. For example, an athlete may enjoy playing football for the experience, rather than for an award. It is an interest or enjoyment in the task itself, and exists within the individual rather than relying on external pressures or a desire for consideration. Deci (1971) explained that some activities provide their own inherent reward, meaning certain activities are not dependent on external rewards. The phenomenon of intrinsic motivation was first acknowledged within experimental studies of animal behavior. In these studies, it was evident that the organisms would engage in playful and curiosity-driven behaviors in the absence of reward. Intrinsic motivation is a natural motivational tendency and is a critical element in cognitive, social, and physical development. The two necessary elements for intrinsic motivation are self-determination and an increase in perceived competence. In short, the cause of the behavior must be internal, known as internal locus of causality, and the individual who engages in the behavior must perceive that the task increases their competence. According to various research reported by Deci's published findings in 1971, and 1972, tangible rewards could actually undermine the intrinsic motivation of college students. However, these studies didn't just affect college students, Kruglanski, Friedman, and Zeevi (1971) repeated this study and found that symbolic and material rewards can undermine not just high school students, but preschool students as well. Students who are intrinsically motivated are more likely to engage in the task willingly as well as work to improve their skills, which will increase their capabilities. Students are likely to be intrinsically motivated if they... attribute their educational results to factors under their own control, also known as autonomy or locus of control believe they have the skills to be effective agents in reaching their desired goals, also known as self-efficacy beliefs are interested in mastering a topic, not just in achieving good grades don't act from pressure, but from interest An example of intrinsic motivation is when an employee becomes an IT professional because he or she wants to learn about how computer users interact with computer networks. The employee has the intrinsic motivation to gain more knowledge, and will continue to want to learn even in the face of failure. Art for art's sake is an example of intrinsic motivation in the domain of art. Traditionally, researchers thought of motivations to use computer systems to be primarily driven by extrinsic purposes; however, many modern systems have their use driven primarily by intrinsic motivations. Examples of such systems used primarily to fulfill users' intrinsic motivations, include on-line gaming, virtual worlds, online shopping, learning/education, online dating, digital music repositories, social networking, online pornography, gamified systems, and general gamification. Even traditional management information systems (e.g., ERP, CRM) are being 'gamified' such that both extrinsic and intrinsic motivations must increasingly be considered. Deci's findings didn't come without controversy. Articles stretching over the span of 25 years from the perspective of behavioral theory argue that there isn't enough evidence to explain intrinsic motivation and this theory would inhibit "scientific progress." As stated above, we now can see technology such as various forms of computer systems are highly intrinsic. Not only can intrinsic motivation be used in a personal setting, but it can also be implemented and utilized in a social environment. Instead of attaining mature desires, such as those presented above via the internet which can be attained on one's own, intrinsic motivation can be used to assist extrinsic motivation to attain a goal. For example, Eli, a 4-year-old with autism, wants to achieve the goal of playing with a toy train. To get the toy, he must first communicate to his therapist that he wants it. His desire to play is strong enough to be considered intrinsic motivation because it is a natural feeling, and his desire to communicate with his therapist to get the train can be considered extrinsic motivation because the outside object is a reward (see incentive theory). Communicating with the therapist is the first, the slightly more challenging goal that stands in the way of achieving his larger goal of playing with the train. Achieving these goals in attainable pieces is also known as the goal-setting theory. The three elements of goal-setting (STD) are Specific, Time-bound, and Difficult. Specifically, goals should be set in the 90th percentile of difficulty. Intrinsic motivation comes from one's desire to achieve or attain a goal. Pursuing challenges and goals come easier and more enjoyable when one is intrinsically motivated to complete a certain objective because the individual is more interested in learning, rather than achieving the goal. Edward Deci and Richard Ryan's theory of intrinsic motivation is essentially examining the conditions that "elicit and sustain" this phenomenon. Deci and Ryan coined the term "cognitive evaluation theory" which concentrates on the needs of competence and autonomy. The CET essentially states that social-contextual events like feedback and reinforcement can cause feelings of competence and therefore increase intrinsic motivation. However, feelings of competence will not increase intrinsic motivation if there is no sense of autonomy. In situations where choices, feelings, and opportunities are present, intrinsic motivation is increased because people feel a greater sense of autonomy. Offering people choices, responding to their feelings, and opportunities for self-direction have been reported to enhance intrinsic motivation via increased autonomy. An advantage (relative to extrinsic motivation) is that intrinsic motivators can be long-lasting, self-sustaining, and satisfying. For this reason, efforts in education sometimes attempt to modify intrinsic motivation with the goal of promoting future student learning performance, creativity, and learning via long-term modifications in interests. Intrinsic motivation has been found to be hard to modify, and attempts to recruit existing intrinsic motivators require a non-trivially difficult individualized approach, identifying and making relevant the different motivators needed to motivate different students, possibly requiring additional skills and intrinsic motivation from the instructor. In a workplace situation, intrinsic motivation is likely to be rare and risks being falsely identified, as most workers will always be subject to extrinsic motivation such as the fear of unemployment, the need to gain a living and fear of rejection by coworkers in cases of poor performance. Extrinsic motivation Extrinsic motivation comes from influences outside of the individual. In extrinsic motivation, the harder question to answer is where do people get the motivation to carry out and continue to push with persistence. Usually, extrinsic motivation is used to attain outcomes that a person wouldn't get from intrinsic motivation. Common extrinsic motivations are rewards (for example money or grades) for showing the desired behavior, and the threat of punishment following misbehavior. Competition is an extrinsic motivator because it encourages the performer to win and to beat others, not simply to enjoy the intrinsic rewards of the activity. A cheering crowd and the desire to win a trophy are also extrinsic incentives. For example, if an individual plays the sport tennis to receive an award, that would be extrinsic motivation. VS. if the individual plays because he or she enjoys the game, which would be intrinsic motivation. The most simple distinction between extrinsic and intrinsic motivation is the type of reasons or goals that lead to an action. While intrinsic motivation refers to doing something because it is inherently interesting or enjoyable and satisfying, extrinsic motivation, refers to doing something because it leads to a separable outcome. Extrinsic motivation thus contrasts with intrinsic motivation, which is doing an activity simply for the enjoyment of the activity itself, instead of for its instrumental value. Social psychological research has indicated that extrinsic rewards can lead to overjustification and a subsequent reduction in intrinsic motivation. In one study demonstrating this effect, children who expected to be (and were) rewarded with a ribbon and a gold star for drawing pictures spent less time playing with the drawing materials in subsequent observations than children who were assigned to an unexpected reward condition. This shows how if an individual expects an award they don't care about the outcome. VS. if an individual doesn't expect a reward they will care more about the task. However, another study showed that third graders who were rewarded with a book showed more reading behavior in the future, implying that some rewards do not undermine intrinsic motivation. While the provision of extrinsic rewards might reduce the desirability of an activity, the use of extrinsic constraints, such as the threat of punishment, against performing an activity has actually been found to increase one's intrinsic interest in that activity. In one study, when children were given mild threats against playing with an attractive toy, it was found that the threat actually served to increase the child's interest in the toy, which was previously undesirable to the child in the absence of threat. Advantages of extrinsic motivators are that they easily promote motivation to work and persist to goal completion. Rewards are tangible and beneficial. A disadvantage for extrinsic motivators relative to internal is that work does not persist long once external rewards are removed. As the task is completed for the reward, the quality of work may need to be monitored, and it has been suggested that extrinsic motivators may diminish in value over time. Flow theory Flow theory refers to desirable subjective state a person experiences when completely involved in some challenging activity that matches the individual's skills. Mihaly Csikszentmihalyi described Flow theory as "A state in which people are so involved in an activity that nothing else seems to matter; the experience is so enjoyable that people will continue to do it even at great cost, for the sheer sake of doing it." The idea of flow theory was first conceptualized by Csikszentmihalyi. Flow in the context of motivation can be seen as an activity that is not too hard, frustrating or madding, or too easy boring and done too fast. If one has achieved perfect flow, then the activity has reached maximum potential. Flow is a part of something called positive psychology of the psychology of happiness. Positive psychology looks into what makes a person happy. Flow can be considered as achieving happiness or at the very least positive feelings. A study that was published in the journal Emotion looked at flow experienced in college students playing Tetris. The students that were being evaluated on looks then told to wait and play Tetris. There were three categories; Easy, normal, and hard. The students that played Tetris on normal level experienced flow and were less stressed about the evaluation. Csikszentmihalyi describes 8 characteristics of flow as - the complete concentration on the task, clarity of goals & reward in mind and immediate feedback, transformation of time (speeding up/slowing down of time), the experience is intrinsically rewarding, effortlessness & ease, a balance between challenge and skills, merged actions and awareness, loss of self-conscious rumination and a feeling of control over the task. The activity no longer becomes something seen as a means to an end and it becomes something an individual wants to do. This can be seen as someone who likes to run for the sheer joy of running and not because they need to do it for exercise or because they want to brag about it. Peak flow can be different for each person. It could take an individual years to reach flow or only moments. If an individual becomes too good at an activity they can become bored. If the challenge becomes too hard then the individual could become discouraged and want to quit. Behaviorist theories While many theories on motivation have a mentalistic perspective, behaviorists focus only on the observable behavior and the theories founded on experimental evidence. In the view of behaviorism, motivation is understood as a question about what factors cause, prevent, or withhold various behaviors, while the question of, for instance, conscious motivation would be ignored. Where others would speculate about such things as values, drives, or needs, that may not be observed directly, behaviorists are interested in the observable variables that affect the type, intensity, frequency, and duration of the observable behavior. Through the basic research of such scientists as Pavlov, Watson and Skinner, several basic mechanisms that govern behavior have been identified. The most important of these are classical conditioning and operant conditioning. Classical and operant conditioning In classical (or respondent) conditioning, behavior is understood as responses triggered by certain environmental or physical stimuli. They can be unconditioned, such as in-born reflexes, or learned through the pairing of an unconditioned stimulus with a different stimulus, which then becomes a conditioned stimulus. In relation to motivation, classical conditioning might be seen as one explanation as to why an individual performs certain responses and behaviors in certain situations. For instance, a dentist might wonder why a patient does not seem motivated to show up for an appointment, with the explanation being that the patient has associated the dentist (conditioned stimulus) with the pain (unconditioned stimulus) that elicits a fear response (conditioned response), leading to the patient being reluctant to visit the dentist. In operant conditioning, the type and frequency of behavior are determined mainly by its consequences. If a certain behavior, in the presence of a certain stimulus, is followed by a desirable consequence (a reinforcer), the emitted behavior will increase in frequency in the future, in the presence of the stimulus that preceded the behavior (or a similar one). Conversely, if the behavior is followed by something undesirable (a punisher), the behavior is less likely to occur in the presence of the stimulus. In a similar manner, the removal of a stimulus directly following the behavior might either increase or decrease the frequency of that behavior in the future (negative reinforcement or punishment). For instance, a student that gained praise and a good grade after turning in a paper, might seem more motivated in writing papers in the future (positive reinforcement); if the same student put in a lot of work on a task without getting any praise for it, he or she might seem less motivated to do school work in the future (negative punishment). If a student starts to cause trouble in the class gets punished with something he or she dislikes, such as detention (positive punishment), that behavior would decrease in the future. The student might seem more motivated to behave in class, presumably in order to avoid further detention (negative reinforcement). The strength of reinforcement or punishment is dependent on schedule and timing. A reinforcer or punisher affects the future frequency of a behavior most strongly if it occurs within seconds of the behavior. A behavior that is reinforced intermittently, at unpredictable intervals, will be more robust and persistent, compared to the ones that are reinforced every time the behavior is performed. For example, if the misbehaving student in the above example was punished a week after the troublesome behavior, that might not affect future behavior. In addition to these basic principles, environmental stimuli also affect behavior. Behavior is punished or reinforced in the context of whatever stimuli were present just before the behavior was performed, which means that a particular behavior might not be affected in every environmental context, or situation, after it is punished or reinforced in one specific context. A lack of praise for school-related behavior might, for instance, not decrease after-school sports-related behavior that is usually reinforced by praise. The various mechanisms of operant conditioning may be used to understand the motivation for various behaviors by examining what happens just after the behavior (the consequence), in what context the behavior is performed or not performed (the antecedent), and under what circumstances (motivating operators). Incentive motivation Incentive theory is a specific theory of motivation, derived partly from behaviorist principles of reinforcement, which concerns an incentive or motive to do something. The most common incentive would be a compensation. Compensation can be tangible or intangible. It helps in motivating the employees in their corporate life, students in academics, and inspire them to do more and more to achieve profitability in every field. Studies show that if the person receives the reward immediately, the effect is greater, and decreases as delay lengthens. Repetitive action-reward combination can cause the action to become a habit "Reinforcers and reinforcement principles of behavior differ from the hypothetical construct of reward." A reinforcer is anything that follows an action, with the intention that the action will now occur more frequently. From this perspective, the concept of distinguishing between intrinsic and extrinsic forces is irrelevant. Incentive theory in psychology treats motivation and behavior of the individual as they are influenced by beliefs, such as engaging in activities that are expected to be profitable. Incentive theory is promoted by behavioral psychologists, such as B.F. Skinner. Incentive theory is especially supported by Skinner in his philosophy of Radical behaviorism, meaning that a person's actions always have social ramifications: and if actions are positively received, people are more likely to act in this manner, or if negatively received people are less likely to act in this manner. Incentive theory distinguishes itself from other motivation theories, such as drive theory, in the direction of the motivation. In incentive theory, stimuli "attract" a person towards them, and push them towards the stimulus. In terms of behaviorism, incentive theory involves positive reinforcement: the reinforcing stimulus has been conditioned to make the person happier. As opposed to in drive theory, which involves negative reinforcement: a stimulus has been associated with the removal of the punishment—the lack of homeostasis in the body. For example, a person has come to know that if they eat when hungry, it will eliminate that negative feeling of hunger, or if they drink when thirsty, it will eliminate that negative feeling of thirst. Motivating operations Motivating operations, MOs, relate to the field of motivation in that they help improve understanding aspects of behavior that are not covered by operant conditioning. In operant conditioning, the function of the reinforcer is to influence future behavior. The presence of a stimulus believed to function as a reinforcer does not according to this terminology explain the current behavior of an organism – only previous instances of reinforcement of that behavior (in the same or similar situations) do. Through the behavior-altering effect of MOs, it is possible to affect the current behavior of an individual, giving another piece of the puzzle of motivation. Motivating operations are factors that affect learned behavior in a certain context. MOs have two effects: a value-altering effect, which increases or decreases the efficiency of a reinforcer, and a behavior-altering effect, which modifies learned behavior that has previously been punished or reinforced by a particular stimulus. When a motivating operation causes an increase in the effectiveness of a reinforcer or amplifies a learned behavior in some way (such as increasing frequency, intensity, duration, or speed of the behavior), it functions as an establishing operation, EO. A common example of this would be food deprivation, which functions as an EO in relation to food: the food-deprived organism will perform behaviors previously related to the acquisition of food more intensely, frequently, longer, or faster in the presence of food, and those behaviors would be especially strongly reinforced. For instance, a fast-food worker earning minimal wage, forced to work more than one job to make ends meet, would be highly motivated by a pay raise, because of the current deprivation of money (a conditioned establishing operation). The worker would work hard to try to achieve the raise, and getting the raise would function as an especially strong reinforcer of work behavior. Conversely, a motivating operation that causes a decrease in the effectiveness of a reinforcer, or diminishes a learned behavior related to the reinforcer, functions as an abolishing operation, AO. Again using the example of food, satiation of food prior to the presentation of a food stimulus would produce a decrease on food-related behaviors, and diminish or completely abolish the reinforcing effect of acquiring and ingesting the food. Consider the board of a large investment bank, concerned with a too small profit margin, deciding to give the CEO a new incentive package in order to motivate him to increase firm profits. If the CEO already has a lot of money, the incentive package might not be a very good way to motivate him, because he would be satiated on the money. Getting even more money wouldn't be a strong reinforcer for profit-increasing behavior, and wouldn't elicit increased intensity, frequency, or duration of profit-increasing behavior. Motivation and psychotherapy Motivation lies at the core of many behaviorist approaches to psychological treatment. A person with autism-spectrum the disorder is seen as lacking motivation to perform socially relevant behaviors – social stimuli are not as reinforcing for people with autism compared to other people. Depression is understood as a lack of reinforcement (especially positive reinforcement) leading to the extinction of behavior in the depressed individual. A patient with specific phobia is not motivated to seek out the phobic stimulus because it acts as a punisher, and is over-motivated to avoid it (negative reinforcement). In accordance, therapies have been designed to address these problems, such as EIBI and CBT for major depression and specific phobia. Socio-cultural theory Sociocultural theory (also known as Social Motivation) emphasizes the impact of activity and actions mediated through social interaction, and within social contexts. Sociocultural theory represents a shift from traditional theories of motivation, which view the individual's innate drives or mechanistic operand learning as primary determinants of motivation. Critical elements to socio-cultural theory applied to motivation include, but are not limited to, the role of social interactions and the contributions from culturally-based knowledge and practice. Sociocultural theory extends the social aspects of Cognitive Evaluation Theory, which espouses the important role of positive feedback from others during the action, but requires the individual as the internal locus of causality. Sociocultural theory predicts that motivation has an external locus of causality, and is socially distributed among the social group. Motivation can develop through an individual's involvement within their cultural group. Personal motivation often comes from activities a person believes to be central to the everyday occurrences in their community. An example of socio-cultural theory would be social settings where people work together to solve collective problems. Although individuals will have internalized goals, they will also develop internalized goals of others, as well as new interests and goals collectively with those that they feel socially connected to. Oftentimes, it is believed that all cultural groups are motivated in the same way. However, motivation can come from different child-rearing practices and cultural behaviors that greatly vary between cultural groups. In some indigenous cultures, collaboration between children and adults in the community and household tasks is seen as very important A child from an indigenous community may spend a great deal of their time alongside family and community members doing different tasks and chores that benefit the community. After having seen the benefits of collaboration and work, and also have the opportunity to be included, the child will be intrinsically motivated to participate in similar tasks. In this example, because the adults in the community do not impose the tasks upon the children, the children therefore feel self-motivated and have a desire to participate and learn through the task. As a result of the community values that surround the child, their source of motivation may vary according to the different communities and their different values. In more Westernized communities, segregation between adults and children participating in work-related tasks is a common practice. As a result of this, these adolescents demonstrate less internalized motivation to do things within their environment than their parents. However, when the motivation to participate in activities is a prominent belief within the family, the adolescents autonomy is significantly higher. This therefore demonstrates that when collaboration and non-segregative tasks are norms within a child's upbringing, their internal motivation to participate in community tasks increases. When given opportunities to work collaboratively with adults on shared tasks during childhood, children will therefore become more intrinsically motivated through adulthood. Social motivation is tied to one's activity in a group. It cannot form from a single mind alone. For example, bowling alone is naught but the dull act of throwing a ball into pins, and so people are much less likely to smile during the activity alone, even upon getting a strike because their satisfaction or dissatisfaction does not need to be communicated, and so it is internalized. However, when with a group, people are more inclined to smile regardless of their results because it acts as a positive communication that is beneficial for pleasurable interaction and teamwork. Thus the act of bowling becomes a social activity as opposed to a dull action because it becomes an exercise in interaction, competition, team building and sportsmanship. It is because of this phenomenon that studies have shown that people are more intrigued in performing mundane activities so long as there is company because it provides the opportunity to interact in one way or another, be it for bonding, amusement, collaboration, or alternative perspectives. Examples of activities that one may not be motivated to do alone but could be done with others for the social benefit are things such as throwing and catching a baseball with a friend, making funny faces with children, building a treehouse, and performing a debate. Push and pull Push Push motivations are those where people push themselves towards their goals or to achieve something, such as the desire for escape, rest & relaxation, prestige, health & fitness, adventure, and social interaction. However, with push motivation, it's also easy to get discouraged when there are obstacles present in the path of achievement. Push motivation acts as a willpower and people's willpower is only as strong as the desire behind the willpower. Additionally, a study has been conducted on social networking and its push and pull effects. One thing that is mentioned is "Regret and dissatisfaction correspond to push factors because regret and dissatisfaction are the negative factors that compel users to leave their current service provider." So we now know that Push motivations can also be a negative force. In this case, that negative force is regret and dissatisfaction. Pull Pull motivation is the opposite of push. It is a type of motivation that is much stronger. "Some of the factors are those that emerge as a result of the attractiveness of a destination as it is perceived by those with the propensity to travel. They include both tangible resources, such as beaches, recreation facilities, and cultural attractions, and traveler's perceptions and expectation, such as novelty, benefit expectation, and marketing image." Pull motivation can be seen as the desire to achieve a goal so badly that it seems that the goal is pulling us toward it. That is why pull motivation is stronger than push motivation. It is easier to be drawn to something rather than to push yourself for something you desire. It can also be an alternative force when compared to negative force. From the same study as previously mentioned, "Regret and dissatisfaction with an existing SNS service provider may trigger a heightened interest toward switching service providers, but such a motive will likely translate into reality in the presence of a good alternative. Therefore, alternative attractiveness can moderate the effects of regret and dissatisfaction with switching intention" And so, pull motivation can be an attracting desire when negative influences come into the picture. Self-control The self-control aspect of motivation is increasingly considered to be a subset of emotional intelligence; it is suggested that although a person may be classed as highly intelligent (as measured by many traditional intelligence tests), they may remain unmotivated to pursue intellectual endeavors. Vroom's "expectancy theory" provides an account of when people may decide to exert self-control in pursuit of a particular goal. Drives A drive or desire can be described as a deficiency or need that activates behavior that is aimed at a goal or an incentive. These drives are thought to originate within the individual and may not require external stimuli to encourage the behavior. Basic drives could be sparked by deficiencies such as hunger, which motivates a person to seek food whereas more subtle drives might be the desire for praise and approval, which motivates a person to behave in a manner pleasing to others. Another basic drive is the sexual drive which just like food motivates us because it is essential to our survival. The desire for sex is wired deep into the brain of all human beings as glands secrete hormones that travel through the blood to the brain and stimulates the onset of sexual desire. The hormone involved in the initial onset of sexual desire is called Dehydroepiandrosterone (DHEA). The hormonal basis of both men and women's sex drives is testosterone. Men naturally have more testosterone than women do and so are more likely than women to think about sex. Drive-reduction theory Drive theory grows out of the concept that people have certain biological drives, such as hunger and thirst. As time passes, the strength of the drive increases if it is not satisfied (in this case by eating). Upon satisfying a drive, the drive's strength is reduced. Created by Clark Hull and further developed by Kenneth Spence, the theory became well known in the 1940s and 1950s. Many of the motivational theories that arose during the 1950s and 1960s were either based on Hull's original theory or were focused on providing alternatives to the drive-reduction theory, including Abraham Maslow's hierarchy of needs, which emerged as an alternative to Hull's approach. Drive theory has some intuitive validity. For instance, when preparing food, the drive model appears to be compatible with sensations of rising hunger as the food is prepared, and, after the food has been consumed, a decrease in subjective hunger. There are several problems, however, that leave the validity of drive reduction open for debate. Cognitive dissonance theory As suggested by Leon Festinger, cognitive dissonance occurs when an individual experiences some degree of discomfort resulting from an inconsistency between two cognitions: their views on the world around them and their own personal feelings and actions. For example, a consumer may seek to reassure themselves regarding a purchase, feeling that another decision may have been preferable. Their feeling that another purchase would have been preferable is inconsistent with their action of purchasing the item. The difference between their feelings and beliefs causes dissonance, so they seek to reassure themselves. While not a theory of motivation, per se, the theory of cognitive dissonance proposes that people have a motivational drive to reduce dissonance. The cognitive miser perspective makes people want to justify things in a simple way in order to reduce the effort they put into cognition. They do this by changing their attitudes, beliefs, or actions, rather than facing the inconsistencies, because dissonance is a mental strain. Dissonance is also reduced by justifying, blaming, and denying. It is one of the most influential and extensively studied theories in social psychology. Temporal motivation theory A recent approach in developing a broad, integrative theory of motivation is temporal motivation theory. Introduced in a 2006 Academy of Management Review article, it synthesizes into a single formulation, the primary aspects of several other major motivational theories, including Incentive Theory, Drive Theory, Need Theory, Self-Efficacy and Goal Setting. It simplifies the field of motivation and allows findings from one theory to be translated into the terms of another. Another journal article that helped to develop temporal motivation theory, "The Nature of Procrastination", which received American Psychological Association's George A. Miller award for outstanding contribution to general science. where Motivation is the desire for a particular outcome, Expectancy or self-efficacy is the probability of success, Value is the reward associated with the outcome, Impulsiveness is the individual's sensitivity to delay and Delay is the time to realization. Achievement motivation Achievement motivation is an integrative perspective based on the premise that performance motivation results from the way broad components of personality are directed towards performance. As a result, it includes a range of dimensions that are relevant to success at work but which are not conventionally regarded as being part of performance motivation. The emphasis on performance seeks to integrate formerly separate approaches as need for achievement with, for example, social motives like dominance. Personality is intimately tied to performance and achievement motivation, including such characteristics as tolerance for risk, fear of failure, and others. Achievement motivation can be measured by The Achievement Motivation Inventory, which is based on this theory and assesses three factors (in 17 separated scales) relevant to vocational and professional success. This motivation has repeatedly been linked with adaptive motivational patterns, including working hard, a willingness to pick learning tasks with much difficulty, and attributing success to effort. Achievement motivation was studied intensively by David C. McClelland, John W. Atkinson and their colleagues since the early 1950s. This type of motivation is a drive that is developed from an emotional state. One may feel the drive to achieve by striving for success and avoiding failure. In achievement motivation, one would hope that they excel in what they do and not think much about the failures or the negatives. Their research showed that business managers who were successful demonstrated a high need to achieve no matter the culture. There are three major characteristics of people who have a great need to achieve according to McClelland's research. They would prefer a work environment in which they are able to assume responsibility for solving problems. They would take a calculated risk and establish moderate, attainable goals. They want to hear continuous recognition, as well as feedback, in order for them to know how well they are doing. Cognitive theories Cognitive theories define motivation in terms of how people think about situations. Cognitive theories of motivation include goal-setting theory and expectancy theory. Goal-setting theory Goal-setting theory is based on the idea that individuals have a drive to reach a clearly defined end state. Often, this end state is a reward in itself. A goal's efficiency is affected by three features: proximity, difficulty, and specificity. One common goal setting methodology incorporates the SMART criteria, in which goals are: specific, measurable, attainable/achievable, relevant, and time-bound. Time management is an important aspect, when regarding time as a contributing factor to goal achievement. Having too much time allows for distraction and procrastination, which also serves as a distraction to the subject by steering their attention away from the original goal. An ideal goal should present a situation where the time between the beginning of the effort and the end state is close. With an overly restricting time restraint, the subject could potentially feel overwhelmed, which could deter the subject from achieving the goal because the amount of time provided is not sufficient or rational. This explains why some children are more motivated to learn how to ride a bike than to master algebra. A goal should be moderate, not too hard, or too easy to complete. Most people are not optimally motivated, as many want a challenge (which assumes some kind of insecurity of success). At the same time, people want to feel that there is a substantial probability that they will succeed. The goal should be objectively defined and understandable for the individual. Similarly to Maslow's Hierarchy of Needs, a larger end goal is easier to achieve if the subject has smaller, more attainable yet still challenging goals to achieve first in order to advance over a period of time. A classic example of a poorly specified goal is trying to motivate oneself to run a marathon when s/he has not had proper training. A smaller, more attainable goal is to first motivate oneself to take the stairs instead of an elevator or to replace a stagnant activity, like watching television, with a mobile one, like spending time walking and eventually working up to a jog. Expectancy theory Expectancy theory was proposed by Victor H. Vroom in 1964. Expectancy theory explains the behavior process in which an individual selects a behavior option over another, and why/how this decision is made in relation to their goal. There's also an equation for this theory which goes as follows: or M (Motivation) is the amount an individual will be motivated by the condition or environment they placed themselves in, which is based on the following. Hence the equation. E (Expectancy) is the person's perception that effort will result in performance. In other words, it's the person's assessment of how well and what kind of effort will relate to better performance. I (Instrumentality) is the person's perception that performance will be rewarded or punished. V (Valence) is the perceived amount of the reward or punishment that will result from the performance." Procrastination Procrastination is the act to voluntarily postponing or delaying an intended course of action despite anticipating that you will be worse off because of that delay. While procrastination was once seen as a harmless habit, recent studies indicate otherwise. In a 1997 study conducted by Dianne Tice and William James Fellow Roy Baumeister at Case Western University, college students were given ratings on an established scale of procrastination and tracked their academic performance, stress, and health throughout the semester. While procrastinators experienced some initial benefit in the form of lower stress levels (presumably by putting off their work at first), they ultimately earned lower grades and reported higher levels of stress and illness. Procrastination can be seen as a defense mechanism. Because it is less demanding to simply avoid a task instead of dealing with the possibility of failure, procrastinators choose the short-term gratification of delaying a task over the long-term uncertainty of undertaking it. Procrastination can also be a justification for when the user ultimately has no choice but to undertake a task and performs below their standard. For example, a term paper could be seen as a daunting task. If the user puts it off until the night before, they can justify their poor score by telling themselves that they would have done better with more time. This kind of justification is extremely harmful and only helps to perpetuate the cycle of procrastination. Over the years, scientists have determined that not all procrastination is the same. The first type is chronic procrastinators whom exhibit a combination of qualities from the other, more specialized types of procrastinators. "Arousal" types are usually self-proclaimed "pressure performers" and relish the exhilaration of completing tasks close to the deadline. "Avoider" types procrastinate to avoid the outcome of whatever task they are pushing back - whether it be a potential failure or success. "Avoider" types are usually very self-conscious and care deeply about other people's opinions. Lastly, "Decisional" procrastinators avoid making decisions in order to protect themselves from the responsibility that follows the outcome of events. Models of behavior change Social-cognitive models of behavior change include the constructs of motivation and volition. Motivation is seen as a process that leads to the forming of behavioral intentions. Volition is seen as a process that leads from intention to actual behavior. In other words, motivation and volition refer to goal setting and goal pursuit, respectively. Both processes require self-regulatory efforts. Several self-regulatory constructs are needed to operate in orchestration to attain goals. An example of such a motivational and volitional construct is perceived self-efficacy. Self-efficacy is supposed to facilitate the forming of behavioral intentions, the development of action plans, and the initiation of action. It can support the translation of intentions into action. John W. Atkinson, David Birch and their colleagues developed the theory of "Dynamics of Action" to mathematically model change in behavior as a consequence of the interaction of motivation and associated tendencies toward specific actions. The theory posits that change in behavior occurs when the tendency for a new, unexpressed behavior becomes dominant over the tendency currently motivating action. In the theory, the strength of tendencies rises and falls as a consequence of internal and external stimuli (sources of instigation), inhibitory factors, and consummatory in factors such as performing an action. In this theory, there are three causes responsible for behavior and change in behavior: Instigation (Ts) – increases tendency when an activity has an intrinsic ability to satisfy; Inhibition (Taf) – decreases tendency when there are obstacles to performing an activity; and Consummation – decreases a tendency as it is performed. Thematic apperception test Thematic Apperception Test (TAT) was developed by American psychologists Henry A. Murray and Christina D. Morgan at Harvard during the early 1930s. Their underlying goal was to test and discover the dynamics of personality such as internal conflict, dominant drives, and motives. Testing is derived from asking the individual to tell a story, given 31 pictures that they must choose ten to describe. To complete the assessment, each story created by the test subject must be carefully recorded and monitored to uncover underlying needs and patterns of reactions each subject perceives. After evaluation, two common methods of research, Defense Mechanisms Manual (DMM) and Social Cognition and Object Relations (SCOR), are used to score each test subject on different dimensions of the object and relational identification. From this, the underlying dynamics of each specific personality and specific motives and drives can be determined. Attribution theory Attribution theory describes individual's motivation to formulate explanatory attributions ("reasons") for events they experience, and how these beliefs affect their emotions and motivations. Attributions are predicted to alter behavior, for instance attributing failure on a test to a lack of study might generate emotions of shame and motivate harder study. Important researchers include Fritz Heider and Bernard Weiner. Weiner's theory differentiates intrapersonal and interpersonal perspectives. Intrapersonal includes self-directed thoughts and emotions that are attributed to the self. The interpersonal perspective includes beliefs about the responsibility of others and emotions directed at other people, for instance attributing blame to another individual. Approach versus avoidance Approach motivation (i.e., incentive salience) can be defined as when a certain behavior or reaction to a situation/environment is rewarded or results in a positive or desirable outcome. In contrast, avoidance motivation (i.e., aversive salience) can be defined as when a certain behavior or reaction to a situation/environment is punished or results in a negative or undesirable outcome. Research suggests that, all else being equal, avoidance motivations tend to be more powerful than approach motivations. Because people expect losses to have more powerful emotional consequences than equal-size gains, they will take more risks to avoid a loss than to achieve a gain. Conditioned taste aversion Conditioned taste aversion is the only type of conditioning that only needs one exposure. It does not need to be the specific food or drinks that cause the taste. Conditioned taste aversion can also be attributed to extenuating circumstances. An example of this can be eating a rotten apple. Eating the apple and then immediately throwing up. Now it is hard to even be near an apple without feeling sick. Conditioned taste aversion can also come about by the mere associations of two stimuli. Eating a peanut butter and jelly sandwich, but also having the flu. Eating the sandwich makes one feel nauseous, so one throws up, now one cannot smell peanut butter without feeling queasy. Though eating the sandwich does not cause one to through up, they are still linked. Unconscious Motivation In his book A General Introduction to Psychoanalysis, Sigmund Freud explained his theory on the conscious-unconscious distinction. To explain this relationship, he used a two-room metaphor. The smaller of the two rooms is filled with a person's preconscious, which is the thoughts, emotions, and memories that are available to a person's consciousness. This room also houses a person's consciousness, which is the part of the preconscious that is the focus at that given time. Connected to the small room is a much larger room that houses a person's unconscious. This part of the mind is unavailable to a person's consciousness and consists of impulses and repressed thoughts. The door between these two rooms acts as the person's mental censor. Its job is to keep anxiety-inducing thoughts and socially unacceptable behaviors or desires out of the preconscious. Freud describes the event of a thought or impulse being denied at the door as repression, one of the many defense mechanisms. This process is supposed to protect the individual from any embarrassment that could come from acting on these impulses or thoughts that exist in the unconscious. In terms of motivation, Freud argues that unconscious instinctual impulses can still have great influence on behavior even though the person is not aware of the source. When these instincts serve as a motive, the person is only aware of the goal of the motive, and not its actual source. He divides these instincts into sexual instincts, death instincts, and ego or self-preservation instincts. Sexual instincts are those that motivate humans to stay alive and ensure the continuation of mankind. On the other hand, Freud also maintains that humans have an inherent drive for self-destruction, or the death instinct. Similar to the devil and angel that everyone has on their shoulder, the sexual instinct and death instinct are constantly battling each other to both be satisfied. The death instinct can be closely related to Freud's other concept, the id, which is our need to experience pleasure immediately, regardless of the consequences. The last type of instinct that contributes to motivation is the ego or self-preservation instinct. This instinct is geared towards assuring that a person feels validated in whatever behavior or thought they have. The mental censor, or door between the unconscious and preconscious, helps satisfy this instinct. For example, one may be sexually attracted to a person, due to their sexual instinct, but the self-preservation instinct prevents them to act on this urge until that person finds that it is socially acceptable to do so. Quite similarly to his psychic theory that deals with the id, ego, and superego, Freud's theory of instincts highlights the interdependence of these three instincts. All three instincts serve as checks and balances system to control what instincts are acted on and what behaviors are used to satisfy as many of them at once. Priming Priming is a phenomenon, often used as an experimental technique, whereby a specific stimulus sensitizes the subject to later presentation of a similar stimulus. "Priming refers to an increased sensitivity to certain stimuli, resulting from prior exposure to related visual or audio messages. When an individual is exposed to the word "cancer," for example, and then offered the choice to smoke a cigarette, we expect that there is a greater probability that they will choose not to smoke as a result of the earlier exposure." Priming can affect motivation, in the way that we can be motived to do things by an outside source. Priming can be linked with the mere exposure theory. People tend to like things that they have been exposed to before. Mere exposer theory is used by advertising companies to get people to buy their products. An example of this is seeing a picture of the product on a signboard and then buying that product later. If an individual is in a room with two strangers they are more likely to gravitate towards the person that they occasionally pass on the street, than the person that they have never seen before. An example of the use of mere exposure theory can be seen in product placements in movies and TV shows. We see a product that is in our favorite movie, and hence we are more inclined to buy that product when we see it again. Priming can fit into these categories; Semantic Priming, Visual Priming, Response Priming, Perceptual and Conceptual Priming, Positive and Negative Priming, Associative and Context Priming, and Olfactory Priming. Visual and Semantic priming is the most used in motivation. Most priming is linked with emotion, the stronger the emotion, the stronger the connection between memory and the stimuli. Priming also has an effect on drug users. In this case, it can be defined as, the reinstatement or increase in drug craving by a small dose of the drug or by stimuli associated with the drug. If a former drug user is in a place where they formerly did drugs, then they are tempted to do that same thing again even if they have been clean for years. Conscious Motivation Freud relied heavily upon the theories of unconscious motivation as explained above, but Allport (a researcher in 1967) looked heavily into the powers of conscious motivation and the effect it can have upon goals set for an individual. This is not to say that unconscious motivation should be ignored with this theory, but instead, it focuses on the thought that if we are aware of our surroundings and our goals, we can then actively and consciously take steps towards them. He also believed that there are three hierarchical tiers of personality traits that affect this motivation: Cardinal traits: Rare, but strongly determines a set behavior and can't be changed Central traits: Present around certain people, but can be hidden Secondary traits: Present in all people, but strongly reliant on context- can be altered as needed and would be the focus of a conscious motivation effort. Mental Fatigue Mental fatigue is being tired, exhausted, or not functioning effectively. Not wanting to proceed further with the current mental course of action is in contrast with physical fatigue, because in most cases no physical activity is done. This is best seen in the workplace or schools. A perfect example of mental fatigue is seen in college students just before finals approach. One will notice that students start eating more than they usually do and care less about interactions with friends and classmates. Mental fatigue arises when an individual becomes involved in a complex task but does no physical activity and is still worn out, the reason for this is because the brain uses about 20 percent of the human body's metabolic heart rate. The brain consumes about 10.8 calories every hour. Meaning that a typical human adult brain runs on about twelve watts of electricity or a fifth of the power need to power a standard light bulb. These numbers represent an individual's brain working on routine tasks, things that are not challenging. One study suggests that after engaging in a complex task, an individual tends to consume about two hundred more calories than if they had been resting or relaxing; however, this appeared to be due to stress, not higher caloric expenditure. The symptoms of mental fatigue can range from low motivation and loss of concentration to the more severe symptoms of headaches, dizziness, and impaired decision making and judgment. Mental fatigue can affect an individual's life by causing a lack of motivation, avoidance of friends and family members, and changes in one's mood. To treat mental fatigue, one must figure out what is causing the fatigue. Once the cause of the stress has been identified the individual must determine what they can do about it. Most of the time mental fatigue can be fixed by a simple life change like being more organized or learning to say no. According to the study: Mental fatigue caused by prolonged cognitive load associated with sympathetic hyperactivity, "there is evidence that decreased parasympathetic activity and increased relative sympathetic activity are associated with mental fatigue induced by a prolonged cognitive load in healthy adults." this means that though no physical activity was done, the sympathetic nervous system was triggered. An individual who is experiencing mental fatigue will not feel relaxed but feel the physical symptoms of stress. Learned Industriousness Learned industriousness theory is the theory about an acquired ability to sustain the physical or mental effort. It can also be described as being persistent despite the building up subjective fatigue. This is the ability to push through to the end for a greater or bigger reward. The more significant or more rewarding the incentive, the more the individual is willing to do to get to the end of a task. This is one of the reasons that college students will go on to graduate school. The students may be worn out, but they are willing to go through more school for the reward of getting a higher paying job when they are out of school. Reversal Theory Reversal theory, first introduced by Dr. Michael Apter and Dr. Ken Smith in the 1970s, is a structural, phenomenological explanation of psychological states and their dynamic interplay. The theory contributes to an understanding of emotions and personality in which endogenous (cognitive) and exogenous (environmental) implications are considered. The theory proposes eight meta-motivational states arranged into four pairs that drive and respond to all human experience. When a state is interrupted or satiated, one "reverses" to the other state in the pair (domain). Unlike many theories related to personality, reversal theory proposes that human behavior is better understood by studying dynamic states than by the average of behavior over time trait theory. Another distinction of reversal theory is its direct contrast with the Hebbian version of the Yerkes–Dodson law of arousal, which can be found in many forms of psychotherapy. Optimal arousal theory proposes that the most comfortable or desirable arousal level is not too high or too low. Reversal theory proposes in its principle of bistability that any level of arousal or stimulation may be found either desirable or undesirable depending on the meta-motivational state one is in. Reversal theory has been academically supported and put to practical use in more than 30 fields (e.g., sports psychology, business, medical care, addiction, and stress) and in over 30 countries. Sources McGregor, D. (1960). The human side of enterprise. New York, 21. Notes References Motivational theories

Insignificance

People may face feelings of insignificance due to a number of causes, including having low self-esteem, being depressed, living in a huge, impersonal city, comparing themselves to wealthy celebrity success stories, working in a huge bureaucracy, or being in awe of a natural wonder. Psychological factors A person's "...sense of personal insignificance comes from two primary experiences: (a) the developmental experience with its increasing awareness of separation and loss, transience, and the sense of lost felt perfectibility; and (b) the increasing cognitive awareness of the immutable laws of biology and the limitations of the self and others in which idealization gives way to painful reality." To deal with feelings of insignificance, "...each individual seeks narcissistic reparation through the elaboration of a personal narrative or myth, a story, which gives one's life a feeling of personal significance, meaning, and purpose." These "...myths provide the individual with a personal sense of identity, and they confirm and affirm memberships in a group or community, and provide guidelines and an idealized set of behaviors..., [and] endorse an explanation for the mysterious universe." In modern society, people living in crowded, anonymous major cities may face feelings of insignificance. George Simmel's work has addressed the issue of how the "dissociation typical of modern city life, the freeing of the person from traditional social ties as from each other" can lead to a "loss or diminution of individuality." Moreover, when a person feels like "...just another face in the crowd, an object of indifference to strangers", it can "lead to feelings of insignificance..." Individuals working in large, bureaucratic organizations who do not have "concrete evidence of success" may have "feelings of insignificance, disillusionment, and helplessness, which are the hallmarks of burnout. Some people in bureaucratic jobs who lack meaningful tasks, and who feel that institutional mechanisms or obstacles prevent them from receiving official recognition for their efforts, may also face boreout. People facing an acute depression constantly have "[g]uiltiness and insignificance feelings". People facing issues of inferiority, due to the subjective, global, and judgmental self-appraisal that they are deficient may also have feelings of insignificance. In the book The Fear of Insignificance, psychologist Carlo Strenger "...diagnoses the wide-spread fear of the global educated class of leading insignificant lives." Strenger warns "...that the global celebrity culture is adding fuel to the 'fear of insignificance' by undermining one’s self-image and sense of self-worth." He noted that "...over recent years people around the world have been suffering from an increasing fear of their own 'insignificance'." He argues that the "impact of the global infotainment network on the individual is to blame," because it has led to the creation of "a new species...homo globalis – global man." In this new system, people "...are defined by our intimate connection to the global infotainment network, which has turned ranking and rating people on scales of wealth and celebrity into an obsession." Strenger states that "...as humans we naturally measure ourselves to those around us, but now that we live in a “global village” we are comparing ourselves with the most “significant” [celebrity] people in the world, and finding ourselves wanting." He notes that "...in the past being a lawyer or doctor was a very reputable profession, but in this day and age, even high achievers constantly fear that they are insignificant when they compare themselves to [celebrity] success stories in the media. Strenger claims that this "...creates highly unstable self-esteem and an unstable society." Alain de Botton describes some of the same issues in his book Status Anxiety. Botton's book examines people's anxiety about whether they are judged a success or a failure. De Botton claims that chronic anxiety about status is an inevitable side effect of any democratic, ostensibly egalitarian society. Edith Wharton stated that “It is less mortifying to believe one's self unpopular than insignificant, and vanity prefers to assume that indifference is a latent form of unfriendliness.” Leo Tolstoy wrote that “If you once realize that to-morrow, if not to-day, you will die and nothing will be left of you, everything becomes insignificant!” In philosophy Blaise Pascal emphasized "the apparent insignificance of human existence, the "...dread of an unknown future", and the "...experience of being dominated by political and natural forces that far exceed our limited powers"; these elements "strike a chord of recognition with some of the existentialist writings that emerged in Europe following the Second World War." Erich Fromm states that in modern capitalist societies, people develop a "...feeling of personal insignificance and powerlessness" due to "...economic recessions, global wars and terrorism." Fromm argues that in capitalist societies, the "...individual became subordinated to capitalist production and worked for profit's sake, for the development of new investment capital and for conspicuous spending." In making people "...work for extrapersonal ends," capitalism made people into a "servant to the very machine he built" and caused feelings of insignificance to arise. In religion Martin Luther believed that the solution to the feelings of insignificance felt by the common person "...was to accept individual insignificance, to submit, to give up individual will and strength and hope to become acceptable to God." In relation to awe A person who is in awe of a monumental natural wonder, such as a massive mountain peak or waterfall, may feel insignificant. Awe is an emotion comparable to wonder but less joyous, and more fearful or respectful. Awe is defined in Robert Plutchik's Wheel of emotions as a combination of surprise and fear. One dictionary definition is "an overwhelming feeling of reverence, admiration, fear, etc., produced by that which is grand, sublime, extremely powerful, or the like: in awe of God; in awe of great political figures". In general awe is directed at objects considered to be more powerful than the subject, such as the breaking of huge waves on the base of a rocky cliff, the thundering roar of a massive waterfall, the Great Pyramid of Giza, the Grand Canyon, or the vastness of open space in the cosmos (e.g., the overview effect). In her column in Scientific American, Jennifer Ouellette referred to the vastness of the cosmos: If one embraces an atheist worldview, it necessarily requires embracing, even celebrating, one's insignificance. It's a tall order, I know, when one is accustomed to being the center of attention. The universe existed in all its vastness before I was born, and it will exist and continue to evolve after I am gone. But knowing that doesn't make me feel bleak or hopeless. I find it strangely comforting. In literary philosophy The concept of "insignificance" is also important to the literary philosophy of cosmicism. One of the prominent themes in cosmicism is the utter insignificance of humanity. H. P. Lovecraft believed that "the human race will disappear. Other races will appear and disappear in turn. The sky will become icy and void, pierced by the feeble light of half-dead stars. Which will also disappear. Everything will disappear." Colin Wilson criticizes “the sense of defeat, or disaster, or futility, that seems to underlie so much...20th century literature", and its tendency "...to portray human existence as insignificant and futile." Wilson "...calls this affliction the "fallacy of insignificance", and as he explains in The Stature of Man this fallacy is unconsciously embedded in the psychology of the modern individual." Wilson argues that the "other-directed individual...is the typical person found in our modern society today and is a victim of the "fallacy of insignificance"." He claims that the "...other directed individual has been conditioned by society to lack self-confidence in their ability to achieve anything of real worth, and thus they conform to society to escape their feelings of unimportance and uselessness." References See also The Festival of Insignificance, a novel by Milan Kundera Emotions Conformity Mental states

Discovery (observation)

Discovery is the act of detecting something new, or something previously unrecognized as meaningful. Concerning sciences and academic disciplines, discovery is the observation of new phenomena, new actions, or new events and providing new reasoning to explain the knowledge gathered through such observations with previously acquired knowledge from abstract thought and everyday experiences. A discovery may sometimes be based on earlier discoveries, collaborations, or ideas. Some discoveries represent a radical breakthrough in knowledge or technology. New discoveries are acquired through various senses and are usually assimilated, merging with pre-existing knowledge and actions. Questioning is a major form of human thought and interpersonal communication, and plays a key role in discovery. Discoveries are often made due to questions. Some discoveries lead to the invention of objects, processes, or techniques. A discovery may sometimes be based on earlier discoveries, collaborations or ideas, and the process of discovery requires at least the awareness that an existing concept or method can be modified or transformed. However, some discoveries also represent a radical breakthrough in knowledge. Science Within scientific disciplines, discovery is the observation of new phenomena, actions, or events which help explain the knowledge gathered through previously acquired scientific evidence. In science, exploration is one of three purposes of research, the other two being description and explanation. Discovery is made by providing observational evidence and attempts to develop an initial, rough understanding of some phenomenon. Discovery within the field of particle physics has an accepted definition for what constitutes a discovery: a five-sigma level of certainty. Such a level defines statistically how unlikely it is that an experimental result is due to chance. The combination of a five-sigma level of certainty, and independent confirmation by other experiments, turn findings into accepted discoveries. Education Within the field of education, discovery occurs through observations. These observations are common and come in various forms. Observations can occur as observations of students done by the teacher or observations of teachers done by other professionals. Student observations help teachers identify where the students are developmentally and cognitively in the realm of their studies. Teacher observations are used by administrators to hold teachers accountable as they stay on target with their learning goals and treat the students with respect. Observations of students completed by teachers Teachers observe students throughout the day in the classroom. These observations can be informal or formal. Teachers often use checklists, anecdotal notes, videos, interviews, written work or assessments, etc. By completing these observations, teachers can evaluate at what 'level' the student is understanding the lessons. Observations allow teachers to make the necessary adaptations for the students in the classroom. These observations can also provide the foundation for strong relationships between teachers and students. When students have these relationships, they feel safer, more comfortable in the classroom and are more willing and eager to learn. Through observations teachers discover the most developmentally appropriate practices to implement in their classrooms. These encourage and promote healthier learning styles and positive classroom atmospheres. Observations of teachers completed by other professionals There are a set of standards set in the education system by government officials. Teachers are responsible for following these academic standards as a guideline for developmentally appropriate instruction. In addition to following those academic goals, teachers are also observed by administrators to ensure positive classroom environments. One of the tools that teachers could use is the Classroom Assessment Scoring System (CLASS) tool. After using this tool, "over 150 research studies prove that students in classrooms with high-CLASS scores have better academic and social outcomes." The tool itself is known for encouraging positive classroom environments, regard for the students' perspectives, behavior management skills, quality of feedback, and language modeling. The administrators rate each of the ten categories on a scale of one to seven. One being the lowest score and seven being the highest score that the teacher may receive. Exploration Western culture has used the term "discovery" in their histories to lay claims over lands and people as "discovery" through discovery doctrines and subtly emphasize the importance of "exploration" in the history of the world, such as in the "Age of Discovery", the New World and any frontierist endeavour even into space as the "New Frontier". In the course of this discovery, it has been used to describe the first incursions of peoples from one culture into the geographical and cultural environment of others. However, calling it "discovery" has been rejected by many indigenous peoples, from whose perspective it was not a discovery but a first contact, and consider the term "discovery" to perpetuate colonialism, as for the discovery doctrine and frontierist concepts like terra nullius. Discovery and the age of discovery have been alternatively, particularly regionally, referred to through the terms contact, Age of Contact or Contact Period. See also Bold hypothesis :Category:Discoverers :Category:Lists of inventions or discoveries Creativity techniques Contact zone List of German inventions and discoveries List of multiple discoveries Logology (science) Multiple discovery Revelation Rights of nature Role of chance in scientific discoveries Scientific priority Serendipity Timeline of scientific discoveries References Specific references General references (preprint) External links A Science Odyssey: People and discoveries from PBS. TED-Education video - How simple ideas lead to scientific discoveries. A Guide to Inventions and Discoveries: From Adrenaline to the Zipper from Infoplease. Learning Observation Cognition

Emotional Design

Emotional Design is both the title of a book by Donald Norman and of the concept it represents. Content The main topic covered is how emotions have a crucial role in the human ability to understand the world, and how they learn new things. In fact, studies show that emotion influences people's information processing and decision-making For example: aesthetically pleasing objects appear to the user to be more effective, by virtue of their sensual appeal. This is due to the affinity the user feels for an object that appeals to them, due to the formation of an emotional connection with the object. Consequently, It is believed that companies and designers should not rely on pricey marketing; they should link their services to customers' emotions and daily lives to get them "hooked" on a product. Norman's approach is based on classical ABC model of attitudes. However, he changed the concept to be suitable for application in design. The three dimensions have new names (visceral, behavioral and reflective level) and partially new content . The first is the "visceral" level which is about immediate initial reactions people unconsciously do and are greatly determined by sensory factors (look, feel, smell, and sound). Norman argued that attractive products work better because they can engage multiple senses to evoke emotional responses and bonds through use of visual factors of color, texture, and shape. He contends that beautifully designed products make people feel good. This is where appearance matters, and first impressions are formed, and the texture and surface of an object become important in evoking a specific emotional reaction. Thus, viscerally well-designed products tend to evoke positive emotions and experiences in the consumers. The second is "behavioral" level which is all about use; what does a product do, what function does it perform? Good behavioral design should be human centered, focusing upon understanding and satisfying the needs of people who use the product. This level of design starts with understanding the user's demands, ideally derived from conducting studies of relevant behavior in homes, schools, places of work, or wherever the product will be used.   The third is "reflective" level at which the product has meaning for consumers; the emotional connections which are formed over time using the product and are influenced by cultural, social, and personal factors. Via good reflective design, people will feel a sense of personal bond and identity with an object, and it will become a part of their daily lives. It is how we remember the experience itself and how it made us feel. In summary, the visceral level concerns itself with the aesthetic or attractiveness of an object. The behavioral level considers the function and usability of the product. The reflective level takes into account prestige and value; this is often influenced by the branding of a product. In the book, Norman shows that design of most objects are perceived on all three levels (dimensions). Therefore, a good design should address all three levels. Norman also mentions in his book that "technology should bring more to our lives than the improved performance of tasks: it should be richness and enjoyment." (pg 101) He stresses the importance of creating fun and pleasurable products instead of dull and dreary ones. By mixing all three design levels and the four pleasures by Patrick W. Jordan, the product should evoke an emotion when the user is interacting with the product. The interaction of these three levels of design leads to the culmination of the "emotional design," a new, holistic approach to designing successful products and creates enduring and delightful product experience. Emotional design is an important element when generating ideas for human-centered opportunities. People can more easily relate to a product, a service, a system, or an experience when they are able to connect with it at a personal level. Rather than thinking that there is one solution for all, both Norman's three design levels and Jordan's four pleasures of design can help us design for each individual's needs. Both concepts can be used as tools to better connect with the end user that it is being design for. This viewpoint is gaining a lot of acceptance in the business world; for example, Postrel argues that the "look and feel" of people, places, and things are more important than we think. In other words, people today are more concerned with the look and feel of products than with their functionality. Cover The front cover of Emotional Design showcases Philippe Starck's Juicy Salif, an icon of industrial design that Norman heralds as an "item of seduction" and the manifestation of his thesis. Concept Emotions are a fundamental aspect of human experience, and our emotional responses to people, places, and objects are shaped by a complex interplay of factors. As Peter Boatwright and Jonathan Cagan point out, "emotion is human, and its reach is vast". In the current marketplace, successful companies are not just creating good products, but also producing captivating ones that not only attract consumer attention, but also influence their demands and increase their engagement based on both the product's performance and how it makes them feel. Emotional design is also influenced by the four pleasures, identified in Designing Pleasurable Products by Patrick W. Jordan. In this book Jordan builds on the work of Lionel Tiger to identify the four kinds of pleasures. Jordan describes these as "modes of motivation that enhance a product or a service. Life is unenjoyable without appreciating what we do, and it is human intuition to seek pleasure." The idea of incorporating pleasure into products is to provide the buyer with an added experience. Jordan points out in his book that a product should be more than something functional and/or aesthetically pleasing and it should evoke an emotion through the use of pleasures. Although it is hard to achieve all four pleasures into one product, by simply focusing on one, it might be what can bring a product from being chosen over another. The four pleasures that could be implemented into products or a service are: Physio-pleasure deals with the body and pleasure derived from the sensory organs. This includes taste, touch, and smell, as well as sexual and sensual pleasure. In the context of products, these pleasures can be associated with tactile properties (the way interaction with the product feels) or olfactory properties (the leather smell in a new car, for example). Socio-pleasure is the enjoyment derived from the company of others. Products can facilitate social interaction in a number of ways, either through providing a service that brings people together (a coffee-maker enabling a host to provide their guests with fresh coffee) or by being a talking point in and of itself. Psycho-pleasure is defined as pleasure which is gained from the accomplishment of a task. In a product context, psycho-pleasure relates to the extent in which a product can help in task completion and make the accomplishment a satisfying experience. This pleasure may also take into account the efficiency with which a task can be completed (a word processor with built-in formatting decreasing the amount of time spent on creating a document, for example). Ideo-pleasure refers to pleasure derived from theoretical entities such as books, music, and art. It may relate to the aesthetics of a product and the values it embodies. A product made of bio-degradable material, for example, can be seen as holding value in the environment which, in turn, may appeal to someone who wishes to be environmentally responsible. The use of emotional design In film People mostly know film as an entertainment but film can do more than that. Gianluca Sergi and Alan Lovell cite a study in their essays on cinema entertainment that the film users (the viewers) see films as an escape from reality and a source of amusement, relaxation and knowledge, meaning films also function as an educational tool and a method of stress relief. Specifically, comparing to emotional design, film fulfills the requirements it needs. Firstly, movies have an attractive appearance. Whether movies start with a black and white concept like in Oz the Great and Powerful or an oddly colorful, but serious theme as in Suicide Squad, they usually capture the audiences' attention, who then want to continue watching the whole show. The "wow" reaction that viewers have is the visceral reaction, according to how Don Norman explains the three levels of design in his book Emotional Design: Why We Love (or Hate) Everyday Things, "[w]hen we perceive something as "pretty," that judgment comes directly from the visceral level." (65–66) Secondly, the behavioral level: in a literal sense, the only function of movies is to be watched. With the advancement of technology, movies now have high resolution, as well as various lighting dynamics and camera angles. Lastly, applying Don Norman's statement on how products can add positively to the self-image of the users and how good the users feel after owning the products, film does influence its viewers greatly and affect the way they act. Trice and Greer indicate that "we identify with characters on the screen who are like us in terms of age, sex and other characteristics; we also identify with people we would like to be like.[...] We tend to imitate "good" characters" (135). That being said, movies do not label any of their characters good or bad in a straightforward manner; the viewers only learn about the characters through the narrative, which production design is a part of. In physical space design Emotional design is one of the important aspects of creating a successful and enjoyable experience for customers in a physical space such as Starbucks. Emotional design refers to the ability of design elements to evoke certain emotions or feelings in customers. [13] One example of emotional design at Starbucks is the use of warm lighting, comfortable seating, and relaxing music to create a cozy and inviting atmosphere. This creates a sense of comfort and relaxation, which can be particularly appealing to customers who are looking for a place to unwind or catch up with friends. Another example of emotional design at Starbucks is the use of distinctive and recognizable branding elements, such as the green logo, the mermaid icon, and the signature cup design. These elements create a sense of familiarity and loyalty among customers, who often associate the Starbucks brand with a certain lifestyle or personality. Relationship between emotion and design Emotion and design are intricately linked in the field of emotional design, which is concerned with creating products, interfaces, and experiences that engage users on an emotional level. Emotions design involves the intentional use of design elements to evoke specific emotional responses in users. The relationship between emotion and design in emotional design is rooted in the idea that emotions are a key driver of human behavior. People are more likely to engage with products and interfaces that evoke positive emotions such as joy, excitement, and delight, while negative emotions such as frustration and anger can lead to disengagement and avoidance. In emotional design, designers use a variety of techniques to evoke emotions in users. These may include the use of color, typography, imagery, sound, and motion, among others. For example, a website might use bright, cheerful colors and playful animations to create a sense of fun and whimsy, while a meditation app might use soft, calming colors and soothing sounds to create a sense of relaxation and tranquility. See also Kansei engineering – a design approach incorporating emotional elements Sustainable design References Psychology books Industrial design 2003 non-fiction books

Theoretical ecology

Theoretical ecology is the scientific discipline devoted to the study of ecological systems using theoretical methods such as simple conceptual models, mathematical models, computational simulations, and advanced data analysis. Effective models improve understanding of the natural world by revealing how the dynamics of species populations are often based on fundamental biological conditions and processes. Further, the field aims to unify a diverse range of empirical observations by assuming that common, mechanistic processes generate observable phenomena across species and ecological environments. Based on biologically realistic assumptions, theoretical ecologists are able to uncover novel, non-intuitive insights about natural processes. Theoretical results are often verified by empirical and observational studies, revealing the power of theoretical methods in both predicting and understanding the noisy, diverse biological world. The field is broad and includes foundations in applied mathematics, computer science, biology, statistical physics, genetics, chemistry, evolution, and conservation biology. Theoretical ecology aims to explain a diverse range of phenomena in the life sciences, such as population growth and dynamics, fisheries, competition, evolutionary theory, epidemiology, animal behavior and group dynamics, food webs, ecosystems, spatial ecology, and the effects of climate change. Theoretical ecology has further benefited from the advent of fast computing power, allowing the analysis and visualization of large-scale computational simulations of ecological phenomena. Importantly, these modern tools provide quantitative predictions about the effects of human induced environmental change on a diverse variety of ecological phenomena, such as: species invasions, climate change, the effect of fishing and hunting on food network stability, and the global carbon cycle. Modelling approaches As in most other sciences, mathematical models form the foundation of modern ecological theory. Phenomenological models: distill the functional and distributional shapes from observed patterns in the data, or researchers decide on functions and distribution that are flexible enough to match the patterns they or others (field or experimental ecologists) have found in the field or through experimentation. Mechanistic models: model the underlying processes directly, with functions and distributions that are based on theoretical reasoning about ecological processes of interest. Ecological models can be deterministic or stochastic. Deterministic models always evolve in the same way from a given starting point. They represent the average, expected behavior of a system, but lack random variation. Many system dynamics models are deterministic. Stochastic models allow for the direct modeling of the random perturbations that underlie real world ecological systems. Markov chain models are stochastic. Species can be modelled in continuous or discrete time. Continuous time is modelled using differential equations. Discrete time is modelled using difference equations. These model ecological processes that can be described as occurring over discrete time steps. Matrix algebra is often used to investigate the evolution of age-structured or stage-structured populations. The Leslie matrix, for example, mathematically represents the discrete time change of an age structured population. Models are often used to describe real ecological reproduction processes of single or multiple species. These can be modelled using stochastic branching processes. Examples are the dynamics of interacting populations (predation competition and mutualism), which, depending on the species of interest, may best be modeled over either continuous or discrete time. Other examples of such models may be found in the field of mathematical epidemiology where the dynamic relationships that are to be modeled are host–pathogen interactions. Bifurcation theory is used to illustrate how small changes in parameter values can give rise to dramatically different long run outcomes, a mathematical fact that may be used to explain drastic ecological differences that come about in qualitatively very similar systems. Logistic maps are polynomial mappings, and are often cited as providing archetypal examples of how chaotic behaviour can arise from very simple non-linear dynamical equations. The maps were popularized in a seminal 1976 paper by the theoretical ecologist Robert May. The difference equation is intended to capture the two effects of reproduction and starvation. In 1930, R.A. Fisher published his classic The Genetical Theory of Natural Selection, which introduced the idea that frequency-dependent fitness brings a strategic aspect to evolution, where the payoffs to a particular organism, arising from the interplay of all of the relevant organisms, are the number of this organism' s viable offspring. In 1961, Richard Lewontin applied game theory to evolutionary biology in his Evolution and the Theory of Games, followed closely by John Maynard Smith, who in his seminal 1972 paper, “Game Theory and the Evolution of Fighting", defined the concept of the evolutionarily stable strategy. Because ecological systems are typically nonlinear, they often cannot be solved analytically and in order to obtain sensible results, nonlinear, stochastic and computational techniques must be used. One class of computational models that is becoming increasingly popular are the agent-based models. These models can simulate the actions and interactions of multiple, heterogeneous, organisms where more traditional, analytical techniques are inadequate. Applied theoretical ecology yields results which are used in the real world. For example, optimal harvesting theory draws on optimization techniques developed in economics, computer science and operations research, and is widely used in fisheries. Population ecology Population ecology is a sub-field of ecology that deals with the dynamics of species populations and how these populations interact with the environment. It is the study of how the population sizes of species living together in groups change over time and space, and was one of the first aspects of ecology to be studied and modelled mathematically. Exponential growth The most basic way of modeling population dynamics is to assume that the rate of growth of a population depends only upon the population size at that time and the per capita growth rate of the organism. In other words, if the number of individuals in a population at a time t, is N(t), then the rate of population growth is given by: where r is the per capita growth rate, or the intrinsic growth rate of the organism. It can also be described as r = b-d, where b and d are the per capita time-invariant birth and death rates, respectively. This first order linear differential equation can be solved to yield the solution , a trajectory known as Malthusian growth, after Thomas Malthus, who first described its dynamics in 1798. A population experiencing Malthusian growth follows an exponential curve, where N(0) is the initial population size. The population grows when r > 0, and declines when r < 0. The model is most applicable in cases where a few organisms have begun a colony and are rapidly growing without any limitations or restrictions impeding their growth (e.g. bacteria inoculated in rich media). Logistic growth The exponential growth model makes a number of assumptions, many of which often do not hold. For example, many factors affect the intrinsic growth rate and is often not time-invariant. A simple modification of the exponential growth is to assume that the intrinsic growth rate varies with population size. This is reasonable: the larger the population size, the fewer resources available, which can result in a lower birth rate and higher death rate. Hence, we can replace the time-invariant r with r’(t) = (b –a*N(t)) – (d + c*N(t)), where a and c are constants that modulate birth and death rates in a population dependent manner (e.g. intraspecific competition). Both a and c will depend on other environmental factors which, we can for now, assume to be constant in this approximated model. The differential equation is now: This can be rewritten as: where r = b-d and K = (b-d)/(a+c). The biological significance of K becomes apparent when stabilities of the equilibria of the system are considered. The constant K is the carrying capacity of the population. The equilibria of the system are N = 0 and N = K. If the system is linearized, it can be seen that N = 0 is an unstable equilibrium while K is a stable equilibrium. Structured population growth Another assumption of the exponential growth model is that all individuals within a population are identical and have the same probabilities of surviving and of reproducing. This is not a valid assumption for species with complex life histories. The exponential growth model can be modified to account for this, by tracking the number of individuals in different age classes (e.g. one-, two-, and three-year-olds) or different stage classes (juveniles, sub-adults, and adults) separately, and allowing individuals in each group to have their own survival and reproduction rates. The general form of this model is where Nt is a vector of the number of individuals in each class at time t and L is a matrix that contains the survival probability and fecundity for each class. The matrix L is referred to as the Leslie matrix for age-structured models, and as the Lefkovitch matrix for stage-structured models. If parameter values in L are estimated from demographic data on a specific population, a structured model can then be used to predict whether this population is expected to grow or decline in the long-term, and what the expected age distribution within the population will be. This has been done for a number of species including loggerhead sea turtles and right whales. Community ecology An ecological community is a group of trophically similar, sympatric species that actually or potentially compete in a local area for the same or similar resources. Interactions between these species form the first steps in analyzing more complex dynamics of ecosystems. These interactions shape the distribution and dynamics of species. Of these interactions, predation is one of the most widespread population activities. Taken in its most general sense, predation comprises predator–prey, host–pathogen, and host–parasitoid interactions. Predator–prey interaction Predator–prey interactions exhibit natural oscillations in the populations of both predator and the prey. In 1925, the American mathematician Alfred J. Lotka developed simple equations for predator–prey interactions in his book on biomathematics. The following year, the Italian mathematician Vito Volterra, made a statistical analysis of fish catches in the Adriatic and independently developed the same equations. It is one of the earliest and most recognised ecological models, known as the Lotka-Volterra model: where N is the prey and P is the predator population sizes, r is the rate for prey growth, taken to be exponential in the absence of any predators, α is the prey mortality rate for per-capita predation (also called ‘attack rate’), c is the efficiency of conversion from prey to predator, and d is the exponential death rate for predators in the absence of any prey. Volterra originally used the model to explain fluctuations in fish and shark populations after fishing was curtailed during the First World War. However, the equations have subsequently been applied more generally. Other examples of these models include the Lotka-Volterra model of the snowshoe hare and Canadian lynx in North America, any infectious disease modeling such as the recent outbreak of SARS and biological control of California red scale by the introduction of its parasitoid, Aphytis melinus . A credible, simple alternative to the Lotka-Volterra predator–prey model and their common prey dependent generalizations is the ratio dependent or Arditi-Ginzburg model. The two are the extremes of the spectrum of predator interference models. According to the authors of the alternative view, the data show that true interactions in nature are so far from the Lotka–Volterra extreme on the interference spectrum that the model can simply be discounted as wrong. They are much closer to the ratio-dependent extreme, so if a simple model is needed one can use the Arditi–Ginzburg model as the first approximation. Host–pathogen interaction The second interaction, that of host and pathogen, differs from predator–prey interactions in that pathogens are much smaller, have much faster generation times, and require a host to reproduce. Therefore, only the host population is tracked in host–pathogen models. Compartmental models that categorize host population into groups such as susceptible, infected, and recovered (SIR) are commonly used. Host–parasitoid interaction The third interaction, that of host and parasitoid, can be analyzed by the Nicholson–Bailey model, which differs from Lotka-Volterra and SIR models in that it is discrete in time. This model, like that of Lotka-Volterra, tracks both populations explicitly. Typically, in its general form, it states: where f(Nt, Pt) describes the probability of infection (typically, Poisson distribution), λ is the per-capita growth rate of hosts in the absence of parasitoids, and c is the conversion efficiency, as in the Lotka-Volterra model. Competition and mutualism In studies of the populations of two species, the Lotka-Volterra system of equations has been extensively used to describe dynamics of behavior between two species, N1 and N2. Examples include relations between D. discoiderum and E. coli, as well as theoretical analysis of the behavior of the system. The r coefficients give a “base” growth rate to each species, while K coefficients correspond to the carrying capacity. What can really change the dynamics of a system, however are the α terms. These describe the nature of the relationship between the two species. When α12 is negative, it means that N2 has a negative effect on N1, by competing with it, preying on it, or any number of other possibilities. When α12 is positive, however, it means that N2 has a positive effect on N1, through some kind of mutualistic interaction between the two. When both α12 and α21 are negative, the relationship is described as competitive. In this case, each species detracts from the other, potentially over competition for scarce resources. When both α12 and α21 are positive, the relationship becomes one of mutualism. In this case, each species provides a benefit to the other, such that the presence of one aids the population growth of the other. See Competitive Lotka–Volterra equations for further extensions of this model. Neutral theory Unified neutral theory is a hypothesis proposed by Stephen P. Hubbell in 2001. The hypothesis aims to explain the diversity and relative abundance of species in ecological communities, although like other neutral theories in ecology, Hubbell's hypothesis assumes that the differences between members of an ecological community of trophically similar species are "neutral," or irrelevant to their success. Neutrality means that at a given trophic level in a food web, species are equivalent in birth rates, death rates, dispersal rates and speciation rates, when measured on a per-capita basis. This implies that biodiversity arises at random, as each species follows a random walk. This can be considered a null hypothesis to niche theory. The hypothesis has sparked controversy, and some authors consider it a more complex version of other null models that fit the data better. Under unified neutral theory, complex ecological interactions are permitted among individuals of an ecological community (such as competition and cooperation), providing all individuals obey the same rules. Asymmetric phenomena such as parasitism and predation are ruled out by the terms of reference; but cooperative strategies such as swarming, and negative interaction such as competing for limited food or light are allowed, so long as all individuals behave the same way. The theory makes predictions that have implications for the management of biodiversity, especially the management of rare species. It predicts the existence of a fundamental biodiversity constant, conventionally written θ, that appears to govern species richness on a wide variety of spatial and temporal scales. Hubbell built on earlier neutral concepts, including MacArthur & Wilson's theory of island biogeography and Gould's concepts of symmetry and null models. Spatial ecology Biogeography Biogeography is the study of the distribution of species in space and time. It aims to reveal where organisms live, at what abundance, and why they are (or are not) found in a certain geographical area. Biogeography is most keenly observed on islands, which has led to the development of the subdiscipline of island biogeography. These habitats are often a more manageable areas of study because they are more condensed than larger ecosystems on the mainland. In 1967, Robert MacArthur and E.O. Wilson published The Theory of Island Biogeography. This showed that the species richness in an area could be predicted in terms of factors such as habitat area, immigration rate and extinction rate. The theory is considered one of the fundamentals of ecological theory. The application of island biogeography theory to habitat fragments spurred the development of the fields of conservation biology and landscape ecology. r/K-selection theory A population ecology concept is r/K selection theory, one of the first predictive models in ecology used to explain life-history evolution. The premise behind the r/K selection model is that natural selection pressures change according to population density. For example, when an island is first colonized, density of individuals is low. The initial increase in population size is not limited by competition, leaving an abundance of available resources for rapid population growth. These early phases of population growth experience density-independent forces of natural selection, which is called r-selection. As the population becomes more crowded, it approaches the island's carrying capacity, thus forcing individuals to compete more heavily for fewer available resources. Under crowded conditions, the population experiences density-dependent forces of natural selection, called K-selection. Niche theory Metapopulations Spatial analysis of ecological systems often reveals that assumptions that are valid for spatially homogenous populations – and indeed, intuitive – may no longer be valid when migratory subpopulations moving from one patch to another are considered. In a simple one-species formulation, a subpopulation may occupy a patch, move from one patch to another empty patch, or die out leaving an empty patch behind. In such a case, the proportion of occupied patches may be represented as where m is the rate of colonization, and e is the rate of extinction. In this model, if e < m, the steady state value of p is 1 – (e/m) while in the other case, all the patches will eventually be left empty. This model may be made more complex by addition of another species in several different ways, including but not limited to game theoretic approaches, predator–prey interactions, etc. We will consider here an extension of the previous one-species system for simplicity. Let us denote the proportion of patches occupied by the first population as p1, and that by the second as p2. Then, In this case, if e is too high, p1 and p2 will be zero at steady state. However, when the rate of extinction is moderate, p1 and p2 can stably coexist. The steady state value of p2 is given by (p*1 may be inferred by symmetry). If e is zero, the dynamics of the system favor the species that is better at colonizing (i.e. has the higher m value). This leads to a very important result in theoretical ecology known as the Intermediate Disturbance Hypothesis, where the biodiversity (the number of species that coexist in the population) is maximized when the disturbance (of which e is a proxy here) is not too high or too low, but at intermediate levels. The form of the differential equations used in this simplistic modelling approach can be modified. For example: Colonization may be dependent on p linearly (m*(1-p)) as opposed to the non-linear m*p*(1-p) regime described above. This mode of replication of a species is called the “rain of propagules”, where there is an abundance of new individuals entering the population at every generation. In such a scenario, the steady state where the population is zero is usually unstable. Extinction may depend non-linearly on p (e*p*(1-p)) as opposed to the linear (e*p) regime described above. This is referred to as the “rescue effect” and it is again harder to drive a population extinct under this regime. The model can also be extended to combinations of the four possible linear or non-linear dependencies of colonization and extinction on p are described in more detail in. Ecosystem ecology Introducing new elements, whether biotic or abiotic, into ecosystems can be disruptive. In some cases, it leads to ecological collapse, trophic cascades and the death of many species within the ecosystem. The abstract notion of ecological health attempts to measure the robustness and recovery capacity for an ecosystem; i.e. how far the ecosystem is away from its steady state. Often, however, ecosystems rebound from a disruptive agent. The difference between collapse or rebound depends on the toxicity of the introduced element and the resiliency of the original ecosystem. If ecosystems are governed primarily by stochastic processes, through which its subsequent state would be determined by both predictable and random actions, they may be more resilient to sudden change than each species individually. In the absence of a balance of nature, the species composition of ecosystems would undergo shifts that would depend on the nature of the change, but entire ecological collapse would probably be infrequent events. In 1997, Robert Ulanowicz used information theory tools to describe the structure of ecosystems, emphasizing mutual information (correlations) in studied systems. Drawing on this methodology and prior observations of complex ecosystems, Ulanowicz depicts approaches to determining the stress levels on ecosystems and predicting system reactions to defined types of alteration in their settings (such as increased or reduced energy flow), and eutrophication. Ecopath is a free ecosystem modelling software suite, initially developed by NOAA, and widely used in fisheries management as a tool for modelling and visualising the complex relationships that exist in real world marine ecosystems. Food webs Food webs provide a framework within which a complex network of predator–prey interactions can be organised. A food web model is a network of food chains. Each food chain starts with a primary producer or autotroph, an organism, such as a plant, which is able to manufacture its own food. Next in the chain is an organism that feeds on the primary producer, and the chain continues in this way as a string of successive predators. The organisms in each chain are grouped into trophic levels, based on how many links they are removed from the primary producers. The length of the chain, or trophic level, is a measure of the number of species encountered as energy or nutrients move from plants to top predators. Food energy flows from one organism to the next and to the next and so on, with some energy being lost at each level. At a given trophic level there may be one species or a group of species with the same predators and prey. In 1927, Charles Elton published an influential synthesis on the use of food webs, which resulted in them becoming a central concept in ecology. In 1966, interest in food webs increased after Robert Paine's experimental and descriptive study of intertidal shores, suggesting that food web complexity was key to maintaining species diversity and ecological stability. Many theoretical ecologists, including Sir Robert May and Stuart Pimm, were prompted by this discovery and others to examine the mathematical properties of food webs. According to their analyses, complex food webs should be less stable than simple food webs. The apparent paradox between the complexity of food webs observed in nature and the mathematical fragility of food web models is currently an area of intensive study and debate. The paradox may be due partially to conceptual differences between persistence of a food web and equilibrial stability of a food web. Systems ecology Systems ecology can be seen as an application of general systems theory to ecology. It takes a holistic and interdisciplinary approach to the study of ecological systems, and particularly ecosystems. Systems ecology is especially concerned with the way the functioning of ecosystems can be influenced by human interventions. Like other fields in theoretical ecology, it uses and extends concepts from thermodynamics and develops other macroscopic descriptions of complex systems. It also takes account of the energy flows through the different trophic levels in the ecological networks. Systems ecology also considers the external influence of ecological economics, which usually is not otherwise considered in ecosystem ecology. For the most part, systems ecology is a subfield of ecosystem ecology. Ecophysiology This is the study of how "the environment, both physical and biological, interacts with the physiology of an organism. It includes the effects of climate and nutrients on physiological processes in both plants and animals, and has a particular focus on how physiological processes scale with organism size". Behavioral ecology Swarm behaviour Swarm behaviour is a collective behaviour exhibited by animals of similar size which aggregate together, perhaps milling about the same spot or perhaps migrating in some direction. Swarm behaviour is commonly exhibited by insects, but it also occurs in the flocking of birds, the schooling of fish and the herd behaviour of quadrupeds. It is a complex emergent behaviour that occurs when individual agents follow simple behavioral rules. Recently, a number of mathematical models have been discovered which explain many aspects of the emergent behaviour. Swarm algorithms follow a Lagrangian approach or an Eulerian approach. The Eulerian approach views the swarm as a field, working with the density of the swarm and deriving mean field properties. It is a hydrodynamic approach, and can be useful for modelling the overall dynamics of large swarms.<ref>Toner J and Tu Y (1995) "Long-range order in a two-dimensional xy model: how birds fly together" Physical Revue Letters, '75 (23)(1995), 4326–4329.</ref> However, most models work with the Lagrangian approach, which is an agent-based model following the individual agents (points or particles) that make up the swarm. Individual particle models can follow information on heading and spacing that is lost in the Eulerian approach. Examples include ant colony optimization, self-propelled particles and particle swarm optimization. On cellular levels, individual organisms also demonstrated swarm behavior. Decentralized systems are where individuals act based on their own decisions without overarching guidance. Studies have shown that individual Trichoplax adhaerens behave like self-propelled particles (SPPs) and collectively display phase transition from ordered movement to disordered movements. Previously, it was thought that the surface-to-volume ratio was what limited the animal size in the evolutionary game. Considering the collective behaviour of the individuals, it was suggested that order is another limiting factor. Central nervous systems were indicated to be vital for large multicellular animals in the evolutionary pathway. Synchronization Photinus carolinus firefly will synchronize their shining frequencies in a collective setting. Individually, there are no apparent patterns for the flashing. In a group setting, periodicity emerges in the shining pattern. The coexistence of the synchronization and asynchronization in the flashings in the system composed of multiple fireflies could be characterized by the chimera states. Synchronization could spontaneously occur. The agent-based model has been useful in describing this unique phenomenon. The flashings of individual fireflies could be viewed as oscillators and the global coupling models were similar to the ones used in condensed matter physics. Evolutionary ecology The British biologist Alfred Russel Wallace is best known for independently proposing a theory of evolution due to natural selection that prompted Charles Darwin to publish his own theory. In his famous 1858 paper, Wallace proposed natural selection as a kind of feedback mechanism which keeps species and varieties adapted to their environment. The action of this principle is exactly like that of the centrifugal governor of the steam engine, which checks and corrects any irregularities almost before they become evident; and in like manner no unbalanced deficiency in the animal kingdom can ever reach any conspicuous magnitude, because it would make itself felt at the very first step, by rendering existence difficult and extinction almost sure soon to follow. The cybernetician and anthropologist Gregory Bateson observed in the 1970s that, though writing it only as an example, Wallace had "probably said the most powerful thing that’d been said in the 19th Century". Subsequently, the connection between natural selection and systems theory has become an area of active research. Other theories In contrast to previous ecological theories which considered floods to be catastrophic events, the river flood pulse concept argues that the annual flood pulse is the most important aspect and the most biologically productive feature of a river's ecosystem.Benke, A. C., Chaubey, I., Ward, G. M., & Dunn, E. L. (2000). Flood Pulse Dynamics of an Unregulated River Floodplain in the Southeastern U.S. Coastal Plain. Ecology, 2730-2741. History Theoretical ecology draws on pioneering work done by G. Evelyn Hutchinson and his students. Brothers H.T. Odum and E.P. Odum are generally recognised as the founders of modern theoretical ecology. Robert MacArthur brought theory to community ecology. Daniel Simberloff was the student of E.O. Wilson, with whom MacArthur collaborated on The Theory of Island Biogeography, a seminal work in the development of theoretical ecology. Simberloff added statistical rigour to experimental ecology and was a key figure in the SLOSS debate, about whether it is preferable to protect a single large or several small reserves. This resulted in the supporters of Jared Diamond's community assembly rules defending their ideas through Neutral Model Analysis. Simberloff also played a key role in the (still ongoing) debate on the utility of corridors for connecting isolated reserves. Stephen P. Hubbell and Michael Rosenzweig combined theoretical and practical elements into works that extended MacArthur and Wilson's Island Biogeography Theory - Hubbell with his Unified Neutral Theory of Biodiversity and Biogeography and Rosenzweig with his Species Diversity in Space and Time. Theoretical and mathematical ecologists A tentative distinction can be made between mathematical ecologists, ecologists who apply mathematics to ecological problems, and mathematicians who develop the mathematics itself that arises out of ecological problems. Some notable theoretical ecologists can be found in these categories: :Category:Mathematical ecologists :Category:Theoretical biologists Journals The American Naturalist Journal of Mathematical Biology Journal of Theoretical Biology Theoretical Ecology Theoretical Population Biology Ecological ModellingSee also Butterfly effect Complex system biology Ecological systems theory Ecosystem model Integrodifference equation – widely used to model the dispersal and growth of populations Limiting similarity Mathematical biology Population dynamics Population modeling Quantitative ecology Taylor's law Theoretical biology References Further reading The classic text is Theoretical Ecology: Principles and Applications, by Angela McLean and Robert May. The 2007 edition is published by the Oxford University Press. . Bolker BM (2008) Ecological Models and Data in R Princeton University Press. . Case TJ (2000) An illustrated guide to theoretical ecology Oxford University Press. . Caswell H (2000) Matrix Population Models: Construction, Analysis, and Interpretation'', Sinauer, 2nd Ed. . Edelstein-Keshet L (2005) Mathematical Models in Biology Society for Industrial and Applied Mathematics. . Gotelli NJ (2008) A Primer of Ecology Sinauer Associates, 4th Ed. . Gotelli NJ & A Ellison (2005) A Primer Of Ecological Statistics Sinauer Associates Publishers. . Hastings A (1996) Population Biology: Concepts and Models Springer. . Hilborn R & M Clark (1997) The Ecological Detective: Confronting Models with Data Princeton University Press. Kokko H (2007) Modelling for field biologists and other interesting people Cambridge University Press. . Kot M (2001) Elements of Mathematical Ecology Cambridge University Press. . Murray JD (2002) Mathematical Biology, Volume 1 Springer, 3rd Ed. . Murray JD (2003) Mathematical Biology, Volume 2 Springer, 3rd Ed. . Pastor J (2008) Mathematical Ecology of Populations and Ecosystems Wiley-Blackwell. . Roughgarden J (1998) Primer of Ecological Theory Prentice Hall. . Ulanowicz R (1997) Ecology: The Ascendant Perspective Columbia University Press. Ecology

Benefits of physical activity

The benefits of physical activity range widely. Most types of physical activity improve health and well-being. Physical activity refers to any body movement that burns calories. “Exercise,” a subcategory of physical activity, refers to planned, structured, and repetitive activities aimed at improving physical fitness and health. Insufficient physical activity is the most common health issue in the world. Staying physically active can help prevent or delay certain diseases, including cancer, stroke, hypertension, heart disease, and diabetes, and can also relieve depression and improve mood. Recommended amount Two and a half hours of moderate-intensity exercise per week is recommended for reducing the risk of health issues. However, even doing a small amount of exercise is healthier than doing none. Immediate benefits Some of the benefits of physical activity on brain health happen right after a session of moderate to vigorous physical activity. Benefits include improved thinking or cognition for children ages 6-13, short-term reduction of anxiety for adults, and enhanced functional capacity in older adults. Regular physical activity can keep thinking, learning, and judgment skills sharp with age. It can also reduce the risk of depression and anxiety and improve sleep. Weight management Both dieting and physical activity play a critical role in maintaining healthy body weight, or maintaining successful weight loss. Physical activity helps control weight by using excess calories that would otherwise be stored as fat. Most activities burn calories, including sleeping, breathing, and digesting food. Balancing the calories consumed with the calories burned through physical activity will maintain one's weight. Long-term benefits Frequent physical activity lowers the risk of cardiovascular diseases, type 2 diabetes, and some cancers. Obesity is a complex disease that affects whole-body metabolism and is associated with an increased risk of cardiovascular disease (CVD) and Type 2 diabetes (T2D). Physical exercise results in numerous health benefits and is an important tool to combat obesity and its co-morbidities, including cardiovascular diseases. Exercise prevents both the onset and development of cardiovascular disease and is an important therapeutic tool to improve outcomes for patients with cardiovascular disease. Some benefits of exercise include enhanced mitochondrial function, restoration and improvement of vasculature, and the release of myokines from skeletal muscle that preserve or augment cardiovascular function. In this review, we will discuss the mechanisms through which exercise promotes cardiovascular health. Regular physical exercise has several beneficial effects on overall health. While decreasing body mass and adiposity are not the primary outcomes of exercise, exercise can mediate several diseases that accompany obesity, including T2D and CVD. Several recent studies have shown that sustained physical activity is associated with decreased markers of inflammation, improved metabolic health, decreased risk of heart failure, and improved overall survival. There are several risk factors leading to the development and progression of CVD, but one of the most prominent is a sedentary lifestyle. A sedentary lifestyle can be characterized by both obesity and consistently low levels of physical activity. Thus, lifestyle interventions that aim to increase physical activity and decrease obesity are attractive therapeutic methods to combat most non-congenital types of CVD. Effect on cardiovascular risk factors Regular physical exercise is associated with numerous health benefits to reduce the progression and development of diseases. Several randomized clinical trials have demonstrated that lifestyle interventions, including moderate exercise and a healthy diet, improve cardiovascular health in at-risk populations. Individuals with metabolic syndrome who participated in a 4-month program of either a diet (caloric restriction) or exercise intervention had reduced adiposity, decreased systolic, diastolic, and mean arterial blood pressure, and lower total and low-density lipoprotein (LDL) cholesterol lipid profiles compared to the control group. Both the diet and exercise interventions improve these cardiovascular outcomes to a similar extent. Several previous studies have investigated the effects of diet and exercise, independently or in combination, on metabolic and cardiovascular health and have determined that diet, exercise, or a combination of diet and exercise induces weight loss, decreases visceral adiposity, lowers plasma triglycerides, plasma glucose, HDL levels, and blood pressure, and improves VO2max. Studies have shown that exercise can improve metabolic and cardiovascular health independent of changes in body weight, including improved glucose homeostasis, endothelial function, blood pressure, and HDL levels. These data indicate exercise, independent of changes in body mass, results in significant improvements in cardiovascular and metabolic health. Although a detailed analysis of the vast impact of diet on cardiometabolic health is outside the scope of this review, the importance of diet and exercise in tandem should not be ignored, as many studies have shown that cardiometabolic health is improved to a higher extent in response to a combined diet and exercise programs compared to either intervention alone. Exercise has a similar effect on cardiovascular improvements in lean and overweight normoglycemic subjects. In a 1-year study of non-obese individuals, a 16–20% increase in energy expenditure (of any form of exercise) with no diet intervention resulted in a 22.3% decrease in body fat mass and reduced LDL cholesterol, total cholesterol/HDL ratio, and C-reactive protein concentrations, all risk factors associated with CVD. In overweight individuals, 7–9 months of low-intensity exercise (walking ~19 km per week at 40–55% VO2peak) significantly increased cardiorespiratory fitness compared to sedentary individuals. Together these data indicate that exercise interventions decrease the risk or severity of CVD in subjects who are lean, obese, or have type 2 diabetes. Cardiac rehabilitation Exercise is also an important therapeutic treatment for patients who have cardiovascular diseases. A systematic review of 63 studies found that exercise-based cardiac rehabilitation improved cardiovascular function. These studies consisted of various forms of aerobic exercise at a range of intensities (from 50 to 95% VO2), over a multitude of time periods (1–47 months). Overall, exercise significantly reduced CVD-related mortality, decreased risk of MI, and improved quality of life. Another study looked specifically at patients with atherosclerosis post-revascularization surgery. Patients who underwent 60 min of exercise per day on a cycle ergometer for 4 weeks had an increased blood flow reserve (29%) and improved endothelium-dependent vasodilatation. A recent study provided personalized aerobic exercise rehabilitation programs for patients who had an acute myocardial infarction for 1 year after a coronary intervention surgery. The patients who underwent the exercise rehabilitation program had increased ejection fraction (60.81 vs. 53% control group), increased exercise tolerance, and reduced cardiovascular risk factors 6 months after starting the exercise rehabilitation program. This improvement in cardiovascular health in patients with atherosclerosis or post-MI is likely the result of increased myocardial perfusion in response to exercise, however, more research is required to fully understand these mechanisms. One defining characteristic of heart failure is exercise intolerance, which resulted in a prescription for bed rest for these patients until the 1950s. However, it has now been shown that a monitored rehabilitation program using moderate-intensity exercise is safe for heart failure patients, and this has now become an important therapy for patients with heart failure. Meta-analyses and systemic reviews have shown that exercise training in heart failure patients is associated with improved quality of life, reduced risk of hospitalization and decreased rates of long-term mortality. One study of heart failure patients found that aerobic exercise (walking or cycling) at 60–70% of heart rate reserve 3–5 times per week for over 3 years led to improved health and overall quality of life (determined by a self-reported Kansas City Cardiomyopathy Questionnaire, a 23-question disease-specific questionnaire). Other studies have shown that exercise-based rehabilitation at a moderate intensity in heart failure patients improves cardiorespiratory fitness and increases both exercise endurance capacity and VO2max (12–31% increase). More recent studies have examined the effects of high-intensity exercise on patients with heart failure. A recent study found that 12 weeks of high-intensity interval training (HIIT) in heart failure patients (with reduced ejection fraction) was well-tolerated and had similar benefits compared to patients who underwent moderate continuous exercise (MCE) training, including improved left ventricular remodeling and aerobic capacity. A separate study found that 4 weeks of HIIT in heart failure patients with preserved ejection fraction improved VO2peak and reduced diastolic dysfunction compared to both pre-training values and compared to the MCE group. These studies indicate that both moderate and high-intensity exercise training improve cardiovascular function in heart failure patients, likely related to increased endothelium-dependent vasodilation and improved aerobic capacity. Other benefits Bones and muscles Routine physical activity is important for building strong bones and muscles in children, but it is equally important for older adults. Bones and muscles work together to support daily movements. Physical activity strengthens muscles. Bones adapt by building more cells, and as a result, both become stronger. Strong bones and muscles protect against injury and improve balance and coordination. In addition, active adults experience less joint stiffness and improved flexibility. This becomes especially important with age, as it helps to prevent falls and the broken bones that may result. For those with arthritis, an exercise that keeps the muscles around the joint strong can act like a brace that will react to movement without the use of an actual brace. Daily activity The ability to perform daily activities and maintain independence requires strong muscles, balance, and endurance. Regular physical activity or exercise helps to improve and prevent the decline of muscalking, getting up out of a chair or leaning over to pick something up. Balance problems can reduce independence by interfering with activities of daily living. Regular physical activity can improve balance and reduce the risk of falling. Exercising regularly has many benefits for both your physical and mental health. Cancer Exercise increases the chances of surviving cancer. If one exercises during the early stages of cancer treatment it may allow time to reduce the detrimental side effects of the chemotherapy. It also improves physical functions along with reducing distress and fatigue. Studies have shown that exercise has the possibility to improve the chemotherapy drug uptake, thanks to the increase in peripheral circulation. This also makes changes to tumor vasculature from the increase of cardio and blood pressure. Stroke Regular physical activity and exercise decrease the risk of ischemic stroke and intracerebral hemorrhage. There is a dose-response relationship between increased physical activity and the risk of stroke. Being physically active before a stroke is associated with decreased admission stroke severity and improved post-stroke outcomes. Research indicates that individuals who engage in regular physical activity before experiencing a stroke demonstrate fewer stroke symptoms, smaller infarct volumes in ischemic strokes, smaller hematoma volumes in intracerebral hemorrhages, and higher post-stroke survival rates. Being physically active after a stroke is associated with improved recovery and function. Sleep condition Exercise triggers an increase in body temperature, and the post-exercise drop in temperature may promote falling asleep. Exercise may also reduce insomnia by decreasing arousal, anxiety, and depressive symptoms. Insomnia is commonly linked with elevated arousal, anxiety, and depression, and exercise has effects on reducing these symptoms in the general population. These issues count among the most common among most of the population. Anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults in the United States age 18 and older, or 18.1% of the population every year. A 2010 review suggested that exercise generally improved sleep for most people, and may help with insomnia, but there is insufficient evidence to draw detailed conclusions about the relationship between exercise and sleep. A 2020 systematic review and meta-analysis suggested that physical activity has little association with sleep in healthy children. However, there have been several research findings indicating that certain forms of physical activity can improve the quality and duration of sleep. In fact, a 2019 study at The Federal University of São Paulo concluded that moderate physical activity resulted in an increase in sleep efficiency and duration in adults diagnosed with insomnia. The duration refers to the hours of sleep a person gets on a nightly basis, while the quality indicates how well or sufficient it was. Having poor sleep quality can lead to negative short-term consequences like emotional distress and performance deficits. The psychosocial issues associated with these consequences can vary between adults, adolescents, and children. Some of the long-term effects of poor sleep quality can lead to conditions like hypertension, metabolic syndrome, and even weight-related issues. See also International Charter of Physical Education, Physical Activity and Sport References External links Physical activity - it's important | betterhealth.vic.gov.au Better Health, May 22, 2020 "Physical activity - it's important." Exercise & Fitness Health Harvard, May 22, 2020. "Exercise & Fitness" Physical Activity CDC, May 22, 2020. "Physical Activity" Physical fitness Health effects by subject Physical exercise Health and sports

Syndemic

Syndemics is the evaluation of how social and health conditions arise, in what ways they interact, and what upstream drivers may produce their interactions. The word is a blend of "synergy" and "epidemics". The idea of syndemics is that no disease exists in isolation and that often population health can be understood through a confluence of factors (such as climate change or social inequality) that produces multiple health conditions that afflict some populations and not others. Syndemics are not like pandemics (where the same social forces produce clustered conditions equally around the world); instead, syndemics reflect population-level trends within certain states, regions, cities, or towns. A syndemic or synergistic epidemic is generally understood to be the aggregation of two or more concurrent or sequential epidemics or disease clusters in a population with biological interactions, which exacerbate the prognosis and burden of disease. The term was developed by Merrill Singer in the early 1990s to call attention to the synergistic nature of the health and social problems facing the poor and underserved. Syndemics develop under health disparity, caused by poverty, stress, climate, or structural violence and are studied by epidemiologists and medical anthropologists concerned with public health, community health and the effects of social conditions on health. The concept was translated from anthropology to a larger audience in 2017, with the publication of a Series on Syndemics in The Lancet, led by Emily Mendenhall. The syndemic approach departs from the biomedical approach to diseases to diagnostically isolate, study, and treat diseases as distinct entities separate from other diseases and independent of social contexts. Definition A syndemic is a synergistic epidemic. The term was developed by Merrill Singer in the mid-1990s, culminating in a 2009 textbook. Disease concentration, disease interaction, and their underlying social forces are the core concepts. Disease co-occurrence, with or without interactions, is known as comorbidity and coinfection. The difference between "comorbid" and "syndemic" is per Mustanski et al. "comorbidity research tends to focus on the nosological issues of boundaries and overlap of diagnoses, while syndemic research focuses on communities experiencing co-occurring epidemics that additively increase negative health consequences." It is possible for two afflictions to be comorbid, but not syndemic i.e., the disorders are not epidemic in the studied population, or their co-occurrence does not cause an interaction that then contributes to worsened health. Two or more diseases can be comorbid without interactions, or interaction occurs but it is beneficial, not deleterious. Syndemic theory seeks to draw attention to and provide a framework for the analysis of adverse disease interactions, including their causes and consequences for human life and well-being. Although the majority of this research has focused on HIV, an emerging body of work on syndemics has expanded to other co-occurring conditions. Syndemic methods: from historical archives to mathematical models Methods for evaluating syndemics have been a focus on scholarship for deepening the application of what has largely served as theory to understand why and how social and health conditions cluster together, interact, and are driven by shared forces, from climate (such as escalation of heat, rain, drought, and events) to poverty (such as food insecurity, poor housing, lack of safety, and limited work opportunities). In 2022, Alexander Tsai (an epidemiologist), Emily Mendenhall (a medical anthropologist), and Timothy Newfield (a historian) teamed up on a Special Issue in Social Science and Medicine to explore the various methodological ways in which syndemics can be understood, interpreted, and evaluated through history. For instance, historical syndemics may be evaluated using archival data that is incomplete but provides a novel way of thinking about disease biography. This is exemplified by Dylann Atcher Proctor's historical work on gastrointestinal distress in Gabon using historical archives that had never yet been evaluated on their own or synergistically. Ethnographic data provides a deeper understanding of how and why larger social forces produce disease clusters and interactions and are crucial for understanding "why" syndemics occurr. Ethnographic insights have served as the bedrock of syndemic thinking since Merrill Singer's pioneering intellectual and practical work with the concept beginning in the 1990s. His first article based on ethnographic thinking about the SAVA Syndemic came from real time observations as the AIDS epidemic that unfolded in tandem with substance use amidst structural violence in urban America throughout the 1990s and early 2000s. Singer demonstrated how it was impossible to think about one condition without contextualizing the broader social, structural, and health contexts in which people lived. Discussion of ethnographic methods were detailed in Emily Mendenhall's books Syndemic Suffering and Rethinking Diabetes and is also exemplified in Mac Marshall's book Drinking Smoke. The largest body of methodological scholarship has emerged around the utility of epidemiological data. Epidemiological data provides opportunities to investigate the synergistic ways in which diseases emerge and interact with social and health conditions. This latter method has been the focus of contention, particularly in dialogue between Alexander Tsai and Ronald Stall. Early epidemiological studies, for example, evaluated the ways in which social and health conditions co-occurred. Tsai argued that instead, there is a deeper need to interrogate how conditions syngistically interact to cause more adverse health conditions that the conditions would produce on their own. This has led to a slough of emergent research interrogating mathematical models that can take seriously how health conditions may cluster together and interact to affect the health and well being of populations residing in a specific nation, region, city, or town. A particularly useful model based on the Soweto Syndemics study was published in Nature Human Behavior. In particular, spatial models for thinking through syndemic clusters, such as using GIS, are an emerging area of interest in syndemics research. Types of disease interaction Diseases regularly interact and this interaction influences disease course, expression, severity, transmission, and diffusion. Interaction among diseases may be both indirect (changes caused by one disease that facilitate another through an intermediary) and direct (diseases act in direct tandem). One disease can assist the physical transmission of the microbe causing another disease, for example, genital-tract ulceration caused by syphilis allowing sexual transmission of HIV. One disease may enhance the virulence of another, as for example, herpes simplex virus co-infection exacerbates HIV infection with progression to AIDS, periodontal bacteria may enhance the virulence of herpesvirus, HIV-infected individuals are more susceptible to tuberculosis; As of 2011, the cause was not fully understood. Changes in biochemistry or damage to organ systems, as for example diabetes weakening the immune system, promotes the progression of another disease, SARS. A coinfection may open up multiple syndemic pathways. Lethal synergism between influenza virus and pneumococcus, causes excess mortality from secondary bacterial pneumonia during influenza epidemics. Influenza virus alters the lungs in ways that increase the adherence, invasion and induction of disease by pneumococcus, alters the immune response with weakened ability to clear pneumococcus or, alternately amplifying the inflammatory cascade. Direct interaction of diseases occurs in the case of genetic recombination among different pathogens, for instance between Avian sarcoma leukosis virus and Marek's disease virus (MDV) in domestic fowl. Both cancer-causing viruses are known to infect the same poultry flock, the same chicken, and, even the same anatomic cell. In coinfected cells, the retroviral DNA of the avian leukosis virus can integrate into the MDV genome, producing altered biological properties compared to those of the parental MDV. The frequency of gene reassortment among human pathogens is less clear than it is the among plant or animal species but of concern as animal diseases adapt to human hosts and as man new diseases comes into contact. When one disease diminishes or eradicates another it is a counter-syndemic disease interaction. The linkage also may not be clear, despite apparent syndemic interactions among diseases, as for example in type 2 diabetes mellitus and hepatitis C virus infection. Iatrogenic The term iatrogenesis refers to adverse effects on health caused by medical treatment. This is possible if medical treatment or medical research creates conditions that increase the likelihood that two or more diseases come together in a population. For example, if gene splicing unites two pathogenic agents and the resulting novel organism infects a population. One study suggests the possibility of iatriogenic syndemics. During a randomized, double-blind clinical trial testing the efficacy of the prototype HIV vaccine called V520 there appeared to be an increased risk for HIV infection among the vaccinated participants. Notably, participants immune to the common cold virus adenovirus type 5 had a higher risk of HIV infection. The vaccine was created using a replication-defective version of Ad5 as a carrier, or delivery vector, for three synthetically produced HIV genes. On November 6, 2007, Merck & Co. announced that research had been stopped suspecting the higher rate of HIV infection among individuals in the vaccinated was because the vaccine lowered defenses against HIV. Examples Various syndemics though not always labeled as such have been described in the literature, including: HIV/AIDS and food insecurity compromise an unrecognized syndemic axis in many resource-limited settings in sub-Saharan Africa SAVA syndemic (substance abuse, violence and AIDS, the VIDDA syndemic (violence, immigration/isolation, depression, diabetes, abuse) the hookworm, malaria and HIV/AIDS syndemic, the Chagas disease, rheumatic heart disease and congestive heart failure syndemic, the possible asthma and infectious disease syndemic, the malnutrition and depression syndemic, the TB, HIV and violence syndemic, the whooping cough, influenza, tuberculosis syndemic, the HIV incidence, substance use, mental health, childhood sexual abuse, and intimate partner violence syndemics the HIV and STD syndemic, the stress and obesity syndemic, the HIV infection, mental health and substance abuse syndemic. the built environment, physical inactivity and obesity/diabetes syndemic, which Prince Charles pointed out in January 2006, in a speech at the Enhancing the Healing Environment conference hosted by The Prince's Foundation for the Built Environment and The King's Fund, St James's Palace, London. HIV infection and opportunistic microbial infections and viral-caused malignancies like Kaposi's sarcoma periodontitis and herpes virus: bacteria of several different species (e.g., Porphyromonas gingivalis, Dialister pneumosintes, Prevotella intermedia) that adhere to and reproduce on tooth surfaces under the gum line multiply when bodily defenses are weakened by an HSV infection of the periodontium. HIV being transiently suppressed during an acute measles infection. Several potential mechanisms could be responsible. Measles virus infection causes lymphopenia, a reduction in the number of CD4+ T lymphocytes circulating in the blood. The low point occurs just prior to the onset of the characteristic skin rash. Within a month of this nadir, the number of lymphocytes returns to normal levels. The drop in HIV virus levels may be due to a lack of target CD4+ T cells in which they replicate, or measles virus may stimulate the production of proteins suppressing HIV replication, including the β-chemokines, CD8+ cell noncytotoxic anti-HIV response, and the cytokines IL-10 and IL-16. median plasma levels of RANTES, a chemokine that attracts immune system components like eosinophils, monocytes, and lymphocytes were higher in HIV-infected children with measles than in those without measles (Moss and co-workers). HIV suppression in tsutsugamuchi disease or scrub typhus, a mite-borne infection in Asia and Australia, but how this occurs is unclear. COVID-19 is a syndemic of SARS‑CoV‑2 coronavirus infection combined with an epidemic of non-communicable diseases, both inter-acting on a social substrate of poverty and inequality, according to Richard Horton in the Lancet Global Burden of Disease study 2020 (GBD 2020). 19th century Native American Contact between Native Americans and Europeans during the Columbian Exchange led to lethal syndemics within the Native American population due to diseases introduced which the Native Americans had not encountered before and had not built-up immunity to. An example of a syndemic from the 19th century can be found on the reservations on which Native Americans were confined with the closing of the U.S. frontier. It is estimated that in 1860 there were well over 10 million bison living on the American Plains. By the early 1880s, the last of the great herds of bison upon which Plains Indian peoples like the Sioux were dependent as a food source were gone. At the same time, after the U.S. military's defeat at the Battle of the Little Bighorn in 1876, there was a concerted effort to beat the Sioux into total submission. Thus, in 1872, Secretary of the Interior Columbus Delano stated: "as they become convinced that they can no longer rely upon the supply of game for their support, they will return to the more reliable source of subsistence [i.e., farming]." As a result, they were forced to give up their struggle for an independent existence on their own lands and take up reservation life at the mercy of government authority. Treaties that were signed with the Sioux in 1868 and 1876 stipulated that they would be provided with government annuities and provisions in payment for sections of their land and with the expectation among federal representatives that the Sioux would become farmers on individually held plots of land. The Sioux found themselves confined on a series of small reservations where they were treated as a conquered people. Moreover, the government reneged on its promises, food was insufficient and of low quality. Black Elk, a noted Sioux folk healer, told his biographer: "There was hunger among my people before I went across the big water [to Europe in 1886], because the Wasichus [whites] did not give us all the food they promised in the Black Hills treaty... But it was worse when I came back [1889]. My people looked pitiful... We could not eat lies and there was nothing we could do." Under extremely stressful conditions, with inadequate diets, and as victims of overt racism on the part of the registration agents appointed to oversee Indian reserves, the Sioux confronted infectious disease from contact with whites. knowledge about the epidemiology of the Sioux from this period is limited, James Mooney, an anthropologist and representative of the Bureau of Indian Affairs sent to investigate a possible Sioux rebellion, described the health situation on the reservation in 1896: "In 1888 their cattle had been diminished by disease. In 1889, their crops were a failure ... Thus followed epidemics of measles, grippe [influenza], and whooping cough Pertussis, in rapid succession and with terrible fatal results..." Similarly, the Handbook of American Indians notes, "The least hopeful conditions in this respect prevail among the Dakota [Sioux] and other tribes of the colder northern regions, where pulmonary tuberculosis and scrofula are very common... Other more common diseases, are various forms of, bronchitis ...pneumonia, pleurisy, and measles in the young. Whooping cough is also met with." Indian children were removed to white boarding schools and diagnosed with a wide range of diseases, including tuberculosis, trachoma, measles, smallpox, whooping cough, influenza, and pneumonia. The Sioux were victims of a syndemic of interacting infectious diseases including the 1889–1890 flu pandemic, inadequate diet, and stressful and extremely disheartening life conditions, including outright brutalization with events like the massacre at Wounded Knee in 1890 and the murder of their leader Sitting Bull. While the official mortality rate on the reservation was between one and two percent, the death rate was probably closer to 10 percent. Influenza There were three influenza pandemics during the 20th century that caused widespread illness, mortality, social disruption, and significant economic losses. These occurred in 1918, 1957, and 1968. In each case, mortality rates were determined primarily by five factors: the number of people who became infected, the virulence of the virus causing the pandemic, the speed of global spread, the underlying features and vulnerabilities of the most affected populations, and the effectiveness and timeliness of the prevention and treatment measures that were implemented. The 1957 pandemic was caused by the Asian influenza virus (known as the H2N2 strain), a novel influenza variety to which humans had not yet developed immunities. The death toll of the 1957 pandemic is estimated to have been around two million globally, with approximately 70,000 deaths in the United States. A little over a decade later, the comparatively mild Hong Kong influenza pandemic erupted due to the spread of a virus strain (H3N2) that genetically was related to the more deadly form seen in 1957. The pandemic was responsible for about one million deaths around the world, almost 34,000 of which were in the United States. In both of these pandemics, death may not have been due only to the primary viral infection, but also to secondary bacterial infections among influenza patients; in short, they were caused by a viral/bacterial syndemic (but see Chatterjee 2007). The worst of the 20th-century influenza pandemics was the 1918 pandemic, where between 20 and 40 percent of the world's population became ill and between 40 and 100 million people died. More people died of the so-called Spanish flu (caused by the H1N1 viral strain) pandemic in the single year of 1918 than during all four-years of the Black Death. The pandemic had devastating effects as disease spread along trade and shipping routes and other corridors of human movement until it had circled the globe. In India, the mortality rate reached 50 per 1,000 population. Arriving during the closing phase of World War I, the pandemic impacted mobilized national armies. Half of U.S. soldiers who died in the "Great War," for example, were victims of influenza. It is estimated that almost of a million Americans died during the pandemic. In part, the death toll during the pandemic was caused by viral pneumonia characterized by extensive bleeding in the lungs resulting in suffocation. Many victims died within 48 hours of the appearance of the first symptom. It was not uncommon for people who appeared to be quite healthy in the morning to have died by sunset. Among those who survived the first several days, however, many died of secondary bacterial pneumonia. It has been argued that countless numbers of those who expired quickly from the disease were co-infected with tuberculosis, which would explain the notable plummet in TB cases after 1918. Climate change As a result of the floral changes produced by global warming, an escalation is occurring in global rates of allergies and asthma. Allergic diseases constitute the sixth leading cause of chronic illness in the United States, impacting 17 percent of the population. Asthma affects about 8 percent of the U.S. population, with rising tendency, especially in low income, ethnic minority neighborhoods in cities. In 1980 asthma affected only about three percent of the U.S. population according to the U.S. CDC. Asthma among children has been increasing at an even faster pace than among adults, with the percentage of children with asthma going up from 3.6 percent in 1980 to 9 percent in 2005. Among ethnic minority populations, like Puerto Ricans the rate of asthma is 125 percent higher than non-Hispanic white people and 80 percent higher than non-Hispanic black people. The asthma prevalence among American Indians, Alaska Natives and black people is 25 percent higher than in white people. Air pollution Increases in asthma rates have occurred despite improvements in air quality produced by the passage and enforcement of clean air legislation, such as the U.S. Clean Air Act of 1963 and the Clean Air Act of 1990. Existing legislation and regulation have not kept pace with changing climatic conditions and their health consequences. Compounding the problem of air quality is the fact that air-borne pollens have been found to attach themselves to diesel particles from truck or other vehicular exhaust floating in the air, resulting in heightened rates of asthma in areas where busy roads bisect densely populated areas, most notably in poorer inner-city areas. For every elevation of 10 μg/m3 in particulate matter concentration in the air a six percent increase in cardiopulmonary deaths occurs according to research by the American Cancer Society. Exhaust from the burning of diesel fuel is a complex mixture of vapors, gases, and fine particles, including over 40 known pollutants like nitrogen oxide and known or suspected carcinogenic substances such as benzene, arsenic, and formaldehyde. Exposure to diesel exhaust irritates the eyes, nose, throat and lungs, causing coughs, headaches, light-headedness and nausea, while causing people with allergies to be more susceptible allergy triggers like dust or pollen. Many particles in disease fuel are so tiny they are able to penetrate deep into the lungs when inhaled. Importantly, diesel fuel particles appear to have even greater immunologic effects in the presence of environmental allergens than they do alone. "This immunologic evidence may help explain the epidemiologic studies indicating that children living along major trucking thoroughfares are at increased risk for asthmatic and allergic symptoms and are more likely to have respiratory dysfunction." according to Robert Pandya and co-workers. The damaging effects of diesel fuel pollution go beyond a synergistic role in asthma development. Exposure to a combination of microscopic diesel fuel particles among people with high blood cholesterol (i.e., low-density lipoprotein, LDL or "bad cholesterol") increases the risk for both heart attack and stroke above levels found among those exposed to only one of these health risks. According to André Nel, Chief of Nanomedicine at the David Geffen School of Medicine at UCLA, "When you add one plus one, it normally totals two... But we found that adding diesel particles to cholesterol fats equals three. Their combination creates a dangerous synergy that wreaks cardiovascular havoc far beyond what's caused by the diesel or cholesterol alone." Experimentation revealed that the two mechanisms worked in tandem to stimulate genes that promote cell inflammation, a primary risk for hardening and blockage of blood vessels (atherosclerosis ) and, as narrowed arteries collect cholesterol deposits and trigger blood clots, for heart attacks and strokes as well. A Note on Mathematical Models A mathematical model is a simplified representation using mathematical language to describe natural, mechanical or social system dynamics. Epidemiological modelers unite several types of information and analytic capacity, including: 1) mathematical equations and computational algorithms; 2) computer technology; 3) epidemiological knowledge about infectious disease dynamics, including information about specific pathogens and disease vectors; and 4) research data on social conditions and human behavior. Mathematical modelling in epidemiology is now being applied to syndemics. For example, modelling to quantify the syndemic effects of malaria and HIV in sub-Saharan Africa based on research in Kisumu, Kenya researchers found that 5% of HIV infections (or 8,500 cases of HIV since 1980) in Kisumu are the result of the higher HIV infectiousness of malaria-infected HIV patients. Additionally, their model attributed 10% of adult malaria episodes (or almost one million excess malaria infections since 1980) to the greater susceptibility of HIV infected individuals to malaria. Their model also suggests that HIV has contributed to the wider geographic spread of malaria in Africa, a process previously thought to be the consequence primarily of global warming. Modelling offers an enormously useful tool for anticipating future syndemics, including eco-syndemic, based on information about the spread of various diseases across the planet and the consequent co-infections and disease interactions that will result. PopMod is a longitudinal population tool developed in 2003 that models distinct and possibly interacting diseases. Unlike other life-table population models, PopMod is designed to not assume the statistical independence of the diseases of interest. The PopMod has several intended purposes, including describing the time evolution of population health for standard demographic purposes (such as estimating healthy life expectancy in a population), and providing a standard measure of effectiveness for health interventions and cost-effectiveness analysis. PopMod is used as one of the standard tools of the World Health Organization's (WHO) CHOICE (Choosing Interventions that are Cost-Effective) program, an initiative designed to provide national health policymakers in the WHO's 14 epidemiological sub-regions around the world with findings on a range of health intervention costs and effects. Future research First, there is a need for studies that examine the processes by which syndemics emerge, the specific sets of health and social conditions that foster multiple epidemics in a population and how syndemics function to produce specific kinds of health outcomes in populations. Second, there is a need to better understand processes of interaction between specific diseases with each other and with health-related factors like malnutrition, structural violence, discrimination, stigmatization, and toxic environmental exposure that reflect oppressive social relationships. There is a need to identify all of the ways, directly and indirectly, that diseases can interact and have, as a result, enhanced impact on human health. Third there is a need for the development of an eco-syndemic understanding of the ways in which global warming contributes to the spread of diseases and new disease interactions. There is a need for a better understanding of how public health systems and communities can best respond to and limit the health consequences of syndemics. Systems are needed to monitor the emergence of syndemics and to allow early medical and public health responses to lessen their impact. Systematic ethno-epidemiological surveillance with populations subject to multiple social stressors must be one component of such a monitoring system. See also Endemic List of epidemics List of human diseases associated with infectious pathogens References Further reading Books Marshall, Mac 2013 Drinking Smoke: The Tobacco Syndemic in Oceania. Honolulu, HI: University of Hawaiʻi Press. Mendenhall, Emily 2012 Syndemic Suffering: Social Distress, Depression, and Diabetes among Mexican Immigrant Women. Left Coast Press, Inc. Singer, Merrill 2009 Introduction to Syndemics: A Critical Systems Approach to Public and Community Health. San Francisco, CA: Jossey-Bass. Articles, chapters Biello, K.B., Colby, D., Closson, E., Mimiaga, M.J., 2014. "The syndemic condition of psychosocial problems and HIV risk among male sex workers in Ho Chi Minh City, Vietnam". AIDS Behav 18, 1264–1271. . Biello, K.B., Oldenburg, C.E., Safren, S.A., Rosenberger, J.G., Novak, D.S., Mayer, K.H., Mimiaga, M.J., 2016. Multiple syndemic psychosocial factors are associated with reduced engagement in HIV care among a multinational, online sample of HIV-infected MSM in Latin America. AIDS Care 28 Suppl 1, 84–91. https://doi.org/10.1080/09540121.2016.1146205 Blashill AJ, Bedoya CA, Mayer KH, O'Cleirigh C, Pinkston MM, Remmert JE, Mimiaga MJ, Safren SA. Psychosocial Syndemics are Additively Associated with Worse ART Adherence in HIV-Infected Individuals. AIDS Behav. 2015 Jun;19(6):981-6. doi: 10.1007/s10461-014-0925-6. PMID 25331267; PMCID: PMC4405426. http://www.dynamicchiropractic.ca/mpacms/dc_ca/article.php?id=55088&no_paginate=true&p_friendly=true&no_b=true Chu, P., Santos, G.-M., Vu, A., Nieves-Rivera, G., Colfax, J., Grinsdale, S., Huang, S., Phillip, S., Scheer, S. and Aragon, T. 2012 Impact of syndemics on people living with HIV in San Francisco. Presented at the XIX International AIDS Conference, Washington, D.C. (MOACO202 Oral Abstract). Dyer TV, Turpin RE, Stall R, Khan MR, Nelson LE, Brewer R, Friedman MR, Mimiaga MJ, Cook RL, OʼCleirigh C, Mayer KH. Latent Profile Analysis of a Syndemic of Vulnerability Factors on Incident Sexually Transmitted Infection in a Cohort of Black Men Who Have Sex With Men Only and Black Men Who Have Sex With Men and Women in the HIV Prevention Trials Network 061 Study. Sex Transm Dis. 2020 Sep;47(9):571-579. doi: 10.1097/OLQ.0000000000001208. PMID 32496390; PMCID: PMC7442627 Easton, Delia 2004 The Urban Poor: Health Issues. Encyclopedia of Medical Anthropology, Volume 1, pp. 207–13. New York: Kluwer Academic/Plenum Publishers. Gilbert, Louisa, Primbetova, Sholpan, Nikitin, Danil, Hunt, Timothy, Terlikbayeva, Assel, Momenghalibaf, Azzi, Murodali, Ruziev and El-Bassel, Nabila 2013 Redressing the epidemics of opioid overdose and HIV among people who inject drugs in Central Asia: The need for a syndemic approach. Drug and Alcohol Dependence (in press). Guadamuz, Thomas, Friedman, Mark, Marshal, Michael, Herrick, Amy, Lim, Sin How, Wei, Chongyi, and Stall, Ron 2013 Health, Sexual Health, and Syndemics: Toward a Better Approach to STI and HIV Preventive Interventions for Men Who Have Sex with Men (MSM) in the United States. In S. Aral, K. Fenton, J. Lipshuz, Eds. The New Public Health and STD/HIV Prevention: Personal, Public and Health Systems Approaches. New York: Springer Sciences and Business Media. Hein, Casey and Small, Doreen 2007 Combating Diabetes, Obesity, Periodontal Disease and Interrelated Inflammatory Conditions with a Syndemic Approach. Herring, D Ann 2008 Viral Panic, Vulnerability and the Next Pandemic. In Health, Risk and Adversity, Catherine Panter-Brick and Agustín Fuentes, Eds, pp 78–100. Oxford, U.K.: Berghahn Books, 2008. Himmelgreen, David and Romero-Daza, Nancy. Environment: Science and Policy for Sustainable Development "The Global Food Crisis, HIV/AIDS, and Home Gardens"\. Environment: Science and Policy for Sustainable Development June–July 2010. Jain S, Oldenburg CE, Mimiaga MJ, Mayer KH. High Levels of Concomitant Behavioral Health Disorders Among Patients Presenting for HIV Non-occupational Post-exposure Prophylaxis at a Boston Community Health Center Between 1997 and 2013. AIDS Behav. 2016 Jul;20(7):1556-63. doi: 10.1007/s10461-015-1021-2. PMID 25689892; PMCID: PMC4540681 Johnson, C.V., Mimiaga, M.J., White, J.M., Reisner, S.L., Mayer, K.H. Co-occurring psychosocial conditions additively increase risk for unprotected anal sex among MSM at sex parties. Poster presented at the CDC National HIV Prevention Conference, Atlanta, GA, 2011. Lim, S.H. Herrick, A., Guadamuz, T., Kao, U., Plankey, M., Ostrow, D., Shoptaw, S. and Stall, R. 2010 Childhood sexual abuse, gay-related victimization, HIV infection and syndemic productions among men who have sex with men (MSM): findings from the Multicenter AIDS Cohort Study (MACS). Presented at the XVIII International AIDS Conference, July 18–23. Vienna, Austria. Littleton, Juditith and Julia Park 2009 Tuberculosis and syndemics: Implications for Pacific health in New Zealand. Social Science & Medicine (11):1674–80. doi: 10.1016/j.socscimed.2009.08.042. Epub 2009 Sep 27. PMID 19788951. Littleton, Judith, Julie Park, Ann Herring and Tracy Farmer 2008 Multiplying and Dividing Tuberculosis in Canada and Aotearoa New Zealand, Research in Anthropology and Linguistics e3. University of Auckland. Lyons, Thomas, Johnson, Amy and Garofalo, Robert 2013 "What Could Have Been Different": A Qualitative Study of Syndemic Theory and HIV Prevention Among Young Men Who Have Sex With Men. Journal of HIV/AIDS & Social Services 2013;12(3-4):10.1080/15381501.2013.816211. doi: 10.1080/15381501.2013.816211. PMID 24244112; PMCID: PMC3825850. Martin, Yolanda 2013 The Syndemics of Removal: Trauma and Substance Abuse. In Outside Justice: Immigration and the Criminalizing Impact of Changing Policy and Practice edited by David Brotherton, Daniel Stageman and Shirley Leyro. New York: Springer, 91–107. Mavridis, Agapi 2008 Tuberculosis and Syndemics: Implications for Winnipeg, Manitoba. In Multiplying and Dividing Tuberculosis in Canada and Aotearoa New Zealand, Judith Littleton, Julie Park, Ann Herring and Tracy Farmer, Eds. Research in Anthropology and Linguistics e3: 43–53. MacQueen, Kate 2002 Anthropology and Public Health. Encyclopedia of Public Health. New York: Macmillan Reference. McKenzie, Kellye, Mbajah, Joy, Seegers, Angela, and Davis, Celeste 2008 The Landscape of HIV/AIDS among African American Women in the United States. NASTAD National Alliance of State and Territorial AIDS Directors. Issue Brief No. 1:1–12. Mercado, Susan, Kirsten Havemann, Keiko Nakamura, Andrew Kiyu, Mojgan Sami, Roby Alampay, Ira Pedrasa, Divine Salvador, Jeerawat Na Thalang, and Tran Le Thuey 2007 Responding to the Health Vulnerabilities of the Urban Poor in the 'New Urban Settings' of Asia. Presented at Improving Urban Population Health Systems, sponsored by the Center for Sustainable Urban Development, July. Millstein, Bobby 2001 Introduction to the Syndemics Prevention Network. Atlanta: Centers for Disease Control and Prevention. Millstein, Bobby 2004 Syndemics. In: Encyclopedia of Evaluation. Sandra Mathison, Ed. pp. 404–05. Thousand Oaks, CA: Sage Publications. Mimiaga, M.J., Biello, K.B., Robertson, A.M., Oldenburg, C.E., Rosenberger, J.G., O'Cleirigh, C., Novak, D.S., Mayer, K.H., Safren, S.A., 2015. High prevalence of multiple syndemic conditions associated with sexual risk behavior and HIV infection among a large sample of Spanish- and Portuguese-speaking men who have sex with men in Latin America. Arch Sex Behav 44, 1869–1878. https://doi.org/10.1007/s10508-015-0488-2 Mimiaga, M.J., OʼCleirigh, C., Biello, K.B., Robertson, A.M., Safren, S.A., Coates, T.J., Koblin, B.A., Chesney, M.A., Donnell, D.J., Stall, R.D., Mayer, K.H., 2015. The effect of psychosocial syndemic production on 4-year HIV incidence and risk behavior in a large cohort of sexually active men who have sex with men. J. Acquir. Immune Defic. Syndr. 68, 329–336. https://doi.org/10.1097/QAI.0000000000000475 Mimiaga, M.J., Hughto, J.M.W., Biello, K.B., Santostefano, C.M., Kuhns, L.M., Reisner, S.L., Garofalo, R., 2019. Longitudinal Analysis of Syndemic Psychosocial Problems Predicting HIV Risk Behavior Among a Multicity Prospective Cohort of Sexually Active Young Transgender Women in the United States. J. Acquir. Immune Defic. Syndr. 81, 184–192. https://doi.org/10.1097/QAI.0000000000002009 Mimiaga, M.J. Hughto, J.M.W., Klasko-Foster, L., Jin, H., Mayer, K.H., Safren, S.A., Biello, K.B. Substance use, mental health problems, and physical and sexual violence additively increase HIV risk between male sex workers and their male clients in Northeastern United States. J Acquir Immune Defic Syndr. 2020 Nov 3. doi: 10.1097/QAI.0000000000002563 Nichter, Mark 2003 "Harm Reduction, Harm Reduction, Ecosocial Epidemiology, Ecosocial Epidemiology, and Syndemics". Ogunbajo, A., Oke, T., Jin, H., Rashidi, W., Iwuagwu, S., Harper, G.W., Biello, K.B., Mimiaga, M.J., 2020a. A syndemic of psychosocial health problems is associated with increased HIV sexual risk among Nigerian gay, bisexual, and other men who have sex with men (GBMSM). AIDS Care 32, 337–342. https://doi.org/10.1080/09540121.2019.1678722 Rosenberg, Rhonda and Malow, Robert 2006 Hardness of Risk: Poverty, Women and New Targets for HIV/AIDS Prevention. Psychology & AIDS Exchange 34:3–4, 9, 12. Rhodes, Jeselyn 2010 Early Syphilis and HIV Syndemic in Nashville/Davidson Co., Tennessee: Implications for Improving Syphilis Screening for People Living with and at Risk for HIV. Presented at the National STD Prevention Conference. Atlanta, GA. Safren, Steven, Blashill, Aaron and O'Cleirigh, Conall 2011 Promoting the Sexual Health of MSM in the Context of Comorbid Mental Health Problems. AIDS and Behavior Supplement 1:S30–34. Safren SA, Blashill AJ, Lee JS, O'Cleirigh C, Tomassili J, Biello KB, Mimiaga MJ, Mayer KH. Condom-use self-efficacy as a mediator between syndemics and condomless sex in men who have sex with men (MSM). Health Psychol. 2018 Sep;37(9):820-827. doi: 10.1037/hea0000617. Epub 2018 Jun 21. PMID 29927272; PMCID: PMC6107409 Sanchez, Melissa, Scheer, Susan, Shallow, Sue, Pipkin, Sharon and Huang, Sandra 2014 Epidemiology of the Viral Hepatitis-HIV Syndemic in San Francisco: A Collaborative Surveillance Approach. Public Health Reports 129(Supplement 1):95-101. Sattenspiel, Lisa and Herring, Ann 2010 Emerging Themes in Anthropology and Epidemiology: Geographic Spread, Evolving Pathogens and Syndemics. In Clark Spencer Larsent, ED. A Companion to Biological Anthropology. Malden, MA: Wiley. Scrimshaw, Neville, Taylor Carl, and Gordon, John 1968 Interactions of Nutrition and Infection. Geneva: World Health Organization Shields, Sara and Lucy M. Candib, Eds. 2010 Women-Centered Care in Pregnancy and Childbirth. Oxon, United Kingdom: Radcliffe Publishing Ltd. Sibley, Candace Danielle 2011 A Multi-Methodological Study of a Possible Syndemic among Female Adult Film Actresses. MSPH Thesis University of South Florida. Singer, Merrill 2004 Critical Medical Anthropology. In Encyclopedia of Medical Anthropology: Health and Illness in the World's Cultures. Vol. 1:23–30. Carol Ember and Melvin Ember, (eds). New York: Kluwer. Singer, Merrill 2006 Syndemics. Encyclopedia of Epidemiology. Sarah Boslaugh (ed). Thousand Oaks, CA:Sage Publications, Inc. Singer, Merrill 2008 The Perfect Epidemiological Storm: Food Insecurity, HIV/AIDS and Poverty in Southern Africa. Anthropology Newsletter (American Anthropological Association) 49(7): October 12 & 15. Singer, Merrill 2008 Drug-related Syndemics and the Risk Environment: Assessing Street risk among Hispanics in Hartford. Presented at the 8th Annual National Hispanic Science Network on Drug Abuse. Bethesda, Maryland. Singer, Merrill 2009 Desperate Measures: A Syndemic Approach to the Anthropology of Health in a Violent City. In Global Health in the Time of Violence, Barbara Rylko-Bauer, Linda Whiteford, and Paul Farmer, Editors. Santa Fe, NM: SAR Press. Singer, Merrill 2010 Ecosyndemics: Global Warming and the Coming Plagues of the 21st Century. In Plagues: Models and Metaphors in the Human 'Struggle' with Disease, D. Ann Herring and Alan C. Swedlund, Editors, pp. 21–38. London: Berg. Singer, Merrill 2011 Double Jeopardy: Vulnerable Children and the Possible Global Lead Poisoning/Infectious Disease Syndemic. In Routledge Handbook in Global Health, Richard Parker and Marni Sommer, Editors, pp. 154–61. New York: Routledge. Singer, Merrill 2011 The Infectious Disease Syndemics of Crack Cocaine. Journal of Equity in Health (in press). Singer, Merrill and Baer, Hans 2007 Introducing Medical Anthropology: A Discipline in Action. AltaMira/ Rowman Littlefield Publishers, Inc. Singer, Merrill, Herring, D. Ann, Littleton, Judith, and Rock, Melanie 2011 Syndemics in Global Health. In A Companion to Medical Anthropology, Merrill Singer and Pamela I. Erickson, Editors, pp. 219–49. Malden, MA: Wiley-Blackwell. Specter, Michael 2005 Higher Risk: Crystal Meth, the Internet, and dangerous Choices about AIDS. The New Yorker, May 23, pp. 39–45. Stall, Ron 2007 "An Update on Syndemic Theory Among Urban Gay Men" . Presented at the American Public Health Association meetings, Washington, DC. Abstract #155854. Stall, Ron, Friedman, M.S., and Catania, J. 2007 Interacting Epidemics and Gay Men's Health: A theory of Syndemic Production among Urban Gay Men. In Unequal Opportunity: Health Disparities Affecting Gay and Bisexual Men in the United States, Richard J. Wolitski, Ron Stall, and Ronald O. Valdiserri (Eds). Oxford: Oxford University Press. Stall, Ron, Friedman, M.S., Kurz, M. and Buttram, M.. "2012 Syndemic associations of HIV risk among sex-working MSM in Miami and Ft. Lauderdale, USA". Presented at the XIX International AIDS Conference, Washington, D.C. (MOPE328, Poster exhibit). Stall, Ron and Mills, Thomas 2006 "Health Disparities, Syndemics and Gay Men's Health" . Presented at the Center for Health Intervention and Prevention. University of Connecticut. Stall, Ron and van Griensven, Frits 2005 New Directions in Research Regarding Prevention for Positive Individuals: Questions Raised by the Seropositive Urban Men's Intervention Trial. AIDS 19 Supplement 1: S123–27. Stephens, Christianne V. 2008 "She was Weakly for a Long time and the Consumption Set" In Using Parish Records to Explore Disease Patterns and Causes of Death In a First Nations Community. Research in Anthropology and Linguistics (RAL-e) Monograph Series. Ann Herring, Judith Littleton, Julie Park and Tracy Farmer (eds.) No. 3 134–48. Stephens, Christianne V. 2009 Syndemics, Structural Violence and the Politics of Health: A Critical Biocultural Approach to the Study of Disease and Tuberculosis Mortality in a Parish Population at Walpole Island (1850–1885). In Proceedings of the 39th Annual Algonquian Conference. Vol. 39 581–613. Karl Hele, (ed). London: University of Western Ontario. External links Syndemic Prevention Network: Home Wayback Machine Epidemics Influenza pandemics

Differential Emotions Scale

The Differential Emotions Scale (DES) (Izard, 1997s) is a multidimensional self-report device for assessment of an individual's emotions (whether fundamental emotions or patterns of emotions). The DES helps measure mood based on Carroll Izard's differential emotions theory, The DES consists of thirty items, three for each of the ten fundamental emotions as visualized by Izard: interest, joy, surprise, sadness, anger, disgust, contempt, fear, shame/ shyness, and guilt, which are represented on 5-point Likert scale. There are currently four different versions of the scale. Despite the different versions, the basic idea of are very similar. Participants are asked to rate each of the emotions on a scale, and depending on the instructions given, they either rate their current feelings, feelings over the past week, or over long-term traits (i.e. how often do you feel this emotion in your day-to-day living). The DES is similar to other scales such as the Multiple Affect Adjective Check List (MAACL) and the Multiple Affect Adjective Check List-Revised (MAACL-R) which are used to assess either the state or trait affect by varying the time of which instructions are given to the participants. Theory The Differential Emotions Theory evaluates the intensity of primary emotions to gain understanding between basic emotions and associated constructs of facial expression. The theory defines emotion(s) as an intricate process within neuromuscular, phenomenological, and neurophysiological areas. Within the neuromuscular aspect, it is the facial activity and patterning and body response. In the phenomenological aspect, it is the motivational experience or experience that has instant significance towards the individual. As for the neuropsychological aspect, it is primarily the patterns of the electrochemical activity within the brain. The theory emphasises on the discrete emotions along with five assumptions (one: the fundamental emotions; two: the fundamental emotions each have distinctive motivational properties; three: these fundamental emotions lead to different experiences and behaviour; four: emotions interact and one emotion can trigger another; five: emotions influence and interact with other processes such as: homeostatic, drive, perceptual, cognitive, and motor processes). The first significant evidence that supports the DET is based on Ekman's (1971) neurocultural theory (recognition of facial expression and emotion). Data collected from this field of research led to Izard's development of the DET. Unlike Ekman's research and theory where it focuses on the explanation of universal and cultural differences in facial expression of emotion, Izard focuses on the functions of emotions and its role as a component in motivating human behaviour. Development The name Differential Emotions Scale came from the examination of verbal labels and facial expressions. Research have shown that participants of different backgrounds (i.e. ethnicity, culture, language) are all able to agree on and can differentiate different facial expressions among the fundamental emotions. Research was done on American, English, French, and Greek subjects, who were asked to verbally describe a series of fundamental emotion photographs of cross-cultural and standardised facial expressions. This provided background support and allowed for further development upon the DES by helping generate a set of words for the different emotions that could be understood across cultures. DES-IV The DES-IV is a version of the DES where it has 49 items. This version of mood-state inventory is a multidimensional instrument, and is used to look over and examine the frequency of multiple fundamental human emotions. The 49 items of the DES-IV help measure 12 basic emotions (interest, joy, surprise, sadness, anger, disgust, contempt, hostility, fear, shame, shyness and guilt). It was also suggested by Boyle (1985) that DES-IV and the Eight State Questionnaire are one of the more promising self-report multivariate mood-state instruments. Reliability and validity The DES takes form of self-report, where individuals are asked to rank their emotions within the discrete categories of fundamental emotions. Due to the subjective-experience component of this system, this therefore leads to the many concerns and criticism as to whether or not this will hinder the reliability and validity of the results attained. DES is different from other multivariate measures of mood states as it is based on the principle that characteristic patterns of fundamental emotions are involved in the mood states such as anxiety and depressed feelings. Many studies have been carried out on large samples, these factor analyses have supported at least eight of the suggested fundamental emotions. However, findings from these studies also suggest that the construct validity of the DES sub-scales are not clear. Improvement in areas of sub-scales, internal consistency, and reliability of the instrument throughout retests will be needed to help improve overall reliability and validity. One of the largest setbacks of this scale is self-reporting factor. The transparency of items may lead to self-distortion and response bias (i.e. poor self-perception or faking responses). Many studies have exploited the DES and have been able to prove that emotions factors as highly stable. From these studies and analyses, it suggests that factors acquired are constant with the theoretically defined factors. The DES has been used in studies of anxiety and depression, patterns of emotion in love and jealousy, and relationship of subjective sexual arousal and emotion. Analytic technique Computational analyses Computational analysis is a strategy that consists of exploratory or bind factor analyses which is then also processed through confirmatory factor analyses. Results of an exploratory analysis may be able to provide a heuristic and suggestive value, which can then be helpful in the generation of hypotheses that are able to carry out more objective testing. Confirmatory factor analyses provides a direct test of a specific model, therefore making it the primary source in determining the validity of DES. The analysis also provides an estimate for the correlation between items within the group factors and correlation between group factors. Criticism Although Izard's theory and differential scale have been used in multiple studies, it has also been criticised to that it is too narrow and focuses too much on negative emotions rather than keeping a balance. Although the DES allows researchers to assess emotions in a continuous aspect, due to the exclusion and lack of consideration of low-energy states (i.e. fatigue and serenity), it can affect results gathered through different emotion studies. In fact, these low-energy states are said to have great relation to mood, and are also feelings that are commonly felt in our day-to-day life. Which therefore means that they have great relevance and should be considered in the process of studying about moods, feelings, and emotions. Another criticism upon Izard's Differential Emotions Scale was that it may be impossible to capture the little differences within everyday experiences without including many different states instead of using non-specific terms (i.e. upset, distressed) which are ambiguous and do not correspond to one single emotion. This applies to positive emotions as well as interest, joy, happiness and excitement are usually the terms used. Despite being able to show high intercorrelations, the scale of this instrument is only able to show low internal consistency. Due to the minimal number of items, it can also cause reliability problems upon results attained. See also Caroll E. Izard Discrete Emotions Theory References Emotions Psychological tests and scales

Malacology

Malacology is the branch of invertebrate zoology that deals with the study of the Mollusca (mollusks or molluscs), the second-largest phylum of animals in terms of described species after the arthropods. Mollusks include snails and slugs, clams, and cephalopods, along with numerous other kinds, many of which have shells. Malacology derives . Fields within malacological research include taxonomy, ecology and evolution. Several subdivisions of malacology exist, including conchology, devoted to the study of mollusk shells, and teuthology, the study of cephalopods such as octopus, squid, and cuttlefish. Applied malacology studies medical, veterinary, and agricultural applications, for example the study of mollusks as vectors of schistosomiasis and other diseases. Archaeology employs malacology to understand the evolution of the climate, the biota of the area, and the usage of the site. Zoological methods are used in malacological research. Malacological field methods and laboratory methods (such as collecting, documenting and archiving, and molecular techniques) were summarized by Sturm et al. (2006). History In 1681, Filippo Bonanni wrote the first book ever published that was solely about seashells, the shells of marine mollusks. The book was entitled: In 1868, the German Malacological Society was founded. Malacologists Those who study malacology are known as malacologists. Those who study primarily or exclusively the shells of mollusks are known as conchologists, while those who study mollusks of the class Cephalopoda are teuthologists. Societies (Asociación Argentina de Malacología) American Malacological Society Association of Polish Malacologists Belgian Malacological Society – French speaking – Dutch speaking Brazilian Malacological Society Conchological Society of Great Britain and Ireland Conchologists of America Dutch Malacological Society Estonian Malacological Society European Quaternary Malacologists Freshwater Mollusk Conservation Society German Malacological Society Hungarian Malacological Society Italian Malacological Society Malacological Society of Australasia Malacological Society of London Malacological Society of the Philippines, Inc. Mexican Malacological Society Spanish Malacological Society Western Society of Malacologists Journals More than 150 journals within the field of malacology are being published from more than 30 countries, producing an overwhelming amount of scientific articles. They include: American Journal of Conchology (1865–1872) American Malacological Bulletin Basteria Bulletin of Russian Far East Malacological Society Fish & Shellfish Immunology Folia conchyliologica Folia Malacologica Heldia Johnsonia Journal de Conchyliologie – volumes 1850–1922 at Biodiversity Heritage Library; volumes 1850–1938 at Bibliothèque nationale de France Journal of Conchology Journal of Medical and Applied Malacology Journal of Molluscan Studies Malacologia Malacologica Bohemoslovaca Malacological Review – volume 1 (1968) – today, contents of volume 27 (1996) – volume 40 (2009) Soosiana Zeitschrift für Malakozoologie (1844–1853) → Malakozoologische Blätter (1854–1878) Miscellanea Malacologica Mollusca Molluscan Research – impact factor: 0.606 (2007) Mitteilungen der Deutschen Malakozoologischen Gesellschaft Occasional Molluscan Papers (since 2008) Occasional Papers on Mollusks (1945–1989), 5 volumes Ruthenica Strombus Tentacle – The Newsletter of the Mollusc Specialist Group of the Species Survival Commission of the International Union for Conservation of Nature. The Conchologist (1891–1894) → The Journal of Malacology (1894–1905) The Festivus – a peer-reviewed journal which started as a club newsletter in 1970, published by the San Diego Shell Club The Nautilus – since 1886 published by Bailey-Matthews Shell Museum. First two volumes were published under name The Conchologists’ Exchange. Impact factor: 0.500 (2009) The Veliger – impact factor: 0.606 (2003) 貝類学雑誌 Venus (Japanese Journal of Malacology) Vita Malacologica a Dutch journal published in English – one themed issue a year Vita Marina (discontinued in May 2001) Museums Museums that have either exceptional malacological research collections (behind the scenes) and/or exceptional public exhibits of mollusks: Academy of Natural Sciences of Philadelphia American Museum of Natural History Bailey-Matthews Shell Museum Cau del Cargol Shell Museum Maria Mitchell Association Museum of Comparative Zoology at Harvard National Museum of Natural History, France Natural History Museum, London Rinay Royal Belgian Institute of Natural Sciences, Brussels: with a collection of more than 9 million shells (mainly from the collection of Philippe Dautzenberg) Smithsonian Institution See also Invertebrate paleontology History of invertebrate paleozoology Treatise on Invertebrate Paleontology Notes References Further reading Cox L. R. & Peake J. F. (eds.). Proceedings of the First European Malacological Congress. September 17–21, 1962. Text in English with black-and-white photographic reproductions, also maps and diagrams. Published by the Conchological Society of Great Britain and Ireland and the Malacological Society of London in 1965 with no ISBN. Heppel D. (1995). "The long dawn of Malacology: a brief history of malacology from prehistory to the year 1800." Archives of Natural History 22(3): 301–319. External links Periodicals about molluscs at WorldCat Subfields of zoology Marine biology

Caffeine-induced psychosis

Caffeine-induced psychosis is a relatively rare phenomenon that can occur in otherwise healthy people. Overuse of caffeine may also worsen psychosis in people suffering from schizophrenia. It is characterized by psychotic symptoms such as delusions, paranoia, and hallucinations. This can happen with ingestion of high doses of caffeine, or when caffeine is chronically abused, but the actual evidence is currently limited. Understanding psychosis Psychosis is a symptom of psychotic disorders like schizophrenia and severe mood disorders like depression or bipolar disorder. Simply put, psychosis affects the human brain in ways that alter the person's ability to perceive reality. During a psychotic episode, a person may misinterpret and struggle to understand their own thoughts, and additionally "they may have difficulty recognizing what is real and what is not." In order to spot an individual who could be experiencing Psychosis, look for these symptoms: Schizophrenia: A type of psychotic disorder that impacts how a person experiences reality. Schizophrenia interferes with a person's abilities of cognition, behavior, and emotions. Symptoms of schizophrenia include: Hallucinations- The ability to see or hear something that is not occurring in reality, though to someone with schizophrenia these experiences feel real because it has the "full force and impact of a normal experience." Most hallucinations that come from schizophrenia consist of hearing things that aren't said, or imagining voices. Delusions- Imagining an event that has falsely occurred or believing something that has not occurred/ is not based in reality. Disorganized thinking and speech- The incapacity to form coherent thoughts, leading to disorganized speech. Disorganized speech is recognized as words put together that do not relate to each other or combine to make any sense logically. Speech in which words are put together meaninglessly in a way that is not able to be understood is commonly referred to as word salad. Disorganized thinking is a common symptom of schizophrenia. Negative Symptoms- The inability to function normally which may include a lack of interest in activities the person has once enjoyed before, experiencing emotions, or participating in normal human routines such as personal hygiene. Bipolar disorder: A type of mood disorder that is typically known for its extreme mood swings and inconsistent behavior patterns. Symptoms of bipolar disorder include: Mania- A main characteristic of bipolar disorder that occurs after a period of severe depression. During this time the person will likely experience: high amounts of energy and happiness, as well as a deep sense of self importance, feeling extremely impulsive/indecisive, making decisions that are potentially risky/harmful, becoming distracted easily, falling into delusions, or thinking illogically. Depression- Another main characteristic of bipolar disorder that occurs before a period of mania. Symptoms of depression include: feeling amounts of deep sadness or irritability, lacking enough energy to function in routine activities, losing interest in activities one has previously enjoyed, suicidal thoughts, an overwhelming sense of worthlessness, difficulty remembering events or focusing, lack of appetite, and illogical thinking. Patterns of mania and depression- Episodes of depression that follow mania or vice versa. During periods of mania and depression, one may actually experience a "normal" mood. Some people can experience: Rapid Cycling: "where a person with bipolar disorder repeatedly swings from a high to a low phase quickly." Mixed State: "where a person with bipolar disorder experiences symptoms of depression and mania together; for example, overactivity with a depressed mood." General Depression: Also known as major depressive disorder, is a type of mood disorder that negatively impacts a person's mood and ability to function in daily activities. If a person has any one of these symptoms, they are most likely prone to experience Psychosis. Caffeine use & its risks Consuming excessive amounts of caffeine and combining this with psychotic and mood disorders can impact the severity of the disorders, but excessive consumption can severely affect people who are schizophrenic. 85% of the population of the United States ingests caffeine in some form every day. The most common ways people ingest caffeine is through freshly brewed coffee, instant coffee, tea, soda, and chocolate. Average caffeine levels are: Brewed coffee- 100 mg/6 oz serving Instant coffee- 65 mg Tea- 40 mg Soda- 35 mg Chocolate- 5 mg A majority of the population ingests roughly 210 mg of caffeine every day, while people who have higher tolerances/consume more excessive amounts ingest more than 500 mg of caffeine daily. 80% of people with schizophrenia smoke daily and are heavy smokers. Smoking tends to deplete much of ingested caffeine, so the majority of users with schizophrenia have to consume much more caffeine than others to regulate their caffeine levels. Many people with schizophrenia use caffeine to combat boredom or to fight the sedating effects of antipsychotic medications. Additionally people with schizophrenia may have polydipsia (causes someone to feel an immense amount of thirst, despite already drinking plenty of hydrating fluids), so people with this disorder may try to consume more caffeine than normal. A lot of antipsychotic medications contain ingredients that make the mouth more prone to dryness, which would also increase the amount of coffee (containing caffeine) one may uptake. "Caffeine use can cause restlessness, nervousness, insomnia, rambling speech, and agitation" worsening the symptoms of schizophrenia. "Caffeine is metabolized by the CYP1A2 enzyme and also acts as a competitive inhibitor of this enzyme. Thus, caffeine can interact with a wide range of psychiatric medications, including antidepressant agents, antipsychotic agents, antimanic agents, antianxiety agents, and sedative agents." So when caffeine interacts with these specific medications, it can complicate the side effects of the disorder and possibly the medication. To lessen the side effects, people with schizophrenia should consume lower amounts of caffeine. A consumption of less than 250 mg of caffeine a day has been seen to give better results in better performances on cognitive tasks in people with schizophrenia. Although, more research still needs to be done to determine if the same amount of caffeine that is safe to consume by schizophrenics (> 250 mg/a day) matches up with the general population of people without schizophrenia. Treatment & prevention Chronic caffeine-induced psychosis has been reported in a 47-year-old man with high caffeine intake. The psychosis resolved within seven weeks after lowering caffeine intake, without the use of anti-psychotic medication. For schizophrenic people that have an addiction to caffeine, the best way to treat caffeine-induced psychosis is to gradually consume smaller amounts of it over a period of time. Withdrawal to certain drugs may worsen side effects of any psychotic or mood disorders, so it is best for people that have an addiction to slowly drop their levels of caffeine over time instead of completely restricting their consumption of caffeine. For people who consume excessive amounts of caffeine and don't already have a psychotic disorder, a doctor may prescribe antipsychotics to help stop the effects of psychosis. For people with a psychotic disorder, it is best to slowly limit caffeine intake and continue taking antipsychotics. References Caffeine Psychosis Schizophrenia

PsycINFO

PsycINFO is a database of abstracts of literature in the field of psychology. It is produced by the American Psychological Association and distributed on the association's APA PsycNET and through third-party vendors. It is the electronic version of the now-ceased Psychological Abstracts. In 2000, it absorbed PsycLIT which had been published on CD-ROM. PsycINFO contains citations and summaries from the 19th century to the present of journal articles, book chapters, books, and dissertations. Overview The database, which is updated weekly, contained over 3.5 million records as of October 2013. Approximately 175,000 records were added to the database in 2012. Coverage More than 2,540 peer-reviewed journal titles are included in the database, and they make up 78% of the overall content. Journals are included if they are archival, scholarly, peer-reviewed, and regularly published with titles, abstracts, and keywords in English. As of October 2013, over 1,700 journal titles were included in their entirety (i.e. "cover to cover"). Articles were selected for psychological relevance from the remaining titles. Chapters from authored and edited books make up 11% of database, while entire authored and edited books make up 4% of the database. Books are selected if they are scholarly, professional, or research-based, English-language, published worldwide, and relevant to psychology. Dissertations are selected from Dissertation Abstracts International (A and B), and make up 10% of database. They are selected on basis of classification in DAI in sections with psychological relevance. The database contains abstracts in dissertation records starting from 1995. Publications from at least 50 countries are included, with journals in more than 27 languages, and non-English titles in Roman alphabets from 1978 to the present. Record contents Each record contains a bibliographic citation, abstract, index terms from the Thesaurus of Psychological Index Terms, keywords, classification categories, population information, the geographical location of the research population, and cited references for journal articles, book chapters, and books, mainly from 2001 to present. Records of books include the book's table of contents. Abstracts range from 1995 to present, and virtually 100% of records have abstracts (0.007% no abstracts). For non-dissertation documents added from 1967 to present, 99.2% contain abstracts. The 11th Edition (print) of Thesaurus of Psychological Index Terms was released in July 2007, containing 200 new terms. There are more than 8,400 controlled terms and cross-references, with hierarchical, alphabetical, and subject arrangements. Records are indexed with the most specific term applicable, and major and minor terms assigned, with a maximum of 15 total terms, 5 major terms. The Thesaurus, no longer available in print format, is included with all PsycINFO licenses and is updated regularly. The classification system consists of 22 major categories and 135 subcategories, and a list of codes. Each record is assigned to one or two classifications. There were more than 57 million cited references in approximately 1.4 million entries for journal articles, books, and book chapters as of October 2013, all in APA-style format. Historic records Sources: Psychological Abstracts 1927–1966; Psychological Bulletin 1921–1926; American Journal of Psychology 1887–1966; All APA journals back to first issue of publication; Psychological Index (1894–1935); citations to English language journals only; Classic Books in Psychology of the 20th Century and the Harvard Book List, 1840–1971 All records published in Psychological Abstracts are now in PsycINFO. There are more than 335,000 historic records in PsycINFO, which differ from 1967–present records No controlled vocabulary (descriptor) field; index field may contain descriptor terms, but they are not controlled; other indexing fields, such as Age Groups, form/Content are not present; classifications are broad only Access and cost As PsycINFO has grown, so has the cost of accessing it. At one time it was free to individuals. As of February 2016 it costs at least $11.95 for 24 hours access. Institutions pay much more, but verified members of those institutions can then access PsycINFO for free. APA members get special pricing. There are also discounted access pricing packages with APA's related databases PsycNET, PsycARTICLES, PsycEXTRA, etc. See also PsycCRITIQUES List of academic databases and search engines References External links Bibliographic databases and indexes Works about psychology American Psychological Association

Virtual reality therapy

Virtual reality therapy (VRT), also known as virtual reality immersion therapy (VRIT), simulation for therapy (SFT), virtual reality exposure therapy (VRET), and computerized CBT (CCBT), is the use of virtual reality technology for psychological or occupational therapy and in affecting virtual rehabilitation. Patients receiving virtual reality therapy navigate through digitally created environments and complete specially designed tasks often tailored to treat a specific ailment; and is designed to isolate the user from their surrounding sensory inputs and give the illusion of immersion inside a computer-generated, interactive virtual environment. This technology has a demonstrated clinical benefit as an adjunctive analgesic during burn wound dressing and other painful medical procedures. Technology can range from a simple PC and keyboard setup, to a modern virtual reality headset. It is widely used as an alternative form of exposure therapy, in which patients interact with harmless virtual representations of traumatic stimuli in order to reduce fear responses. It has proven to be especially effective at treating PTSD, and shows considerable promise in treating a variety of neurological and physical conditions. Virtual reality therapy has also been used to help stroke patients regain muscle control, to treat other disorders such as body dysmorphia, and to improve social skills in those diagnosed with autism. Description Virtual reality therapy (VRT) uses specially programmed computers, visual immersion devices and artificially created environments to give the patient a simulated experience that can be used to diagnose and treat psychological conditions that cause difficulties for patients. In many environmental phobias, reaction to the perceived hazards, such as heights, speaking in public, flying, close spaces, are usually triggered by visual and auditory stimuli. In VR-based therapies, the virtual world is a means of providing artificial, controlled stimuli in the context of treatment, and with a therapist able to monitor the patient's reaction. Unlike traditional cognitive behavioral therapy, VR-based treatment may involve adjusting the virtual environment, such as for example adding controlled intensity smells or adding and adjusting vibrations, and allow the clinician to determine the triggers and triggering levels for each patient's reaction. VR-based therapy systems may allow replaying virtual scenes, with or without adjustment, to habituate the patient to such environments. Therapists who apply virtual reality exposure therapy, just as those who apply in-vivo exposure therapy, can take one of two approaches concerning the intensity of exposure. The first approach is called flooding, which refers to the most intense approach where stimuli that produce the most anxiety are presented first. For soldiers who have developed PTSD from combat, this could mean first exposing them to a virtual reality scene of their fellow troops being shot or injured followed by less stressful stimuli such as only the sounds of war. On the other hand, what is referred to as graded-exposure takes a more relaxed approach in which the least distressing stimuli are introduced first. VR-exposure, as compared to in-vivo exposure has the advantage of providing the patient a vivid experience, without the associated risks or costs. VRT has great promise since it historically produces a "cure" about 90% of the time at about half the cost of traditional cognitive behavior therapy authority, and is especially promising as a treatment for PTSD where there are simply not enough psychologists and psychiatrists to treat all the veterans with anxiety disorders diagnosed as related to their military service. VRT is also a promising adjunctive therapy for the treatment of other clinical populations, such as individuals with psychosis. A recent systematic review of psychosocial interventions using virtual reality shows these interventions are safe and well accepted in this population. The studies identified in the review show that psychosocial VRT can improve cognitive, social, and vocational skills as well as symptoms of auditory verbal hallucinations and paranoia in individuals with psychosis. Recently there have been some advances in the field of virtual reality medicine. Virtual reality is a complete immersion of the patient into a virtual world by putting on a headset with an LED screen in the lenses of the headset. This is different from the recent advancements in augmented reality. Augmented reality is different in the sense that it enhances the non-synthetic environment by introducing synthetic elements to the user's perception of the world. This in turn "augments" the current reality and uses virtual elements to build upon the existing environment. Augmented reality poses additional benefits and has proven itself to be a medium through which individuals with a specific phobia can be exposed "safely" to the object(s) of their fear, without the costs associated with programming complete virtual environments. Thus, augmented reality can offer an efficacious alternative to some less advantageous exposure-based therapies. History Virtual reality therapy (VRT) was pioneered and originally termed by Max North documented by the first known publication (Virtual Environment and Psychological Disorders, Max M. North, and Sarah M. North, Electronic Journal of Virtual Culture, 2,4, July 1994), his doctoral VRT dissertation completion in 1995 (began in 1992), and followed with the first known published VRT book in 1996 (Virtual Reality Therapy, an Innovative Paradigm, Max M. North, Sarah M. North, and Joseph R. Coble, 1996. IPI Press. ). His pioneered virtual reality technology work began as early as 1992 as a research faculty at Clark Atlanta University and supported by funding from U.S. Army Research Laboratory. An early exploration in 1993–1994 of VRT was done by Ralph Lamson a USC graduate then at Kaiser Permanente Psychiatry Group. Lamson began publishing his work in 1993. As a psychologist, he was most concerned with the medical and therapeutic aspects, that is, how to treat people using the technology, rather than the apparatus, which was obtained from Division, Inc. Psychology Today reported in 1994 that these 1993–1994 treatments were successful in about 90% of Lamson's virtual psychotherapy patients. Lamson wrote in 1993 a book entitled Virtual Therapy which was published in 1997 directed primarily to the detailed explanation of the anatomical, medical and therapeutic basis for the success of VRT. In 1994–1995, he had solved his own acrophobia in a test use of a third party VR simulation and then set up a 40 patient test funded by Kaiser Permanente. Shortly thereafter, in 1994–1995, Larry Hodges, then a computer scientist at Georgia Tech active in VR, began studying VRT in cooperation with Max North who had reported anomalous behavior in flying carpet simulation VR studies and attributed such to phobic response of unknown nature. Hodges tried to hire Lamson without success in 1994 and instead began working with Barbara Rothbaum, a psychologist at Emory University to test VRT in controlled group tests, experiencing about 70% success among 50% of subjects completing the testing program. In 2005, Skip Rizzo of USC's Institute for Creative Technologies, with research funding from the Office of Naval Research (ONR), started validating a tool he created using assets from the game Full Spectrum Warrior for the treatment of posttraumatic stress disorder. Virtual Iraq was subsequently evaluated and improved under ONR funding and is supported by Virtually Better, Inc. They also support applications of VR-based therapy for aerophobia, acrophobia, glossophobia, and substance abuse. Virtual Iraq proved successful in normalization of over 70% of people with PTSD, and that has now become a standard accepted treatment by the Anxiety and Depression Association of America. However, the VA has continued to emphasize traditional prolonged exposure therapy as the treatment of choice, and VR-based therapies have gained only limited adoption, despite active promotion by DOD, and despite VRT having much lower cost and apparently higher success rates. A $12-million ONR funded study is currently underway to definitively compare the efficacy of the two methods, PET and VRT. Military labs have subsequently set up dozens of VRT labs and treatment centers for treating both PTSD and a variety of other medical conditions. The use of VRT has thus become a mainstream psychiatric treatment for anxiety disorders and is finding increasing use in the treatment of other cognitive disorders associated with various medical conditions such as addiction, PTSD and schizophrenia. Applications Psychological therapy Exposure therapy Virtual reality technology is especially useful for exposure therapy – a treatment method in which patients are introduced and then slowly exposed to a traumatic stimulus. Inside virtual environments, patients can safely interact with a representation of their phobia, and researchers don't need to have access to a real version of the phobia itself. One of the primary challenges to the efficacy of Exposure therapy is recreating the level of trauma existing in real environments  inside a virtual environment. Virtual reality aids in overcoming this by engaging with different sensory stimuli of the patient while heightening the realism and maintaining the safety of the environment. One very successful example of virtual reality therapy exposure therapy is the PTSD treatment system, Virtual Iraq. Using a head mounted display and a game pad, patients navigate a Humvee around virtual recreations of Iraq, Afghanistan, and the United States. By being safely exposed to the traumatic environments, patients learned to reduce their anxiety. According to a review of the history of Virtual Iraq, one study found that it reduced PTSD symptoms by an average of fifty percent, and disqualified over seventy-five percent of participants for PTSD after treatment. Virtual Reality Exposure Therapy (VRET) is also commonly used for treating specific phobias, especially small animal phobia. Commonly feared animals such as spiders can be easily produced in a virtual environment, instead of finding the real animal. VRET has also been used experimentally to treat other fears such as public speaking and claustrophobia. Another successful study attempted treating 10 individuals who experienced trauma as a result of events during 9/11. Through repeated exposure to increasingly traumatic sequences of World Trade Center events, immediate positive results were self reported by test subjects. In a 6-month follow-up, 9 of the test subjects available for follow up maintained their results from exposure. Virtual Reality Exposure Therapy (VRET) offers a wide range of advantages compared to traditional exposure therapy techniques. Recent years have suggested an increase in familiarly and trust in virtual reality technology as an acceptable mirror of reality. A higher trust in the technology could lead to more effective treatment results as more phobics seek out help. Another consideration for VRET is the cost effectiveness. While the actual cost of VRET may vary based on the hardware and software implementation, it is supposedly more effective than the traditional in vivo treatment used for exposure therapy while maintaining a positive return on investment. Future research might pave an alternative to extensive automated lab or hospital environments. For instance, in 2011, researchers at York University proposed an affordable virtual reality exposure therapy (VRET) system for the treatment of phobias that could be set up at home. Such developments in VRET  may pave a new way of customised treatment that also tackles the stigma attached to clinical treatment. While there is still a lot unknown about the long-term effectiveness of the relatively new VRET, the future seems promising with growing studies reflecting the benefits of VRET to combat phobias. Virtual rehabilitation The term virtual rehabilitation was coined in 2002 by Professor Daniel Thalmann of EPFL (Switzerland) and Professor Grigore Burdea of Rutgers University (USA). In their view the term applies to both physical therapy and cognitive interventions (such as for patients with Post Traumatic Stress Disorder, phobias, anxieties, attention deficits or amnesia). Since 2008, the virtual rehabilitation "community" has been supported by the International Society on Virtual Rehabilitation. Virtual rehabilitation is a concept in psychology in which a therapeutic patient's training is based entirely on, or is augmented by, virtual reality simulation exercises. If there is no conventional therapy provided, the rehabilitation is said to be "virtual reality-based". Otherwise, if virtual rehabilitation is in addition to conventional therapy, the intervention is "virtual reality-augmented." Today, a majority of the population uses the virtual environment to navigate their daily lives and almost one fourth of the world population uses the internet. As a result, virtual rehabilitation and gaming rehabilitation, or rehabilitation through gaming consoles, have become quite common. In fact, virtual therapy has been used over regular therapeutic methods in order to treat a number of disorders. Some factors to consider when virtual rehabilitation include cultural sensitivity, accessibility, and ability to finance the virtual therapy. Advantages Virtual rehabilitation offers a number of advantages compared to conventional therapeutic methods: It is entertaining, thus motivating the patient; Potential for involvement of the patients' stimulus modalities for more realistic environments for treatment. It provides objective outcome measures of therapy efficacy (limb velocity, range of movement, error rates, game scores, etc.); These data are transparently stored by the computer running the simulation and can be made available on the Internet. Virtual rehabilitation can be performed in the patient's home and monitored at a distance (becoming telerehabilitation) The patient feels more actively involved in the desensitization The patient may "forget" they are in treatment or undergoing observation resulting in more authentic expressions. Effective for hospitals to reduce their costs because of lowered cost of medicine and equipment. Great impact of virtual reality on pain relief Disadvantages Despite all the merits of VR therapy as listed in the sections above, there are pitfalls and obstacles in the development of widespread VR solutions. Cost effectiveness: VRET may show promising returns on investment but the fact remains that the true development cost of VRET environments depends heavily on the choice of hardware and software chosen. Treatment effectiveness: For the treatment to take effect, a patient should be able to successfully project and experience their anxiety in a virtual environment. Unfortunately, this projection is highly subjective and personalised per patient; and outside the control of the therapists.  This limitation might adversely impact the therapy. Migrating back to reality from virtual reality: Another skepticism is the correlation between virtual reality and actual reality. If a patient successfully combats their phobia in a virtual environment, does that guarantee success in real life too? Further, when treating more complicated ailments such as schizophrenia, there is inadequate projection on how delusions and hallucinations may translate from the real world to the virtual one. VR sickness: Movement in a virtual environment is said to cause visual discomfort. Prolonged periods of exposure to VR may lead to side effects like dry eyes, headaches, nausea and sweating; symptoms similar to motion sickness. Ethical and legal considerations: Since VR is a relatively new technology, its ethical implications are not as comprehensive as other forms of treatment. There is a need to formalize the limits, side effects, disclaimers, privacy regulations as we increase the breadth of impact of VR therapy; especially in matters related to forensic cases. Acceptance by the medical community: As VR-based therapy increases, it might pose a challenge to licensed therapists and medical professionals who may perceive VR as a threat. Afterall, VR deviates from the pre-established norm of  "talking cure" . Therapeutical targets Depression In February 2006 the UK's National Institute of Health and Clinical Excellence (NICE) recommended that VRT be made available for use within the NHS across England and Wales, for patients presenting with mild/moderate depression, rather than immediately opting for antidepressant medication. Some areas have developed, or are trialing. At Auckland University in New Zealand, a team led by Dr. Sally Merry have been developing a computerized CBT fantasy "serious" game to help tackle depression amongst adolescents. The game, Sparx, has a number of features to help combat depression, where the user takes on a role of a character who travels through a fantasy world, combating "literal" negative thoughts and learning techniques to manage their depression. Schizophrenia Avatar Therapy is a form of therapy that can be delivered through virtuality reality designed for people with schizophrenia who experience distressing auditory hallucinations, particularly hearing hostile voices. In this therapy, patients engage in real-time, face-to-face dialogue with a digital avatar that represents the voice they hear. The therapist operates the avatar, allowing it to verbally communicate with the patient in a controlled and safe environment. Over time, the patient learns to confront and reduce the power of the hallucination, often finding relief from its intensity and frequency. Avatar therapy aims to help patients gain control over their symptoms, reduce distress, and improve overall mental health. This therapy is grounded in the idea that giving a “face” and voice to auditory hallucinations can help individuals reframe their relationship with these experiences. Avatar therapy has shown promising results in clinical trials, demonstrating improvements in reducing the impact of auditory hallucinations compared to standard treatment options. It is part of a broader effort to utilize VR and other innovative technologies in mental health care for conditions like schizophrenia. Eating disorders and body dysmorphia Virtual reality therapy has also been used to attempt to treat eating disorders and body dysmorphia. One study in 2013 had participants complete various tasks in virtual reality environments which could not have been easily replicated without the technology. Tasks included showing patients the implications of reaching their desired weight, comparing their actual body shape to an avatar created using their perceived body size, and altering a virtual reflection to match their actual body size. Gender dysphoria Early research suggests that virtual reality experiences may offer therapeutic benefits to transgender individuals experiencing gender dysphoria. More experimentation and professional examination is needed before virtual reality could be prescribed as a treatment in practice. However, some transgender individuals have engaged in what can be characterized as an anecdotally alleviating form of self-administered, virtual sex reassignment therapy. Digital spaces offer a form of anonymous self-expression that trans individuals, due to exposure of discrimination and violence, are not fully granted to them in real life or IRL. The sophistication of virtual reality expands on these newfound liberties by providing an avenue for those with gender dysphoria to embody their gender identity, if it not accessible for them to do so in their real life. Through use of available VR videogames and chat rooms, those with gender dysphoria can create avatars of themselves, interact anonymously, and work towards therapeutic goals. Acrophobia A study published in The Lancet Psychiatry proved that virtual reality therapy can help treat acrophobia. Over the course of the study, participants were introduced to intimidating heights in a virtual reality environment then asked to complete various activities at those heights while under the supervision and support of a coach. This study, although insufficient in terms of scope and scrutiny for direct adoption into remedial practices, surrounds future research and treatment modeling with promise, as a majority of the participants considered themselves no longer afraid of heights. Physical therapy Stroke Research suggests that patients who had a stroke found virtual reality (VR) rehab techniques in their Physical Therapy treatment plans very beneficial. Throughout a rehabilitation program aimed to restore and/or retain balance and walking skills, patients who have had a stroke often must relearn how to control certain muscles. In most physical therapy settings, this is done through high intensity, repetitive, and task-specific practice. Programs of this type can prove to be physically demanding, are expensive, and require several days of training per week. Additionally, regimens may seem redundant, and produce only modest and/or delayed effects in patient recovery. A physical therapy regimen using VR provides an opportunity to individualize training to fit the specific needs of the patient. While the exercises and movements required for proper motor learning can seem repetitive, using VR adds a level of intrigue and engagement for the patient. Training with VR enhances motor learning by giving the patient opportunities to practice their movements/exercise protocol in different VR environments. This ensures that patients are always challenged and may be better prepared to perform in their environments. Feedback is an important element of physical therapy for patients recovering from stroke and/or other neuromuscular disorders. Within the scope of motor learning, receiving feedback during performance of a task improves the learning rate. According to a Cochrane Review, visual feedback, specifically, has been shown to aid in balance recovery for patients who have had a stroke. VR can provide continuous visual feedback that a physical therapist may not be able to during their sessions. Results have also suggested that in addition to improvements in balance, positive effects are also seen in walking ability. In one study, patients with VR training coupled with their physical therapy program had better improvements in walking speed than others not using VR training. The most recent review about the effect of VR training on balance and gait ability showed significant benefits of VR training on gait speed, Berg Balance Scale (BBS) scores, and Timed "Up & Go" Test scores when VR was time dose matched to conventional therapy. Parkinson's disease Many studies (Cochrane Review) have shown that using VR technology during physical therapy treatments for patients with Parkinson's disease had positive outcomes. For patients with PD the VR therapy: Increased gait and balance. Improved functions of activities of daily living (ADL's). Improved quality of life. Improved cognitive function. It is speculated that these improvements occurred because the VR gave increased feedback to the patient regarding their performance during the VR sessions. VR stimulates a patient's motor and cognitive processes, both of which may be impaired as a result of the disease. Another benefit of VR is that it replicates real life scenarios, allowing patients to practice functional activities. Wound care Additionally, VR provides beneficial outcomes when it is implemented for patients who are receiving wound care rehabilitation. Studies have speculated that the more immersive the VR, the greater the experience and concentration the patient will have on the virtual environment. Equally important, VR has shown to reduce pain, anxiety and depressive symptoms, as well as an increasing their treatment adherence. In other studies, the results point to the benefits of VR in relation to increased distraction, and patients reported less time thinking about pain, less intense pain and immersion, which facilitates care such as dressing changes and physiotherapy. Wound dressing often generates a pain-provoking experience. Therefore, use of VR was related to more efficient dressings, increased distraction from the pain during procedures (e.g. dressing and physical rehabilitation) which reduced the patients' stress and anxiety. Cardiovascular The use of VR and video games could be considered as complementary tools for physical training in patients with Cardiovascular diseases. Certain games designed for exercise have been shown to promote increases in heart rate, fatigue perception, and physical activity. In addition, it has been shown to reduce pain and increase adherence to physical therapy programs in patients with cardiovascular diseases. Finally, virtual reality and video games enhance motivation and adherence in cardiac rehabilitation programs. Occupational therapy Autism Virtual reality has been shown to improve the social skills of young adults with autism. In one study, participants controlled a virtual avatar in different virtual environments and maneuvered through various social tasks such as interviewing, meeting new people, and dealing with arguments. Researchers found that participants improved in the areas of emotional recognition in voices and faces and in considering the thoughts of other people. Participants were also surveyed months after the study for how effective they thought the treatments were, and the responses were overwhelmingly positive. Many other studies have also explored this occupational therapy option. Attention deficit hyperactivity disorder A clinical trial published in the Journal of Attention Disorders found that school age children with ADHD who underwent a virtual classroom cognitive treatment series were able to achieve the same management of symptoms of impulsivity and distractibility as children who were medicated with a stimulant. Post-traumatic stress disorder It may also be possible to use virtual reality to assist those with PTSD. The virtual reality allows the patients to relive their combat situations at different extremes as a therapist can be there with them guiding them through the process. Some scholars believe that this is an effective way to treat PTSD patients as it allows for the recreation of exactly what they experienced. "It allows for greater engagement by the patient and, consequently, greater activation of the traumatic memory, which is necessary for the extinction of the conditioned fear." Stroke Virtual reality also has applications in the physical side of occupational therapy. For stroke patients, various virtual reality technologies can help bring fine control back to different muscle groups. Therapy often includes games controlled with haptic-feedback controllers that require fine movements, such as playing piano with a virtual hand. The Wii gaming system has also been used in conjunction with virtual reality as a treatment method. Chronic and acute pain Virtual reality (VR) has been shown to be effective in immediately decreasing procedural or acute pain. To date there have been few studies on its efficacy in chronic pain. Such chronic pain patients can tolerate the VR session without the side effects that sometimes come with VR such as headaches, dizziness or nausea. Neurological Rehabilitation Virtual reality is also helping patients overcome balance and mobility problems resulting from stroke or head injury. In the study of VR, the modest advantage of VR over conventional training supports further investigation of the effect of video-capture VR or VR combined with conventional therapy in larger-scale randomized, more intense controlled studies. It shows the VR-assisted patients had better mobility when the doctors checked in two months later. Other research has shown similarly successful outcomes for patients with cerebral palsy undergoing rehab for balance problems. Therapeutic goals of VR in children with cerebral palsy target balance, walking, and enhancing function of real-world activities. Several randomized controlled trials found that VR therapy significantly improved balance and walking in children with cerebral palsy. Studies also found significant improvements in upper extremity function and postural control after VR therapy. VR interventions were more effective in younger patients, likely as there is greater neuroplasticity during development. Advantages of VR include increased patient motivation through gamification and the creation of virtual spaces that are safe and therapeutically supportive. Children may repeat therapeutic tasks more often than with conventional modalities alone, more easily meeting the repetitions required for structural, neurological change. Functional MRI studies of cerebral palsy patients with upper limb involvement suggest that VR therapy can lead to neuroplastic changes in the sensory motor cortex, and subsequent improvements in motor function. Provider peer training and VR therapies collaboratively developed by engineers, providers, and patients, lead to improved outcomes in provider competency and patient motor function. While commercially available VR gaming systems can be therapeutically effective, VR systems engineered to meet specific therapeutic needs additionally account for engagement in tasks, relevance of the virtual environment, appropriate feedback sensors and monitors. VR that mimics the complexity of real-world tasks improves skills transfer from virtual to real environments. Complex tasks permit infinite path variability for each movement necessary to complete the task. Multiple possible solutions allow the patient to critically think through a task and to develop adaptive solutions for their body, further improving outcomes. Surgery VR smoothly blurs the demarcation between the physical world and the computer simulation as surgeons can use latest versions of virtual reality glasses to interact in a three-dimensional space with the organ that requires surgical treatment, view it from any desired angle and able to switch between 3D view and the real CT images. Efficiency Randomized, tightly controlled, acrophobia treatment trials at Kaiser Permanente provided >90% effectiveness, conducted in 1993–94. (Ext. Ref. 2, pg. 71) Of 40 patients treated, 38 showed marked reduction in phobic reaction to heights and self-reported reaching their goals. Research found that VRT allows patients to achieve victory over virtual height situations they could not confront in real life, and that gradually increasing the height and danger in a virtual environment produced increasing victories and greater self-confidence in the patient that they could actually confront the situation in real life. "Virtual therapy interventions empower people. The simulation technology of virtual reality lends itself to mastery oriented treatment ... Rather than coping with threats, phobics manage progressively more threatening aspects in a computer-generated environment ... The range of applications can be extended by enhancing the realness and interactivity so that actions elicit reactions from the environments in which individuals immerse themselves" (Ext. Ref. 3, pg. 331–332). Another study examined the effectiveness of virtual reality therapy in treating military combat personnel recently returning from the current conflicts in Iraq and Afghanistan. Rauch, Eftekhari and Ruzek conducted a study with a sample of 42 combat servicemen who were already diagnosed with chronic PTSD (post-traumatic stress disorder). These combat servicemen were pre-screened using several different diagnostic self-reports including the PTSD military checklist, a screening tool used by the military in the determination of the intensity of the diagnosis of PTSD by measuring the presence of PTSD symptoms. Although 22 of the servicemen dropped out of the study, the results of the study concerning the 20 remaining servicemen still has merit. The servicemen were given the same diagnostic tests after the study which consisted of multiple sessions of virtual reality exposure and virtual reality exposure therapy. The servicemen showed much improvement in the diagnostic scores, signaling a decrease of symptoms of PTSD. Likewise, a three-month follow-up diagnostic screening was also administered after the initial sessions that were undergone by the servicemen. The results of this study showed that 15 of the 20 participants no longer met diagnostic criteria for PTSD and improved their PTSD military checklist score by 50% for the assessment following the study. Even though only 17 of the 20 participants participated in the 3-month follow-up screening, 13 of the 17 still did not meet the criteria for PTSD and maintained their 50% improvement in the PTSD military checklist score. These results show promising effects and help to validate virtual reality therapy as an efficacious mode of therapy for the treatment of PTSD (McLay, et al., 2012). VR combined real instrument training was effective at promoting recovery of patients' upper-extremity and cognitive function, and thus may be an innovative translational neurorehabilitation strategy after stroke. In the study, the experimental group showed greater therapeutic effects in a time-dependent manner than the control group, especially on the motor power of wrist extension, spasticity of elbow flexion and wrist extension, and Box and Block Tests. Patients in the experimental group, but not the control group, also showed significant improvements on the lateral, palmar, and tip pinch power, Box and Block, and 9-HPTs from before to immediately after training. Continued development Larry Hodges, formerly of Georgia Tech and now Clemson University and Barbara Rothbaum of Emory University, have done extensive work in VRT, and also have several patents and founded a company, Virtually Better, Inc. In the United States, the United States Department of Defense (DOD) continues funding of VRT research and is actively using VR in treatment of PTSD. Millions of funding is being put towards developments and early trials in the realm of virtual reality as companies race for FDA approval for their medical applications. BRAVEMIND software In 2014, a virtual reality application used as a prolonged exposure (PE) therapy tool for military related trauma called BRAVEMIND was reported BRAVEMIND is as an acronym for Battlefield Research Accelerating Virtual Environments for Military Individual Neuro Disorders. Virtual reality exposure therapy (VRET) applications have been used to assist civilian populations with anxieties about flying, public speaking, and heights. BRAVEMIND has been studied in populations of military medics as well as survivors of military sexual assault and combat. This technology was developed by researchers at the University of the Southern California in collaboration with the U.S. Army Research Laboratory. In 2004, reports stated that 40% of military members experience PTSD but only 23% seek medical help. Emory physicians described one of the strongest indicators of PTSD to be avoidance, saying this inhibits those affected from seeking treatment. PE requires that the patient close their eyes and relate the pertinent episode in as much detail as possible. The methodology was based on the concept that in facing the event, the charge of the triggers may be attenuated over time. The VRET application BRAVEMIND differs from PE in that the patient does not reimagine the episode but instead wears a headset that places them in the familiar environment. This headset is equipped with two screens (one for each eye), headphones, and a position monitor that shifts the visual scene to match the patient's head movements. Depending on the patient's experience they may be standing or sitting on top of a raised platform with a bass shaker. This allows for vibrations that simulate the experience of riding a military vehicle. Other accessories such as joysticks or mock machine guns are given to the patients, if appropriate, to enhance realism. The clinician introduces triggers, such as gunfire, explosions, etc. into the virtual environment as they see fit. The clinician can also adapt sound and lighting conditions to match the patient's description. The researchers who developed the BRAVEMIND system reported that in a 20-patient trial, the patients' scores on the diagnostic PTSD checklist–military version (PCL-M) dropped from 54.4 pre-treatment to 35.6 post-treatment after eleven sessions. In another clinical trial, consisting of 24 active-duty soldiers, it was reported that after 7 sessions 45% no longer were identified as positive for PTSD while 62% demonstrated symptomatic improvement. These experimental results were compared with those of alternative PE treatments. The BRAVEMIND software has 14 different environments available including military barracks, Iraqi markets, and desert roads. Included in these are environments specific to military sexual trauma (MST). Designed environments such as U.S. base settings, shower areas, latrines, remote shelters, and others were developed after consulting subject matter experts from Emory University. Proponents of this research have said that with military based videogames being so prevalent, this technology may be more appealing to patients and reduce the stigma surrounding treatment. They also have argued that as research on PTSD unfolds, possible subtypes may respond to treatments differently, and therefore diversifying treatment options is best. Others have expressed reservations about the capacity to properly personalize VRET for individualized treatment and the use of ethnic stereotyping while developing Arab populated environments. Treatment for lesions Virtual reality therapy has two promising potential benefits for treatment of hemispatial neglect patients. These include improvement of diagnostic techniques and as a supplement to rehabilitation techniques. Current diagnostic techniques usually involve pen and paper tests like the line bisection test. Though these tests have provided relatively accurate diagnostic results, advances in virtual reality therapy (VRT) have proven these tests to not be completely thorough. Dvorkin et al. used a camera system that immersed the patient into a virtual reality world and required the patient to grasp or move object in the world, through tracking of arm and hand movements. These techniques revealed that pen and paper tests provide relatively accurate qualitative diagnoses of hemispatial neglect patients, but VRT provided accurate mapping into a 3-dimensional space, revealing areas of space that were thought to be neglected but which patients had at least some awareness. Patients were also retested 10 months from initial measurements, during which each went through regular rehabilitation therapy, and most showed measurably less neglect on virtual reality testing whereas no measurable improvements were shown in the line bisection test. Virtual reality therapy has also proven to be effective in rehabilitation of lesion patients with neglect. A study was conducted with 24 individuals with hemispatial neglect. A control group of 12 individuals underwent conventional rehabilitation therapy including visual scanning training, while the virtual reality group (VR) were immersed in 3 virtual worlds, each with a specific task. The programs consisted of "Bird and Ball" in which a patient touches a flying ball with his or her hand and turns it into a bird "Coconut", in which a patient catches a coconut falling from a tree while moving around "Container" in which a patient moves a box carried in a container to the opposite side. Each of the patients of VR went through 3 weeks of 5-day-a-week 30-minute intervals emerged in these programs. The controls went through the equivalent time in traditional rehabilitation therapies. Each patient took the star cancellation test, line bisection test, and Catherine Bergego Scale (CBS) 24 hours before and after the three-week treatment to assess the severity of unilateral spatial neglect. The VR group showed a higher increase in the star cancellation test and CBS scores after treatment than the control group (p<0.05), but both groups did not show any difference in the line bisection test and K-MBI before and after treatment. These results suggest that virtual reality programs can be more effective than conventional rehabilitation and thus should be further researched. VR advantages over IVE The preference of virtual reality exposure therapy over in-vivo exposure therapy is often debated, but there are many obvious advantages of virtual reality exposure therapy that make it more desirable. For example, the proximity between the client and therapist can cause problems when in-vivo therapy is used and transportation is not reliable for the client or it is impractical for them to travel as far as needed. However, virtual reality exposure therapy can be done from anywhere in the world if given the necessary tools. Going along with the idea of unavailable transportation and proximity, there are many individuals who require therapy but due to various forms of immobilizations (paralysis, extreme obesity, etc.) they can not physically be moved to where the therapy is conducted. Again, because virtual reality exposure therapy can be conducted anywhere in the world, those with mobility issues will no longer be discriminated against. Another major advantage is fewer ethical concerns than in-vivo exposure therapy. Another advantage to virtual reality rehab over the traditional method is patient motivation. When presented with difficult tasks during a prolonged period, patients tend to lose interest in these tasks. This causes a decrease in compliance due to decreased motivation of completing a given task. Virtual reality rehab is advantageous in such a way that it challenges and motivates the patient to do more. With simple things like high scores, in-game awards, and ranks, not only are patients motivated to do their daily therapies, they are having fun doing it. Not only is this advantageous to the patients, it is advantageous to the physical therapist. With these high scores, and data the game or application collects, therapists can analyze the data to see progression. This progression can be charted and visually shown to the patient for increased motivation on their performance and the progression they have made thus far in their therapies. This data can then be charted with other participants doing similar tasks and can show how they compare to people with similar therapy regimens. This charted data in the program or game can then be used by researchers and scientists alike for further evaluation of optimal therapy regimens. A recent study done in 2016 where a VR based virtual simulation of a city named Reh@City was made. This city in virtual reality evoked memory, attention, visuo-spatial abilities and executive functions tasks are integrated in the performance of several daily routines. This study looked at Activities of Daily Living in post stroke patients and found it to have more of an impact than conventional methods in the recovery process. Regulatory Approvals and Standards The introduction of Virtual Reality Therapy (VRT) into the healthcare sector has prompted the need for regulatory standards and approvals to ensure the safety and efficacy of this technology. VRT has been recognized for its potential in providing therapeutic benefits across various medical conditions, including pain management, anxiety, rehabilitation, and mental health challenges. The regulatory landscape for VRT is evolving, with guidelines aiming to categorize these solutions under the medical devices framework, ensuring they meet the required safety, quality, and performance standards. In the United States, VRT solutions are considered medical devices, subject to categorization and regulatory approval by the Food and Drug Administration (FDA). The classification of a VR solution as a medical device hinges on its intended use in diagnosis, treatment, cure, mitigation, or prevention of disease. The FDA categorizes medical devices into Class I, Class II, and Class III, based on their intended use and associated risks. VR solutions typically fall into Class II, requiring a pre-market notification or 510(k) clearance, demonstrating that the device is as safe and effective as a legally marketed device not subject to premarket approval. The FDA’s approach towards VRT emphasizes the importance of device categorization, application procedures, and adherence to established regulatory controls. For instance, the EaseVRx system by AppliedVR received FDA approval through the De Novo premarket review pathway, highlighting the role of regulatory controls in classifying VRT solutions and ensuring their safety and efficacy. Furthermore, the Federal Register highlighted the classification of a Virtual Reality Behavioral Therapy Device for Pain Relief into class II with special controls. This classification necessitates compliance with specific controls, including clinical performance testing and biocompatibility evaluation, to mitigate associated risks and protect patient safety. As VRT continues to evolve, regulatory bodies like the FDA will remain instrumental in guiding the development and deployment of these technologies. Concerns There are a few ethical concerns concerning the use and development of using virtual reality simulation for helping clients/patients with mental health issues. One example of these concerns is the potential side effects and aftereffects of virtual reality exposure. Some of these side effects and aftereffects could include cybersickness (a type of motion sickness caused by the virtual reality experience), perceptual-motor disturbances, flashbacks, and generally lowered arousal (Rizzo, Schultheis, & Rothbaum, 2003). If severe and widespread enough, these effects should be mitigated via various methods by those therapists using virtual reality. Another ethical concern is how clinicians should receive VRT certification. Due to the relative newness of virtual reality as a whole, there may not be many clinicians who have experience with the nuances of virtual reality exposure or VR programs' intended roles in therapy. According to Rizzo et al. (2003), virtual reality technology should only be used as a tool for qualified clinicians instead of being used to further one's practice or garner an attraction for new clients/patients. Some traditional concerns with virtual reality therapy is the cost. Since virtual reality in the field of science and medicine is so primitive and new, the costs of virtual reality equipment would be a lot higher than some of the traditional methods. With medical costs growing at an exponential level this would be another cost that is added to the growing list of medical bills for a patient's recovery process. Regardless of the benefits with virtual reality rehab, the costs of the equipment and the resources for a virtual reality setup would make it difficult for it to be mainstream and available to all patients including the indigent population. However, a new market of lower cost virtual reality hardware is emerging, specifically with improved head-mounted displays. In addition there are some issues which are related to virtual reality that can arise from its use such as social isolation where the users can become detached from real-world social connections and the overestimation of a person's abilities where users – especially the young – often fail to distinguish between their feats in real life and virtual reality. References Further reading Next Stop: Virtual Psychology and Therapy; Current Topics in Psychology; Fenichel, M.; (2010) External links Burn Victim Sam Brown Treated With Virtual-Reality Video Game SnowWorld. GQ: Newsmakers Virtual Reality Pain Reduction project of University of Washington Seattle and U.W. Harborview Burn Center. PHOBOS Anxiety Management Virtual Reality Platform project of PsyTech LLC currently in development to be used as a professional virtual reality exposure therapy tool to treat a variety of patients' common phobias and anxiety disorders. ShahrbanianSh; Ma X; Aghaei N; Korner-Bitensky N; Moshiri K; Simmonds MJ. Use of virtual reality (immersive vs. non immersive) for pain management in children and adults: A systematic review of evidence from randomized controlled trials. European Journal of Experimental Biology 2012, 2 (5): 1408–22. American inventions Virtual reality Therapy

Therapy speak

Therapy speak is the incorrect use of jargon from psychology, especially jargon related to psychotherapy and mental health. It tends to be linguistically prescriptive and formal in tone. Therapy speak is related to psychobabble and buzzwords. It is vulnerable to miscommunication and relationship damage as a result of the speaker not fully understanding the terms they are using, as well as using the words in a weaponized or abusive manner. Therapy speak is not generally used by therapists during psychotherapy sessions. Motivation Although the use of therapy speak may be unconscious, a variety of different motivations have been identified in different situations. People use therapy speak because it makes themselves or their emotions sound more important or superior. In this sense, the use of therapy speak may be no different from academese, which is jargon needlessly used by university professors and other academics to make themselves sound educated. This can come across as the speaker being condescending and unkind. Therapy speak may be used in other ways to claim social status, e.g., by engaging in conspicuous consumption under the guise of self-care. The motivation may be to win an argument, or to prevent people from questioning why they have issued a demand. Therapy speak is sometimes used by "deeply insecure" people to mask their discomfort, avoid conflict, or to create distance in a relationship. Instead of saying something clear, like "I don't want to be friends any longer", they may use therapy speak and instead say something vague like "I don't have the emotional capacity for a relationship". It may be used as a defence mechanism to put emotional distance between them, their feelings, and the situation. They may be hoping that using therapy speak will elicit more sympathy, or at least tamp down overt criticism of themselves. Because it can distance the speaker from culpability for what they say and do, it has been compared to the jargon used in businesses in human resource policies and similarly formal corporate communications to employees. People also use therapy speak to cover up being controlling. Rather than using the language of psychology to describe oneself, the speaker uses it to judge others. Another motivation for using therapy speak is to get more support. Some people may find that their needs are more likely to be met when they use therapy speak (e.g., "I was traumatized by the traffic jam this morning") than if they use ordinary language (e.g., "I felt stressed because the traffic made me late"). Among people who are dating, using therapy speak may be an attempt to signal that the speaker is emotionally mature or financially stable. Talking about psychotherapy during a first date may increase the likelihood of a second date. Employers may use therapy speak as well as psychology-based activities, such educational sessions about burnout and stress management, to address some complaints from employees. This may be considered psychwashing (whitewashing a bad situation through psychology), as it redirects attention away from the problems caused by the company (e.g., poor management, overworked employees, low pay) towards problems with the individual (e.g., feeling stressed because the work is pointless and poorly paid). Effects Therapy speak can be associated with controlling behavior. It can be used as a weapon to shame people or to pathologize them by declaring the other person's behavior (e.g., accidentally hurting the other person's feelings) to be a mental illness, as well as a way to excuse or minimize the speaker's choices, for example, by blaming a conscious behavior like ghosting on their attachment style, rather than working to change the behavior. Like other forms of pop psychology, therapy speak can result in miscommunication. When people use the same word to mean different things, they may have difficulty understanding each other. For example, someone might talk about trauma bonding, thinking that it's the emotional bond between survivors of a shared experience; the actual meaning is the emotional attachment of abuse victims to their abusers. Using the word to refer to a relationship between abuse survivors will confuse people who believe it refers to an abuser–victim relationship, and vice versa. Therapists may deal with this by asking the speaker to define the word or explain it in more detail. It also impairs communication by substituting a superficial judgement for clear communication. Therapy speak can prevent the person from clearly and correctly understanding their situation or relationship. Labeling a person or situation with psychology jargon may stop people from exploring any of the nuances or complexities. For example, someone may say that a person is toxic, when it would be more productive to understand how they have been hurt by this person, or even whether they have been hurt. Additionally, it may disempower people and reduce their psychological resilience by causing them to believe that minor or ordinary unpleasant feelings are symptoms of psychological disorders. This can make managing the situation seem more difficult and can produce an identity around being mentally ill. Mislabeling a situation (e.g., calling it trauma, when what the person is experiencing may be better described as grief, feeling overwhelmed, being upset, or experiencing a stress response) may prevent the person from finding effective coping mechanisms. The lack of nuance, and its tendency towards glibness, may make it harder for the speaker to authentically interrogate and understand their own responses. According to psychotherapist Esther Perel, "[in therapy speech], there is such an emphasis on the ‘self-care’ aspect of it that is actually making us more isolated and more alone, because the focus is just on the self". Therapists find that using therapy speak can prevent people from being open and vulnerable with each other. It may be used in an attempt to define the other person's lived experiences. It is frequently used in ways that elevate a one-sided view of a relationship or situation. When used to exaggerate – to describe an everyday harm as more serious trauma, conflating a normal level of tidiness with obsessive–compulsive disorder, mislabeling conflict as abuse – therapy speak can harm people who have serious mental conditions by taking away the language used to describe their more extreme situations. However, therapy speak also has the effect of normalizing and de-stigmatizing mental health problems. Therapy speak is often used to confess failings. Misuse of specific words may have specific effects. For example, overuse of trauma can make people with post-traumatic stress disorder feel like their life and identity is centered around their trauma. Using narcissism to complain about ordinary self-interest or inconsiderateness can harm communication and discourage other people from seeking fair arrangements, for fear that asking for fairness will be called narcissistic behavior. Saying "I was triggered" can minimize the interior experience of fear or anger. More generally, when the jargon of psychology becomes commonplace, the words may lose their meanings, through a process called semantic bleaching. Examples Some words encountered in psychotherapy are commonly misused. Trauma Many psychotherapists consider the term "trauma" to be overused to describe "anything bad", in the words of George Bonanno, psychological trauma is often defined to begin with a horrific "violent or life-threatening event that is outside the range of normal experience", such as rape, a natural disaster, or a mass shooting. Early symptoms may include shock and denial; later symptoms, for those who develop post-traumatic stress disorder, may include unpredictable labile mood (e.g., a normal comment provokes an obviously abnormal feeling), intense nightmares or flashbacks (feeling like the traumatic event is happening again), and other debilitating symptoms. However, other clinicians will argue that another form of trauma isn't yet included in the DSM, caused by experiences that may not be explicitly violent, but still mirror the effects of more "severe" trauma and affects people deeply. Trigger The term "trigger" is often used to say that the person is upset, or that a behavior caused the person to feel bad. However, a trauma trigger in clinical settings describes something harmless (e.g., the sound of a motorcycle) that is mentally tied for that individual to a previous terrible event (e.g., witnessing gun violence). Gaslighting Declared to be the 2022 word of the year by Merriam-Webster, gaslighting is often used to describe ordinary disagreement or lying and people who refuse to believe that they have caused any harm. In its original meaning, gaslighting, which is also called coercive control, is used to describe a form of long-term psychological manipulation and emotional abuse by a close, trusted person (such as a romantic partner, family member, or close friend), that increases the abuser's power and control by making the other person doubt their perception of reality. Narcissism The word "narcissism", increasingly used in common speech to imply narcissistic personality disorder, may be used casually to imply that people with ordinary or individual acts of self-centeredness, selfishness, rudeness, or self-importance have a serious disorder. However, narcissistic personality disorder is instead a pattern of long-term behavior that takes self-involvement to an unhealthy extreme, involving an unrealistic sense of superiority (grandiosity), the need for others to admire them, and a lack of empathy. Depressed Used for many unpleasant experiences, including temporary sadness, experiencing disappointment, and feeling discouraged, clinical depression is an extreme level of sadness that lasts for weeks (or longer) and that interferes with activities of daily life (such as eating, sleeping, and maintaining basic hygiene standards). Boundaries "Setting a boundary" is often misused to mean creating a family estrangement if the speaker's wishes are not fulfilled by others, but in psychotherapy, a boundary is carefully considered choice that is meant to preserve relationships. A boundary is about the actions taken by the person who set the boundary. For example, a person might decide that if someone asks about a painful situation, they will say "I don't feel like talking about that right now", and then repeat that statement as many times as necessary. Rather than hiding from other people or trying to control what others do, a proper boundary supports interaction and takes the other person's needs into account. Codependency "Codependency" may be sometimes used to say that the speaker believes that a person is too invested in a relationship; however, codependency is instead an unhealthy relationship that enables destructive behavior. Self-care Meant to refer to ordinary care for the body, such as by getting enough sleep, it is often used to mean pampering, such as through an expensive day at a spa. History The phenomenon of jargon from psychology appearing in everyday language predates even Sigmund Freud, who popularized concepts such as repression and denial more than a century ago. For example, the word triggered has become more popular since the mid-20th century. It became trendy on social media platforms during the 2010s, and can be found in dating apps. The popularity of therapy speak correlates with the decline of institutionalized religion, which provides opportunities to make sense of difficult experiences, and the increased use of mental health services, especially during the COVID-19 pandemic. It is also connected to the rise of therapy culture, which is a belief that everyone benefits from undergoing psychotherapy and that psychotherapy can solve people's problems. Therapy speak has also been used in academic publications. The act of claiming that another person is mentally ill without much evidence, or being an "armchair psychologist", is also not a new social or relationship phenomenon. The trend towards using therapy speak online may be due to loss of nuance and the sound bite nature of social media. A brief, impersonal example of how to break off a friendship might be misinterpreted on social media as a correct, humane, and emphathetic way to treat other people. Related therapeutic problems In addition to the jargon of psychology appearing in everyday speech, there are related problems, such as expecting everyone to behave like a therapist. This can manifest in the form of expecting emotional validation (a therapeutic technique) from everyone, which, when accepted within a larger group, can slide into overvaluing people's emotional experiences. See also Curse of knowledge – using technical jargon correctly, but not being understood because the audience does not know the same jargon References External links What Happens When Therapy-Speak Creeps Into a Relationship at Psychology Today Buzzword Social sciences terminology Popular psychology Psychological manipulation

Interaction

Interaction is action that occurs between two or more entities, generally used in philosophy and the sciences. It may refer to: Science Interaction hypothesis, a theory of second language acquisition Interaction (statistics), when three or more variables influence each other Interactions of actors theory, created by cybernetician Gordon Pask Fundamental interaction or fundamental force, the core interactions in physics Human–computer interaction, interfaces for people using computers Social interaction between people Biology Biological interaction Cell–cell interaction Drug interaction Gene–environment interaction Protein–protein interaction Chemistry Aromatic interaction Cation-pi interaction Metallophilic interaction Arts and media Interaction (album), 1963, by Art Farmer's Quartet ACM Interactions, a magazine published by the Association for Computing Machinery "Interactions" (The Spectacular Spider-Man), an episode of the animated television series 63rd World Science Fiction Convention, titled Interaction See also Interact (disambiguation)

Generalization (learning)

Generalization is the concept that humans, other animals, and artificial neural networks use past learning in present situations of learning if the conditions in the situations are regarded as similar. The learner uses generalized patterns, principles, and other similarities between past experiences and novel experiences to more efficiently navigate the world. For example, if a person has learned in the past that every time they eat an apple, their throat becomes itchy and swollen, they might assume they are allergic to all fruit. When this person is offered a banana to eat, they reject it upon assuming they are also allergic to it through generalizing that all fruits cause the same reaction. Although this generalization about being allergic to all fruit based on experiences with one fruit could be correct in some cases, it may not be correct in all. Both positive and negative effects have been shown in education through learned generalization and its contrasting notion of discrimination learning. Overview Generalization is understood to be directly tied to the transfer of knowledge across multiple situations. The knowledge to be transferred is often referred to as abstractions, because the learner abstracts a rule or pattern of characteristics from previous experiences with similar stimuli. Generalization allows humans and animals to recognize the similarities in knowledge acquired in one circumstance, allowing for transfer of knowledge onto new situations. This idea rivals the theory of situated cognition, instead stating that one can apply past knowledge to learning in new situations and environments. Generalization can be supported and partly explained by the connectionism approach. Just as artificial intelligences learn to distinguish between different categories by applying past learning to novel situations, humans and animals generalize previously learned properties and patterns onto new situations, thus connecting the novel experience to past experiences that are similar in one or more ways. This creates a pattern of connections that allows the learner to classify and make assumptions about the novel stimulus, such as when previous experience with seeing a canary allows the learner to predict what other birds will be like. This categorization is a foundational aspect of generalizing. Research on generalization In scientific studies looking at generalization, a generalization gradient is often used. This tool is used to measure how often and how much animals or humans respond to certain stimuli, depending on whether the stimuli are perceived to be similar or different. The curvilinear shape of the gradient is achieved by placing the perceived similarity of a stimulus on the x-axis and the strength of the response on the y-axis. For example, when measuring responses to color, it is expected that subjects will respond to colors that are similar to each other, like shades of pink after being exposed to red, as opposed to a non-similar shade of blue. The gradient is relatively predictable, with the response to similar stimuli being slightly less strong than the response to the conditioned stimulus, then steadily declining as the presented stimuli become increasingly dissimilar. Several studies have suggested that generalization is a fundamental and naturally-occurring learning process for humans. Nine-month-old infants require very few (sometimes only 3) experiences with a category before learning to generalize. In fact, infants generalize so well during early stages of development (such as learning to recognize specific sounds as language) that it can be hard for them to discriminate between variations of the generalized stimuli at later stages of development (such as failing to distinguish between the subtly different sounds of similar phonemes). One potential explanation for why children are such efficient learners is that they operate in accordance with the goal of making their world more predictable, therefore encouraging them to hold strongly to generalizations that effectively help them to navigate their environment. Some evidence suggests that children are born with innate processes for accurately generalizing things. For example, children tend to generalize based on taxonomic rather than thematic similarities (an experience with one ball leads to the child identifying other ball-shaped objects as “ball” rather than labeling a bat as “ball” because a bat is used to hit a ball). Wakefield, Hall, James, and Goldin (2018) found that children are more flexible in generalizing new verbs when they are taught the verb by observing gestures as opposed to being taught by performing the action themselves. When helping a child learn a new word, providing more examples of the word increases the child's capacity to generalize the word to different contexts and situations. Furthermore, writing interventions for grade-school students yield better results when the intervention actively targets generalization as an outcome. Generalization has been shown to be refined and/or stabilized after sleep. Implications Without the ability to generalize, it would likely be very difficult to navigate the world in a useful way. For example, generalization is an important part of how humans learn to trust unfamiliar people and a necessary element in language acquisition. For a person who lacked the capacity to generalize from one experience to the next, every instance of a dog would be completely separated from other instances of dogs, so prior experience would do nothing to help the person know how to interact with this seemingly new stimulus. In fact, even if the person experienced the very same dog multiple times, he or she would have no way of knowing what to expect and each instance would be as if the individual were encountering a dog for the first time. Therefore, generalization is a valuable and integral part of learning and everyday life. Generalization is shown to have implications on the use of the spacing effect in educational settings. In the past, it was thought that the information forgotten between periods of learning when implementing spaced presentation inhibited generalization. In more recent years, this forgetting has been seen as promoting generalization through repetition of information during each occasion of spaced learning. The effects of gaining long-term generalization knowledge through spaced learning can be compared with that of massed learning (lengthy and all at once; for example, cramming the night before an exam) in which a person only gains short-term knowledge, decreasing the likelihood of establishing generalization. Generalization is also considered to be an important factor in procedural memory, such as the near-automatic memory processes necessary for driving a car. Without being able to generalize from previous experiences driving, a person would essentially need to relearn how to drive every time he or she encountered a new street. People who are diagnosed with NVLD - non verbal learning disorder - are known to sometimes have difficulty applying learned concept to new situations. Not all of generalization's effects are beneficial, however. An important part of learning is knowing when not to generalize, which is called discrimination learning. Were it not for discrimination learning, humans and animals would struggle to respond correctly to different situations. For example, a dog may be trained to come to its owner when it hears a whistle. If the dog generalizes this training, it may not discriminate between the sound of the whistle and other stimuli, so it would come running to its owner when it hears any high-pitched noise. Fear generalization A specific type of generalization, fear generalization, occurs when a person associates fears learned in the past through classical conditioning to similar situations, events, people, and objects in their present. This is important for the survival of the organism; humans and animals need to be able to assess aversive situations and respond appropriately based on generalizations made from past experiences. When fear generalization becomes maladaptive it is connected to many anxiety disorders. This maladaptation is often referred to as the overgeneralization of fear and can also lead to the development of posttraumatic stress disorder. Overgeneralization is hypothetically attributed to “dysregulation of prefrontal-amygdalo-hippocampal circuitry” (Banich, et al., 2010, p. 21). One of the earliest studies about fear generalization in humans was conducted by Watson and Raynor (1920): the Little Albert experiment. In their study, an infant known as Little Albert was exposed to various kinds of animals, none of which elicited a fear response from Little Albert. However, after 7 pairings of a white rat and the sound of a hammer clanging against a steel bar (which did elicit a fear response), the 11-month old child began to cry and try to get away from the white rat even without the loud noise. Months later, additional trials showed that Little Albert had generalized his fear response to things that were similar to the white rat, including a dog, a rabbit, and a fur coat. Brain regions involved in fear generalization include the amygdala and the hippocampus. The hippocampus seems to be more involved in the development of context fear generalization (developing a generalized fear for a specific environment) than stimulus fear generalization (such as Little Albert's acquisition of a fear response to white, furry objects). The amygdala, which is associated with all types of emotional responses, is fundamental in developing a classically conditioned fear response to either a stimulus or the context in which it is found. Generalization in machine learning See also Chunking (psychology) References Learning theory (education)

Primary socialization

Primary socialization in sociology is the period early in a person's life during which they initially learn and develop themselves through experiences and interactions. This process starts at home through the family, in which one learns what is or is not accepted in society, social norms, and cultural practices that eventually one is likely to take up. Primary socialization through the family teaches children how to bond, create relationships, and understand important concepts including love, trust, and togetherness. Agents of primary socialization include institutions such as the family, childhood friends, the educational system, and social media. All these agents influence the socialization process of a child that they build on for the rest their life. These agents are limited to people who immediately surround a person such as friends and family—but other agents, such as social media and the educational system have a big influence on people as well. The media is an influential agent of socialization because it can provide vast amounts of knowledge about different cultures and society. It is through these processes that children learn how to behave in public versus at home, and eventually learn how they should behave as people under different circumstances; this is known as secondary socialization. A vast variety of people have contributed to the theory of primary socialization, of those include Sigmund Freud, George Herbert Mead, Charles Cooley, Jean Piaget and Talcott Parsons. However, Parsons' theories are the earliest and most significant contributions to socialization and cognitive development. Theories Talcott Parsons Talcott Parsons believed that the family is one of the most important institutions during primary socialization and that aside from providing basic essentials such as shelter, food and safety, it teaches a child a set of cultural and social standards that guide the child through life as they mature. However, it is just as important that the child be able to internalize these standards and norms rather than just learn them, otherwise they will not be able to successfully participate in their culture or society later on. According to Parsons' theory, primary socialization prepares children for the various roles they take up as adults, and also has a big influence on the child's personality and emotional state of being. If we skip or try not to focus on primary socialization, norms of the society will not be known by the child. Sigmund Freud The physician and creator of psychoanalysis, Sigmund Freud, devised a theory of personality development which states that biological instincts and societal influences shape the way a person becomes as an adult. Freud stated that the mind is composed of three components: the id, the superego and the ego. All of these three parts must cohesively work together in balance so that an individual may be able to successfully interact with and be a part of society. If any of these parts of the mind exceeds the others or becomes more dominant, the individual will face social and personal problems. Of the three components, Freud claims that the id forms first; the id makes a person act strictly for their pleasure. A newborn's mind only contains the id since all they ask for are physical desires. The superego develops as an individual moves into childhood and is described as the development of a conscience. The individual becomes aware that there are societal norms to follow and conforms to them. Lastly, the ego develops into late adolescence and adulthood and is the part of the mind that resolves conflicts between the id and the superego. The ego helps a person make rational decisions that comply with the rules of society. George Herbert Mead George Herbert Mead created the theory of social behaviorism, which states that the self is created by social experiences. The self is the portion of the being consisting of self-image and self-consciousness. As individuals interact with others, they build up this self. Unlike Freud, Mead believes that the self is not created by biological instincts, but rather solely by societal influences. He also stated that the use of language and exchanging of symbols to convey meaning is what societal experiences are made up of. Furthermore, one must place themselves in the other person's position to be able to understand them; they must take up the other person's role, and only by understanding the other person's role can self-awareness be achieved. Charles Horton Cooley Sociologist Charles Horton Cooley developed the theory of the looking-glass self, which is similar to Mead's theory in that it states that our societal interactions form our self-image. Cooley discussed how significant others are people whose opinions are of importance to us, and thus they have strong influences over the way we think about things and ourselves. In this case, a significant other can be any person: a friend, family member, or spouse. The theory of the looking-glass self proposes three steps for the formation of the self. In the first step, an individual thinks about how a significant other perceives them. In the second step, they imagine that a judgement about them is made by the significant other based on the perception they have of the individual. Lastly, in the third step, the individual creates a self-image based on how they believe the significant other sees them. Jean Piaget Psychologist Jean Piaget created the theory of cognitive development, which talks about how the mentality of children develops and matures as they grow older and further interact with society. Piaget defined four main periods of development: the sensorimotor period, the pre-operational period, the concrete operational period and the formal operational period. The sensorimotor period takes place from birth to about two years of age and is defined as the stage when infants learn by using their senses and motor skills. In this stage, the main goal is for an infant to learn that an object still exists even when it is not directly in sight; this is known as object permanence. During the pre-operational period, from roughly two to seven years of age, a child is much more capable of conceiving symbolic thought, but is not capable of reasoning yet. Also, children during this period cannot comprehend conservation, which is the ability to understand that different-looking objects can have the same measurable features, such as area, volume, and length. The next period, the concrete operational period, takes place from ages seven to eleven. In this stage, children are able to solve problems or mental operations, only in regards to real events or tangible objects, in their minds. The final stage is the formal operational period, taking place from age eleven through adulthood, and is the period in which individuals learn to solve problems based on hypothetical situations. During this stage, the individual can think logically, symbolically and abstractly. Means of socialization The family Family, the closest set of people to an individual, are the ones that have the greatest impact on the socialization process. Many people, from birth to early adulthood, rely heavily on their family for support, basic necessities such as shelter and food, nurturing, and guidance. Due to this, many of the influences from the family become a part of the growing individual. The family imposes on the child their language, culture, race, religion, and class, and as a result all of these concepts contribute to the child's self. Failure of the family to be continuously present as a strong influence can lead to deviant behaviors later on in life. Various theories of primary socialization state that the degree of bonding during this process and the norms acquired during childhood may lead to deviant behavior and even drug abuse as an adult. Also, the ego levels of the adults surrounding the person during primary socialization, as well their behaviors towards others, affect the primary socialization process of the individual. Education and peer groups Educational systems introduce new knowledge to children as well as order and bureaucracy. In school a child learns about other cultures, races and religions different from their own. Education influences individuals to think and act certain ways that pertain to the norms and values of their current society. One example of this is gender roles; from a young age, schools teach children to act in particular manners based on their gender. A peer group can be identified as a group of individuals who are similar in age and social class. By joining peer groups, children begin to detach from the authority the family has imposed in them, and start making choices of their own. Negative influences from peer groups can also lead to deviant behavior, due to peer pressure. These groups in an individual's life have significant effects on the primary socialization process as they can influence an individual to think or act differently. Social and mass media Social and mass media are some of the most influential agents of socialization. Magazines, television, social networks, newspapers, internet, films, and radio are all forms of mass media that entertain and send messages to large audiences. As a result, all of these messages sent out by social media have an effect on the way children see themselves and the world around them. Some examples of influential messages that are constantly seen from mass media include unrealistic or even unhealthy beauty standards, racial and sexual stereotypes, and violence around the world. These messages can all impact how a child creates their self and how they act as individuals in society. Boundaries Primary socialization takes place during infancy, childhood and early adolescence, in which an individual builds their basic core identity and personality. During this process a person forms their self-image and self-awareness through social experience. In primary socialization the family has a grand influence on the individual, as well as peer groups, educational institutions, and mass media. Overlapped with this is the process of secondary socialization, which occurs from childhood through adulthood, wherein an individual encounters new groups, and must take up new roles to successfully participate in society. However, this process involves smaller changes than those of primary socialization and is more so associated with teenagers and adults. During secondary socialization an individual begins to partake in smaller groups of larger societies, and as a result must learn to behave appropriately. The behavioral patterns that were created by the socialization agents during primary socialization are put into action in secondary socialization. See also Developmental psychology Hidden curriculum Institutional theory Social constructionism References Socialization Sociological terminology

Hierarchical Taxonomy of Psychopathology

The Hierarchical Taxonomy Of Psychopathology (HiTOP) consortium was formed in 2015 as a grassroots effort to articulate a classification of mental health problems based on recent scientific findings on how the components of mental disorders fit together. The consortium is developing the HiTOP model, a classification system, or taxonomy, of mental disorders, or psychopathology, aiming to prioritize scientific results over convention and clinical opinion. The motives for proposing this classification were to aid clinical practice and mental health research. The consortium was organized by Drs. Roman Kotov, Robert Krueger, and David Watson. At inception it included 40 psychologists and psychiatrists, who had a record of scientific contributions to classification of psychopathology The HiTOP model aims to address limitations of traditional classification systems for mental illness, such as the DSM-5 and ICD-10, by organizing psychopathology according to evidence from research on observable patterns of mental health problems. When the HiTOP model is complete, it will form a detailed hierarchical classification system for mental illness starting from the most basic building blocks and proceeding to the highest level of generality: combining individual signs and symptoms into narrow components or traits, and then combining these symptom components and traits into (in order of increasing generality) syndromes, subfactors, spectra, and superspectra. Currently, several aspects of the model are provisional or incomplete. History of the quantitative classification movement through HiTOP Throughout the history of psychiatric classification, two approaches have been taken to deciding the content and boundaries of mental disorders that enter official diagnostic rubrics. A first one might be termed authoritative: experts and members of official bodies meet to determine classificatory rubrics through group discussions and associated political processes. This approach characterizes traditional classification systems, such as the DSM and the ICD. A second approach might be termed empirical. In this approach, data are gathered on psychopathological building blocks. These data are then analyzed to address specific research questions. For example, does a specific list of symptoms delineate a single psychopathological entity or multiple entities? This approach is sometimes characterized as more "bottom up" (i.e., starting with raw observations and inferring the presence of diagnostic concepts), compared with the more "top down" approach (i.e., starting with a general clinical concept and deducing the symptoms that might define it) of official classification systems. These approaches, although distinguishable, are not entirely separable. Some amount of empiricism and some amount of expert authority is inevitably present in both (i.e., authoritative classification approaches have relied on specific types of empiricism as part of their construction process, and an empirical approach begins with the expertise needed to assemble and assess specific psychopathological building blocks). Nevertheless, authoritative approaches tend to weigh putative expertise, disciplinary background, and tradition heavily. The consortium aims for an empirical rather than authoritative approach, but it has been argued that the HiTOP model is partly authoritative as it is grounded on a traditional but arbitrary statistical approach. The empirical movement has a long history, beginning with the work of Thomas Moore, Hans Eysenck, Richard Wittenborn, Maurice Lorr, and John Overall, who developed measures to assess signs and symptoms of psychiatric inpatients, and identified empirical dimensions of symptomatology through factor analysis of these instruments. Others have searched for natural categories using such techniques as cluster analysis. Similarly, research on patterns of emotional (also called affective) experience helped to identify dimensions of depression and anxiety symptoms. Factor analytic studies of child symptomatology found clusters of emotional and behavioral problems that remain in use in research and clinical assessment today. Finally, factor analyses of comorbidity among common adult disorders revealed higher-order dimensions of psychopathology that inspired a growing and diverse literature. The most recent large-scale effort in this movement toward empirically based classification emerged in the spring of 2015. Forty scholars working in the classification of psychopathology started a consortium (now over 160 members with 10 workgroups) devoted to articulating an empirically based classification system of mental illness. Their initial proposed model – the Hierarchical Taxonomy of Psychopathology – has been claimed to provide a marked departure from DSM and ICD. The HiTOP model is based on structural studies that span from age 2 to 90 and include samples from many non-Western societies. However, Western samples are over-represented in this literature and very little research has been done with people over age 60. The HiTOP model does not account for individual level developmental processes that may lead to various disorder outcomes. To update HiTOP as new structural and validation studies become available, the Consortium formed a Revisions Workgroup. This workgroup has designed a process for continuous evidence-based revision of the model. This process is intended to be nimble enough to keep pace with a rapidly growing literature on the structure of psychopathology, but not so fickle as to result in numerous changes without substantiated support. HiTOP structure Fundamental findings that shaped HiTOP Three fundamental findings shaped HiTOP. First, psychopathology is best characterized by dimensions rather than in discrete categories. Dimensions are defined as continua that reflect individual differences in a maladaptive characteristic across the entire population (e.g., social anxiety is a dimension that ranges from comfortable social interactions to distress in nearly all social situations). Dimensions reflect differences in degree (i.e., continua), rather than in kind (i.e., people are either in or outside of each category), as the evidence to date suggests that psychopathology exists on a continuum with normal-range functioning. These dimensions can be organized hierarchically from narrowest to broadest (see Figure). Specifically, dimensional description improves reliability and eliminates the need for “Other Specified” or “Unspecified” diagnoses, as every person has a standing on each dimension and thus is described. Nevertheless, some qualitative boundaries may exist in psychopathology. If categorical entities are identified and replicated, they would be added to HiTOP. Indeed, the term dimensional is not used in the name of the model, in recognition of openness to evidence on discrete entities. Second, HiTOP assumes that the natural organization of psychopathology can be discerned in co-occurrence of its features. Classification that follows co-occurrence ensures coherence of diagnostic entities, so that related signs and symptoms are assigned together to tightly knit dimensions, whereas unrelated features are placed on different dimensions. Moreover, such constructs capture information about common genetics, risk factors, biomarkers, and treatment response shared by co-occurring forms of psychopathology. Third, psychopathology can be organized hierarchically from narrow to broad dimensions. Numerous studies have found that specific psychopathology dimensions aggregate into more general factors. Patterns of comorbidity are represented by higher-order dimensions. Accordingly, comorbidity is measured and expressed in scores that researchers and clinicians can use. Organization of HiTOP model Consistent with these three fundamental findings, the HiTOP model consists of hierarchically organized dimensions identified in covariation of psychopathology features. Signs, symptoms, and maladaptive traits and behaviors are grouped into homogeneous components- constellations of closely related symptom manifestations; for example, fears of working, reading, eating, or drinking in front of others form performance anxiety cluster. Maladaptive traits are specific pathological personality characteristics, such as submissiveness. The leading conceptualization is that symptoms and maladaptive traits differ only in time frame. A symptom component reflects current functioning (e.g., past month), whereas the corresponding trait reflects functioning on the same dimension in general—that is, over many years. Closely related homogenous components are combined into dimensional syndromes (e.g., social anxiety). Syndromes are composites of related components/traits, such as a social anxiety syndrome that encompasses both performance anxiety and interaction anxiety. Of note, the term syndrome can be used to indicate a category (for instance, some medical diseases such as Lyme disease are probably best thought of as natural discrete problems that someone either wholly has or wholly does not have), but here we use it to indicate a dimension. Importantly, HiTOP syndromes do not necessarily map onto traditional, categorical disorders like those found in DSM and ICD. Studies often have used categorical disorders to define HiTOP dimensions, but these categorical disorders are used as proxies and are not part of HiTOP as such. Rather than re-arranging DSM and ICD disorders, HiTOP aims to create a system based on signs and symptoms described in these manuals (as well as additional symptoms) and reorganize them based on how studies have found them to occur in combination. Clusters of closely related syndromes form subfactors, such as the fear subfactor formed by strong links between social anxiety, agoraphobia, and specific phobias. Spectra are larger constellations of syndromes, such as an internalizing spectrum composed of syndromes from fear, distress, eating pathology, and sexual problems subfactors. Six spectra have been included in HiTOP so far: The thought disorder spectrum comprises maladaptive traits of peculiarity, unusual beliefs, unusual experiences, and fantasy proneness, as well as symptom dimensions of disorganization and reality distortion; also symptom dimensions of dissociation and mania are linked to this spectrum provisionally. The thought disorder spectrum includes some signs and symptoms of such disorders as schizophrenia and related disorders, mood disorders with psychosis, schizotypal personality disorder, and paranoid personality disorder, and provisionally dissociative disorders and bipolar disorders. The detachment spectrum comprises maladaptive traits of emotional detachment, anhedonia, social withdrawal, and romantic disinterest, as well as symptom dimensions of inexpressivity and avolition. The detachment spectrum includes some signs and symptoms of such disorders as schizoid personality disorder, avoidant personality disorder, schizotypal personality disorder, and schizophrenia and related disorders. The antagonistic externalizing spectrum comprises maladaptive traits of manipulativeness, deceitfulness, callousness, grandiosity, aggression, rudeness, domineering, and suspiciousness, as well as symptom dimensions characteristic of antisocial behavior, such as theft, fraud, destruction of property, and aggression. The antagonistic externalizing spectrum includes some signs and symptoms of such disorders as conduct disorder, antisocial personality disorder, intermittent explosive disorder, oppositional defiant disorder, histrionic personality disorder, paranoid personality disorder, narcissistic personality disorder, and provisionally borderline personality disorder. The disinhibited externalizing spectrum comprises maladaptive traits of impulsivity, irresponsibility, distractibility, disorganization, risk taking, (low) perfectionism, (low) workaholism, as well as symptom dimensions characteristic of antisocial behavior (listed above), substance use and abuse, inattention, and hyperactivity. The disinhibited externalizing spectrum includes some signs and symptoms of such disorders as alcohol use disorder, substance use disorders, ADHD, conduct disorder, antisocial personality disorder, intermittent explosive disorder, oppositional defiant disorder, and provisionally borderline personality disorder. The internalizing spectrum comprises maladaptive traits of emotional lability, anxiousness, separation insecurity, submissiveness, perseveration, and anhedonia, as well as symptom dimensions characteristic of distress, fear, eating problems, and sexual problems; also symptom dimensions of mania are linked to this spectrum provisionally. The internalizing spectrum includes some signs and symptoms of such disorders as major depressive disorder, dysthymia, generalized anxiety disorder, posttraumatic stress disorder, borderline personality disorder, agoraphobia, obsessive-compulsive disorder, panic disorder, social anxiety disorder, specific phobias, anorexia nervosa, binge eating disorder, bulimia nervosa, sexual problems such as arousal difficulties, low desire, orgasmic dysfunction, and sexual pain, and provisionally bipolar disorders. The somatoform spectrum comprises symptom dimensions of conversion, somatization, malaise, head pain, gastrointestinal symptoms, and cognitive symptoms. The somatoform spectrum includes some signs and symptoms of such disorders as illness anxiety and somatic symptom disorder. Superspectra are very broad dimensions comprising multiple spectra, such as a general factor of psychopathology (or p-factor) that represents the liability shared by all mental disorders and the externalizing superspectrum that captures the overlap between the disinhibited and antagonistic externalizing spectra. Recently, emotional dysfunction and psychosis superspectra have also been proposed, capturing the overlap between the internalizing and somatoform spectra, and between the thought disorder and detachment spectra, respectively. Limitations of traditional classification systems Arbitrary boundaries between psychopathology and normality Traditional systems consider all mental disorders to be categories (i.e., people are either in or outside of each category), whereas the evidence to date suggests that psychopathology exists on a continuum with normal-range functioning. In fact, not a single mental disorder has been established in the scientific literature as a discrete categorical entity. Consistent with this evidence, the HiTOP model defines psychopathology along continuous dimensions rather than in discrete categories. Importantly, HiTOP treats the discrete vs. continuous nature of psychopathology as a research question, and the consortium continues to investigate it. Heterogeneity within disorders Many existing diagnoses are quite heterogeneous in terms of observable symptoms. For instance, there are over 600,000 symptom presentations that satisfy diagnostic criteria for DSM-5 posttraumatic stress disorder. The HiTOP model is informed by evidence from research on observable patterns of mental health problems, grouping related symptoms together and assigning unrelated symptoms to different syndromes, thereby identifying unitary constructs and reducing diagnostic heterogeneity. One limitation of a taxonomy based on symptom correlations such as HiTOP is their inability to handle the multifinality and equifinality of developmental processes. Frequent disorder co-occurrence Co-occurrence among mental disorders, often referred to as comorbidity, is very common in the clinic and general population alike. Comorbidity complicates research design and clinical decision-making, as additional conditions can distort study results and affect treatment (i.e. researching the specific causes of a condition like major depressive disorder is complicated when many study participants will meet criteria for additional syndromes). In terms of classification, high comorbidity suggests that some conditions have been split unnecessarily into multiple diagnoses, indicating the need to redraw boundaries between disorders. Comorbidity also conveys important information about shared risk factors, pathological processes, and illness course. A hierarchical and dimensional classification system such as HiTOP aims to explain these patterns and make it explicitly available to researchers and clinicians. Unclear boundaries between disorders and diagnostic instability Traditional diagnoses generally show limited reliability, as can be expected when arbitrary groups are created out of naturally dimensional phenomena. For example, the DSM-5 Field Trials found that 40% of diagnoses did not meet even a relaxed cutoff for acceptable interrater reliability, indicating boundaries between disorders are unclear. Further, DSM diagnoses have shown low stability over time (i.e., people can fluctuate in diagnostic status even over short intervals with trivial changes in symptom severity). A quantitative classification such as HiTOP also helps to address the issue of instability, as indicated by the high test–retest reliability of dimensional psychopathology constructs. Validity evidence Validation of an empirical classification system like HiTOP is an ongoing process, but it already has produced a substantial body of evidence that can be summarized in the following five areas: Substantial twin and molecular evidence indicates that genetic associations among forms of psychopathology largely parallel HiTOP organization. Biobehavioral constructs of Research Domain Criteria link to HiTOP dimensions with appreciable specificity. Accumulating evidence suggests that environmental exposures, such as childhood maltreatment and discrimination, are better construed as risk factors for HiTOP dimensions rather than DSM disorders. Many treatments such as antipsychotics, serotonin reuptake inhibitors, and various psychotherapies are thought to act on HiTOP dimensions ranging from symptom components to superspectra. Emerging evidence suggests that HiTOP constructs show stronger associations with genetic and neurobiologic markers than DSM diagnoses. Research utility Theoretical models of the causes and consequences of psychiatric problems have traditionally been framed around diagnoses. New research highlights the importance of extending this focus to encompass dimensions that span many diagnoses, including both narrowly defined symptoms and traits (e.g., obsessions) and broader clusters of psychological conditions (e.g., internalizing spectrum). The hierarchical structure of HiTOP implies that any cause or outcome of mental illness could emerge because of its effects on broad higher order dimensions, the syndromes, or specific lower order dimensions. An association between a DSM diagnosis and some outcome could reflect one (or more) qualitatively distinct pathways. As an example, individual differences in HiTOP spectra and superspectra are more strongly linked than traditional syndromes to potent stressors that occur early in development like childhood maltreatment, peer victimization, racial discrimination. Although this approach of comparing pathways to and from dimensions at different levels of HiTOP has been the most common application, it is not the only one. HiTOP constructs are useful predictors of clinical outcomes, such as chronicity, impairment, and suicidality. Ample evidence indicates that dimensional phenotypes tend to be more informative than traditional diagnoses in prognostication. They also account for psychosocial impairment both concurrently and prospectively, explaining differences in impairment several times better than categorical diagnoses. Other outcomes, such as suicidality and future treatment-seeking, appear to follow the same pattern. Other researchers have evaluated the joint predictive power of sets of HiTOP dimensions above and beyond the corresponding DSM–5 diagnosis. This approach explicitly compares the explanatory potential of dimensional versus categorical approaches to psychopathology. Additional ways HiTOP can be useful in empirical research include its dimensions serving as outcomes of experimental manipulations both in the lab and in a randomized clinical trial, although such applications are understudied. HiTOP can be assessed directly with validated measures, avoiding the complications of extracting dimensions from DSM-based data using tools like factor analysis that require larger samples. Finally, modeling of symptom-level data enables investigators to simultaneously examine psychopathology at multiple levels of breadth in relation to the same criterion. The Measure Development Workgroup is currently constructing both questionnaire and interview tools to measure all HiTOP dimensions and provide crucial comprehensive data for testing and revising HiTOP. Clinical utility In the HiTOP framework, psychopathology of given patient is no longer described with a list of categorical diagnoses, but as a profile on dimensions with varying degrees of severity and including all levels from components and traits through spectra and superspectra. HiTOP explicitly acknowledges the clinical reality that no clear divisions are empirically supported between most mental disorders and normality or, oftentimes, even between neighboring disorders. In practice, clinical decisions are not simply whether to treat the patient or not (reflecting whether the disorder is present or not). Rather, a graded set of interventions varying in intensity is typically deployed in response to a corresponding level of clinical need. HiTOP profile is compatible with this approach, and multiple ranges can be specified on a given dimension to guide the choice of intervention. Currently there is no evidence that compares treatment outcomes using HiTOP model results to conventional approaches including the DSM. HiTOP’s adoption of a dimensional perspective does not necessarily preclude the use of categories in clinical practice. For example, it is common in medicine to superimpose data-driven categories (e.g., normal, mild, moderate, or severe) on dimensional measures, such as blood pressure, cholesterol, or weight. A similar approach can be used with HiTOP. Ranges of cut points can be based on a pragmatic assessment of relative costs and benefits. For instance, in primary care settings, a more liberal (i.e., inclusive or sensitive) threshold can be used for identifying patients requiring more detailed follow-up. Conversely, decisions about more intensive or risky treatments can use a more conservative (i.e., exclusive or specific) threshold. Research has begun to delineate such ranges for some measures, but much more is needed to cover the full spectrum. Most importantly, HiTOP explicitly acknowledges that ranges are pragmatic and not absolute, recognizing the need for flexibility in clinical decision-making. Categorical and dimensional systems can relay equivalent information as long as cut points are not reified, an approach that is explicit in the HiTOP model. Clinicians tend to use DSM diagnoses for billing much more than for case conceptualization or treatment decisions. Many clinicians report that formal diagnosis does not provide helpful guidance beyond cardinal symptoms (e.g. after recording the primary features of the disorder, clinicians may not refer back to the formal diagnosis for purposes of treatment planning or selection). A chief objective of HiTOP is to make diagnosis more useful for clinicians. Three types of evidence support this aspiration. First, HiTOP dimensions show substantially higher reliability than DSM diagnoses, meaning the dimensional profile is likely to be more consistent over time and more likely to be agreed upon across multiple clinicians. Second, growing evidence indicates that these dimensions are about twice as informative as diagnoses in answering such clinical questions as who is impaired by symptoms, who will need services, who will recover, and who will attempt suicide. Third, though it is debated, initial survey data from clinicians indicated that they see more utility in HiTOP dimensions than DSM diagnoses. Nevertheless, much is currently unknown about the clinical utility of HiTOP. The topic needs both further research and pragmatic guidance such as the development of HiTOP-based practice guidelines. In the HiTOP consortium, the Measure Development Workgroup is constructing a comprehensive new inventory expected to be ready for clinical use in 2022. Meanwhile, the Clinical Translation Workgroup has assembled a battery of existing normed and validate self-report measures that assesses most of the model and requires 40 minutes to complete. The battery is free, self-administered, and automatically scored. The Workgroup also developed manuals, trainings, and online resources to help clinicians with practical questions such as billing. The battery is used in a dozen psychology and psychiatry clinics that participate in the HiTOP Field Trials to test questions about clinical utility of the system. Personality and personality disorders Included within the HiTOP structure are personality disorders, as well as general personality traits. It is worth providing particular attention to the personality disorders and personality because the shift to a dimensional structure has been rather successful for the personality disorders, including even a formal recognition within Section III of DSM-5 (for emerging measures and models) and within the forthcoming ICD-11. Personality disorders have been included within every edition of the DSM as categorical syndromes, such as the borderline, narcissistic, schizotypal, and antisocial (or psychopathic). However, the validity of these diagnostic categories have long been questioned, including the concerns regarding arbitrary boundary with normal personality functioning, substantial overlap across the different syndromes, and considerable heterogeneity within each diagnostic category. The heterogeneity within each category and the overlap across categories hinder considerably the ability to identity a pathology that is specific to a particular syndrome and a unified, consistent treatment protocol. The Five Factor Model (FFM) is arguably the predominant dimensional model of general personality structure, consisting of the domains of neuroticism (or emotional instability), extraversion versus introversion, openness (or unconventionality), agreeableness versus antagonism, and conscientiousness (or constraint). The FFM has substantial construct validity, including multivariate behavior genetics with respect to its structure, cognitive neuroscience coordination, childhood antecedents, temporal stability across the life span, and cross-cultural validity, both through emic studies considering the structures indigenous to alternative languages and a large number of etic studies across major regions of the world, including North America, South America, Western Europe, Eastern Europe, Southern Europe, the Middle East, Africa, Oceania, South–Southeast Asia, and East Asia.  The FFM has also been shown to be useful in predicting a wide variety of important life outcomes, both positive and negative. There is also a considerable body of research to demonstrate that the DSM and ICD personality disorders are maladaptive variants of the domains (and facets) of the FFM. This empirical support includes researchers descriptions of each personality disorder in terms of the FFM, clinicians descriptions, and research relating measures of the FFM to alternative measures of the personality disorders. One can in fact use an FFM measure to assess for the presence of many of the personality disorders, such as borderline and antisocial, yielding indices that are equal in validity to the direct, traditional measures of these personality disorders. Finally, there is also a body of research to indicate that clinicians prefer dimensional trait models over the DSM categorical syndromes for patient description and treatment planning. Section III of DSM-5, for emerging measures and models, now includes a dimensional trait model, consisting of the five dimensional trait domains of negative affectivity, detachment, psychoticism, antagonism, and disinhibition, along with 25 underlying facets, which can be assessed with the Personality Inventory for DSM-5 (PID-5). Research with the PID-5 has indicated excellent coverage of the DSM-5 Section II (or DSM-IV) categorical syndromes. It should be acknowledged though that the DSM-5 Section III Alternative Model of Personality Disorder does still retain six of the DSM-IV categorical syndromes. A more extensive shift to a dimensional trait model is provided by the forthcoming ICD-11, which includes the five trait domains of negative affectivity, detachment, dissociality, disinhibition, and anankastia (along with a borderline pattern specifier). The ICD-11 trait model does not include a domain of psychoticism as the ICD has placed schizotypal traits within the spectrum of schizophrenia rather than within the personality disorders. The DSM-5 trait model does not include a domain of anankastia, but in the initial version of the trait model there was a domain of compulsivity that is closely aligned with anankastia. Both the DSM-5 Section III and ICD-11 dimensional trait models are aligned with the FFM. “These domains [of the DSM-5 dimensional trait model] can be understood as maladaptive variants of the domains of the five-factor model of personality”. As stated in DSM-5, “these five broad domains are maladaptive variants of the five domains of the extensively validated and replicated personality model known as the ‘Big Five,’ or the Five Factor Model of personality”. The five domains of ICD-11 are likewise aligned with the FFM: “Negative Affective with neuroticism, Detachment with low extraversion, Dissocial with low agreeableness, Disinhibited with low conscientiousness and Anankastic with high conscientiousness” References Classification of mental disorders

Clinical social work

Clinical social work is a specialty within the broader profession of social work. The American Board of Clinical Social Work (ABCSW) defines clinical social work as "a healthcare profession based on theories and methods of prevention and treatment in providing mental-health/healthcare services, with special focus on behavioral and bio-psychosocial problems and disorders". The National Association of Social Workers defines clinical social work as "a specialty practice area of social work which focuses on the assessment, diagnosis, treatment, and prevention of mental illness, emotional, and other behavioral disturbances. Individual, group and family therapy are common treatment modalities". Clinical social work applies social work theory and knowledge drawn from human biology, the social sciences, and the behavioral sciences. History Many suggest that the roots of clinical social work began with the social casework methods used by Charity Organization Societies around 1877 to 1883. In 1898, the first U.S. social work class was offered at Columbia University by the New York Charity Organization Society. In 1904 Simmons College, in collaboration with Harvard University, established the Boston School for Social Workers. Also, in 1904, Columbia University offered the first graduate program in social work, although it was not named the New York School of Social Work until 1917. In 1917 Mary E. Richmond conceptualized social casework in her text Social Diagnosis. The term social casework began to fade from use after 1920 and the term psychiatric social work became more in common as well as the application of psychoanalytic theory. Ehrenkranz reported that the first use of the term clinical social work was in 1940 at the Louisiana State University School of Social Work which offered a clinical curriculum. The National Federation of Societies for Clinical Social Work was established in 1971, which later became the Clinical Social Work Association in 2006. The Clinical Social Work Journal began in 1973 shortly after founding of the National Federation of Societies for Clinical Social Work. In 1978 the National Association of Social Workers' Task Force on Clinical Social Work Practice drafted the first working definition of clinical social work. The National Association of Social Workers established the Diplomate in Clinical Social Work (DCSW) in 1986. In 1987, the American Board of Examiners in Clinical Social Work was founded, which later became the American Board of Clinical Social Work in 2020, and established the Board Certified Diplomate in Clinical Social Work (BCD) credential. Today, clinical social work is licensed in all 50 of the United States, the District of Columbia, the U.S. Virgin Islands, all 10 Canadian Provinces, Guam and the U.S. Commonwealth of the Northern Mariana Islands, as well as licensed or certified by other jurisdictions around the world. Practice Methods The core methods of clinical social work require "the application of social work theory, knowledge, methods, ethics, and the professional use of self to restore or enhance social, psychosocial, or biopsychosocial functioning of individuals, couples, families, groups, organizations and communities. The practice of clinical social work requires the application of specialized clinical knowledge and advanced clinical skills in the areas of assessment, diagnosis and treatment of mental, emotional, and behavioral disorders, conditions and addictions. Treatment methods include the provision of individual, marital, couple, family and group counseling and psychotherapy. Clinical social workers are qualified to diagnose using the Diagnostic and Statistical Manual of Mental Disorders (DSM), the International Classification of Diseases (ICD), and other diagnostic classification systems in assessment, diagnosis, psychotherapy, and other activities. The practice of clinical social work may include private practice and the provision of clinical supervision". Assessment methods typically refers to a biopsychosocial assessment, clinical interview, direct behavioral observation, and/or the administering, scoring, and interpreting of various tests, inventories, questionnaires, and rating scales. Further, clinical social workers engage in consultation, program and practice evaluation, and the administration of clinical programs and services. Psychiatric Social Work Psychiatric Social Work is a practice area of social work involving the care of individuals with Serious mental illness who require intensive care. They may be involved with referring, treating (with psychotherapy) or otherwise managing such patients. Most Psychiatric Social Workers work in psychiatric institutions or hospitals, though in some programs they may work outside the institution for a period of intense observation. Education The Master of Social Work (M.S.W.) degree, accredited by the Council on Social Work Education, is the minimum education requirement in clinical social work and is the terminal practice degree. These M.S.W. degree are typically two full-time years of study in length and require 900 to 1,200 hours of internship practice. If an applicant to a M.S.W. degree program has a Bachelor of Social Work (B.S.W.) degree, accredited by the Council on Social Work Education, they may be offered "advanced standing" shorting their M.S.W. degree program to one years of full-time study. The Doctor of Social Work (D.S.W.) is the advanced practice professional degree in social work. The D.S.W. may be specialized in an area or in multiple areas of social work practice, one of which may be clinical social work at some universities. The Doctor of Philosophy (Ph.D.) in social work is typically considered a "research degree;" however, some schools may offer the Ph.D. degree in social work with a clinical social work practice specialization. Licensure In the United States Licensure is required to practice social work in the United States, and in many other jurisdictions. Clinical social work licensure typically requires 1,500 to 5,760 hours of post-master's clinical work experience under clinical supervision with a board approved clinical supervisor, and a passing score on an Association of Social Work Boards approved clinical level examination. The number of post-master's clinical hours may vary by jurisdiction. Clinical licensure titles also may vary by jurisdiction. The Association of Social Work Boards recommends the use of Licensed Clinical Social Worker (LCSW) as the preferred title. However, some jurisdictions have used other titles including, but not limited to Licensed Independent Social Worker (LISW), Licensed Independent Clinical Social Worker (LICSW), Licensed Specialist Clinical Social Worker (LSCSW), and Licensed Certified Social Worker-Clinical (LCSW-C). Certification Certification is a voluntary process that typically does not authorize practice, but may suggest specialization in a subfield of practice. There are several certifications in clinical social work. In the United States The American Board of Clinical Social Work (ABCSW) offers the Board Certified Diplomate in Clinical Social Work (BCD), and several clinical social work specialization credentials including practice with children and their families, clinical supervision, and in psychoanalysis. The ABCSW states that the BCD is "the profession's premier" advanced clinical social work certification, having the highest standards of clinical education, training, and experience. The ABCSW offers three specialty certifications including Practice with Children and Their Families, Clinical Supervision, and Psychoanalysis. Each of these specialty certifications require the applicant to hold advanced clinical certification as a BCD in Clinical Social Work, have acceptable peer evaluations, to have accumulated a specified number of clinical practice hours, have the specified number of clock hours of clinical continuing education related to the specialty, and have had a specified number of supervision or consultation hours. The National Association of Social Workers also offers several clinical social work credentials including the Qualified Clinical Social Worker (QCSW), Diplomate in Clinical Social Work (DCSW), Clinical Social Worker in Gerontology (CSW-G), and the Certified Clinical Alcohol, Tobacco & Other Drugs Social Worker (C-CATODSW). The Qualified Clinical Social Worker (QCSW) is the beginning level generalist clinical social work credential offered by NASW; NASW membership is not required to obtain the QCSW. The Diplomate in Clinical Social Work (DCSW) is the advanced level generalist clinical social work credential offered by NASW; NASW membership is required to obtain the DCSW. The Clinical Social Worker in Gerontology (CSW-G) is a specialty credential offered by NASW to clinical social workers who specialize in working in the area of gerontology; NASW membership is not required to obtain the CSW-G. The Certified Clinical Alcohol, Tobacco & Other Drugs Social Worker (C-CATODSW) is a specialty credential for clinical social workers who work in the area of alcohol, tobacco, and other drugs; NASW membership is not required to obtain the CSW-G. The National Association of Forensic Counselors offers the Clinically Certified Forensic Social Worker (CCFSW) credential. The NAFC suggests that the CCFSW is a clinical level certification for clinical social workers who hold an M.S.W. or D.S.W. degree, have obtained clinical licensure in their state, have earned a specified amount of related continuing education, obtained a passing exam score, and work with adult and/or juvenile criminal offenders. See also Behaviour therapy Child psychotherapy Cognitive therapy Cognitive-behavioral therapy Counseling Couples therapy Crisis intervention Differential diagnosis Family therapy Forensic social work Grief counseling Group psychotherapy Interpersonal psychotherapy Mental health professional Psychiatric rehabilitation Psychoanalysis Psychodynamic psychotherapy Psychoeducation Psychotherapy School social worker Caseworker (social work) Solution-focused brief therapy Qualifications for professional social work References Social work

Introduction to Psychoanalysis

Introduction to Psychoanalysis or Introductory Lectures on Psycho-Analysis is a set of lectures given by Sigmund Freud, the founder of psychoanalysis, in 1915–1917 (published 1916–1917, in English 1920). The 28 lectures offer an elementary stock-taking of his views of the unconscious, dreams, and the theory of neuroses at the time of writing, as well as offering some new technical material to the more advanced reader. The lectures became the most popular and widely translated of his works. However, some of the positions outlined in Introduction to Psychoanalysis would subsequently be altered or revised in Freud's later work; and in 1932 he offered a second set of seven lectures numbered from 29 to 35—New Introductory Lectures on Psychoanalysis—as complement (though these were never read aloud and featured a different, sometimes more polemical style of presentation). Contents In his three-part Introductory Lectures, by beginning with a discussion of Freudian slips in the first part, moving on to dreams in the second, and only tackling the neuroses in the third, Freud succeeded in presenting his ideas as firmly grounded in the common-sense world of everyday experience. Making full use of the lecture-form, Freud was able to engage in a lively polemic with his audience, constantly engaging the reader/listener in a discussion, so as to take on their views and deal with their possible objections. The work allows the reader acquainted with the concepts of Freud to trace the logic of his arguments afresh and follow his conclusions, backed as they were with examples from life and from clinical practice. But Freud also identified elements of his theory requiring further elaboration, as well as bringing in new material, for example, on symbolism and primal fantasies, taking up with the latter a train of thought he would continue in his re-working of "The Wolf Man". In the New Introductory Lectures, those on dreams and anxiety/instinctual life offered clear accounts of Freud's latest thinking, while the role of the super-ego received an update in lecture 31. More popular treatments of occultism, psychoanalytic applications and its status as a science helped complete the volume. Appraisals Karl Abraham considered the lectures elementary in the best sense, for presenting the core elements of psychoanalysis in an accessible way. G. Stanley Hall in his preface to the 1920 American translation wrote: These twenty-eight lectures to laymen are elementary and almost conversational. Freud sets forth with a frankness almost startling the difficulties and limitations of psychoanalysis, and also describes its main methods and results as only a master and originator of a new school of thought can do. These discourses are at the same time simple and almost confidential, and they trace and sum up the results of thirty years of devoted and painstaking research. While they are not at all controversial, we incidentally see in a clearer light the distinctions between the master and some of his distinguished pupils. Freud himself was typically self-deprecating about the finished work, describing it privately as "coarse work, intended for the multitude". Influence Max Schur, who became Freud's personal physician, was present at the original 1915 lectures, and drew a lifelong interest in psychoanalysis from them. Karl Jaspers turned from a supporter to opponent of psychoanalysis, after being especially struck in the Introductory Lectures by Freud's claim that his technique could be applied to mythology and to cultural study, as much as to the neuroses. Notes External links Full text Books by Sigmund Freud 1917 non-fiction books Books about psychoanalysis

A Guide for the Perplexed

A Guide for the Perplexed is a short book by E. F. Schumacher, published in 1977. The title is a reference to Maimonides's The Guide for the Perplexed. Schumacher himself considered A Guide for the Perplexed to be his most important achievement, although he was better known for his 1973 environmental economics bestseller Small Is Beautiful, which made him a leading figure within the ecology movement. His daughter wrote that her father handed her the book on his deathbed, five days before he died and he told her "this is what my life has been leading to". As the Chicago Tribune wrote, "A Guide for the Perplexed is really a statement of the philosophical underpinnings that inform Small Is Beautiful". Schumacher describes his book as being concerned with how humans live in the world. It is also a treatise on the nature and organisation of knowledge and is something of an attack on what Schumacher calls "materialistic scientism". Schumacher argues that the current philosophical "maps" that dominate western thought and science are both overly narrow and based on some false premises. However, this book is only in small part a critique. Four Great Truths Schumacher put forward what he considers to be the four great truths of philosophy: The world is a hierarchical structure with at least four "levels of being". The "Principle of Adequateness" determines human ability to accurately perceive the world. Human learning relates to four "fields of knowledge". The art of living requires an understanding of two types of problem: "convergent" and "divergent". Critique of materialistic scientism Schumacher was very much in favor of the scientific spirit, but felt that the dominant methodology within science, which he called materialistic scientism, was flawed and stood in the way of achieving knowledge in any other arena than inanimate nature. Schumacher believed that this flaw originated in the writings of Descartes and Francis Bacon, when modern science was first established. He makes a distinction between the descriptive and instructional sciences. According to Schumacher the descriptive sciences are primarily concerned with what can be seen or otherwise experienced, e.g. botany and sociology, while the instructional sciences are concerned with how certain systems work and can be manipulated to produce certain results, e.g. biology and chemistry. Instructional science is primarily based on evidence gained from experimentation. Materialistic scientism is based on the methodology of the latter, which developed to study and experiment with inanimate matter. According to Schumacher many philosophers of science fail to recognize the difference between descriptive and instructional science, or ascribe this difference to stages in the evolution of a specific science, which for these philosophers means that the instructional sciences are seen as being the most advanced variety of science. He is particularly offended by the view that instructional science is the most advanced form of science, because for Schumacher, it is the study of the low hanging fruit of inanimate matter, or less metaphorically the study of the lowest and least complex level of being. As Schumacher sees it, knowledge gained about the higher levels of being, while far harder to get and far less certain, is all the more valuable. He argues that applying the standards and procedures of instructional science to descriptive sciences is erroneous, because in the descriptive fields it is simply not possible to use the experimental techniques of instructional sciences. Experimentation is an appropriate method when dealing with inanimate matter, but applying it to the living world is liable to destroy or damage living things and systems, and is therefore inappropriate. He uses the term scientism because he argues that many people, including some philosophers of science, have misunderstood the theory behind instructional science and instead believe that it produces truth. But the instructional sciences are based on induction; and as David Hume famously points out induction is not the same as truth. Furthermore, according to Schumacher, instructional sciences are primarily concerned only with the parts of truth that are useful for manipulation, i.e. they focus on those instructions which are necessary to reliably produce certain results. For Schumacher, instructional sciences therefore produce theories which are useful: pragmatic truths. By contrast, Schumacher argues that the descriptive sciences are interested in the truth in the wider sense of the word. He argues that materialistic scientism follows a policy of leaving something out if it is in doubt. Consequently, the maps of western science fail to show large 'unorthodox' parts of both theory and practice of science and social science, and reveal a complete disregard for art and many other high level humanistic qualities. Such an approach, Schumacher argues, provides a grey, limited, utilitarian worldview without room for vitally important phenomena like beauty and meaning. He observes that the mere mention of spirituality and spiritual phenomena in academic discussion is seen among scientists as a sign of 'mental deficiency' . Schumacher argues that where there is near total agreement a subject becomes effectively dead; it is therefore the subjects where there is doubt that deserve the most intense research. Schumacher believes in contrast to materialistic science that what is in doubt should be shown prominently, not hidden away or ignored. His biggest complaint against materialistic scientism is that it rejects the validity of certain questions, which for Schumacher are actually the most important questions of all. Materialistic scientism rejects the idea of levels of being, but for Schumacher this leads to a one-sided view of nature. For Schumacher, you can learn much about humanity by studying from the perspective of minerals, plants and animals, because humans contain the lower levels of being. But that is not the full or even the most important part of the story, as he puts "...everything can be learned about him except that which makes us human." Evolutionism Schumacher first states that the evolutionist doctrine clearly sits in the descriptive sciences rather than instructive sciences. Schumacher accepts that evolution as a generalization within the descriptive science of biological change has been established beyond any doubt whatsoever. However, he considers the "evolutionist doctrine" to be a very different matter. The evolutionist doctrine purports to prove and explain biological change in the same manner as the proof and explanation offered by the instructional sciences. Schumacher quotes the 1975 Encyclopædia Britannica as an example of this view: "Darwin did two things: he showed that evolution was in fact contradicting scriptural legends of creation and that its cause, natural selection, was automatic leaving no room for divine guidance or design." He considers the evolutionist doctrine to be a major philosophical and scientific error. Schumacher argues that the evolutionist doctrine starts with the perfectly reasonable explanation of change in living beings, and then jumps to using it as an explanation for the development of consciousness, self-awareness, language, social institutions and the origin of life itself. Schumacher points out that making this conceptual leap simply does not meet the standards of scientific rigor and the uncritical acceptance of this leap is, for Schumacher, completely unscientific. Levels of being For Schumacher one of science's major mistakes has been rejecting the traditional philosophical and religious view that the universe is a hierarchy of being. Schumacher makes a restatement of the traditional chain of being. He agrees with the view that there are four kingdoms: Mineral, Plant, Animal, Human. He argues that there are important differences of kind between each level of being. Between mineral and plant is the phenomenon of life. Schumacher says that although scientists say we should not use the phrase 'life energy', the difference between inorganic and organic matter still exists and has not been explained by science to the extent of rendering said phrase fully invalid. Schumacher points out that though we can recognize life and destroy it, we can't create it. Schumacher notes that the 'life sciences' are 'extraordinary' because they hardly ever deal with life as such, and instead content themselves with analyzing the "physico-chemical body which is life's carrier." Schumacher goes on to say there is nothing in physics or chemistry to explain the phenomenon of life. For Schumacher, a similar jump in level of being takes place between plant and animal, which is differentiated by the phenomenon of consciousness. We can recognize consciousness, not least because we can knock an animal unconscious, but also because animals exhibit at minimum primitive thought and intelligence. The next level, according to Schumacher, is between Animal and Human, which are differentiated by the phenomenon of self-consciousness or self awareness. Self-consciousness is the reflective awareness of one's consciousness and thoughts. Schumacher realizes that the terms—life, consciousness and self-consciousness—are subject to misinterpretation so he suggests that the differences can best be expressed as an equation which can be written thus: "Mineral" = m "Plant" = m + x "Animal" = m + x + y "Human" = m + x + y + z In his theory, these three factors (x, y and z) represent ontological discontinuities. He argues that the differences can be likened to differences in dimension; and from one perspective it could be argued that only humans have actualized existence insofar as they possess life, consciousness and self-consciousness. Schumacher uses this perspective to contrast with the materialistic scientism view, which argues that what is true is inanimate matter, denying the realness of life, consciousness and self-consciousness, despite the fact each individual can verify those phenomena from their own experience. He directs our attention to the fact that science has generally avoided seriously discussing these discontinuities, because they present such difficulties for strictly materialistic science, and they largely remain mysteries. Next he considers the animal model of humanity which has grown popular in science. Schumacher notes that within the humanities the distinction between consciousness and self consciousness is now seldom drawn. Consequently, people have become increasingly uncertain about whether there is any difference between animals and humans. Schumacher notes that a great deal of research about humans has been conducted by studying animals. Schumacher argues that this is analogous to studying physics in the hope of understanding life. Schumacher goes on to say that much can be learned about humanity by studying minerals, plants and animals because humans have inherited those levels of being: all, that is, "except that which makes him [sic] human." Schumacher goes on to say that nothing is "more conducive to the brutalisation of the modern world" than calling humans the "naked ape". Schumacher argues that once people begin viewing humans as "animal machines" they soon begin treating them accordingly. Schumacher argues that what defines humanity are our greatest achievements, not the common run of the mill things. He argues that human beings are open-ended because of self-awareness, which as distinct from life and consciousness has nothing mechanical or automatic about it. For Schumacher "the powers of self awareness are, essentially, a limitless potentiality rather than an actuality. They have to be developed and 'realized' by each human individual if one is to become truly human, that is to say, a person." Progressions Schumacher points out that there are a number of progressions that take place between the levels. The most striking, he believes, is the movement from passivity to activity; there is a change in the origination of movement between each level: Cause (Mineral kingdom) Stimulus (Plant kingdom) Motive (Animal kingdom) Will (Humanity) One consequence of this progression is that each level of being becomes increasingly unpredictable, and it is in this sense that humans can be said to have free will. He notes increasing integration is a consequence of levels of being. A mineral can be subdivided and it remains of the same composition. Plants are more integrated; but sometimes parts of a plant can survive independently of the original plant. Animals are physically integrated; and so an appendage of an animal does not make another animal. However, while animals are highly integrated physically, they are not integrated in their consciousness. Humans, meanwhile, are not only physically integrated but have an integrated consciousness; however they are poorly integrated in terms of self-consciousness. Another interesting progression, for him, is the change in the richness of the world at each level of being. A mineral has no world as such. A plant has some limited awareness of its immediate conditions. An animal, however, has a far more rich and complex world. Finally, humans have the most rich and complicated world of all. Implications For Schumacher, recognizing these different levels of being is vital, because the governing rules of each level are different, which has clear implications for the practice of science and the acquisition of knowledge. Schumacher denies the democratic principles of science. He argues that all humans can practice the study of the inanimate matter, because they are a higher level of being; but only the spiritually aware can know about self-consciousness and possibly higher levels. Schumacher states that "while the higher comprises and therefore in a sense understands the lower, no being can understand anything higher than themselves." Schumacher argues that by removing the vertical dimension from the universe and the qualitative distinctions of "higher" and "lower" qualities which go with it, materialistic scientism can in the societal sphere only lead to moral relativism and utilitarianism. While in the personal sphere, answering the question "What do I do with my life?" leaves us with only two answers: selfishness and utilitarianism. In contrast, he argues that appreciating the different levels of being provides a simple but clear morality. The traditional view, as Schumacher says, has always been that the proper goal of humanity is "...to move higher, to develop one's highest faculties, to gain knowledge of the higher and highest things, and, if possible, to "see God". If one moves lower, develops only one's lower faculties, which we share with the animals, then one makes oneself deeply unhappy, even to the point of despair." This is a view, Schumacher says, which is shared by all the major religions. Many things, Schumacher says, while true at a lower level, become absurd at a higher level, and vice versa. Schumacher does not claim there is any scientific evidence for a level of being above self-consciousness, contenting himself with the observation that this has been the universal conviction of all major religions. Adequateness Schumacher explains that the bodily senses are adequate for perceiving inanimate matter; but we need 'intellectual' senses for other levels. Schumacher observes that science has shown that we perceive not only with the senses, but also with the mind. He illustrates this with the example of a complex scientific book; it means quite different things to an animal, illiterate man, educated man and scientist. Each person possesses different internal 'senses' which means they 'understand' the book in quite different manners. He argues that the common view that "...the facts should speak for themselves" is problematic because it is not a simple matter to distinguish fact and theory or perception and interpretation. He quotes R. L. Gregory in Eye and Brain, "Perception is not determined simply by the stimulus pattern, rather it is a dynamic searching for the best interpretation of data." He argues that we 'see' not just with our eyes; but our mental equipment and "since this mental equipment varies greatly from person to person, there are inevitably many things which some people can 'see' while others cannot, or, to put it differently, for which some people are adequate while others are not." For him, higher and more significant perceptive abilities are based on the ability to be critically aware of one's presuppositions. Schumacher writes "There is nothing more difficult than to be aware of one's thought. Everything can be seen directly except the eye through which we see. Every thought can be scrutinised directly except the thought by which we scrutinise. A special effort, an effort of self-awareness is needed — that almost impossible feat of thought recoiling upon itself: almost impossible but not quite. In fact, this is the power that makes man human and also capable of transcending his humanity." He notes that for anyone who views the world through materialistic scientism this talk of higher perception is meaningless. For a scientist who believes in materialistic scientism, higher levels of being "simply do not exist, because his faith excludes the possibility of their existence." He points out that materialistic science is principally based on the sense of sight and looks only at the external manifestation of things. Necessarily according to the principle of adequateness, materialistic science cannot know more than a small portion of nature. Schumacher argues that by restricting the modes of observation, a limited "objectivity" can be attained; but this is attained at the expense of knowledge of the object as a whole. Only the 'lowest' and most superficial aspects are accessible to objective scientific instruments. He notes that science became "science for manipulation" following Descartes. Descartes promised humanity would become "masters and possessors of nature", a point of view first popularised by Francis Bacon. For Schumacher this was something of a wrong turn, because it meant the devaluation of "science for understanding" or wisdom. One of Schumacher's criticisms is that "science for manipulation" almost inevitably leads from the manipulation of nature to the manipulation of people. Schumacher argues that 'science for manipulation' is a valuable tool when subordinated for wisdom; but until then "science for manipulation" has become a danger to humanity. Schumacher argues that if materialistic scientism grows to dominate science even further, then there will be three negative consequences: Quality of life will fall, because solutions of quantity are incapable of solving problems of quality. 'Science for understanding' will not develop, because the dominant paradigm will prevent it being treated as a serious subject. Problems will become insoluble, because the higher powers of man will atrophy through lack of use. Schumacher argues that the ideal science would have a proper hierarchy of knowledge from pure knowledge for understanding at the top of the hierarchy to knowledge for manipulation at the bottom. At the level of knowledge for manipulation, the aims of prediction and control are appropriate. But as we deal with higher levels they become increasingly absurd. As he says "Human beings are highly predictable as physico-chemical systems, less predictable as living bodies, much less so as conscious beings and hardly at all as self aware persons." The result of materialistic scientism is that humanity has become rich in means and poor in ends. Lacking a sense of higher values Western societies are left with pluralism, moral relativism and utilitarianism, and for Schumacher the inevitable result is chaos. Four fields of knowledge Schumacher identifies four fields of knowledge for the individual: I → inner I → other persons (inner) other persons → I I → the world These four fields arise from combining two pairs: Myself and the World; and Outer Appearance and Inner Experience. He notes that humans only have direct access to fields one and four. Field one is being aware of your feelings and thoughts and most closely correlates to self awareness. He argues this is fundamentally the study of attention. He differentiates between when one's attention is captured by the item it focusses upon, which is when a human being functions much like a machine; and when a person consciously directs their attention according to their choosing. This for him is the difference between "being lived" and living. Field two is being aware of what other people are thinking and feeling. Despite these problems, we do experience a "meeting of minds" with other individuals at certain times. People are even able to ignore the words actually said, and say something like "I don't agree with what you are saying; but I do agree with what you mean." Schumacher argues that one of the reasons we can understand other people is through bodily experience, because so many bodily expressions, gestures and postures are part of our common human heritage. Schumacher observes that the traditional answer to the study of field two has been "You can understand others to the extent you understand yourself." Schumacher points out that this is a logical development of the principle of "adequateness": how can you understand someone's pain unless you too have experienced pain? Field three is understanding oneself as an objective phenomenon. Knowledge in field three requires a person to be aware of what other people think of them. Schumacher suggests that the most fruitful advice in this field can be gained by studying the Fourth Way concept of "external considering". Schumacher observes that relying on just field one knowledge makes one feel that they are the centre of the universe; while focusing on field three knowledge makes one feel that they are far more insignificant. Seeking self-knowledge via both fields provides more balanced and accurate self-knowledge. Field four is the behaviourist study of the outside world. Science is highly active in this area of knowledge, and many people believe it is the only field in which true knowledge can be gained. For Schumacher, applying the scientific approach is highly appropriate in this field. Schumacher summarises his views about the four fields of knowledge as follows: Only when all four fields of knowledge are cultivated can one have true unity of knowledge. Instruments and methodologies of study should only be applied to the appropriate field they are designed for. Clarity of knowledge depends on relating the four fields of knowledge to the four levels of being. The instructional sciences should confine their remit to field four, because it is only in the field of "appearances" that mathematical precision can be obtained. The descriptive sciences, however, are not behaving appropriately if they focus solely on appearances, and must delve in meaning and purpose or they will produce sterile results. Self-knowledge can only be effectively pursued by balanced study of field one and field three. Study of field two (understanding other individuals) is dependent on first developing a powerful insight into field one (self awareness). Two types of problems Schumacher argues that there are two types of problems in the world: convergent and divergent. For him, discerning whether a problem is convergent or divergent is one of the arts of living. Convergent problems are ones in which attempted solutions gradually converge on one solution or answer. An example of this has been the development of the bicycle. Early attempts at developing human-powered vehicles included three- and four-wheelers and involved wheels of different sizes. Modern bicycles look much the same nowadays. Divergent problems are ones which do not converge on a single solution. A classic example he provides is that of education. Is discipline or freedom the best way to teach? Education researchers have debated this issue for thousand of years without converging on a solution. He summarises by saying that convergent problems are those that are concerned with the non-living universe. While divergent problems are concerned with the universe of the living, and so there is always a degree of inner experience and freedom to contend with. According to Schumacher, the only solution to divergent problems is to transcend them, arguing that in education, for instance, that the real solution involves love or caring; love and discipline work effectively, but so does love and freedom. Art Schumacher, in a digression from his main argument, discusses the nature and importance of art. He notes that there is considerable confusion about the nature and meaning of art; but argues that this confusion dissipates when one considers art with relation to its effect on human beings. Most art fits into two categories. If art is designed to primarily affect our feelings then it is entertainment; while if art is primarily designed to affect our will then it is propaganda. Great art is a multi-faceted phenomenon, which is not content to be merely propaganda or entertainment; but by appealing to people's higher intellectual and emotional faculties, it is designed to communicate truth. When entertainment and propaganda are transcended by, and subordinated to, the communication of truth, art helps develop our higher faculties and that makes it "great". Tasks of humanity Schumacher notes that within philosophy there is no field in more disarray than ethics. He argues that this is because most ethical debate sidesteps any "prior clarification of the purpose of human life on the earth." Schumacher believes that ethics is the study of divergent problems; which require transcendence by the individual, not a new type of ethics to be adopted by all. He argues that there is an increasing recognition among individuals that many solutions to human problems must be made by individuals, not by society, and cannot be solved by political solutions that rearrange the system. For Schumacher, the "modern attempt to live without religion has failed." He says that the tasks of an individual can be summed up as follows: Learn from society and tradition. Interiorize this knowledge, learn to think for yourself and become self-directed. Grow beyond the narrow concerns of the ego. Humanity, he says, in the larger sense must learn again to subordinate the sciences of manipulation to the sciences of wisdom; a theme he further develops in his book Small Is Beautiful. Reviews The reviews of this book include: America v. 138 (February 11, 1978). Best Sellers v. 37 (December 1977). Choice v. 15 (September 1978). The Christian Century v. 94 (October 12, 1977). The Christian Science Monitor (Eastern edition) (September 28, 1977). Commonweal v. 105 (April 14, 1978). Critic v. 36 (spring 1978). The Economist v. 265 (October 1, 1977). Library Journal (1876) v. 102 (October 1, 1977). The New York Times Book Review (October 2, 1977). New Statesman (London, England: 1957) v. 94 (October 7, 1977). Footnotes References Schumacher, E.F. (1977). A Guide for the Perplexed. (; paperback, ). (Chapter 2) 1977 non-fiction books Philosophy books Cognitive science literature Religious philosophical literature Books in philosophy of technology ja:エルンスト・フリードリッヒ・シューマッハー