Friday Factoids: Did You Know . . . (Facts About Schizophrenia)

 

  • No one born blind has ever developed Schizophrenia.
  • Auditory hallucinations seem to be culturally shaped. In the U.S., AH of voices are often described as harsh and threatening, while those heard by individuals with the same diagnosis in Africa and India report the voices are more benign and playful.
  • The Soviet Union created a fake mental disorder called “Sluggish Schizophrenia” in the 1970s. It allowed anyone who criticized the leadership to be arrested.
  • Schizophrenia come from the Greek language and roughly translated means “split mind.” This does not imply an individual has a split personality, but rather a split from reality.
  • Schizophrenia is mentioned in literature dating as far back as the second millennium BC in the Egyptian text called The Book of Hearts.
  • Addiction to nicotine is the most common form of substance abuse in people diagnosed with Schizophrenia.
  • The cause of Schizophrenia is unknown. It is thought to be a combination of genetics, brain biology (including chemistry and structure) and environment.
  • Many individuals diagnosed with Schizophrenia experience anosognosia. This means “without knowledge” and refers to the fact that the person is unable to identify that they have a mental disorder. They often do not realize they have developed symptoms and may deny experiencing the symptoms.
  • Auditory hallucinations are more common than visual hallucinations.
  • When experiencing active psychosis, individuals diagnosed with Schizophrenia are often mistaken as being under the influence of a substance.

 

 

Crystal Henson, Psy.D.
WKPIC Instructor

 

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Friday Factoids: Double Trouble ? A Brief Look at Comorbid Substance Use in Schizophrenia

Schizophrenia affects one in every one hundred persons with half of those affected likely to experience co-morbid substance use (as cited in Hunt et al., 2018). This use, in turn, exacerbates the overall symptomologic course of individuals diagnosed with schizophrenia and has been associated with an increased frequency of adverse consequences (Hunt et al., 2018).

 

 

In comparison to those who are singly diagnosed with schizophrenia alone, persons with co-morbid alcohol and/or illicit drug use are more likely to experience “hospitalization, homelessness, aggression, violence, incarceration, and suicidality” (as cited in Hunt et al., 2018, p. 234).

 

 

Specifically pertaining to an increased frequency of hospitalizations, Schmidt, Hesse, and Lykke (2011) found that patients who were dually diagnosed with schizophrenia and substance use disorder were psychiatrically hospitalized two times more frequently than individuals who were diagnosed with schizophrenia alone. Likewise, this group of patients were three times more likely to experience an outpatient episode, including emergency room visits. (Schmidt et al., 2011). However, the duration of their treatment was typically briefer (Schmidt et al., 2011).

 

 

References

Hunt, G. E., Large, M. M., Cleary, M., Xiong Lai, H. M., & Saunders, J. B. (2018). Prevalence of comorbid substance use in schizophrenia spectrum disorders in community and clinical settings, 1990-2017: Systematic review and meta-analysis. Drug and Alcohol Dependence, 191, 234-258. doi: 10.1016/j.drugalcdep.2018.07.011

 

 

Schmidt, L. M., Hesse, M., & Lykke, J. (2011). The impact of substance use disorders on the course of schizophrenia – A 15-year follow up study: Dual diagnosis over 15 years. Schizophrenia Research, 130, 1-3, 228-233. doi: 10.1016/j.schres.2011.04.011

 

 

Shirreka Mackay, LPC
Practicum Student, Western State Hospital

 

 

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Article Review: Freeman, G. M., Martin, B. A., & Hu, R. J. (2016) G-CSF Dosing to Prevent Recurrent Clozapine-Induced Agranulocytosis

A case study conducted by Freeman, Martin, and Hu, (2016) found that stabilization of psychiatric symptoms using Clozapine was possible in an individual with three consecutive instances of Clozapine-induced agranulocytosis.

 

The study involved the five and a half year treatment of a 19-year-old male with schizoaffective disorder. The individual developed agranulocytosis subsequent to three consecutive Clozapine trials. The individual was initially prescribed Clozapine after multiple failed attempts of numerous other antipsychotic medications. After nine months agranulocytosis occurred and was then discontinued with subsequent administration of granulocyte colony stimulating factor (G-CSF) for a brief time.

 

Based on the individual’s resistance to all other attempted forms of treatment (pharmacotherapy and ECT), risks and benefits were discussed and Clozapine was used again, yet with concurrent administration of G-CSF. Stabilization of psychiatric symptoms occurred for a longer period of time with no development of agranulocytosis or substantially elevated absolute neutrophil count (ANC). However, after 68 days of symptom stabilization agranulocytosis occurred. G-CSF dosing was adjusted based on the individual’s lack of hereditary predisposition to developing neutropenia, and a lack of other relevant symptoms being reported.

 

The most recent trial for the individual in this study included a daily dosage of clozapine, 700mg with G-CSF dosing ultimately adjusted to 480mg every 5 days (6.4mg/kg/week). The current clozapine trial, along with G-CSF dosing resulted in 380 days of a positive psychiatric response, which is 83 days beyond what was achieved on the individual’s first Clozapine trial before development of agranulocytosis. At the time the article documenting this case study was written, the individual in the study had not developed agranulocytosis, was self-administering his Clozapine along with G-CSF, and was residing with his family.

 

References
Freeman, G. M., Martin, B. A., & Hu, R. J. (2016). G-CSF dosing to prevent recurrent clozapine-induced agranulocytosis. American Journal of Psychiatry, 173(6), 643-643. doi:10.1176/appi.ajp.2016.15101303

 

Blake Palmer, LPA (Temp)
WKPIC Doctoral Intern

 

 

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Friday Factoids Catch-Up: December Fun Facts

This time of year is one of the more enjoyable times for adults, but especially children. The darkest time of the year is also a time whereby a hero emerges. Lights on the Christmas tree are symbolic of the return of illumination. Beaming through the nighttime sky emerges Santa and his reindeer. Santa and the representation of a “all knowing” creature bringing gifts for good children is an innocent game played between children and parents. Some parents believe that exposing their children to Santa is harmful. As future psychologists, it’s important to note the distinctions on both sides of the “Santa” debate.

 

Some psychologists view the belief in Santa as a negative occurrence. Johnson (2012) argues that parents who promote Santa are guilty of lying unjustly to their children, damaging parental trust, and encouraging negative behavior (Johnson, 2012). Furthermore, Johnson states that engaging in the Santa fantasy risks even more damaging consequences such as diminishing the child’s spiritual beliefs or allowing the promulgation of magical thinking (Johnson, 2012). Other arguments include the belief that sometimes even the “good” children do not receive gifts due to financial hardships. This time of year can be extremely difficult for children in poverty and their parents whom feel shame and guilt if they are unable to provide material gifts for their families.

 

A counter argument for the promotion of Santa with children underscores the value that Santa plays in developing the imagination of young children (Waugaman, 2013). Waugaman also emphasizes the idea that parents are able to create magical memories for their children that ultimately represent a parents eternal love (Waugaman, 2013). Upon the age whereby, the child comes to the realization of Santa he graduates to a stage from being a receiver of gifts to more importantly a giver of gifts. The ultimate hope is that children when matured will one day share their unique gifts and talents with human kind.

 

Parenting is one of the most difficult aspects of life. Deciding as to whether to incorporate holiday traditions into Christmas family routines should be handled carefully. The complexity of the Santa debate will continue to go forward in the future. However, for all parents the challenge is to keep the spirit of Christmas alive for their children. Anyone can adopt the spirit of hope, peace, and goodwill to humankind. The epitome of the Christmas spirit does not require a white beard or sleigh full of reindeer. Instead, anyone with a big heart and twinkle in their eye can become Santa.

 

References
Johnson, D. K. (2012, December 12, 2012). Say Goodbye to the Santa Claus Lie. Psychology Today. Retrieved from https://www.psychologytoday.com/us/blog/plato-pop/201212/say-goodbye-the-santa-claus-lie

Waugaman, E. P. (2013). The Santa Question. Retrieved from https://www.psychologytoday.com/us/blog/whats-in-name/201312/the-santa-question

 

References
Johnson, D. K. (2012, December 12, 2012). Say Goodbye to the Santa Claus Lie. Psychology Today. Retrieved from https://www.psychologytoday.com/us/blog/plato-pop/201212/say-goodbye-the-santa-claus-lie

Waugaman, E. P. (2013). The Santa Question. Retrieved from https://www.psychologytoday.com/us/blog/whats-in-name/201312/the-santa-question

 

Chris Morrison, MA, M.Ed.
WKPIC Doctoral Intern

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Article Review: Turner, JA; Edwards, L; Eicken, IM; Yokoyama, K; Castro, JR; Ngoc-Thuy Tran, A; & Haggkins, KL (2005) Intern Self-Care: An Exploratory Study Into Strategy Use and Effectiveness

As a current intern who has now completed my third month of my internship year, I was reflecting on the days/weeks/months in which I felt I was starting to feel more confident and comfortable as my position as an intern. When I first started, there was a period of time in which I felt the ‘imposter syndrome’. I also thought of how my self-care techniques had decreased some since I started my internship and how that might have affected my overall wellbeing.

 

There was an exploratory study completed that looked at 363 interns and their use and frequency of self-care techniques that they implemented during the year on internship. These are important aspects to consider when looking at the stressors during internship year and students going from possibly becoming concerned with performance evaluations or adjusting to a full-time schedule of clinical work. The author of this article identified common self-care techniques such as having a hobby, taking a vacation, exercising, reading for pleasure, praying, and supervising peers. The authors also identified various factors that have the potential to prevent an individual from engaging in self care such as relationships with their family and partners, self-awareness, balance in their personal and professional lives, and the personal values that an individual may have. The current study looked at the types of self-care activities that the current interns might have engaged in and the effectiveness of the activities.

 

The current study included 363 total interns, who were mainly at hospitals, university counseling centers, or VA centers. The current authors created their own Intern Self-Care Scale (ISCS) in order to assess the effectiveness and frequency of self-care activities. The authors found that of the items that were in the survey, 60% of the items were used ‘frequently’, 37% were used ‘sometimes’, and 3% were used ‘rarely’. The authors found the effectiveness of the self-care activities were 77% ‘frequently effective’ and 23% were ‘sometimes effective’. The authors of this study wanted to start the dialogue of looking at intern self-care and possibly future studies could looking at the relationship between self-care strategies and stress.

 

One of the main takeaways from this article was looking at self-care activities in a long-term direction instead of the short term of internship. When young psychologist are starting off their careers, it can be important to look at their strategies for taking care of themselves, but also making sure that they are able to get their work on and helping them using those self-care strategies long-term and carry them into their careers. This can be difficult because as students we can be taught that getting the work done is the most important aspect and putting our self-care techniques to the side and not paying as much attention to them. This article focuses on prospective and current interns and how they should consider the self-care techniques when looking at potential sites. As potential interns are beginning the process of interviewing for intern sites, look at your current self-care techniques and how much you are implementing them and consider having that as a question that you ask potential supervisors and current interns on the views of self-care. Also, make sure that as an interviewee that you are taking care of yourself
throughout the interviewing process and starting implement those self-care techniques now before you go on internship.

 

https://epublications.marquette.edu/cgi/viewcontent.cgi?referer=https://www.google.com/&httpsredir=1&article=1045&context=edu_fac

 

Hannah Sutherland, MA, LPA (Temp)
WKPIC Doctoral Intern

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Article Review: Kentucky Drinking at All-Time High

The holiday season represents a celebratory time for most Americans, and celebrations occur with friends and family alike. It can be a joyous time for many, but an emotionally challenging time for others. During this time many chose to engage in social drinking as part of the holiday festivities. It’s important to keep in mind that drinking even in a social setting comes with a social responsibility to understand the repercussions of one’s behavior and the risks associated with drinking.

 

The Centers for Disease Control conducted a study of the harmful impact of alcohol from 2006-2010 across the United States. That same study found that 1,356 Kentuckians suffered from alcohol-attributable related deaths (“Alcohol and Your Health,” 2018). Binge drinking in the State of Kentucky is at an all-time high. Kentucky ranks third in the nation with the number of heavy drinking episodes by people who reported being binge drinkers. (Estep, 2018) These statistics offer a sobering viewpoint to a widespread issue in the region. It’s also important to be mindful of the proclivity to indulge in drinking during the holiday for even the most moderate drinkers.

 

Examining a study conducted (2005) by Peterson, Morey, and Higgins allows one to gain the perspective of how social context leads to alcohol consumption (Peterson, Morey, & Higgins, 2005). This study included 60 drinkers who were assessed by the NEO-FFI. The 20 highest and ten lowest drinkers were oversampled 2:1 to ensure a moderate distribution of social drinking behavior. (Peterson et al., 2005, p. 26)

 

The results of this study indicated that individuals who drink socially tend to drink as much as their peers, especially if they are agreeable, sociable, positive, and open people (Peterson et al., 2005, p. 27) Thus, people who tend to pay attention to their social setting and peers, drink more either unconsciously or consciously in order to accommodate that milieu. Less open and agreeable people tend to ignore their social environment and go their own way. This study makes it apparent that social context plays an enormous role in the regulation of drinking behavior among non-alcoholic social drinkers.

 

The danger of overindulgence during the holidays whether it be eating, spending, drinking, is a real possibility for all of us. The reality is that some behaviors even if deemed ok by societal standards can still leave us vulnerable to chaos. Alcohol is one widely accepted societal practice that can impact every one of us in a negative light if given the opportunity. During this holiday season, it’s important to understand that even “social” drinkers can fall victim to the dangers of alcohol. Thus, if an individual chose to drink, he must do so at his peril. Solid planning and good insight are critical to understanding one’s vulnerability to minimize one’s susceptibility to drinking in excess.

 

References
CDC Fact Sheets – Alcohol Use and Your Health. (2018). Retrieved from https://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm

 

Estep, B. (2018, March 18, 2018). 652 drinks a year. Kentucky binge drinking rate among highest in the nation, . Lexington Herald-Leader. Retrieved from https://www.kentucky.com/news/state/article205769849.html

 

Peterson, J. B., Morey, J., & Higgins, D. M. (2005). You Drink, I Drink Alcohol Consumption, Social Context, and Personality. Individual Differences Research, 3, 23-35. Retrieved from https://www.academia.edu/20722305/You_drink_I_drink_alcohol_consumption_social_context_and_personality

 

Chris Morrison, MA, M.Ed.
WKPIC Doctoral Intern

 

 

 

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Friday Factoids Catch-up: Examining the Link between Folic Acid Levels and Negative Symptoms in Patients with Schizophrenia

Folic Acid deficiency is considered to play a role in patients with Schizophrenia. Serum or plasma concentration of folic acid is substantially lower in individuals with Schizophrenia than in the general population (Cao et al., 2016).

 

Mutations in key enzymes that regulate folic acid levels have been demonstrated as a moderator between folic acid levels and severity of negative symptoms in individuals with Schizophrenia (Nishi et al., 2014).

 

A systemic review of meta analyses revealed substantial improvements in negative symptoms in individuals with schizophrenia who were given folic acid supplementation (Sakuma et al., 2018).

 

References
Cao B., Wang D.F., Xu M.Y., Liu Y.Q., Yan L.L., Wang J.Y., Lu Q.B. (2016) Lower folate levels in schizophrenia: a meta-analysis. Psychiatry Res 245:1–7

 

Nishi A., Numata S., Tajima A., Kinoshita M., Kikuchi K., Shimodera S., Tomotake M., Ohi K., Hashimoto R., Imoto I., Takeda M., Ohmori T. (2014) Meta-analyses of blood homocysteine levels for gender and genetic association studies of the MTHFR C677T polymorphism in schizophrenia. Schizophrenia Bulletin 40:1154–1163

 

Sakuma, K., Matsunaga, S., Nomura, I., Okuya, M., Kishi, T., & Iwata, N. (2018). Folic acid/methylfolate for the treatment of psychopathology in schizophrenia: a systematic review and meta-analysis. Psychopharmacology, 235(8), 2303-2314. doi:10.1007/s00213-018-4926-4

 

Blake Palmer,
WKPIC Intern

 

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Friday Factoids Catch-Up: Exercising in the Winter Months

Ugh. It’s *that* time again…

 

As we begin to head into the winter months, it is important to consider how our exercise and fitness habits might change, and the benefits of exercising.

 

Exercise can be weather-dependent for many people, as they may not want to exercise out in bad weather (i.e. rain, cloudy, snow, etc.) and they may not want to exercise when it is dark outside (i.e. early morning or late evening.  This can leave limited amounts of time to exercise during the winter months when the length of the days becomes shorter and there are more possibilities for rain or snow.

 

<Nooooo, not jogging in snow!>

 

<But…>

 

There are many benefits to exercising other than just an increase in endorphins, and these benefits just might nudge you toward exercising even during the winter months, up to and including, yes, jogging in the snow. The Mayo clinic reports that physical activity can “reduce your risk of chronic disease, improve your balance and coordination, help you lose weight, and even boost your self-esteem.”  The Mayo clinic also recommends a combination of strength training and aerobic activity and they even provide examples and videos of various exercises to help get individuals started!

 

So as we enter in these next few months of decreased sun exposure, sunny days, and lower temperatures, consider looking for exercises to do inside your home! Below are some resources to help you get started.

References
https://www.mayoclinic.org/healthy-lifestyle/fitness/basics/fitness-basics/hlv-20049447

 

Hannah Sutherland, MA, LPA (Temp)
WKPIC Doctoral Intern

 

 

 

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Friday Factoids Catch-Up: Psychology for Dogs

 

For many dog parents, we all know the struggle of training new commands to puppies or new dogs. We might have tried different techniques, positive reinforcement, negative reinforcement, verbal signs, or visual signs. However, there are many dogs for which some techniques do not always work–or your dog does not always respond to the command.  So why is it that some dogs are able to learn faster than others, and is there really a difference among verbal and visual cues that go along with commands?

 

If you have ever taken a dog to a pet training course at a place like PetsMart, you will see that their animal trainers will pair a command with a visual cue. For instance, they will give a hand signal while they are telling the dog to ‘sit’ or point to the ground while they are saying ‘down’.

 

 

New research conducted at Emory University in Atlanta, Georgia might shed some insight on the dog’s brain and the types of signals they perceive when learning a new command. This research supports the theory that visual commands can be more effective when training a dog. The fMRI data supports this notion as well.

 

References
https://www.psychologytoday.com/us/blog/canine-corner/201810/do-dogs-learn-more-quickly-verbal-or-visual-signals

 

 

Hannah Sutherland, MA, LPA (Temp)
WKPIC Doctoral Intern

 

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Friday Factoids: Screen Time Controls

 

When was the last time you looked at your phone? How recent was it? Do you remember what you were looking at or did you just check it out of habit?

 

Many technology companies are starting to come out with more controls to monitor how much we look at our phones, or our “screen time.” The companies are designing these controls for both adults and kids to help reduce the amount of time we use our electronic devices without thinking about it.  The new monitors will even help set limits for the amount of time we can use for different apps. The monitors can also use a password to set, in case you do not have much self-discipline and keep adding extra time.

 

It can also be helpful to set limits for how much time kids are on their phones or tablets. These screen time controls may become a naturalistic, non-invasive way of reducing children’s obsessions with their devices, and model healthy limits for younger users of electronics.

 

So the next time you see yourself checking your phone for the 30th time today, remember that you can set limits for yourself to help improve productivity!

 

References
https://www.mynbc5.com/article/too-much-screen-time-new-phone-controls-for-you-and-kids/23301326

 

Hannah Sutherland, MA, LPA (Temp)
WKPIC Doctoral Intern

 

 

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