Friday Factoids Catch-Up: Optogenetics

Posted on February 9, 2016 by Susan Vaught

 

Optogenetics involves tweaking the genes of neurons so that they become sensitive to light. By combining this technique with genetic and viral approaches, researchers can insert these channels into very specific populations of neurons. Ultimately, this approach allows researchers to control distinct groups of neurons and individual circuits of the brain by stimulating them with light-emitting devices inserted into the brain. First, researchers inject the subject with a genetically engineered virus, designed to infect brain tissue. These viruses aren’t harmful and have been engineered by scientists to deliver a benign DNA strand that code for special surface proteins, which respond to specific wavelengths of light. These single-celled organisms produce a protein called channelrhodopsin that makes them sensitive to sunlight.

 

At present, optogenetics can be used only on animals whose brain functions associated with elemental emotions, like fear and anxiety and reward, are similar to those in humans. Early tests have been successful in mice and primates to restore sight in blind test animals. Optogenetics was a major spur to the Obama Administration’s announcement, in 2013, of the BRAIN Initiative, a $300 million program for developing technologies to treat such neurological ailments as Alzheimer’s disease, autism, schizophrenia, and traumatic brain injury. It is possible that optogenetics could be used as a therapeutic tool in humans. Some clinicians are already looking at possible treatments in the peripheral nervous system

 

Optogenetics has given researchers unprecedented access to the workings of the brain, allowing them not only to observe its precise neural circuitry in lab animals but to control behavior through the direct manipulation of specific cells. The aim is to gain an understanding of brain functions such as attention, memory, social skills and emotions. For instance, a person diagnosed with schizophrenia displays cognitive impairment, which may hinder the performance of day-to-day tasks, such as showing up to work or the ability to make decisions. The challenge is to understand how the brain performs cognitive processes in the first place and how this is changed in psychiatric disorders. Several new studies have shown the potential of optogenetic stimulation to rapidly modify depression and anxiety related behaviors in animal models. It is potentially more effective and has fewer adverse effects than classic light therapy or pharmacological approaches to treat mental illness.

 

Circuit-level understanding of psychiatric symptoms is allowing more sophisticated pathophysiological hypotheses, which is important for replacing the current system of subjective report-based measures. Second, by combining patient interviews and personalized genomics, diagnoses of mental illnesses are well poised to change substantially in a manner that could improve both prevention and treatment. Third, direct knowledge of cells that are involved in psychiatric symptoms is facilitating identification of clinically relevant circuit biomarkers, which could revolutionize not only diagnosis but also prediction of treatment outcomes. It’s too early to say that optogenetics could inform the treatment in humans. But the research could enact changes on our models of mental illness.

 

References:
Albert, P.R. (2014). Light up your life: Optogenetics for depression? Journal of PsychiatryNeuroscience 39, 3-5.

 

Colapinto, J. (2015, May 18). Lighting the Brain. The New Yorker. Retrieved from http://www.newyorker.com/magazine/2015/05/18/lighting-the-brain

 

Myers, A. (2012, November 18). Optogenetics illuminates pathways of motivation through brain, study shows. Stanford Medicine. Retrieved from https://med.stanford.edu/news/all-news/2012/11/optogenetics-illuminates-pathways-of-motivation-through-brain-study-shows.html

 

Jonathan Torres, M.S.
WKPIC Doctoral Intern

 

[Director’s Note:  No, Dr. Greene, you may not go back to the rat lab just because this is interesting. Seriously. No.]

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Congratulations, Dr. McNeill!

Posted on January 29, 2016 by Susan Vaught

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A big WOOHOO to former intern and current post-doc Dr. Danielle McNeill for passing her licensing exam! WAY TO GO!!

 

Susan R. Redmond-Vaught, Ph.D., Director WKPIC
Zach Meny, Psy.D., Training Director WKPIC
WKPIC Staff

 

 

 

 

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Friday Factoids: Social Psychology and Southern “Snow Panic”

Posted on January 29, 2016 by Susan Vaught

 

Being a student of human behavior at times causes me to observe phenomena in my world with fascination. Social Psychology is widely defined as “the study of the manner in which the personality, attitudes, motivations, and behavior of the individual influence and are influenced by social groups.” One such phenomenon, which caught my attention was recently when many people in middle TN and Western KY were preparing for an upcoming winter weather event on the evening of 1/19. I needed to run a routine errand to a local grocery store pharmacy. I had noticed some jokes on my Facebook feed prior to going out. The jokes revolved around the tendency of people to swarm into grocery stores prior to winter weather events. I laughed it off as an exaggeration due to being new to this area of the country.

 

I knew something different was happening when I got to the store and the parking lot was full. This is not a usual occurrence on a week night. I entered the store and saw checkout lines snaking, through the aisles, and clear to the back of the store. After a sigh of relief that I did not have to get into those lines due to the nature of my errand, I was struck by the behaviors of the social group involved in this event.

 

I am fairly certain that people shopping in this grocery store were not aware of belonging to a social group. The first behaviors I identified were a group of people in a state of conflict and competition. The top items being “competed” for seemed to be mainly perishable food items like milk, eggs, and unfrozen meats. I noticed a smaller, but still significant number of people who were purchasing non-perishable items such as canned goods, bottled water, and breakfast cereal. Competition is a process that is always present among humans as a group but what I witnessed was the result of competition being converted into conflict during a time of perceived crisis the group primarily was competing for perishable goods that were perceived useful.

 

In actuality bread, milk, eggs and other perishables are not the go to items that will help the group survive in an actual crisis. One suggestion is that when the group is having an initial reaction to an impending storm situation the lean toward perishable items when preparing for a short term event. The drive toward choosing perishable items may be unconscious. The shoppers I saw with non-perishable items were largely in military uniforms and likely from nearby Fort Campbell. It has been suggested by some that when a person is seeking and competing for non-perishable items the unconscious drive is more driven by ideas that the crisis/storm event could be a longer term event. In a long term event perishables would quickly become useless. It is quite possible that individuals trained in the military are not functioning at an unconscious level as much as they are relying on a better awareness of what would help if they were stranded in their homes for multiple days.

 

While observing the aforementioned behaviors and patterns, a loud verbal argument began between two customers waiting in line. The two individuals seemed to be arguing because they felt the other had cut in front of them in line. A baseline sense of competition was already heightened and aggravated and a behavior that may have been met with irritation was met with aggression. The verbal conflict soon escalated into a physical fight with punches being thrown. Quickly, two uniformed military personnel came and broke up the fight. The two men in the fight were both people buying perishable goods. The military personnel both were consistent with their colleagues and had a cart full of canned goods, batteries and water. There may have been a higher level of urgency in the perishable food buyers because of the short sighted plans. They are seeking perishables to last over a short time period and then move on to the next crisis. The opposing group which had enough training to not fall into less viable crisis supplies were also those who retained order in the group as a whole.

 

Since the non-perishable buyers seemed so better adapted at handling uncontrollable circumstances it was curious to me that they too were out scrambling for their chosen crisis supplies literally hours before a storm. Noticing this again made me question why there was so much activity in the store. If a person is trained and prepared for disasters why did they not shop at a time when competition for goods was lower ? I think to some extent that even those who are prepared for a disaster may have been out obtaining even small items they thought they might happen to need. While people compete with one another in an outward group once back in our homes we tend to think more altruistically. If we have excess, we are more likely to share with our neighbors. The group in the store outside of their neighborhood group came to blows, but it is likely that if asked these individuals would share their perishable goods with their neighbors i.e. “can I borrow an egg.”

 

Overall while watching this scene unfold, my anxiety began to heighten because I thought “what if I run out of food.” Prior to entering the store I was not thinking about this at all and as I mentioned I was laughing at the “bread and milk before the snow” jokes on Facebook. I am not from the area and maybe the rest of the group who is established here should be followed. The thought seemed even more valid when I gauged the intensity of the group. I began to doubt my ability to make decisions as an individual. The group must know something I don’t. It was a hard conscious effort to resist getting a cart and grabbing a just a couple items, just in case they were needed. I took pause and thought about how our home is likely more prepared for disaster than average since I lived in an Earthquake area prior to TN. Shopping before an Earthquake is simply not an option so the whole paradigm for preparation is different. I was quite struck by the anxiety that rose up when watching the group and then a mental accounting for the supplies I knew I had on hand. Despite knowing that I was well supplied I literally fought an urge to get in the long lines with the rest of the group.

 

This trip on a basic errand transformed into an incredible, unplanned, observational experience of Social Psychology. I still after leaving the store have a pull toward thinking the group knows better than me even though I am certain that I have at least three weeks of emergency supplies, which are more substantial than bread and milk. Let’s just hope that I am prepared enough for the upcoming winter storm and that my effort against joining the group on this occasion will not backfire.

 

References
Dove, L (2015).Why do people buy up all the bread and milk before a storm hits: The psychology of stockpiling. http://science.howstuffworks.com/nature/natural-disasters/buy-bread-and-milk-before-storm1.htm

 

Nelson, Lowry, (1948). Rural sociology. American sociology series, (pp. 149-171). New York, NY, US: American Book Company, xvi, 567 pp.

 

Rain Blohm, MS
WKPIC Doctoral Intern

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Friday Factoids: Don’t Forget Behavioral Interventions in Treatment for Hypertension

Posted on January 29, 2016 by Susan Vaught

Health Psychology is both the science and art of when a person’s behaviors interact with their health status. This interaction can take place in overt, very noticeable ways or in ways that are outside of one’s awareness.

 

A big issue health psychologists often address is stress. The stress response is known to interact with a variety of health problems. Hypertension (HTN) is a health problem where many biological and psychological factors converge. There are two types of HTN, type I and type II. Type one is the more prevalent form and type II is secondary to other pathology such as kidney failure. Type I HTN has a variety of factors that contribute to its development. Some of these factors are well known like genetics, obesity, sedentary life style, and a high sodium diet.

 

Some factors such as a person’s “personality structure” and environmental stressors are less well defined. The important consideration with HTN management is there are many psychosocial factors that if addressed by a health psychologist can improve the health outcome of patients with HTN. Diet and lifestyle are behavioral issues that can be addressed, with assistance offered. Understanding how a person deals with stress is also an important area for intervention. Yet another area of interest to HTN management is underlying emotional issues like preexisting trauma, depression, or anxiety. These problems increase physiological reactivity and thus increase HTN risk. However, very few patients with HTN speak to a health psychologist.

 

HTN is a very important sentinel condition appropriate for psychological intervention. HTN is letting the patient know that their body is in need of care and changes. HTN typically develops prior to heart disease, diabetes and other vascular diseases. These chronic conditions could be significantly reduced with aggressive behavioral management of HTN. Patients could benefit from identification of HTN and medication and behavioral management as a part of an overall plan to reduce the burden of future chronic diseases.

 

Rain Blohm, MS
WKPIC Doctoral Intern

 

 

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Article Review: Predicting Medication Noncompliance after Hospital Discharge Among Patients with Schizophrenia

Posted on January 28, 2016 by Susan Vaught

 

Medication non-compliance is a pervasive problem among individuals with a serious and chronic mental illness. The first few weeks after discharge from the hospital signify a critical period in the course of recovery. Previous research indicates that 79 percent of patients with schizophrenia who discontinue medications for less than one week subsequently restart and maintain compliance. Unfortunately, 91 percent of patients who stop medication for more than one week continue to stay off antipsychotic medications until they relapse (Olfson, et al., 2000).

 

Generally, patients who are admitted for acute hospitalization are highly symptomatic and must make the transition from inpatient to outpatient care in a few short days. This transition puts the patient in a position to assume greater autonomy and control over aspects of their daily lives. The increased independence heightens the risk of noncompliance with medications. In this study, the authors focus on the role of severity of illness, substance use, insight, treatment alliance, family involvement, and aspects of medication management as possible predictors of medication noncompliance after hospital discharge.

 

The article highlighted that several cross-sectional studies link severity of psychopathology to medication noncompliance. Previous studies have shown that substance intoxication may impair judgment, reduce motivation to pursue long-term goals, and lead to a devaluation of the benefits offered by antipsychotic medications (Owen, Fischer, & Booth, 1996). The availability of family members who remind patients to take their medications is widely believed to lower the risk of medication noncompliance. Several studies have revealed there are lower rates of medication noncompliance among patients who live with family members or with people who supervise their medications (Razali & Yahya, 1995). Additionally, patients who form a strong therapeutic alliance with their therapists seem to be more likely to comply with prescribed medications than patients who form weaker alliances (Frank & Gunderson, 1990).

 

In the study reported here, medication compliance was assessed in a sample of inpatients with schizophrenia who were interviewed at hospital discharge and then again three months later. This design permitted an examination of whether factors evident during the inpatient stay, such as illness severity, substance use, insight, therapeutic alliance, family support, and medication, predicted medication noncompliance after hospital discharge.

 

Method
Participants that were eligible for this study were newly admitted to four New York City psychiatric inpatient hospitals, between 18 and 64 years of age, and had an admitting clinical diagnosis of schizophrenia or schizoaffective disorder. A total of 316 patients were eligible for the study and 263 (83 percent) were located for a three-month follow-up interview. Subjects who received depot injections after hospital discharge were not included in the study.

 

Patients completed a structured assessment spanning clinical symptoms, substance use disorders, insight into illness, and aspects of their medication management. Substance use disorders were assessed at hospital admission with the Mini-International Neuropsychiatric Interview for DSM-IV. Clinical symptoms were assessed at hospital discharge by a research assistant with the BPRS, GAS, and Center for Epidemiological Studies—Depression Scale (CES-D). Insight into illness was assessed with two probes: “Do you believe you have a mental illness?” and “Would you say you have emotional problems?”  In addition, an item was included from the National Health Interview Mental Health Supplement: “How difficult was it for you to recognize the symptoms of your illness?” Possible responses were very difficult, somewhat difficult, and not difficult.

 

Therapeutic alliance was measured with the six-item Active Engagement Scale completed by inpatient clinicians at the time of discharge. Family involvement was evaluated by asking staff whether patients had any family members, whether family members visited the patient in the hospital, whether they agreed or refused to become involved during the admission, whether they met with staff, and whether they received family therapy. Three months after hospital discharge, patients were re-interviewed in person with the same instruments to assess change in symptoms, mental health service utilization, and use of antipsychotic medication.

 

Results
The results of the study found of the patients followed up, 41 (19.2 percent) were found to be noncompliant with medication and 172 (80.8 percent) were compliant. The mean ages of the medication noncompliant and compliant groups were 34.8±9.7 years and 37.6±9.6 years, respectively. Patients who became medication noncompliant were significantly more likely than those who remained compliant to have been medication noncompliant during the three-month period before hospitalization. Patients who became medication noncompliant were significantly more likely than their compliant counterparts to meet past-six-month criteria for a substance use disorder. A significant number of patients who became medication noncompliant reported that they found it somewhat or very difficult to recognize their clinical symptoms.

 

Discussion
The authors found that approximately one in five patients with schizophrenia reported missing one week or more of oral antipsychotic medications during the first three months after hospital discharge. Missing or stopping antipsychotic medication was strongly associated with several problematic outcomes, including symptom exacerbation, noncompliance with outpatient treatment, homelessness, emergency room visits, and re-hospitalization. A recent history of substance abuse or dependence emerged as the strongest predictor of medication noncompliance. Additionally, medication noncompliance was also associated with noncompliance during the transition to outpatient care and proved to be a strong predictor of future noncompliance.

 

In this study, little evidence was found that family visits or family therapy sessions during hospitalization was related to future medication compliance. However, patients whose families refused to participate in treatment were at high risk for stopping their medications. Patients who were more actively involved in inpatient treatment were more likely to remain on their medications. This finding may help explain the success of psychological strategies that seek to reduce noncompliance by building the patient’s motivation to take antipsychotic medications.

 

The authors found that medication compliance was not related to whether a patient acknowledged having a mental illness or diagnosis of schizophrenia, but rather to the patient’s ability to recognize clinical symptoms. Patients who have difficulty recognizing their own symptoms may be less aware of their ongoing need for maintenance treatment and the benefits of antipsychotic medications. Various aspects of symptom severity failed to predict medication noncompliance. Symptoms of grandiosity and suspiciousness were only weakly related to noncompliance. The authors noted that patients treated with Clozapine or Risperidone, or treated with lower doses of antipsychotic medications tended to be less likely to become medication noncompliant, although this relationship was not statistically significant.

 

The findings are inhibited by several limitations. First, they relied exclusively on patient self-reports to determine medication compliance. Problems with recall and reality distortions may have introduced inaccuracies in their histories. Having other informants would have strengthened measurement in this area. Second, only short-term follow-up data were available. A longer follow-up period might have yielded larger numbers of medication noncompliant patients and a different pattern of predictors.

 

What We Can Do
Several important findings can be taken from this study to further assist our hospital staff with improving patient medication compliance after discharge. First, staff who takes a careful history of recent medication noncompliance may improve their prediction of who is at risk for stopping their antipsychotic medications. Second, staff who detects that family members oppose or do not support some aspect of their relative’s psychiatric treatment should make a concerted effort to understand and address these family attitudinal barriers. Third, staff can help patients work through their ambivalence about antipsychotic medications by asking inductive questions, examining the pros and cons of medication compliance, and selectively reinforcing adaptive attitudes. Finally, it is possible that psychoeducational strategies that help patients develop more accurate subjective health assessments may improve compliance with maintenance antipsychotic treatment.

 

References:
Bartko, G., Herczeg, I., Zador, G. (1988). Clinical symptomatology and drug compliance in schizophrenic patients. Acta Psychiatrica Scandinavica, 77, 74–76.

 

Frank, A.F., Gunderson, J.G. (1990). The role of the therapeutic alliance in the treatment of schizophrenia. Archives of General Psychiatry, 47, 228–236.

 

Kemp, R., Kirov, G., & Everitt, B. (1998). Randomised controlled trial of compliance therapy. British Journal of Psychiatry, 172, 413–419.

 

Olfson, M., Mechanic, D., Hansell, S., Boyer, C.A., Walkup, J., & Weiden, P.J. (2000). Predicting Medication Noncompliance After Hospital Discharge Among Patients with Schizophrenia. Psychiatric Services, 51, 216-222.

 

Owen, R.R., Fischer, EP., & Booth, E.M. (1996). Medication noncompliance and substance abuse among patients with schizophrenia. Psychiatric Services, 47, 853–858.

 

Razali, M.S., & Yahya, H. (1995). Compliance with treatment in schizophrenia: a drug intervention program in a developing country. Acta Psychiatrica Scandinavica, 91, 331–335.

 

Jonathan Torres, M.S.
WKPIC Doctoral Intern

 

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Winter Storm Jonas Interviews

Posted on January 24, 2016 by Susan Vaught

img_2634WKPIC would like to extend a belated thank-you to the interns who participated in our first ever weather-necessitated Skype interviews. With closed interstates, a state of emergency in Kentucky and elsewhere, and buckets of snow dumping out of the sky–you guys were champs. We all made it through! Whether you match with us or elsewhere, good luck in all that you do.

 

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Susan R. Redmond-Vaught, Ph.D.
Director, WKPIC

 

 

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Intern Interviews During Snowmaggedon 2016

Posted on January 22, 2016 by Susan Vaught

We are moving through our interviews at this time, running approximately 15 minutes behind schedule due to initial technical difficulties. Thank you for your patience, applicants!

Susan R. Redmond-Vaught, Ph.D

Director, WKPIC

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Friday Factoids: Underplaying Tobacco as a Health Issue

Posted on January 15, 2016 by Susan Vaught

 

As an ex-smoker I understand the struggles involved in quitting. I used to joke that the messages I received to quit sounded like the nagging, wordless voice of the Charlie Brown teacher. I think that in order for any of us to change a behavior, addictive or not, we need to have an “Ah-Ha” moment.

 

I began working in the medical field at a young age as a respiratory therapist. I saw the effects of smoking on others, but I rationalized this by looking at how much older they were than me. Some of them were in fact in their 40’s, but in my early 20’s this seemed pretty far off. My perspective changed though. I saw patients tracheostomies beg to be taken outside the hospital to smoke. I worked with people who were very severe asthmatics who would fight with staff over being able to remove supplemental oxygen so that they could smoke. I saw burn victims who had caught a bed on fire. I worked with COPD patients who became burn victims while smoking at home on oxygen. Unfortunately for me, it took this high level of exposure to negative outcomes in order to make changes.

 

Every smoker or tobacco user knows that it is something they “shouldn’t” be doing. Clinical staff tends to look at smoking as a minor problem when a patient presents with high levels of substance abuse or other behaviors that threaten health and wellbeing. Despite knowing how much tobacco use will cost someone in the long run, I feel like clinicians and patients have a greater sense of complacency with this particular issue. As psychologists, we tend to shy away from the diagnosis of Nicotine Use Disorder even when it seems severe. I have often times not addressed a patient’s smoking for different reasons. If it was a substance abusing patient, I feared that smoking cessation would increase relapse risk. Research hasn’t supported this idea. I really worried that adding smoking cessation goals to patients’ care plans would prove to be too much for them.

 

As clinicians we have a duty to help our patients, especially when they are engaging in behaviors that have a high likelihood to result in death and disability. In my opinion, we need to take just as strong a stand on tobacco use as any other substance of abuse that is resulting in damage to our patients. Since smoking is a slower more gradual killer, it tends to get overlooked. Sometimes “over compassion” and not wanting to add additional “stress” to a patient keeps clinicians from pursuing smoking cessation/education more aggressively. I think patients need to see a strong tobacco free stance from all healthcare personnel. We ourselves should strongly consider quitting if we are smokers. Having our own stories of what led us to quit and how we did it will only help our patients.

 

Kentucky Department of Public Health supports an online program offering education and individual coaching: https://www.quitnowkentucky.org/

 

References:
Knudsen, H., Studts, C., & Studts, J. (2012). The Implementation of Smoking Cessation Counseling in Substance Abuse Treatment. Journal Of Behavioral Health Services & Research, 39(1), 28-41. doi:10.1007/s11414-011-9246-y

 

Rain Blohm, MS
WKPIC Doctoral Intern

 

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Friday Factoids Catch-Up: Being with A Life Until The End

Posted on January 14, 2016 by Susan Vaught

I am experiencing the impending death of an elderly family member, our matriarch, my Granny. Thankfully, she will be able to pass on in peace. Our family knew what she wanted the end of her life to look like. We had very much agreed with her wishes.

 

Despite whatever differences our family may have on other fronts, we are a unified front for her now. We are sure about our decisions for her. When a doctor had come in and suggested she be transferred to a large medical center for very aggressive treatment we were able to smile and nod in understanding. Her kidneys have failed as a part of the dying process and her doctor wants to help by “fixing” this. Most of the people in the small community my Granny lived in knew her well and this doctor is no exception. He wants to do everything his training in the healing arts has given him to stop death. It is his imperative. When we were able to talk with him and describe what we knew were her wishes, he understood, but seemed defeated somehow.

 

I have worked in intensive care unit settings as a respiratory therapist prior to becoming a doctoral intern in psychology. I have assisted in brain death determinations on patients a day old to 104 years old. I have been a part of ethics committees questioning the continuation of aggressive treatment via life support. I have been in situations where a very few medical staff, usually three of us, an MD, RN, and RT, remove life support alone because a dying person’s family has fractured and no one can emotionally or physically attend the death.  I have seen and heard reactions to death by medical staff despite the denial that they are affected. Broken professionals are leading broken families at times and creating poor outcomes for dying patients.

 

What is a “poor outcome” in death? The medical community most certainly identifies death itself as a “poor outcome.” Aggressive treatment is used too often with dying patients and this is something I personally identify as a poor outcome. The message that there is still hope is easier to deliver than there is no hope. I disagree with the idea that there is no hope in the dying process itself, if it is recognized. There have been great strides made in awareness of death and dying, but too many still die in pain and with modern medicine trying valiantly to “save” them. Why? Most medical staff in intensive care units know they do not want the same measure of treatment they provide to others every day. This should provide a better guide in the care administered in these settings. The more I practiced in medical settings initiating and maintaining life support, the more times I administered care I would personally never want. This happened to most all I worked alongside regardless of religion, culture, or creed.

 

I hope at some point to be able to help other families and medical teams in providing a death like my Granny’s for others–where there is a sense of calm and not a flurry of anxious activity meant to avoid what cannot be avoided. Our family and her medical team are sitting with her calmly. There is no push to “save” a life when the proper course is to simply be with a life until its end.

 

Rain Blohm, MS
WKPIC Doctoral Intern

 

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Friday Factoids Catch-Up: Exposure to Violence

Posted on January 14, 2016 by Susan Vaught

Unfortunately, exposure to acts of violence has become all too common. Adults as well as children can be affected by the media information streaming into our homes after yet another act of terrorism or violence scrolls across our electric windows to the world. I think that we underestimate the impact of our exposure as a whole to these events via media.
 
 
The information age has resulted in real time coverage of some violent events as they unfold. As a survivor of trauma, observing the public reaction to media when these events occur has become of interest to me. I observe a response that looks like a unique group form of the “fight or flight” response. I am concerned about how the long term effects of these frequent exposures and responses might manifest. We know very little about how the public as a group reacts to repeated exposure to violence.
 
 
I do not think that the same physiological intensity comes into play with violent media exposure because we identify the event as not an IMMEDIATE threat. However, we are more frequently exposed to violent events through the media. Learning about an event can produce traumatic stress. The immediate reaction to many media stories seems to be one of interest or curiosity in the event. We want to gather all the facts we can about the event that has caught out attention. I feel it is a part of why our attention is quickly drawn into seeing violent events on screen. It is important to our survival to be able to quickly identify danger in our environment. The computer screen provides an element of separation from the event, which is a part of why I think we become less likely to have the same strong physiological response as if we were a part of the actual event.
 
 
Watching the violent media event seems to induce enough of a fear response for people to want to fight. Our fight response is not fulfilled by just watching the media event but wants to “do” something. This may turn into positive “fights” like advocacy for the event victims or donations to charities. An example of this was demonstrated after the 9/11 attacks. Donations flowed into the Red Cross and other charitable organizations related to this tragedy. People lined up for blocks to donate blood to ensure resources would be available for those injured during the attack. Other times it seems our fight reactions bring out some of our less desirable traits as human beings. Prejudice against Muslims and those assumed to be of Middle Eastern origin developed and continues to increase. Retaliatory attacks and acts of war were carried out in a very tangible example of fighting. Those answering the 9/11 fight response were not at ground zero but exposed by media and information given to them.
 
 
I think the flight response takes its own form in our reactions to at large violence as well. At one time it was simple to turn off the TV and not have yourself or children exposed to unfolding violent events. This is not realistic in our current world of instant information availability. If we know we cannot win a fight, we will try to escape. I think that we do not truly appreciate the effect of the current lack of this ability to escape from violent events. A dripping faucet will eventually fill a bathtub, but not as quickly as a sudden opening of the faucet. A drip is more difficult to notice at first and I think constant drips of fear from violent events cannot be escaped in the information age. When an animal or a human cannot escape, they adapt to the threat. This again seems to be able to take both positive and negative forms on our human group as a whole. Adaptation to violence by being appropriately vigilant and not hypervigilant can prove helpful. Children and adults seem comforted by the presence of an emergency plan even if it is never used. Many emergency plans for dealing with violence have been put into place with the increase in mass shootings and terroristic acts. Changes in airport security may be another example of adaptation. I think in some of the more negative manifestations adaptation in this situation could prove to decrease our empathy for those involved in the tragedies we see unfolding. We accept the higher levels and more frequent violent events as a part of our modern society, in other words we just blindly accept that the violence is here. That it cannot be changed. Apathy may produce depression in an individual but in the group it seems to create dangerous stagnation.
 
 
I think that as a group we could do more to limit the real time coverage of violent events to help stem the “drips” that come into our tub constantly without notice. Unfortunately our inaction to decrease this flow seems apathetic. Making a stronger push for our positive fighting mechanisms that we have in fact demonstrated could help us develop solutions to unwanted violent media exposure.
 
 
Rain Blohm, MS
WKPIC Doctoral Intern

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