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As with fugue treatment bursitis cheap indometacin 50mg with mastercard, dissociative amnesia typically has a sudden onset following trauma or extreme stress and an equally sudden recovery of memory treatment keratosis pilaris cheap indometacin 25mg without prescription. The following case study provides one dramatic account medicine you can take while pregnant buy indometacin 25 mg otc, based on an article written by David Grann for the New York Times (January 13 medicine reactions buy indometacin 75mg free shipping, 2002). In 1990, George Franklin was convicted of the brutal murder of an 8-year-old girl. Eileen claimed she had witnessed her father commit a rape and murder, but dissociation pushed the memory into her unconscious mind. Eileen provided both verifiable and inconsistent accounts of the horrifying event. On the other hand, Eileen changed her story about the time of day and whether her sister also was with them. District Court judge ruled that the lower court erred in excluding evidence that Eileen could have learned details of the 1969 murder from newspaper articles. In the 1990s, as many as 25 percent of therapists said that recovering memories, particularly of sexual abuse, was an important part of their therapy with female clients (Poole et al. Often the knowledge that you were abused starts with a tiny feeling, an intuition. Faced with accusations of past abuse, many parents say that misguided therapists have created false memories. In fact, the term, false memory syndrome, was coined to account for the implanting of false beliefs (Kihlstrom, 1998a). Research shows that memories, even of highly dramatic events, can be inaccurate (Loftus, 2003, 2004). In one study, researchers interviewed Where were you when the World Trade Center towers collapsed Researchers find that even powerful "flashbulb" memories of dramatic events often grow inaccurate over time. About one-third reported vivid and grossly inaccurate memories (Neisser & Harsch, 1992). The key to the deception was using actual school photos to help participants to "remember" (Lindsay et al. Such research does not prove that recovered memories of trauma are false (Gleaves et al. In fact, recent experimental research shows that laboratory-induced interference and subsequent cuing can produce forgetting and remembering, respectively (Smith & Moynan, 2008). There certainly are good reasons to question the validity of "recovered memories" from early in life, since few people can report any accurate memories before age 3 or 4 (Loftus, 2003, 2004). The fact that people are especially likely to remember emotionally intense events is another reason to think critically about claims of recovered Are recovered memories. And, of course, documented cases of forgetting do not prove that undocumented cases of remembering are accurate. A recent study found that memories that returned outside of therapy were more likely to be corroborated than memories "recovered" in therapy (Geraerts et al. Sadly, some patients with recovered memories apparently are victims of their therapists, not of abuse. Depersonalization disorder, a less dramatic problem, is characterized by feelings of being detached from oneself, including such sensations as feeling as though you are living in a dream or floating above your body and watching yourself. In depersonalization disorder, the symptoms are persistent or recurrent and cause marked personal distress. The onset of the disorder commonly follows a new or disturbing event, such as drug use. All depersonalization experiences are "as-if " feelings, not rigid, delusional beliefs. In fact, some experts question whether depersonalization should be considered a dissociative disorder, because it involves only limited splitting between conscious and unconscious mental processes, and no memory loss occurs (Spiegel & Cardena, 1991). This extremely unusual disorder is characterized by the existence of two or more distinct personalities in a single individual. The original personality especially is likely to have amnesia for subsequent personalities, which may or may not be aware of other "alters" (Aldridge-Morris, 1989).

Violence and aggression attract our attention more than nonaggressive or nonviolent interactions administering medications 6th edition buy cheap indometacin 50mg on line. They get more attention culturally and when they do occur they can have serious physical and health impacts treatment resistant anxiety buy 25 mg indometacin with visa. This can sometimes lead us to think that aggression and violence are more important (or at least impactful) than everything else we do symptoms 3 weeks into pregnancy purchase indometacin 50mg otc, and Aggression 119 thus must reflect a specific part of human nature treatment vs cure buy cheap indometacin 50 mg on-line. In this chapter we review substantial biological, psychological, primatological, and anthropological literature in an evolutionary context to demonstrate that there is no consistent support for the concept that aggression and associated violence are a specific human adaptation. This does not mean that aggression occurs infrequently or that it is not important, but only that it is less central to humanity and our evolution as many think. In fact, most people do not realize that when we use the term "aggression" we are actually referring to many different things. It is not something that can be examined evolutionarily in the same ways as a hand or a tooth or hair color; aggression is much more complex. Aggression is not a uniform or discrete trait When talking about aggression we frequently treat it as a single thing. Think about what we mean when we say "humans are naturally aggressive" or "men are more aggressive than women. Feeling really angry at someone or being very fearful of someone can produce aggressive reactions, but are these reactions the same thing What about if you accidentally harm a bystander while directing aggression at another, are both victims receiving the same kind of aggression from you In order to think about the "naturalness" of human aggression we first need to clarify just exactly what we mean by aggression, and whether or not we can think of aggression as a discrete trait. In general, researchers who study behavior recognize that there is a wide spectrum covered by the term "aggression. Agonism is a broad category for behaviors associated with conflict and potential conflict, such as aggression, defense, and avoidance. Agonism is a general term for what we call antisocial behavior-actions by an individual or group that violate personal (or cultural) standards for appropriate behavior in a social context. Agonism may be tracked on a scale, from very mild antisocial behavior to more extreme antisocial behavior (this is the end that most of us think of as aggression). However, this terminology is not in wide use either by the public or by many researchers. So, for our purposes here, we can just think of aggression as a general term referring to a wide range of antisocial (agonistic) behavior. This has been applied to competitive aggression, for example in studies of the conditions under which animals show territorial aggression. This means that aggression is a general category term for describing these responses and not a specific unit or trait. So the view is that particular behavioral patterns evolved in response to specific kinds of threats or conflicts that were common and regular in the lives of animals. This view largely assigns the display of aggressive behavior to the needs of survival and reproduction. Inherent in this notion of the origin of aggressive behaviors is the acknowledgment that there is an integral relationship between aggression and conflict and that aggression is generally defined by, and thought of as existing in, ecological or social relationships between organisms. When we are specifically thinking about human aggression and aggressive behaviors there is a set of related definitions that are used. Generally, aggression is seen as being overt (measurable or obvious) behavior by one individual (the aggressor) that has the intention of inflicting physical or psychological harm on another individual (the victim). It is usually assumed that the intent to harm is immediate and not at some point in the future. However, this basic definition does not really include threats and general hostility, which might also be relevant to our broader discussion or notion of aggression, especially considering the basic definition of doing either physical or psychological harm. When thinking about human aggression there is usually a separate definition for violence, which is seen as extreme, destructive, severe, and potentially cruel aggression. Many psychologists also make the differentiation between normal aggression Aggression 121 and pathological aggression. The psychiatrists Allan Siegal and Jeff Victoroff assert that "it is empirically obvious and universally accepted that aggression is not a unitary phenomenon and that there is more than one type of aggression. However, most researchers also agree that these types are not exclusive and that any single aggressive interaction can potentially have multiple types of aggression in it. The aggressive behaviors can fall at different places along the continuum of mild to severe.

One of the most significant differences between precocial and altricial species is the extent to which maternal glucocorticoids can cross the placenta and influence fetal development symptoms 7 days after iui buy 50mg indometacin overnight delivery. Glucocorticoids act as a general orchestrator of late gestational fetal differentiation and maturation playing a central role in the preparations the fetus makes for independent life [Fowden et al lb 95 medications order indometacin 50mg with amex. The major precocial animal investigated in the field of developmental programming has been the sheep which had great advantages in the ease of accessibility of the fetus medicine games order indometacin 75mg, extensive Am J Primatol symptoms 2dpo cheap 50mg indometacin with amex. Page 12 documentation on fetal development and the ability to conduct interventions to determine mechanisms and indicate potential markers in human development [Fowden et al. Therefore nonhuman primate studies of programming, in ways that allow translation to human development, are needed. To date the major approaches to developmental programming that have been conducted in nonhuman primates have included; global nutrient reduction during pregnancy and lactation in the baboon [Antonow-Schlorke et al. This last model is of importance because excessive glucocorticoid exposure can produce organs that are both smaller and contain the wrong balance of different cell types. The central role of glucocorticoids is further indicated by the observation that different challenges to the developing mammal can result in similar outcome phenotypes. Several other candidate mechanisms have been proposed that are either dependent on epigenetic mechanisms [Wadhwa et al. Data from nonhuman primate models such as this model and the obese Japanese macaque model studied by investigators at the Oregon Regional Primate Center [Grayson et al. Page 13 needed to remove barriers to progress in development of human clinical diagnostic markers, preventative and therapeutic strategies. Human reagents, such as gene probes and antibodies, generally cross-react in these nonhuman primate species and are available for molecular studies addressing mechanism. In a similar way, studies by another group of investigators noted differential expression of 1,973 genes by microarray between neonates of average or low birth weight. Gene ontology studies showed changes in several metabolic pathways including carbohydrate metabolism [Emerald et al. Alterations that are likely to have persistent epigenetic effects have been described in the Japanese macaque [Suter et al. In summary information of great value in understanding the challenges, exposures, mechanisms and outcomes that lead to developmental programming in humans requires a synthesis of data from common, altricial experimental species as well as precocial nonhuman primates. Much can be learned from the similarities and differences that will be of great value in identifying markers that will enable the choice of preventative interventions and the design of therapies. The study of nonhuman primates has been and will continue to be a critical aspect of the broader field of genetics and genomics. There are many reasons why investigators study the genetics and genomics of humans and other organisms. Among the major motivations are the desires to understand how genetic variation influences individual differences in risk for or treatment of disease, and the genetic basis of human and primate evolution. A variety of animal species have proven valuable as model organisms for research related to human health and disease. A second example of the necessity of primate genetic studies for biomedical research involves psychiatric illness. Anxiety disorders and depression affect millions of people each year, leading to substantial suffering and disability that affects patients, their families, and the wider society. Susceptibility to anxiety disorders and depression is influenced by various factors, but it is clear that some people inherit a genetic predisposition to these psychiatric problems by virtue of inheriting genetic variation that can reduce their ability to effectively cope with various stressful experiences (Binder and Nemeroff 2010). The hippocampus is well established as a central component of the neural circuitry that underlies emotion and reactivity to stress in humans and other mammals. Numerous other examples of disease processes that are specific to primates and are significantly influenced by genetic differences among individuals could be described. For example, polycystic ovary syndrome is a common disorder that causes anovulation and infertility in women, is associated with increased risk for obesity and diabetes and is significantly influenced by genetic differences among women [Kosova and Urbanek, 2013]. This disorder is also well documented in rhesus macaques but cannot be adequately modeled in non-primate species [Abbott et al.

Paraphilias 321 this case illustrates the compelling and often contradictory nature of the fantasies that are associated with paraphilias medicine plus buy discount indometacin 25 mg on line. This successful and independent woman schedule 8 medications victoria generic 50 mg indometacin amex, who did not believe in using corporal punishment with her own daughter 400 medications proven 50 mg indometacin, found great pleasure associated with fantasies of being spanked by a man symptoms toxic shock syndrome indometacin 25 mg without a prescription. Merkin would not have qualified for a diagnosis of sexual masochism, even after she had acted on her fantasies, unless she experienced subjective distress or social impairment as a result. Like Daphne Merkin, many people who engage in masochistic sexual practices are highly educated and occupationally successful. Masochists tend to be disproportionately represented among the privileged groups in society. This pattern leads to the suggestion that masochism may be motivated by an attempt to escape temporarily from the otherwise constant burden of maintaining personal control and pursuing self-esteem (Baumeister & Butler, 1997). Sexual Sadism Someone who derives pleasure by inflicting physical or mental pain on other people is called a sadist. The term is based on the writings of the Marquis de Sade, whose novels describe the use of torture and cruelty for erotic purposes. Sadistic fantasies often involve asserting dominance over the victim; the experience of power and control may be as important as inflicting pain (Hucker, 1997). Some people engage in sadistic sexual rituals with a consenting partner (who may be a sexual masochist) who willingly suffers pain or humiliation. About half of these men have erections while exposing themselves, and some masturbate at the time. Their intent usually involves a desire to shock the observer, but sometimes they harbor fantasies that the involuntary observer will become sexually aroused. They rarely attempt to touch or otherwise molest their victims, who are usually women or children (Murphy & Page, 2008). Most exhibitionists begin to expose themselves when they are teenagers or in their early twenties. Exhibitionism is seldom an isolated behavior; men who engage in this type of behavior tend to do it frequently (Abel & Osborn, 1992). Voyeurism the focus of sexual arousal in voyeurism is the act of observing an unsuspecting person, usually a stranger, who is naked, in the process of disrobing, or engaging in sexual activity (Metzl, 2004). Many people, especially men, are sexually aroused by the sight of people who are partially clad or naked. The person might fantasize about having a sexual relationship with the people who are being observed, but direct contact is seldom sought. In fact, the secret nature of the observation and the risk of discovery may contribute in an important way to the arousing nature of the situation. The voyeur reaches orgasm by masturbating during observation or later while remembering what he saw. Frotteurism In frotteurism, a person who is fully clothed becomes sexually aroused by touching or rubbing his genitals against other, nonconsenting people. The frotteur usually chooses crowded places, such as sidewalks and public transportation, so that he can easily escape arrest. Like exhibitionism, frotteurism is a high-frequency form of paraphilia; interviews with people being treated for frotteurism indicate that they may engage in hundreds of individual paraphilic acts. People who engage in frotteurism seek to escape as quickly as possible after touching or rubbing against the other person. Every year, more than 100,000 children in the United States are 322 Chapter 12 Sexual and Gender Identity Disorders To protect women from frotteurs, some railway companies in Japan set aside special women-only cars during peak hours and late at night. This sign in a Tokyo subway station says, "Beware of men who fondle women on crowded trains. The effects of child abuse on victims have been the subject of intense debate in recent years. Some victims later engage in excessive and risky sexual activities that lead to additional problems (Browning & Laumann, 1997). One controversial review concluded that negative consequences are neither pervasive nor typically intense (Rind, Tromovitch, & Bauserman, 1998).

Television violence is rampant medications going generic in 2016 order 75mg indometacin with mastercard, as is violence in computer games symptoms 8 days before period buy indometacin 50 mg, and research shows that aggressive children both prefer and become more aggressive in response to video violence (Anderson et al treatment 3rd degree heart block 25mg indometacin. When it came time to discipline Billy symptoms nicotine withdrawal generic indometacin 25 mg online, she usually gave in-either because this was the easiest thing to do or because she felt too guilty to say no. Feeling resentful and resigned, she would grab a bag of M&Ms and give it to Billy. Billy also (negatively) reinforced his mother by quieting down when she gave in to his demands. Because both parties were reinforced, the coercive interaction should (and did) continue over time (Patterson, 1982). Parents need to break the pattern by ignoring the misbehavior (extinction), punishing it, or rewarding more positive actions (Herbert, 2002). The next time Billy acted up in the grocery Accepting, Responsive, Child-centered Demanding, controlling Undemanding, low in control attempts Authoritative Rejecting, Unresponsive, Parent-centered Authoritarian figurE 16. Indulgent Neglectful 430 Chapter 16 Psychological Disorders of Childhood A young boy playing Grand Theft Auto. More aggressive children seek out, and are influenced by, the violence found routinely in video games, television shows, and other popular media. Psychological Factors Low self-esteem, feelings of low worth, is sometimes blamed as causing externalizing problems. However, increased prison use is not tied to lower crime rates-and international comparisons contradict the frequent charge that the U. Krisberg, 1994, Images and Reality: Juvenile Crime, Youth Violence, and Public Policy, San Francisco: National Council on Crime and Delinquency. Externalizing Disorders 431 illusory bias appears to be self-protection, trying to appear more competent to peers and oneself (Owens et al. Lack of self-control, the internal regulation of behavior, is often linked to externalizing disorders. A specific problem with self-control is delay of gratification-the ability to defer smaller but immediate rewards for larger, long-term benefits, for example, studying for an exam rather than going out with friends. Children with externalizing problems are less able to delay gratification than are other children. They opt for immediate rewards rather than for long-term goals, an impediment to achieving educational and career goals (Nigg, 2001). They view other children as threatening and may attempt to "get you before you get me. Physically abused children see more anger in neutral facial expressions than normal children (Pollak & Tolley-Schell, 2003). A young boy may say that the reason he behaves well is because "Mommy will get mad. However, they do not appear to benefit learning or lead to long-term improvements. Psychostimulants heighten energy and alertness, and they lead to restless, even frenetic, behavior when abused. One reason for the enduring "paradoxical effect" paradox is that it was deemed unethical to give psychostimulants to normal children, even though the medication was given regularly to millions of "abnormal" children. A group of researchers at the National Institute of Mental Health eventually found a clever way around this problem. They obtained permission from colleagues to study the effects of psychostimulants on their children. In fact, psychostimulants have the same effects on adults when taken in comparably small dosages. Usage and Effects the most commonly prescribed psychostimulants are known by the trade names of Ritalin, Dexedrine, Cylert, and Adderall.

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