Friday, February 28, 2014

Sideline concussion test gets a new thumbs-up



Concussion test
As fast as a coach can ask, "Did you get your bell rung?" a new test can, with good reliability, detect whether a player should be removed from play and assessed for concussion. (Irfan Khan / Los Angeles Times / September 14, 2013)
A screening test for concussion that can be performed quickly on the sidelines was able to detect mild traumatic brain injury in about 4 in 5 college athletes who had sustained a concussion, a forthcoming study has found.
The King-Devick test capitalizes on a subtle but important symptom of brain injury: a disruption in the eyes' ability to travel smoothly across a page, and to shift direction upon the brain's command.
In a new study conducted on male and female athletes at the University of Florida, most subjects who took the King-Devick test soon after suffering a concussion showed reductions in speed and accuracy that were marked enough to reveal mild traumatic brain injury.
When results of the King-Devick test were combined with two more comprehensive tests for concussion, researchers said they were able to detect 100% of 30 concussions that occurred over a single season among 217 subjects. The study participants were members of the University of Florida's men's football, women's lacrosse and women's soccer teams.
The King-Devick test is remarkably simple: the test-taker is asked to read, fast and accurately, several pages of single-digit numbers that are arrayed left to right in columns that don't vertically align. The test requires smooth and steady eye movement across and down the page, as well as concentration, the rapid recognition of numbers and fast language production. Some or all of these can be compromised by a concussion, making the test a good measure of, at least, whether an athlete should be removed from play and professionally assessed for concussion.
The findings, which remain preliminary until published, are to be presented in late April in Philadelphia at the American Academy of Neurology's annual meeting. The team conducting the research was led by New York University/Langone Medical Center neurologist Dr. Laura J. Balcer.
To establish a baseline for an individual's performance on the test, the King-Devick screening must first be conducted when the individual is healthy and well-rested, and away from the field (and while baseline tests are best done by a professional trained in neuropsychiatric testing, the King-Devick test is easy enough to administer that even a parent could do it). After that, the screening test can be administered in just a couple of minutes on the side of a playing field, using a flip-chart or an electronic tablet.
An athlete who has sustained a blow to the head that is likely to result in concussion typically will be unable to match his or her baseline speed and accuracy on the test.
Balcer said that having a reliable, quick and easily administered test available to evaluate an athlete is especially important because many are unwilling to acknowledge - or unable to detect - the confusion.


http://www.latimes.com/science/sciencenow/la-sci-sn-sideline-concussion-20140226,0,2345562.story#ixzz2ugG6ESC5
READ MORE - Sideline concussion test gets a new thumbs-up

Meandering Michele’s Mind: To forgive, or not to forgive?



Posted by Michele Rosenthal
Friday, February 28th, 2014 • PTSD Recovery Tips •
 
letting-go-emerging-design-photographyA while ago I saw the movie Invictus and was impressed by how Nelson Mandela exercised his right to forgive. That sort of monumental ability to emotionally release the perpetrators of such wrongdoing seems….. well, impossible! And yet, research and studies clearly show that when survivors forgive, they are the ones who experience release. Hmmm. What does this mean?
I have a client (with extreme PTSD symptoms) who recently hit upon the forgiveness stumbling block. He’s the victim of horrific child abuse and harbors (who wouldn’t?!) some very harsh anger towards his mother. We’ve talked about the idea of forgiving before, and he swore he never would. Totally understandable, we all feel that way at first. When the idea of forgiveness is initially suggested it sounds like we (the ones who have been wronged) are supposed to absolve the ones who wronged us. But that isn’t what forgiveness is about.
Forgiveness does not even come close to condoning or accepting horrific acts that have been done. Instead, it is forgiving the perpetrators of our traumas for their own faulty wiring. It is recognizing that the people who have so wronged us have something so wrong with them, and because of this they have acted monstrously. This is all forgiveness requires: recognizing that in some way our abusers are broken and forgiving them for being in that state.
As with everything about moving toward feeling better, forgiving comes in its own time and everyone reaches it at his or her own pace. My client and I did a lot more self-empowering and other work before he got to a point where he was able to forgive from a place of power. And then he did, and it’s been a real breakthrough for him. We’re moving on to some really evolutionary work because he’s freed of something that was holding him back.
The idea of forgiveness can feel so wrong, and yet — the mind and subconscious really grow when we do forgive. In my trauma training I keep learning what an important step forgiveness is in being able to move on. In my work with many clients I see how hard it is to forgive, and also: how much better everyone feels when they do. I’m thinking today that I’m beginning to get the power of forgiveness on a whole new level.
When we don’t forgive — criminals, fate, chance, whatever caused our pain – we are the ones who remain imprisoned. While we harbor our anger, while we are drained by our resentment, those who wronged us move through the world unaffected by our present pain. Who wins there? THEY DO!
So I’ve come to embrace the idea that when we forgive — no matter how difficult it is to do — we live. We take back some of our power because we release those who are siphoning it off.
What’s your take on all of this??
http://healmyptsd.com/2014/02/meandering-micheles-mind-to-forgive-or-not-to-forgive.html?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+ParasitesoftheMind+%28Heal+My+PTSD+Blog%29
READ MORE - Meandering Michele’s Mind: To forgive, or not to forgive?

Marginalization of Military Women, Minorities, and War Stress Casualties -- Part I



Posted: Updated: 
Recently I was interviewed by AP reporters for another disturbing story of military sexual trauma (MST). As a proud and concerned parent of a daughter actively enlisted in the Navy, and sons enlisted in the Marine Corps and Navy, who are both war veterans, there are clear parallels between how the military negligently deals with those exposed to MST and war stress.
Tragically, what is true for the military is also the painful reality for how the private sector treats millions of female and male survivors of sexual assault and mental illness. I hope this will connect the dots for our Commander-in-Chief, Congress, and the general public on the signature social justice issue of our time: The eradication ofmental health stigma and disparity!
The Historically Marginalized
Women and African Americans have served honorably in the U.S. military in every war since the American Revolution. Combatants suffering from war stress injuries have been documented since at least the 16th century, whereas mental healthcare specialists emerged during the U.S. Civil War, and officially served with distinction since the First World War (WWI:1914). What else do these three diverse segments of American population have in common? Plenty! For example, immoral oppression, societal discrimination, and inequality of women and African-Americans is widely known -- less well-publicized is the destructive impact of benign neglect perpetrated on the mentally ill, particularly veterans returning with war stress injuries, as well as the damaging disparity between medical and mental healthcare responsible for generations of preventable wartime crises.
However, American women, African-Americans, and mental health clinicians also share the dubious distinction of being summarily dismissed from the military at war's end -- a discriminatory personnel policy that was ended after the Second World War (WWII) when major contributions to the war effort by each marginalized group could no longer be denied. Therefore by order of the president and Congress, in 1946 the military revised its unjust policies, establishing permanent integration of women, African-Americans, and mental health providers [1].
Impetus for Major Societal Reforms
The aforementioned post-WWII social justice initiatives eventually paved the way for the long overdue national penance reflected in civil rights legislation, constitutional amendments, and the National Mental Health Parity Act (1946)-the latter intended to eradicate antiquated, harmful "dualistic" beliefs about the separate nature and legitimacy of mental and physical health, leading to injurious mental health stigma and disparity.
To be certain, the U.S. military entered WWII as the chief protagonist for perpetuating mental health stigma, prejudice, and disparity after reaching the faulty conclusion that the dishonorable epidemic of war stress casualties from the First World War (WWI: 1918), which led to over 69,000 pensions for neuropsychiatric disability had nothing to do with toxicity of industrial warfare, but instead, reflected personal weakness aided by the rise of a psychiatric culture of victims [1]-a popular perspective today.
Consequently, the American military embarked on a grand social experiment of aggressively screening out the morally, intellectually, physically, and emotionally weak from entering the military. By 1943, over 1.6 million volunteers were rejected on the grounds they were vulnerable to mental breakdown after 5-years of combat [1]. Moreover, the Army dismantled the weakening influence of its mental health services. Thus the U.S. military was the most physically and psychiatrically fit and resilient the world has ever known.
Predictably, the American experiment ended in dismal failure, as 604,000 of America's strongest soldiers returned home to join the ranks of the neuropsychiatrically disabled. Additionally, the phenomena known as 'Old Sergeant's Syndrome' [2] re-emerged on the battlefield, whereby senior, battle-tested, and decorated leaders succumbed to the cumulative effects of war stress. By 1943, the U.S. military reconstituted its mental health services and adopted a de-stigmatizing universal paradigm that 'every human being is vulnerable to transient breakdown' due to the ravages of war stress.
Tragically, the American military maintains its harmful prejudice and stigma toward those suffering from chronic war/traumatic stress injuries, with a faulty misleading paradigm that less than 5-10 percent of veterans develop debilitating stress injuries, and those who do, are typically predisposed, greedy, cowardly, and/or naively suggestible to 'pseudo-illness' from the corrosive influence of permissive Western culture.
The full re-learning of war trauma lessons from the WWI generation requires the eradication of antiquated dualistic beliefs, stigma, and disparity of mental healthcare by acknowledging the inevitability and legitimacy of invisible wounds. However, the military's re-awakening occurred too late to prevent the ensuing mental health crisis in the 1940-1950s. Enlightened military leaders with a heavy conscience, were determined to end the cycle of self-inflicted crises of national ignorance by publishing two volumes of "lessons learned" with the explicit purpose that future generations would never again neglect doing what is right [1]- a similar social justice vein responsible for the permanent integration of military women, African Americans, and mental health clinicians.
Unmistakable progress has been made over the decades to correct social injustice perpetrated on marginalized Americans, including our gay and lesbian citizens. However, the plight of the mentally ill, stigma, and disparity have flourished in the 21st century -- responsible for the systematic neglect and preventable crisis as reported by the Department of Defense Task Force on Mental Health in 2007 with impunity.
Cultural Stigma of Inferiority and Weakness
Historically, American women, African-Americans, war stress casualties and their healers also share the common burden of being perceived by mainstream, white European male dominated military culture as "inherently inferior and weak." The most feared taboo in warrior cultures is to be labeled as "weak" and "cowardly." American society has condoned open discrimination against women, African-Americans, and the mentally ill because they were viewed as intellectually, morally, physically, and emotionally weak compared to their white male counterparts. However, during times of extended war, it became expedient to tolerate inclusion of such inferior beings in order to fight and win wars.
However, there was a limit to the military's tolerance of the weak. This is why at war's end, women, African-Americans and mental health practitioners were quickly purged from the rank and file until 1946.
Summary
The second part of this blog will examine the previously unrecognized parallels between the crises of MST and mental healthcare. Specifically, what are the common sociocultural barriers responsible for under-reporting, under-investigating, under-prosecuting, and perpetuating stigma and injustice?
References
[1] Glass, A. J., & Bernucci, R. J. (1966). Medical Department United States Army.Neuropsychiatry in World War II volume I: Zone of interior. Washington DC: Office of the Surgeon General, Department of the Army.
[2] Sobel, R. (1947). The "old sergeant" syndrome. Psychiatry
http://www.huffingtonpost.com/mark-c-russell-phd-abpp/marginalization-of-milita_b_4855166.html
READ MORE - Marginalization of Military Women, Minorities, and War Stress Casualties -- Part I

Sideline concussion test gets a new thumbs-up



Concussion test
As fast as a coach can ask, "Did you get your bell rung?" a new test can, with good reliability, detect whether a player should be removed from play and assessed for concussion. (Irfan Khan / Los Angeles Times / September 14, 2013)
A screening test for concussion that can be performed quickly on the sidelines was able to detect mild traumatic brain injury in about 4 in 5 college athletes who had sustained a concussion, a forthcoming study has found.
The King-Devick test capitalizes on a subtle but important symptom of brain injury: a disruption in the eyes' ability to travel smoothly across a page, and to shift direction upon the brain's command.
In a new study conducted on male and female athletes at the University of Florida, most subjects who took the King-Devick test soon after suffering a concussion showed reductions in speed and accuracy that were marked enough to reveal mild traumatic brain injury.
When results of the King-Devick test were combined with two more comprehensive tests for concussion, researchers said they were able to detect 100% of 30 concussions that occurred over a single season among 217 subjects. The study participants were members of the University of Florida's men's football, women's lacrosse and women's soccer teams.
The King-Devick test is remarkably simple: the test-taker is asked to read, fast and accurately, several pages of single-digit numbers that are arrayed left to right in columns that don't vertically align. The test requires smooth and steady eye movement across and down the page, as well as concentration, the rapid recognition of numbers and fast language production. Some or all of these can be compromised by a concussion, making the test a good measure of, at least, whether an athlete should be removed from play and professionally assessed for concussion.
The findings, which remain preliminary until published, are to be presented in late April in Philadelphia at the American Academy of Neurology's annual meeting. The team conducting the research was led by New York University/Langone Medical Center neurologist Dr. Laura J. Balcer.
To establish a baseline for an individual's performance on the test, the King-Devick screening must first be conducted when the individual is healthy and well-rested, and away from the field (and while baseline tests are best done by a professional trained in neuropsychiatric testing, the King-Devick test is easy enough to administer that even a parent could do it). After that, the screening test can be administered in just a couple of minutes on the side of a playing field, using a flip-chart or an electronic tablet.
An athlete who has sustained a blow to the head that is likely to result in concussion typically will be unable to match his or her baseline speed and accuracy on the test.
Balcer said that having a reliable, quick and easily administered test available to evaluate an athlete is especially important because many are unwilling to acknowledge - or unable to detect - the confusion.


http://www.latimes.com/science/sciencenow/la-sci-sn-sideline-concussion-20140226,0,2345562.story#ixzz2udN7MlBk
READ MORE - Sideline concussion test gets a new thumbs-up

Thursday, February 27, 2014

Feds Block FDA-Approved PTSD-Marijuana Research



A study on marijuana’s effects on treating patients with post-traumatic stress disorder has been approved, but it can’t go forward without the marijuana that it needs from a federal agency.
By   @katierucke 
  • Twitter
  • Facebook
    • Google+
    Jake Dimmock, co-owner of the Northwest Patient Resource Center medical marijuana dispensary, works on balancing the pH level of the soil used to grow new medical marijuana plants, Wednesday, Nov. 7, 2012, in Seattle. (AP Photo/Ted S. Warren)
    Jake Dimmock, co-owner of the Northwest Patient Resource Center medical marijuana dispensary, works on balancing the pH level of the soil used to grow new medical marijuana plants, Wednesday, Nov. 7, 2012, in Seattle. (AP Photo/Ted S. Warren)
    Almost four months after the U.S. Food and Drug Administration and the University of Arizona Institutional Review Board approved a study on how marijuana could be used to help treat veterans experiencing post-traumatic stress disorder, researchers are still waiting for the federal government to sign off on the study and allow them to purchase marijuana.
    Proposed by the non-profit organization Multidisciplinary Association for Psychedelic Studies, the studywould examine the safety and efficacy of smoked and vaporized marijuana for 50 U.S. veterans with chronic, treatment-resistant PTSD.
    Since the U.S. Public Health Service is not allowing researchers to buy any marijuana from the federal government to conduct the study, the research is currently on hold. Technically, the agency hasn’t outright refused to sell marijuana to the researchers for the study, as the PHS is not required to respond to inquiries within a certain number of days.
    The FDA, on the other hand, must respond to inquiries within 30 days. Until the PHS decides to respond — which could be never — this potentially life-saving research is on hold.
    For years, medical marijuana legalization advocates have argued that the drug can be used to help persons suffering from PTSD-related symptoms such as haunting nightmares and sleeplessness, but they have no scientific evidence to back up their empirical claims.
    While animal studies have found marijuana helps “quiet an overactive fear system,” there have been few, if any, controlled clinical studies examining marijuana’s effectiveness in helping human PTSD patients, which is why so many applauded the FDA’s decision to approve this study.
    According to MAPS, marijuana is the only drug in the United States that has to be reviewed by the PHS before research can occur, saying the National Institute on Drug Abuse “has a Drug Enforcement Administration-protected monopoly” on the supply of marijuana that can be legally used in FDA-regulated research.
    In other words, although the government has a supply of marijuana that has been specifically set aside for research purposes, the NIDA and DEA require that extra review be given to those who are requesting to study marijuana and its effects — a mandate that is not required for any other drug, including those that, like marijuana, have been classified as a Schedule I substance such as MDMA, LSD or psilocybin.
    “This groundbreaking research could assist doctors in how to recommend treatment for PTSD patients who have been unresponsive to traditional therapies,” said Rick Doblin, Ph.D., executive director at MAPS. He encouraged the PHS to allow the researchers to obtain the substance.
    “If the PHS review requirement was removed,” added Dr. Sue Sisley, who would lead the study, “we would gather information that could help veterans today. The stifling of medical research on marijuana stands in the way of our vets returning to a normal life.”

    A cure for PTSD in THC?

    Though it’s sometimes viewed as a lesser medical condition than other illnesses such as cancer, PTSD is considered a life-threatening illness, since those who suffer from it are at an increased risk of becoming homeless, more likely to abuse drugs and alcohol, and more likely to commit suicide.
    It’s estimated that PTSD currently affects about 600,000 veterans, or 40 percent of all returning U.S. soldiers.
    The effects of PTSD last for years, and according to R. Andrew Sewell, a professor of psychiatry at Yale University, marijuana can help those who suffer from PTSD with “extinction learning,” which is when positive information outweighs the negative fears that came about as a result of a traumatic experience.
    Sewell conducted a study early last year examining whether exposure to THC, marijuana’s psychoactive ingredient, would help those suffering from PTSD as they went through “exposure therapy” — a treatment Sewell believes to be the most effective for treating the medical condition.
    Many people who suffer from PTSD find exposure therapy to be a painful process because they have to revisit traumatic memories on a consistent basis. Sewell studied whether THC would help PTSD patients through this process.
    What he found was that veterans injected with 1 milligram of THC were calmed down enough to realize that a negative experience may not occur again.
    Dr. Raphael Mechoulam, an Israeli neuroscientist credited with discovering THC, agrees that marijuana has properties that could help heal neurological and psychiatric conditions such as Alzheimer’s and Parkinson’s disease, in addition to PTSD.
    Mechoulam, also a senior advisor to the Israeli government on marijuana policy and the ethics of research with human subjects, said that “the use of cannabis and THC to treat PTSD in humans appears to provide symptomological (sic) relief at best,” and he sees no reason why the drug isn’t already being used for PTSD.
    “In and of itself, there is nothing wrong with symptomological relief,” Mechoulam said. “That’s what taking aspirin for a headache, a diuretic for high blood pressure, opiates to control severe pain, or olanzapine for rapid-cycling mania is all about. We do have the potential, however, to do better than just treating symptoms of PTSD via activation of the cannabinoid receptors.”
    He continued, explaining that with the right combination of extinction/habituation therapy and “judicious administration” of drugs such as marijuana, there is a potential to actually cure many cases of PTSD.

    Turning a blind-eye to marijuana’s healing power

    “In light of all evidence currently available, it is striking that the FDA refuses to investigate cannabinoids for the treatment of anxiety disorders like PTSD,” Mechoulam said, “yet (the federal government has) approved studies of MDMA, the club drug Ecstasy, for the treatment of PTSD.”
    He pointed out that modern Western medicine currently uses substances that are widely known to be dangerous to use and carry a high rate of abuse, yet doctors still prescribe these drugs because they assume there is some medicinal value.
    “With the lives and well being of so many veterans AND private citizens at stake, those in the scientific community and police makers alike cannot afford to miss the wake up call,” he said. “Even a child should be able to see the hypocrisy evident in the relative policies concerning cannabinoids and opiates. It is time to fix this appalling imbalance in our policies concerning the pharmacopia (sic) or else be the laughing stock of future generations.”
    Russ Belville, host of the Russ Belville Show and a contributor to High Times, agrees with Mechoulam that the government needs to study marijuana, and pointed out in an article in November that while the government has refused to legalize or allow the use of medical marijuana, the FDA continues to approve painkillers that have been proven to be dangerously addictive and highly abused.
    Belville pointed to the recently approved painkiller called Zohydro, which he says contains 10 times the opioid hydrocodone found in Vicodin, a highly abused painkiller, and is not cut with acetaminophen or ibuprofen — additives that are used to prevent users from “crushing and snorting or shooting the drug.”
    Another facet of this drug that caught Belville’s eye is that this new “Super-Vicodin” is made by the pharmaceutical company Alkermes, and is intended for use in treating opioid addictions. As Belville noted, Alkermes financially supports the American Society of Addiction Medicine, or “Big Rehab.”
    Though the DEA is completely aware of the increased use and abuse of drugs such as heroin, which is often sparked by a painkiller addiction, the DEA said it is allowing the increased production of pain pills to ensure there is “enough left for legitimate patients.”
    If the federal government’s hands are not only tied by the money it’s earning law enforcement officials with the war on drugs, but also by pharmaceutical companies who have an interest pushing both their drugs and their rehab programs, it’s likely that breakthrough studies like this one will continue to be put on the back burner.
    In the meantime, MAPS says it will continue to pursue its decade-long lawsuit against the DEA, hoping to establish a marijuana-growing facility for FDA-approved research, which the group says would put an end to the National Institute on Drug Abuse’s marijuana monopoly.
    http://www.mintpressnews.com/feds-block-fda-approved-ptsd-marijuana-research/180621/
    READ MORE - Feds Block FDA-Approved PTSD-Marijuana Research