Monday, February 27, 2017

"Fortune favored their fright" -- Montaigne






"Nevertheless, as to cannon-shot, when a body of men are drawn up in the face of a train of artillery, as the occasion of war often requires, it is unhandsome to quit their post to avoid the danger, forasmuch as by reason of its violence and swiftness we account it inevitable; and many a one, by ducking, stepping aside, and such other motions of fear, has been, at all events, sufficiently laughed at by his companions. 
And yet, in the expedition that the Emperor Charles V. made against us into Provence, the Marquis de Guast going to reconnoitre the city of Arles, and advancing out of the cover of a windmill, under favour of which he had made his approach, was perceived by the Seigneurs de Bonneval and the Seneschal of Agenois, who were walking upon the ‘theatre aux ayenes’; who having shown him to the Sieur de Villiers, commissary of the artillery, he pointed a culverin so admirably well, and levelled it so exactly right against him, that had not the Marquis, seeing fire given to it, slipped aside, it was certainly concluded the shot had taken him full in the body. And, in like manner, some years before, Lorenzo de’ Medici, Duke of Urbino, and father to the queen-mother—[Catherine de’ Medici, mother of Henry III.]—laying siege to Mondolfo, a place in the territories of the Vicariat in Italy, seeing the cannoneer give fire to a piece that pointed directly against him, it was well for him that he ducked, for otherwise the shot, that only razed the top of his head, had doubtless hit him full in the breast. 
To say truth, I do not think that these evasions are performed upon the account of judgment; for how can any man living judge of high or low aim on so sudden an occasion? And it is much more easy to believe that fortune favoured their apprehension, and that it might be as well at another time to make them face the danger, as to seek to avoid it. 
For my own part, I confess I cannot forbear starting when the rattle of a harquebuse thunders in my ears on a sudden, and in a place where I am not to expect it, which I have also observed in others, braver fellows than I."

-- Michel de Montaigne, Of Constancy





Sunday, February 26, 2017

Casualty -- Mental Ward -- Vernon Scannell (1922-2007)





Something has gone wrong inside my head.
The sappers have left mines and wire behind,
I hold long conversations with the dead.
I do not always know what has been said;
The rhythms, not the words, stay in my mind;
Something has gone wrong inside my head.
Not just the sky but grass and trees are red,
The flares and tracers—or I’m colour-blind;
I hold long conversations with the dead.
Their presence comforts and sustains like bread;
When they don’t come its hard to be resigned;
Something has gone wrong inside my head.
They know about the snipers that I dread
And how the world is booby-trapped and mined;
I hold long conversations with the dead;
As all eyes close, they gather round my bed
And whisper consolation. When I find
Something has gone wrong inside my head
I hold long conversations with the dead.



Saturday, February 25, 2017

One for My Baby (and one more for the road) -- Johnny Mercer (1946)







It's quarter to three, there's no one in the place
Except you and me
So set 'em' up Joe, I got a little story
I think you should know
We're drinking my friend, to the end
Of a brief episode
Make it one for my baby
And one more for the road
I know the routine, put another nickel
In the machine
I feel kind of bad, can't you make the music
Easy and sad
I could tell you a lot, but it's not
In a gentleman's code
Make it one for my baby
And one more for the road
You'd never know it, but buddy I'm a kind of poet
And I've got a lot of things I'd like to say
And if I'm gloomy, please listen to me
Till it's talked away
Well that's how it goes, and Joe I know your gettin'
Anxious to close
Thanks for the cheer
I hope you didn't mind
My bending your ear
But this torch that I found, It's gotta be drowned
Or it's gonna explode
Make it one for my baby
And one more for the road
Songwriters: Harold Arlen / Johnny Mercer

Friday, February 24, 2017

Buprenorphine decreases suicidal ideation?

It's amazing what clinicians will do just to avoid entering into a therapeutic relationship with their suicidal patients (especially the borderlines). I really wish they had a control condition in which the hospitalized suicidal patients had daily individual sessions with an empathic therapist (the same therapist they would get to see on a weekly basis after their release). This study would have to replicated, of course. And we should keep in mind that there are other ways to reduce pain and suicidal ideation that don't involve drugs, such as building physical endurance in high-risk suicidal patients through mountain hiking. Seriously, check it out.



Scientific American
"Could mental pain be treated like physical pain, and would a reduction in suicidal thoughts follow?  A surprising new study by Yovell and colleagues in Israel addressed that question in a randomized, placebo-controlled trial of very low doses of an opioid, buprenorphine, in severely suicidal subjects
The authors looked to the concept of “separation distress” to justify the trial of buprenorphine.  All young animals, including humans, are distressed when separated from the attachment figures on whom their physical and emotional well-being depends.  Very low doses of opioids have been known to ameliorate that distress since the 1970s. The authors of the current study drew on attachment literature which established that endogenous opioids—the ones that occur naturally in our brains—help us feel good when we are with loved ones.  When we separate from loved ones, internal opioid levels drop, and we experience mental pain—the human version of separation distress. 
Neurobiological studies have suggested that separation distress overlaps with pain circuitry in the brain in a general “neural alarm system” when an animal, or a person, is under threat.  A trial of opioid painkillers, which might quiet that neural alarm system, seemed reasonable.
It was also necessary.  There are currently no medications to quickly relieve suicidal thoughts.  Antidepressants can take a month or longer to ease depression, and many psychiatrists today, like Shneidman, believe that depression and suicidal ideation are separate conditions.  Treating depression might not even address suicidal thinking.  A medication that specifically targets suicidal ideation—quickly—could be lifesaving.
Buprenorphine, sold as Subutex in pure form and as Suboxone when combined with naloxone (which decreases its abuse potential) is an unusual opioid in that it stimulates some, but not all, of the brain’s opioid receptors.  It causes less euphoria than opioids like hydrocodone, the active ingredient in Vicodin, and hydromorphone, the active ingredient in Dilaudid, but relieves pain and withdrawal symptoms; in fact, it was developed as a treatment for opioid addiction.  Because it is less pleasurable, it is less likely to be abused, and because it is weaker, it is safer in overdose.  Individuals who do abuse buprenorphine get high by crushing the tablets and injecting a solution made from the powder.  The investigators used a gelatin-based lozenge that dissolves under the tongue to make that impossible. 
Yovell and colleagues recruited patients from four hospitals in Israel and assigned them to receive tiny doses of buprenorphine or placebo.  At the outset, the subjects were quite ill; the majority had made suicide attempts in the past, and 57% met criteria for borderline personality disorder, which is characterized by chronic suicidal ideation and rejection-sensitivity—meaning that mild slights can cause their mood to plunge.  The Beck Scale for Suicide Ideation was used to rate patients’ suicidality before, during, and after the intervention. 
The authors found a significant drop in suicidal thinking in the buprenorphine group versus the placebo group.  Buprenorphine had a positive effect on depression, but the impact on suicidal thinking was even greater. Further, patients who met criteria for borderline personality disorder benefited even more than patients with depression alone.  For the investigators, this finding closed a loop: extreme distress over real or perceived abandonment is a hallmark of borderline personality disorder.  In borderline patients, suicidal thoughts may emerge when their highly sensitive separation distress systems are activated, with a drop in endogenous opioids and subsequent mental pain.  The robust improvements in suicidal ideation in borderline patients suggested that buprenorphine treats the psychache associated with abandonment and rejection. 
The study could not prove that opioids treat mental pain—it wasn’t designed to do so—but it did show that buprenorphine decreases suicidal ideation.  Perhaps the study’s most important contribution is its implication that treatments that help us withstand mental pain may prevent suicide."




Thursday, February 23, 2017

Conditioning males to become sexually aroused by a penny jar (Plaud & Martini, 1999)



Behavioral scientists, using classical conditioning, can make this penny jar sexually arousing.



1999 Feb;23(2):254-68.

The respondent conditioning of male sexual arousal.

Abstract

The respondent (classical) conditioning of male sexual arousal was investigated, employing penile plethysmography and 2 control procedures. Nine participants participated in three sessions, for three consecutive weeks. Each session consisted of fifteen stimulus periods and fifteen detumescence periods. Three participants participated in each of three different experimental conditioning procedures. Sexually explicit visual stimuli preselected by each participant were utilized as the unconditioned stimuli (US), and a neutral slide of a penny jar was employed as the conditioned stimulus (CS). In the first procedure, short delay conditioning, the CS was presented for 15 seconds, followed immediately by the US for 30 seconds. The second procedure was a backward conditioning procedure. In the third procedure, a random control condition, the presentation of CS and US was determined randomly. Results indicated that participants showed systematic maximum increases in penile tumescence from baseline in the short delay conditioning procedure, but not in the other two control procedures. Implications of these results to behavior therapy strategies which are based upon the conditioning of human sexual arousal are examined and discussed.


 

Wednesday, February 22, 2017

Our Miserable 21st Century -- Nicholas N. Eberstadt


One out of eight adult American males is a felon. Super.

Read the whole article. It's insanely depressing. 

Commentary


"Most well-informed readers know that the U.S. currently has a higher share of its populace in jail or prison than almost any other country on earth, that Barack Obama and others talk of our criminal-justice process as “mass incarceration,” and know that well over 2 million men were in prison or jail in recent years.4 But only a tiny fraction of all living Americans ever convicted of a felony is actually incarcerated at this very moment. Quite the contrary: Maybe 90 percent of all sentenced felons today are out of confinement and living more or less among us. The reason: the basic arithmetic of sentencing and incarceration in America today. Correctional release and sentenced community supervision (probation and parole) guarantee a steady annual “flow” of convicted felons back into society to augment the very considerable “stock” of felons and ex-felons already there. And this “stock” is by now truly enormous.
One forthcoming demographic study by Sarah Shannon and five other researchers estimates that the cohort of current and former felons in America very nearly reached 20 million by the year 2010. If its estimates are roughly accurate, and if America’s felon population has continued to grow at more or less the same tempotraced out for the years leading up to 2010, we would expect it to surpass 23 million persons by the end of 2016 at the latest. Very rough calculations might therefore suggest that at this writing, America’s population of non-institutionalized adults with a felony conviction somewhere in their past has almost certainly broken the 20 million mark by the end of 2016. A little more rough arithmetic suggests that about 17 million men in our general population have a felony conviction somewhere in their CV. That works out to one of every eight adult males in America today.
We have to use rough estimates here, rather than precise official numbers, because the government does not collect any data at all on the size or socioeconomic circumstances of this population of 20 million, and never has. Amazing as this may sound and scandalous though it may be, America has, at least to date, effectively banished this huge group—a group roughly twice the total size of our illegal-immigrant population and an adult population larger than that in any state but California—to a near-total and seemingly unending statistical invisibility. Our ex-cons are, so to speak, statistical outcasts who live in a darkness our polity does not care enough to illuminate—beyond the scope or interest of public policy, unless and until they next run afoul of the law.
Thus we cannot describe with any precision or certainty what has become of those who make up our “criminal class” after their (latest) sentencing or release. In the most stylized terms, however, we might guess that their odds in the real America are not all that favorable."



Tuesday, February 21, 2017

The Null Hypothesis in Education, Restated

In other words, there isn't a single piece of education "research" out there that is worth reading. None.


Arnold Kling

"Consider an education intervention and a set of tests that it must pass. The intervention could be “more spending” or “method X used in the classroom” or “longer school days” or “charter schools” or what have you.
1. It should show a meaningful difference under experimental conditions, meaning that selection bias is eliminated.
2. The difference should persist, rather than fade out. If you show a difference in first grade but by third grade or fifth grade the experimental group is on on the same level as the control group, then there is fade-out.
3. The results should be replicated. One experiment that works one time does not count.
4. The intervention should be scalable. The intervention does not depend on a uniquely gifted teacher.
The Null Hypothesis is that no intervention passes all four tests."